EAS 043 BOROUGH OF EAST HAM. PUBLIC HEALTH DEPARTMENT. Annual Reports OF THE MEDICAL OFFICER OF HEALTH AND CHIEF SANITARY INSPECTOR For Year ended 31st December, 1904. South Essex Printing and Publishing Co., Ltd., High Street South, East Ham, E. 1905. Public Health Committee. *Councillor C. NORTH FIELD (Chairman). The MAYOR, Alderman J. H. BETHELL, J.P. *The DEPUTY MAYOR, Councillor G. PRATT, C.C. *Alderman J. BROOKS, C.C. J. H. CARTE. E. EDWARDS. Councillor O. R. ANSTEAD, C.C. W. C. FORD. * „ F. W. HILL. MURRELL OAKES. * Members of Hospital Sub-Committee Borough of East Ham. PUBLIC HEALTH DEPARTMENT. Annual Report of Medical Officer of Health for 1904 Town Hall, East Ham, E. 3rd April, 1905. To His Worship the Mayor, the Aldermen and Councillors of the Borough of East Ham. Mr. Mayor and Gentlemen, It gives me pleasure ro present to you for your consideration my fifteenth Annual Report upon the health of the Borough of East Ham for the year ended 31st December, 1904, and to congratulate the Council upon the fact that East Ham still occupies a prominent place as one of the healthiest of the 76 great towns of England and Wales. The work of the Public Health Department, which is largely detailed in this report, has been consistently in progress during the year, and much work of a permanent character has been performed, and I here desire to express my appreciation of the loyalty and devotion of the Chief Inspector and Sanitary Staff in the execution of their duties. The corrected Death Rate for the year, viz., 14.4, shows an increase compared with that of the preceding year, which was 12.6, but the Borough may still claim to be one of the healthiest of the 76 large towns of England and Wales, 4 The Zymotic Death Rate equals 2.9, and shows an increase over that of the preceding year, which was 1.5, due to an epidemic of Diarrhoea during the summer months. STATISTICAL SUMMARY, 1904. Acreage 3,355 Population (Census 1901) 96,018 Do. (estimated 30th June, 1904) 116,902 Do. ( „ January, 1905) 121,428 Number or persons per acre 36.19 Births 3.717 Birth Rate per 1,000 living 31-78 Birth Rate (decennial average) 35.3 Nett Deaths 1,612 Recorded Death Rate 13.77 Death Rate (corrected for age and sex distribution) 14.69 Death Rate (decennial average) 13.2 Zymotic Death Rate per 1,000 living 2.9 Do. Death Rate per 100 deaths 21.8 Deaths of Infants under one year of age 575 Infantile Mortality per 1,ooo deaths 331 Do. per 1,000 births 154.6 Do. (decennial average) 144 Enteritis Mortality per 1,000 births 11.3 Diarrhœa Mortality per 1,000 births 50.8 Death Rates per 1,000 persons living from:— Small Pox Nil Measles 0.46 Scarlet Fever 0.08 Diphtheria 0.38 Whooping Cough 0.19 Typhoid Fever 0.12 Phthisis 1.18 Other Tubercular Diseases 0.49 Respiratory Diseases 2.32 Diarrhœa 1.61 5 Number of Infectious Disease cases notified:— Cases. Deaths. Small Pox 2 — Scarlet Fever 711 10 Diphtheria 327 45 Membranous Croup 12 2 Typhoid Fever 59 14 Continued Fever 2 — Puerperal Fever 11 1 Erysipelas 132 8 1,256 80 Number of cases removed to Borough Isolation Hospital:— Cases. Deaths. Scarlet Fever 322 5 Diphtheria 210 31 Membranous Croup 5 1 Typhoid Fever 37 6 Continued Fever 1 — 575 43 Number of Scarlet Fever Convalescents treated at Rancliffe House, 246. POPULATION AND GROWTH OF DISTRICT. According to the returns of the Registrar General, the population at the Census (1st April, 1901) was 96,018, which comprised 47,843 males and 48,175 females. The estimated population at the middle of 1904 was 116,902, and for the purposes of this Report, this estimate is the basis of calculation. In the first week of January, 1905, the work of enumerating the number of houses in the Borough for the purpose of ascertaining the approximate population at that date was carried out, and it was then estimated that the population was 121,428. This figure was obtained by multiplying the number of inhabited houses by 5.75, this being the average number of persons per occupied house at 1901 Census. 6 Since the District became incorporated, the Borough is divided into six Wards, the number of houses and estimated population at January, 1905, was as follows Occupied Houses. Empty Houses. Houses in course of construction. Estimated Population Beckton & N. Woolwich Ward 1,247 117 24 7,170 Central Ward East 3.434 215 143 19,745 Central Ward West 3.988 184 38 22,931 Manor Park Ward 4,668 655 58 26,841 Plashet Ward East 3.417 165 2 19,648 Plashet Ward West 4.364 173 — 25,093 21,118 1.509 265 121,428 The Growth of the District during the past 50 Years is as follows:— 1851 the Population was 1,737 1861 „ „ „ 2,858 1871 „ „ „ 5,009 1881 „ „ „ 10,706 1891 „ „ „ 32,712 1901 „ „ „ 96,018 DENSITY OF POPULATION. The area of the Borough in statute acres is 3.355, including 53 acres of Inland water, 20 acres tidal, and 9 acres foreshore. The estimated population at January, 1905, was 121,428. This is equal to 36.19 persons per acre. BIRTHS. The number of births registered in the Borough for the year was 3,717—1,923 males and 1,794 females. This being equal to a birth-rate of 31.78. The birth-rate for the previous year was 34 4, and the average for the past 10 years 35.07. The excess of births over deaths was 2,105. The births were registered in the different Wards as follows:— Births. Birth-rate. Manor Park Ward 881 35.24 Plashet Ward 1253 29.96 Central Ward 1359 32.93 Beckton & N. Woolwich Ward 224 25.38 7 CAUSES OF, AND AGES AT, DEATH DURING YEAR, 1904. Causes of Death. deaths at the subjoined ages of "residents" whether occurring in or beyond the borough. Deaths at all ages of "residents" belonging to the Wards, whether oc- CURRING IN OR BE YOND THE BOROUGH. Total Deaths whether of "Residents" or non "Residents" in PublicInstitutions in the Borough. All Ages. Under l year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Manor Park Ward. Plashet Ward. Central Ward. Bcckton & North Woolwich Ward. Measles 56 11 40 5 .. .. .. 16 12 24 4 .. Scarlet Fever 10 .. 7 3 .. .. .. .. 3 4 3 5 Whooping Cough 24 12 12 .. .. .. .. 6 4 13 1 .. Diphtheria 45 3 28 14 .. .. .. 10 14 17 4 31 Membranous Croup 2 .. 1 1 .. .. .. .. .. 2 .. 1 Croup 2 .. 2 .. .. .. .. 1 .. 1 .. 1 Enteric Fever 14 .. .. .. 6 7 .. 3 5 6 .. 6 Epidemiclnfluenza 9 1 1 .. .. 6 .. 3 4 2 .. .. Diarrhœa 189 152 31 1 1 2 2 35 45 85 24 1 Enteritis 45 34 7 .. .. 3 1 12 18 14 1 .. Puerperal Fever 1 .. .. .. .. 1 .. 1 .. .. .. .. Erysipelas 8 6 .. .. .. 2 .. 1 3 4 0 .. Other Septic Dis 10 1 2 .. l 3 3 5 3 1 1 .. Phthisis 139 8 8 14 24 83 2 29 52 51 7 .. Other Tubercular Diseases 58 22 26 4 1 5 .. 11 18 21 8 1 Cancer, Malignant Disease 71 .. .. .. 1 49 21 18 30 21 2 .. Bronchitis 114 33 12 3 .. 24 42 23 31 47 13 .. Pneumonia 160 47 46 7 3 43 14 35 43 66 16 2 Other Diseases of Respiratory Organs 1 .. .. .. .. 1 .. .. 1 .. .. .. Alcoholism 4 .. .. .. .. 4 .. 1 .. 3 .. .. Cirrhosis of Liver 10 .. .. .. .. 9 1 3 2 4 1 .. Venereal Diseases 2 2 .. .. .. .. .. 1 .. 1 .. .. Premature Birth 69 69 .. .. .. .. .. 18 17 29 5 .. Diseases and Accidents of Parturition 4 2 .. .. .. 2 .. .. 2 1 1 .. Heart Diseases 91 6 4 8 6 44 23 16 38 29 8 1 Accidents 27 9 4 2 3 5 4 4 8 11 4 3 Suicides 6 .. .. .. 2 3 1 2 2 1 1 1 Inanition and Marasmus 73 69 4 .. .. .. .. 19 20 31 3 .. Convulsions 31 23 6 1 .. .. 1 6 11 12 2 .. Senility 64 .. .. .. .. 2 62 13 22 25 4 .. Nephritis and Bright's Disease 24 .. 1 1 .. 17 5 10 5 7 2 .. Hemiplegia and Apoplexy 51 .. 1 1 .. 29 20 6 31 11 3 .. Murder 3 2 .. .. .. 1 .. .. 2 1 .. All other causes 195 63 28 7 10 60 27 45 73 68 9 3 All causes 1612 575 271 74 58 405 229 353 919 612 128 56 8 DEATHS. The number of deaths registered in the Borough during the year amounted to 1,406 (including those of 27 "illegitimate" children and 6 uncertified deaths), equivalent to a rate of iro per 1,000 living. This figure only represents the rate of deaths occurring in the Borough, and is subject to correction. In the first place, it is necessary to add to this total the number of deaths (208) of persons who were residents of East Ham and died in institutions outside the Borough, and then to exclude from the latter total the number of deaths (2) of visitors from other parishes who died in Public Institutions in the Borough. After these additions and deductions have been made, the mortality rate equals 13-77. To obtain the corrected death-rate of a district, consideration has to be given to the age and sex distribution. The RegistrarGeneral has fixed the factor for correction for East Ham as 1.067. The corrected death-rate for the past year equals 14.69. Of these 1,612 deaths registered in the Borough, 353 belonged to Manor Park Ward, 519 to Plashet Ward, 612 to Central Ward, and 128 to Beckton and N. Woolwich Ward. The deaths of East Ham residents which occurred outside the Borough, were—30 in West Ham Workhouse, 88 in West Ham Infirmary, 49 in London Hospital, 7 in East London Children's Hospital, 1 in St. Bartholomew's Hospital, 4 in Great Ormonde Street Hospital, 4 in Victoria Park Hospital, 2 in Westminster Hospital, 2 in German Hospital, Hackney, and 21 in other institutions. The total number of deaths belonging to the Borough is equivalent to a recorded death-rate of 13.77 as compared with 11.4 for the previous year. 9 The number and percentage proportion of the deaths, divided nto their respective age-groups, was as follows:— 575 or 35.6 per cent. under 1 year of age. 271 „ 16.8 „ over 1 year and under 5 years. 74 „ 4.5 „ „ 5 years „ 15 „ 58 „ 3.6 „ „ 15 25 „ 405 „ 25.1 „ „ 25 „ ,1 65 „ 229 „ 14-2 „ „ 65 years of age. The average death-rate for the previous ten years, was 13.2. THE DEATH RATE FROM ALL CAUSES. 1903. 1904. East Ham 11.4 13.7 England and Wales 15.4 16.2 76 Great Towns 16.3 17.2 142 Smaller Towns 14.6 15.6 England and Wales less 218 Towns 14.8 15.3 THE DEATH RATE UNDER ONE YEAR PER 1,000 BIRTHS. 1903. 1904. East Ham 113 154 England and Wales 132 146 76 Great Towns 144 160 142 Smaller Towns 135 154 England and Wales less 218 Towns 118 125 The death-rate for the several Wards was as follows 1903. 1904. Manor Park Ward 11.9 14.1 Plashet Ward 10.5 12.4 Central Ward 11.4 14.8 Beckton & North Woolwich Ward 14.6 14.5 UNCERTIFIED DEATHS. The following causes of death were given by the Registrars:— Convulsions 2 deaths Senility 2 „ Inanition 1 „ Syncope 1 „ Total 6 10 INFANTILE MORTALITY. The number of deaths at ages under one year was 575, equal to an Infantile Death-rate of 154 per 1000 births registered. The deaths occurred in the different Wards as follows:— 1903. 1904. Manor Park Ward 94 146 Plashet Ward 145 156 Central Ward 156 232 Beckton & North Woolwich Ward 35 41 Of the 3,717 Infants born, 197 died within a month of birth. Year. Total Births. Total Deaths. Deaths under 1 Year. Deaths from Diarrhœa. Deaths under 1 year per 1000 births registered. 1894 1616 574 184 25 113 1895 1834 706 257 44 140 1896 2015 707 299 37 148 1897 2209 822 335 72 151 1898 26l4 964 428 80 160 1899 3028 1201 529 139 174 1900 3297 1255 549 142 166 1901 3503 1279 549 106 156 1902 3805 1120 446 51 117 1903 3805 1133 430 58 113 1904 3717 1612 575 189 154 The question of Infantile Mortality is one that is being discussed by all thinking people to-day. The fact that the population of the country is shewing a decline is largely responsible for the discussion. 11 If the Birth-rate had kept its normal position, the Infantile Mortality could have gone on as it has for 50 years with little variation, but if the decline in the population has caused people to think, more especially mothers to exercise greater care with their children it will not be at all a serious thing, but a veiled blessing, for it will be better to have a lower birth-rate if it means a lower Infantile Mortality, but something more than talking or writing must be done if it is to be bought about. Many suggestions have been made, such as the establishment of pure milk depots under public control, the appointment of Lady Health Visitors, the teaching of Domestic Hygiene in the Public Elementary Schools, the opening of special Evening Classes for young women in which to be taught Domestic and Infant Hygiene. • These suggestions are all good, and when put into practical form will reduce the Infantile Mortality rate. Personally, I look to education as the best means of uprooting existing ignorance. DEATHS FROM THE SEVEN PRINCIPAL ZYMOTIC DISEASES. Three hundred and forty deaths were registered in the Borough from the seven principal Zymotic Diseases, being equal to a Zymotic Death-rate of 2.9 per 1000 living, as compared with 174 deaths and a death-rate of 1.57 for the year 1903, and an average death-rate of 2.33 for the past 5 years. 