With the Medical Officer of Health's Compliments. Town Hall, Fulham, S. W. Ful 8 Council of Borough of Fulham. ANNUAL REPORT OF THE Medical Officer of Health, J. CHARLES JACKSON. For the Year ending December 31st, 1902. INDEX. page. Accidents, Deaths from 44 Alcoholism, 43 Bacteriological Examinations 48 Bakehouses 51 Births and Birth-rate 6 Cancer, Deaths from 43 Chicken-pox 39 Childbirth, Deaths after 44 Cowsheds 52 Death-rate (corrected) 12 Deaths and Death-rate 8 Deaths at different ages 13 Deaths, Causes of 10 Deaths, Distribution of 9 Diarrhœa 40 Diphtheria 32 ,, in Schools 37 Drainage, Combined 49 ,, House 48 Enteric Fever 37 Enteritis, Deaths from 41 Erysipelas 41 Factory and Workshop Act 50 Food supply 51 Heart, Deaths from Diseases of 44 Housing of the Working Classes Act 55 Ice Creams 52 Illegitimate Children, Births of 8 ,, Deaths of 14 Infants, Deaths of 13 ,, Insurance of 14 Infectious Diseases, Distribution of 17 ,, Isolation of 38 ,, Notification of 16 ,, in Metropolitan Boroughs 75 Influenza, Deaths from 43 Inquests 44 pag£. Marriages 6 Measles 39 Meteorological Conditions and Mortality 60 Midwives Bill 58 Mortuary 47 Phthisis, Deaths from 41 ,, Notification of 43 Public Health (London) Act, Prosecutions under 56 Public Institutions, Deaths in 45 Puerperal Fever 38 Respiratory Diseases, Deaths from 43 Sale of Food and Drugs Acts, Proceedings under 53 Sanitary Staff 59 Sanitary Work 59 Scarlet Fever 31 ,, and Schools 35 Slaughter Houses 59 Small-pox 18 Smoke Abatement 55 Stillborn Children 8 Tubercular Diseases, Deaths from 41 Vaccination and Small-pox 22 ,, Statistics of 30 ,, and Schools 23 Venereal Diseases, Deaths from 43 Whooping Cough, Deaths from 41 Zymotic Diseases, Deaths from 15 Town Hall, Fulham, S.W. To the Mayor, Aldermen and Councillors of the Borough of Fulham. Sir and Gentlemen, I have the honour to present to you my Annual Report on the vital statistics and the conditions affecting the health of the borough for the year 1902. The statistics of births, deaths and infectious diseases, relate to the 53 weeks ending January 3rd, 1903. POPULATION. The population of Fulham as enumerated at the Census taken on April 6th, 1901, was 137,289, having increased from 113,781 during the previous five years. The population in the middle of 1902, as estimated on the assumption that the rate of increase which prevailed between 1896 and 1901 has been continued since, was 143,102, and on that figure the statistics in this report are based. Marriages and Marriage-rate. 1,123 marriages were solemnized in Fulham during the year compared with 1,153, 1,162 and 1,137 in the preceding three years. The marriage-rate, i.e., persons married per 1,000 inhabitants, was 15.3, the rate of the County of London being 17.8, and that of England and Wales, 16.2. Births and Birth-rate. The births registered during the year numbered 4,790— 2,467 males and 2,323 females. There was one birth to every 30 inhabitants, and 100 births of males to 94.2 of females. These births correspond to a birth-rate of 32.9 per 1,000, being the lowest yet recorded in Fulham. The progressive decline in the birth-rate of recent years will be seen or. reference to Table I. 6 TABLE I. VITAL STATISTICS OF WHOLE DISTRICT DURING 1902 AND PREVIOUS YEARS. Year. 1. Population estimated to Middle of each Year. 2. Births. Total Deaths Registered in the District. Total Deaths in Public Institutions in the District. 9. Deaths of Non-residents Registered in Public Institutions in the District. 10. Deaths of Residents Registered in Public Institutions beyond the District. 11. Nett Deaths at all ages belonging to the District. Number. 3. Rate.* 4. Under One Year of Age. At all Ages. Number. 12. Rate.* 13. Number. 5. Rate per 1,000 Births Registered. 6. Number. 7. Rate.* 8. 1892 97,126 3,596 37.0 579 166 2130 21.9 586 357 190 1,963 19.9 1893 101,472 3,711 36.5 659 177 2245 22.1 686 447 226 2,024 19.9 1894 105,884 3,763 35.5 559 149 2105 19.9 707 445 237 1,868 17.6 1895 110,385 3,930 35.7 735 187 2337 21.2 632 360 218 2,195 19.9 1896 115,008 4,068 34.8 710 175 2375 20.6 805 508 186 2,053 17.5 1897 119,550 4,106 34.4 662 161 2240 18.8 679 419 209 2,030 17.0 1898 124,000 4,306 34.7 722 167 2416 19.4 788 475 207 2,148 17.3 1899 128,620 4,574 35.5 862 189 2714 21.1 812 452 235 2,497 19.4 1900 133,496 4,525 33.9 666 146 2498 18.8 698 376 206 2,347 17.7 1901 138,426 4,596 33.2 700 152 2298 16.6 669 367 248 2,179 15.8 Averages for years 1892-1901 117,397 4,118 35.1 686 167 2336 20.0 706 421 216 2,131 18.2 1902 143,102 4,790 32.9 708 148 2587 17.8 766 403 304 2,488 17.1 *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 district or division. The deaths included in Column 12 are the number in Column 7, corrected by the substraction 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 district on account of sickness or infirmity, and dying in public institutions there; and by the term "Residents" is meant persons who have been taken out of the district on account of sickness or infirmity, and have died in public institutions elsewhere. The "Public Institutions" to be 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. Area of District in acres (exclusive of area covered by water), 1,703.5. Total population at all ages 137,249 Number of inhabited houses 18,534 Census at 1901. Average number of persons per house 7.4 7 The birth-rate of the County of London was 28.5, being lower than in any preceding year, and in the three adjoining boroughs the rates were—Kensington, 19.3, Hammersmith 27.5, and Chelsea, 22.4. In the other metropolitan boroughs the rates ranged from 13.1 in the City of London, 17.9 in Westminster, and 18.2 in Hampstead to 34.8 in Bethnal Green, 36.2 in Finsbury, and 38.0 in Stepney. In England and Wales the births were in the proportion of 28.6 annually per 1,000 of the population, and in 76 great towns the birth-rate averaged 30.0 per 1,000. Distribution of Births. The following table gives the number of births and the birth-rate in the various wards. TABLE II. No. of Birth Ward. Males. Females. Total. Birth-rate. Baron's Court 103 116 219 17.5 Lillie 357 327 684 30.4 Walham 169 167 336 25.6 Margravine 396 356 752 42.6 Munster 660 601 1261 40.1 Hurlingham 111 134 245 26.7 Sand's End 468 468 936 36.8 Town 203 154 357 25.7 The Borough 2467 2323 4790 32.9 The birth-rate of Margravine Ward is swollen by the births occurring in the Fulham Infirmary, and of these 161 were the children of women who did not reside prior to their confinement 8 within the borough, and 75 the children of women residing in other wards. Corrected for these, the birth-rate of Margravine Ward was 37.6 and that of the Borough 32.5. Illegitimacy. The illegitimate births were 248 in number, 128 males and 120 females, forming 5.2 per cent. of the total births. Still-born Children. 153 still-born children were buried in Fulham Cemetery, being in the proportion of one still-born child to every 31 living. Excess of Births over Deaths. The natural increase of the population of the Borough by the excess of births over deaths was 2,302, compared with 2,079, 2,178 and 2,417 in the three preceding years. Deaths and Death-rate. The deaths of 2,587 persons, 1,272 males and 1,315 females, were registered in Fulham during the year, but of these, 403, 207 males and 196 females, were of persons not residing in the district who died in public institutions within the Borough, while the deaths of 304 persons—186 males and 118 females— belonging to Fulham occurred outside the district, chiefly in various public institutions. There were, therefore, 2,488 deaths of persons belonging to Fulham—1,251 males and 1,237 females— being at the rate of 17.1 per 1,000 for the year, the rate for males being 18.4 and for females 16.1. 9 Localisation of Deaths. In Table IV. will be found the number and the causes of the deaths occurring in the several wards of the Borough, and the following table gives the death-rate of each ward:— TABLE III. Ward. Death-rate. Baron's Court Ward 13.5 Lillie Ward 16.8 Walham Ward 20.2 Margravine Ward 20.0 Munster Ward 16.3 Hurlingham Ward 14.5 Sands End Ward 18.8 Town Ward 14.3 The death-rate of the County of London was 17.7, and of the three adjoining boroughs that of Kensington was 15.3, of Hammersmith 16.3, and of Chelsea 18.0. The lowest rates in the 28 metropolitan boroughs were 10.8 in Hampstead, 13.4 in Stoke Newington, and 13.5 in Wandsworth; the highest rates were 21.3 in Holborn, 21.4 in Southwark, and 22.9 in Finsbury. The deaths in England and Wales were in the proportion of 16.3 annually per 1,000 living, and in the 76 large towns the death-rate averaged 17.4 per 1,000. TABLE IV. Causes of, and Ages at, Death during Year 1902. Causes of Death. Deaths in or belonging to whole District at subjoined Ages. Deaths in or belonging to Localities (at all Ages). Total Deaths in Public Institutions in the District All ages. Under 1 year. I and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Barons Court Ward. Lillie Ward. Walham Ward. Margravine Ward. Munster Ward. Hurlingham Ward. Sands End Ward. Town Ward. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Small-pox 13 2 1 2 1 7 ... ... 3 ... 5 2 2 1 ... 1 Measles 168 27 135 6 ... ... ... 5 18 29 30 17 8 58 3 13 Scarlet-fever 19 1 13 5 ... ... ... ... 3 2 4 5 1 4 ... 60 Whooping-cough 65 26 37 2 ... ... ... 1 6 7 18 12 5 15 1 13 Diphtheria and membranous croup 51 4 24 21 ... 2 ... 5 8 4 6 16 ... 9 3 92 Croup 1 ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Enteric 9 ... ... 3 2 4 ... 2 ... 2 1 3 ... ... 1 17 Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza 36 2 ... 2 2 16 14 5 5 4 4 6 2 1 9 ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrœha. (See notes)... 129 115 12 ... ... 1 1 4 20 8 24 29 1 37 6 45 Enteritis. (See notes) 18 15 1 ... ... 1 1 1 2 ... 2 5 1 7 ... ... Puerperal fever 3 ... ... ... ... 3 ... ... ... ... ... 3 ... ... ... 3 Erysipelas 4 2 ... ... ... ... 2 ... ... 1 2 ... 1 ... ... 4 Other septic diseases 11 2 ... 1 1 6 1 2 3 ... 1 2 1 1 1 4 Phthisis 201 1 4 4 37 149 6 13 38 26 30 41 13 28 12 102 Other tubercular diseases 88 33 24 18 4 9 ... 6 12 8 7 20 5 18 12 13 Cancer, malignant disease 108 ... ... ... 1 74 33 12 14 9 14 24 8 10 17 29 Bronchitis 245 63 22 1 1 69 89 13. 50 22 36 51 13 38 22 48 Pneumonia 291 92 77 3 12 74 33 17 42 25 36 68 14 76 13 45 Pleurisy 12 1 1 ... ... 8 2 1 ... 1 1 5 1 3 ... 3 Other diseases of Respiratory organs 12 4 2 1 ... 3 2 1 1 1 4 3 ... 1 1 ... Alcoholism 39 ... ... ... ... 35 4 5 10 6 ... 3 5 5 5 8 Cirrhosis of liver; Venereal diseases 23 13 5 ... ... 5 ... 1 5 5 3 4 ... 3 2 9 Premature birth 115 115 ... ... ... ... ... 6 19 11 13 29 4 2.7 6 13 Diseases and accidents of parturition 8 ... ... ... 1 7 ... ... 1 ... 1 4 ... 2 ... 1 Heart diseases 122 6 ... 6 9 67 34 9 22 15 16 23 9 18 10 24 Accidents 79 23 13 9 3 19 12 9 5 9 12 17 6 17 4 18 Suicides 16 ... ... ... ... 14 2 2 2 2 2 3 ... 3 2 3 All other causes 602 161 39 20 18 192 172 49 88 68 82 118 32 98 67 178 All causes 2488 708 411 104 92 765 408 169 377 265 354 513 132 481 197 766 Notes.—(a) In this Table all deaths of "Residents" occurring in public institutions, whether within or without the district, are included with the other deaths in the columns for the several age groups (columns 2-8). They are also, in columns 9-16. included among the deaths in their respective "Localities" according to the previous addresses of the deceased as given by the Registrars. Deaths of "Non-Residents" occurring in public institutions in the district are in like manner excluded from columns 2-8 and 9-16 of this Table. (b) See notes on Table I. as to the meaning of "Residents" and "Non-residents," and as to the "Public Institutions" to be taken into account for the purposes of these Tables. (c) All deaths occurring in public institutions situated within the district, whether of "Residents" or of "Non-Residents," are, in addition to being dealt with as in note (a), entered in the last column of this Table. (a) Under the heading of "Diarrhœa" are to be included deaths_certified as from diarrhœa, alone or in combination with some other cause of ill-defined nature ; and also deaths certified as from Epidemic enteritis; Zymotic enteritis; Epidemic diarrhœa. Summer diarrhœa Dysentery and dysenteric diarrhœa; Choleraic diarrhœa, cholera, cholera nostras (in the absence of Asiatic cholera). Under the heading of "Enteritis" are included those certified as from Gastro-enteritis, Muco-enteritis, and Gastric catarrh, unless from information obtained by enquiry from the certifying practitioner or otherw:se, the Medical Officer of Health should have reason for including such deaths, especially those of infants, under the specific term "Diarrhœa." Deaths from diarrhœa secondary to some other well-defined disease are included under the latter. 12 Corrected Death-rate. The Medical Officer of Health of the County of London has published a factor for correction for differences in the age and sex constitution of the population, for each of the sanitary areas of London, based upon the age and sex constitution of the respective populations, as enumerated at the census of 1901. The following table gives the crude and corrected deathrates per 1,000 persons living, in Fulham, the adjoining boroughs and the County of London. TABLE V. Crude Death-rate, 1902. Corrected Death-rate, 1902. Fulham 17.1 17.9 Kensington 15.3 16.3 Hammersmith 16.3 17.0 Chelsea 18.0 17.4 County of London 17.7 18.6 Mortality in former years. The following table gives the death-rates of Fulham and of London, uncorrected for age and sex distribution, during the previous 10 years :— TABLE VI. Fulham Death-rate per 1,000. London Death-rate per 1,000. 