Ful 15 Council of the Borough of Julham. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, J. CHARLES JACKSON. FOR THE YEAR 1912. INDEX. page Anthrax 32 Antitoxin, Provision of 29 Bacteriological Examinations 47 Bakehouses 48 Births and Birth-rates 7 Births, Notification of 18 Cancer, Deaths from 43 Cerebro-spinal Fever, Notification of 32 Cleansing of Children 62 Deaths and Death-rates 9 Deaths, Causes of 11& 66 Deaths, Certification of Causes of 44 Deaths, Distribution of 13 Diarrhœa, Deaths from 43 Diphtheria 29 Disinfection 46 Dispensary for Prevention of Tuberculosis 36 Drainage, Combined 61 Drainage of Buildings 61 Enteric Fever 30 Epidemic Diseases. Deaths from 19 Epidemic Diseases, Distribution of 21 Erysipelas 32 Factory and Workshops Act, Proceedings under 48 Food Supply, Supervision of 53 Ice Creams, Premises for Manufacture of 53 Illegitimate Children, Births of 7 Illegitimate Children, Deaths of 18 Infants, Causes of Death of 15 Infants, Insurance of 19 Infantile Mortality, Prevention of 18 Infectious Diseases, Notification of 23 Infectious Diseases in Metropolitan Boroughs 86 Influenza, Deaths from 43 4 page Insurance Act and Tuberculosis 39 Marriages 6 Measles 41 Meteorological Conditions 82 Milk Shops 53 Mortuary 47 Notification of Births Act 18 Ophthalmia, Notification of 32 Outworkers 48 and 51 Phthisis. Deaths from 33 Phthisis, Notification of 32 Poliomyelitis 32 Population 5 Public Institutions, Deaths in 44 Puerperal Fever 31 Respiratory Diseases, Deaths from 44 Restaurants, Inspection of Kitchens of 48 Revenue Acts, Certificates under 62 Sale of Food and Drugs Acts, Proceedings under 54 Sanitary Staff 65 Sanitary Work, General 63 Sanatorium, Provision of Beds in 37 Scarlet Fever 27 School for Mothers 18 School Medical Treatment Centre 62 Seasonal Mortality 10 Slaughter Houses 53 Small pox 26 Still-born Children 7 Tuberculosis, Treatment and Prevention of 35 Underground Rooms, Regulations in respect of 58 Unsound Food 53 Vaccination 26 Violence, Deaths from 44 Water Supply in Tenement Houses 61 Whooping Cough, Deaths from 42 Town Hall, Fulham. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Fulham. Sir and Gentlemen, I have the honour to present to you my 20th Annual Report on the vital statistics and the conditions affecting the health of the borough for the year 1912. The statistics of births, deaths and infectious diseases relate to the fifty-two weeks ended December 28th, 1912. POPULATION. The population of Fulham as enumerated at the Census taken on April 2nd, 1911, was 153,284, and in the middle of 1912, estimated in the usual way on the assumption that the rate of increase which prevailed between 1901 and 1911 has been maintained since, it was 155,402. The following table shows the increase of the population of the borough since 1851:— TABLE I. Year. Population. Increase per cent, during previous intercensal period. Persons to the Acre. Rateable Value. 1851 Census 11,166 - 7.0 £ 47,492 1861 ,, 15,589 30.9 9.1 55,916 1871 ,, 28,378 50.5 13.7 96,661 1881 ,, 42,900 83.5 25.2 149,899 1891 ,, 91,640 113.6 53.8 385,407 1896 ,, 113,781 24.4 66.8 560,965 1901 ,, 137,289 20.6 80.6 677,332 1911 „ 153,284 11.7 90.1 902,640 1912 Estimated 155,402 - 91.4 904,867 6 MARRIAGES AND MARRIAGE-RATE. The number of marriages registered during the year was 1,387, compared with 1,182, 1,273 and 1,353 in the preceding three years. The marriage-rate, i.e., the num ber of persons married per 1,000 inhabitants, was 17.9, the average rate for the ten previous years being 16.2. BIRTHS AND BIRTH-RATE. Excluding 8 births among non-residents, but including 142 children born of Fulham mothers in lying-in institu tions situate in other boroughs, the total number of births registered in 1912 was 4,213, of whom 2,140 were boys and 2,073 girls, representing a birth-rate of 27.1 per 1,000 inhabitants, which is 0.2 per 1,000 above that of 1911, but 3.8 per 1,000 below the mean rate of the ten years 1902—1911. The birth-rate of the County of London was 24.5 per 1,000, and among the several Metropolitan boroughs the rates, after correction by the distribution of the births in lying-in institutions to the boroughs in which the mothers ordinarily resided, ranged from 9.9 in the City of London, 149 in Hampstead, and 15.3 in Westminster, to 31.0 in Bermondsey, 31.3 in Poplar, to 32.3 in Shoreditch. The following table gives the number of births and the birth-rates in the various wards, corrected by the distribution of the births in Fulham Infirmary and the inclusion of those occurring in outside Maternity Institutions:- 7 TABLE II. Births and Birth-rates. Ward Males. Females. Total Births. Birth-rate. Barons Court 90 72 162 13.0 Lillie 373 336 709 28.8 Walham 167 184 351 28.0 Margravine 296 300 596 32.4 Munster 595 572 1,167 30.6 Hurlingham 94 107 201 21.2 Sands End 394 396 790 29.7 Town 131 106 237 18.0 The Borough 2,140 2,073 4,213 27.1 Illegitimacy. The illegitimates numbered 205, or 4.9 percent, of the total births, of these 168 occurred among those born within and 37 among those born outside the borough. Still-born Children. 75 still born children were buried in Fulham Cemetery, being in the proportion of one still-born child to every 56 living. Excess of Births over Deaths. The natural increase of the population by the excess of births over deaths was 2,190, compared with 2,192, 2,402 and 1,894 in the preceding three years. 8 TABLE III. VITAL STATISTICS OF WHOLE DISTRICT DURING 1912 AND PREVIOUS YEARS. Prepared in accordance with the instructions of the Local Government Board. Year. Population Estimated to Middle of each Year. Births. Total Deaths Registered in the District. Transferable Deaths. Nett Deaths belonging to the District. Uncorrected Number. Nett. Number * Rate. of NonResidents registered in the District. of Residents not registered in the District. Under 1 Year of Age. At all Ages. Number. Rate Number. * Rate per 1,000 Nett Births. Number. * Rate. 1 2 3 4 6 6 7 8 9 10 11 12 13 1907 150,670 4,507 4,617 30.6 1,967 13.1 153 351 565 122 2,195 14.6 1908 151,659 4,607 4,715 31.1 1,999 13.2 163 321 545 115 2,157 14.2 1909 152,501 4,199 4,306 28.2 1,940 12.7 154 329 466 108 2,115 13.9 1910 153,166 4,213 4,310 28.1 1,701 11.2 99 306 462 107 1,908 12.5 1911 153,284 4,012 4,122 26.9 2,019 13.2 169 378 517 125 2,228 14.5 1912 155,402 4,079 4,213 27.1 1,830 11.8 173 366 395 94 2,023 13.0 Notes.—This Table is arranged to show the gross births and deaths in the district, and the births and deaths properly belonging to it with the corresponding rates. The rates are calculated per 1000 of the estimated gross population. *In Column 6 are included the whole of the deaths registered during the year as having actually occurred within the district. In Column 12 is entered the number in Column 6, corrected by subtraction of the number in Column 8 and by addition of the number in Column 9. Deaths in Column 10 are similarly corrected by subtraction of the deaths under 1, included in the number given in Column 8, and by addition of the deaths under 1 included in the number given in Column 9. fTransferable Deaths" are deaths of persons who, having a fixed or usual residence in England or Wales, die in a district other than that in which they resided. The deaths of persons without fixed or usual residence, e.g., casuals, are not included in Columns^ or 9, except in certain instances under 3 (b) below. In Column 8 is stated the number of transferable deaths of "non-residents" which are deducted, and in Column 9 the number of deaths of "residents" registered outside the district which are added in calculating the nett death-rate of his district. The following special cases arise as to Transferable Deaths (1) Persons dying in Institutions for the sick or nfirm, such as hospitals, lunatic asylums, workhouses, and nursing homes (but not almshouses) are regarded as residents of the district in which they had a fixed or usual residence at rhe time of admission. If the person dying in an Institution had no fixed residence at the time of admission, the death is not transferred. If the patient has been directly transferred from one such institution to another, the death is transferred to the district of residence at the time of admission to the first Institution. {2) The deaths of infants born and dying within a year of birth in an Institution to which the mother was admitted for her confinement are referred to the district of fixed or usual residence of the parent. (3) Deaths from Violence are referred (a) to the district of residence, under the general rule; (b) if this district is unknown, or the deceased had no fixed abode, to the district where the accident occurred, if known ; (c) failing this, to the district where death occurred, if known ; and (d) failing this, to the district where the body was found. Total population at all ages 153,284 Number of inhabited tenements 36.430 At Census of 1911. Area of District in acres (exclusive of area covered by water), 1701. Average number of persons per tenement 4*2 BIRTHS AND DEATHS, 1886 - 1912 9 DEATHS AND DEATH-RATE. The deaths registered in the borough during 1912 numbered 1,830, 920 males and 910 females, but of these 173—82 males and 91 females—were of persons not belonging to the borough, while 366 inhabitants of Fulham, 219 males and 147 females, died outside the borough, chiefly in various public institutions. There were therefore 2,023 deaths of persons having their usual residence in Fulham, representing an annual rate of 13.0 per 1,000 of the estimated population. With the exception of that of 1910, which was 12.5 per 1,000, this is the lowest rate recorded in Fulham, and is 1.9 per 1,000 below the mean rate of the preceding ten years. Among the Metropolitan boroughs the death rates ranged from 9.9 in Hampstead, 10.4 in Wandsworth and 10.6 in Lewisham to 16.9 in Bermondsey, 18.2 in Shoreditch and 18.9 in Finsbury, and in the following table the mortality of Fulham may be compared with that of the adjoining boroughs, of the County of London, and of other groups of areas :— TABLE IV. Death-rate in 1912 Fulham 13.0 Chelsea 14.8 Hammersmith 13.3 Kensington 13.3 County of London 13.7 95 Great Towns 13.8 146 Smaller Towns 12.4 England and Wales less the 241 Towns 12.9 England and Wales 13.3 10 Seasonal Mortality. The mortality in the four quarters of the year was as under:— Deaths. Death-rate. First quarter 596 15.3 Second quarter 461 11.9 Third quarter 402 10.3 Fourth quarter 564 14.5 Mortality in Former Years. In Table III. will be found the number of deaths and the death-rate in each of the preceding five years. The difference between the rate for 1912 and the average rate of the five years, 1907-1911, represents a saving of 138 lives. 11 table v. Causes of and Ages at Death during the Year 1912. Nett Deaths at the subjoined of "Residents " whether occurring within or without the District (a). Total Deaths whether of "Residents " or NonResidents" in Institutions in the District (b) Nett Deaths at all ages of "Residents" in the Wards of the Borough whether occurring in or beyond the Wards. Causes of Death All Ages Under 1 Year l and under 2 years 2 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 45 years 45 and under 65 years 65 and upwards Barons Court Ward Lillie Ward Walham Ward Margravine Ward Munster Ward i Hurlingham Ward ! Sands End Ward Town Ward 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 All Causes Certified (c) 2022 395 78 119 67 87 317 464 495 641 171 338 176 264 450 115 339 169 Uncertified 1 ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... Enteric Fever 8 ... ... 1 3 3 1 ... 8 ... 3 1 1 2 1 ... ... Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 65 12 17 33 3 ... ... ... ... 83 2 15 5 12 10 1 13 7 Scarlet Fever 6 ... ... 2 4 ... ... ... ... 17 ... ... 3 ... 3 ... ... ... Whooping Cough 45 23 8 11 3 ... ... ... ... 21 2 9 3 5 14 ... 10 2 Diphtheria and Croup 15 1 2 8 4 ... ... ... ... 45 2 1 ... 1 7 ... 4 ... Influenza 16 ... ... ... ... 1 1 7 7 ... 4 ... ... 3 ... 3 3 3 Erysipelas 5 1 1 ... ... ... ... 1 2 67 ... 3 1 ... ... ... 1 ... Phthisis (Pulmonary Tuberculosis) 213 1 3 8 4 31 91 60 15 84 23 38 13 27 47 13 38 14 Tuberculous Meningitis 21 3 1 13 4 ... ... ... ... 5 1 2 ... 6 7 1 3 1 Other Tuberculous Diseases 22 5 2 3 2 2 4 4 ... 12 1 4 2 3 4 2 5 1 Cancer, malignant disease 155 ... ... ... ... 1 13 81 60 35 15 23 15 15 30 11 25 21 Rheumatic Fever 5 ... ... ... 3 1 1 ... ... 1 ... 2 ... ... 3 ... ... ... Meningitis. See note (d) 17 5 ... ... 5 2 3 2 ... 6 ... 3 1 5 5 ... 1 2 Organic Heart Disease 169 ... ... 1 9 6 33 61 59 27 13 28 15 20 22 14 39 18 Bronchitis 177 35 6 1 ... ... 