12 It will be seen from the following table that the Zymotic Death.rate for East Ham (2.9) is higher than the average death. rate of England and Wales (1.94) and the 76 great towns (2.49). Population. EAST HAM. England and Wales. 76 Great Towns. 142 Smaller Towns. England and Wales less 218 Great Towns. 1900. 1901. 1902. 1903. 1904. 1904. 1904. 1904. 1904. 92,000 96,000 104,000 110,451 116,902 33,763,434 15,250,000 4,500,000 14 Millions Deaths Death Rate Deaths Death Rate Deaths Death Rate Deaths Death Rate Deaths Death Rate Death Rate Death Rate Death Rate Death Rate Small Pox — — — — 24 .23 — — — — .01 .01 .03 .01 Scarlet Fever.. 2 .02 7 .07 9 .08 13 .11 10 .08 .11 .12 .13 .09 Measles 45 .49 17 .17 26 .25 36 .32 56 .47 .36 .47 .36 .23 Diphtheria 34 .36 35 .36 34 .32 15 .13 47 .40 .17 .19 .16 .14 Typhoid Fever 20 .21 17 .17 22 .21 14 .12 14 .12 .09 .10 .10 .08 Diarrhoea 142 1.47 106 112 51 .49 58 .52 189 1.61 .86 1.20 .89 .46 Whooping Couch 33 .35 27 .28 48 .46 38 .34 24 .20 .34 .40 .35 .27 276 300 209 217 214 205 174 1.57 340 2.91 1.94 2.49 202 1.28 13 Deaths month by month during 1903-4 from principal Zymotic Diseases. Name of Disease. Jan. Feb. March. April. May. June. July. Aug. Sept. Oct. Nov. Dec. Totals. 1903 1904 1903 1904 1903 1904 1903 1904 1903 1904 1903 1904 1903 1904 1903 1904 1903 1904 1903 1904 1903 1904 1903 1904 1903 1904 Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever 2 1 1 .. 3 1 3 .. 1 2 .. 2 .. 1 .. 1 1 .. .. .. 1 1 1 1 13 10 Diphtheria 2 4 2 5 2 5 .. .. .. 1 1 1 .. 2 1 1 1 2 1 6 .. 6 3 12 14 45 Typhoid Fever 2 1 2 2 1 1 1 .. 1 1 1 1 .. 1 2 .. 3 1 .. 2 2 3 .. 1 15 14 Measles 3 5 1 1 5 1 10 7 6 6 10 5 .. 4 1 9 •• 1 .. 3 .. 9 .. 3 36 54 Whooping Cough 2 .. 6 5 7 4 3 2 4 2 5 4 4 1 1 .. 3 2 .. 1 .. .. 3 2 38 23 Diarrhœa .. .. .. 2 .. .. .. 1 1 1 1 3 3 15 14 138 18 20 14 7 5 2 2 .. 58 189 11 11 12 15 18 12 17 10 13 13 18 16 7 24 19 149 26 26 15 19 8 21 9 19 174 335 14 SCARLET FEVER Has caused 10 deaths, being equal to a mortality rate of 0.08 per 1000 living, as compared with 13 deaths and a death-rate of 0.11 for the previous year. Of the 10 deaths, 5 died in the Borough Isolation Hospital, and 5 at the houses of the patients. MEASLES. Caused 56 deaths, or a death-rate of 0.46 per 1000, as against 36 deaths and a death-rate of 0.32 for the previous year. Measles is not a notifiable disease in this Borough, but the School Attendance Officers and Head Teachers forward particulars of all children detained from school in consequence of Measles, and during the year I have been informed of some 1260 cases. This like Whooping Cough is considered very lightly by parents, with the result that it has a high Mortality. It has been necessary to close the Infants' Departments of Castle Street and Bessborough Road Schools for a period of 21 days each, in consequence of outbreaks of this disease during the year. The control of Measles is exceedingly difficult. It is extremely infectious, and able to be communicated to others even before the rash makes its appearance. For this reason it is impossible to isolate so as to prevent its spread amongst the rest of the family or in a school. Most children of public school class contract Measles during the early stage of school life. WHOOPING COUGH. There were 24 deaths due to this disease, being equal to a death rate of 0.19, as compared with 38 deaths and a death rate of 0.34 per 1,000 living for the previous year. The Death Rate of England and Wales from this disease for 1904 was 034, the 76 Great Towns 0.40, and the 142 Small Towns 0.35. 15 This disease is one that is looked upon by poor people to be of little importance, and in many fatal cases, if greater care had been exercised, some of the deaths might have been prevented. DIPHTHERIA AND MEMBRANOUS CROUP. Diphtheria and Membranous Croup caused 47 deaths, equalling a death rate of 0-40 per 1,000 living, as compared with 14 deaths and a death rate of 0-13 per 1,000 for the year 1903, the case mortality being 13-86. Four deaths occurred in Hospitals outside the Borough. SMALL POX Has caused no deaths during the year. In the year 1898, Antitoxin was first introduced, and the following table shows the deaths from Diphtheria for the six years before its use, and the six years after:— Year. Population. Cases Notified. Deaths. Case Mortality. 1892 37,000 30 9 30.00 per cent. 1893 42,000 135 34 25.11 „ 1894 45.500 192 58 30.20 „ 1895 50,000 161 48 29.81 „ 1896 55,000 172 27 15.69 „ 1897 60,000 172 28 16.27 „ *1898 70,000 212 20 9.43 „ 1899 68,000 389 35 9.00 „ 1900 92,000 297 32 10.77 „ 1901 96,000 296 31 10.47 „ 1902 104,000 303 30 9.9o „ 1903 110,451 211 14 6.6o .„ 1904 116,902 327 47 13.89 „ * First year of use of Antitoxin. 16 DIARRHœA. Table showing the Annual Death Rate per 1,000 living, from Diarrhœa, in East Ham and other London Districts in each Week of the Third or Summer quarter of 1904. TOWNS. Annual rate in 13 Weeks. July 9th. July 16th. July 23rd. July 30th. Aug. 6th. Aug. 13th. Aug. 20th. Aug. 27th. Sept. 3rd. Sept. 10th. Sept. 17th. Sept. 24th. October 1st. London 3.4 0.4 0.6 1.8 3.4 6.3 7.7 7.9 5.4 3.8 2.9 2.1 1.2 0.8 Croydon 2.2 0.4 0.4 — — 1.l 3.6 6.1 5.4 2.5 4.0 1.1 2.2 1.8 wlllesden 3.8 — 1.6 0.4 2.0 47 11.0 11.8 7.9 3.5 2.4 2.4 0.8 1.2 Hornsey 1.2 — — — — 2.6 3.2 3.9 1.9 1.3 0.6 1.3 0.6 — Tottenham 4.8 0.9 — 2.8 6.0 37 12.5 16.6 97 4.6 2.8 0.5 1.8 0.9 West Ham 7.3 0.5 0.9 3.1 9.2 15.4 18.4 14.6 11 .0 6.1 6.9 34 2.9 2.4 EAST HAM 6.5 — 0.9 2.2 4.0 12.5 17.8 17.4 16.5 5.8 4.0 1.3 1.3 0.9 Leyton 6.3 0.5 0.9 0.9 6.1 9.9 21.6 14.1 11.8 6.6 5.2 1.9 1.4 09 Walthamstow 6.0 0.5 0.5 0.9 4.2 117 16.4 13.6 15.5 7.5 3.3 0.9 09 1.9 17 TYPHOID FEVER. Typhoid Fever caused 14 deaths, equivalent to a death. rate of 0.12 per 1,000 living, as compared with 15 deaths and a death-rate of 0.13 for the previous year. The death-rate for England and Wales is 0.09 and for the 76 great towns, in which East Ham is insluded, 0.18 Of the 14 deaths registered, six occurred at the East Ham Isolation Hospital, one at the Guardians' Infir,ary, and seven at their homes. The case mortality (23.72 per cent.) is the highest for the past 10 years;. PUERPERAL FEVER. 1 death was registered during the year, as compared with 8 for 1903. Printed instructions as to means of disinfection, etc., were left with nurses in attendance upon these cases. INFLUENZA. This disease was registered as the primary cause of 9 deaths, as compared with 15 for the previous year, and 18 for the year 1902. Patients recovering from influenza often exhibit great recklessness, and subsequently have to pay a heavy penalty for so doing. ALCOHOISM & CIRRHOSIS OF LIVER Has been the cause of 14 deaths, equal to a death-rate of 0.12 per 1,000 due to intemperate habits. For the year 1904 there were 16 deaths and a death-rate of 0.14. 18 CANCER. 71 deaths were due to cancerous disease. This is equal to a death-rate of 0.61 per 1,000 living, as compared with 60 deaths and a death.rate of 0.54 per 1,000 for the previous year. The average death-rate for the past five years is 0.50 per 1,000:— 1900 0'49 per 1,000 1901 056 „ 1902 0.34 „ 1903 0.54 „ 1904 0.61 „ TUBERCULAR DISEASES. 197 deaths were due to this class of disease, being equal to a death rate of 1.68 per 1,000 living, as compared with 137 deaths, and a death-rate of 1.24 for the year 1903. Manor Park Ward. Plashbt Ward. Central Ward. Bkckton and N. Woolwich Ward. Total Average. Phthisis Deaths. Death Rate. Deaths. | Death Rate. Deaths. Death Rate. Deaths. Death | Rate. j Deaths. 1 Death | Rate. 29 1.16 52 1.26 51 1.24 7 0.77 139 118 Other Tubercular Diseases 11 0.44 18 0.71 21 0.51 8 0.88 58 0.49 DEATHS FROM ACCIDENT AND SUICIDE. There were 17 deaths due to Accident and 6 Suicides. INQUESTS. During the year inquests were held on the bodies of 115 persons who died suddenly or by violence, and the following causes of death returned:— Deaths. Syncope 16 Accidents 12 Suffocation (overlaying) 11 Carried forward 39 19 Brought forward 39 Pneumonia 10 Heart Diseases 7 Convulsions 6 Suicides 6 Apoplexy 5 Acute Peritonitis 4 Shock 3 Diarrhœa 3 Bronchitis 3 *Murder 3 Want of proper expansion of lungs at birth 2 Tetanus 2 Exhaustion 2 Spasm of the Glottis 1 Croup 1 Misadventure 1 Paralysis 1 Septic Poisoning 1 Rupture of Blood Vessel on Brain 1 Wasting 1 Concussion of Brain 1 Want of Vitality 1 Hœmorrhage 1 Found Dead 1 Alcoholism 1 Cancer 1 Want of Proper Attention at Birth 1 Pleurisy 1 Acute Intussusception of Bowel 1 Erysipelas 1 Inanition 1 Opium Poisoning 1 Drowning 1 Total 115 *Two of these were Children found in railway carriages at the terminus, and the other a Lascar seaman murdered by another Lascar on board a ship at the Royal Albert Dock. b 20 LOCAL INDUSTRIES. The principal locaa industries are Brckton Gas Works and the Products Works in connection with the same, the Royal Albert Docks, the Bus and Tramway Depots together with a number of Factories and Workshops, detailed on pages 54 & 55. SUBSOIL. The subsoil is sand and gravel overlaying the London clay: some of the district in the South and in the Roding Valley is marshy. SEWERAGE. The Council are still giving much time and attention to the perfecting of the Main Sewerage of the District. New Mian Sewers have been and are still being constructed. The rapid growth of the Borough and the development of new estates makes immense demands upon the present system. The purity of the effluent and the general conduct of the operation of Sewage purification are subject to the control and jurisdiction of the Conservators of the River Thames, whose Inspectors regularly visit the Sewage Works, taking away with them samples of the effluent. The Council have recently expended considerable amounts in the re-construction of these works with most satisfactory results, the effluent turned out of the tanks being of a "good" class, and capable of supporting fish life. SEWER VENTILATION. The ventilation of the Sewers Continues to receive that close attention which its importance merits. Whenever complaints are received of emissions from the surface venti0ating grids, an inspection is made, and generally in the immediate vicinity a tall 30 ft. shaft is put up clear of all buildings. 