1892 19.9 20.3 1893 19.9 21.0 1894 17.6 17.4 1895 19.9 19.5 1896 17.5 18.2 1897 17.0 17.8 1898 17.3 18.5 1899 19.4 19.6 1900 17.6 18.6 1901 15.8 17.1 Average of 10 years) 1892-1901 18.2 18.8 1902 17.1 17.7 The difference between the rate for 1902 and the mean of the preceding 10 years represents in Fulham a saving of 160 lives. 13 Mortality at different Ages. Infantile Mortality.—Of the 2,488 deaths registered, 708 or 28.3 per cent, were of infants under one year of age, and the rate of infant mortality measured by the proportion of deaths under one year to births registered was equal to 148 per 1,000. The corresponding rate of the County of London was 139 per 1,000, the rates in the various boroughs ranging from 87 in Hampstead, 107 in Marylebone and 115 in Stoke Newington to 155 in Bethnal Green and in Bermondsey, 166 in Southwark and 174 in Shoreditch. TABLE VII. The rates in the several wards were:- Deaths of Infants under one year of age to 1,000 births. Baron's Court Ward 137 Lillie Ward 165 Walham Ward 170 Margravine Ward 136 Munster Ward 134 Hurlingham Ward 100 Sands End Ward 184 Town Ward 107 The following Table gives the infantile mortality in London, Fulham and the adjoining boroughs for the preceding ten years:— TABLE VIII. Deaths under One Year per 1,000 Births. Mean of 10 years. 1892. 1893. 1894. 1895. 1896. 1897. 1898. 1899. 1900. 1901. 18921901. 1902. Fulham 166 177 149 187 176 161 167 189 146 152 167 148 Hammersmith 167 160 147 182 179 171 183 183 162 168 170 143 Kensington 159 169 173 175 178 166 181 180 180 163 172 149 Chelsea 164 158 131 155 169 161 176 164 149 138 157 145 London 154 164 143 165 161 159 166 166 158 148 158 139 14 Between the age of one and five years 411 deaths were recorded, so that the deaths of children under the age of five years numbered 1,119, or 45 per cent. of the total number of deaths. These deaths were equal to an annual rate of 59.1 per 1,000 of the population estimated to be living at that age. Deaths of Illegitimate Children. 95 of the children who died before attaining the age of one year were illegitimate, the mortality among them being in the proportion of 383 deaths to every 1,000 births, or more than twice as heavy as that of children born in wedlock. Insurance of Infants. Certificates under the Friendly Societies' Acts were issued in respect of 554 children under the age of 5 years, upwards of 49 per cent, of the children dying at this age being insured. Mortality at School Age. At the age of 5 to 15 years, which is approximately the school period of life, there were 104 deaths or 4.2 per cent, of those at all ages, being equivalent to a rate of 3.5 per 1,000 of those living at that age. Mortality at Adolescence. Between the ages of 15 and 25 years, 92 deaths or 3.7 per per cent, of the total number were recorded, the rate of mortality being 3.9 per 1,000. Mortality at Maturity. 765 or 30.8 per cent. of the deaths occurred between the ages of 25 and 65, the mortality at this age period being at the rate of 11.6 per 1,000. Mortality at Decline. At the age of 65 and upwards there were 408 deaths, or 16.5 per cent. of those at all ages, corresponding to a death-rate of 85.0 per 1,000. 15 Deaths and Death-rate from Zymotic Diseases. 454 deaths were due to the seven principal Zymotic diseases, viz.:— TABLE IX. Small-pox 13 Measles 168 Scarlet Fever 19 Whooping Cough 65 Diphtheria 51 Enteric Fever 9 Diarrhœa 129 454 These deaths correspond to a death-rate per 1,000 living of 3.13. Distribution of Deaths from Zymotic Disease. The following table gives the death-rate in each ward from the several zymotic diseases :— TABLE X. Deaths from the seven principal Zymotic diseases per 1,000 of the population. Smallpox. Measles. Scarlet Fever. Diphtheria. ing Cough. Enteric Fever. Diarrhœa. Total. Baron's Court Ward 0.00 0.40 0.00 0.40 0.08 0.13 0.32 1.33 Lillie Ward 0.13 0.80 0.13 0.36 0.27 0.00 0.90 2.59 Walham Ward 0.00 2.13 0.14 0.23 0.53 0.14 0.61 3.78 Margravine Ward 0.28 1.81 0.23 0.34 1.02 0.06 1.38 5.12 Munster Ward 0.07 0.45 0.13 0.51 0.38 0.09 0.92 2.55 Hurlingham Ward 0.22 0.87 0.11 0.00 0.55 0.00 0.11 1.86 Sand's End Ward 0.04 2.29 0.20 0.36 0.59 0.00 1.45 4.93 Town Ward 0.00 0.28 0.00 0.22 0.07 0.07 0.43 1.07 The Borough 0.09 1.16 0.13 0.35 0.45 0.06 0.89 3.13 The death-rate from Zymotic diseases in the County of London was 2.21 per 1,000, ranging from 0.81 in Hampstead, 1.17 in Stoke Newington, and 1.28 in Westminster, to 3.18 in Finsbury, 3.31 in Stepney, and 5.53 in Shoreditch. In the 76 large towns, the rate averaged 2.12 per 1,000. 16 During the past 10 years the deaths and death-rates from the seven principal Zymotic diseases have been as under:— TABLE XI. Year. Deaths. Death-rate. 1892 448 4.6 1893 344 3.3 1894 426 4.0 1895 345 3.1 1896 422 3.6 1897 360 3.0 1898 396 3.2 1899 423 3.3 1900 397 2.9 1901 387 2.8 Average for 10 years 395 3.3 Sickness and Deaths from Notifiable Infections Diseases. The following table gives the number of cases of infectious diseases notified in Fulham since 1890, when compulsory notification came into force, excluding duplicate notifications:— TABLE XII. 1890 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 Small-pox — — 3 32 40 2 2 — — 1 9 16 94 Scarlet Fever 286 118 517 701 529 339 627 759 811 847 552 600 552 Diphtheria 70 69 96 230 329 368 341 378 465 514 630 636 417 Membranous Croup 23 13 15 20 13 18 14 10 11 14 11 8 12 Enteric Fever 72 51 41 58 37 57 53 53 71 111 92 133 74 Continued Fever — — — 6 2 3 5 5 1 1 2 1 — Typhus Fever 2 3 — 1 — — — — — — — — — Cholera — — — 5 — — 2 1 — 4 — 1 — Puerperal Fever 6 6 10 18 10 6 6 14 8 13 9 7 7 Erysipelas 114 67 104 153 113 94 99 134 121 178 154 132 121 Chicken-pox — — — — — — — — — — — — 473 Totals 573 327 786 1124 1073 887 1149 1354 1488 1683 1459 1534 1750 Distribution of cases of notifiable infectious diseases. Table XIII, gives the actual number of cases of infectious diseases notified, and Table XIV. the number of cases notified per 10,000 of the population in each Ward. 17 TABLE XIII. Cases of Infections Disease notified during the year 1902. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Locality. No. of Cases removed to Hospital from each Locality. At all Ages. At Ages—Years. 65 and upwards. Barons Court Ward. Lillie Ward. Walham Ward. Margravine Ward. Munster Ward. Hurlingham Ward. Sands End Ward. Town Ward. Fulham Infirmary and Workhouse. Barons Court Ward. Lillie Ward. Walham Ward. Margravine Ward. Munster Ward. Hurlingham Ward. Sands End Ward. Town Ward. Fulham Infirmary and Workhouse Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. Small-pox 94 2 3 19 17 53 — 8 13 3 12 21 9 23 4 1 8 13 3 12 21 8 23 4 1 Cholera — — — — — — — — — — — — — — — — — — — — — — — — — Diphtheria 417 7 141 201 34 34 — 26 51 22 36 141 17 90 22 12 19 49 20 30 127 12 78 14 10 Membranous Croup 12 3 6 3 — — — — — — 4 7 — 1 — — — — — 1 6 — 1 — — Erysipelas 121 6 3 8 9 79 16 6 18 12 14 27 7 19 6 12 — — — — — — — — — Scarlet Fever 552 5 202 286 41 18 — 22 56 22 94 92 24 206 36 — 13 49 17 82 89 14 191 19 — Typhus Fever — — — — — — — — — — — — — — — — — — — — — — — — — Enteric Fever 74 — 3 22 19 30 — 4 16 2 14 17 2 14 5 — 2 12 2 1 11 2 10 3 — Relapsing Fever — — — — — — — — — — — — — — — — — — — — — — — — — Continued Fever — — — — — — — — — — — — — — — — — — — — — — — — — Puerperal Fever 7 — — — — 7 — — 1 1 1 4 — — — — — — — — — — — — — Plague — — — — — — — — — — — — — — — — — — — — — — — — — Chicken-pox 473 48 207 201 11 6 — 20 56 42 109 85 37 97 22 6 — — — — — — — — — Totals 1750 71 565 740 131 227 16 86 211 104 284 393 96 450 95 31 42 123 42 136 254 36 203 40 11 18 TABLE XIV. Cases of Infectious Diseases notified per 10,000 inhabitants. Small-pox. Scarlet Fever. Diphtheria & Membranous Croup. Enteric Fever. Erysipelas Puerperal Fever. Chickenpox. Total. Barons Court Ward 6.4 17.5 21.2 3.2 4.9 0.0 15.9 70.1 Lillie Ward 5.8 24.9 22.7 7.2 8.0 0.5 25.0 94.1 Walham Ward 2.3 16.8 16.7 1.5 9.1 0.8 31.9 79.1 Margravine Ward 6.8 53.1 22.6 8.0 8.0 0.6 61.6 160.7 Munster Ward 6.7 29.3 47.2 5.4 8.6 1.3 27.1 125.6 Hurlingham Ward 9.9 26.4 18.7 2.2 7.7 0.0 40.7 105.6 Sands End Ward 9.0 80.7 35.6 5.5 7.5 0.0 38.1 176.4 Town Ward 2.9 26.0 15.9 3.6 4.4 0.0 15.8 68.6 The Borough 6.5 37.9 29.5 5.1 8.3 0.07 32.5 119.8 SMALL-POX. The epidemic of Small-pox, which commenced in London in August, 1901, continued throughout the first eight months of the year, attaining its maximum prevalence in March, and then rapidly declining, till it had practically ceased by the beginning of September. In Fulham, during 1902, 94 cases were notified, making a total during the epidemic of 109, or 7.4 cases per 10,000 of the population. In London, 7,783 cases were notified in 1902 and 4,466 in 1901, the attack rate being 20.6 per 10,000 inhabitants, the rates in the various boroughs ranging from 3.1 in Hampstead, 5.9 in Chelsea and Wandsworth, 6.3 in Kensington, 7.4 in Fulham and 7.5 in Lewisham to 30.3 in Finsbury, 38.9 in Shoreditch, 40.3 in Poplar, 42.3 in Bethnal Green, 51.3 in Stepney and 73.1 in Holborn. CHART SHEWING WEEK BY WEEK THE NUMBER OF CASES OF ENTERIC FEVER & SMALL POX. Notified by Medical Practitioners as haing occurred in the 53 Weeks ending January 3rd 1903. Enteric Fever 1902. Small -Pox 1902 . G.Pite & C° Ltd Lower Clapton N.E 19 Sources of Infection.—Table XV. gives brief particulars of the known sources of infection of all the cases notified which may be classified as under:— Infected by notified cases occurring within the Boiough 28 Infected by unrecognised cases within the Borough 13 Infected by cases occurring outside the Borough 15 Source of infection not known 38 94 Of the cases giving rise to secondary attacks, the following are the most noteworthy:— On January 16th, I was asked to see a woman and her child residing in Reporton Boad, whom I found suffering from Small-pox and on making enquiries found that they had both been in the habit of visiting the adjoining house in which a woman (Mrs.B.) died, on December 30th, from, as returned at the inquest, Peritonitis, two days after confinement, but I ascertained that this woman's husband (J.B.) had been, about November 29th, in the company of W.N., a plasterer, residing at Bowton House, who, as mentioned in the report for 1901, had been working in Fulham while suffering from Small-pox, and had infected 10 persons. J.B. fell ill about December 10th, had a rash and was attended by a medical practitioner, who considered him to be suffering from Acne. His wife was taken ill on December 30th, was confined on December 31st, and died on January 2nd, doubtless from Small-pox, and her baby was taken to a house in Sherbrooke Boad, died there on January 8th from unrecognised Small-pox, and gave rise to 4 other cases in that house. The succession of cases to which W.N. gave rise were as under:— '20 21 On March 19th, two children attending the same class at Hugon Road School, both unvaccinated, were notified with Small-pox, and on the following day I was asked to see a man in Townmead Road who was suffering from Small-pox, and, on examining the other members of his family, I found a girl of 14 recovering from Small-pox, who had been ill about 3 weeks, but had not been attended by a doctor. This girl's sister, who slept with her, attended the same class in Hugon Road School as the two girls notified on the previous day and had, no doubt, conveyed the infection to them. I made enquiries at Hugon Road School respecting the children in this class and visited those who were absent, and found two of them suffering from modified Small-pox, the illness being in one case of so mild a character that no doctor had been called in, while in the other the nature of the illness had not been recognised. The classroom attended by the children was closed for 14 days and the children living in the same houses with the children in that class were excluded from school during the same period, and kept under observation. No further cases, however, arose among the Hugon Road School children, but, in all, 11 cases resulted from the girl in Townmead Road. Fatality.—Of the 94 cases notified in 1902, 12 proved fatal, while the death of a parishioner of Fulham, from Small-pox, occurred in Dartford Asylum, so that 13 deaths of persons belonging to Fulham were registered as due to this disease in 1902. In addition to these, as stated, two deaths ascribed to other diseases were really due to Small-pox. With the exception of a baby 4 weeks old, who died within a few hours of the appearance of the rash, all the notified cases were removed to the Metropolitan Asylum Board's Hospitals. Five families were accommodated at the Council's Shelter, Townmead Road, during the disinfection of their houses. All known contacts were kept under observation during the incubation period, so that secondary cases were recognised in an early stage of the disease and promptly removed to hospital, 22 The cost to the Council of the epidemic for the maintenance of contacts at the shelter, and compensation for loss of work and destruction of infected articles, amounted to only .£'26 12s. 6d., the disinfection of infected houses, bedding, &c., the supervision of contacts, and other work in connection with the outbreak being carried out by the ordinary staff. Vaccination and Small-pox. The following table gives the number of, and the mortality among, the vaccinated and unvaccinated cases occurring at different age periods during the epidemic :— Vaccinated. Unvaccinated. No. of Cases. Deaths. No. of Cases. Deaths. Under 1 year — — 2 2 1—5 years — — 3 1 5—10 years l — 8 1 10—15 years 7 — 4 1 15—25 years 24 — 2 2 25—65 years 58 8 — .