EDM 1 ANNUAL REPORT of Medical Officer of Health, for the EDMONTON URBAN SANITARY DISTRICT. For the Year 1894. printed by Crusha & Son, (Trade Union), "Herald" Office, 823, High Road, Tottenham. REPORT. Addison House, Upper Edmonton. March 10th, 1895. Gentlemen, I have the honour to present you with the report on the Vital Statistics and Sanitary Work of your district, for the year 1894, being my fourth annual report as Medical Officer of Health. vital statistics. I append herewith the two tables, "A" of deaths, and “B” of population, births, and new cases of sickness prescribed by the Local Government Board, duly filled up. population. The population of the district, exclusive of that of the two Unions situated therein, was by census 1881, 13,065, and by census 1891, 23,473; assuming that the same rate of increase holds good, the population in June, 1894, would be 28,419; this calculation is made by means of the formula P = pRn, where P = population required p that at last census and R rate of increase during last inter-censal period, n being the number of years (in this case 3.25) since the last census was taken. The following figures have been calculated from those in the tables. deaths. The number of deaths in Edmonton district was 350 „ „ of persons belonging to Edmonton, but occurring in Institutions outside it, was 22 Total 372 Death rate, excluding both population and deaths in Edmonton Union Workhouse, and using estimated population as the basis of calculation = 13 09 per thousand. Death rate, including both population and deaths in Edmonton Workhouse in the calculation = 18.07 per 4 thousand, the mean of these two, which is probably nearer the true death rate, is 15 57 per thousand, a lower rate than that of 1893, calculated in the same way. infantile mortality. The number of deaths of children under one year, was in Edmonton district, 119; and in Edmonton Workhouse, 11; total 130. From these should be deducted 9 deaths attributed to premature birth, leaving 121, this, using the mean of registered births in 1893 and 1894 (915), as a basis of calculation, gives an Infantile Mortality of 132.24 per thousand, also a lower rate than that of the preceeding year. The Infantile Mortality in the Edmonton Workhouse, calculated in the same way, would be 168.06 per thousand. All the deaths in the district were certified by medical practitioners, or after a Coroner's enquiry, of which there were 38 during the year; of these ten concerned infants under one year. In only 15 of the 38 was there any reason for attributing the death to other than natural causes, and of these 3 were suicides, 2 cases in which verdicts of manslaughter were returned, and 10 accidental injuries. The accommodation provided for the making of the post mortem examinations necessitated by these enquiries is of a most meagre description, and the proper performance of a pout mortem examination at the Council's Mortuary is, on a dark day in winter, a matter of considerable difficulty and discomfort. zymotic death rate. The deaths from the principal zymotic diseases were as follows :— Scarlet Fever 3 Diphtheria 22 Membranous Croup 1 Enteric Fever 5 Measles 11 Whooping Cough 17 Diarrhoea and Dysentery 28 Total 87 This, with the estimated population as the basis of calculation, gives a zymotic death rate of 306 per 1,000. 5 births. The number of births in Edmonton district was 8i7, and 10 of the 53 births which occurred in the Edmonton Workhouse were of persons belonging to Edmonton, total 857, this, with the estimated population as the basis of calculation, gives a birth rate of 30 152 per thousand persons living, a slightly less rate than that of 1893. The actual number both of births and of deaths, is slightly less than in 1893, and this would lead one to infer that the population may be somewhat over estimated, owing to the same rate of increase not being maintained, and the birth and death rates in consequence somewhat under estimated. Nothing but a more frequent census could give an accurate knowledge of the population of this district, as it is one in which the increase by immigration, owing to the building of whole streets of, for the most part, small houses, far exceeds that due to excess of births over deaths, and the age distribution of the population, a most important factor in estimating vital statistics, probably alters considerably in the course of a few years. relation of public institutions to the vital statistics of the district. There are two large Public Institutions situated in the district, viz.: The Strand Union Workhouse and Schools, and the Edmonton Union Workhouse. As regards the first of these, the case is simple; its population is entirely composed of persons not belonging to this district, and its vital statistics are excluded from all calculations. As regards the latter however, the case is more complex, for while the majority of its inhabitants are persons from other districts, a certain proportion are from this district; the most accurate way of dealing with its statistics would be to include in the calculations, those of its inhabitants who belonged originally to this district, but I have no returns which would enable me to adopt this course, I have