21 REFUSE DESTRUCTOR. A Refuse Destructor for the cremation of domestic and trade refuse has been provided adjacent to. the Sewage Works, the plant consisting of two four-chambered refuse cells with flues, bye-pass, etc., to chimney. Two boilers, each capable of evaporating 7,000 lbs. of water per hour, feed water pumps, economiser, and all necessary pertinents to a perfect plant. The Destructor is about to be completed as originally designed. The heat of combustion is applied to the generation of steam for sewage pumping, so that a substantial saving in the annual coal bill is effected. The resultant clinker and ash from the thorough cremation of the refuse is a valuable bye-product of refuse cremation. WATER SUPPLY. The Water Supply is from the Metropolitan Water Board's mains. There has been a copious and constant supply during the year, and samples have been taken from standpipes and draw taps. On every occasion the water has proved upon analysis to be of excellent character, agreeing with the official reports published monthly by the Local Government Board of their analysis. The consumption is about 30 gallons per head per day. In no instance has the constant service been suspended, save temporarily in small local areas for the purpose of repairs. BOUNDARIES. The Thames forms the southern, the River Roding the eastern boundary (both rivers being tidal), Wanstead Park the north, and West Ham the western boundary. The boundary line in the south is of an irregular formation, and difficult to define. It would be a great advantage if the River Thames was the division between the counties of Essex and Kent. 22 CEMETERIES. There are four large Cemeteries, covering over 250 acres, situated in the northern part of the Borough, of excellent soil and important burial grounds for the Metropolis. The largest is the City of London Cemetery. There are also Churchyards attached to the two ancient Parish Churches of St. Mary Magdalene, East Ham, and St. Mary the Virgin, Little Ilford. I have inspected them all and found them satisfactory. RIVER RODING. The River Roding which forms the eastern boundary of the Borough (and into which is poured the effluent of several districts), is frequently in a polluted condition. The new bridges crossing the river in the Romford and Barking Roads are now completed, and are of great benefit to all who use the High Roads. BUILDING OPERATIONS. Plans for 699 single tenements, 36 double tenements and 44 shops (779) have been submitted and approved during the year, as compared with 1,202 for the previous year. The average number of houses erected during the past five years is 1,300 per annum. A number of inspections have been made under the Customs and Inland Revenue Act, 1890, on application from owners for exemption from Inhabited House Duty. These were granted to 401 tenements where they were constructed so as to afford suitable accommodation for each of the families or persons inhabiting them, and that due provision for their sanitary requirements was made. A large number of applications have been refused because the necessary requirements have not been satisfactory. This work of inspecting properties at the request of owners occupies a great deal of the time of the Medical Officer of Health, especially is this the case, where the houses are occupied by two families, and the landlord thinks that if he lets to each family direct he is entitled to exemption. 23 BAKEHOUSES. There are 51 Bakehouses in the district—12 underground and 39 on the ground level. During the year, 99 inspections have been made by myself and the Sanitary Inspectors. The Bakehouses generally are kept in a clean and sanitary condition, especially during the hours that are subject to inspection, but during the hours when the business is in full progress one is afraid the baker is more concerned about the bread than his health. He has cultivated a natural abhorrence of fresh air, and frequently makes the rising of his bread the excuse or reason for debarring its entrance into his bakehouse. The following is a list of Bakehouses:— Ground Level Bakehouses. 110, Albert Road. 319, Barking Road. 75, Barking Road. 37, Barking Road. 16, Barking Road. 18, Queen's Parade, Barking Road. 5, Town Hall Buildings, Barking Road. 7, Hockley Terrace, Barking Road. 2, Barrington Road. 54, Browning Road. 103, Burges Road. Church Road (corner of Harcourt Avenue) 2, Avenue Terrace, Church Road. 90, Elizabeth Street. 277, Green Street. 311, Green Street. 25, Greenhill Grove. High Street South. 505, High Street North. 427, High Sttree North. 410, High Street North. 378, High Street North. 24 234. High Street North. 216, High Street North. 155, High Street North. 76, High Street North. 491, Katherine Road. 105, Katherine Road. 55, Market Street. 118, Plashet Grove. 890, Romford Road. 837, Romford Road. 793, Romford Road. 721, Romford Road. 504, Romford Road. 471, Romford Road. 30, Station Road. 23, Seymour Road. Kenneth Terrace, Vicarage Lane. Underground Bakehouses. 181, Green Street. 328, High Street North. 245, High Street North. 5, High Street North. 389, Katherine Road. 352, Katherine Road. 140, Katherine Road. 113, Katherine Road. 61, Malvern Road. 42, Plashet Grove. 32, Plashet Lane. 57, Plashet Lane. SLAUGHTERHOUSES. There are 14 Slaughterhouses in the Borough, and they have been regularly inspected by myself and the Sanitary Inspectors puring the year. 25 Systematic whitewashing and cleansing have been carried out FACTORIES AND WORKSHOPS. Much of the time of the Department has been devoted to systematic inspection of Factories and Workshops (particularly the latter) during the year. In cases where nuisances have been discovered, Notices were served for their abatement, and in every instance complied with. No difficulty has been experienced in enforcing the provisions of the Factory and Workshops Act. There are 210 Factories and Workshops on the Register. OUTWORKERS. In compliance with the provisions of Section 107 of the Factory and Workshop Act, 1901, I have been officially informed of some 250 persons resident in the Borough receiving home work from manufacturers carrying on business in this and other districts. Upon receipt of the list they are thereupon visited for the purpose of seeing that the premises are in a suitable sanitary condition, and the strictest attention given to cleansing, overcrowding, W.C. accommodation, etc., and immediate notification given in the event of the occurrence of a case of infectious disease. The Act provides that the above-mentioned list must be forwarded twice yearly. There are 472 Outworker's premises in the Borough. 26 OPEN SPACES, SWIMMING BATHS, &c. East Ham has some five Parks and Pleasure Grounds comprising 160 acres, used for Cricket, Football, Lawn Tennis, and other sports, and are, in my opinion, an important factor in East Ham's low death-rate. The Council has also apportioned seven acres of land for allotments which are much appreciated by the industrious workmen of the Borough. In the Central Park there is an open-air Swimming Bath, 90 feet long by 30 feet wide. It is fitted with all the accessories of a first-class bath. The water is supplied from the Water Board's mains, and during the season it is re-charged at least twice weekly. It is highly appreciated by the inhabitants, and the charges are nominal—Adults, 1d.; children, ½d. School children under charge of a master at prescribed times, free. During the three seasons it has been open the bath was used by 69,575 persons. In 1902 17,797 persons. „ 1903 18,872 „ „ 1904 32,906 „ ARTIZANS' DWELLINGS. In order that the artizans and labourers of the Borough might have a healthy and comfortable home, the District Council inaugurated a scheme under the Housing of the Working Classes Act to build some 350 tenement houses. They are situated near the Docks and Gas Works, where they can be of the greatest service to those for whom they are erected. The accommodation is excellent, great care having been exercised in planning the sanitary arrangements. They are lighted by electricity, and there is a constant supply of water. 27 BYE-LAWS. New Bye-laws have been drawn up and submitted to the Local Government Board for the purpose of more stringent administration of sanitary regulations, especially in connection with the construction of new buildings. NOTIFICATION OF INFECTIOUS DISEASES. In accordance with the provisions of the Infectious Disease (Notification) Act, 1899, there have been 1,256 cases reported, being equal to a Notification rate of 107 per 1,000. The following table shews the Notification rate for the past five years:— 1900. 1901. 1902.* 1903. 1904. Whole District 9.0 11.1 18.7 9.7 10.7 Manor Park Ward 8.2 12.1 21.4 7.7 8.8 Plashet Ward 7.0 8.0 16.0 12.0 10.5 Central Ward 10.8 14.3 20.0 9.2 11.6 Beckton and North Woolwich Ward 18.5 13.3 21.0 5.2 12.0 * Including Chicken Pox. The following Table shews the number of notifications of each disease for the past five years:— 1900. 1901. 1902. 1903. 1904. Scarlet Fever 305 453 583 659 711 Diphtheria 297 296 303 206 327 Membranous Croup 11 18 23 5 12 Typhoid Fever 156 159 157 66 59 Erysipelas 59 77 110 112 132 Puerperal Fever 6 5 12 12 11 Continued Fever — — — 4 2 Small Pox 2 31 211 5 2 Chicken Pox — 29 554 — — 836 1,068 1,953 1,069 1,256 28 Table showing the number of Infectious Diseases notified month by month for the past five years:— 1900. 1901. 1902. 1903. 1904. January 91 79 198 108 100 February 85 70 157 91 85 March 54 58 179 166 80 April 48 49 166 70 79 May 51 66 192 57 95 June 43 66 2I0 68 99 July 53 67 191 80 108 August 59 65 110 79 98 September 73 100 110 85 133 October 99 149 135 84 132 November 95 136 169 86 140 December 85 167* 136 95 107 836 1,068 1,953** 1,069 1.256 * Including 29 Cases of Chicken Pox. ** Including 554 Cases of Chiken Pox. From this Table it will be seen that there is an increase of 187 cases of Infectious Diseases notified. The number of cases of all diseases notified for each Ward for five years was as follows:— 1900. 1901. 1902. 1903. 1904. Manor Park Ward 165 267 514 186 221 Plashet Ward 280 321 655 491 444 Central Ward 280 400 658 352 478 Beckton& North Woolwich Ward 111 80 126 40 113 836 1,068 1,983 1,069 1,256 29 The number of cases of each disease notified for the four wards, was as follows:— Disease. Manor Park. Plashet. Central. Beckton and North Woolwich. Total. 1903 1904 1903 1904 1903 1904 1903 1904 1903 1904 Small Pox 1 — 3 1 1 1 — — 5 2 Scarlet Fever 105 104 342 279 182 248 30 80 659 711 Diphtheria 41 77 73 101 85 128 7 21 206 327 Membranous Croup 1 — 1 1 3 11 — — 5 12 Typhoid Fever 11 12 25 17 29 25 1 5 66 59 Erysipelas 21 25 41 44 48 56 2 7 112 131 Puerperal Fever 2 3 6 1 4 7 — — 12 11 Continued Fever 4 — — — — 2 — — 4 2 Totals 186 221 491 444 352 478 40 113 1069 1256 30 The number of cases removed to Isolation Hospital was 607, being 101 more than the previous year. The percentage of cases removed to Hospital was:— Scarlet Fever 47 per cent, of cases notified, Diphtheria and Membranous Croup 64 per cent, of cases notified, Typhoid Fever 61 per cent, of cases notified, Small Pox 100 per cent, of cases notified. The average percentage of all cases removed was 48 per cent. TABLE SHEWING COMPARISONS OF EACH INFECTIOUS DISEASE NOTIFIED FOR THE PAST FIVE YEARS:— Scarlet Fever. Diphtheria. Membranous Croup. Typhoid Fever. Continued Fever. Erysipelas. Puerperal Fever. Chicken Pox. Small Pox. Totals. 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 January 39 28 45 66 43 37 29 47 21 38 3 1 .. .. 1 7 11 10 6 8 .. .. .. 4 .. 5 10 14 7 8 .. .. 1 4 2 .. .. 60 .. .. .. .. 21 .. .. 91 79 198 108 100 February 22 26 57 64 31 42 27 30 19 32 .. 1 .. .. 3 12 9 6 3 5 .. .. .. .. .. 7 7 7 5 14 2 .. 2 .. .. .. .. 35 .. .. .. .. 20 .. .. 85 70 157 91 85 March 23 16 40 116 22 25 33 18 27 41 3 3 3 1 1 1 2 10 6 4 .. .. .. .. .. 2 4 11 13 10 .. .. .. 1 1 .. .. 31 .. .. .. .. 66 2 1 54 58 179 166 80 April 20 23 44 47 50 15 18 16 8 10 .. 2 1 .. .. 8 3 10 4 1 .. .. .. .. 1 4 3 4 10 14 1 .. 1 .. 2 .. .. 37 .. .. .. .. 53 1 1 48 49 166 70 79 May 20 34 36 40 58 22 14 32 10 20 .. 2 2 .. 2 6 10 7 2 3 .. .. .. .. .. 3 6 5 4 12 .. .. 1 .. .. .. .. 80 .. .. .. .. 29 .. .. 51 66 192 57 95 June 23 35 49 43 76 12 17 29 7 16 .. .. 1 .. .. 3 7 9 4 1 .. .. .. .. .. 2 6 10 13 6 1 .. 1 1 .. .. .. 100 .. .. 2 1 11 .. .. 43 66 210 66 99 July 12 34 55 55 70 21 16 14 11 24 .. 2 1 .. 2 14 8 29 2 3 .. .. .. .. .. 5 6 7 11 8 1 1 1 1 1 .. .. 76 .. .. .. .. 8 .. .. 53 67 191 80 108 August 23 30 48 42 68 18 9 14 17 16 1 .. 1 .. .. 13 21 18 9 4 .. .. .. .. .. 4 5 9 9 9 .. .. .. 2 1. .. .. 17 .. .. .. .. 3 .. .. 59 65 110 79 98 September 24 43 48 49 87 20 22 20 12 25 .. 2 1 2 .. 24 26 14 9 12 .. .. .. .. .. 4 6 8 12 8 1 1 3 1 1 .. .. 16 .. .. .. .. .. .. .. 73 100 110 85 133 October 32 62 48 50 81 31 39 28 16 26 .. .. 2 1 .. 24 37 26 10 10 .. .. .. .. 1 12 7 9 6 14 .. 1 .. 1 .. .. .. 22 .. .. .. 3 .. .. .. 99 149 135 84 132 November 44 62 56 54 70 21 28 27 16 43 1 3 9 .. 3 23 16 12 6 6 .. .. .. .. .. 6 7 11 9 18 .. .. 1 .. .. .. .. .. .. .. 16 .. 1 .. 95 132 169 86 140 December. 23 60 57 33 55 33 44 28 42 36 3 2 2 1 .. 21 9 6 5 2 .. .. .. .. .. 5 10 15 13 11 .. 2 1 1 3 .. 29 27 .. .. .. 11 .. .. .. 85 167 136 95 107 Totals 305 453 583 659 711 297 296 303 206 327 11 18 23 5 12 156 159 157 66 59 .. .. .. 4 2 59 77 110 112 132 6 5 12 12 11 .. 29 554 .. .. 2 31 211 5 2 836 1068 1953 1069 1256 31 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1904. Notifiable Disease. Cases Notified in Whole District. Cases Notified in Each Ward. No. of Cases removed to Hospital from each Ward. At all Ages. Under 1 year. 1 too. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Manor Park Ward. Pla6het Ward. Central Ward. Beckton and North Woolwich Ward. Total. Manor Park Ward. Plashet Ward. Central Ward. Beckton and North Woolwich Ward. Total. Small Pox 2 .. 