— 90 8 19 7 The case mortality of the vaccinated cases was 8.9%, of the unvaccinated 369%, and there was no death among vaccinated persons under the age of 25 years. It will be noticed that among vaccinated children under the age of 10 years there was only one case, while among unvaccinated children of the same age there were 13 cases with 4 deaths. The vaccination returns show that during the last 10 years 11% of the children born in Fulham have escaped vaccination, so that the incidence rate among the vaccinated children under 10 years was 0.33 per 10,000, among the unvaccinated children of the same age 34.8 per 10,000, or, in other words, if the incidence rate had been the same among vaccinated children under 10 as among the unvaccinated, there would have been 105 cases at that 23 age period instead of one. The average length of detention in hospital of the vaccinated patients who recovered was 28 days of the unvaccinated 65 days. Vaccination of Contacts. All known contacts residing in the Borough were, when willing, at once vaccinated, and no case occurred among those who were vaccinated within 4 days of their exposure to infection, while eleven cases occurred among those who refused to be at once vaccinated. Examination of School Children. The Borough Council, though strongly advised to do so, refused to ask the School Board to grant permission to the Public Vaccinators to examine the arms of children attending Board Schools, whose parents did not object to the examination, with a view to the detection of unvaccinated children, but on their default, the Fulham Board of Guardians made the necessary application to the School Board, and Drs. Appleton and Wells examined the children in their respective districts with the following results :— Number on roll. Number examined. Found unvaccinated. Subsequently vaccinated. North District. Dr. Wells. 9,962 6,034 319 175 South District. Dr. Appleton 11,159 6,813 551 192 Re-vaccination. 9,411 persons were re-vaccinated during the epidemic period by the Public Vaccinators. The re-vaccinations carried out by private medical practitioners cannot, be accurately given, but from what I can learn, numbered about 4,000. 24 25 TABLE XV. NOTIFIED CASES OF SMALLPOX. Cases. Sex. Age. Residence. Date of attack. Date of Removal to Hospital. Probable Source of Infection. Conditions as to Vaccination. Result. 1. W. O. M. 20 Bayonne Road Dec: 27 Dec. 29 Brother removed from same house to hospital on Dec. 16. Refused re-vaccination. Vaccinated in infancy. Recovered. 2. M. C. M. 31 Beryl Road Dec. 25 Dec. 28 ? Died. 3. H. C. M. 35 Oakbury Road Dec. 30 Jan. 2 ? Recovered. 4. E. O. F. 42 Bayonne Road Dec. 31 Jan. 1 Son removed Dec. 16. Refused re-vaccination. „ „ 5. J. A. M. 42 10, Star Road, Church Army House Jan. 4 Jan. 6 ? „ „ 6. H. S. M. 35 „ „ Jan. 7 Jan, 9 ? „ ,, 7. W. H. M. 34 „ „ Jan. 10 Jan.11 ? „ ,, 8. W. A. M. 34 , „ „ Jan. 10 Jan.11 ? „ 9. M. B. F. 38 Tournay Road Jan.8 Jan. 11 Supposed case of Chicken-pox at public house in Notting Hill, where she was in service. „ •• 10. C. W. F. 33 Crefeld Road Jan. 18 Jan. 21 ? „ Died. 11. G. B. M. 8 Reporton Road Jan. 15 Jan. 20 Unrecognised case in next house Unvaccinated Recovered. 12. M. B. F. 40 „ „ Jan. 12 Jan. 20 „ „ Vaccinated in infancy. „ 13. A. J. F. 19 26, Novello Street Jan.18 Jan. 21 ? Unvaccinated „ 14. W. H. M. 35 Fulham Palace Terrace Jan. 18 Jan. 21 ? Vaccinated in infancy. „ 15. J. B. F. 41 Sherbrook Road Jan. 19 Jan. 22 Infant who died in house from unrecognised Small-pox. „ „ 16. G. N. M. 43 Munden Street Jan.25 Jan.28 ? „ 17. E. B. M. 39 Hilmer Street Jan. 23 Jan. 26 Son who had unrecognised at tack Vaccinated in infancy. Recovered 18. W. D. M. 14 Basuto Road Jan. 25 Jan. 28 Father, a porter at St. George's Infirmary, who assisted in removing a case of Small-pox & had a mild unrecognised attack. „ „ 19. T. D. M. 12 „ Jan. 30 Feb. 2 „ „ „ „ 20. F. B. F. 5 Reporton Road Jan. 29 Jan. 30 Cases 11 and 12 Vaccinated Jan. 22, 1903 „ 21. J. B. M. 30 Sherbrook Road Jan. 28 Jan. 31 Infant who died in house from unrecognised Small-pox. Vaccinated in infancy. „ 22. P. R. F. 14 „ Feb. 2 Feb. 3 Case 15. Re-vaccinated Jan. 26, refused at first „ 23. F. B. M. 20 Hatfield Street Jan. 30 Feb. 2 Cases at Holborn Union Workhouse, Shepherdess Walk, where he had been working Vaccinated in infancy. „ 24. H. B. M. 27 Seagrave Road Jan. 31 Feb. 3 Driver of M.A.B. Ambulance Van. Re-vaccinated „ 25. W. D. M. 26 Hazlebury Road Jan. 29 Feb. 3 ? Vaccinated in infancy. „ 26. E. G. M. 23 1 St. Albans Terrace Feb. 6 Feb. 9 Case in Hammersmith mistaken for Chicken-pox. „ „ 27. J. H. M. 30 21, Biscay Road Feb. 8 Feb. 12 „ „ „ Died. 28. S. H. F. 27 „ Feb. 10 Feb. 12 „ „ „ „ 29. R. S. F. 37 Coomer Road Feb. 9 Feb. 12 ? „ Recovered 30. H. S. F. 40 „ Feb. 9 Feb. 12 Child of R. S., case 29 Unvaccinated Died. 31. T. D. M. 27 Yeldham Road Feb. 10 Feb. 13 ? Vaccinated in infancy. Recovered 32. J. R. M. 48 Sherbrook Road Feb. 13 Feb. 15 Case 22. Refused re-vaccination „ Died. 33. G. L. F. 18 Stamford Road Feb. 17 Feb. 20 Mother, who had unrecognise attack. Vaccinated in infancy. Recovered '26 27 NOTIFIED CASES OF SMALLPOX—continued. Cases. Sex. Age. Residence. Date of attack. Date of Removal to Hospital. Probable Source of Infection. Conditions as to Vaccination Result. 34. J. H. M. 9 Bulosv Road Feb. 18 Feb. 21 ? Unvaccinated Recovered. 35. W. H. M. 30 34, Adeney Road Feb. 17 Feb. 22 ? Vaccinated in infancy. „ 36. G. W. M. 22 76, Adeney Road Feb. 24 Feb. 27 Had been working at Small-pox Hospital, Dartford. „ „ 37. C. S. M. 29 Bronsart Road Mar. 5 Mar. 7 Case 35. Refused to be revaccinated. „ „ 38. A. A. F. 23 Waterford Road Feb. 28 Mar. 23 ? ,, „ 39. C. B. M. 14 Lindt-op Street Mar. 8 Mar. 12 ? Unvaccinated Died. 40. P. B. F. 28 76, Adeney Road Mar. 11 Mar. 13 Case 36. Refused to be re-vaccinated. Vaccinated in infancy. Recovered. 41. I. W. F. 48 73, Adeney Road Mar. 12 Mar. 14 Case 36. Refused to be cinated „ „ 42. B. R. F. 14 60, Townniead Road Feb. 25 (about) Mar. 18 Probably in Battersea. „ „ 43. C. R. M. 25 „ „ Mar. 15 „ Case 42. „ „ 44. E. S. F. 10 18, Dymock Street „ „ Sister of case 42 attending same class in school. Unvaccinated „ 45. E. R. F. 11 Marinefield Road „ „ „ „ „ „ 46. M. W. F. 18 25, Hamble Street Mar. 16 Mar. 19 Case 42 Vaccinated in infancy. „ 47. E. D. F. 5 60, Townniead Road Mar. 18 „ Case 42 Unvaccinated „ 48. J. D. M. 34 „ „ Mar. 17 „ Case 42 Vaccinated in infancy. „ 49. A. K. F. 14 16, Townmead Road Mar. 15 „ By sister of case 41 attending same class in school. „ „ 50. A. H. * F. 10 Isniailia Road Mar. 16 „ „ „ „ „ 51. N. B. F. 13 Lindrop Street Mar. 20 Mar. 22 Case 39 Vaccinated Mar. 13, 1903. Recovered. 52. W. B. M. 44 „ Mar. 23 Mar. 25 Case 39. Refused vaccination at first. Re-vaccinated Mar. 17. „ 53. E. R. F. 17 60, Townmead Road Mar. 25 Mar. 27 Case 42 Re-vaccinated Mar. 19. „ 54. E. B. F. 31 64, Townmead Road „ „ Case 42 Vaccinated in infancy. „ 55. S. W. M.. 50 73, Adeney Road „ „„ Case 36. Refused to be re-vaccinated. „ „ 56. G. B. M.. 29 17, Hamble Street Mar. 31 April 2 Worked at Small-pox hospital. „ „ 57. J. D. F. 44 18, Dymock Street April 1 April 4 Case 44. Refused to be re vaccinated. „ „ 58. C. D. F. 19 31, Dymock Street April 5 April 8 ? „ „ 59. W. H. M. 28 Haldane Flats April 11 April 14 ? „ „ 60. S. L. F. 49 Vera Road April 12 April 15 Daughter who had unrecognised attack. „ „ 61. S. L. F. 19 „ April 13 „ Sister who had unrecognised attack. „ „ 62. H. S. M. 23 Lilyville Road April 12 „ Working at Small-pox hospital. „ „ 63. L. F. F. 39 Lillie Road April 13 April 16 ? „ „ 64. T. S. M. 45 Radipole Road April 14 April 17 ? „ „ 65. A B. M. 38 Disbrowe Road April 24 April 26 ? „ Died. 66. H. B. M. 28 24, Broom house Road April 30 May 2 ? „ Recovered. 67. C. F. M. 35 Danehurst Street May 6 May 9 ? „ „ 68. W. H. M. 54 Biscay Road May 7 „ ? „ „ 69. E. R. M. 18 Crookham Road May 9 May 12 ? „ „ 28 to o NOTIFIED CASES OF SMALL POX—continued. Cases. Sex. Age. Residence. Date of attack. Date of Removal to Hospital. Probable Source of Infection. Conditions as to Vaccination. Result. 70. W. S. M. 7 22, Novello Street May 10 May 15 ? Unvaccinated. Died. 71. W. B. M. 36 Wandsworth Bridge Road May 12 May 16 Case in Marylebone Vaccinated in infancy. Recovered. 72. J. S. M. 23 Molesford Road May 14 May 17 ? „ „ 73. G. S. M. 1 mth. 22, Novello Street May 25 Died Mav 26 Case Vaccinated May 16. Died. 74. J. S. M. 38 Furness Road May 23 May 26 ? „ Recovered. 75. G. S. M. 37 May Street May 25 May 28 ? „ „ 76. G. F. M. 40 26, Estcourt Road „ „ Case in Chelsea „ ,, 77. A. F. F. 41 „ May 28 May 29 „ „ „ 78. F. L. M. 15 Church Path May 29 „ ? „ Died. 79. H. B. F. 47 32, Estcourt Road May 29 June 2 ? Notified as Chicken-pox Vaccinated in infancy. Recovered. 80. T. L. M. 8 Council's Shelter, Church Path June 8 June 9 Case 78 „ „ 81. W. B. M. 19 Church Path June 10 June 12 Case 78. Refused vaccination Unvaccinated. Died. 82. E. B. F. 20 „ June 11 „ „ Vaccinated in infancy. Recovered. 83. B. VV. F. 49 „ „ „ „ „ „ 84. F.C. F. 35 46, Broom house Road June 10 June 14 ? „ ,, 85. P. E. M. 9 Tynemouth Street June 12 June 17 ? Notified as Chicken-pox Unvaccinated. „ 86. C. B. F. 42 Munden Street June 15 „ Case 79. Refused to be re-vaccinated. Vaccinated in infancy. „ 87. W. L. M. 27 Seagrave Road July 16 July 19 ? Vaccinated in infancy. Recovered. 88. M. P. F. 1 Munster Road Sept. 6 Sept. 11 Unrecognised case in adjoining street. Unvaccinated. „ 89. S. P. M. 3 ,, Sept. 8 „ „ „ „ Died. 90. E. P. F. 9 ,, Sept. 9 „ „ „ „ Recovered. 91. E. P. F. 7 ,, Sept. 17 Sept. 18 Case 88 „ „ 92. W. W. M. 57 Casual Ward, Fulham Workhouse Nov. 10 Nov. 13 ? ? „ 93. F. H. M. 40 Cassidy Road Nov. 27 Dec. 1 ? Vaccinated in infancy. „ 94. F. H. M. 3 Greyhound Road Dec. 13 Dec. 17 ? Unvaccinated. „ 30 PRIMARY VACCINATION. The following tables, furnished by Mr. Davies, the Vaccination Officer, give the Vaccination returns for 1901, and for the first six months of 1902, those for the last six months not being yet, complete:— TABLE XVI. Supplemental Return for 1901, for the Borough of Fulham. No. of Births Registered from 1st Jan 1901, to Dec. 31st, 1001. Successfully Vaccinated. Insusceptible of Vaccination. Had Small Pox. Dead. Postponed by Medical Certificate. Removed. Outstanding. Certificates Granted under Clause 2 of the Vaccination Act of 1898. 4,605 3,603 11 — 441 19 469 9 53 Return of Vaccination for the Period from January to June, 1902, for the Borough of Fulham. TABLE XVII. No. of Births Registered from 1st Jan., 1902, to June 30th, 19' 2. Successfully Vaccinated. Insusceptible of Vaccination. Had Small Pox. Dead. Postponed by Medical Certificate. Removed. Outstanding. Certificates Granted under 1Clause 2 of the Vaccination Act of 1898. 2,337 1,842 10 — 198 52 205 9 21 The following table shows the proportion of children who have escaped vaccination during the ten years, 1892-1901:— TABLE XVIII. Ear. Births. Successfully Vaccinated. Insusceptible of Vaccination. Died Unvaccinated. Vaccination postponed. Removed, &c. Certificates Granted under Clause 2 of the Vaccination Act of 1898. Percentage not finally accounted for. 1892 3,518 2,930 14 341 21 212 — 7.0 1893 3,704 2,840 22 459 29 354 — 10.9 1894 3,792 3,068 22 333 46 323 — 10.3 1895 3,951 3,125 19 465 49 293 — 9.1 1896 4,015 3,151 24 434 34 372 — 10.7 1897 4,107 3,341 22 432 42 266 4 8.2 1898 4,311 3,170 23 453 78 497 90 16.2 1899 4,581 3,360 27 615 76 384 66 12.1 1900 4,552 3,445 13 470 65 458 63 13.2 1901 4,605 3,603 11 641 19 478 53 13.5 31 Scear let Fever. Scarlet Fever was slightly less prevalent in Fulbam in 1902 than in 1901, 552 cases being notified as compared with 600 in 1901. The returns for the four quarters were as under :— Cases. Deaths. 1st Quarter 92 5 2nd 108 2 3rd 169 7 4 th 183 5 552 19 It will be noticed 011 reference to the chart that the disease attained its maximum prevalence in the third week of August, a period when, owing to the schools being closed for the summer holiday, it is usually at its lowest. This was largely due to the occurrence of some unrecognised attacks of Scarlet Fever among children sent into the country by the Managers of the Children's Country Holiday Fund. In one instance, a child who was sent to a village in Berkshire developed the disease shortly after his arrival there, having probably been infected before leaving Fulham and communicated it to three other children also from Fulham, but the nature of the illness was not recognised until after their return home when, on the occurrence of several cases in their homes and some neighbouring houses, they were examined and found to be evidently recovering from mild Scarlet Fever. In another instance, a child who had been sent to a village in Middlesex contracted Scarlet Fever while there, but it was not until her return home, and the occurrence there of some secondary cases, that the nature of her illness was recognised. Of the 552 cases, 474, or 85.9 per cent, were removed to hospital. Fatality.—The disease was again of a mild type, there being 19 deaths, representing a case mortality of 3.5 per cent. Return Cases. — 16 cases occurred within 10 days of the return of a child living in the same house from one of the Metropolitan Asylums Board Hospitals, after recovery from a similar attack. 