therefore, except where I have otherwise indicated, excluded both its population and deaths from the calculations, as in previous reports. With regard to Public Institutions without the district, whose statistics affect those of this district, I have returns of deaths of persons belonging to this district which occurred in the Wandsworth Asylum, and in the various London Hospitals, and these are included in the calculations. infectious diseases. The Notification Act was in force during the entire year. Some infractions of it were noted, but they 6 did not appear to call for more than letters of enquiry to the medical practitioners concerned. As regards notification by householders, however, the Act remains a dead letter. The year was not marked by any widespread epidemic. The following is a statement of the number of cases notified:— Scarlet Fever 100 Diphtheria 51 Membranous Croup 1 Enteric Fever 27 Small Pox 1 Puerperal Fever 2 Erysipelas 53 235 scarlet fever. 100 cases were notified during 1894, of which 25 occurred in the month of January. The disease had been extensively prevalent in the District in 1893, as may be seen on reference to my Annual Report for that year, and at the commencement of 1894 there were cases in 32 houses in the District. In these houses 4 secondary cases occurred in 1894. Of the remaining 96 cases, two occurred in the Strand Union premises, and came from without the district, and two others were instances of secondary infection through patients returning from a fever hospital; in both of these instances a child had been admitted to one of the Hospitals of the Metropolitan Asylums Board from a house without this District suffering from Scarlet Fever, and on recovery was taken from the Hospital to a house in this District, to which its home had in the meantime been transferred, and within a few days of the return of the patient another child of the family, in each instance, became affected. Of the 92 cases left by deducting these, 29 were secondary cases in infected houses, nearly one-third of the whole, showing how defective home isolation is in many of the houses. These 29 secondary cases arose in 17 houses. In one house there were five secondary cases; in two houses, three ; in four houses, two; and in ten houses, one secondary case besides the primary case. Deducting the secondary cases there remain 63 primary cases for consideration. Of these 36 appear to have arisen in connection with attendance at Public Elementary Schools, viz.: 20 among children attending the Brettenham Road School, 6 among children attending the St. James' Schools, and 10 among children attending the Croyland 7 Road School. The cases among children attending the Brettenham Road School occurred in three distinct groups; one at the beginning of the year, which may be regarded as an extension from the 1893 outbreak; one in April and beginning of May, and one in November and December. With the last of these groups were connected four out of the six cases occurring at St. James' School, for among them was a family whose children attended both schools, and also the St. James' Sunday School; the existence of the disease in this family was not discovered until four cases had occurred in the house. In connection with this group, as tending to its extension, may also be mentioned the case of a child who was found to have attended the school for several days while peeling from the disease, and whose case was only discovered by my visiting the house in consequence of a complaint that had been made to me about the child. Five of the other primary cases were in all probability contracted from neighbouring houses through the intercourse of the respective families. Three others were certainly connected in some way with each other, for they all developed on the same day, and all occurred in the same part of the district where there were other infected houses, but I was not able definitely to fix the source of contagion. Three may be regarded as doubtful cases, as no desquamation followed; six were persons above school age; and the remaining ten were below school age, or were not attending school, or were attending a school to which no other cases could be traced. In these last 16 cases no facts were elicited which would enable them to be more definitely grouped. Three of the total number of cases were fatal; two being cases of the malignant form of the disease, and dying in the early stage ; and the third having proved fatal at a late stage from the septic complications of suppuration in the ear. The drainage of the premises on which this death occurred was found to be very defective, and was re-constructed under the supervision of the Inspector. At the close of the year two houses remained infected, viz.: 15, Beale Street, and 6, Town End Villas, Town Road. I regard it as probable that one or more mild and unrecognised cases may have occurred. diphtheria. Fifty-one cases of this disease were notified during the year, with 22 deaths; 11 were secondary cases. In two 8 houses there were two, and in seven houses one such secondary case besides the primary one. Of the 40 primary cases remaining, after deduction of the 11 secondary cases, 13 occurred in a special outburst of the disease which took place in September and October, towards the close of an epidemic of measles with which the district had been visited; of these 13 cases, six were in the Tanners End portion of the district, and four out of the six were in the same row of houses, viz.: the south side of Ashwell Grove, and the corner house of this side, facing Bull Lane, a volatile test introduced into the drain of one of these houses was perceived by all the others in the row, showing the drainage to have at least defective joints, and it is worthy of remark that no result was obtained from a volatile test introduced in a similar manner into the house drains on the opposite side of the road and that no case was notified there. 