1 1 .. .. .. .. 1 1 .. 2 .. 1 1 .. 2 Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 327 6 134 162 15 10 .. 77 101 128 21 327 55 55 85 19 214 Membranous Croup 12 .. 9 3 .. .. .. .. 1 11 .. 12 .. .. 5 .. 5 Erysipelas 132 13 6 11 16 76 10 25 44 56 7 132 1 4 1 2 8 Scarlet Fever 711 8 210 423 49 20 1 104 279 248 80 711 56 96 130 52 334 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 59 2 10 21 24 2 12 17 25 5 59 8 8 20 5 41 Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever 2 .. .. .. .. 2 .. .. .. 2 .. 2 .. .. 1 .. 1 Puerperal Fever 11 .. .. .. 3 8 .. 3 1 7 .. 11 1 .. 1 .. 2 Plague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 1256 27 362 610 104 140 13 221 444 478 113 1256 121 164 244 78 607 32 SCARLET FEVER. 1903. 1904. Number of cases notified 659 711 N umber of deaths registered 13 10 Death-rate per 1,000 living 0.1l 0.08 Case-rate per 1,000 5.99 6.12 Case mortality per cent. 1.9 1.40 Cases removed to Hospital 320 334 Deaths in Hospital 5 5 Hospital case-mortality per cent. 1.8 1.4 Cases transferred to Convalescent Home 225 246 The Scarlet Fever Hospital is of a temporary character, and, although it has done good service, it is now inadequate to comply with the demands of the Borough. When first used as a Scarlet Fever Hospital the population was about 40,000 persons, and to-day there are three times that number. The Hospital has 32 beds, and the Convalescent Home 28, making 60 beds for the treatment of this disease, but I am of opinion that there should be 60 beds independent of the Convalescent Home for a population of 120,000. Plans and estimates have been considered and agreed to for a new Scarlet Fever Hospital, to provide accommodation for 60 beds, and I shall be glad when the building is completed. The building is to be of a permanent character designed for future requirements for some time to come. The Scarlet Fever Convalescent Home is situated in the Central Park. 246 patients have been treated there during the year. The patients remain at the Home for a considerable time after desquamating, with a view of preventing return cases. Although during the year under review there has been an occasional return case, I am of opinion that the Home is doing an essentially good work. "Return Cases" seem to be inevitable with the isolation of Scarlet Fever in Hospitals. 33 It is suggested that these cases are due to patients being continually re-infected while in the Hospital by other patients in the acute stage of the disease. Whether this is a fact it is impossible to definitely say. Every patient before leaving is well examined for desquamation, ear and nose discharges, and not sent out before all these have ceased, and not even then before thorough disinfection. In consequence of Measles and Chicken Pox existing in houses where Scarlatina occurred, some cases could not be removed, but had to be isolated at home. Periodical weekly visits were then made by the Sanitary Inspectors for the purpose of ensuring isolation, with the result that in houses where a special room was provided for the patient, and ordinary common sense precautions taken, no second cases occurred. New Beckton Schools were closed from 27th September to 17th October owing to an outbreak of this disease. The following table shows the number of cases for five years, 1900-4, aud Ward comparisons:— 34 Incidence of Scarlet Fever Cases, and Wards in which they occurred for the past five years:— Manor Park Ward. Plashet Ward. Central Ward. Beckton and North Woolwich Ward. Totals. 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 January .. 5 14 16 5 2 9 11 36 26 16 11 20 13 10 2 3 .. 1 2 39 28 45 66 43 February 2 9 21 13 8 9 7 13 39 15 8 8 22 9 8 3 2 1 3 .. 22 26 57 64 31 March 1 5 10 18 4 13 7 10 69 10 8 3 13 26 7 1 1 7 3 1 23 16 40 116 22 April 3 5 16 7 8 13 12 11 25 25 4 4 16 15 16 .. 2 1 .. 1 20 23 44 47 50 May 3 13 8 7 7 11 11 15 19 36 6 10 11 14 10 .. .. 2 .. 5 20 34 36 40 58 June 8 9 17 7 8 9 15 13 24 29 4 10 16 12 30 2 1 3 .. 9 23 35 49 43 76 July 2 7 23 6 7 4 14 17 29 20 5 9 15 19 31 1 4 .. 1 12 12 34 55 55 70 August 6 3 19 11 5 5 8 14 15 22 8 13 15 15 28 4 6 .. 1 13 23 30 48 42 68 September 6 20 16 6 17 9 11 11 14 22 8 9 18 23 28 1 3 3 6 20 24 43 48 49 87 October 2 25 11 4 15 16 19 22 26 36 13 15 15 15 23 1 3 .. 5 7 32 62 48 50 81 November 5 31 11 9 10 22 20 22 27 23 16 9 21 12 32 1 2 2 6 5 44 62 56 54 70 December 2 28 13 1 10 8 18 35 19 15 9 14 6 9 25 4 .. 3 4 5 23 60 57 33 55 Totals 40 160 179 105 104 140 151 194 342 279 105 115 188 182 248 20 27 22 30 80 305 453 583 659 711 35 DIPHTHERIA AND MEMBRANOUS CROUP. 1903. 1904. Number of cases notified 211 339 Deaths registered 14 47 Case mortality per cent. 6.79 13.8 Death-rate per 1,000 living 0.12 0.40 Case-rate per 1,000 1.87 2.89 Cases removed to Hospital 133 219 Deaths in Hospital 9 32 Case mortality in Hospital, per cent. 6.92 14.61 From the above figures it will be seen that there was an increase of 128 cases compared with the previous year. The highest number of cases notified in any one month was 43 in November, equal to a case-rate of 4.44 per 1,000 per annum. The lowest number in any one month was 10 in April, equal to a caserate of 0.96 per 1 000 per annum. 219 cases were removed to Hospital for treatment, or 64 per cent, of the cases notified, resulting in 32 deaths, equalling a case mortality of 14.6 per cent. 120 cases were treated at home, resulting in 15 deaths, equalling a case mortality of 12.5 percent. In comparing the mortality figures of Hospital treated cases and home treated cases, it should be considered that the most severe are sent to the Hospital, and the mild cases kept at home. It frequently happens that a parent will decide to keep the case at home until the condition of the patient is such that human aid can render but little service, and then, and not till then, a request is made for its immediate removal to Hospital. The Infants' Department of Fourth Avenue Schools was closed for 14 days during the month of February, owing to an outbreak of this disease. 36 Incidence of Diphtheria Cases and Wards in which they occurred for the past five years:— Manor Park Ward. Plashet Ward. Central Ward. Beckton and North Woolwich Ward. Totals. 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 January 11 7 12 7 21 14 2 11 8 5 6 19 23 4 12 6 1 1 2 .. 37 29 47 21 38 February 6 2 12 4 7 13 6 11 10 4 12 16 5 5 17 11 3 2 .. 4 42 27 30 19 32 March 10 7 3 2 5 8 5 4 17 9 3 19 11 5 22 4 2 .. 3 5 25 33 18 27 41 April 6 1 3 1 3 3 5 6 2 1 1 10 6 5 5 5 2 1 .. 1 15 18 16 8 10 May 6 4 8 2 7 5 3 9 5 5 3 5 14 3 8 8 2 1 .. .. 22 14 32 10 20 June 5 1 12 2 7 2 9 7 1 4 1 6 9 4 3 4 1 1 .. 2 12 17 29 7 16 July 6 6 5 1 8 9 4 5 9 8 - 5 4 1 8 6 1 .. .. .. 21 16 14 11 24 August 5 3 7 6 1 5 4 1 5 6 5 1 4 6 8 3 1 .. .. 1 18 9 14 17 16 September 3 3 7 2 7 7 7 8 2 14 8 12 5 7 3 2 .. .. 1 1 20 22 20 12 25 October 8 3 4 2 6 7 15 9 4 15 14 19 13 10 4 2 2 .. .. 1 31 39 28 16 26 November 3 5 7 1 3 6 10 11 4 22 11 12 8 10 18 1 1 1 1 .. 21 28 27 16 43 December 3 8 6 11 2 5 13 11 6 8 22 21 10 25 20 3 2 1 .. 6 33 44 28 42 36 Totals 72 50 86 41 77 84 83 93 73 101 86 145 112 85 128 55 18 12 7 21 297 296 303 206 327 37 TYPHOID FEVER. 1903. 1904. Number of cases notified. 66 59 Deaths registered 15 14 Case mortality per cent. 22.72 23.73 Death-rate per 1,000 living 0.13 0.12 Case-rate per 1,000 0.58 0.50 Cases removed to Borough Hospital 40 37 Deaths in Borough Hospital 6 6 Case-Mortality per cent, in Hospital 15.0 16.2 Cases removed to Hospitals outside the Borough boundary 5 4 There is a falling off of seven cases from the previous year. By referring to the five preceding years it will be seen that it is from July to November, when the disease is usually most prevalent. (See Table on page 39.) There has been a lower number of cases this year than during the previous six years notwithstanding the increase of population. The case mortality is the highest for eight years, indicating that the disease has been severe. 38 The following table shows the case mortality for the past nine years:— Year. Population. Cases. Deaths. Case Mortality. 1894 45.500 40 7 17.50 per cent. 1895 50,000 39 7 17.94 „ 1896 55.000 56 8 14.28 „ 1897 60,000 50 8 16.00 ,, 1898 70,000 79 10 12.65 „ 1899 88,000 92 16 17.39 „ 1900 92,000 156 20 12.82 „ 1901 96,000 159 17 10.69 „ 1902 104,000 157 22 14.01 „ 1903 110,451 66 15 22.72 „ 1904 116,902 59 14 23.72 „ Only five cases occurred in North Woolwich Ward during the year. In the other three Wards the disease was about equally divided, and, with the exception of the autumn months, was distributed generally over the whole year. In several cases the disease was traced to have originated outside the Borough, and in one case the patient had been bathing in the Thames near the Northern Sewer Outfall Works and had swallowed a quantity of water. In every case that has occurred the strictest investigation of the drainage of the houses has been carried out by the Sanitary Inspectors. Drains and sanitary appliances were tested, and where defects were discovered means taken to remedy them. I have visited the houses in addition to the Inspectors with a view to ascertain the origin of the disease. 37 cases were removed to the Borough Hospital, resulting in six deaths, or a case mortality of 16 per cent. 22 cases were treated at home, resulting in eight deaths, being equal to a case mortality of 36 per cent. The following Table shows the number of cases for five years, 1900-4, and Ward comparisons:— Incidence of Typhoid Fever Cases and Wards in which they occurred for the past five years :. Manor Park Ward. Plashet Ward. Central Ward. Beckton and North Woolwich Ward. Totals. 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 1900 1901 1902 1903 1904 January .. 4 5 1 .. 3 3 1 3 5 4 1 4 2 3 .. 3 .. .. .. 7 11 10 6 8 February 3 3 1 1 1 3 2 1 2 1 6 1 4 .. 2 .. 3 .. .. 1 12 9 6 3 5 March .. .. 1 2 1 1 .. 2 .. .. .. 1 7 4 3 .. 1 .. .. .. 1 2 10 6 4 April 4 .. 2 1 .. 3 .. 3 2 1 1 3 4 1 .. .. .. 1 .. .. 8 3 10 4 1 May .. 2 3 .. .. 1 3 2 2 1 3 3 2 .. 2 2 2 .. .. .. 6 10 7 2 3 June 1 1 2 .. 1 2 2 3 2 .. .. 4 2 2 .. .. .. 2 .. .. 3 7 9 4 1 July 1 2 4 .. .. 2 1 11 1 1 10 5 7 .. 1 1 .. 7 1 1 14 8 29 2 3 August 7 1 2 2 .. 2 5 6 4 1 3 13 .. 3 2 1 2 3 .. 1 13 21 18 9 4 September 3 2 3 1 .. 1 7 6 4 5 18 16 4 4 5 2 1 1 .. 2 24 26 14 9 12 October 5 2 4 2 4 3 6 6 3 1 9 29 16 5 5 7 .. .. .. .. 24 37 26 10 10 November 2 5 2 .. 3 4 4 3 2 1 11 6 7 4 2 6 1 .. .. .. 23 16 12 6 6 December 1 5 3 1 2 8 3 1 .. .. 5 1 2 4 .. 7 .. .. .. .. 21 9 6 5 2 Totals 27 27 32 11 12 33 36 45 25 17 70 83 66 29 25 26 13 14 1 5 156 159 157 66 59 39 40 SMALL POX. Two cases of Small Pox were notified and removed to Dagenham Small Pox Hospital, where they recovered. The last case was notified in April. The Council decided to renew the agreement with West Ham Corporation to provide accommodation for East Ham cases at Dagenham Hospital for a further period of five years. The following table shows the cases notified for the past four years Incidence of Small Pox Cases and Wards in which they occurred for the past four years:— Manor Park Ward. Plashet Ward. Central Ward. Beckton and North Woolwich Ward. Total. 1901 1902 1903 1904 1901 1902 1903 1904 1901 1902 1903 1904 1901 1902 1903 1904 1901 1902 1903 1904 January . 1 . . . 6 . . . 10 . . . 4 . . . 21 . . February . 7 . . . 3 . . . 8 . . . 2 . . . 20 . . March . 5 — — . 15 1 . — 35 1 1 — 11 . . — 66 2 1 April . 6 1 — . 13 . 1 . 32 — . — 2 . — — 53 1 1 May . 7 — — — 11 1 . — 9 . — — 2 . — — 29 1 — June — 4 — — — 2 — — 1 5 — — — — — — 1 11 — . July . 3 . . . . . . . 5 . . . . . . . 8 — — August . 1 . . . 2 . . . . . . . . . . . 3 . . September . . . . . . . . . . . . . . . . . . . . October 2 . . . 1 . . . . . . . . . . . 3 . . . November — — — — 2 — 1 — 3 — — — 11 — — — 16 — 1 . December 1 . . . 1 . . . 8 . . . 1 . . . 11 . . . 3 34 1 — 4 52 3 1 12 104 1 1 12 21 — — 31 211 5 2 41 42 CHILDREN'S DISEASES. The four principal Zymotic Diseases which are responsible for most of the deaths of children are Diphtheria (including Membranous Croup), Diarrhœa, Measles, and Whooping Cough. From these four diseases there has been 316 deaths, being equal to a death.rate of 2.70 per 1,000 per annum, as compared with the preceding year of 147 deaths and a death.rate of 1.33. The following table shows deaths and rates per annum from these four specific diseases for the past five years 1900. 