32 Scarlet Fever in Fulham and the adjoining Boroughs. The following table shows the comparative prevalence of Scarlet Fever in Fulham, the adjoining boroughs and London during the last 10 years. TABLE XIX. Number of cases of Scarlet Fever notified per 1,000 of the population. 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 Mean of 10 years, 1892-1901. ###] Fulham 5.5 6.8 4.9 3.0 5.4 6.3 6.5 6.5 4.1 4.3 5.3 3.8 Kensington 4.3 5.6 2.3 3.1 6.0 4.4 2.8 2.6 2.1 2.7 3.6 2.1 Hammersmith 4.6 6.7 3.2 3.6 5.1 3.7 4.3 4.1 3.2 3.1 4.2 3.1 Chelsea 5.0 6.5 3.1 6.6 5.7 4.1 3.5 3.0 2.5 2.6 4.3 2.8 London 6.4 8.6 4.3 4.5 5.8 5.1 3.8 4.0 3.0 4.1 5.0 4.0 Diphtheria. There was a decline of the prevalence of this disease in 1902, 417 cases being notified, and 12 of Membranous Croup, which is identical with Laryngeal Diphtheria, compared with 636 of Diphtheria and 8 of Membranous Croup in 1901, and the incidence rate was the lowest recorded since 1893. The cases occurring in the four quarters of the year were:— Cases. s. 1st Quarter 105 13 2nd ,, 92 8 3rd ,, 91 11 4th ,, 141 19 429 51 Fatality.—The disease was more fatal than in 1901, 51 deaths being recorded, giving a case mortality of 11.9 per cent, as against 7.5 per cent, in the previous year. Chart Shewing Week by Week the Number of Cases of Scarlet Fever. Notified by Medical Praclitioner as having occurred in the Borough of Fulham during the 53 Weeks ending Jaunary 3rd 1903 Scarlet Fever 1902 Scarlet Fever Mean for 9 years 1893-1901 CHART SHEWING WEEK BY WEEK THE NUMBER OF CASES OF DIPHTHERIA & MEMBRANOUS CROUP. Notified by Medical Practitioners as haying occurred in the Borough of f ufham. During the 53 weeks January 3rd 1903. Diphtheria 1902. Diphtheria Mean for 9 Years 1893—1901. 33 365 or 85.1 per cent, of the notified cases were removed to hospital, and of these 45 or 12.4 per cent, died, the fatality of the cases treated at home being 94 per cent. The following table gives the fatality at different age periods of hospital and home cases: — TABLE XX. Cases removed to Hospital. Cases treated at Home. Age. No. of Cases. Deaths. Mortality per cent. No. of Cases. Deaths. Mortality per cent. 0—1 7 2 28.6 3 2 66.6 1—2 22 6 27.3 1 1 100 2—3 26 5 19.3 5 — — 3—4 44 9 20.5 1 — — 4—5 40 3 7.5 8 — — 5—10 135 18 13.4 12 — — 10—15 46 1 2.2 11 2 18.2 15—25 25 — — 9 — — 25—65 20 1 5.0 14 1 7.2 Over 65 — — — — — — 365 45 12.4 64 6 9.4 Comparative prevalence of Diphtheria. Although, as compared with the preceding year, there was a decrease in the amount of diphtheria, the disease was again for the sixth year in succession more prevalent in Fulham than in the adjoining boroughs or in the County of London, and in 3 boroughs only, viz.:—St. Pancras, Wandsworth and Hackney, was the attack rate higher than in Fulham. 34 The comparative prevalence and fatality of diphtlieria during recent years in Fulbam, the adjoining boroughs, and London, will be seen in the two following tables, which give the rates of incidence and mortality of the disease in the several localities. TABLE XXI. Deaths from Diphtheria per 1,000 Inhabitants. 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 Mean of 10 years 18921901. ###] Fulham 0.32 0.63 0.99 0.70 0.66 0.52 0.49 0.45 0.47 0.35 0.56 0.35 Kensington 0.20 0.49 0.46 0.53 0.40 0.47 0.15 0.25 0.16 0.22 0.33 0.11 Hammersmith 0.74 0.53 0.49 0.43 0.49 0.28 0.21 0.23 0.25 0.32 0.40 0.20 Chelsea 0.41 0.54 0.56 0.59 1.17 0.56 0.43 0.27 0.18 0.13 0.49 0.17 London 0.44 0.75 0.61 0.52 0.59 0.50 0.39 0.43 0.34 0.30 0.49 0.25 TABLE XXII. Cases notified per 1,000 Inhabitants. 1892 1893 1894 1895 1806 1897 1898 1899 1900 1901 Mean of 10 years 18921901. 1902 Fulham 1.0 2.2 3.1 3.4 3.0 3.2 3.8 40 4.7 4.7 3.3 2.95 Kensington 1.0 2.1 1.6 2.2 2.1 1.9 1.2 1.5 1.9 1.6 1.7 1.04 Hammersmith 2.7 2.7 1.7 1.8 2.1 1.5 1.5 1.8 2.3 2.0 2.0 1.59 Chelsea 2.2 2.7 2.8 3.6 5.7 3.2 2.0 2.5 2.0 1.5 2.8 1.77 London 1.9 3.0 2.4 2.5 3.1 3.0 2.6 3.0 2.6 2.7 2.7 2.35 School Influences. The following tables give the number of children in actual attendance at each School who were notified in each month as suffering from Scarlet Fever and Diphtheria :— 35 TABLE XXIII. Number of children attending the Board and other primary Schools in Fulham who were notified in each month as suffering from Scarlet Fever. School. Jan. Feb. March. April. May. June. July. August. Sept. Oct. Nov. Dec. Total. Ackmar Road ... ... 1 1 1 ... ... ... 1 ... ... ... 4 All Saints (Denominational) ... ... ... ... ... ... ... ... ... ... ... ... ... BarclayHall(denominational) ... ... ... ... ... ... ... 1 ... ... ... ... 1 Clancarty Road 1 ... 1 1 1 2 1 ... 4 ... 1 6 18 Elizabethan (denominational) ... ... ... ... ... ... ... ... ... ... ... ... ... Everington St. 1 ... 2 1 1 2 4 ... 2 ... 1 ... 14 Fulham Palace Road ... ... ... ... ... ... ... ... 3 ... 2 2 7 Halford Road ... 4 ... ... ... ... ... ... ... 1 1 1 7 Harwood Road 2 ... ... ... ... ... ... ... 1 2 ... 2 7 Holy Cross (Denominational) ... ... ... ... ... ... ... ... ... ... ... ... ... Hugon Road 1 ... 2 ... 9 10 4 ... 3 6 9 ... 44 Kingwood Road ... 2 1 ... ... ... 1 ... 1 3 2 2 12 Langford Road ... 1 2 2 1 1 2 ... 1 1 4 ... 15 Lillie Road ... ... 2 ... ... 1 2 ... 4 5 ... 1 15 Macmurdo Rd. ... ... 2 ... 1 ... ... ... ... ... ... ... 3 Munster Road 3 ... ... 1 ... 1 ... ... 7 1 1 4 18 North End Rd. ... ... ... 5 4 ... ... 1 3 ... ... ... 13 Sherbrooke Rd. 1 ... 1 ... 2 ... 1 2 ... l ... 1 9 St. Dunstan's Road ... 1 1 1 2 l ... 1 5 ... 6 2 20 St. Thomas's Road (Denominational) ... ... ... ... ... ... ... ... ... ... ... ... ... St. John's (Denominational) ... ... 1 ... ... ... ... ... ... ... 2 1 4 Star Road ... ... ... ... ... ... ... ... 1 ... ... ... 1 Townmead Rd. 1 ... ... ... ... 2 1 ... ... l ... ... 5 William Street ... ... 3 1 1 1 ... ... 1 ... ... ... 7 10 8 19 13 23 21 16 5 37 21 29 22 224 36 TABLE XXIV. Number of children attending the Board and other primary Schools who were notified in each month as suffering from Diphtheria. School. Jan. Feb. March. April. May. June. July. August. Sept. Oct. Nov. Dec. Total. Ackmar Road 1 2 1 1 2 1 ... ... ... ... ... 3 11 All Saints (Denominational) ... ... ... ... ... ... ... ... ... ... ... ... ... BarclayHall(denominational) ... ... ... ... ... ... ... ... ... ... 1 3 4 Clancarty Road ... ... ... 1 ... 1 1 1 ... 3 1 2 10 Elizabethan (denominational) ... ... ... ... ... ... ... ... ... ... ... ... ... Everington St 1 ... ... 2 ... 3 1 ... ... ... ... ... 7 Fulham Palace Road ... ... ... ... 1 1 ... ... ... ... 1 ... 3 Halford Road ... ... ... ... ... 1 ... ... ... 2 1 1 5 Harwood Road ... ... ... ... 1 ... ... ... ... 1 1 ... 3 Holy Cross (Denominational) ... ... ... ... ... ... ... ... ... ... ... ... ... Hugon Road 2 2 1 1 1 2 1 ... ... 1 1 ... 12 Kingwood Road ... ... 1 ... ... 2 3 ... 2 6 2 5 21 Langford Road ... ... 1 ... 3 2 3 1 1 ... ... ... 11 Lillie Road ... ... 4 2 3 1 ... ... 1 5 2 2 20 Macmurdo Rd. ... ... ... ... ... ... ... ... ... 1 ... 1 2 Munster Road 2 4 ... 2 ... ... 3 ... 1 ... 3 1 16 North End Rd. ... 1 ... 1 5 ... 1 ... ... 5 1 1 15 Sherbrooke Rd. 1 ... 3 ... ... ... ... ... ... ... ... ... 4 St. Dunstan's Road ... ... 2 ... 1 ... ... ... ...... ... ... 1 4 St. Thomas's Road (Denominational) ... ... ... ... ... 1 ... ... 2 ... ... ... 3 St. John's (Denominational) 3 1 ... ... ... ... ... ... ... ... ... ... 4 Star Road ... ... 1 ... ... ... ... ... ... 3 1 ... 5 Townmead Rd. ... ... ... ... ...... ... ... ... ... ... ... ... ... William Street ... ... ... ... ... ... ... ... 1 ... ... 1 2 10 10 14 10 17 15 13 2 8 27 15 21 162 87 Enteric Fever. There was a notable diminution in the prevalence of Enteric Fever as compared with the preceding year, 74 cases being notified, against 133 in 1901, giving an attack rate of 52 per 10,000 inhabitants against 9.7 in 1901. Renewed attention has been recently called to the causation of Enteric Fever by the consumption of contaminated shellfish, and the Council have urged upon the Local Government Board the necessity for legislation to prevent the laying down of all edible forms of shellfish in sewage-polluted creeks or other dangerous localities and to protect all unpolluted beds from sewage contamination. Last year 5 of the Fulham cases were probably connected with the consumption of shellfish, some form of these having been partaken of at a time which corresponded with the incubation period of Typhoid Fever, while no other source of infection seemed probable. The shellfish in these cases were eaten at Ramsgate (oysters), Brighton and Southend (oysters and cockles), Littlehampton (oysters), Dublin (cockles), and London (oysters). 53 or 72 per cent. of the cases notified were removed to hospital. Fatality. The disease was the cause of 9 deaths, giving a case mortality of 122 per cent., the average for the past 9 years being 19'5 per cent. Comparative Incidence of Enteric Fever in Fulham. The following table shows the incidence of Enteric Fever in Fulham, the adjoining boroughs, and the County of London, during the last ten years:— TABLE XXV. Cases of Enteric Fever notified per 1,000 inhabitants. 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 Mean for 10 years, 1892-1901. 1902 Fulham 0.43 0.56 0.32 0.52 0.46 0.44 0.53 0.84 0.69 0.97 0.58 0.52 Kensington 0.31 0.58 0.58 0.59 0.56 0.62 0.42 0.61 0.61 0.56 0.55 0.45 Hammersmith 0.41 0.65 0.51 0.54 0.49 0.42 0.57 1.01 0.90 0.68 0.62 0.45 Chelsea 0.52 0.77 0.92 0.73 0.68 0.54 0.57 0.60 0.84 0.56 0.68 0.49 London 0.61 0.92 0.53 0.80 0.72 0.70 0.68 1.00 0.97 0.70 0.77 0.74 38 Isolation of patients suffering from Infectious Diseases. Accommodation for persons suffering from Scarlet Fever, Diphtheria, Enteric Fever, Typhus Fever, and Small-pox, is provided by the Managers of the Metropolitan Asylums Board at their various hospitals, and the increasing recognition by the public of the advantages accruing from the isolation of the infectious sick, is shown by the steadily increasing proportion of patients suffering from those diseases who are removed to hospital. TABLE XXVI. Percentage of notified cases in Fulham removed to Isolation Hospitals. Scarlet Fever. Diphtheria. Enteric Fever. Small Pox. 1891 64.4 41.5 37.3 — 1892 75.0 64.0 66.0 100 *1893 63.6 48.0 45.0 97 1894 78.0 70.0 70.0 98 *1895 70.0 74.0 45.6 100 *1896 62.5 60.0 38.0 100 1897 75.0 65.0 41.5 — 1898 79.0 81.1 50.0 — 1899 81.7 81.6 51.0 100 1900 84.0 86.9 72.5 100 1901 85.4 82.0 68.2 94 1902 85.9 85.1 72.0 99 *In these years the accommodation in the Board's hospitals was inadequate, and many patients remained at home who otherwise would have been removed. Puerperal Fever. Seven cases of Puerperal Fever, or 1.4 per 1,000 births were notified, and 3 deaths, or 0 4 per 1,000 births were registered. Erysipelas. During 1902,121 persons were certified to be suffering from Erysipelas, which was the assigned cause of 4 deaths. 39 Chicken-pox. In consequence of the prevalence of Small-pox and the difficulty of distinguishing between Chicken-pox and modified Small-pox, this disease was added to the list of notifiable diseases for a period of one year from February 7th, 1902. 472 cases were notified, and of these, two, a woman of 47 and a boy of 9, were found to be suffering from Small-pox. Deaths from Non-notifiable Infectious Diseases. Measles. 168 deaths were registered, the death-rate from this disease, 1.15 per 1,000, being the highest recorded since 1894, and above that of any Metropolitan borough, excepting Bermondsey. The epidemic ran an unusually protracted course, as it commenced in November, 1901, in Munster Ward, and continued more or less throughout the year, attaining its maximum prevalence in February and March. 79 deaths occurred in the 1st quarter, 45 in the 2nd, 20 in the 3rd, and 24 in the 4th. The disease was most prevalent in Sands End Ward, but all parts of the borough suffered severely. The deaths and the death-rate from Measles during the preceding 10 years are shewn in the following table:— TABLE XXVII. Year. No. of Deaths. Death-rate per 1,000. 1892 128 1.32 1893 12 0.12 1894 160 1.51 1895 50 0.46 1896 101 0.88 1897 50 0.42 1898 59 0.48 1899 68 0.53 1900 80 0.60 1901 38 0.28 1902 168 1.15 The London County Council have recently made an order which conies into force on April 1st, that certain sections of the Public Health (London) Act, 1891, which relate to dangerous 40 infectious diseases, shall apply to Measles. These sections now applied to Measles do not deal with the notification of the disease, but relate to the cleansing and disinfection of infected houses, bedding, etc., by the sanitary authority, the letting of infected houses, the exposure of persons suffering from the disease, and of infected bedding and clothes, the carrying on of any trade or business by an infected person, the conveyance of an infected person in a public vehicle, and the disposal of an infected dead body. As the deaths that occurred from Measles last year probably represented some 4,000 cases, it will be seen that when it is epidemic in the district, although only a certain proportion of the cases will become known to the sanitary authority, a great amount of work in connection with disinfection will be entailed on them. Whooping Cough. 65 deaths were ascribed to Whooping Cough, representing a death-rate of 0 44 per 1,000, the mean rate for the 10 preceding years being 0.52. Influenza. 