1 think that, however the contagion was introduced into these houses it certainly was to some extent spread by way of the drains. The other two cases of this group of six, were in houses not in direct connection with these but in the vicinity; one of the children had been to a mission room used by residents in this portion of the district, the other had suffered in the measles outbreak and occurred in August, but it is included in this group, as although no direct connection could be traced, it seems not improbable that a mild and unrecognised case or cases may have occurred in the meantime. Of the other seven primary cases constituting this outburst, two were in Claremont Street, one in Linton Cottages, one in Fairfield Road, one in Lower Fore Street, one in Town Road, and one in Bounces Road; these coincided in point of time with the others, but no connection could be traced between them, nor was there any one factor common to them all. Four secondary cases occurred in this outburst, making a total of 17 cases. The disease was in this outburst of a most virulent type, 11 out of the 17 cases having been fatal. I submitted a detailed report of these cases at the time of their occurrence; to them should be added one death not notified as diphtheria and not certified as such, the circumstances attending which were set forth in detail in the said report. Two other cases occurred in the Tanners End portion of the district earlier in the year; both were probably contracted in the course of school attendance, and both were fatal. 9 Another small but well-defined group of cases occurred in November. It was clearly a school attendance group, and consisted of four primary and two secondary cases, all occurring about the same time and all attending the same school. The outbreak ceased on the temporary closure of the school in question. To these should be added a case of sore throat, to which no medical practitioner was called in, and a case of septic sore throat which was under my own care, and which was not, in my opinion, Diphtheria. I had attended this child in a well-marked attack of Diphtheria in a previous year. All these children not only attended the same school, but when at school were in the same class room—an apartment well lighted and ventilated, and having an available cubic space of about 1,500 cubic feet—the average number of children in it during class time was given as 14, shewing some aggregation ; but this was minimised by the children not being in the room more than two hours consecutively, and by the windows being thrown open in the interval. The drainage of the premises was examined and found defective, as was also that of the adjoining house. I am not of opinion, however, that the outburst was caused by the defective drainage, because when a volatile test was applied to the drain the smell was strongly perceived in the class room on the first floor, and not one case occurred among the children using this room, while no smell whatever could be detected in the room used by the children who contracted the disease. I regard the outbreak as due to the accidental introduction of an infected person, probably a child suffering from a mild attack, into the room. Instances of Diphtheria outbursts preceded by cases of ill-defined throat illness are not uncommon. No deaths occurred as the result of this outburst. It is worthy of remark that one of the earlier cases had been twice previously notified to the Sanitary Authority as suffering from Diphtheria, and once as suffering from Scarlet Fever, during the two preceeding years. The whole of the defective drains were taken up and re-constructed before the school was re-opened. The other primary cases were sporadic in character, and occurred at different times and in different localities. Two of them were associated with Scarlet Fever; one occurred in a house in Tramway Avenue, and in the adjoining house was a fatal case of Scarlet Fever, and the other was a case with which were associated two secondary cases, all three children having been notified as suffering from Scarlet Fever some 10 weeks previously. Six cases occurred in Snells Park and Grove Street at various times, 10 Two cases occurred at different times in the same block of houses in Bounces Road, the drainage of which on examination proved to be defective. The remainder call for no special comment; six only were cases of adults. One case (fatal; was notified under the name of Membranous Croup and should