1901. 1902. 1903. 1904. Population 92,000 96,000 104,000 110,451 116,902 Diphtheria (including Membranous Croup) 34 35 34 15 47 Diarrhœa 142 106 51 58 189 Measles 45 26 36 56 Whooping Cough 33 27 48 38 24 254 185 159 147 316 Death.rat per 1,000 per annum 2.76 1.92 1.50 1.33 2.70 OFFICIAL RETURNS OF INFECTIOUS DISEASES. Weekly returns have been made of all infectious cases to the Local Government Board, and monthly returns to the Medical Officer of Health of the Essex County Council. The Teachers of Day and Sunday Schools are informed of all cases attending their respective schools. The Librarians, Pawnbrokers, and School Attendance Officers are also notified. DISINFECTION. 1,083 houses, and a number of borrowed books from infected houses have been disinfected before being again circulated from the Public Libraries. 43 COST OF NOTIFICATION OF DISEASES. £157 have been paid to medical practitioners for notification of infectious diseases in compliance with the provisions of the Infectious Disease (Notification) Act, 1889. AMBULANCES. The Council possess two excellent up.to.date Brougham Ambulances, which during the year have been used for the removal of 607 cases of Infectious Diseases to hospital. PUBLIC HEALTH DEPARTMENT. The Sanitary Staff consists of a Medical Officer of Health, Deputy Medical Officer of Health, Chief Sanitary Inspector, three Inspectors, Clerk, two Junior Clerks, Dust Inspector, Disinfector, Ambulance Coachman, and Assistant. There is, in addition, a staff of 40 at the Hospital and Convalescent Home combined, and eight Laundresses. (Signed), A. W. Beaumont, B.A., M.D., Medical Officer of Health. Vital Statistics of separate Wards in 1904 and previous years : Year. Whole District. Manor Park Ward. Plashet Ward. Central Ward. Beckton & North Woolwich Ward. Population estimated to middle of eacb year Births registered. Deaths under 1 year. Deaths at all Ages. Population estimated to middle of each year. Births registered. Deaths under 1 year. Deaths at all ages. Population estimated to middle of each year. Births registered. Deaths under 1 year. Deaths at all Ages. Population estimated to middle of each year. Births registered. Deaths under 1 year. Deaths at all Ages. Population estimated to middle of each year. Births registered. Deaths under 1 year. Deaths at all Ages. 1894 45, 500 1616 184 574 1895 50,000 1834 257 728 1896 57,500 2015 299 729 1897 65,000 2209 335 847 1898 75,000 2614 428 1004 1899 88,000 3028 529 1245 1900 92,000 3297 549 1303 1901 96,000 3503 549 1457 1902 104,023 3805 446 1242 1903 110,451 3805 430 1265 24,044 921 94 288 40,763 1261 145 429 38,055 1403 156 437 7589 220 35 111 Averages of Years 1894 to 1903. 78,347 2772 400 1039 1904 110,902 3717 575 1612 25,004 881 146 353 41,814 1253 155 519 41,261 1359 232 612 8823 224 42 128 44 45 RAINFALL 1904. Time of Observation, 9 a.m. Month. Amount collected in inches. No. of days on which rain fell 001 in. and over. Mean rate of fall for Rainy Days. Greatest fall in 24 hours. Date of greatest fall. Inches. January 1.87 23 0.08 0.30 12th February 2.57 23 0.11 0.45 9th March 1.22 17 0.07 0.22 2nd April 0.96 0.09 0.23 1st & 22nd May 1.66 16 0.10 0.46 31st June 1.53 7 0.22 0.46 1st July 1.58 10 0.15 0.78 25th August 0.65 9 0.07 0.75 31st September 1.31 9 0.14 0.14 1st October.. 1.65 13 0.12 0.27 21st November 1.43 12 0.12 0.37 10th December 1 .94 17 0.11 0.93 6th Total Averages 18.32 167 0.1l 0.93 Dec. 6th N.B.—The Rainfall is registered by a Rain Gauge, 5 inches in diameter, placed 1 foot above the ground, and 12.5 feet above sea.level. 46 Vital Statistics of Whole District during 1904 and previous Years :— Year Population estimated to Middle of each Year. BIRTHS. Total Deaths Registered in the Borough. Total Deaths in Public Institutions in the Borough. Deaths of Non-residents registered in Public Institutions in the Borough. Deaths of Residents registered in Public Institutions beyond the Borough. Nett Deaths at all Ages belonging to the Borough. Number. Rate.* Under 1 Year of Age. At all Ages. Number. Rate per 1,000 Births registered. Number. Rate.* Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1894 45,500 1,616 35.5 184 113 561 12.3 .. .. 13 574 12.6 1895 50,000 1,834 36.6 257 140 706 14.1 .. .. 22 728 14.6 1896 57,500 2,015 35.0 299 148 707 12.3 .. .. 22 729 12.6 1897 65,000 2,209 34. 0 335 151 822 12.6 .. .. 25 847 13.0 1898 75,000 2,614 34.8 428 163 964 12.8 .. .. 40 1,004 13.3 1899 88,000 3,028 34.4 529 174 1,201 13.6 .. .. 44 1,245 1.41 1900 92,000 3,297 35.8 549 166 1,255 13.6 35 .. 48 1,303 1.41 1901 96,000 3,503 36.4 549 156 1,279 13.3 34 .. 178 1,457 15.1 1902 104,023 3,805 36.5 446 117 1,120 10.7 44 .. 122 1,242 11.9 1903 110,451 3,805 34.4 430 113 1,133 10.2 37 .. 132 1,265 11.4 Averages for years 1894. 1903. 78,347 2,772 35.3 400 144 974 12.5 .. .. 64 1,039 13.2 1904. 116,902 3,717 31.7 575 154 1,406 12.0 54 2 208 1,612 13.7 * Rates in Columns 4, 8, and 13 calculated per 1,000 of estimated population. Note.—The deaths included in Column 7 of this table are the whole of those registered during the year as having actually occurred within the Borough. The deaths included in Column 12 are the number in Column 7, corrected by the subtraction of the number in Column 10 and the addition of the number in Column 11. By the term "Non.residents" is meant persons brought into the Borough on account of sickness or infirmity, and dying in public institutions here; and by the term " Residents" is meant persons who have been taken out of the Borough on account of sickness or infirmity, and have died in public institutions elsewhere. The "Public institutions" taken into account for the purposes of these Tables are those into which persons are habitually received on account of sickness or infirmity, such as hospitals, workhouses, and lunatic asylums. 47 Statement shewing expenditure on Isolation Hospital and Scarlet Fever Convalescent Home for year ended March 31st, 1904:— Isolation Hospital. Convalescent Home. £ s. d. £ s. d. Salaries and Wages 1095 12 4 292 14 3 Bread and Flour 96 15 0 24 0 9 Groceries 311 5 4 89 10 3 Fruit and Vegetables 89 15 11 36 8 5 Milk 157 19 9 53 4 2 Meat 267 9 3 147 16 5 Fish 48 18 1 15 x7 8 Stimulants (Brandy, etc.) 29 16 6 — Disinfectants and Drugs 250 15 10 27 7 5 Medical Appliances 12 10 8 0 12 0 Maintenance of outside Patients 22 1 0 — Maintenance of Small Pox Patients 188 8 0 — Chandlery and Domestic Articles 155 0 6 32 15 5 Coal and Coke 156 11 9 33 6 10 Lighting, Water, etc. 217 6 4 80 15 5 Rates, Taxes and Insurance 51 11 7 24 12 8 Bedding, Linen and Nurses' Uniforms 145 15 6 46 6 1 Furniture 142 9 4 66 15 6 Printing, Stationery and Books 36 9 3 13 16 2 Proportion of cost of Maintenance of Ambulance 214 4 6 91 8 2 Proportion of cost of Maintenance of Laundry 432 14 8 207 10 7 General Repairs to Buildings 131 16 6 107 13 9 Laying out Grounds 137 2 11 — £4392 10 6 £1392 11 11 Essex County Council— Grant in aid of Maintenance £233 19 3 £63 4 9 48 Annual Report of the Chief Sanitary Inspector. To His Worship the Mayor, the Aldermen and Councillors of the Borough of East Ham. Mr. Mayor and Gentlemen, I herewith beg to submit for your consideration my tenth Annual Report of the work accomplished by the Sanitary Inspectors during the year ended 31st December, 1904. INSPECTION OF THE BOROUGH AND REMOVAL OF NUISANCES. In investigating complaints lodged, notifications of Infectious Diseases received, house-to-house inspections, etc., 3802 primary inspections were made as under: — Manor Park Ward. Plashet Ward. Central Ward. Beckton and N. Woolwich Ward. Total. January 70 106 106 5 287 February 62 54 128 5 246 March 57 100 221 11 389 April 86 72 207 33 398 May 56 84 152 36 328 June 99 80 142 25 346 July 70 68 70 34 242 August 78 80 90 19 267 September 98 104 115 18 335 October 77 99 99 38 313 November 8O 83 149 56 368 December 60 71 130 19 280 Totals 893 1001 1609 299 3802 Details and particulars of these inspections are entered in the Inspector's Journal. At 59 per cent. of the premises inspected, various works of sanitary amendment were required to be executed to place the houses in a sanitary condition. 49 There have been 3682 nuisances discovered in the course of the inspections made. 1054 Preliminary Notices were served, and in cases where the provisions were not complied with, the serving of 199 Statutory Notices was necessary, 277 Dust Bin Notices, and 51 Notices to provide a Water Supply have also been served. In only two cases has it been necessary to institute legal proceedings for non.compliance with the Councils Statutory Notices. It will be noticed from the following table that the nuisances discovered are in excess of the Notices served. This is owing to the fact that one Notice will call for the abatement of several nuisances, and in many instances personal interviews were obtained and the required works executed by the respective persons liable without the service of a Notice. The following table sets forth the details of work done:— Manor Park Ward. Plashet Ward. Central Ward. Beckton & North W'lw'h Ward. Total. Primary inspections made 893 1001 1609 299 3802 Notificationsof Infectious Diseases 221 444 478 113 1256 House to house inspections 180 65 491 117 853 Houses found in a sanitary condition 286 495 661 83 1525 Walls and ceilings requiring repair 90 78 155 24 347 Yards insufficiently and not paved 142 68 115 8 333 Forecourts unpaved 58 95 118 7 278 Defective drains and connections 53 81 278 119 531 Defective W.C. traps 3 4 4 3 14 Defective flushing apparatus or no water to W.C. 33 23 36 15 107 Foul and broken soil pans 51 65 100 20 236 Defective drain ventilating shafts 15 14 11 3 43 Defective rainwater pipes and eaves gutters 76 10 22 9 117 Rainwater pipes directly connected to drains 5 4 11 - 20 Roofs not water-tight 26 16 49 7 98 50  Manor Park Ward. Plashet Ward. Central Ward. Beckton & North W'lw'h Ward. Total. Defective sink waste pipes !7 8 18 3 46 Houses without water (Metropolitan Water Board) 28 48 26 3 105 Drinking water cisterns without covers 163 37 43 1 244 Drinking water improperly stored and dirty cisterns 71 19 69 - 159 Dilapidated floors 13 11 20 6 50 No underfloor ventilation 93 24 106 16 239 Dampness 39 5 12 6 62 Offensive accumulations 24 27 50 2 103 Inundations 4 1 2 — 7 Overcrowding 11 2 4 — 17 Unsound food 1 — 2 — 3 No dust bins 5 9 28 2 44 No manure bins 2 - 8 - 10 Animals improperly kept 8 4 8 1 21 Breaches of Council's Bye-Laws 37 21 23 3 84 Gipsies removed 23 - - 3 26 Other nuisancts 94 63 153 28 338 Drains tested and proved sound 147 294 349 62 852 Nuisances abated ... 1109 655 1365 , 246 3375 OVERCROWDING. It will be seen from the foregoing table that overcrowding is becoming more prevalent within the Borough. It has been necessary to take action in 17 instances for its abatement. I have remarked in previous reports that overcrowding is the inevitable consequence of high rents, for the number of rooms in occupation by a working man and his family is not so much determined by the size of the family as by the amount of rent that can be afforded from the weekly income, which in very many cases in East Ham is limited, and employment precarious. Notice was served upon an owner to reduce the number of persons occupying a house in Fourth Avenue, Manor Park. A 51 mid-night inspection was made, and it was proved that the Notice had not been complied with, for 18 persons were discovered on the premises, seven being in one room. The Owner was summoned and convicted for not complying with the Council's Notice. INFECTIOUS DISEASES. 