35 deaths were registered from Influenza, the numbers for the 3 preceding years being 49, 49 and 15. Diarrhœa. The deaths from Diarrhoea which were below the average, owing to the cool and rainy weather prevalent in July and August, number 129, the figures for the 3 preceding years being 183, 156 and 181, while 18 deaths were ascribed to Enteritis as compared with 141, 34 and 27 in the 3 preceding years. But although the mortality from Diarrhœal disorders was lower than usual, it compared very unfavourably with that of the rest of London, the death-rate from it, viz., 0 89 per 1,000 being higher than in any Metropolitan Borough excepting Shoreditch. 41 Of the 147 deaths from Diarrhœa and Enteritis, 130 were of infants under one year of age, the great majority of whom were hand-fed. The Public Health Committee recommended the Council to provide a depot for the sale of Pasteurized milk on similar lines to those that have been opened in St. Helens, Battersea, and other towns, but the Local Government Board informed the Council that they had no power to sanction the expenditure. The following table gives the Diarrhœal death-rate of Fulham, London, and the adjoining boroughs, during the last 10 years. TABLE XXVIII. Deaths from Diarrhœa per 1000 living. 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 Average of 10 yr. 1892-3. 1902 Fulham 0.94 1.30 0.53 1.18 1.15 1.21 1.45 1.40 1.17 1.31 1.16 0.59 Kensington 0.41 0.60 0.33 0.68 0.35 0.70 0.64 0.59 0.62 0.66 0.56 0.45 Hammersmith 0.70 0.79 0.46 0.79 0.80 1.20 1.12 0.93 0.86 1.02 0.87 0.55 Chelsea 0.77 0.76 0.34 0.82 0.67 1.03 0.77 0.66 0.85 0.51 0.72 0.53 London 0.60 0.80 0.41 0.82 0.71 0.92 0.97 0.92 0.80 0.86 0.78 0.53 DEATHS FROM OTHER DISEASES. Tubercular Diseases. From tubercular diseases there were 289 deaths, 201 being due to Phthisis and 88 to other tubercular diseases such as Tubercular Meningitis, Tabes Mesenterica, and General Tuberculosis, and it is probable that many of the deaths ascribed to Marasmus, Debility, Convulsions, etc., were tubercular in nature. 42 In the several Wards of the Borough the death-rates from Phthisis and other tubercular diseases were as under:— Deaths per 1,000 of the population of each Ward from Phthisis and other Tubercular Diseases. TABLE XXIX. Death-rate from Phthisis. Death-rate from other Tubercular Diseases. Death-rate from all Tubercular Diseases. Barons Court Ward 1.04 0.48 1.52 Lillie Ward 1.64 0.54 2.18 Walham Ward 2.05 0.61 2.66 Margravine Ward 1.70 0.40 2.10 Munster Ward 1.34 0.64 1.98 Hurlingham Ward 1.43 0.55 1.98 Sands End Ward 1.21 0.71 1.92 Town Ward 0.87 0.87 1.74 The Borough 1.38 0.61 1.99 The following table gives Phthisis death-rate of Fulham, the adjoining boroughs of London during the preceding 9 years. Table giving the Phthisis death-rate of Fulham, the adjoining boroughs and London for 1902, and the preceding 9 years. TABLE XXX. 1893 1894 1895 1896 1897 1898 1899 1900 1901 Average of 9 yrs. 1893-02. 1902 Fulham 1.51 1.42 1.40 1.66 1.53 1.47 1.83 1.57 1.35 1.53 1.38 Kensington 1.57 1.53 1.49 1.42 1.44 1.26 1.34 1.18 1.36 1.40 1.28 Hammersmith 1.51 1.58 1.56 1.40 1.39 1.48 1.72 1.61 1.42 1.52 1.43 Chelsea 1.75 1.64 1.92 1.82 1.80 1.74 1.79 1.72 1.73 1.77 1.45 London 1.90 1.72 1.77 1.68 1.71 1.72 1.82 1.80 1.65 1.75 1.60 43 Notification of Phthisis. Voluntary notification of phthisis by medical practitioners was begun in Fulham on April 21st, the Council paying the same fees as are paid in respect of cases of infectious diseases notified under the Public Health (London) Act, 1901, viz.:— Two shillings and six pence for each case occurring in private practice; and One shilling for each case in public practice. During the year, 137 cases were notified, 62 occurring in private and 75 in public practice. In 70 cases the rooms, bedding, &c., were disinfected by the Council after the removal or death of the patient. Cancer. Malignant diseases caused 108 deaths, being 9 in excess of the average of the preceding 9 years, allowing for the increase of the population. Diseases of the Respiratory System. From these diseases, excluding phthisis, there were 560 deaths, or 22.5 per cent. of the deaths from all causes, being 20 above the average of the last nine years, allowing for the increase of the population. Alcoholism and Cirrhosis of the Liver. Thirty-nine deaths were attributed to alcoholism or cirrhosis of the liver, and in 12 cases the disease to which death was attributed was stated to have been accelerated by alcohol, though these probably represent but a small proportion of the actual number. Venereal Diseases. Twenty-three deaths were registered from venereal diseases, 18 of which were due to congenital syphilis, but a considerable proportion of other fatal diseases, more particularly those of the nervous system, are due to syphilis. 44 Diseases of the Heart. Heart disease was the assigned cause of 122 deaths, the average for the preceding nine years being 116. Diseases and Accidents of Parturition. Eight deaths were returned as due to diseases and accidents of parturition, and, including the deaths from septicaemia, the total number of deaths reported as occurring within twenty-one days of childbirth was 18, or one death to every 266 births. Deaths from Violence. Different forms of violence caused 95 deaths, viz.:— TABLE XXXI. Accident or Negligence. Falls 26 Run over 11 Drowning 2 Burns or scalds 8 Suffocation of infants in bed 12 Otherwise 17 - 76 Suicides 16 Murder 2 Manslaughter 1 — 19 95 Certification of the Causes of Death. Of the 2,488 deaths registered, 2,271, or 91.3 per cent. were certified by registered medical practitioners, and 216 by the Coroner after inquest, only one death being uncertified. Inquests. At 121 inquests the deaths were returned as due to natural causes, and in 95 to some form of violence. Those due to natural causes may be classified as under:— 45 TABLE XXXII. Zymotic diseases 5 Tubercular „ 10 Respiratory ,, 21 Circulatory ,, 22 Convulsions and other diseases of the nervous system 28 Other diseases 35 121 DEATHS IN PUBLIC INSTITUTIONS. Fulham Infirmary and Workhouse. Although the two boroughs, Fulham and Hammersmith, which formerly constituted the Fulham Union, are now separated for poor law purposes, the poor of Hammersmith are still, by an arrangement between the Boards of Guardians, received into this institution. In 1902 the deaths of 552 persons occurred in the Infirmary and 24 in the Workhouse. Of these 305 were parishioners of Fulham, and 271 belonged to Hammersmith and other districts. Western Fever Hospital. One hundred and ninety deaths occurred in the Western Fever Hospital. Of these 62 belonged to Fulham and 128 to other Metropolitan boroughs. Deaths occurring outside the Borough among persons belonging thereto. The deaths of residents in Fulham in public institutions and elsewhere outside the borough numbered 304, and occurred in the following places:— TABLE XXXIII. St. George's Hospital 71 West London Hospital 43 Charing Cross Hospital 9 St. Mary's Hospital 3 St. Thomas' Hospital 3 Guy's Hospital 1 46 Deaths of residents in Fulham in public institutions— continued. Middlesex Hospital 2 Royal Free Hospital 2 University College Hospital 2 King's College Hospital 1 Westminster Hospital 2 Jubilee Hospital 7 Bolingbroke Hospital 2 St. Bartholomew's Hospital 1 French Hospital 1 Homœopathic Hospital 1 Brompton Hospital 10 Victoria Hospital for Children 14 Great Ormond Street Hospital for Children 1 Hospital for Children, Paddington 1 Cancer Hospital 5 Chelsea Hospital for Women 1 Throat and Ear Hospital, Golden Square 2 ,, „ ,, Gray's Inn Road 1 National Hospital 1 Hospital for Incurables 1 St. Peter's Hospital 1 City of London Hospital for Diseases of Chest 1 Grove Fever Hospital 6 Fountain Fever Hospital 3 Hospital Ships 9 Long Beach Hospital 2 Banstead Asylum 20 Cane Hill Asylum 8 Claybury Asylum 3 Colney Hatch Asylum 4 Dartford Asylum 4 Darenth Asylum 1 Hanwell Asylum 11 Horton Asylum, Epsom 9 Leavesden Asylum 1 Manor Asylum, Epsom 6 Middlesex Asylum 1 47 Deaths of residents in Fulham in public institutions— continued. Kensington Infirmary 1 Chelsea Infirmary 1 Lambeth Infirmary 1 St. George's „ 1 Holborn Workhouse 1 Licensed Victualler's Asylum 1 St. Pelagia's Creche 2 Friedenheim 3 Elsewhere 15 304 Of the 2,488 deaths registered, 649, or 26.1 per cent., took place in public institutions. The percentages in the several classes of institutions in Fulham and London were as follows:— TABLE XXXIV Percentage of total Deaths. Fulham. London. Deaths occurring in Workhouses and Workhouse Infirmaries 12.2 16.6 Deaths occurring in Metropolitan Asylums Board Hospitals 3.3 3.5 Deaths occurring in other Hospitals 7.8 11.4 Deaths occurring in Public Lunatic and Imbecile Asylums 2.8 2.6 26.1 34.1 Public Mortuary. Two hundred and two bodies were removed to the Mortuary during the year, and were admitted as follows :— At the request of the Coroner 180 Brought in by the Police 20 At the request of the Medical Officer of Health 2 202 Inquests were held on 199, and post-mortem examinations were made in 107 of the above cases. 48 Bacteriological Examinations. Increasing use continues to be made by medical practitioners of the facilities afforded by the Council for the bacteriological examination of suspected material as an aid in diagnosis, and 408 specimens were examined compared with 102, 164, 259, and 342 in the four preceding years, the following being the particulars. Material from suspected cases of diphtheria :— No. of Specimens. Klebs Loffler or true diphtheria bacillus isolated 61 Pseudo diphtheria bacillus of Hoffman isolated 16 Negative result 159 - 236 Examinations of blood from suspected cases of enteric fever :— Widal or typhoid reaction obtained 20 „ ,, „ not obtained ... 34 - 54 Examinations of sputa from suspected cases of tuberculosis:— Tubercle bacillus found 42 „ „ not found 76 - 118 408 Drainage of New Buildings. During the year the following plans of proposed new buildings were submitted to and approved by the Public Health Committee:— Houses and shops 372 Blocks of flats 10 Stables 2 Schools 1 Manufactories, &c. 11 396 49 Combined Drainage. Fifty systems of combined drains, for portions of which the Council were liable, owing to their being "sewers" within the meaning of the Metropolis Management Act, were reconstructed during the year at a cost of £879 10s., the work being carried out by a contractor at a schedule of prices. £64 was also paid to owners in respect of work executed by them at 6 houses in compliance with the notices of the Council in connection with house drains which were sewers within the meaning of the Act. An action was brought in the King's Bench Division by Messrs. Silles against the Council to recover the sum of £177, being moneys expended by them in repairing the drains of certain houses in Hazlebury Road and Wandsworth Bridge Road in pursuance of notices served under the Metropolis Local Management Act, Section 85. Each of the houses in question was drained by a separate drain, but the rain water from the roof of an adjoining house was discharged, together with the rain water from the house itself, by means of a common stack pipe over a gulley in the yard connected with the drain. Mr. Justice Wright, who heard the case, after hearing the evidence, held that as regards the question of drain or sewer he was bound by the decision of Mr. Justice Bruce in the case of Holland v. Lazarus that the pipes in question constituted a "sewer," though at the same time he expressed an opinion that there was much to be said with reference to the latter case in a superior court. At some of the houses the work had been done by the owner, on receipt of an intimation from the Sanitary Inspector served in pursuance of Section 3 of the Public Health (London) Act, 1891, bringing under his notice the existence of a nuisance on the premises, and in these cases Mr. Justice Wright held that the plaintiffs were not entitled to recover the amount expended from the Borough Council; but as regards the notices served under Section 85 of the Metropolis Management Act, 1855, he held that there was sufficient compulsion to justify the plaintiffs doing the work, and gave judgment in respect of the claims 50 where those notices had been served in a sum of £'118 2s. 3d. with costs, and directed a stay of proceedings both as regards payment of the amount allowed and costs until after the final issue of the case, strongly intimating that in his opinion the case was a proper one to be carried to the Court of Appeal. The Council instructed their Solicitor to take the opinion of the Court on the decision of the King's Bench Division. Since the above was written, the Appeal of the Borough Council has been heard by Lords Justices Vaughan Williams, Stirling and Matthew, sitting in the Court of Appeal, when they held unanimously that a pipe becomes a "sewer" within the meaning of the Metropolis Local Management Act, 1855, from the point where it receives the rain water of two houses and dismissed the Appeal with costs. Lord Justice Vaughan Williams further expressed his opinion that the stack pipe which conveyed the rain water from the roofs of two houses was a "sewer." The Council have resolved to submit a case for the opinion of Counsel as to the prospects of success in an Appeal to the House of Lords against the decision of the Court of Appeal. FACTORY AND WORKSHOP ACT. The following is a resume of the work done under the Factory and Workshop Act in the Borough. One hundred and seventy-one workshops have been placed on the register, viz.:— Laundries 37 Milliners and dressmakers 50 Bootmakers and repairers 20 Tailors 8 Cycle makers 7 Cabinet makers and upholsterers 10 Plumbers 3 Watchmakers 5 Van builders 2 Wigmakers 3 Builders 5 Locksmiths 2 Various 19 171 51 In connection with those 95 notices have been served, viz.:— Notices requiring cleansing and whitewashing 43 Notices requiring general repairs 4 ,, ,, additional sanitary conveniences 18 Notices relating to defective sanitary fittings 15 Notices relating to defective ventilation 11 ,, requiring the provision of a sufficient water supply 4 95 Arrangements have also been made for the inspection of the kitchens, &c., of the restaurants and coffee houses in the Borough, and 2(5 have been inspected and 9 notices served in respect of them. Appointment of a Female Sanitary Inspector. With the view of exercising more efficient supervision over the laundries and workshops where women are employed, the Council have appointed a Female Sanitary Inspector who will shortly take up her duties. Bakehouses. There are 73 bakehouses now in use in Fulham, of which 53 are underground. The attention of the occupiers of the underground bakehouses has been drawn to the provisions of the Factory and Workshop Act, 1901, that an underground bakehouse shall not be used after January 1st, 1904, unless certified by the Borough Council to be suitable for that purpose, and they have been requested to submit plans and particulars of their bakehouses. The Public Health Committee have laid down certain requirements with which underground bakehouses must comply before the Council will be recommended to grant a certificate, and all the bakehouses, of which the occupiers have applied for certificates and furnished the necessary plans and particulars, are being visited by the Medical Officer of Health, and the applicants then furnished with the details of the necessary alterations. 