be added to the Diphtheria total. enteric fever. Twenty-five cases of this disease with 5 deaths, were notified as occurring in the district during the year ; of these, four occurrcd in houses already infected at the beginning of the year, three were secondary infections in one house, and afforded the only instance of multiple cases in one house that occurred during the year; the family consisted of a woman (whose husband had left her) and her children; they were in receipt of relief and were dependent on the charity of neighbours for what little attention they got. I reported the facts at the time, but there was no hospital accommodation at the disposal of the Board. All four made good recoveries, though the woman was extremely ill, and no other case could be traced thereto; the woman herself contracted the disease from nursing a case in a dirty house and was the only certain instance of house to house transference that occurred, though one other instance was probable by way of defective drains. The others were sporadic cases; four of them were certainly contracted without the district, seven occurred on premises which were filthy or with defective drainage or both. In two the diagnosis was at least extremely doubtful. I have not yet met with any serious spread of Enteric Fever in this district since I have been Medical Officer. small pox. Only one case occurred; it was removed to the Hospital. One other case was reported, but it proved to have been an error of diagnosis. puerperal fever. Only two cases were reported, neither of them were fatal. erysipelas. Fifty-three cases were reported, of which 13 were in the two Union Workhouses ; one man has been four times Edmonton Arban Sanitary District.. Extract from Annual Report of Medical Officer of Health, for 1893. " Provision for the Isolation of infectious cases. "The Board have at their disposal absolutely no accommodation for the isolation of infectious cases, and the want of such provision is much felt in the district. "Both in the interest of the Public Health, and in that of many of the patients themselves, it is eminently desirable that the Board should have under their control, or at their disposal, some suitable place where infectious cases can be efficiently treated and effectively isolated. As a rule the Board's applications in cases of special difficulty for assistance from other bodies have proved unsuccessful, and however unsuitable the accommodation, the cases have had to remain wherever they happened to arise. Several instances have occurred where application was made to me for removal of cases to hospital, and there were many others in which the parents would have been ready to avail themselves of such accommodation, and several in which the cases might fairly be described as " infected persons without proper lodging," within the meaning of the Public Health Act, one instance may be mentioned in which a girl at 1(5 years, a boy at 19 years, and one younger child, all suffering from Scarlet Fever, were confined in one small room. "I have in previous reports pointed out that in a large number, perhaps the majority of houses in this district, it is impossible to isolate satisfactorily an infectious case, for the house is fully occupied oy the family renting it, or when there is spare accommodation it is let to lodgers, and that there are a considerable number of houses let to two or more families, an arrangement which unfortunately seems on the increase. Moreover, in a large proportion of instances, the mistress of the house has to nurse the patient, and perforin all other household duties. "A well equipped and well managed Isolation Hospital would do much to prevent the spread of infectious disease, particularly Scarlet Fever, in the district it would diminish the number of secondary cases, and the multiplicity of infected articles, which it is not possible to adequately disinfect, and it must be remembered that wnen several cases of Scarlet Fever are treated in one house, for the most part in one room, the walls of which are in many instances far from being non-absorbent, the apartment becomes thoroughly imbued with the Scarlet Fever poison, and also that it is very easy for articles of clothing, especially articles belonging to those attending on the patients, to be exposed to the contagion and to escape disinfection altogether. It is well known that the virus of Scarlet Fever may lie dormant in infected articles, and after long periods give rise to fresh cases of the disease. Some instances have occurred in which Scarlet Fever has occurred in different families occupying the same house in successive years, without other obvious source of contagion. "An Isolation Hospital would also provide the Board with a means of promptly dealing with infected persons without proper lodgings, a want that has on several occasions been much felt; and would further tend considerably to diminish the number of infected houses and consequent possible centres of infection. "It cannot be expected however, that it would wholly prevent the spread of Scarlet Fever, for it would have no influence over one potent source of its extension, viz.: those cases in which the disease is of a mild type and in which the parents do not consider medical advice necessary and allow the child after one or two days to mix freely with others, careless alike of the risks run by their own children and of the danger to others. ADDISON HOUSE, UPPER EDMONTON. Dear Sir, In reply to your renewed application for a copy of my annual report as M. O. H. for Edmonton for 1893, I rep-ret to say that I have not a copy as the reports are not printed I will endeavour to obtain one for you it you will pay the cost of Type-writing the same; my report for 1894 is in preparation and when copies are made I will obtain one for you but the report for 1893 has passed out of my possession, Yours faithfully, Charles D. Green. 