1256 notifications of Infectious Diseases were received, and particulars entered in the " Infectious Diseases Register." Upon receipt of the notification, the premises were immediately visited and directions given as to isolation, and a printed list of precautions handed to the responsible person of the house, setting forth the usual rules to be observed to prevent the spread of disease. The premises were inspected for sanitary defects, and drains tested. Where any defects were found to exist, a Notice was served upon the responsible person, and the work carried out under the supervision of the Department. A full inquiry was made as to the probable origin of the disease, where possible the history traced, and a detailed report written and presented to the Medical Officer of Health. A postcard was left for the patient's Medical Attendant to sign and forward to the office, at the termination of the illness. On receipt of this postcard, the Disinfector at once proceeded to the premises for the purpose of fumigating them. The Head Teachers of Day Schools, Superintendents of Sunday Schools, and the Librarian of the Public Libraries were daily advised of all cases of infectious disease ; they were further informed when the houses were disinfected. During the past year some 1475 School letters have been forwarded by the Department. D 52 OFFAL COLLECTION. The collection of fish offal and butchers' refuse being of such an offensive nature, must of necessity cause annoyance in the summer months, but with due care and sanitary precaution (aided by the recollection of expensive legal proceedings), it has been reduced to a minimum. The collection of offal is largely done late at night. Complaints are occasionally made of nuisance arising from premises at the time of removal, but the nature of the material should be considered, and also what would result if the offal was not regularly collected, but allowed to remain in back premises until action by the Sanitary Authority caused its removal. URINALS. There are eight public urinals, exclusive of those in the Schools, which are cleansed daily by a man, whose duty it is to maintain them in a clean and proper manner. The external urinals attached to public houses, have been regularly inspected, and with a few exceptions have been well kept. At the instance of the Public Health Committee, several of the public house urinals have been enlarged and reconstructed. DAIRIES AND COWSHEDS. There are five registered cow.sheds and 151 dairies in the Borough. During the year 37 dairymen and purveyors of milk have been added to the Register. 161 inspections were made and the work of cleansing, lime. whiting etc., has been carefully carried out under the supervision of the Inspector responsible for the district in which the dairies and cowsheds are situated. The general condition may be said to be satisfactory. The following is a list of cow.houses:— Forest View Farm Rear—316, High Street North Shaftesbury Road Rear—55, Woodstock Road. 53 SLAUGHTER HOUSES. There are 14 registered and licensed slaughter houses, which have been periodically visited and kept under regular supervision. Cleansing and limewhiting have been done twice during the year, in accordance with the Bye.laws. The following is a list of Slaughter Houses :— Forest View Farm. Greenhill Grove. Rear—363, Green Street. Rear—14, High Street North. Rear—170, High Street North. Rear—330, Katherine Road. Rear—89, Plashet Grove. Rear—32a, Plashet Lane. Rear—638, Romford Road. Rear—626, Romford Road. Rear—28, Station Road. Shaftesbury Road. Rear—24, Wakefield Street. Whitta Road. BACK PASSAGES. The business premises throughout the Borough are generally provided with a secondary means of access at rear of the premises. These passages lend themselves as favourable collecting grounds for offensive matter. In a great many instances they are not paved or drained, and as the tradesman often uses the open space for washing his van and horse there, it becomes a serious nuisance. Under the East Ham Improvement Act, 1903, special provisions were obtained giving powers for the Council to call upon the responsible person to properly pave and drain such passageways, and, failing a compliance with the request, to do the work and recover the cost. 54 HOUSES UNFIT FOR HABITATION. Notices were served with reference to 10 houses under the Housing of the Working Classes Act, 1890, as being unfit for human habitation, two in North Woolwich Ward, and eight in Central Ward. It was not found necessary to apply to the Magistrates for Closing Orders, as in three cases the houses were rendered habitable, and in seven instances the houses (which were a row of ancient cottages) were demolished. PETROLEUM LICENSES. In consequence of the demand for petrol, many more Petroleum Licenses have been granted, necessitating more inspections and supervision. In every case the strictest care is taken to enforce the provisions of the Act and conditions upon which the licenses are granted. FACTORIES AND WORKSHOPS. There are 210 Factories and Workshops, including Laundries and Domestic Workshops, on the Register, which comprise:— Laundries Tailors Dress Makers Shirt Makers Surgical Instrument Makers Printers Modellers Paper Bag Makers Match Factory Carpenters and Joiners Cycle Works Artificial Flower Makers Umbrella Makers Boot and Shoe Makers Tin Plate and Iron Workers Blouse Makers 55 Underclothing Manufacturers Book Binders Mineral Water Works Cabinet Makers Wheelwrights Stonemasons Patent Food Manufactory Tie Makers Horsehair Weaver Periodical inspections have been made and Notices served to remedy any defects where found to exist. In three factories additional provisions have been made for exit in case of fire. HIGHWAY REFUSE. This nuisance is still one that needs constant attention. By arrangement with the Surveyor's Department, and with the approval of the Council, ordinary trade refuse is collected free of charge by the scavenging carts if placed in a receptacle in an available place outside the premises. This method works well, and has resulted in a greatly improved condition of the highways. It is chiefly among new comers, who are not acquainted with our system, that a breach of the bye.laws relating to this subject occurs. It may be objected that the removal of trade refuse is not a duty falling upon the Sanitary Authority, but I have found from many years' experience in this and other districts that it is by far the most economical, efficient, and sanitary method of dealing with this untidy nuisance. Prior to the introduction of daily removal, it was found that the refuse was deposited in the street channels or else taken during the night and shot upon the nearest vacant plot of land, and ultimately had to be removed by the Council. 56 GIPSIES. These troublesome visitors still continue to annoy, The method adopted for removing them is to call upon the Inspector of Police for the district in which they are squatted, viz.: East Ham, Ilford, or Forest Gate, for Police assistance in order to prevent a breach of the peace, and, with the aid of some of the Council's workmen and a chain.horse, to draw them on the highway, where they come under the jurisdiction of the Police. I have recently adopted a method of serving Notices on the occupiers of the caravans and tents to furnish them with a wholesome supply of water under the East Ham Improvement Act, the penalty being five pounds for non.compliance. Some 30 Gipsies who were so served left the Borough next morning and have not been seen since. MARKET PLACES AND SHOPS. Careful attention has been given to the Market Places and Shops. An Inspector is on special duty every Saturday evening. As pointed out in my previous reports, the food supplies of the Borough are in the hands of good class tradesmen, who have shops in the main thoroughfares, which is a distinct advantage, inasmuch as they are under the constant observation of the Inspectors and general public. The better.class tradesman is desirous of supplying wholesome goods, and, in the event of an occasional bad consignment, is only too anxious to have such food condemned. On a few occasions this has happened during the year, and the food has been brought to the Council's depot, condemned, and destroyed. COMPLAINTS. 763 were received for this period, 485 written and 278 verbal, each of which invariably received attention on the same day. A large proportion of these complaints relates to bad smells alleged to emanate from defective drainage. On examination, it is found that the offensive smell emanates from the sink waste. pipe, usually in the scullery. 57 The liberal flushings with hot soda water, disinfectants, and the like, are entirely useless to remedy the nuisance, in fact such action only aggravates it. The most successful and simple method is the application of dilute muriatic acid, swept through the pipes with a flue brush kept specially for the purpose, thus effectually cleansing the pipe and removing the cause of the nuisance. The usual batch of anonymous and irrelevant letters has received attention as is customary, bona-fide complaints being dealt with either by this Department or referred to the proper Authority. There has also been a number of complaints received relative to offensive odours emitted from what are erected as fresh air inlets, but are frequently foul air outlets. If the theory of drain ventilation work out true in practice, there should be no nuisance emanating from these sources of annoyance, but alas! one has to admit that there is a disturbing element which prevents the Mica Valve Flap shutting down at the right moment, or that the gas coming out is more persistent than that desirous of going in. There is no doubt that it is stronger, which perhaps will account for its obtaining the mastery, and the cause of the Inspector receiving so many complaints. It is exceeding difficult to know where to fix the fresh air inlet in cottage property, where the drains go under the house, that is, to keep it clear of windows; the only safe place in my opinion, is above the eaves gutters, for it seems a little ludicrous to insist upon water.tight joints several feet under ground, then erect a ventilator with an opening (at nose and mouth level), which is frequently emitting sewer gas. DRAIN TESTING. During the year 1397 drains were tested with chemical, smoke, or water tests, of which 545 were proved defective. A considerable percentage of those proved defective, was found upon opening up for examination, to be due not to any defect in the drain itself, 58 but in the fixing of the trap and its construction to the drain. In all re.construction work this connection is now and has been for some years past, carefully watched, and experience shows how necessary this is. In the East Ham Improvement Act, 1903, there is a section especially providing against scamping and shoddy work, and the workman as well as his employer is held responsible and liable to punishment for knowingly performing ba 1 work. This is an advantage, but one regrets that the section does not give power over bad material as well as bad work, for much of the material used as drain ventilating pipes, is toually unfit for this work, as it quickly decays and becomes a nuisance. COMBINED DRAINS. Section 19 of the East Ham Improvement Act, 1903, is most useful, as it defines what is a "drain," and settles as far as East Ham is concerned, the vexed question of Drain v. Sewer, and in future two or more houses may be drained by a combined drain without transforming the drain into an alleged sewer, and saddling the responsibility of maintenance upon the general body of ratepayers. As the drainage system of the Borough is on the combined principle, this new definition is a great advantage. During the year some 264 houses drained with the combined system, have had the drains re.constructed under the powers conferred by this Section of the Act. In nearly every instance the work of re.construction has been done by the Council's workmen, under the supervision of the Sanitary Inspector, and at the owner's expense, amounting to considerably over £1000. Prior to the passing of the Act referred to, this burden would have fallen upon the rates. 59 The following premises have been reconstructed with combined drains:—- i to 6 (con.), Forest View Terrace ... 6 houses 60 to 80, Harcourt Avenue 11 i> 946 to 952, Romford Road ... 4 .. 1 to 15, Southborough Road 8 10 to 14, Greenhill Grove ... 3 » 24 to 48, Compton Avenue ... *3 .. 28 to 30, Ernald Avenue 2 ,, 1 to 10 (con.), Fair view Terrace, Barking Rd. 10 „ 2 and 4, Napier Road 2 ,, 2 to 10, Market Street 5 .. 