8 37 90 38 12 38 16 22 38 8 31 12 Pneumonia (all forms) 197 66 22 20 3 4 34 23 25 49 20 31 23 25 44 8 38 8 Other diseases of Respiratory organs 21 2 2 2 ... ... 3 7 5 2 2 2 3 2 6 2 2 2 Diarrhœa and Enteritis 38 33 1 2 ... ... 1 1 ... 20 1 6 2 10 10 ... 6 3 Appendicitis and Typhlitis 9 ... ... ... 2 2 3 2 ... 4 2 2 ... ... 3 1 1 ... Cirrhosis of Liver 19 ... ... ... ... ... 1 14 4 4 4 3 2 ... 5 ... 3 2 Alcoholism 7 ... ... ... ... ... 2 5 ... 7 1 2 1 ... 1 ... 1 1 Nephritis and Bright's Disease 68 1 ... 1 2 4 10 37 13 24 5 7 4 9 19 8 10 6 Puerperal Fever 7 ... ... ... ... 1 5 1 ... 6 ... 2 1 2 2 ... ... ... Other accidents and diseases of Pregnancy and Parturition 7 ... ... ... ... 2 4 1 ... ... ... 1 1 2 1 1 1 ... Congenital Debility and Malformation, including Premature Birth 151 144 2 1 2 2 ... ... ... 23 5 27 14 26 35 6 28 10 Violent Deaths, excluding Suicide 67 15 3 11 4 8 10 11 5 8 7 7 9 8 15 3 13 5 Suicides 18 ... ... ... ... 2 11 4 1 1 1 4 ... ... 4 ... 4 5 Other Defined Diseases 473 48 8 2 12 15 75 104 209 104 48 75 41 60 112 32 59 46 Diseases ill-defined or unknown 2 ... ... ... ... ... 1 1 ... ... 1 ... ... ... 1 ... ... ... 2023 395 78 119 67 87 317 465 495 641 172 338 176 264 450 115 339 169 (a) All "Transferable Deaths" of residents, i.e., of persons resident in the District who have died outside it, are included with the other deaths in columns 2—10. Transferable deaths of non-residents, i.e., of persons resident elsewhere in England and Wales who have died in the^ District, are in like manner excluded from these columns. For the precise meaning of the term ' transfeiable deaths see footnote to Table IV. (b) All deaths occurring in institutions for the sick and infirm situated within the district whether of residents or of non-residents, are entered in column 11 of Table VI. (c) All deaths certified by registered Medical Practitioners and all Inquest cases are classed as Certi fied ,"all other deaths are to be regarded as Uncertified (d)Exclusive of" Tuberculous Meningitis" (10). but inclusive of Cerebro-Spinal Meningitis. 13 Distribution of Deaths. Table V. gives the number and causes of deaths in the several wards of the borough and in the following will be found the death-rates of each ward for 1912 and the ten preceding years:— TABLE VI. Death-rate per 1,000 persons in each Ward. Barons Court Ward. Lillie Ward. Walham Ward. Margravine Ward. Minister Ward. Hurlingham Ward. Sands End Ward. Town Ward. 1902 13.5 16.8 20.2 20.0 16.3 14.5 18.5 14.3 1903 10.9 14.5 15.5 18.4 12.5 13.0 13.1 14.1 1904 13.9 15.8 19.9 16.4 15.3 15.0 14.6 14.2 1905 13.3 16.1 18.0 16.8 14.1 15.0 15.3 13.9 1906 11.6 14.3 17.7 18.1 13.4 13.3 13.3 11.8 1907 12.9 15.0 16.9 19.5 13.1 11.9 12.4 11.3 1908 11.9 14.3 17.2 14.2 12.9 15.1 14.1 10.4 1909 12.7 14.6 18.2 16.2 12.5 12.1 12.5 12.2 1910 11.8 11.3 16.5 15.8 11.4 10.9 11.6 12.5 1911 11.8 15.1 19.0 18.2 14.1 10.4 14.3 12.2 Average of 10 years, 1902-11. 12.4 14.8 17.9 17.4 13.6 13.1 14.0 12.7 1912 13.8 13.7 14.1 14.3 11.9 12.1 12.7 12.8 It is satisfactory to note the uniformity of the rates in 1912, no ward being conspicuous by a heavy mortality. MORTALITY AT DIFFERENT AGES. Infantile Mortality. Of the 2023 deaths registered, 395 or 19.5 per cent. were of infants under one year of age and the rate of 14 infant mortality, measured by the proportion of deaths under one year to registered births, was 94 per 1,000, being 13 per 1,000 below that of 1910, hitherto the lowest recorded and 33 per 1,000 below the average rate of the ten years 1902-1911. The low death-rate was, of course, largely due to the cold and wet summer with the consequent absence of epidemic diarrhœa, the mortality being actually lowest in the third quarter of the year when the rate was 66 per 1,000, compared with 218 per 1000 in the corresponding quarter of 1911, which was exceptionally hot and dry. Making, however, every allowance for weather influences, the marked decline of late years in the infantile mortality, as shown in the diagram, clearly points to the removal of conditions prejudicial to infant life, to which so much attention is now directed, and since disease, when it does not kill often disables, its diminution should tend to the improvement of the physique and efficiency of the surviving children. 17 Causes of Infantile Mortality. Table VII. gives the causes of infantile mortality at various periods under one year, and the following gives the proportion of deaths occurring at certain age periods:— TABLE VIII. Age Period. Percentage of Total Deaths under one Year. Under one week 23.3 Over one and under four weeks 11.4 One and under three months 22.3 Three and under six months 19.5 Six and under nine months 11.1 Nine and under twelve months 12.4 Table IX. gives the infantile death-rates of the several wards of the borough, corrected by the bution of the births in Fulham Infirmary. TABLE IX. Deaths under one year per 1,000 Births. Ward. 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 Average Ten Years 1902-1911 1912 Barons Court 134 98 181 108 88 146 91 75 122 70 111 148 Lillie 159 138 137 147 137 151 106 122 103 128 133 85 Walham 164 142 185 183 166 184 152 140 156 124 160 91 Margravine 157 144 179 153 171 136 129 133 135 154 149 112 Munster 130 125 140 137 142 116 120 102 103 137 125 91 Hurlingham 99 104 159 98 150 99 81 76 43 59 97 59 Sands End 182 121 156 168 127 107 136 94 109 138 134 97 Town 106 76 121 105 72 64 64 98 81 51 84 76 The Borough 148 127 152 144 133 122 115 108 107 128 128 94 18 Notification of Births Act—Prevention of Infantile Mortality. 3,180 notifications of living and 60 of still-born children were received under the above Act, 76 per cent. of the births registered during the year being notified. Of these 2,164 or 67 per cent, were notified by midwives, 875 or 27 per cent, by medical practitioners and 201 or 6 per cent. by the relatives. Visits were paid to 1,753 or 43 per cent. of the mothers either by your Sanitary Inspector, Mrs. Davies, or by the Superintendent or Assistant Superintendent of the Fulham School for Mothers, and about one-third of these were again visited on one or more occasions according to their needs, 2,120 revisits being made. To the consultations held by the Honorary Medical Officers of the Fulham School for Mothers at 92, Greyhound Road and Broughton Road Hall, 533 babies were brought, or 13 per cent, of those born within the borough, and 5,497 attendances were recorded. I have in previous reports emphasised the value of the work done at this Institution, which has been further enhanced by the appointment by the Committee of Management of an Assistant Superintendent, resulting in a great increase in the amount of revisiting which can now be undertaken, a matter of the utmost importance, since to be really effective visiting must be constant, as so many babies requiring special care must be kept under strict supervision. Deaths of Illegitimate Children. Of the children who died before attaining the age of one year 30 were illegitimate, the mortality among them being in the proportion of 147 deaths to 1,000 births against 90 per 1,000 among children born in wedlock. In the preceding three years the average mortality of illegitimate infants was 317 deaths per 1,000 births. 19 Insurance of Children. Certificates under the Friendly Societies Act were issued in respect of 364 children under five years of age, 61.5 per cent. of the children dying at this age period being insured. Deaths at other Age Periods. The proportion which the deaths at age periods over one year bear to the total number of deaths is as under:— TABLE X. Percentage of Total Deaths 1 and under 2 years 3.9 2 ,, 5 „ 5.9 5 ,, 15 „ 3.3 15 „ 25 „ 4.3 25 „ 45 „ 15.7 45 „ 65 ,, 23.0 Over 65 years 24.3 DEATHS FROM EPIDEMIC DISEASES. To the seven principal epidemic diseases 173 deaths were ascribed, representing a death-rate of 1.1 per 1,000 or less than half of the mean rate of the decennium 1902-1911. The following table gives the number of deaths in the borough from the principal epidemic diseases in 1912 and in the preceding ten years, together with the death-rates:— 20 TABLE XI. Deaths from the seven principal Infectious Diseases. 1902. 1903. 1904. 1905. 1906. 1907. 1908. 1909. 1910. 1911. Mean number of Deaths 1902-1911. Mean Deathrate 902—1911. Deaths 1912. Death-rate 1912. Smallpox 13 ... ... ... ... ... ... ... ... ... 1 0.01 ... 0.00 Measles 168 62 64 85 53 69 71 74 65 64 78 0.54 65 0.42 Scarlet Fever 19 8 4 23 18 14 17 10 7 6 13 0.09 6 0.04 Whooping Cough 65 48 58 82 31 75 34 48 60 28 53 0.35 45 0.29 Diphtheria 51 24 24 24 33 38 32 39 14 27 31 0.21 15 0.10 Enteric Fever 9 16 6 10 13 8 10 4 2 8 8 0.05 8 0.05 Diarrhœa and Enteritis under 2 years of age. 140 165 235 202 275 115 130 105 74 211 165 1.11 34 0.22 Total 465 325 391 426 423 319 294 280 222 344 349 2.36 173 1.12 21 Distribution of Epidemic Diseases. The following table gives the number of deaths from epidemic diseases per 1,000 of the population of each ward:— TABLE XII. Deaths from the seven principal Epidemic Diseases per 1,000 of the population in each Ward in 1912. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Rnteric Fever. Diarrhœa & Enteritis under 2. Total. Barons Court Ward 0.00 0.00 0.08 0.08 0.08 0.08 0.40 0.72 Lillie Ward 0.00 0.25 0.00 0.08 0.08 0.06 1.82 2.27 Walham Ward 0.00 0.48 0.00 0.08 0.40 0.00 2.48 3.44 Margravine Ward 0.00 0.39 0.11 0.22 0.22 0.00 2.38 3.32 Munster Ward 0.00 0.72 0.05 0.14 0.24 0.11 1.41 2.67 Hurlingham Ward 0.00 0.21 0.00 0.10 0.10 0.00 0.75 1.16 Sands End Ward 0.00 0.61 0.04 0.32 0.25 0.04 1.87 3.16 Town Ward 0.00 0.00 0.00 0.30 0.15 0.08 0.38 0.91 The Borough 0.00 0.42 0.04 0.10 0.29 0.05 0.22 1.12 22 SICKNESS FROM NOTIFIABLE INFECTIOUS DISEASES. Table XIII. gives the number of cases of infectious diseases notified in Fulham since 1890, when compulsory notification came into force, excluding duplicate notifications. Table XIV. gives the number of cases notified in each ward in 1912, and Table XV. the number of cases notified per 10,000 of the population of each ward. The chart shows the number of cases of scarlet fever and diphtheria notified in each week of 1912, together with the average number notified in the corresponding weeks of the ten years of 1902-1911. 23 table xiii. Cases of Infectious Diseases notified to the Medical Officer of Health. 1890 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 Smallpox — - 3 32 40 2 2 — — 1 9 16 94 11 - - - - - - - - - Scarlet Fever 286 118 517 701 529 339 627 759 811 847 552 600 552 404 294 779 674 668 596 511 354 384 484 Diphtheria 70 69 96 230 329 368 341 378 465 514 630 636 417 286 299 285 403 603 400 322 257 311 231 Membranous Croup 23 13 15 20 13 18 14 10 11 14 11 8 12 7 3 1 - 1 - - - - - Enteric Fever 72 51 41 58 37 57 53 53 71 111 92 133 74 80 39 56 45 58 39 41 18 38 26 Continued Fever — - — 6 2 3 5 5 1 1 2 1 - - - - - 1 — 1 2 3 - 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 19 8 24 17 15 17 34 20 23 30 Erysipelas 114 67 104 153 113 94 99 134 121 178 154 132 121 115 131 143 141 128 127 115 115 115 115 Epidemic Cerebrospinal Meningitis - - - - - - - - - - - - - - - - - 3 4 3 7 3 2 Ophthalmia Neonatorum - - - - - - - - - - - - - - - - - - - - - 15 13 Poliomyelitis - - - - - - - - - - - - - - - - - - - - - 1 5 Pulmonary Tuberculosis — — - — — - - - - - - - 137 171 165 152 148 151 179 279 326 613 1173 Anthrax - - - - - - - - - - - - - - - - - - - - - - 1 Totals 573 327 786 1224 1073 887 1149 1354 1488 1683 1459 1534 1414 1093 939 1440 1428 1628 1362 1306 1099 1506 2080 24 TABLE XIV. Cases of Infectious Diseases notified, during the Year 1912. Notifiable Disease. Number of Cases Notified. Total Cases Notified in each Ward of the Borough. At all Ages. At Ages—Years. Barons Court Ward. Lillie Ward. Walham Ward. Margravine Ward. Munster Ward. Hurlingham Ward Sands End Ward. Town Ward. Total cases removed to Hospital. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Small-pox - - - - - - - - - - - - - - - - - Cholera (C) Plague (P) - - - - - - - - - - - - - - - - - Diphtheria (including Membranous Croup) 231 6 64 131 16 11 3 - 19 39 26 18 74 7 38 10 214 Erysipelas 115 2 3 15 8 31 40 16 9 13 10 28 23 7 19 6 - Scarlet Fever 484 6 123 310 28 17 — — 17 45 31 49 156 36 116 34 434 Typhus Fever — — — — — — — — — — - — — — — - — Enteric Fever 26 — — 4 9 10 3 — 3 2 5 2 3 2 3 6 20 Relapsing Fever (R) Continued Fever (C) - - - - - - - - - - - - - - - - Puerperal Fever 30 — — — 8 22 — — 1 5 4 2 12 2 3 1 24 Cerebro-spinal Meningitis 2 I — — 1 - — — — — - — 1 — — 1 2 Poliomyelitis 5 — 4 — 1 — — — - 1 - - 2 2 - - 2 Pulmonary Tuberculosis 1173 2 49 318 141 465 171 27 49 209 133 167 316 43 177 79 - Ophthalmia Neonatorum 13 13 — — — — — — 2 3 - 3 1 2 2 - 7 Anthrax 1 - - - - - - - 1 - - - - - - - - Totals 2080 30 243 778 212 556 218 43 101 317 209 269 588 104 358 137 703 25 TABLE XV. Cases of Infectious Diseases notified, per 10,000 inhabitants. Ward. Small-pox. Scarlet Fever. Diphtheria. Enteric Fever. Erysipelas. Puerperal Fever. Pulmonary Tuberculosis. Total Barons Court 0.0 13.6 15.3 2.4 7.2 0.8 39.2 78.5 Lillie 0.0 10.3 15.9 0.8 5.3 2.0 85.0 119.3 Walham 0.0 24.8 28.8 4.0 8.0 3.2 104.0 172.8 Margravine 0.0 26.6 9.8 1.1 15.2 1.1 90.8 144.6 Munster 0.0 40.9 19.4 0.8 6.0 3.2 82.9 153.2 Hurlingham 0.0 37.9 7.4 2.1 7.4 2.1 45.3 102.2 Sands End 0.0 43.5 14.3 1.1 7.1 1.1 66.5 133.6 Town 0.0 25.8 7.6 4.5 4.6 0.8 59.9 103.2 The Borough 0.0 31.1 14.9 1.7 7.4 1.9 75.5 132.5 26 Smallpox. No case of smallpox has been notified in Fulham since 1903. In London only 6 cases were notified during 1912. Primary Vaccination. The following tables, furnished by Mr. Davies, Vaccination Officer, gives the following returns for 1911 and the first six months of 1912:— TABLE XVI. Supplemental Return for 1911 for the Borough of Fulham. No. of Births Registered from Jan. 1st 1911. to Dec. 31st, 1911. Successfully Vaccinated. Insusceptible of Vaccination. Dead Unvaccinated. Postponed by Medical Certificate. Certificates granted under Clause 2 of Vaccination Act. 1898. Removed to Districts in which Vaccination Officer has been notified. Removed to places unknown. Outstanding. 4012 2665 18 318 54 557 30 351 19 TABLE XVII. Return of Vaccination for the period from January to June, 1912, for the Borough of Fulham. No. of Births Registered from Jan. 1st, 1912, to June 30th, 1912. Successfully Vaccinated. Insusceptible of Vaccination. Dead Unvaccinated. Postponed by Medical Certificate. Certificates granted under Clause 2 of Vaccination Act, 1898. Removed to Districts in which Vaccination Officer has been notified. Removed to places unknown. Outstanding. 2098 1350 4 119 49 305 23 187 61 557 children were exempted by statutory declaration of conscientious objection against 486 in the previous year, and 25.5 per cent. of those born in 1911 remain unvaccinated. 27 Scarlet Fever. The notified cases of scarlet fever numbered 484, compared with 511, 354 and 384 in the preceding three years. The returns for the four quarters were:— Cases. Deaths 1st Quarter 99 — 2nd 100 1 3rd „ 136 4 4th „ 149 1 484 6 The cases occurred in 307 houses, as under:— Houses with one case 247 ,, ,, two cases 49 ,, ,, three ,, 8 ,, ,, four „ — ,, ,, five 3 307 Isolation. Of the patients notified 434, or 89.7 per cent., were removed to hospital for treatment. Fatality. The deaths, 6 in number, represent a case mortality of 1.24 per cent., which is the lowest recorded. School Incidence. The special incidence of the disease among children attending Peterborough School which prevailed in November and December, 1911, as mentioned in the 28 report for that year, continued during the first two months of 1912, 18 cases being reported in the Infants', 7 in the Boys', and 3 in the Girls' Department, Repeated examinations were made of the children in the affected classes, but no "missed cases" were discovered. Distribution. In Table XIV. will be found the number of cases notified in each ward of the borough, and the following table shows the proportional prevalence of scarlet fever in the several wards and in the County of London in 1912 and the preceding ten years. TABLE XVII. Number of cases of Scarlet Fever notified per 10,000 of the population. 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 Mean of 10 years 1902-11. 1912 Baron's Court Ward 18 9 20 52 25 17 23 32 7 6 21 13.6 Lillie Ward 25 18 11 54 63 47 36 33 22 21 33 10.3 Walham Ward 17 14 21 43 47 28 21 16 19 26 25 24.8 Margravine Ward 51 37 11 34 40 45 28 33 23 25 32 22.6 Munster Ward 29 27 26 64 41 35 39 40 29 31 36 40.9 Hurlingham Ward 26 22 12 40 42 44 43 14 10 20 28 37.9 Sands End Ward 81 46 24 54 41 64 60 42 24 40 48 43.5 Town Ward 26 32 23 43 29 32 23 19 19 25 27 25.8 The Borough 38 28 19 50 42 42 37 32 22 25 34 31.1 The County of London 40 28 29 42 43 52 46 38 23 23 36 25.0 Chart Shewing Week by Week the Number of Cases of Scarlet Fever and Diphtheria. Notified by Medical Practitioners as having occurred in the Borough of Fulham during the 52 Weeks ended December 28th, 1912. 29 Diphtheria. Fewer cases of diphtheria were notified during 1912 than in any year since 1892, the number reported in each quarter being as under:- Cases. Deaths. 1st Quarter 69 5 2nd „ 57 6 3rd „ 52 2 4th „ 53 2 231 15 The sickness-rate was 14.9 per 10,000 inhabitants, compared with 20.2 in 1911, and an average of 26.4 per 10,000 in the decennium 1902-1911. The cases occurred in 214 houses as under:— Houses with one case 200 „ „ two cases 11 „ „ three „ 3 Isolation. 234 or 92.6 of the patients notified were removed to hospital. Fatality. The 15 deaths represent a case mortality of 6.5 per cent. compared with 14.1, 5.4 and 8.7 per cent. in the preceding three years. Diphtheria Antitoxin. Under the powers given by the Diphtheria Antitoxin Order, 1910, 134,000 units of antitoxic serum were supplied to medical practitioners for use in 22 cases. 30 Distribution. Table XIV. gives the number of cases notified in the several wards, and the following gives the proportional prevalence:— TABLE XIX. Number of cases of Diphtheria notified per 10,000 of the population. 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 Mean of 10 years 1902-11 1912 Barons Court Ward 22 9 10 20 17 7 13 10 14 14 14 15.3 Lillie Ward 23 23 13 14 17 38 24 16 10 9 19 15.9 Walham Ward 17 29 10 17 15 20 22 20 19 17 19 28.8 Margravine Ward 23 15 21 22 40 37 29 26 23 27 26 9.8 Munster Ward 48 15 24 17 24 38 25 22 14 26 25 19.4 Hurlingham Ward 19 27 20 22 16 41 27 23 22 19 24 7.4 Sands End Ward 36 31 34 22 36 68 28 21 20 27 32 14.3 Town Ward 16 17 13 12 20 21 23 21 10 13 17 7.6 The Borough 30 20 20 18 23 38 25 20 16 20 23 14.9 The County of London 24 17 16 14 18 19 17 14 8 8 16 16.2 Enteric Fever. The number of cases notified in Fulham in 1912 as enteric fever was 26, or 1.7 per 10,000 inhabitants, compared with an average of 3.8 per 10,000 in the preceding ten years. Fatality. Among the notified cases there were 6 deaths, giving a case mortality of 23 per cent., and in addition to these, two other deaths from enteric fever were credited to Fulham—that of a Fulham woman who had been an inmate of Hanwell Asylum for some years, and 31 that of a man having no fixed residence who died in the Western Fever Hospital, to which he had been removed from Wandsworth Prison. In 2 cases the infection was contracted outside the borough. Six patients had eaten shellfish—5, oysters, and 1, cockles—within a fortnight of the commencement of the illness. Puerperal Fever. Of puerperal septicaemia 30 cases were notified during the year, or 7.4 per 1,000 births, of which 7 or 1.7 per 1,000 births proved fatal. For the third year in succession, more cases were notified in Fulham in proportion to the population than in any other metropolitan borough. Sixteen of the cases were attended by midwives and 14 by medical practitioners. Five patients were notified on March 19th, who had been attended by the same midwife, one of whom died. Disinfection of the person, clothing and apparatus of the midwives and nurses who had been in attendance was carried out in all cases, and the midwife in whose practice the five cases occurred discontinued work for four weeks. Hospital accommodation for cases of Puerperal Fever. On August 12th, the Local Government Board made an Order empowering the Managers of the Metropolitan Asylums Board to admit into their hospitals, on the recommendation of the Medical Officer of Health, any person who is not a pauper believed to be suffering from puerperal fever, provided that more accommodation is available than is required for the reception of pauper patients suffering from puerperal fever. Of the 30 cases reported in 1912, 22 were admitted into Fulham Infirmary and one into the Western Hospital. 32 Erysipelas. 115 persons were notified as suffering from erysipelas, and 5 deaths were attributed to the disease. Cerebro-Spinal Fever. Two cases were reported by the Medical Superintendent of Fulham Infirmary, both terminating fatally in that institution. Acute Poliomyelitis. Five cases were notified, with two deaths. Two of the patients were sisters, aged one and three years respectively. Ophthalmia Neonatorum. Fourteen cases of inflammation of the eyes in the newly-born were notified, of which five were admitted into Fulham Infirmary and two into hospitals. All the cases notified made a complete recovery. Anthrax. One case of anthrax, or malignant pustule, was notified, the part affected being the forehead. The patient was a poulterer and attended the poultry market at Smithfield regularly. Pulmonary Tuberculosis. The notification of pulmonary tuberculosis limited by the Local Government Board's Order of 1908 to cases occurring amongst the inmates of Poor Law Institutions or amongst persons under the care of District Medical Officers and extended by the Order of March, 1911, to cases occurring amongst the in-patients or out-patients of hospitals, was further extended by the Order of November, 1911, which required every medical practitioner from January 1st, 1912, to notify 38 every case of pulmonary tuberculosis occurring in the course of his public or of his private practice. During the year 1,173 new cases were notified, 609 males and 564 females. 679 re-notifications of cases previously notified were also received. The sources of the notifications were as under:- Notifications of persons resident in Fulham Infirmary 280 Notifications of persons resident in other Poor Law Infirmaries 21 Notifications by District Medical Officers 215 Notifications of persons discharged from Fulham Infirmary 111 Notifications of persons discharged from other Poor Law Infirmaries 17 Notifications from Fulham Dispensary 734 Notifications from other Hospitals and Dispensaries 214 Notifications from Private Practitioners 232 Notifications from School Medical Officers 28 1852 In December, 1912, the Local Government Board issued further Tuberculosis Regulations, which came into force on February 1st, 1913, requiring all forms of tuberculosis, non-pulmonary as well as pulmonary, to be notified. Mortality from Tuberculosis. 213 deaths (130 of males and 83 of females) were registered from phthisis (tuberculosis of the lungs), being 13 in excess of the average number in the ten years 1902-1911. 34 The distribution of the deaths was as under:— Males. Females. Deaths in Poor Law Institutions 58 21 Deaths in Hospitals 15 11 Deaths in Asylums 6 6 Deaths at Home 51 45 130 83 To other tuberculous diseases 43 deaths were ascribed. In the several wards of the borough the death-rates from phthisis and other tuberculous diseases were as under:— TABLE XIX. Deaths per 1,000 of the population of each Ward from Phthisis and other Tuberculous Diseases. Death-rate from Phthisis. Death-rate from other Tuberculous Diseases. Death-rate from all Tuberculous Diseases. Baron's Court Ward 1.84 0.16 2.00 Lillie Ward 1.54 0.25 1.79 Walham Ward 1.04 0.16 1.20 Margravine Ward 1.52 0.49 2.01 Munster Ward 1.23 0.29 1.52 Hurlingham Ward 1.37 0.32 1.69 Sands End Ward 1.43 0.30 1.73 Town Ward 1.06 0.15 1.21 The Borough 1.36 0.28 1.64 35 Treatment and Prevention of Tuberculosis. Circular letters were issued by the Local Government Board in May and July last respecting the distribution of the sum which has been set apart by Parliament for the purpose of the provision of, or making grants in aid of sanatoria and other institutions for the treatment of tuberculosis, and the subsequent maintenance of those institutions. With their letter of May 14th the Board enclosed a copy of the interim report of the Departmental Committee on Tuberculosis, and stated that they unhesitatingly endorsed the opinion of the Committee that the organisation of schemes throughout the country can best be carried out if undertaken by the local authorities, and that any scheme, which is to form the basis of an attempt to deal with the problem of tuberculosis, should be made available for the whole community. Briefly, the recommendations were, that for the prevention, detection and treatment of the disease existing public health administration should be supplemented by the establishment of two units linked up to the general public health work now carried on, and working in harmony with the general practitioners, these units being—(a) Sanatoria or other institution in which inpatient treatment is