11 notified as suffering from this disease. The notification of Erysipelas in my opinion serves no useful purpose. measles. This disease was epidemic in the district principally in April and May, but cases came to my knowledge as late as September. Twelve deaths wereattributed to it during the year, but I can give no figures as to the total number of cases, as it is not notifiable. My experience has been that an outbreak has occurred about every three-and-a-half years. whooping cough Was also prevalent, 17 deaths having been attributed to it in the district, and 4 in the Edmonton Workhouse. hospital accommodation for infectious diseases. The year has not been an absolutely barren one as regards this important question, for an arrangement has been effected with the Enfield Sanitary Authority by which we are able to send cases of Scarlet Fever to their Isolation Hospital provided they have beds to spare, on payment of a fixed charge per week for each case. This has been found of material assistance, and five cases were sent thither, but under it delay is unavoidable, and it is wholly insufficient to meet the permanent needs of the district, and it has already happened that a specially unsuitable case for home treatment could not be received and from this five secondary cases, one of which was fatal, arose, while as regards Enteric Fever and Diphtheria, it leaves the district quite unprovided, and a Small Pox case, for which there is not room at Highgate, may at any time arise. The increasing proportion of cases in which application is made to me for their removal, shews that what has been done in this direction is much appreciated. I would refer to the reports I have on other occasions made on this subject, especially to my annual report for 1893, and to a letter I laid before the Board in Feb., 1891. A proposal was made to utilise the old Local Board Offices for Isolation purposes, in reference to which I made a special report in June, which was unfavourable to the proposal. The matter of Hospital accommodation for cases of infectious disease, is one imperatively demanding the serious consideration of the District Council, as its want is more felt each succeeding year, and at least two of the contiguous districts have already made provision. It is 12 undoubtedly a difficult matter for a small and poor district to provide Hospital accommodation for the various infectious diseases for which such provision is required, and it would be in some respects better were this duty undertaken by a body having a wider administration, but the matter is a pressing one and urgently requires to be met. The measures adopted with regard to Infectious diseases were detailed in my annual report for 1891, to which copies of the various notices served, were attached, and with the exception of the limited extent to which Hospital accommodation has been provided have remained the same. The method of disinfection of infected bedding and clothing is by dry heat, and the use of the apparatus involves much time and labour, as well as consumption of fuel, all of which would be economised by the substitution of a steam disinfection chamber, steam being always available at the pumping station. The Council's ambulance is merely an old carriage, and a properly constructed ambulance is much needed. bake-houses. There are nineteen bake-houses in the district, and they have all been inspected during the year by the Sanitary Inspector and myself; the inspections were made between the hours of six and eight a.m. None of them are situated underground, and in only one is the floor below the level of the footway. The principal defects found were:— 1. Dirty flour stores; in several instances the flour was stored in lofts or outhouses in a dirty and dilapidated condition, the roofs of which were dirty and festooned with cobwebs, which had evidently not been disturbed for long periods. 2. Proximity of stables, for the most part of defective construction and foul and ill-kept. In one instance the stable opened directly into the bake-house, and manure was piled up against the oven walls. The baker, in several instances, appeared to act as stableman and to pass from the stable to the kneading trough without ablution. 3. Defective drains inside the bake-house and proximity of closet to oven. Notice to remedy the defects found has been served in the several cases requiring it, and the necessary works have been executed or are in progress. 4. Neglect of lime-washing. 