34 to 40, Market Street 7 » 96 to 114, Market Street 10 ,, 23 to 45, Market Street 12 „ 2 to 12, Howard Road 6 „ 2 to 12, Arthur Road 6 „ 1 to 12 (con.), Mountfield Road 12 „ 78 to 94, Bonny Downs Road 9 ». 1 to 12 (con.), Crosby Row, High St. South 12 „ 1 to 135, Albert Road, North Woolwich 68 „ 1 to 7 (con.), Staveley Street 7 » 50 to 62, High Street, North Woolwich 7 .. 62 to 74, Salisbury Road 7 » 301 to 319, Green Street 10 » 32 to 38, Plashet Grove 4 » 72 to 84, Wakefield Street ... 7 .. 101 to 119, Elizabeth Road IO „ In the event of a stoppage, the Council send two men who are wholly employed for this special work of drain clearing, and are acquainted with the construction of the drains, knowing exactly the position of the Inspection Chamber, and in the event of the drains becoming stopped, they know where to open to clear, while strangers usually commence by breaking pipes to unstop a drain. In the interest of public health, the Council's system of clearing drains is to be highly commended, for if the work is left to the individual owner to do, he usually calls in the first chimney sweep available, with the result that permanent damage is done, and 60 covered up, and not until perhaps disease necessitates the drains being tested is the work of the amateur drain cleaner disclosed. During the year 2941 house drains have been cleared by the Council's men, and it is essential to all concerned that stoppages should be cleared speedily and efficiently. Traps and Interceptors are frequently broken through ignorance, for there is a great difference between clearing a drain and sweeping a chimney. HOUSES WITHOUT WATER. There have been 105 official intimations from the Metropolitan Water Board of water cut off from inhabited houses. Inspections were at once made, and a 48 hours' Notice served upon the persons liable to reinstate the water supply. Under the provisions of Section 57 of the East Ham Improvement Act, 1898, there is a penalty of £5 for permitting a house to be occupied without water. A conviction was obtained under this Section in April, and a fine of Twenty shillings and costs inflicted. REMOVAL OF HOUSE REFUSE. The work of collecting the house refuse has been for many years vested in the Public Health Department. The Borough is divided into six sub-districts for this purpose, being a division of the Borough for each working day of the week, so that each householder knows the day and approximately the hour to expect the dust van. During the year very few complaints have been received in respect to non-collection of dust. The Council's regular dustmen are trustworthy servants and experienced at their work, and I have pleasure in stating that they have done their work in a manner which reflects credit upon themselves and their employers. 61 The continuous growth of the Borough adds considerably to this department of sanitary administration. There have been over 700 houses built, and this means a like number of calls to be made and refuse collected every week additional to last year, this being equal to over 35,000 calls. Four more roller-top vans have been purchased, bringing the number of these vans to eleven. They are a great improvement on the old style of carts, holding considerably more and making the number of journeys to the shoot less. Being constructed so that only one quarter of the top cover is open at one time, makes them much more hygienic and prevents dust and paper blowing about, and the spilling of refuse on the highway when nearly full, an evil unavoidable by the old method. The policy of this Council has been to gradually replace the old carts by purchasing new vans out of the current Rate, and not by raising a loan. The question of locomotion is now being considered as to which is best for the Borough, whether horses, motor dust vans and trailers, or light traction engines and dust vans. There are 27 men and a responsible Foreman who reports to me daily. 277 Notices have been served on Owners to supply portable iron dust bins. In 254 cases they were complied with, but in 23 cases the Borough Council did the work of providing them and recovered the cost. The following table shows the number of loads of refuse collected for the past three years. The decrease for 1904 is accounted for by substituting vans for carts:— 62 DISINFECTANT DEPOTS. For the convenience of inhabitants there are three depots for distribution of disinfectants, situated in convenient positions, and open daily from 9 a.m. to 11 a.m. From these stations during last year 22 tons of powder and 2432 gallons of disinfectant fluid were distributed to persons applying for it with an order from the Department. During the year a new distributing depot has been opened in Church Road, Manor Park, and this will be a distinct advantage to the inhabitants of that portion of the Borough. SCHOOLS. The Sanitary arrangements of both the Public and Private Schools have been regularly inspected, and were usually found to be in a satisfactory condition. The refuse is collected weekly by the Council's staff. CONTAGIOUS DISEASES (ANIMALS) ACT. Since this District has become a Municipal Borough, one of the duties involved upon the Council is the carrying out of the Contagious Diseases (Animals) Act. NUMBER OF LOADS COLLECTED FROM Manor Park Ward. Plashet Ward. Central Ward. Beckton & N. Woolwich. Ward. Total Loads Collected per Month. 1902 1903 1904 1902 1903 1904 1902 1903 1904 1902 1903 1904 1902 1903 1904 January 288 279 235 638 598 434 424 494 440 78 76 53 1428 1447 1162 February 251 281 266 500 541 430 342 373 339 73 77 53 1166 1272 1088 March 282 339 249 393 573 633 643 387 402 78 94 69 1296 1393 1243 April 349 286 231 372 637 482 638 379 389 103 78 48 1462 1380 1150 May 288 268 279 451 533 478 597 471 349 81 76 66 1417 1347 1172 June 306 288 224 451 541 499 326 366 327 81 90 48 1163 1285 1098 luly 283 290 219 663 602 42o 368 425 421 86 14 60 1390 1391 1115 August 246 264 252 381 465 426 508 374 300 71 70 60 1206 1173 1038 September 268 242 200 497 642 413 347 369 373 72 77 68 1174 1220 1054 October 295 240 266 632 506 414 436 427 3b9 11 66 54 1440 1239 1093 November 287 287 225 642 466 496 415 346 326 78 66 67 1822 1164 1104 December 343 239 217 6ll 563 461 366 358 460 93 b8 50 1413 1248 1178 Totals 3475 3323 2853 6131 6566 5491 5300 4759 4485 971 911 666 15,877 15,559 13,495 63 The Council is considering the policy to be adopted, so that the best results may be obtained. In the meantime, the Inspector for the Beacontree Division of the Essex County Council is carrying out the duties as he did prior to the District becoming incorporated. TEMPORARY BUILDINGS. The Inspectors in their visits have a good opportunity of discovering temporary buildings erected contrary to the Council's Bye-laws, and in cases where they do not constitute a sanitary nuisance capable of being dealt with by this Department, it is the practice to report them to the Surveyor for his attention. (Signed), Joseph G. Banks, A.R. San. I., Chief Sanitary Inspector. 64 Table showing the Localities in which certain Diseases of a Zymotic character occurred during the year 1904. Locality Number of Houses Scarlet Fever Diphtheria Membranous Croup Typhoid Fever Kry. sipelas Puerperal Fever Small Pox Continued Fever Aldersbrook Road 25 .. .. .. .. .. .. .. .. Aldersbrook Lane. 1 2 .. .. .. .. ...... .. .. Albany Road 45 1 1 • • .. .. .. Aintree Avenue 65 1 2 .. .. .. .. .. .. Ashley Road 28 3 2 .. .. .. .. .. .. Alexandra Road 78 3 .. .. .. 1 .. .. .. Arragon Road 110 3 .. .. .. .. .. .. Abbotts Road 66 3 3 .. .. 1 .. .. .. Arthur Road 11 .. .. .. .. .. .. .. .. Altmore Avenue 168 2 3 .. .. 1 .. .. .. Ashford Road 45 .. .. .. .. .. .. .. .. Albert Road 157 7 2 .. 1 .. .. .. Brancaster Road 6 .. .. .. .. .. .. .. .. Barrington Road 37 .. .. .. .. .. ..;; .. .. Bessborough Road 175 4 1 .. .. .. .. .. .. Browning Road 236 11 2 1 .. .. .. Bristol Road 136 4 .. .. .. 1 .. .. .. Bath Road 6 .. .. .. .. .. .. .. .. Balmoral Road 1 .. .. .. .. .. .. .. .. Birchdale Road 73 2 1 .. .. .. .. .. .. Byron Avenue 235 8 . . .. .. 1 .. .. .. Berkeley Road 37 .. .. .. .. l .. .. .. Boundary Road 52 2 2 1 .. .. .. .. Benson Avenue 76 .. .. .. .. .. .. .. .. Barking Road 305 8 5 .. 2 .. .. .. .. Boleyn Road 96 3 8 .. .. .. .... .. .. Burges Road 172 3 1 1 .. 1 .. .. .. Bendish Road 48 1 .. .. .. .. .. .. .. Bonny Downs Road 55 1 .. .. .. 1 .. .. .. Brighton Road 63 6 2 .. .. l 1 .. .. Bartle Avenue 63 9 3 .. .. l l .. .. Becket Avenue 61 2 1 l .. .. .. Bridge Road 21 .. .. .. .. .. .. .. .. Brooks Avenue 80 1 .. .. 1 .. .. .. Beaconsfield Street 30 9 2 .. .. .. .. .. .. Beckton Road 110 6 .. .. .. .. .. .. .. Chesterford Road 99 1 1 .. .. 2 .. .. .. Carlton Road 48 1 .. .. .. .. .. .. .. Clarence Road 29 .. .. .. .. .. .. .. .. Cumberland Road 16 .. .. .. .. .. .. .. .. Capel Road 71 1 .. .. .. 1 .. .. .. Carlyle Road 120 2 3 .. .. .. .. .. .. Colchester Avenue 65 .. 1 .. .. .. .. .. .. Church Road 112 1 .. .. .. 1 .. .... .. Crescent Road 46 .. .. .. • • .. .. .. .. 65 Locality Number of Houses Scarlet Fever Diphtheria Membranous Croup Typhoid Fever Erysipelas Puerperal Fever Small Pox Continued Fever Cowper Avenue 25 1 .. .. .. .. .. .. .. Cromwell Road 63 5 •• 1 .. .. .. .. Colston Road 44 8 .. .. .. .. .. .. .. Clifton Road 34 2 .. .. .. •• .. .. .. Chester Road 65 1 .. .. .. .. .. .. .. Claremont Road 62 .. .. .. .. .. .. .. .. Coleridge Avenue 70 1 1 .. .. •* .. .. .. Compton Avenue 81 3 .. 1 .. .. .. .. .. Campbell Road 36 3 .. .. .. .. .. .. .. Castle Street 39 .. .. .. .. .. .. .. .. Cleves Road 94 6 .. .. 1 1 .. .. .. Colvin Road 61 .. .. .. 3 l .. .. .. Clements Road 120 2 1 .. .. .. .. .. .. Caledon Road 129 2 l .. .. .. .. .. .. Caulfleld Road 111 .. .. .. .. .. .. .. .. Charlemont Road 61 1 1 .. .. .. .. .. .. Creighton Avenue 76 1 3 .. .. .. .. .. .. Central Park Road 223 4 5 .. .. .. .. .. .. Calverton Road 40 1 .. .. .. l .. .. .. Charlotte Terrace 5 .. .. .. .. .. .. .. .. Cranmer Avenue 61 .. .. .. .. .. .. .. .. Cyprus Place 41 6 1 .. .. .. .. .. .. Cameron Street 20 4 .. .. .. .. .. .. .. Church Street 7 .. .. .. ........ .. .. .. .. Claremont Street 59 8 .. .. 1 .. .. .. .. Durham Road 99 4 .. .. 1 l .. .. .. Dersingham Avenue 142 2 .. .. .. • • .. .. .. Dore Road 39 2 .. .. .. .. .. .. .. Dorset Road 67 3 2 .. .. 1 .. .. .. Dickens Road 56 .. 4 .. 1 l .. .. .. Drew Road 6 .. .. .. .. .. .. .. .. Empress Avenue 30 1 .. .. l .. .. .. .. Eighth Avenue 44 2 .. .. .. l .. .. .. Elsenham Avenue 30 1 .. .. .. .. .. .. .. East Avenue 64 4 .. .. .. .. .. .. .. Elizabeth Road 115 5 .. .. .. l .. .. .. Edith Road 30 1 .. .. .. .. .. .. .. Essex Road 112 1 .. .. .. l .. .. .. Ernald Avenue 68 4 .. .. .. .. .. .. .. Eastbourne Road 54 1 .. .. .. .. .. .. .. Eversleigh Road 70 4 1 .. .. .. .. .. .. Elizabeth Street 139 4 1 .. .. .. .. .. .. Forest Drive 39 1 .. .. l .. .. .. .. Forest View Road 26 .. .. .. .. .. .. .. .. First Avenue 144 11 4 .. .. .. .. .. .. Fourth Avenue 149 l 3 .. .. .. .. .. .. 66 Locality Number of Houses Searlet Fever Diphtheria Membranous Croup Ty- phoid Fever Erysipelas Puerperal Fever Small Pox Continued Fever Fifth Avenne 42 .. 2 .. .. .. .. .. .. Fry Road 15 .. 2 .. 1 .. .. .. .. Finden Road 19 4 .. .. .. .. .. .. .. Florence Road 36 .. 2 .. .. .. .. .. .. Friars Road 90 7 1 .. .. .. .. .. .. Folkestone Road 23 .. .. .. .. .. .. .. .. Fabian Street 23 .. 1 .. .. .. .. .. .. Ferndale Street 10 11 1 .. .. .. .. .. .. Francis Street 22 1 .. .. .. .. .. .. Factory Road 1 .. .. .. .. .. .. .. .. Gainsborough Av 46 l .. .. .. .. .. .. .. Gordon Road 10 .. .. .. .. .. .. .. .. Gladding Road 12 3 1 .. .. .. .. .. .. Gloucester Road 49 1 3 .. .. .. .. .. .. Greenhill Grove 97 4 3 .. .. .. .. .. .. Green Street 203 3 1 .. .. .. .. .. .. Goldsmith Avenue 116 .. .. .. .. .. .. .. .. Gladstone Avenue 93 .. .. .. .. .. .. ............ .. Greenleaf Road 15 .. .. .. .. .. .. .. .. Grosvenor Road 29 1 .. .. .. .. .. .. .. Gillett Avenue 57 1 3 .. .. .. .. .. .. Gooseley Lane 35 .. .. .. 2 .. .. .. .. Glenister Street 36 .. .. .. 