given; (b) the Tuberculosis Dispensary. In London, as regards residential treatment, it is desirable that the London County Council should arrange for the provision of the accommodation required, but as regards the Tuberculosis Dispensary, the Metropolitan Borough Councils should provide or arrange for the provision of the institution. In Fulham a Dispensary for the prevention of tuberculosis was opened at 632, Fulham Road, in November, 1911, which was approved by the Local Government Board under Section 16 (b) of the National Insurance Act, and as the Committee of Management of the Dispensary were anxious that it should be maintained, the Council were advised to enter into an arrangement with them to that effect, and to 36 make a contribution of £300 a year towards its maintenance, provided that the Dispensary would undertake to treat any insured patient suffering from tuberculosis, resident in Fulham, and any uninsured person whose means are insufficient to pay for such treatment; that the Council should have power to appoint three of their members to serve on the Committee of the Dispensary, and that the entire control of preventive work of the Dispensary should be in the hands of the Council acting through their Medical Officer of Health, who would be Administrative Officer of the Dispensary, but that in matters appertaining to diagnosis and the treatment of patients the Medical Officer of the Dispensary, who would be Tuberculosis Officer of the Borough, should be entirely independent of the control of the Council, and their Medical Officer of Health. The Council adopted these suggestions, and the scheme having been sanctioned by the Local Government Board, an agreement embodying the above provisions has been submitted to the Dispensary Committee and accepted by them. In their circular letter of December 6th, 1912, the Local Government Board stated that they were prepared to make grants in aid to the amount of half the net cost incurred, within reasonable limits, by local authorities, in the treatment in dispensaries, sanatoria, and hospitals, which form parts of a scheme approved by the Board for the general treatment of tuberculosis in the area, of all persons, whether insured or uninsured, after deducting the amounts received from Insurance Committees, so that the Council will only be responsible for one half of the amount to be paid by them to the Dispensary Committee. Work of the Dispensary. The following is a summary of the work of the Dispensary in 1912:- 37 Patients Examined. Definitely Tuberculous. Under 5 years of age 249 59 5—10 „ „ 420 152 10-15 „ „ 355 109 15—25 „ „ 125 77 25—35 „ „ 219 134 35—45 „ „ 193 128 Over 45 „ „ 137 75 1,698 734 Total attendances of patients 6,097 Doctors' Visits 1,019 Nurses' Visits 1,997 Contacts Examined. Number of families 274 „ „ persons 1,347 „ „ definite cases of Tuberculosis detected 299 „ „ suspected cases of Tuberculosis 373 Sanatorium Treatment. By an arrangement with the National Association for the Establishment and Maintenance of Sanatoria for Workers, the Council retained for a period of 12 months from April 1st, 1912, 6 beds at the National Sanatorium, Benenden, for the use of men resident in the borough who were suffering from pulmonary tuberculosis, at a yearly cost of £78 a bed. The undermentioned patients occupied the Council's beds during the 9 months, 10 of whom had been attending the Fulham Tuberculosis Dispensary and 8 had been under the care of private medical practitioners. Before admission all the patients were examined with regard to their suitability for sanatorium treatment by Dr. T. D. Lister, the Advisory Physician to the Council of the National Association. Two of the patients were insured persons resident in Fulham, who were nominated by the Council to fill vacant beds, there being no suitable cases at the time among the uninsured, and the cost of their maintenance was repaid to the Borough Council by the Insurance Committee of the County of London. 38 Patients sent to the National Sanatorium, Benenden, by the Fulham Borough Council. Cases. Initials. Age. Occupation. Number of Days in Sanatorium. Gain or Loss of Weight. Condition of Disease on Discharge. Prognosis. Present Condition and Occupation. Case 1 S. H. 17 Office Boy 95 +8 lbs. Arrest Good Good health. At work in country. „ 2 F. S. 18 Clerk 123 +6 lbs. Improved Doubtful Has removed. Condition not known. „ 3 G. V. 30 Clerk 202 +26½ lbs. Improved Doubtful Unable to work. „ 4 J. C. 37 Dustman 75 +12 lbs. Arrest Fair Fair health. At work as Road Sweeper. „ 5 F. C. 49 Carman 61 +2 lbs. Unimproved Bad Died, March, 1913. „ 6 W. M. 48 Jeweller 81 +18 lbs. Arrest Good Fair health. At work. „ 7 F. B. 37 Lamplighter 75 +13 lbs. Arrest Good Good health. At work. „ 8 H. W. 40 Milk Carrier 124 +7 lbs. Unimproved Bad Died, 13th January, 1913. „ 9 F. T. 18 Boot Repairer 92 +12 lbs. Arrest Fair Fair health. Out-door work. „ 10 F. S. 38 Brass Finisher 160 +9 lbs. Improved Poor Poor health. Unable to obtain suitable [work. „ 11 W. M. 21 Draughtsman 127 +19 lbs. Arrest Good Good health. At work. „ 12 H. T. 48 Baker 67 +15 lbs. Arrest Good Fair health. At work. „ 13 J. J. 35 Milk Carrier 40 +1 lb. Unimproved Bad In Infirmary. „ 14 C. W. 36 Collector 94 +11 lbs. Arrest Good Good health. At work. ,, 15 A. S. 36 Postman 36 +6 lbs. Improved Very fair Fair health. At work. „ 16 E. W. 44 Bus Conductor 109 +8½ lbs. Arrest Fair Fair health. In work. „ 17 G. H. 33 Porter 101 +16½ lbs. Arrest Good Fair health. In light work. „ 18 A. C. 25 Butcher 78 +18 1bs. Improved Fair Fair health. At work. The term "Arrest" indicates good general health, few, if any, abnormal physical signs in chest, no tubercle bacilli in sputam. 39 National Insurance Act, 1911. Administration of Sanatorium Benefit. Insured persons became entitled to the Sanatorium benefit provided by the National Insurance Act on July 15th, 1912, and in September a temporary local Sub-Committee was formed for each metropolitan borough, to administer the provision of Sanatorium benefit to insured persons within the borough, and the Medical Officer of Health was appointed to serve on the Committee with the permission of the Borough Council. So far as Fulham was concerned, the appointment of the Sub-Committee was a farce, as there was practically nothing for them to administer and they might well have been spared the trouble of meeting. A scale of fees to be paid to medical practitioners for the domiciliary treatment of insured persons suffering from tuberculosis was agreed upon, but only four patients were referred to the Sub-Committee, and of these one had been dead 17 days and another had been admitted into the Poor Law Infirmary. Eight insured persons were recommended by the medical adviser of the Insurance Committee for treatment at the Fulham Dispensary and the Sub-Committee arranged as to the payments to be made to the Dispensary in respect of these patients, but the Insurance Committee have recently informed the Committee of the Dispensary that they have no funds to enable them to pay for the treatment of insured persons. As there were grave complaints of the delay of the Insurance Committee in dealing with applications for Sanatorium benefit, of which the two cases mentioned above are illustrations, the Fulham Sub-Committee passed the following resolution:— "That having regard to the long delay, which is most detrimental to the patient, entailed by the method adopted by the Insurance Committee of the County of London of dealing with applications for a Sanatorium benefit, the provisional Sub-Committee of 40 Fulham are of opinion that the applications for Sanatorium benefit should be made to the SubCommittee, who would at once make the necessary enquiries as to the eligibility of the applicant, arrange if necessary for his medical examination by the local Tuberculosis Officer, and if the latter be of opinion that the case is suitable for, and the applicant desires institutional treatment, the case should be referred to the Insurance Committee to deal with, but that if the patient requires domiciliary or dispensary treatment, the case should be left in the hands of the Local Committee to deal with, and the particulars reported to the Insurance Committee. If this method were adopted the SubCommittee are of opinion that there would be not only a saving of expenditure, but a material saving of time, which would be beneficial to the patient." The Insurance Committee were subsequently again pressed to make arrangements for applicants for Sanatorium benefit to be examined by the local Tuberculosis Officer, as advised by the Local Government Board, and for the suitable treatment to be recommended by him instead of requiring them to go three or four miles to be examined by the Council's expert, as in some instances they have been in quite an unfit condition to travel and unfortunate consequences have, according to their medical attendants, been the result of their doing so. The Insurance Committee, however, have refused to adopt the suggestion. 41 SICKNESS AND DEATHS FROM NON-NOTIFIABLE INFECTIOUS DISEASES. Measles. The deaths from measles in the four quarters of the year were:— 1st Quarter 9 2nd „ 24 3rd „ 6 4th „ 26 65 The death-rate was 0.42 per 1,000, being 0.12 below the average rate of the preceding ten years. 783 cases were reported by the Schools, and these were visited by the Sanitary Inspectors, who gave printed and verbal instructions respecting the precautions to be taken to prevent the spread of the disease. The London County Council regulations with regard to the exclusion of children from infected houses are:— 1.—Boys' and Girls' Departments. (a) If a child has had measles it need not be excluded from attendance at school. (b) If a child has not had measles it should be excluded from attendance at school for a period of 14 days from the date of the occurrence of the first case. 2.—Infants' Departments. All children should be excluded from attendance at school for a period of 14 days from the date of the last case. In addition to the children excluded under the above regulations, 100 class rooms in various schools were either closed for certain periods or all the unprotected children in them were excluded. 42 Attention has been frequently drawn in these reports to the mistaken idea that measles is only a trifling disease, but its high fatality is illustrated by the returns of the Managers of the Metropolitan Asylums Board for 1911, which show that of 3.144 patients admitted with measles in that year 438 died, a mortality of 13.3 per cent. compared with a mortality in their hospitals of 1.9 per cent. in 8,818 cases of scarlet fever and of 8.5 per cent. in 5,034 cases of diphtheria, though it must of course be borne in mind that the cases of measles admitted were of a special class, being either poor-law cases or severe and necessitous cases recommended by Medical Officers of Health. Whooping Cough. The deaths from whooping cough in the four quarters of the year were:- 1st quarter 13 2nd „ 17 3rd „ 10 4th „ 5 45 The death-rate from the disease in Fulham was 0.29 per 1,000, or 0.7 below the average rate for the preceding ten years. Hospital Accommodation for Whooping Cough. In 1910 the Local Government Board issued an Order empowering the Managers of the Metropolitan Asylums Board to receive into their hospitals certain persons suffering from whooping cough "who are either in the institutions of Poor Law Guardians or can be admitted into a Poor Law Infirmary by order of the Relieving Officer," and in August, 1912, the Board made a further Order reqniring the Managers to admit into 43 their hospitals persons suffering from whooping cough who are not paupers, provided they are recommended for admission by the Medical Officer of Health, and there is more accommodation available in the hospitals than is required by pauper patients suffering from whooping cough. Consequent upon this a circular letter was addressed to the medical practitioners practising in Fulham, asking them to acquaint the Medical Officer of Health with any cases under their care whose removal they considered desirable. Although one of the most fatal diseases of early life, the serious nature of whooping cough is largely underestimated, and an attack is often regarded with perfect indifference until some fatal complication ensues. The high mortality among ill-nourished children, who have lived under unfavourable conditions, is illustrated in the Report of the Managers of the Asylums Board, which shows that in 1911 of 1184 children admitted, all Poor Law cases. 