13 5. Omission to exhibit the notice required by the Factory Act. Potato-mash seems to be an essential ingredient for the manufacture of bread in this district, for I found it in the majority of instances. A record of the conditions fouud has been prepared, and will be kept for future reference. slaughter-houses. There are 7 registered slaughter-houses in the district, inclusive of one knacker's yard; these are with one or two exceptions of old construction, and do not afford adequate and suitable accommodation for the preparation of animal carcases for human food in accordance with the requirements of modern sanitation. They have all been regularly inspected, and are as well kept as their construction will admit, and their occupiers have been willing to comply with the bye-laws and with the suggestion of the Sanitary Authority. One of them is licensed under the Public Health Amendment Act, under which, renewal of the license is required annually, an arrangement which gives the Sanitary Authority greater powers of control. No fresh premises have been licensed during the year and there is no public slaughter-house. cowsheds, dairies, and milk-shops. The new regulations came into force this year, but it has not yet been found practicable to effect any alterations under them; in some instances however, more room has been provided as the result of the distribution of copies thereof. The various premises have been inspected with a view to future action. There are ten registered cowkeepers in the district, five dairymen and sellers of milk who do not carry on other business, and 32 sellers of milk in general shops. These latter are for the most part rather unsatisfactory, and the conditions under which milk is kept in these small general shops seem to me to be favourable to its deterioration and contamination, and the district being well patrolled by the regular milk vendors, it does not appear to me that they are necessary to the public convenience. offensive trades. None of the scheduled offensive trades are so far as I am aware carried on in the district, but considerable nuisanee is occasionally experienced from establishments 14 for the preparation and sale of hot fried fish, of which there are several in the district. One house in the district was closed as unfit for human habitation, and the closure of a terrace of ten houses was threatened; the owner, however, at once put in hand the necessary repairs, and the whole terrace was re-drained and put in habitable repair. The making of certain bye-laws under the Public Health Amendment Act, (sec. 23), would much facilitate the work of the Sanitary Department as regards the matters dealt with by that section. The following table is a statement of the general Sanitary Work done during the year, and is exclusive of work done in connection with new buildings. Summary of Nuisances and other matters reported and work accomplished for the year ending December, 1894. Nature of Complaint. Defective drains repaired and efficiently trapped 51 Obstructed drains cleaned and repaired 73 Sink waste water disconnected from arm of closet pan and made to discharge over proper trap 63 Sink waste water disconnected from surface water drains and connected with the sewer 5 Sink waste water disconnected from main drain and made to discharge over proper trap 5 Water supply disconnected from cistern supplying w.c. and taken direct from main 38 Defective water pipes repaired 20 Water supply laid on to closets 92 New pans supplied to closets 40 Pan and other defective form of closets taken out and new forms substituted 7 Lead " D " traps laken out and new forms substituted ... 5 Soil pipes taken outside and ventilated, full size 3 New ventilators fixed 49 Samples of pump water submitted to Medical Officer for analysis 10 Pump water condemned and New River laid on 5 Cesspools cleansed and filled in 7 Cesspools emptied 9 Defective brickwork, guttering, piping, etc., repaired 95 Filthy houses cleansed and whitewashed 25 Yards and sculleries paved 23 Defective roofs repaired 71 Drains tested with chemical compound and smoke 90 15 Drains (defective) reconstructed 115 Inspection chambers put in for easy access to private drains 51 Dustbins provided 22 Houses overcrowded so as to be a nuisance and injurious to health 9 Animals so kept as to be a nuisance 3 Visits to Common Lodging House, midnight and otherwise (only one in the district) 70 Visits to Cowsheds, Dairies, and Slaughterhouses 80 Visits to inspect Bakehouses 38 Visits to remove Gipsies, Settlers, etc. 88 Sundry visits on account of iufectious disease 1 „ „ „ cleansing of rooms 686 „ „ „ disinfection of bedding, etc. Booms cleansed and whitewashed after infectious disease 100 Beddings, etc., disinfected 110 Rooms disinfected 175 Removal of infected persons to Isolation Hospital 8 Compulsory removal of dead body to Mortuary upon Justices' Order 2 Visits to look up work after notices served 560 Houses inspected 303 Carcases of animals removed from brooks, waste land, etc. 23 Quantities of fish „ „ „ „ 5 Notices, verbal and otherwise, to remove manure deposits 10 Three trunks of haddocks (about 180 lbs. fish) seized and condemned, conviction gained 3 Total 3,254 This table is exclusive of any work done in connection with Canal Boats Acts and New Buildings. canal boats. The work done in respect of these is not included in the foregoing table, and may be briefly summarised as follows:— 78 were inspected and, speaking generally, found clean and healthy. Nine contraventions were found, of which eight were remedied. No case of disease was reported, and no boats are registered in this district. water supply. Ten samples of well water were submitted to me for analysis during the year, of which five were condemned on chemical evidence. In one instance the Board were obliged to resort to legal proceedings to enforce compliance with their requirements, and were successful in their action. 