52 FOOD SUPPLY. Milk. Under the powers transferred to the Borough Council from the County Council by the Local Government Act, 1900, 23 Dairies and Milkshops were registered during the year, and there are now 2G7 on the register which are regularly inspected. Cowsheds. The licenses of the undermentioned Cowsheds were renewed by the London County Council in October, no objection being raised by the Borough Council. PREMISES. LICENSEE 23, Burlington Iioad Thomas Ball. 25, Yanston Place Richard Turvey. 2, Haldane Road William Pettit. Ice Creams. The County Council (General Powers Act, 1002, contains sections dealing with places where Ice Creams or other similar commodities are made or stored, but unfortunately no provision has been made for the registration of these places. These provisions, which came into force on November 1st, 1902, have been brought under the notice of the persons concerned, and arrangements made for the regular inspection of the premises. Six samples of Ice Cream taken from street barrows were submitted to a bacterioscopic examination, and in 5 the Bacillus coli was found, which is indicative of uncleanly preparation. Unsound Food. The stalls or places where food is sold and stored have been regularly inspected throughout the year. Proceedings were taken in two instances for exposing for sale unsound food, and penalties of £5 with £5 5s. costs and £2 with 2s. costs imposed. Three lots of fruit and fifteen of fish examined at the request of the owners were condemned and destroyed. 53 Slaughter Houses. The licenses of the undermentioned houses were renewed by the County Council in October, no objections being raised by by the Borough Council. PREMISES. LICENCEE. 611, Fulham Road J. Cragg. 52, Mehnoth Place R. Lowther. 640, King's Road T. Vaughan. 603, King's Road S. Stone. 105, Hammersmith Road H, Boughton. Proceedings under the Sale of Food and Drugs Act. The following samples were taken for analysis in 1902:— TABLE XXXV. Article. No. of Samples. No. Adulterated. Percentage of Adulteration. Milk 147 15 10.2 Butter 110 1 0.9 Lard 17 ... ... Coffee 9 ... ... Pepper 6 ... ... Whisky 21 ... ... Gin 5 ... ... Brandy 3 ... ... Sandal Wood Oil 6 1 16.6 Milk of Sulphur 6 ... ... Mercury Ointment 7 1 14.3 Eucalyptus Oil 17 ... ... 354 18 5.1 In the three preceding years the percentage of adulterated samples was 13.1, 5 8 and 6 6. One sample was obtained to every 404 persons, the proportion in London, in 1901, being one sample to every 302 persons. 54 Proceedings were instituted by the Council in the following cases:— TABLE XXXVI. Defendant. Offence. Result. Penalty. Costs. H. Toye, 9, Knivet Road Selling milk from which 20 per cent. of its natural fat had been abstracted Convicted £ s. d. £ s. d. 1 0 0 0 12 6 C. Wagner, 14, Rylston Road Selling margarine as butter Convicted 1 10 0 0 12 6 J. Lovelace, 114, Burnthwaite Road Selling milk adulterated with 7 per cent. of added water Convicted 2 0 0 0 12 6 A. H. Sadler, 797, Fulham Rd. Selling milk from which 7 per cent. of its natural fat had been abstracted Dismissed, warranty proved ........ ........ T. Jones, 19, Melmoth Place Selling milk from which 16 per cent. of its natural fat had been abstracted Dismissed, warranty proved ........ ........ A. H. Sadler, 797, Fulham Rd. Selling milk from which 20 per cent. of its natural fat had been abstracted Dismissed, warranty proved ........ ........ W. Lambourn, 134, Estcourt Rd. Selling milk from which 25 per cent. of its natural fat had been abstracted Convicted 0 10 0 0 12 6 C. Over, 41, Greyhound Road Selling milk from which 35 per cent. of its natural fat had been abstracted Convicted 1 0 0 0 12 6 J. Spackman, Wootten Bassett, Wilts. Giving a false warranty in respect of milk certified to have been deprived of 20 per cent. of its original fat. Dismissed ...... ...... 55 Defendant. Offence. Result. Penalty. Costs. W. Denyer, 1, Sussex House Terrace Selling milk adulterated with 104 grains of boric acid to the gallon Convicted £ s. d. £ s. d. 0 10 0 0 12 6 E. Satteley, 135, Dawes Road Selling milk adulterated with 6 per cent. of added water Convicted 1 10 0 0 12 6 J. Seaton, 38, Moore Park Road Selling milk adulterated with 9 per cent. of added water Dismissed, warranty proved. ...... ...... R. Crosse, 157, St. Olafs Rd. Selling milk adulterated with 14 per cent. of added water Convicted 0 10 0 0 12 6 Total £ 8 10 0 5 0 0 Housing of the Working Classes Act. Twenty-five houses represented under Part II. of the Housing of the Working Classes Act as being unfit for human habitation have been repaired by the owners. Instructions have been given by the Public Health Committee to the Borough Surveyor to prepare plans of block dwellings, somewhat similar to those built by the Guinness Trust, to be erected on the vacant land in Townmead Road, now in possession of the Council. Smoke Abatement. Eighteen intimation notices and six statutory notices under the Public Health (London) Act were served in respect of chimneys (not being chimneys of private dwelling houses) sending forth black smoke in such quantity as to be a nuisance. Proceedings were taken against the Earl's Court Exhibition Company for having failed to comply with the Council's notice requiring them to prevent the recurrence of the nuisance. but 56 the summonses were dismissed on the ground that they were not the persons by whose act, default or sufferance, the nuisance arose, as the boilers, &c., were being worked under a contract by Messrs. Davey, Paxon and Co., against whom proceedings were then taken, and they were fined £1 with £10 10s. costs, having in the meantime carried out considerable alterations with the view of abating the nuisance. Proceedings under the Public Health (London) Act, and the Metropolis Local Management Acts, were instituted by the Council in the following cases:— TABLE XXIII. Defendant. Offence. Result. Penalty. Costs. Owner of 11, 13 and 15, Marville Road Failing to comply with the Council's notice to do the necessary work for cleansing, altering or amending the drains. Convicted. £ s. d. £ s. d. 0 15 0 0 6 0 Owner of 19 and 21, Marville Road Do. do. Convicted. 0 10 0 0 4 0 W. Wheeler, 72, New King's Road. Exposing for sale unsound pork. Convicted. 5 0 0 5 5 0 P. Puhl, 95, Blythe Road, W. Repairing a drain so as to be a nuisance. Convicted. 2 0 0 0 12 0 W. Connett, 65, Faroe Rd., W. Do. do. Convicted. 1 0 0 0 2 0 Occupier, Normand Stables Failing to remove manure. Convicted. 0 18 0 0 2 0 57 Defendant. Offence. Result. Penalty. Costs. Owner of vacant land between 42 and 56, Cassidy Road. Premises in such a state as to be a nuisance. Order to abate nuisance and prevent its recurrence by properly fencing in land. £ s. d. £ s. d. ... 0 4 0 Owner of vacant land between 17 and 23, Cassidy Road. Do. Do. Do. ... 0 4 0 London Exhibition Company, Ltd. Ear's Court Smoke nuisance, 7 summonses. Dismissed. ... ... Davy, Paxman and Co. Smoke nuisance at Earl's Court Exhibition, 2 summonses. Convicted. 1 0 0 10 10 0 Owner, 51, Everington Street. Failing to comply with Council's notice to do the necessary work for cleansing, altering or amending the drain. Convicted. 1 0 0 4 4 0 Owner, 149, Lillie Road. Failing to comply with Council's notice to abate nuisance. Convicted. 1 0 0 0 2 0 A. Swinford, 665, Fulham Rd. Exposing for sale unsound beef. Convicted. 2 0 0 0 2 0 £15 2 0 £21 17 0 In 23 other cases in which proceedings had been instituted, the summonses were withdrawn, on the payment of the costs, the works necessary to abate the nuisances having been executed. 58 Midwives Act, 1902. Section 8 of the Midwives Act appoints the London County Council as the local supervising authority for the County of London to carry out the following duties:— 1. To exercise general supervision over all midwives practising within their area in accordance with the rules to be laid down under this Act; 2. To investigate charges of malpractice, negligence or misconduct on the part of any midwife practising within their area, and, should a prima facie case be established, to report the same to the Central Midwives Board; 3. To suspend any midwife from practice, in accordance with the rules under this Act, if such suspension appears necessary in order to prevent the spread of infection; 4. To report at once to the said Board the name of any midwife practising in their area convicted of an offence; 5. During the month of January of each year to supply the Secretary of the Central Midwives Board with the names and addresses of all midwives who, during the preceding year, have notified their intention to practice within their area, and to keep a current copy of the roll of midwives accessible at all times for public inspection; 6. To report at once to the Central Midwives Board the death of any midwife, or any change in the name or address of any midwife in their area, so that the necessary alteration may be made in the roll; 7. To give due notice of the effect of the Act, so far as practicable, to persons at present using the title of midwife. Section 9 empowers the London County Council to delegate all or part of the duties set out above, to the Metropolitan Borough Councils. The Borough Council have informed the London County Council that they are of opinion that the Metropolitan Borough 59 Councils should be entrusted with the carrying out of the provisions of Section 8 of the Midwives Act, and that they are willing to undertake such duties so far as regards their administrative area. Sanitary Staff. Six Sanitary Inspectors are employed by the Borough Council, there being 23,500 inhabitants and 3,180 houses to each inspector, whilst in the County of London there are 15,070 and 1,900 houses to each inspector, and only one Borough, viz., Lambeth, has a proportionally smaller staff than Fulham. Even with the appointment of a Female Sanitary Inspector, which has been resolved upon by the Council, the proportion of inspectors to population will still be below that obtaining in 24 of the 28 boroughs of the metropolis. General Sanitary Work. 1,046 complaints were received and attended to, and 2,223 intimation notices and 820 statutory notices were served in respect of nuisances discovered in the course of house to house inspection and the inspection of houses consequent upon complaints or the existence of infectious disease. In conclusion, I have to thank the members of the staff of the Public Health Department for the faithful and willing assistance they have at all times rendered me. I am, Sir and Gentlemen, Your obedient Servant, J. CHARLES JACKSON, Medical Officer of Health. April, 1903 60 APPENDIX. TABLE A. Giving the Meterological Condition of the 53 Weeks ending January 3rd, 1903, together with the number of Deaths from Certain Diseases and at Certain Ajes. Week ending Mean Temperature. Highest Temperature. Lowest Temperature. Mean Temperature of the earth 3.ft. below surface. Mean height of Barometer. Rainfall in inches. Sunshine in hours. Prevailing Wind. Total Deaths. Deaths under 1 year. Deaths over 60. Deaths from Respiratory Diseases. Deaths from Phthisis. Deaths from Zymotic Diseases exclu ding Diarrhcea. Deaths from Diarrhcea. January 4 48.6 52.5 39.4 43.1 29.6 0.84 8.3 s.s.w 54 12 11 13 1 11 — " 11 45.0 52.5 37.2 44.6 30.2 0.04 1.7 s.w 50 8 13 12 6 5 1 " 18 38.2 48.5 24.7 44.2 30.3 0.00 2.6 N. & S.W 46 9 10 9 7 6 1 " 25 43.3 51.7 27.4 43.5 29.8 0.11 9.8 s.w 42 8 8 9 7 9 — Feb. 1 36.3 47.1 29.2 42.8 29.9 0.20 7.3 s.w.&w 49 13 16 10 4 6 2 " 8 33.9 41.0 30.5 40.8 29.6 0.17 1.1 N.N.E 38 7 12 17 3 5 1 " 15 30.4 37.7 19.0 39.7 29.7 0.03 11.6 S.W.&W 64 13 21 23 2 7 — " 22 33.8 50.2 14..3 38.2 29.9 0.15 15.8 N.E.&S.E 87 19 26 38 5 7 — March 1 44.1 54.1 35.4 39.7 29.4 0.44 14.3 S.E. & S.W 73 17 17 29 2 9 — " 8 41.2 53.6 26.6 39.2 29.8 0.07 8.3 Variable 68 14 18 26 6 7 1 " 15 46.2 56.9 34.3 42.5 29.8 0.57 19.4 Variable 60 18 12 20 5 15 — " 22 46.5 60.0 34.5 43.5 29.6 0.30 25.3 S.W 61 15 12 16 5 12 2 " 29 44.3 59.0 31.3 43.1 29.5 0.41 22.6 S.W. &N.W 72 16 13 18 6 16 — 61 Week ending Mean Temperature. Highest Temperature. Lowest Temperature. Mean Temperature of the earth. 