144 died, a fatality of 12.2 per cent. Diarrœha. The deaths from diarrhœa in 1912 numbered 38, or 141 fewer than the decennial average, as owing to the unseasonable weather there was an entire absence of summer diarrhœa, only 6 deaths being registered from it in the summer quarter against 199 in the corresponding period of 1911. DEATHS FROM OTHER DISEASES. Influenza. Sixteen deaths were certified to be due to influenza, the numbers for the three preceding years being 22, 25 and 19. Cancer. To the various forms of cancer 155 deaths were referred, 61 of males and 94 of females, representing a death-rate of 1.0 per 1,000 against a decennial average of 1.04. 44 Diseases of the Respiratory System. From these diseases there were 395 deaths, or 19.5 per cent. of the deaths from all causes, being 23 below the average number in the ten years, 1902-1911. Violence. The deaths of Fulham residents from various forms of violence numbered 85, of which 18 were due to suicide. Other diseases caused the following deaths:— Diseases of the Circulatory System 197 Diseases of the Nervous System 173 Diseases of the Digestive System 80 Diseases of the Urinary System 84 Venereal Diseases 10 Senile Decay 87 CERTIFICATION OF THE CAUSES OF DEATH. Of the 2,023 deaths registered, 1,882, or 93 per cent., were certified by registered medical practitioners and 140 by Coroners after inquest; only one death, that of a woman of 61 from influenza, being uncertified. DEATHS IN PUBLIC INSTITUTIONS. Fulham Infirmary and Workhouse. The deaths of 430 persons, 237 males and 193 females, occurred in Fulham Infirmary, and of 44, 29 males and 15 females, in the Workhouse. Of these 468 belonged to Fulham and 6 to other districts. Western Fever Hospital. In the Western Fever Hospital there were 167 deaths, 78 males and 89 females, of whom 35 lived in Fulham and 132 in other boroughs. 45 Deaths occurring outside the Borough among persons belonging thereto. The deaths of Fulham residents in public institutions and elsewhere outside the borough numbered 366, and occurred in the following institutions:- St. George's Hospital 63 West London „ 45 Other General Hospitals (Metropolitan) 32 General Hospitals (Provincial) 8 Victoria Hospital for Children 23 Other Hospitals for Children 6 Lying-in and other Hospitals for Women 8 Cancer Hospital 8 Brompton Hospital 4 Other Special Hospitals (Metropolitan) 3 Homes for Incurables 11 Provincial Special Hospitals and Convalescent Homes 10 Hospitals of Metropolitan Asylums Board 13 Lunatic Asylums 68 Workhouses and Poor Law Infirmaries 20 In private houses and elsewhere 44 366 Of the deaths registered, 841 or 41.7 per cent. took place either in Poor Law institutions, in hospitals, or in public lunatic asylums, the percentages in the various classes of institutions being as under:— Deaths in Workhouses or Workhouse Infirmaries 24.5 ,, Metropolitan Asylums Board Hospitals 2.4 „ other Hospitals 11.4 „ Public Lunatic and Imbecile Asylums 3.4 41.7 46 GENERAL SANITARY ADMINISTRATION. Disinfection. The following infected articles were disinfected at the Council's Disinfecting Station, Townmead Road, during the year:- Beds 1063 Mattresses 1644 Pillows 2690 Bolsters 1026 Blankets 1686 Sheets 1588 Rugs and Counterpanes 1695 Curtains 1525 Carpets and Rugs 1061 Articles of Clothing 6739 Cushions 410 Spring Beds 9 Sundries 9010 30146 The total cost of the station for the year, including £56 for interest on loans for the building and plant and £216 for repayment of principal, was £937. The following rooms were disinfected and cleansed viz.:- After Phthisis 321 „ Scarlet Fever 443 „ Chickenpox 3 ,, Diphtheria 197 „ Measles 400 „ Erysipelas 76 „ Opthalmia Neonatorum 1 „ Puerperal Fever 26 „ Enteric Fever 24 ,, Anthrax 1 „ Poliomyelitis 2 „ Whooping Cough 1 „ Cerebro Spinal Meningitis 2 „ Scabies 1 „ Cancer 3 Rooms fumigated by request 38 Verminous rooms fumigated 92 School Classrooms sprayed 15 1646 47 BACTERIOLOGICAL EXAMINATIONS. The following bacteriological examinations were made on behalf of the Council by the Lister Institute:— Material from cases of suspected diphtheria:— Number of Specimens. Klebs-Löffler or true diphtheria bacillus isolated 56 Pseudo-diphtheria bacillus of Hoffman isolated 21 Negative result 139 216 Blood from suspected cases of enteric fever :— Widal or typhoid reaction obtained 11 „ „ not obtained 22 33 Sputa from cases of suspected tuberculosis : Tubercle bacillus found 93 „ „ not found 325 418 Other examinations 3 670 PUBLIC MORTUARY. 138 bodies were removed to the Mortuary during 1912, viz.:- At the request of the Coroner 90 Brought in by the Police 23 At the request of the Medical Officer of Health 5 „ „ Relieving Officer 3 For convenience till funeral 17 138 Inquests were held on 110, and post mortems on 57 of the above cases. 48 ADMINISTRATION OF THE FACTORY AND WORKSHOP ACT. The factories and workshops where women are employed were inspected by your Sanitary Inspector, Mrs. Davies, who served 55 notices in respect of defects observed. Outworkers. The homes of outworkers employed by firms both within and without the borough, have been regularly inspected and 31 notices were served in respect of nuisances found in them. Kitchens of Restaurants and Coffee Houses. These have been systematically inspected by Mrs. Davies and 13 notices were served on the occupiers on account of want of cleanliness. Bakehouses. There are 71 bakehouses on the register, of which 49 are underground. In 8 cases cleansing was found necessary, which was at once carried out on receipt of notice. 49 The following tables, prepared at the request of the Secretary of State of the Home Department, gives a summary of the work done in connection with the Factory and Workshop Act:— 2.–INSPECTION OF FACTORIES, SHOPS, AND WORKPLACES. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Factories (Including Factory Laundries) Inspections. Written Notices. Prosecutions. 140 12 ... Workshops (Including Workshop Laundries) 520 37 ... Workplaces Other than Outworkers' premises included in Part 3 of this Report.) 170 31 ... Total 830 80 ... 50 2.—DEFECTS FOUND IN FACTORIES, WORKSHOPS AND WORKPLACES. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H..M. Inspector. Nuisances under the Public Health Acts:—* Want of cleanliness 58 58 ... ... Want of ventilation 2 2 ... ... Overcrowding ... ... ... ... Want of drainage of floors ... ... ... ... Other nuisances 5 5 ... ... Sanitary accommodation— Insufficient 3 3 ... ... Unsuitable or defective 19 19 ... ... Not separate for sexes 2 2 ... ... Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouses (s. 101) ... ... ... ... Breach of special sanitary requirements for bakehouses (ss. 97 to 100) 8 8 ... ... Other offences ... ... ... ... (Excluding offences relating to outwork which are included in Part 3 of this Report) Total 97 97 ... ... * Including those specified in sections 2, 3, 7 and 8 of the Factory and Workshop Act as remediable under the Public Health Acts. 51 3.—HOME WORK. NATURE OF WORK. OUTWORKERS' LISTS, SECTION 107. OUTWORK IN UNWHOLESOME PREMISES, SECTION 108. OUTWORK IN INFECTED PREMISES, SECTIONS 109, 110. Lists received from Employers. Notices served on Occupiers as to keeping or sending lists. Prosecutions. Sending twice in the year. Sending once in the year. Failing to keep or permit inspection of lists. Failing to send lists. Instances. Notices served. Prosecutions. Instances. Orders made (Sec. 110). Prosecutions (Secs. 109, 110). Lists. Outworkers. Lists. Outworkers. Contractors. Workmen. Contractors. Workmen. Wearing Apparel— (1) making, etc. 26 6 60 3 ... 6 6 ... ... 26 26 ... ... ... ... (2) cleaning and washing ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Household linen ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lace, lace curtains and nets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Curtains and furniture hangings ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Furniture and upholstery ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Electro-plate ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... File making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Brass and brass articles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fur pulling ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... Cables and chains ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Anchors and grapnels ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cart gear ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Locks, latches and keys ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Umbrellas, etc. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Artificial flowers ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Nets, other than wire nets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tents ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Sacks ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Racquet and tennis balls ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Paper, etc., boxes, paper bags ... ... ... ... ... ... ... ... ... 3 3 ... ... ... ... Brush making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pea picking ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Feather sorting ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Carding, etc., of buttons, etc. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Stuffed toys ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... Basket making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chocolates and sweetmeats ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total 26 6 60 3 ... 6 6 ... ... 31 31 ... ... ... ... 52 4. —REGISTERED WORKSHOPS. Class. Number. Workshops on the Register (s. 131) at the end of the year:— Bakehouses 71 Laundries 35 * Dressmakers, Milliners, Blousemakers 94 Tailors, Outfitters, etc. 18 Bootmakers 36 Motor and Cycle Makers 24 Cabinet Makers, etc. 26 Other Trades 96 Total number of workshops on Register 400 5.—OTHER MATTERS. Class. Number. Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act, (s. 133) Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5):— Notified by H.M. Inspector 7 Reports (of action taken) sent to H.M. Inspector 7 Other - Underground Bakehouses (s. 101):— Certificates granted during the year - In use at the end of the year 49 53 FOOD SUPPLY. Milk. The milkshops in the borough have been kept under supervision by your Food Inspector. Ice Creams. The registered premises where ice creams are made or stored have been regularly visited by your Sanitary Inspectors. Slaughterhouses and Cowsheds. The licences of the undermentioned slaughter houses were renewed by the London County Council in October, no objection to their renewal being offered by the Borough Council. Slaughterhouses. Premises. Licensee. 611, Fulham Road T. S. Payne. 105. Hammersmith Road R. W. Goodwin. 640, King's Road E. Vauglian. 603, King's Road S. Stone. No application was made for the renewal of the licence of the only cowshed in Fulham, situated at 2, Haldane Road. Unsound Food. The food exposed for sale in shops and on stalls in the streets has been regularly inspected. Proceedings were taken against a butcher, on whose premises a tuberculous bullock's pluck was found, and he was fined £2 and £1 3s. costs. 54 A summons against the wholesale dealer at Smithfield Market, who supplied the butcher, was dismissed, as he proved that at the time he sold the pluck he did not know, and had no reason to believe, that it was tuberculous. The following articles examined at the request of the owners were condemned and destroyed:— 8 boxes of fish. 1 barrel of grapes. 3 sacks of winkles. 114 boxes of dates. 8 bushels of cherries. Proceedings undeer the Sale of Food and Drugs Acts. The undermentioned samples were purchased for analysis in 1912. Article. Number of Samples taken Officially. Number Adulterated. Number of Samples taken Unofficially. Number Adulterated. Total Samples. Total Adulterated. Percentage of Adulteration. Milk 368 26 3 ... 371 26 7.0 Separated Milk 15 ... ... ... 15 ... ... Cream 3 ... ... ... 3 ... ... Dried Milk ... ... 1 ... 1 ... ... Condensed Milk ... ... l ... 1 ... ... Butter 30 9 327 34 357 43 12.1 Lard ... ... 27 ... 27 ... ... Cheese ... ... 26 ... 26 ... ... Coffee 7 2 33 7 40 9 22.5 Cocoa ... ... 7 1 7 1 14.3 Mustard ... ... 19 ... 19 ... ... Pepper ... ... 5 ... 5 ... ... Beef Dripping ... ... 9 ... 9 ... ... Preserved Peas ... ... 3 ... 3 ... ... Bread ... ... 1 ... 1 ... ... Flour ... ... 20 ... 20 ... ... Self Raising Flour ... ... 5 ... 5 ... ... Baking Powder 1 1 22 1 23 2 8.7 Arrowroot ... ... 3 ... 3 ... ... Rice ... ... 5 ... 5 ... ... Sago ... ... 5 ... 5 ... ... Tapioca ... ... 4 ... 4 ... ... Oatmeal ... ... 