16 drainage and sewerage, All new drains are now made to stand the water test before they are passed. A considerable amount of drainage work has been done during the year to remedy defects found in the course of house inspection, but much difficulty is experienced in following up notices, owing to insufficiency of staff. The sewers of certain streets have been relaid under the supervision of your Engineer. Several complaints were received during the year of nuisance from the grid ventilators, but they were not so numerous as in former years. I have the honour to be, Gentlemen, Your obedient servant, CHARLES D. GREEN, M.D. (Lond.) F.R.C.S., (Eng.) Medical Officer of Health. A. TABLE OF DEATHS during the Year 1894, in the Edmonton Urban Sanitary District, classified according to Diseases, Ages, and Localities. Names ok Localities adopted for the purpose of these Statistics ; public institutions being shown as seperate localities. (Columns for Population and Births are in Table B.) Mortality from all Causes, at Subjoined Ages. Mortality from subjoined causes, distinguishing Deaths of Children under Five Years of Age. At all ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. 1 2 3 4 5 6 1 7 1 8 1 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. | Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia Pleurisy. Heart Disease. Injuries. All other Diseases. . Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a) (b) (c) (d) (f) (g) (h) (i) (i) Edmonton District 349 119 67 29 8 75 51 Under 5 5 upwds. - - 17 1 - - - - - - - 11 17 27 1 - 5 40 1 2 64 186 — 3 5 — - 5 — — — - — — 1 2 — 24 26 13 11 74 164 Edmonton Union 144 11 6 2 4 60 61 Under 5 5 upwds. - - - - - - - - - - - - 4 1 — — — 2 - - 10 17 — — — — — 2 — — — — i — — 1 1 — 22 10 12 — 78 127 Strand Union (including Schools) ... 91 7 4 1 — 29 50 Under 5 5 upwds. — - - - - - - - - - - - - - - - - 1 - - 9 11 - - - - - - - - - - - - - - - - 10 20 — — 50 80 Totals 584 137 77 32 12 164 162 Under 5 5 upwds. —' — 17 1 12 21 28 1 — 5 43 1 2 83 214 — 3 5 — 7 — — — - i — — 2 3 - 56 56 25 11 202 371 The subjoined numbers have also to be taken into account in judging of the above records of mortality. Deaths occuring outside the district among persons belonging thereto. 22 — 3 3 2 11 3 Under 5 5 upwds. - - - - - - - - - - - - - - - - - 2 - - 1 3 - - - - - - - - - - - - - - - - 1 - 1 1 16 19 Deaths occuring within the district among persons not belonging thereto. 91 7 4 1 — 29 50 Under 5 5 upwds. - - - - - - - - - - - 1 - - - - - 1 - - 9 11 - - - - - - - - - - - - - - - - 10 20 - — 50 80 B. TABLE OF POPULATION, BIRTHS, AND THE NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, during the year 1894, in the Edmonton Urban Sanitary District ; classified according to Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics ; Public Institutions being shown as separate localities. Population at all Ages. Registered Births. Aged under 5 or over 5. New Cases of Sickness in each Locality, coming to the knowledge of the Medical Officer of Health. Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospital. Census 1891. Estimtd. to middle of 1894. 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11 Smallpox. Scarlatina. Diphtheria Membranous Croup. Typhus. Enteric or Typhoid. Fevers. Puerperal. Cholera Erysipelas. Smallpox. Scarlatina. Diphtheria Membranous Croup. Fevers . Cholera. Erysipelas. Continued. Relapsing. Tyyhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a.) (b.) (c.) (d.) (e.) Edmonton District 23,473 28,419 847 Under 5. - 19 18 1 - - - - - - - - - - - - - - - - - - 5 upwds. 1 79 33 — — 25 — — 2 — 40 1 5 - - - - - - - - - Edmonton Union 561 615 53 Under 5 - - - - - - - - - - - - - - - - - - - - - - 5 upwds. - - - - - 2 - - - - 3 - - - - - - - - - - - Strand Union (including Schools) 1,346 1,474 6 Under 5. - - - - - - - - - - - - - - - - - - - - - - 5 upwds. - 2 - - - - - - - - 10 - - - - - - - - - - - Total 25,380 30,508 906 Under 5. - 21 18 1 - - - - - - - - 1 - - - - - - - - - 5 upwds. 1 79 33 — — 27 - - 2 - 53 1 5 - - - - - - - - - State here whether " Notification of Infectious Disease " is compulsory in the District:—Yes. Since when ?:—March, 1891. State here the name of the Isolation Hospital used by the sick of the District. Mark (H) the Locality in which such Hospital is situated ; and if not within the District, state where it is situated:—None but 5 cases of Scarlet Fever removed to Enfield Isolation Hospital by arrangement, and 1 to North Eastern Fever Hospital. The case of Smallpox to Highgate Smallpox Hospital.