1 .. .. .. .. Herbert Road 142 3 3 •• 1 .. .. .. .. Harcourt Avenue 115 1 3 .. .. .. .. .. .. Halley Road 376 14 3 .. .. .. .. .. .. Henderson Road 93 5 .. .. .. .. .. .. .. Hilda Road 28 .. .. .. .. .. .. .. .. Hampton Road 29 3 .. .. .. .. .. .. .. High Street North 415 9 2 .. .. .. .. .. .. High Street South 96 8 .. .. .. .. .. .. .. Hockley Avenue 69 3 2 .. .. .. .. .. .. Hartley Avenue 45 1 1 .. .. .. .. .. .. Heigham Road 134 2 1 .. .. .. .. .. .. Harrow Road 40 3 .. .. .. .. .. .. .. Holme Road 63 2 2 .. .. .. .. .. .. Henry Road 14 2 .. .. .. .. .. .. .. Howard Road 11 1 .. .. .. .. .. .. .. Holloway Road 7 .. .. .. .. .. .. .. .. High St., N. W'lw'h 50 1 .. .. .. .. .. .. .. Jephson Road 58 3 4 .. 1 .. .. .. .. Johnstone Road 21 .. .. .. .. .. .. .. .. Kensington Avenue 154 5 2 .. 1 2 .. .. .. Katherine Road 415 20 7 .. .. 3 .. .. .. King's Road 36 .. .. .. * • .. .. .. .. 67 Locality Number of Houses Scarlet Fever Diphtheria Membranous Croup Ty: plioid Fever Erysipelas Puerperal Fever Small Pox Continued Fever Kempton Bond 107 3 .. 1 .. .. .. .. .. Keppel Road 74 1 1 .. .. 1 .. .. .. Leader Avenue .. .. .. .. .. .. .. .. .. Landseer Avenue 67 .. .. .. .. .. .. .. .. Little Ilford Lane 112 .. .. .. .. 1 .. .. .. Little Ilford Avenue 24 .. .. .. .. .. .. .. .. Lawrence Avenue 233 12 1 .. .. .. .. .. .. Lansdowne Road 68 7 l .. .. .. .. .. .. Lancaster Road 86 2 l .. .. 1 .. .. .. Langton Avenue 44 .. .. .. .. .. .. .. .. Lawrence Road 72 7 4 .. .. .. .. .. .. ..Lathom Road 152 .. .. .. .. .. .. .. .. Lloyd Road 37 .. 1 Langdon Road 13 .. .. .. .. .. .. .. .. Loxford Avenue 54 3 .. .. .. .. .. .. .. Ladysmith Avenue 29 2 .. .. .. .. .. .. .. Latimer Avenue 72 1 1 .. .. 1 .. .. .. Lydeard Road 20 .. .. .. .. .. .. .. .. Leigh Road 45 .. .. .. .. .. .. .. .. Livingstone Street 19 5 1 .. .. 2 .. .. .. Merlin Road 27 .. .. .. .. .. .. .. .. Manor Park Road 53 .. .. .. .. .. .. .. .. Manor Road 196 3 .. .. .. 1 .. .. .. Manor Avenue 30 .. .. .. .. l .. .. .. Michigan Avenue 20 1 .. .. .. .. .. .. .. Mori is Avenue 60 2 .. .. .. .. .. .. .. Meanley Road 143 3 .. .. .. 2 .. .. .. Milton Avenue 160 3 3 .. .. 2 .. .. .. Marlborough Road 59 3 4 .. .. .. .. .. .. Monega Road 375 20 7 .. .. 2 .. .. .. Macaulay Road 67 3 3 .. .. .. .. .. .. Malvern Road 58 .. 1 .. .. .. .. .. .. Myrtle Road 7 • • .. .. .. .. .. .. .. Mafeliing Avenue 10 .. .. .. .. .. .. .. .. Melbourne Road 92 1 2 .. .. .. .. .. .. Market Street 92 2 .. .. .. .. .. .. Mountfield Road 78 1 .. .. 1 .. .. .. Manor Way 14 .. .. .. .. .. .. .. .. Muir Street 18 .. .. .. .. .. .. .. .. Milk Street 10 .. .. .. .. .. .. .. .. Nigel Road 74 1 1 .. .. 1 .. .. .. Napier Road 81 1 1 Norman Road 22 1 .. .. .. 1 .. .. .. Nelson Street 39 1 1 .. .. .. .. .. .. Navarre Road 12 2 .. .. .. .. .. .. Northfield Road 42 1 .. .. .. .. .. .. .. 68 Locality Number of Houses Scarlet Fever Diphtheria Membranous Croup Typhoid Fever Erysipelas Puerperal Fever Small Pox Continued Fever Newland Street 6 .. .. .. .. .. .. .. .. Oregon Avenue 19 1 1 .. .. .. .. .. .. Osborne Road 39 2 1 .. .. .. .. .. .. Outram Road 74 3 1 .. .. .. .. .. .. Oakfield Road 111 7 3 1 1 .. .. .. .. Parkhurst Road 270 .. 2 .. .. 2 1 .. .. Park Road 63 4 1 .. .. .. .. .. .. Plashet Lane 159 8 .. .. .. .. .. .. .. Plashet Grove 173 3 .. .. .. 2 .. .. .. Prestbury Road 73 3 1 .. .. .. .. .. .. Priory Road 66 .. .. .. .. .. .. .. Parr Koad 85 6 .. .. .. 1 .. .. .. Park Avenue 27 .. .. .. .. .. .. .. .. Poulett Road 54 .. .. .. .. 1 .. .. .. Plevna Street 13 1 .. .. .. 1 .. .. .. Pullens Avenue 18 .. .. .. .. •• .. .. .. Romford Road 520 5 .. .. 3 .. .. .. .. Rabhits Road 12 .. .. .. .. .. .. .. .. Rectory lload 45 2 •• .. .. .. .. .. .. Reynolds Avenue .. .. .. .. .. .. .. .. .. Rosedale Road 74 1 1 .. .. .. .. .. .. Rothsay Road 53 1 .. .. .. 1 .. .. .. Ratcliffe Road 51 1 .. .. .. .. .. .. .. Rutland Road 92 .. 3 .. .. 1 .. .. .. Rosebery Avenue 171 12 .. .. 2 .. .. .. .. Ruskin Avenue 153 8 .. .. .. .. .. .. .. Rixsen Road 31 .. .. .. 1 .. .. .. .. Redclyffe Road 46 .. 1 .. 1 .. .. .. .. Ranelagh Road 72 2 1 .. 1 1 .. .. .. Rancliffe Road 45 .. .. .. .. 1 .. .. .. Roman Road 152 8 .. .. .. 1 .. .. .. Robert Street 32 1 .. .. .. .. .. .. .. St. Margaret's Road 29 .. • • .. .. .. .. .. .. Salisbury Road 70 2 .. .. .. .. .. .. .. Station Road 49 1 1 .. .. .. .. .. .. Southborough Road 157 4 1 .. .. 1 .. .. .. Second Avenue 152 .. 1 .. .. .. .. .. .. Sixth Avenue 180 1 .. .. .. .. .. .. .. Seventh Avenue 127 1 .. .. .. .. .. .. .. Sheridan Road 95 1 .. .. 2 .. .. .. Sheringham Avenue 210 4 1 .. .. 2 .. .. .. School Road 23 .. .. .. .. .. .. .. .. Sebert Road 2 .. .. .. .. .. .. .. .. St. Stephen's Road 137 1 4 .. .. .. .. .. .. Shaftesbury Road 48 5 2 .. .. .. .. .. .. 89 Locality Number of Houses Scarlet Fever Diphtheria Membranous Croup Typhoid Fever Erysipelas Puerperal Fever Small Pox Continued Fever South Esk Road 205 8 3 .. 1 1 .. .. .. Strone Road 382 11 1 .. .. 2 .. .. .. Sherrard Road 412 23 17 .. 1 1 .. 1 .. St. Dunstan's Koad 24 .. .. .. .. .. .. .. .. Sandringham Road 33 1 .. .. .. .. .. .. .. Stafford Road 108 3 .. .. 1 1 .. .. .. Shrewsbury Road 294 14 1 .. 2 3 .. .. .. Sibley Grove 109 2 1 .. .. 2 .. .. .. Shelley Avenue 145 3 3 .. .. 3 .. .. .. Stanley Road 54 1 1 .. .. .. .. .. .. Swinburne Avenue 22 2 .. .. .. .. .. .. .. Shakespeare Cresc't 224 2 2 .. .. .. .. .. .. St. Martin's Avenue 53 2 4 .. .. 1 .. .. .. Sussex Road 5 .. .. .. .. .. .. .. .. Streatfield Avenue 70 2 .. .. .. .. .. .. .. Shoebury Road 23 .. .. .. .. .. .. .. .. Seymour Road 84 3 3 1 .. .. .. .. .. St. Bernards Road 96 1 .. .. .. .. .. .. .. Spencer Road 43 4 .. .. .. 1 1 .. .. Stamford Road 107 5 .. .. .. 2 2 .. .. Skeffington Road 116 3 2 .. .. .. .. .. .. Southend Road 87 .. .. .. .. .. .. .. .. St. John's Road 81 5 .. .. .. .. .. .. .. St. Alban's Avenue 79 4 .. .. 1 .. .. .. .. St. Olaves Road 41 1 .. .. .. .. .. .. .. Springfield Road 27 .. .. .. .. 1 .. .. .. Stevenage Road 40 .. .. .. .. .. .. .. .. Southchurch Road 32 1 .. .. .. 3 .. .. .. S.Bartholomew's R. 37 .. .. .. .. .. .. .. .. Storey Street 51 5 .. .. .. .. .. .. .. Staveley Street 7 3 6 .. .. .. .. .. .. Stanley Street 20 .. .. .. .. .. .. .. .. Savage Gardens 132 .. .. .. .. .. .. .. .. Shepstone Street .. .. .. .. .. .. .. .. .. Station Street 2 .. .. .. .. .. .. .. .. The Chase 3 3 .. .. .. .. .. .. .. The Warren 28 .. 6 .. .. .. .. .. .. Toronto Avenue 11 .. .. .. .. .. .. .. .. Third Avenue 154 3 5 .. .. 1 .. .. .. Trevelyan Avenue .. .. .. .. .. .. .. .. .. Tennyson Avenue 44 .. .. .. .. .. .. .. Thackeray Road 66 2 3 1 .. .. .. .. .. Tudor Road 79 .. 1 .. .. .. .. .. .. Temple Road 16 3 .. .. .. .. .. .. .. Thorpe Road 46 5 2 .. l 1 .. .. .... Talbot Road 112 8 2 .. l 1 .. .. .. Telham Road 96 .. 3 .. .. .. .. .. .. 70 Locality Number of Houses Scarlet Fever Diphtheria Membranous Croup Typhoid Fever Erysipelas Puerperal Fever Small Pox Continued Fever Vernon Avenue 7 .. .. .. .. .. .. .. .. Victoria Avenue 80 3 .. .. .. .. .. .. .. Vicarage Lane 37 2 .. .. .. .. .. .. .. Wolferton Road 6 .. .. .. .. .. .. .. .. Wentvvorth Road 33 .. .. .. .. .. .. .. .. VVhitta Road 48 .. .. .. .. .. .. .. .. Washington Avenue 45 .. .. .. .. .. .. .. .. VVanstead Park Av 103 1 .. .. .. .. .. .. .. Worcester Road 50 .. .. .. .. .. .. .. .. Warwick Road 27 1 .. .. .. .. .. • • .. Washington Road 10 .. .. .. .. .. .. .. .. Waterloo Road 25 .. .. .. .. .. .. .. .. Walpolc Road 39 3 .. .. .. .. .. .. .. Whitfield Road 47 2 .. .. .. .. .. .. .. Whittaker Road 42 1 .. .. .. .. .. .. .. Wyndham Road 40 1 .. .. .. .. .. .. .. Wortley Road 36 3 .. .. .. .. .. .. .. Woodstock Road 61 3 .. .. .. .. .. .. .. Windsor Road 68 1 .. .. .. .. .. .. .. Woodhouse Grove 42 .. .. .. .. .. .. .. .. Wordsworth Avenue 54 1 .. .. .. .. .. .. .. Wilson Road 41 3 .. .. .. .. .. .. .. Wakefield Street 162 7 .. .. 1 2 .. .. .. Wellington Road 73 3 .. .. 1 1 .. .. .. Wellstead Road 92 .. .. .. 1 .. .. .. .. Winter Avenue 36 2 .. .. .. .. .. .. .. Wall End Road 19 1 .. .. .. 1 .. .. .. Wolsey Road 91 .. .. .. .. .. .. .. .. York Road 100 .. 3 .. 1 2 .. .. .. 71 INDEX. A page. Acreage 4 Ages at Death 7, 9 Allotments 26 Ambulance Service 43 Artizan's Dwellings 26 B Back Passages 53 Bakehouses 23 Births 4, 6 Birth Rate 4, 6 Boundaries 21 Building Operations 22 Bye-Laws 27 C Causes of, and Ages at Death 7 Cemeteries 22 Census Returns 5 Children's Diseases 42 Churchyards 22 Closure of Schools 14, 33, 35 Contagious Diseases (Animals) Act 62 Complaints 56 Combined Drains 58 Convalescent Home 32, 35, 38 Corrected Death Rate 3, 4, 8 Cost of Notification of Infectious Diseases 43 Cowhouses 52 72 INDEX—continued. D page. Dairies and Cowsheds 52 Deaths 4, 8 Death Rate (corrected) 3, 4, 8 Do. (Zymotic) 4 Do. (recorded) 4, 8, 9 Do. of Wards 9 Do. from various Diseases 4 Deaths of Infants 4,9, 10 Deaths occurring outside the Borough boundary 8 Deaths, percentage proportion 9 Deaths from Accident 18 Do. Alcoholism 17 Do. Cancer ' 18 Do. Cirrhosis of Liver 17 Do. Diphtheria and Membranous Croup 5, 15 Do. Influenza 17 Do. Measles 14 Do. Puerperal Fever 5, 17 Do. Scarlet Fever 5, 14 Do. Small Pox 15 Do. Suicide 18 Do. Tubercular Diseases 18 Do. Typhoid Fever 5, 17 Do. Whooping Cough 14, 15 Do. Zymotic Diseases 11 Density of Population 6 Destructor 21 Diarrhoea Mortality 4, 16 Diphtheria 35 Disinfectant Depots 62 Disinfection 42 Drain Clearing 59, 60 Do. Re-construction 58, 59 Do. Testing 57 Do. Ventilation 57 Dust Collection 60, 61 73 IN DEX —continued. page. Empty Houses 6 Enteritis Mortality 4 Estimated Population 4, 5, 6 F Factories and Workshops 25, 54 Fish Offal Collection 52 Food Supplies 56 Fresh Air Inlets 57 Fumigation 42 G Gipsies 56 Ground Level Bakehouses 23 Growth of Borough 5 H Highway Refuse Collection 55 Hospital Sub-Committee 2 Housing of Working Classes Act 54 Houses for Working Classes 26 Dc. in course of Construction 6 Do. Unfit for Habitation 54 Do. without Water Supply 60 House Refuse Removal 60 I Industries 20 Infantile Mortality 4, 9, 10 Infectious Diseases 51 Do. notified 27, 28, 29, 31 Do. removed to Hospital 31 Inhabited House Duty Exemption 22 Inspection of the Borough 48 Inquests 18, 19 Isolation Hospital 32 74 IN DEX—continued. L page. Legal Proceedings 49, 51, 60 Local Industries 20 M Market Places 56 Members of Public Health Committee 2 Do. Hospital Sub-Committee 2 Membranous Croup 35 Mica Valve Flaps 57 Murders 19 N Nett Deaths 4 Notices served 49 Notification of Infectious Diseases 27 Do. Rate 27 Nuisances abated 50 Do. discovered 49 Number of Births 4 Do. Infectious Disease cases notified 5 Do. Deaths from Infectious Diseases 5 Do. Infectious Disease cases removed to Hospital 5 Do. Scarlet Fever Convalescents 5 Do. Persons per Acre 4 O Occupied Houses 6 Offal Collection 52 Official Returns of Infectious Diseases 42 Open Spaces 26 Outworkers 25 Overcrowding 50 75 IND EX—continued. P page Passages 53 Percentage Proportion of Deaths 9 Do. Cases removed to Hospital 30 Petroleum Licenses 54 Population 4, 5, 15 Public Health Committee 2 Do. Department 43 R Rainfall 45 Recorded Death Rate 4. 8, 9 Refuse Destructor 20 Removal of Nuisances 48 Do. House Refuse 60 Do. Hospital Cases 5 Returns of Infectious Disease Cases 42 River Roding 22 S Scarlet Fever 32 Do. Deaths 14 Do. Convalescent Home 32 Do. Hospital 32 Schools 62 School Closure 14, 33, 35 Do. Letters 51 Sewerage 20 Sewer Ventilation 20 Shops 56 Slaughter Houses 24, 53 Small Pox 40 Staff 43 Statistical Summary 4 Subsoil 20 Swimming Bath 26 76 INDEX—continued. T Tables, re page. Births 10 Causes of, and Ages at Death 7 Children's Diseases 42 Deaths 7, 9, 10, 12 Deaths from Zymotic Diseases 12, 13 Diarrhoea 10, 16 Diphtheria and Membranous Croup 15 Expenditure on Isolation Hospital and Convalescent Home 47 House Refuse Collection 62 Incidence of Scarlet Fever Cases 34 Do. Diphtheria do. 36 Do. Typhoid Fever do 9 Do. Small Pox do. 41 Infantile Mortality 9, 10 Infectious Disease Cases notified 27,28,29,31 List of Streets where Zymotic Diseases occurred 64, 65, 66, 67, 68, 69, 70 Notification Rates 27 Nuisances discovered 49 Population 6 Primary Inspections made 48 Rainfall 45 Typhoid Fever 38 Vital Statistics 44, 46 Temporary Buildings 63 Trade Refuse 55 Typhoid Fever 37 U Uncertified Deaths 9 Underground Bakehouses 24 Urinals 52 V Vital Statistics 14. 46 77 INDEX—continued. W pack. Ward Death-rates 9 Water Supply 21 Workshops 25, 54 Z Zymotic Death-rate 4, 11, 42