3 ... 3 ... ... Infants' Food ... ... 1 ... 1 ... ... Olive Oil ... ... 7 ... 7 ... ... Red Currant Jelly ... ... 6 ... 6 ... ... Ginger Beer ... ... 1 ... 1 ... ... Mercury Ointment 5 1 5 3 10 4 40.0 Camphorated Oil 2 ... 17 1 19 1 5.3 Emulsion of Cod Liver Oil ... ... 2 ... 2 ... ... 431 39 568 47 999 86 8.6 55 In the ten preceding years the samples purchased for analysis were as under: — Number of Samples. Samples Adulterated. Percentage of Adulteration. 1902 354 18 5.1 1903 487 54 11.1 1904 673 115 17.1 1905 613 141 22.4 1906 559 163 28.1 1907 659 85 12.9 1908 997 162 16.8 1909 1,000 81 8.1 1910 999 127 12.7 1911 1,035 90 8.7 Of the milk samples 7 per cent, were certified as adulterated compared with 8.2, 12.2 and 5.7 per cent, in the preceding three years. The percentage of the adulteration of milk throughout the whole country in 1911 was 11.9. The average composition of the samples purchased as new milk in each of the four quarters was as under:— Solids other than Fat. Fat. Water. 1st Quarter 8.93 3.54 87.53 2nd „ 8.65 3.41 87.94 3rd „ 8.76 3.70 87.54 4th „ 8.64 3.70 87.66 The Milk and Cream Regulations issued by the Local Government Board came into operation on October 1st, 1912. These provide that no preservative shall be added to milk or to cream containing less than 35 per cent. of fat. In the case of cream containing over 35 per cent. of fat, boric acid, borax, or hydrogen peroxide may be added, provided the amount of the preservative used is stated on the label. The addition of any thickening 56 substance to cream is also prohibited. The attention of dairymen and others selling cream in the borough has been called to these regulations. Arsenic in Baking Powder. A sample of baking-powder was certified to contain 1-40th of a grain of arsenic to the pound. The vendor had obtained the baking-powder from a manufacturer in Manchester, but some samples, which were taken at my suggestion by the Medical Officer of Health for Manchester from the manufacturer, were found to be free from arsenic. Prosecutions under the Sale of Food and Drugs Acts were instituted in the following cases:— Defendant. Offence. Result. Penalty. Costs. £ s. d. £ s. d. The Retail Dairy Co., 29, Baldwin Street, Bristol. Selling milk from which 8 per cent. of the original fat had been abstracted. Dismissed (warranty proved) - - James Brighton, 25, Purser'sCross Rd. Fulham, S.W. Selling milk from which 21 per cent. of the original fat had been abstracted. Convicted 2 0 0 12 6 William Haines, 47, Estcourt Road, Fulham, S.W. Selling milk from which 4 per cent. of the original fat had been abstracted. Convicted Nil 12 6 William Mosley, 46, Parsons Gr'n Lane Fulham, S.W. Selling margarine for butter. Convicted 2 0 0 14 6 Thomas Russell, 318, Lillie Road, Fulham, S.W. Selling baking powder containing 1 40th grain of arsenic per pound. Convicted Nil 12 6 James Hedges, 59, I-angthorne St., Fulham. S.W. Selling milk adulterated with 12 per cent. of added water. Convicted 2 0 0 12 6 Edwin Hubert, 161, Dawes Road, Fulham, S.W. Selling margarine for butter. Convicted 1 0 0 14 6 57 Defendant. Offence. Result. Penalty. Costs. £ s. d. £ s. d. John Evans, 463, Fulham Road, Fulham, S.W. Selling margarine for butter. Convicted 1 0 0 14 6 Henry Grainger, 48, Dawes Road, Fulham, S.W. Obstructing Inspector in the execution of his duty. Convicted 2 0 0 2 0 Wm. Arnold Thomas, 155, Lillie Road, Fulham, S.W. Selling margarine for butter. Convicted 2 0 0 14 6 John Towell, 66, Sandilands Rd., Fulham, S.W. Selling coffee adulterated with 25 per cent. of chicory. Convicted 5 0 12 6 James Brighton, 25, Purser's Cross Rd. Fulham, S.W. Selling milk from which 88 per cent. of the original fat had been abstracted. Convicted 15 0 0 12 6 Thomas Davies, 2, Everington St., Fulham, S.W. Selling milk from which 8 per cent. of the original fat had been abstracted. Convicted 1 0 0 12 6 Herbert Reynolds, 203, Munster Road, Fulham, S.W. Selling margarine for butter. Convicted 2 0 0 1 15 6 Fanny Reynolds, 203, Munster Road, Fulham, S.W. Selling margarine for butter. Convicted 5 0 0 14 6 Charles Laurence, 2, Orbain Road, Fulham, S.W. Selling coffee adulterated with 90 per cent, of chicory. Convicted 2 0 0 12 6 Isaac Evans, 73, Masborough Rd., Hammersmith, W. Obstructing Inspector in the execution of his duty. Convicted 15 0 0 2 0 0 Timothy Jones, 44, Brook Green, Hammersmith, W. Selling margarine for butter. Convicted 5 0 0 14 6 Isaac Evans, 73, Masborough Rd., Hammersmith, W. Selling margarine for butter. Convicted 25 0 0 14 6 82 5 0 13 19 0 58 HOUSING, TOWN PLANNING, ETC., ACT, 1909. The number of dwelling-house inspected under and for the purpose of Section 17 of the above Act was as under: Number of houses inspected. Number of houses unfit for habitation. Number of representations. Number of Closing Orders. Number of houses in which defects were remedied without Closing Orders. Number of houses in which defects were remedied after Closing Orders. Number of houses demolished. Number of houses in which repairs were not completed on Dec. 31st, 1912. 44 — — — 44 — — — Demolition.—Three houses in Parson's Green Lane in respect of which closing orders were made in 1911, were demolished. No demolition orders have been made in respect of 15 houses in Langford Road and 6 houses in Hatfield Street which were closed in 1911, although no steps have been taken to render them fit for habitation. Underground Rooms used as Sleeping Places, The following regulations in respect of underground rooms habitually used as sleeping places, made by the Council, pursuant to Section 17 (7) of the Act, have been approved by the Local Government Board:— Regulations prescribed by the Mayor, Aldermen and Councillors of the Metropolitan Borough of Fulham, under Section 17 (7) of the Housing, Town Planning, etc., Act, 1909. Every room habitually used as a sleeping place, the surface of the floor of which is more than three feet below the surface of the 59 part of the street adjoining or nearest to the room, shall comply with the following regulations, namely:— 1. The subsoil of the site of the room shall be effectually drained by means of a subsoil drain properly trapped and ventilated wherever the dampness of the site renders such a precaution necessary. 2. Every drain passing under the room, other than a drain for the drainage of the subsoil of the site of the room, shall be gas-tight and water-tight. 3. The room shall be effectually protected against the rising of any effluvium or exhalation. 4. The space, if any, beneath the floor of the room, shall be provided with adequate means of ventilation. 5. (i.) Every wall of the room shall be provided with a proper horizontal damp-proof course which, if the floor of the room be formed of woodwork, shall be beneath the level of the lowest timbers or woodwork of such floor, and in every other case shall be not less than one inch below the level of the upper surface of such floor. (ii.) No part of any wall of the room shall, where it is practicable to avoid it, be in contact with the ground or earth. Provided that where any wall of the room is in contact with the ground or earth, such wall or such part thereof as is so in contact shall, unless constructed as a hollow wall, have an efficient vertical damp-proof course extending from the base thereof to a height of at least six inches above the surface of such ground or earth. 6. Unless the room is provided with a fire place and a flue properly constructed and properly connected with such fire-place, it shall be provided with special and adequate means of ventilation by one or more suitably placed apertures or air shafts. 7. An area properly paved with impervious material and effectually drained by means of a properly trapped gulley shall adjoin the room and extend either throughout the entire length of one side thereof, or at least throughout the entire width of any window or windows required by these regulations, and (except where the area of such window or windows shall be of not less extent than one seventh of the floor area of the room) for three feet on both sides of such window or windows. Such area shall be not less than two feet wide in every part thereof, and shall be open upwards from a level three inches below the level of the damp-proof course in the adjoining wall of the room 60 Provided (a) that where a bay window in the room having side lights overlooks such area, the width thereof in front of such window may be one foot at the least, (b) that any steps necessary for access to any part of the building comprising the room may be placed in or over such area if they are so placed as not to be over or across any window of the room required by the regulation in that behalf, and (c) that this regulation shall not apply in any case where the room has adjoining the external wall in which the window or windows required by these regulations may be placed an open space which is of not less length and width than the area hereinbefore required. 8. (i.) The room shall be effectually lighted by means of one or more windows opening directly into the external air. (ii.) Every such window shall be so constructed that one half at the least may be opened, and that the opening may extend to the top of the window. (iii.) The total area of such window or windows, clear of the sash frames, shall be equal at the least to one-eighth of the floor area of the room, and a portion of such total area equal in extent to at least one-tenth of such floor area shall be so situated that a line making an angle of thirty degrees with a horizontal plane can be drawn upwards from any point thereon in a vertical plane at right angles to the plane of the window so as not to intersect within a distance of ten feet measured horizontally from the window any wall of any area adjoining the room or any other wall or any kerb or other obstruction except an open fence. For the purposes of this paragraph a bay window having side lights shall be assumed to be equivalent to a flat window of the same area and of the same height in relation to the room, and situated at a distance from the outside area wall equal to the mean width of the area. (iv.) In estimating the area of a window or windows for the purpose of this regulation no account shall be taken of any part of any such window which is above the mean level of the ceiling of the room. (v.) Any such window or windows shall overlook the area provided in pursuance of the regulation in that behalf, or an open space of not less extent than such area. Drainage of Buildings. During the year the following drainage plans were submitted to and approved by the Public Health Committee:— 61 Plans of drainage of new houses 341 ,, „ ,, „ blocks of flats 2 „ „ „ „ workshops, etc. 8 „ „ „ „ additions to existing buildings 36 ,, „ the reconstruction of the drainage of existing buildings 112 499 Combined Drainage. Five systems of combined drainage for which the Council was liable, were reconstructed at a cost of £55 6s., by the Council's contractor. The sum of £67 l1s. was also paid to the owners of 11 houses in respect of work carried out by them in compliance with notices served by the Council in connection with house drains, which were sewers as defined by the Metropolis Local Management Act, 1855. Water Supply in Tenement Houses. An additional water supply on the upper floors was required and provided in 43 tenement houses under the provisions of Section 78 of the London County Council (General Powers) Act, 1907, by which a sufficient supply of water can be required on each separately occupied floor of a tenement house. Certificates under the Revenue Acts. Applications were received for certificates under the Revenue Acts for an exemption from, or an abatement of, inhabited house duty in respect of 484 tenements, of which 344 were granted, 66 were given after certain specified works had been completed, and 94 were refused. Certificates in respect of 706 dwellings, which had been granted for a limited period, were renewed. 