3.ft. below surface. Mean height of Barometer. Rainfall in inches. Sunshine in hours, Prevailing Wind. Total Deaths Deaths under 1year. Deaths over 6o. Deaths from Respiratory Diseases. Deaths from Phthisis. Deaths from Zymotic Diseases excluding Diarrhcea. ; Deaths from Diarrhœa. April 5 45.3 60.5 34.5 44.2 29.7 0.15 23.9 S.W. &N.W 53 12 5 8 8 12 — " 12 41.0 52.3 30.9 44.2 29.9 0.09 12.6 N.N.E 49 9 7 9 6 13 — " 19 49.4 61.4 32.1 44.7 29.7 0.12 25.9 Variable 41 10 6 9 4 7 1 " 26 51.8 65.7 38.2 47.1 29.8 0.06 36.2 S.W. & S.E 45 16 9 12 4 6 1 May 3 46.5 57.3 33.9 48.1 29.7 0.51 45.4 N.E. & S.W 39 7 7 5 4 6 1 " 10 42.3 53.9 34.3 47.3 30.0 0.85 32.5 N.N.W 47 10 12 9 5 4 — " 17 45.0 58.3 29.8 46.7 29.6 0.84 21.7 S.W 41 11 10 7 5 3 — " 24 49.7 67.9 40.2 47.4 29.9 0.57 30.6 N.W. & S.W 41 9 8 5 4 7 — " 31 57.6 71.0 44.0 50.3 29.8 0.56 52.8 Variable 30 8 4 6 2 4 1 June 7 57.6 77.1 46.6 53.2 29.8 0.93 33.1 E.&W. S.W 29 8 2 3 4 3 — " 14 50.2 61.6 41.2 53.5 29.5 1.53 15.1 Variable 32 9 3 5 5 3 2 " 21 55.1 72.8 44.6 53.2 29.7 0.38 27.8 Variable 33 8 3 3 6 2 — " 28 56.3 75.4 45.2 55.4 29.8 0.42 36.4 Variable 38 11 4 4 5 3 1 62 Week ending Mean Temperature. Highest Temperature. Lowest Temperature. Mean Temperature of the earth 3.ft. below surface Mean height of Barometer. Rainfall in inches. Snushine in hours Prevailing Wind. Total Deaths. Deaths under 1 year. Deaths over 6o. Deaths from Respiratory Diseases. Deaths from Phthisis. Deaths from Zymotic Diseases excluding Diarrhcea. Deaths from Diarrhœa. July 5 62.1 80.7 45.2 59.0 29.9 0.58 44.3 Variable 42 15 11 7 2 7 3 " 12 62.8 83.5 42.4 60.6 29.9 0.35 60.4 Variable 38 14 6 2 3 5 3 " 19 61 0 86.1 46.7 61.1 29.9 0.01 71.0 Variable 27 12 3 3 2 2 5 " 26 57.1 74.2 48.5 60.3 29.7 0.21 16.6 S.W 44 10 7 7 2 6 4 August 2 59.1 71.4 42.8 60.0 29.9 0.29 35.6 W.S.W 36 15 2 5 1 4 6 " 9 59.1 73.6 46.7 59.9 29.7 0.44 17.9 S.W 35 17 2 5 . 5 8 " 16 55.5 79.0 45.2 59.3 29.8 0.17 28.1 S.W 43 17 8 8 2 4 5 " 23 60.7 73.9 46.4 59.8 29.8 1 .43 32.6 Variable 41 16 4 5 3 4 7 " 30 60.4 77.0 48.2 59.9 29.7 0.24 37.0 Variable 60 24 10 9 3 7 16 Sept. 6, 60.8 71.9 49.2 60.3 29.7 0.68 34.8 S.W 49 25 7 3 1 5 10 " 13 56.4 70.6 41.2 60.1 29.8 1.45 31.3 Variable 42 19 3 6 2 5 9 " 20 52.9 65.1 36.8 58.4 29.9 0.06 37.2 W.S.W 50 22 5 6 4 4 7 " 27 55.9 75.1 38.3 57.1 30.1 i 0.00 39.0 E S.E. &N.E 45 21 7 5 2 4 10 63 Week ending Mean Temperature. Highest Temperature. Lowest Temperature. Mean Temperature of the earth 3.ft. below surface. Mean height of Barometer. Rainfall in inches. Sunshine in hours. Prevailing Wind. Total Deaths. Deaths under 1 year. Deaths over 6o. Deaths from Respiratory Diseases. Deaths from Phthisis. Deaths from Zymotic Disease excluding Diarrhcea. Deaths from Diarrhœa. Oct. 4 49.1 59.1 41.0 56.2 29.9 0.11 10.8 N.E 41 8 10 6 3 5 4 " 11 51.1 67.1 42.8 54.3 29.6 0.28 10.6 Variable 54 16 10 13 3 5 3 " 18 50.9 61.7 40.4 54.2 29.7 0.62 15.0 Variable 28 7 5 7 1 4 1 " 25 49.9 61.2 32.6 52.8 30.0 0.17 16 .3 S.W 46 8 9 9 7 6 2 Nov. 1 48.6 57.7 36.2 52.3 29.9 0.04 7.1 S.W.&N.W 42 17 8 9 4 4 — " 8 49.5 57.9 40.2 51.5 29.7 0.46 13.5 S.E & S.W 49 7 9 10 4 6 3 " 15 47.4 55.9 34.7 50.9 29.8 0.01 14.5 S.W. & S.E 41 15 10 6 4 6 — " 22 35.4 44.6 27.2 48.7 30.1 0.00 15.6 E 50 21 3 13 5 4 1 " 29 46.0 52.3 36.9 46.6 29.4 0.42 7.0 S.E. & S.W 49 20 5 17 — 8 — Dec. 6 37.2 49.4 25.4 46.8 29.8 0.56 7.9 N.E 48 16 12 18 3 5 1 " 13 36.0 49.8 24.5 43.7 300 0.09 0.1 N.E 52 18 11 14 2 7 1 " 20 42.7 56.7 37.9 44.5 29.9 0.87 6.3 S.W. & N.W 52 14 8 15 5 3 1 " 27 45.5 51.5 35.4 45.8 30.2 0 00 4.1 Variable 55 7 9 12 6 4 2 Jan. 3, 1903 40.8 51.8 29.5 45.0 29.2 0.58 16.4 S.W. 47 10 12 15 3 6 2 64 TABLE B. Showing the localities in which cases of Notifiable Infectious Diseases and Deaths from Measles, Diarrhcea and Phthisis occurred during the year. (The figures in brackets denote the number uf houses in which the cases occurred. The asterisks denote the fatal cases of Notifiable Diseases.) Small-pox. Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Deaths from Measles. Deaths from Diarrhcea. Deaths from Phthisis. Acfold road ... l 1 ... ... ... ... ... ... Ackmar road ... l ... ... ... ... ... ... 1 Adeney road 5(3) 2(1) 1 ... ... ... ... ... ... Aintree street ... 3(1) 1 ... ... 2(2) ... 1 ... Alderville road ... ... ... ... ... ... ... ... ... Allestree road ... ... *3 (3) ... ... ... 2 2 ... Althea street ... 3(3) ... ... ... 2 ... ... Ancill street ... ... 1 ... ... 1 1 3 Anselm road ... 4(4) 2 (2) ... ... ... 2 3 2 Archel road ... 4(3) *3 (3) ... ... ... 1 ... 2 Argon mews ... ... ... ... ... ... 1 ... ... Armadale road ... ... 1 ... ... ... ... ... ... Ashcombe street ... 4 (3) 1 1 ... ... 1 ... ... Ashington road ... ... ... ... ... ... ... ... ... Ashton terrace ... 1 ... ... ... ... ... ... ... Aspenlea road ... 2(2) ... 1 ... ... 1 1 1 Atalanta road ... ... 2(2) ... ... ... ... ... ... Auriol road ... ... 1 ... ... ... ... ... ... Averil street ... 2(2) 3(3) ... ... ... ... ... ... Avon more road ... ... ... ... ... ... ... ... ... Avalon road ... 5(3) 1 1 ... ... ... 2 2 Bagley's lane ... ... *2 (2) ... ... ... 1 ... 1 Barclay road ... 1 3(1) ... ... ... 1 1 ... Barons Court road ... ... 2(2) ... ... ... ... ... ... Barton street ... ... 1 ... ... ... ... ... ... Basuto road 2 (1) ... ... ... ... ... ... ... ... Bayonne road 2(1) 3(3) ... ... ... ... 2 2 2 Beaufort mews ... ... ... ... ... ... ... ... ... Beaumont crescent ... ... ... ... ... ... ... ... ... Bedford place ... ... ... ... ... 1 ... ... ... Beryl road 1 9(6) 1 1 ... 1 ... 2 ... Beltran road ... 4(4) 3(2) ... ... 1 ... ... ... 65  Small.pox. Scarlet Fever. Diphther;a and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Deaths from Measles. Deaths from Diarrhœa. Deaths from Phthis Betteridge road ... ... ... ... ... ... ... ... Biscay road **3(2) 5 (5) 2(2) ... ... 2 l ... Bishop King's road ... 2 ... ... ... ... ... ... Bishop's mews ... ... ... ... ... ... ... ... Bishop's Pk. mansions ... ... ... l ... ... ... ... Bishop's road ... 2(2) 2 (2) ... ... ... l ... Bishop's terrace ... ... ... ... ... ... ... ... Blake road ... ... ... ... ... ... ... ... Bloom Park road ... ... 2 (1) ... ... ... ... ... Bothwell street ... ... 1 ... ... ... ... ... Bovingdon road ... 1 ... l ... ... ... ... Bowerdean street ... 1 2(2) ... ... ... ... ... Bramber road ... 3(1) *4 (4) ... 1 2 ... 2 Brandenburgh road ... 1 ... ... ... 2 l ... Brecon road ... 6 (3) 3(3) ... 2(2) 1 ... 1 Breer street ... 6(6) 4 (4) l ... 1 ... ... Britannia road ... 1 ... ... 1 ... ... ... Broadway ... ... ... ... ... ... ... ... ... Brookville road ... ... 1 ... ... ... l 1 Broomhouse road 2 (2) ... ... ... ... ... ... ... Bronsart road 1 3(3) 10 (8) ... 1 ... 2 3 Broughton road ... 8(7) *5 (3) ... ... 2 2 1 Buer street ... ... ... ... ... ... ... ... Bulow road 1 2(2) *1 ... ... 4 ... ... Burlington road ... 1 1 l ... 1 ... ... Burnfoot avenue ... ... ... ... ... ... ... 1 Burnthwaite road ... 3(3) 1 ... *1 3 1 ... Byam street ... ... 1 ... ... ... ... 1 Branksea street ... 1 3(1) ... ... ... ... ... Bradbourne street ... 1 1 ... ... ... ... ... Cambria street ... 1 ... ... 1 2 2 ... Campbell street ... ... ... ... ... ... ... ... Campana road ... 1 ... ... 2(2) ... ... ... Carlton mews ... ... ... ... ... 1 ... ... Caroline place ... ... ... ... ... ... 2 2 Cassidy road 1 1 2 (1) ... 3(3) 5 1 1 Castletown road ... ... ... ... ... ... ... ... Cedar road ... 1 ... ... ... 4 ... 1 Chaldon road ... 1 ... ... ... ... ... ... Challoner road ... ... ... ... ... ... ... ... Chancellor's road ... 3(3) ... ... ... ... ... 1 Charleville road ... ... ... ... ... ... ... ... Chelmsford street ... ... *1 2(2) 2(2) 1 ... 1 Chesilton road ... 1 1 ... ... ... 2 2 6(5  Small.pox. Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Deaths from Measles. Deaths from Diarrhœa. Deaths from Phthisis. Chesson road ... ... 5(4) ... ... ... l ... 2 Church path *5(1) l ... ... ... l ... ... ... Clancarty road ... l ... ... ... ... 2 ... ... Claxton grove ... 4(4) 5(4) l ... ... 3 l ... Claybrook road ... 4(4) 2(2) l ... l 1 l 1 Clonmel road ... ... ... ... ... ... ... ... ... Colehill lane ... 2(2) 1 ... ... ... ... ... 2 Comeragh mews ... ... 1 ... ... ... ... ... ... Comeragh road ... 1 1 ... ... .... ... ... ... Coniger road ... 2(2) ... ... ... ... ... ... ... Coomer road 2(1) 2(2) 3(3) ... ... ... ... 2 Cornwall street ... ... *1 ... ... ... 2 ... 1 Cortayne road ... ... 4(3) ... ... ... ... ... 1 Crabtree lane ... ... 1 ... ... ... ... ... Cranbury road ... 5(3) 2(2) ... ... l 3 ... 1 Crefeld road *1 ... 1 ... ... ... ... ... 1 Cresford road ... 1 ... ... ... ... 1 l ... Crookham road 1 2(2) 1 ... ... ... ... ... ... Cristowe road ... ... ... ... ... ... ... ... ... Crondace road ... ... ... ... ... ... ... ... 1 Cumberland crescent. ... 1 ... ... ... ... ... ... ... Chiddingstone road... ... 1 2(2) ... ... ... ... ... ... Cloncurry street ... 1 ... ... ... ... ... ... ... Dalebury road ... 1 ... ... ... ... ... ... ... Dancer road ... ... 2(2) ... ... ... ... ... 1 Danehurst street 1 ... 3(3) ... ... l ... ... ... Darlan road ... ... ... ... ... ... 1 ... 1 Dawes road ... . (2) 2(2) ... ... l ... l 1 Dawson street ... ... ... ... ... l ... ... ... Delaford street ... 2(2) 12(8) ... ... ... ... ... 1 Delorme street ... ... 1 ... ... ... 1 ... ... Delvino road ... ... ... ... ... ... ... ... ... De Morgan road ... 1 ... 1 ... ... l 3 ... Devonshire street ... ... ... ... ... ... ... ... ... Dieppe street ... 1 1 ... ... 1 ... ... 1 Dimsdale road ... 1 2(1) ... ... l ... 1 1 Disbrowe road *1 ... 2(1) ... ... ... ... ...... ... Distillery lane ... 3(2) l ... ... ... ... ... Dolby road ... *1 ... ... ... ... ... ... 1 Doria road ... 3(2) 3(3) ... ... ... ... ... ... Dorncliffe road ... 1 1 ... ... ... ... ... ... Dowell mews ... 1 2(2) ... ... ... ... 1 ... Dymock street 3(2) 10(4) 1 ... ... 1 ... ... ... 67  Small.pox. Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Deaths from Measles. Deaths from Diarrhœa. Deaths from Phthisis. Durrell road ... l ... ... ... ... ... ... ... Doneraile street ... l ... ... .... ... ... ... ... Eddiscombe road ... ... 2(2) ... ... ... ... ... ... Eden vale street ... 6(4) 4(4) ... ... ... ... ... ... Edgarley terrace ... ... ... ... ... ... ... l ... Edith road ... l 1 ... ... ... ... ... ... Edith row ... ... 1 ... ... 1 ... .... ... Edith villas ... ... ... ... ... ... ... ... 1 Effie road ... ... ... ... ... ... ... ... ... Elbe street ... 1 ... 1 ... ... ... ... ... Eli mews ... ... ... ... ... ... ... ... ... Eli street ... 1 ... ... ... ... l 1 2 Elmdale street ... *11(7) 3(3) ... ... ... 3 ... 1 Elmstone road ... ... ... ... ... ... ... ... ... Elthiron road ... 1 ... ... ... ... ... ... ... Epirus road ... 2(2) 1 1 ... l 1 ... ... Epple road ... 1 ... ... ... ... ... 1 ... Estcourt road 3(2) 4(4) *5 (5) 1 ... 1 1 ... 3 Eustace road ... 3(3) ... ... ... ... 1 ... ... Everington street ... 5(3) ... ... ... 1 ... ... ... Ewald road ... ... ... 1 ... ... 2 ... 2 Epirus mews ... ... ... ... ... ... ... ... ... Fabian road ... ... ... ... ... 2(2) ... ... ... Factory lane ... ... ... ... ... 1 1 ... ... Fairholme road ... ... 1 ... ... ... ... ... ... Fane street ... ... ... ... ... ... ... ... ... Farm lane ... ... 1 ... ... ... 1 ... 1 Favart road ... 1 ... ... ... ... ... ... ... Felden street ... ... *2(2) ... ... ... ... ... ... Fernhurst road ... 1 1 ... ... ... ... 1 ... Field road ... 3(1) ... ... ... ... ... 3 2 Filmer road ... 1 1 ... 1 ... ... 2 1 Firth gardens ... 1 1 ... ... ... ... ... ... Foskett road ... ... ... ... ... ... ... ... ... Francis street ... 2(1) ... ... ... 1 1 ... ... Friston street ... 2(1) 6(3) ... ... ... 1 2 ... Fulham Palace road 1 2(2) ... ... ... ... ... ... ... Fulham Park gardens ... 1 ... ... ... ... ... 1 ... Fulham Park road ... ... ... ... ... ... ... ... ... Fulham road ... . *7(5) 6(6) *1 ... ... ... ... 3 Furness road 1 4(2) ... ... ... ... 1 1 ... Fitzgeorge avenue ... ... ... ... ... ... ... ... ... 68  Small.pox. Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. lirysipelas. Deaths from Measles. Deaths from Diarrhœa. Deaths from P hthisis Garvan road ... 3(3) ... ... ... *1 2 l 4 Gastein road ... 6(4) ... l ... l ... ... ... George square ... ... ... l ... ... ... ... 1 Gilstead road ... 7(3) l ... ... ... 1 ... 1 Gironde road ... ... l ... ... ... ... ... ... Gledstanes road ... ... ... ... ... ... ... ... ... Gowan avenue ... 1 2(2) ... ... ... ... ... ... Glenrosa street ... ... 3(1) ... ... l 3 ... ... Goodson road ... ... ... ... ... ... 1 ... 1 Greyhound road ... 4 (3) 4(2) ... ... l 2 ... 2 Grimston road ... 1 ... ... ... ... ... ... ... Grove avenue ... 1 *1 ... ... 2(2) 4 ... 3 Grove terrace ... ... ... ... ... ... ... ... ... Guion road ... ... ... ... ... 1 ... ... 1 Gunterstone road ... 1 ... ... ... ... ... ... ... Gwendyr road ... ... ... ... ... ... ... ... ... Haldane road 1 3(2) 1 ... ... ... ... ... 2 Halford road ... 1 ... ... ... 1 ... ... ... H amble street 2(2) 5(3) 2(2) ... ... 1 ... ... 1 Hammersmith road ... 2(2) *2(2) ... ... ... ... ... ... Hannell road ... *2 (2) 3(3) ... ... ... ... ... 3 Harbledown road ... ... ... ... ... ... ... ... ... Hartismere road ... 2(2) 1 ... ... 1 3 ... ... Hartopp avenue ... *4(3) *5(4) ... ... 2(2) ... ... ... Harwood road ... 3(2) 2(2) ... ... ... ... ... 1 Harwood terrace ... ... ... ... ... ... ... ... ... Hatfield street 1 ... 