62 CLEANSING OF CHILDREN. The London County Council's cleansing station in Sedlescombe Road has been in operation since January 16th, 1912, and up to December 31st there were 1608 attendances of children requiring cleansing. The names and addresses of 608 children were forwarded to the Public Health Department, whose homes were visited by your Sanitary Inspectors, and if found verminous cleansed under the powers given by the London County Council's (General Powers) Act, 1904, the bedding, etc., being disinfected at the Council's disinfecting station. SCHOOL MEDICAL TREATMENT CENTRE. Under an agreement entered into by the London County Council with a Committee representing the medical practitioners in the Borough a centre was opened at the end of October at 18, Bagley's Lane, for the medical treatment of school children suffering from affections of the eye, ear, nose and throat, and from minor ailments requiring the services of a nurse working under the instructions of a doctor, such as skin diseases, external eye diseases, and discharging ears. The agreement provided for the treatment yearly of 440 eye (refraction) cases, 880 ear, nose, and throat cases, requiring operation, and 1,100 cases of minor ailments. A dental treatment centre for school children with defective teeth has also been established on the same premises. 63 GENERAL SANITARY WORK. 1,568 complaints were received and dealt with by your Sanitary Inspectors, and 1434 intimation and 460 statutory notices were served. Summonses for failing to comply with the Council's notices were issued in four cases, and a penalty of 10s. and 8s. costs was imposed in each case. The following summary has been prepared at the request of the Medical Officer of Health of the London County Council:— PREMISES. NUMBER OF PLACES. Number of Inspections, 1912. Number of Notices. 1912. Number of Prosecutions, 1912. On register at end of 1911. Added in 1912. Removed in 1912. On registhe at end of 1912. Milk premises 211 42 56 197 530 ... ... Cowsheds 1 ... 1 ... 6 ... ... Slaughter houses 4 ... ... 4 36 ... ... Other offensive trade premises ... ... ... ... ... ... ... Ice cream premises 145 8 15 140 180 6 ... Registered houses let in lodgings 114 ... ... ... ... ... ... 64 Total number of intimation notices served for all purposes 1,434 Overcrowding, 1911. Number of dwelling rooms overcrowded 46 Number remedied 46 Number of prosecutions — Underground rooms— Illegal occupation dealt with during year — Number of rooms closed — Insanitary houses— Number closed under the Public Health (London) Act, 1891 — Number closed under the Housing, Town Planning, etc., Act — Number of rooms cleansed under sec. 20 of the London County Council (General Powers) Act, 1904 220 Shelters provided under sec. 60 (4) of the Public Health {London) Act, 1891— Number of persons accommodated during the year — Revenue Acts— Number of tenements for which applications were received during the year 404 Number of tenements for which certificates were— (a) granted 344 (b) refused 94 (c) deferred 66 Certificates previously issued for a limited period renewed 706 65 SANITARY STAFF. There have been no changes in the staff of the Public Health Department during the year, but the work of the clerical staff has been greatly increased by the extension of notification to all forms of tuberculosis, and an additional clerk is required. I am pleased to have the opportunity of again recording the zeal and fidelity with which all the members of the staff have discharged their duties. I am, Sir and Gentlemen, Your obedient Servant, J. CHARLES JACKSON, Medical Officer of Health. April, 1913. 66 APPENDIX. TABLE A. DEATHS REGISTERED FROM ALL CAUSES DURING THE YEAR 1912. (Exclusive of the Deaths of Non-Parishioners at Public Institutions within the Borough, but inclusive of the Deaths of Parishioners at Public Institutions without the Borough. For a Summary of this Table see page 11. Ages. Diseases. 0-1. 1-2. 2-3. 3-4. 4-5. Total under 5. 5-10. 10-15. 15-25. 25-35. 35-45. 45-55. 55-65. 65-75. Over 75 Males. Females. Total All Ages. Enteric Fever .. .. .. .. .. .. 1 .. 3 1 2 1 .. .. .. 5 3 8 Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 12 17 14 10 9 62 3 .. .. .. .. .. .. .. .. 37 28 65 Scarlet Fever .. .. 1 .. 1 2 4 .. .. .. .. .. .. .. .. .. 6 6 Whooping Cough 23 8 7 3 1 42 3 .. .. .. .. .. .. .. .. 18 27 .45 Diphtheria 1 2 4 1 3 11 4 .. .. .. .. .. .. .. .. 7 8 15 Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Influenza .. .. .. .. .. .. .. .. 1 1 .. .. 7 2 5 9 7 16 Erysipelas 1 1 .. .. .. 2 .. .. .. .. .. 1 .. 2 .. 2 3 5 German Measles .. .. .. 1 .. 1 .. .. .. .. .. .. .. .. .. 1 .. 1 Other Epidemic Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Malaria .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Pyaemia and Septicaemia 1 .. .. .. .. 1 .. .. 1 1 1 .. .. .. .. 3 1 4 Tetanus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tuberculosis :— Pulmonary Tuberculosis 1 3 3 4 1 12 2 2 31 39 52 35 25 14 1 130 83 213 Tubercular Meningitis 3 1 3 7 3 17 3 1 .. .. .. .. .. .. .. 8 13 21 Abdominal Tuberculosis 4 2 .. 1 1 8 1 .. .. .. 1 .. 1 .. .. 5 6 11 Tuberculosis of the Spine .. .. 1 .. .. 1 .. .. 1 .. .. .. .. .. .. 1 1 2 Tuberculosis of the Joints .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. 1 67 Ages. Diseases. 0-1. 1-2. 2-3. 3-4. 4-5. Total Under 5. 5-10. 10-15. 15-25. 25-35. 35-45. 45-55. 55-65. 65-75. Over 75. Males. Females. Total All Ages. Tuberculosis of Other Organs .. .. .. .. .. .. .. .. .. 3 .. 2 1 .. .. 2 4 6 Disseminated Tuberculosis . 1 .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. 2 2 Rickets .. 2 .. .. .. 2 .. .. .. .. .. .. .. .. .. .. 2 2 Venereal Diseases 6 .. .. .. .. 6 1 .. .. 1 1 .. .. 1 .. 4 6 10 Cancer .. .. .. .. .. .. .. .. 1 2 11 42 39 39 21 61 94 155 Tumour, situation undefined . .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. 1 Rheumatic Fever .. .. .. .. .. .. 1 2 1 1 .. .. .. .. .. 3 2 5 Chronic Rheumatism and Rheumatoid Arthritis .. .. .. .. .. .. .. .. .. .. 1 3 3 .. 1 6 7 Diabetes .. .. .. .. .. .. .. .. 1 4 .. 3 2 6 1 8 9 17 Anaemia, Lencocythoemia 1 1 1 1 1 1 4 5 Other General Diseases .. .. .. .. .. .. .. 1 .. 1 1 .. 1 .. .. 1 3 4 Alcoholism .. .. .. .. .. .. .. .. .. 1 1 5 .. .. .. 2 5 7 Lead Poisoning .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. 1 Food Poisoning .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 Cerebro-Spinal Fever .. .. .. .. .. .. .. .. 1 1 .. .. .. .. .. 1 1 2, Simple Meningitis 5 .. .. .. .. 5 2 3 2 2 1 1 1 .. .. 7 10 17 Cerebral Haemorrhage, Apoplexy .. .. .. .. .. .. .. .. .. 2 4 7 10 37 26 42 44 86 Softening of Brain .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Paralysis, without specified cause .. .. .. .. .. .. .. .. .. .. .. 1 1 1 .. 2 1 3 Epilepsy .. .. .. .. .. .. .. .. 1 2 3 1 1 .. 2 5 5 10 Convulsions (not Puerperal) 14 .. .. .. .. 14 .. .. .. .. .. .. .. .. .. 7 7 14 Poliomyelitis .. 1 .. .. .. 1 .. .. 1 .. .. .. .. .. .. 2 .. 2 Other Diseases of Nervous System 1 .. .. .. .. 1 .. 2 3 1 14 14 7 3 1 30 16 46 Diseases of the Ear 2 1 .. .. .. 3 1 1 1 1 2 .. .. .. .. 9* .. 9 Pericarditis .. .. .. 1 .. 1 1 .. .. .. 1 .. 1 .. .. 1 3 4 Acute Endocarditis .. .. .. .. .. .. .. .. 1 4 1 1 .. .. .. 4 3 7 68 Ages. Diseases. 0-1. 1-2. 2-3. 3-4. 4-5. Total under 5. 5-10. 10-15. 15-25. 25-35. 35-45. 45-55. 55-65. 65-75. Over 75 Males. Females. Total All Ages. Organic Disease of Heart .. .. .. 1 .. 1 4 5 6 11 22 23 38 35 24 74 95 169 Embolism and Thrombosis (including Cerebral) .. .. .. .. .. .. .. .. .. 1 1 1 2 2 2 4 5 9 Other Diseases of Circulatory System .. .. .. .. .. .. .. .. .. 2 3 9 6 4 1 19 6 25 Diseases of the Lymphatic System 1 .. .. .. .. 1 .. .. .. .. 1 .. .. 1 .. 1 2 3 Diseases of the Larynx 2 1 1 • • 1 5 .. .. .. .. .. .. .. .. .. 3 2 5 Bronchitis 35 6 1 .. .. 42 .. .. .. 1 7 10 27 46 44 85 92 177 Bronchopneumonia 57 14 5 3 3 82 1 1 1 .. .. .. 2 4 5 58 38 96 Lobar Pneumonia 1 4 2 .. 1 8 .. .. .. 7 8 3 2 2 .. 21 9 30 Pneumonia (type not guished) 8 4 3 2 1 18 1 3 10 9 9 7 5 9 41 30 71 1 Pleurisy .. 1 .. .. .. 1 .. .. .. .. 1 2 2 .. 6 1 7 Other Diseases of Respiratory System .. .. .. .. .. .. .. .. .. .. .. 2 2 3 1 4 4 8 Diseases of Pharynx,Tonsillitis .. .. •• .. •• .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of Stomach 2 .. .. .. .. 2 .. .. 1 6 4 2 9 1 1 12 14 26 Diarrhoea and Enteritis 33 1 .. 1 1 36 .. .. .. .. 1 1 .. .. .. 23 15 38 Appendicitis and Typhlitis • • .. .. .. .. .. 1 1 2 3 .. 1 1 .. .. 6 3 9 Hernia and Intestinal Obstruction 2 .. .. .. .. 2 .. .. .. 1 1 .. 4 3 3 5 9 14 Cirrhosis .. .. .. .. .. .. .. .. .. .. 1 8 6 2 2 11 8 19 Other Diseases of Liver .. .. .. .. .. .. .. .. .. .. 1 2 1 1 1 2 4 6 Peritonitis (cause unknown) .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 1 Other Diseases of Digestive System .. .. .. .. .. .. .. .. 1 1 1 .. .. .. .. 1 2 3 Acute Nephritis 1 .. .. 1 .. 2 1 .. 2 .. 3 .. .. .. .. 4 4 8 Chronic Bright's Disease .. .. .. .. .. .. .. 1 2 3 4 18 19 8 5 33 27 60 Urinary Calculi .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. 2 .. 2 69 Ages. Diseases. 0-1. 1-2. 2-3. 3-4. 4-5. Total under 5. 5-10. 10-15 15-25. 25-35. 35-45. 45-55. 55-65. 65-75. Over 75. Males. Females. Total All Ages. Uterine Tumour (not cancer- ous) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ovarian Tumour .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. 2 2 Other Diseases of Genito- Urinary System) .. .. .. .. .. .. .. .. 1 .. 1 2 2 8 2 13 3 16 Puerperal Fever .. .. .. .. .. .. .. .. .1 3 2 1 .. • • .. .. 7 7 Other causes incident to Childbirth .. .. .. .. .. .. .. .. 2 2 2 1 .. .. .. .. 7 7 Diseases of Skin and Cellular Tissue 1 1 .. .. .. 2 .. .. .. .. 2 .. 2 3 3 5 7 12 Diseases of Locomotor System .. . . .. .. .. 2 2 .. .. .. 1 2 .. 2 7 2 9 Congenital Malformation 16 2 .. 1 .. 19 1 1 2 1 .. .. .. .. .. 18 6 24 Atelectasis 7 .. .. .. .. 7 .. .. .. .. .. .. .. .. .. 6 1 7 Premature Birth 81 .. .. .. .. 81 .. .. .. .. .. .. .. .. .. 41 40 81 Injury at Birth 8 .. .. .. .. 8 .. .. .. .. .. .. .. .. .. 6 2 8 Diseases of U mbilicus 2 .. .... .. 2 .. .. .. .. .. .. .. .. .. 1 1 2 Debility, Atrophy, Marasmus Old Age 47 .. 3 .. .. .. .. .. .. 50 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 16 .. 70 32 29 18 58 50 87 Accident. Poisons, Poisonous Vapours .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. 1 Conflagration.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Burns and Scalds 1 2 4 2 2 11 .. .. .. .. .. .. .. .. .. 6 5 11 Drowning .. .. .. .. .. .. .. •• .. .. 1 2 .. .. .. 3 .. 3 Suffocation in bed 10 .. .. .. .. 10 .. .. .. .. .. .. .. .. 6 4 10 Other Deaths by Accident 4 1 2 1 .. 8 2 2 8 2 7 2 6 3 2 30 12 42 Total Deaths from Accidents 15 3 6 3 2 29 2 2 8 2 8 5 6 3 2 46 21 67 Included in above are Deaths in connection with— Railways .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. 2 • • 2 Vehicular and Horses .. .. 3 .. .. 3 3 •• 4 1 .. 1 4 •• 2 10 8 18 70 Ages. Diseases. 0-1. 1-2. 2-3. 3-4. 4-5. Total under 5. 5-10. 10-15. 15-25. 25-35. 35-45. 45-55. 55-65. 65-75. Over 75. Males. Females. Total All Ages. Ships, Boats, Docks .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Building operations .. .. .. .. .. .. .. .. .. .. 2 .. .. .. .. 2 .. 2 Violence, other than Accidental— Homicide 1 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 1 Suicide .. .. .. .. .. .. .. .. 2 5 6 2 2 1 .. 14 4 18 Execution .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other specified Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ill-defined causes .. .. .. .. .. .. 2 .. .. .. 1 .. 1 .. .. 1 1 2 395 78 51 40 28 592 40 27 87 128 189 220 245 260 235 1057 966 2023 71 TABLE B. Showing the localities in which the cases of Notifiable Infectious Diseases and Deaths from Measles, Diarrhoea and Phthisis occurred during the year. (The figures in brackets denote the number of houses in which the cases occurred. The asterisks denote the fatal cases of Notifiable Diseases.) Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Deaths from Measles. Deaths from Diarrhoea and Enteritis. Under 2 vears. Deaths from Phthisis. Acfold Road .. .. .. .. .. .. .. 1 Ackmar Road .. .. .. .. .. .. .. ... Adeney Road 3(2) .. .. .. 1 .. .. 1 Aintree Street .. 1 .. .. 1 .. .. .. Alderville Road 1 1 .. .. .. .. .. .. Allestree Road 2 (2) 2 (2) .. .. 1 .. .. 1 Althea Street 1 .. .. .. .. .. .. .. Ancill Street 1 *2(2) 1 .. 1 .. .. 1 Anselm Road 1 *2 (2) .. .. .. .. .. 2 (2) Archel Road 2 (1) 2 (2) .. .. 1 1 .. 2(2) Argon Mews .. 1 .. .. .. .. .. .. Armadale Road 1 1 .. .. .. .. .. .. Ashcombe Street 1 1 .. .. . . .. .. .. Ashington Road .. .. .. 1 .. .. .. .. Ashton Terrace 1 .. .. .. .. .. .. .. Aspenlea Road 1 .. .. .. . . 1 1 1 Atalanta Street .. .. .. .. .. .. .. 2 (2) Auriol Road .. .. .. .. .. .. .. .. Avalon Road 1 .. .. .. .. 1 .. .. Averill Street 1 .. .. .. .. .. .. 1 Avonmore Road 1 .. .. .. .. .. .. 1 Bagley's Lane 1 1 .. .. 1 .. 1 1 Barclay Road .. .. .. .. .. .. .. .. Baron's Court Road .. .. .. .. .. .. .. .. Barton Street .. .. .. .. .. .. .. .. Basuto Road .. .. .. .. .. .. .. 1 Bayonne Road 1 *3(3) .. .. 1 1 .. 3(3) Beaulort Mews .. .. .. .. .. .. .. 1 Beaumont Crescent 1 .. .. .. .. .. .. 1 72  Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Deaths from Measles. Deaths from Diarrhoea and Enteritis. Uuder 2 years. Deaths from Phthisis. Beltran Road 3 (3) .. .. .. .. .. .. .. Beryl Road 1 .. *1 1 .. .. .. 