2(1) ... ... ... ... 2 ... Hazlebury road l 6(5) 5(5) ... ... 2(2) ... 1 2 Hestercombe avenue ... ... 1 ... ... ... ... ... ... High street ... ... ... ... ... 2(2) ... 1 1 Hilmer street ... ... *3(2) ... ... ... ... 1 1 Hildyard road ... ... ... ... ... ... ... ... ... Holy port road ... 1 ... ... ... ... ... ... ... Homestead road ... ... ... ... ... ... ... ... 1 Horder road ... 6(5) 2(1) ... ... ... ... ... 1 Hugon road ... 17(8) 1 ... ... ... ... 1 ... Humbolt road ... 1 *2(2) ... ... ... ... 1 1 Hurlingham road ... 3(2) 1 ... ... 1 ... ... ... Hawksmoor street ... ... ... ... ... 1 ... ... ... Imperial cottages ... 2(1) ... ... ... 1 1 ... 1 Imperial road ... ... ... ... ... ... ... ... ... Irene road ... ... ... ... ... ... ... ... 2 Ismailia road l 5(3) ... l ... 2(2) ... ... ... 69  Small.pcx. Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. i Erysipelas. Deaths from Measles. Deaths from Diarrhœa. Deaths from Phthisis. Jerdan place ... ... ... ... ... ... ... ... ... Jervis road ... ... l 1 ... ... l l l John street ... ... ... ... ... ... ... ... ... Kempson road ... ... l ... ... ... ... ... ... Kenneth road ... **2(1) l ... ... ... ... l ... Kilmaine road ... ... ... ... ... l ... l 1 Kimbell gardens ... 2(1) 2(2) ... ... l ... ... ... King's road ... *2 (2) 1 ... ... l ... i 2 Kingwood road ... 7(5) *3(3) ... ... 3(3) ... l 2 Kinnoul road ... 2 (2) 2(2) ... ... ... ... ... ... Knivett road ... ... ... ... ... ... ... ... 1 Kilkee street ... ... 1 ... ... ... ... l 2 Kensington Hall gdns. ... ... ... ... ... ... ... ... ... Lalor street ... ... ... ... ... ... ... ... ... Lambrook terrace ... 2(1) 4(4) ... ... ... ... ... 1 Landridge road ... ... ... ... ... ... ... ... ... Langford road ... ... *1 ... ... 1 1 2 2 Lanfrey place ... 3(3) *1 ... ... ... ... ... ... Laundry road ... 3(2) ... ... ... ... ... ... ... Lawn terrace ... ... ... ... ... ... 1 ... ... Letterstone road ... 1 1 ... ... 1 ... ... ... Lillie road 1 6(5) ***8(8) 3(3) ... 3(3) 3 6 ... Lilyville road 1 2(2) ... ... ... ... ... ... ... Lindrop street *3(1) ... ... ... ... ... 1 ... ... Lintaine grove ... ... 1 ... ... ... ... 2 1 Linver road ... 2(2) ... ... ... ... ... ... ... Lisgar terrace ... ... ... ... ... ... ... ... ... Lodge avenue ... ... ... ... ... ... ... 2 2 Lurgan avenue ... 3(2) 1 ... ... ... ... ... 1 Lysia street ... ... 5(4) ... ... ... ... ... ... Mablethorpe road .. ... 1 2(2) 1 ... ... 1 2 1 Macmurdo road ... ... 1 1 ... 1 ... ... ... Margravine gardens ... ... *1 ... ... 1 ... ... ... Margravine road ... *3(3) 3(3) ... ... ... ... ... 1 Marinefield road l ... *4(1) ... ... ... 1 ... 2 Marville road ... 3(3) 2(2) ... ... ... 1 ... 2 Matherson road ... 1 ... ... ... ... ... ... Maxwell road ... ... ... ... ... ... ... ... ... May street l ... 1 ... ... ... ... ... 4 Melmoth place ... ... ... ... ... ... ... ... 2 Mendora road ... 1 2(2) ... ... ... ... ... 1 Merrington road ... ... ... ... ... ... ... ... 1 70  Small.pox. Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Deaths from Measles. Deaths from Diarrhœa. Deaths from Phthisis. Milton street ... ... ... ... ... ... l l ... Mimosa street ... ... ... ... ... ... ... ... ... Mirabel road ... 2(2) 2(2) ... ... ... ... ... ... Molesford road l ... ... ... ... ... ... ... ... Mooltan street ... ... ... ... ... ... ... ... l Moore Park road ... 1 ... ... ... ... l ... 3 Mornington road ... ... ... ... ... ... ... ... ... Moylan road ... 2(2) 1 ... ... ... ... ... ... Mulgrave road ... ... **4(4) ... ... ... ... ... 2 Mund street ... ... 1 *1 ... ... ... 2 ... Munden place ... ... ... ... ... ... ... ... ... Munden street 2(2) 1 ... ... ... ... l ... 1 Munster road *4(1) 1 *4(4) 2 (2) ... ... ... ... 3 Musard road ... 1 1 1 ... ... ... 1 2 Musgrave crescent ... ... ... ... ... ... ... ... ... Napier avenue ... 3(1) ... ... ... ... ... ... ... Narborough street ... 1 3(1) ... ... ... ... ... ... New King's road ... 5(4) 5(5) 2 (2) ... ... 3 1 1 Niton street ... ... ... ... ... ... ... ... 2 Normand road ... ... 1 1 ... ... ... ... ... Northampton place ... ... 1 ... ... ... ... ... ... North End road ... 3(2) 8(7) ... ... ... ... ... 1 Novello street **3(2) 1 2(1) ... ... ... 3 ... ... Norfolk terrace ... ... ... ... ... ... 1 ... ... Oakbury road 1 4(2) 6(5) ... ... ... ... ... ... Orbain road ... 5(4) *1 ... ... ... 1 3 2 Orchard place ... ... ... ... ... ... ... ... ... Orchard street ... 1 ... ... ... ... ... ... ... Oxberry avenue ... 2(2) 1 1 ... ... ... ... ... Palace terrace ... 2(1) ... ... ... ... ... ... ... Pal liser road ... ... ... ... ... ... ... ... ... Parkville road ... ... ... ... ... ... ... ... ... Parsons Green ... ... 1 ... ... ... ... ... Parsons Green lane ... 4(2) ... *1 ... ... ... 1 ... Parthenia road ... 1 ... ... ... ... ... ... ... Pellant road ... 1 ... ... ... 2(2) ... ... ... Perrymead street ... 1 2(2) ... ... 1 1 ... ... Perham road ... 2(1) ... ... ... ... ... ... ... Peterborough road ... ... 1 ... ... ... ... ... 1 Peterborough villas ... ... ... ... ... ... ... 1 ... Petley road ... ... 1 *1 ... ... ... ... ... Playfair street ... 4(2) *2(2) 2(2) ... ... 3 1 ... 71  Small pox. Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever, Erysipelas. Deaths from Measles. Deaths from Diarrhœa. Deaths from Phthisis. Portland place ... ... ... ... ... ... ... Portland street ... l ... ... ... ... ... l Pownall road ... l l ... ... ... ... 3 Prince of Wales mews ... ... ... ... ... ... ... Protheroe road ... 6(2) 2(2) 3(2) ... ... ... l 1 Purcell crescent ... 1 4(3) 1 ... ... l ... 1 Pursers Cross road ... 4(4) ... ... 1 ... ... 1 Queens Club gardens ... 4(3) ... ... ... ... ... ... Querrin street ... *1 ... 1 2 ... ... Queensmill road ... 1 ... ... 1 ... ... ... Radipole road 1 ... *1 ... ... ... ... ... 2 Racton road ... 1 ... 1 ... ... ... ... ... Rainville street ... 1 ... ... ... ... ... ... ... Ranelagh avenue ... ... ... ... ... ... ... ... ... Rectory road ... ... 2(1) ... ... 1 2 ... 1 Reporton road 3(1) ... 2(2) ... ... l ... ... ... Richmond road ... ... ... ... ... ... ... ... ... Rickett street ... ... 1 ... ... 1 1 ... ... Rigault road ... 1 ... 1 ... ... ... ... ... Ringmer avenue ... 1 1 ... ... ... ... ... ... Rock avenue ... *1 1 1 ... ... 2 ... 1 Rosaline road ... 1 2(2) ... ... ... ... ... 1 Rosaviile road ... ... 3(2) ... ... 1 ... ... 1 Rosebury road ... 8(4) *3(2) ... ... 1 ... ... ... Rostrevor road ... ... 1 ... ... ... ... ... ... Rowallan road ... *6(6) **9(7) ... ... ... 2 ... ... Ruby terrace ... ... ... ... ... ... ... ... ... Roxby place ... 1 ... ... ... ... ... ... ... Rycroft street ... ... 1 ... ... ... ... ... ... Rylston road ... ... ... 1 ... 2(2) ... ... ... Rosebank Flats ... 1 ... ... ... ... ... ... ... St. Alban's terrace 1 1 ... 2(1) ... 1 ... ... ... St. Dunstan's road ... 5(4) 1 ... ... 1 1 ... 1 St. Maur road ... 1 ... ... ... ... ... ... 1 St. Olaf's road ... 3(2) **12(11) ... ... 2(2) 1 l 1 St. Oswald's road ... 1 ... 2(2) ... 1 ... l ... St. Peter's terrace ... ... ... ... ... ... ... ... ... St. Thomas' road ... ... 1 ... ... ... ... ... ... Sandilands road ... 5(3) 2(1) ... ... 1 4 ... ... 72  Small.pox. Scarlet Fever. I 'iphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Deaths from Measles. Deaths from Diarrhœa. Deaths from Phthisis. Seagrave mews ... ... ... ... ... ... ... l ... Seagrave road 2(2) 4(2) ... ... ... ... ... ... l Settrington street ... 2(2) 7(5) ... ... ... l ... ... Sherbrooke road *4(1) 2(1) 1 2(2) ... ... l ... 3 Shorrolds road ... 1 *2(2) ... ... l l ... 4 Shottendane road ... ... ... ... ... ... ... ... ... Sotheron road ... ... ... ... ... ... l ... ... Stamford road 1 1 * 2(2) ... ... ... ... ... 1 Stamford place ... 3(3) ... ... ... ... ... ... 1 Stamford street ... 2 ... ... ... ... 3 ... 1 Stanley road ... 1 ... ... ... l 6 ... 1 Stanwick road ... ... ... ... ... l ... ... ... Star road 4 (1) ... 2(2) ... ... ... ... ... ... Stokenchurch street . ... 1 1 ... ... ... ... ... ... Stonor road ... ... ... ... ... ... ... ... ... Strode road ... ... ... ... ... ... ... ... ... Studdridge street ... 1 1 ... ... ... ... ... ... Suffolk street ... 1 ... ... ... ... 2 ... 1 Stephendale road ... *23 (13) 4(4) 3(3) ... ... 2 9 3 Sylvio street ... ... ... ... ... ... ... ... ... Talgarth road ... ... ... 1 ... l ... ... ... Tamworth street ... *4(2) 1 1 ... ... ... ... ... Tasso road ... ... ... 1 ... 3(3) 1 1 2 Tilton street ... ... 1 ... ... ... ... ... ... Tournay road 1 ... ... ... ... ... 1 ... ... Townmead road 7(3) 11(7) *6(5) ... ... ... 1 4 1 Turneville road ... ... ... 1 ... ... 1 1 ... Tyrawley road ... ... ... ... ... ... 1 ... ... Trevanion road ... ... ... ... ... 1 ... ... ... Tynemouth street 1 5(3) 1 ... ... ... ... ... ... Vanston place ... ... ... ... ... ... ... ... ... Varna road ... ... ... ... ... ... 1 ... ... Vereka road ... ... ... ... ... ... ... ... ... Vernon street ... 1 ... ... ... ... ... ... 3 Victoria road ... 2(2) 1 1 ... ... ... ... 2 Vera road 2(1) 1 3(3) ... ... ... ... ... ... Waldemar avenue ... ... *2(1) 1 ... ... ... 1 ... Walham avenue ... ... ... ... l *1 1 2 2 Walham grove ... ... ... ... ... 1 ... ... 2 73  Small.pox. Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Deaths from Measles. Deaths from Diarrhœa. Deaths from Phthisis. .Wandon road ... ... ... ... ... l ... ... l Wandsworth Bdge.rd. ... *20(17) 3(3) ... ... ... 4 ... 2 Wardo avenue ... 1 *3(3) ... ... ... ... ... 1 Waterford road ... 1 1 ... ... 2(2) ... ... 1 Werley avenue ... ... ... ... ... 1 ... ... ... Westbury terrace ... ... ... ... ... ... ... ... ... Wheatsheaf terrace ... ... ... ... ... ... ... ... ... Whittingstall road ... ... ... ... ... ... ... ... ... Wigan street ... ... ... ... ... ... ... ... ... William street ... 2(2) ... ... ... ... ... ... ... Wyfold road ... ... ... ... ... ... ... ... ... Whiteley's cottages ... ... ... ... ... ... ... ... Winchendon road ... ... ... ... ... ... ... ... ... Woodlavvn road ... ... ... ... ... ... ... ... 1 Woolneigh street • ... ... ... ... ... ... ... ... ... Yeldham road 1 4(3) 2 1 ... ... ... l ... Fulham Union Infirm. ... ... *11 ... ... ... ... ... ... Fulham Workhouse 1 ... 1 ... ... *12 ... l 4 TABLE C. COMPARISON OF PREVALENCE OF SICKNESS & DEATHS FROM NOTIFIABLE INFECTIOUS DISEASES. (Rates calculated per 1000 persons on the population estimated to the middle of each year.) Small.pox. Scarlet Fever. Dipththeria and Membranous Croup. Enteric and Continued Fever. Typhus Fever. Cholera. Erysipelas. Cases. Deaths, Cases. Deaths Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. 1891 — — 1.33 0.09 0.93 0.21 0.62 — 0.03 — — — 0.84 0.05 1892 0.02 — 5.45 0.23 1.13 0.32 0.47 — — — — — 1.12 0.08 1893 0.30 0.03 6.98 0.32 2.48 0.63 0.59 0.13 0.01 — 0.05 — 1.54 0.17 1894 0.38 0.03 5.07 0.32 3.26 0.99 0.39 0.05 — — — — 1.09 0.06 1895 0.02 — 3.12 0.20 3.57 0.70 0.57 0.10 — — — — 0.89 0.05 1896 0.02 — 5.37 0.19 3.05 0.66 0.50 0.08 — — 0.01 — 0.85 0.04 1897 — — 6.34 0.23 3.24 0.52 0.45 0.10 — — — — 1.12 0.03 1898 — — 6.49 0.28 3.81 0.49 0.58 0.14 — — — — 0.97 0.05 1899 0.01 — 6.50 0.26 4.05 0.45 0.85 0.19 — — 0.03 — 1.37 0.06 1900 0.07 — 4.05 0.17 4.77 0.49 0.67 0.14 — — — — 1.15 0.09 1901 0.11 0.02 4.33 0.15 4.65 0.35 0.97 0.15 — — — — 0.97 0.06 1902 0.65 0.09 3.84 0.13 2.98 0.35 0.52 0.06 — — — — 0.92 0.03 75 TABLE D. Showing the number of Cases of Infectious Diseases notified to the several Metropolitan Medical Officers of Health during the Year 1902. Cities and Boroughs. Estimated Population in the Middle of 1902. Small.pox. Scarlet Fever. Diphtheria and Membranous Croup Typhus Fever. Enteric Fever. Other Continued Fevers. Puerperal Fever. Erysipelas. Cholera. Total. Annual Rate per 1,000 persons living. West Districts. Fulham 143,102 94 552 429 — 74 — 7 121 — 1,277 8.8 Paddington 145,107 113 364 222 — 83 1 14 148 — 945 6.4 Kensington 177,605 99 378 186 — 83 4 15 189 — 954 5.3 Hammersmith 114,210 100 353 182 — 51 1 7 118 — 812 7.0 Chelsea 74,018 39 204 133 — 35 — 7 60 — 478 6.4 City of Westminster 180,800 232 475 285 — 133 1 6 144 — 1,276 6.9 North Districts. St. Marylebone 132,145 154 414 237 — 96 — 14 219 — 1,134 8.4 Hampstead 83,743 20 255 98 — 46 1 7 57 — 484 5.7 St. Pancras 235,521 360 1,219 836 — 197 2 12 258 — 2,884 12.0 Islington 337,270 302 1,380 881 — 263 5 19 364 — 3,214 9.4 Stoke Newington 51,700 51 202 99 — 22 — 1 52 — 427 8.1 Hackney 221,926 425 883 721 — 184 6 17 329 — 2,565 11.4 Central Districts. Holborn 58,535 219 203 117 — 40 — 7 85 — 671 11.3 Finsbury 100,487 211 392 240 — 83 6 7 155 — 1,094 10.7 City of London 25,598 39 83 97 — 15 1 32 — 267 10.3 East Districts. Shoreditch 118,004 442 250 233 — 150 4 9 175 — 1,263 10.5 Bethnal Green 129,865 516 529 324 — 132 — 10 255 — 1,766 13.4 Stepney 300,551 1,387 1,070 780 1 297 — 22 447 — 4,004 13.1 Poplar 169,214 630 670 469 — 210 — 10 191 — 2,180 12.7 South Districts. Southwark 206,825 518 1,098 539 — 193 — 10 372 — 2,730 13.0 Bermondsey 130,218 224 506 283 1 130 1 6 190 — 1,341 10.1 Lambeth 305,102 362 1,357 490 — 219 11 17 337 1 2,794 9.0 Battersea 171,401 189 893 294 — 96 — 15 200 — 1,687 9.7 Wandsworth 241,810 131 1,079 758 1 145 1 21 243 — 2,379 9.7 Camberwell 262,775 356 1,390 693 1 146 — 15 309 — 2,910 10.9 Deptford 111,577 145 649 268 — 76 — 6 150 — 1,294 11.4 Greenwich 98,013 102 463 183 — 68 — 6 122 — 944 9.5 Lewisham 132,432 88 664 401 — 60 1 14 112 — 1,340 10.0 Woolwich 119,556 236 278 252 — 61 1 11 97 — 936 7.7 Port of London — 14 4 5 — 24 _ — — — 47 — LONDON 4,579,110 7,798 18,257 10,735 4 3,412 47 312 5,531 1 46,097 9.9