1 Bettridge Road 1 .. .. .. .. .. 2 (2) Biscay Road .. .. .. .. .. .. .. .. Bishop King's Road .. .. .. .. .. .. .. .. Bishop's Pk. Mans. 1 .. .. .. .. .. .. .. Bishop's Road *3 (3) .. .. .. .. .. .. 1 Blake Road 1 .. * * .. .. .. .. .. Bloompark Road .. .. .. .. .. .. .. .. Bothwell Road .. .. .. .. .. .. .. .. Bovingdon Road 2(2) *1 .. .. .. .. .. .. Bowerdean Street 2 (2) 1 .. .. 1 .. .. .. Bradbourne Street 1 .. .. .. .. .. .. .. Bramber Road 1 1 .. .. l 3(*3) 1 1 Brandenburgh Road 1 .. .. .. .. .. .. .. Branksea Street 2 (2) 2(2) .. .. .. .. .. .. Brecon Road 3(3) 1 .. .. .. .. .. .. Breer Street 5 (1) .. .. .. .. 1 1 Britannia Road .. .. .. .. .. .. .. .. Brookville Road 1 1 .. *1 .. .. .. .. Broomhouse Road 2 (2) .. .. .. .. .. .. .. Bronsart Road 7(4) 1 .. 1 1 .. .. 1 Broughton Road 8(6) 2(2) 1 .. 1 .. .. .. Buer Road .. .. .. .. .. .. .. .. Bullow Road 1 .. .. 1 1 1 .. 1 Burlington Gdns. .. .. .. .. .. .. .. .. Burlington Road .. .. .. .. 2 (2) .. 1 .. Burnfoot Avenue .. .. .. .. .. .. 1 2 (2) Burnthwaite Road 5(5) 2(2) 1 1 .. .. .. 2 (2) By am Street .. 1 .. 1 .. .. .. .. Cambria Street 1 .. .. .. .. .. .. .. Campbell Street .. .. .. .. .. .. .. .. Campana Road ... 1 .. .. .. .. .. 1 Carlton Mews .. .. .. .. .. .. 1 1 Carnworth Street .. .. .. .. .. .. .. .. Caroline Place .. .. .. .. .. .. 1 .. Cassidy Road *1 3 (3) 1 .. .. .. .. 1 Castletown Road .. 1 .. .. .. .. .. 2(2) Cedar Road .. 1 .. .. .. .. .. .. Chaldon Road .. .. .. .. .. .. .. • • Challoner Street 2(1) .. .. .. .. .. .. 1 Chancellor's Road 5 (4) .. .. .. .. .. .. .. Charleville Road 2(2) .. .. .. .. .. .. .. 73  Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Deaths from Measles. Deaths trom Diarrhoea and Enteritis. Under 2 years. Deaths from Phthisis. Chelmsford Street 1 1 .. .. 1 .. .. 3(3) Cliesilton Road 4(3) .. 1 .. .. .. .. 1 Chesson Road .. .. .. .. *1 .. .. 1 Chiddingstone Street 4(3) .. .. .. .. .. .. 1 Chipstead Street 1 .. 1 .. .. .. .. .. Church Path 1 .. .. .. .. 4 (3) .. .. Clancarty Road 1 .. .. .. .. .. .. .. Claxton Grove 8(5) 2(2) .. .. 1 .. .. .. Claybrook Road .. 2(2) .. .. 1 .. l 1 Cloncurry Street 2(1) .. .. .. .. .. .. .. Clonmel Road 3(2) .. .. .. 1 .. .. .. Colehill Lane 3(2) .. .. 1 .. .. .. .. Comeragh Mews .. .. .. .. .. .. .. .. Comeragh Road .. .. .. .. .. .. .. 1 Conan Street 1 .. .. .. .. .. .. 1 Coniger Road 1 .. .. .. .. .. .. .. Coomer Road 3(3) 1 .. .. .. .. .. .. Cornwall Street .. .. .. .. .. .. .. .. Cortayne Road .. .. .. .. .. .. .. .. Crabtree Lane 2(2) 1 .. .. .. .. .. .. Cranbury Road 5(5) *3 (3) .. .. .. 1 .. 1 Crefeld Road 1 1 .. .. 1 .. .. 2(2) Cresford Road .. .. .. .. .. .. .. .. Crookham Road .. .. .. .. .. .. .. .. Cristowe Road 2(1) .. .. .. .. .. .. .. Crondace Road .. 1 .. .. .. .. .. .. Crown Mews .. .. .. .. .. .. .. .. Cumberland Cres. •• 1 .. • • .. •• .. .. Dalebury Road .. .. .. .. .. .. .. .. Dancer Road .. .. .. .. .. .. .. .. Danehurst Street 1 1 .. *1 .. .. .. .. Darlan Road 1 .. .. .. .. .. .. .. Dawes Road 6(5) 1 .. .. 1 .. .. 3(3) Dawson Street .. .. .. .. .. 3(3) l 2(2) Delaford Street .. 2(2) .. .. * * .. .. 1 Delorme Street 2(2) 1 .. 1 .. .. •• .. Delvino Road 1 .. .. .. .. .. .. .. De Morgan Road 1 1 .. .. .. 2(2) .. .. Devonshire Street .. .. .. .. .. .. .. .. Dieppe Street .. 2(2) .. .. .. .. .. 2(2) Dimsdale Road 1 .. .. .. *1 .. .. 3(3) Disbrowe Road .. .. .. .. .. 1 l 1 Distillery Lane .. .. .. .. .. .. .. 1 74  Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Deaths from Measles. Deaths from Diarrhœa and Enteritis. Deaths from Phthisis. Dolby Road .. .. .. .. .. .. .. .. Doneraile Street .. 1 .. .. .. .. .. .. Doria Road 2 (1) .. .. .. 1 .. .. .. Dorncliffe Road .. .. .. .. .. .. .. .. Dowell Mews .. .. .. .. .. .. .. .. Durrell Road .. .. .. .. .. .. .. .. Dymock Street 1 .. .. .. 1 1 .. 1 Eddiscombe Road 1 .. .. .. .. .. .. .. Edenhurst Avenue .. .. .. .. 1 .. .. .. Edenvale Street 1 .. .. .. .. .. 1 .. Edgarley Terrace .. 1 .. .. .. .. .. .. Edith Road .. *1 1 .. 1 .. .. 2(2) Edith Row .. .. .. .. .. .. .. .. Edith Villas 1 .. .. .. .. .. .. .. Eelbrook Terrace .. .. .. .. .. .. .. .. Effie Road .. .. .. .. .. .. .. .. Elbe Street 1 .. .. .. .. .. .. 1 Eli Mews .. .. .. .. .. .. .. .. Eli Street .. .. .. .. .. .. .. 1 Ellerby Street .. .. .. .. .. .. .. .. Elmdale Street 2 (2) .. .. .. 1 .. .. 1 Elmstone Road .. .. .. .. .. .. .. .. Elthiron Road .. .. .. .. .. .. .. 1 Elswick Street .. .. .. .. .. .. .. .. Elysium Mews .. .. .. .. .. .. .. .. Epirus Mews .. .. .. .. .. .. .. .. Epirus Road .. 1 .. .. .. .. .. .. Epple Road 1 .. .. .. .. .. .. 1 Estcourt Road .. 2(2) .. .. 1 .. 3 (3) 4(4) Eustace Road .. .. .. 1 .. .. .. Everington Street .. .. .. 1 .. .. .. 1 Ewald Road 1 .. .. 1 .. .. .. 1 Fabian Road 1 .. .. .. .. .. .. 1 Fairholme Road .. 1 .. .. .. .. .. .. Fane Street .. .. .. .. .. .. .. 1 Farm Lane 4 (4) .. .. .. .. .. .. 1 Favart Road 1 .. .. .. .. .. .. .. Felden Street 2 (2) 1 .. .. .. .. .. .. Fernhurst Road .. .. .. .. .. .. .. .. Field Road .. .. .. .. 1 2 (2) .. 2 (2) Filmer Road 11 (7) .. .. 1 1 1 .. .. Finlay Street 2(1) 1 .. .. .. .. .. .. 75  Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Deaths from Measles. Deaths from Diarrhœa and Enteritis. Under 2 years. Deaths from Phthisis. Firth Gardens 2(2) 3 (3) .. .. .. .. * * .. Fitzgeorge Avenue .. 1 1 .. .. .. .. .. Fitzjames Avenue . . 1 .. .. .. .. .. .. Foskett Road .. .. .. .. .. .. .. .. Francis Street .. . . .. .. .. .. .. .. Friston Street 1 .. .. .. .. .. .. .. Fulham Palace Road 9 (6) .. .. .. 1 .. .. 1 Fulham Pk. Gardens 3 (1) .. .. .. .. .. .. .. Fulham Pk. Road .. .. .. .. .. .. .. .. Fulham Road **6 (4) 9 (8) .. .. 2 (2) .. .. 3 (3) Furness Road 1 .. .. .. .. .. .. .. Garvan Road 2 (2) 1 .. .. .. 1 .. .. Gastein Road .. .. .. 1 .. .. .. .. Gilstead Road .. .. .. .. .. .. .. .. Gironde Road 1 l .. .. .. .. .. .. Glazbury Road .. .. .. .. .. .. .. .. Gledstanes Road 1 .. .. .. .. .. .. .. Glenrosa Street 3 (3) 1 .. .. .. .. .. 2 (2) Gliddon Road .. .. .. .. .. .. .. .. Goodson Road 2 (2) .. .. .. .. 1 .. .. Gorleston Street .. .. .. .. . . .. .. .. Gowan Avenue 1 *1 .. .. 1 1 .. 1 Greswell Street .. 1 .. .. .. .. .. .. Greyhound Road 2 (2) 1 .. .. 4 (4) 2(2) 1 1 Grimston Road . . .. .. .. 1 .. .. .. Grove Terrace .. .. .. .. .. .. .. .. Guion Road 2 (1) .. .. .. .. .. .. .. Gunterstone Road 2(2) . . .. .. 1 . . .. .. Gwendyr Road .. .. .. .. .. .. .. .. Haldane Road 1 .. .. .. .. .. 1 .. Halford Road 5(3) .. .. *3 (3) . . 1 3 (3) Hamble Street 1 .. .. 1 1 1 .. .. Hammersmith Road .. 2 (2) .. .. .. .. .. .. Hannell Road 1 1 .. .. .. . . .. .. Harbledown Road .. .. .. .. .. .. .. 1 Harbord Street 2 (2) 1 .. .. .. .. .. 1 Hartismere Road .. .. .. .. .. .. .. .. Hartopp Avenue .. .. .. .. .. .. .. .. Harwood Road .. 2 (2) .. .. .. .. .. .. Harwood Terrace .. . . .. .. .. .. .. .. Hatfield Street .. .. .. .. .. .. .. .. Hawksmoor Street .. .. .. .. .. .. .. .. 76  Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever, Erysipelas. Deaths from Measles. Deaths from Diarrhœa and Enteritis. Under 2 years. s from Phthisis. Hazlebury Road 2 (1) 1 .. .. 1 .. .. .. Heckfield Place 4 (3) . . *2 (2) 1 *4 (4) 2 (2) 1 3 (3) Hestercombe Avenue . . 1 .. .. .. .. .. .. High Street 1 . . .. .. .. .. .. .. Hilmer Street . . .. .. 1 .. 1 .. 3 (3) Hildyard Road .. .. .. .. .. .. .. .. Holyport Road *7(4) . . .. 1 .. 1 .. . . Homestead Road 1 1 .. .. .. .. .. .. Horder Road 1 .. .. 1 .. .. l .. Hugon Road 1 3 (3) .. .. 1 .. .. 3 (2) Humbolt Road 1 . . .. .. 1 .. 1 1 Hurlingham. Road 4 (3) .. 1 .. •• .. .. .. Imperial Cottages .. .. 2 (2) .. .. .. .. .. .. Inglethorpe Street 2 (2) . . .. .. .. .. .. .. Irene Road 3 (3) .. .. .. .. .. .. 1 Ismilia Road .. .. •• 1 .. .. .. Jerdan Place .. 1 .. .. .. .. .. .. Jervis Road 1 .. •• .. •• .. .. .. Kelvedon Road 2 (1) .. 1 .. .. .. .. .. Kempson Road .. .. .. .. . . .. .. .. Kenneth Road 1 .. *1 .. 1 .. .. ... Kensington Hall Gardens .. 1 .. .. 1 .. .. .. Kenyon Street 5 (4) 2 (2) .. .. .. .. .. , . Kilmaine Road .. 1 .. .. 1 .. l .. Kimbell Gardens 1 . . .. .. .. .. .. .. King's Road .. . . 1 .. .. .. .. 4 (3) Kingwood Road 5 (4) 2 (1) .. 1 .. .. .. 1 Kinnoul Road 2 (2) 1 .. .. .. .. .. .. Kilkie Street .. .. .. .. .. 2 (2) .. 1 Knivet Road •• .. .. .. .. .. .. •• Lalor Street .. .. .. .. .. .. .. 1 Lambrook Terrace .. .. .. .. .. .. .. . . Landridge Road . . .. .. .. .. .. .. . , Lanfrey Place .. .. .. .. .. .. .. . . Langford Road .. 1 .. .. .. 1 .. . . Langthorn Street 2 (1) .. .. .. .. .. .. 1 Laundry Road . . .. .. .. .. 1 1 . . Lawn Terrace . . .. .. .. .. .. .. .. Letterstone Road 1 1 .. .. .. .. .. 1 77  Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Deaths from Measles. Deaths from Diarrhœa and Enteritis. Under 2 years. Deaths from Phthisis. Lettice Street .. .. .. .. .. .. • • 1 Li llie Road 5(5) 5(4) *i .. .. .. l 6(6) Lilyville Road 1 .. 1 .. .. .. . .. Lindrop Street 3(2) .. .. .. .. 1 .. 1 Lintaine Grove 3(3) 4(3) .. .. .. 1 .. 1 Linver Road 1 .. .. .. 2(2) .. .. .. Lisgar Terrace .. .. .. .. .. .. .. .. Lodge Avenue .. .. .. .. 1 .. .. 1 Lochaline Street .. .. .. .. .. .. .. .. Lundy Street .. .. .. .. .. .. .. 1 Lurgan Avenue 3(2) .. .. .. 1 1 .. 2(2) Lysia Street 6(5) .. .. .. .. .. .. 1 Mablethorpe Road 3(3) .. .. .. 1 .. .. .. Macmurdo Road .. .. .. .. .. .. .. .. Margravine Gdns 1 .. .. .. .. .. .. .. Margravine Road 1 .. .. .. .. .. .. .. Marin efield Road .. 2(2) .. .. .. .. .. .. Marville Road 5(4) 2(2) .. 1 .. .. 1 Matheson Road .. .. .. .. 1 .. .. .. Maxwell Road 2(1) l .. .. .. .. .. .. May Street 1 .. .. .. .. .. .. 2(2) Melmoth Place .. .. .. .. .. .. .. .. Melton Street .. , , .. .. 1 Mendora Road 1 . . .. 2(2) .. .. l Merrington Road .. .. .. .. .. .. .. .. Micklethwaite Road 1 .. .. .. .. .. .. .. Mimosa Street .. .. 1 .. 1 .. .. 1 Mirabel Road 1 2(2) .. .. .. .. .. 2(2) Molesford Road .. .. .. .. .. .. .. .. Mooltan Street .. .. .. .. .. .. .. .. Moore Park Road 2(2) 1 .. .. .. .. .. .. Mornington Avenue .. .. . .. .. .. .. .. Moylan Road .. .. .. .. .. .. .. .. Mulgrave Road .. .. .. 1 .. .. .. 1 Mund Street .. 1 .. .. 2(2) .. .. .. Munden Place .. 1 .. .. .. .. .. 1 Munden Street .. 1 .. .. .. .. .. 2(2) Munster Road 12(7) *4(4) .. .. 2(2) 1 .. 1 Musard Road .. 1 .. .. .. .. .. 1 Musgrave Crescent .. .. .. .. •• .. .. 1 Napier Avenue .. 1 .. . 1 .. .. .. Narborough Street 2(2) .. . .. •• .. .. .. 78  Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Deaths from Measles. Deaths from Diarrhœa and Enteritis. Under 2 years. Deaths from Phthisis. New King's Road 13(10) 6(4) 1 .. 1 .. .. 4 (4) Niton Street 2(2) *1 .. .. .. .. .. 1 Norfolk Terrace .. .. .. .. .. .. .. .. Normand Gdns. .. .. .. .. .. .. .. .. Noimand Road 1 .. .. .. .. .. .. 1 Northampton Place 3(1) . . .. .. .. .. .. .. North End Road 4(4) 3(3) .. .. .. .. 1 1 Novello Street 3(2) 1 .. .. .. .. .. .. Oakbury Road 1 1 .. .. 1 • • .. 1 Ongar Road . . .. .. .. .. 1 .. .. Orbain Road 1 2(2) .. 1 .. .. 1 2 (2) Orchard Place . . .. .. .. .. .. .. .. Orchard Street .. .. .. .. .. .. .. .. Oxberry Avenue .. •• .. .. .. .. .. .. Palliser Road .. .. .. .. .. .. .. .. Parfrey Street 1 2(2) .. .. .. .. .. .. Parkville Road 3 (3) 1 .. .. .. 1 .. .. Parsons Green .. .. *1 .. 1 .. .. .. Parson's Green L. 1 .. .. .. .. .. .. .. Parthenia Road 1 .. .. .. .. .. .. .. Pearscroft Street .. .. .. .. .. 2 (2) .. 1 Pellant Road 2(2) .. .. .. .. .. .. .. Perrymead Street 5(5) 1 .. .. .. .. .. .. Perham Road . . 1 1 .. 1 .. .. .. Peterborough Road 1 .. .. .. .. .. .. 1 Peterborough Villas .. .. .. .. .. .. .. .. Petley Road 5(5) .. .. .. .. .. .. 1 Playfair Street 2(2) .. *1 .. 1 1 .. .. Portland Place .. .. .. .. .. .. .. .. Pownall Road 1 .. .. .. .. .. .. .. Prince of W. Mews .. .. .. .. .. .. .. .. Protheroe Road 2(2) 4 (3) .. .. .. .. .. .. Purcell Crescent .. 1 .. .. 1 1 .. 1 Purser's Cross Road .. .. .. .. .. .. .. .. Quarrendon St. 1 2(2) .. .. 1 .. .. 1 Queen's Club Gdns. 1 . . .. .. . . .. .. .. Querrin Street .. 2(2) .. .. .. .. .. 1 Queensmill Road 4(4) .. .. .. .. .. .. .. Radipole Road 2(2) 2(2) .. .. .. .. .. .. Racton Road 6(3) 2(2) .. .. 1 1 .. .. 79  Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Deaths from Measles. Deaths from Diarrhœa and Enteritis. Under 2 years. Deaths from Phthisis. Rainville Road .. *1 .. .. .. .. .. 1 Ranelagh Avenue .. .. .. .. .. 1 1 .. . . Ranelagh Gdns. .. .. .. .. .. .. .. . . Rectory Road 4(4) 1 .. .. .. .. .. 1 Reporton Road 3(3) .. .. .. .. • • .. 2(2) Richmond Road . . . . .. .. .. .. .. .. Rickett Street .. 1 .. .. .. .. .. .. Rigault Road . . .. .. .. .. .. .. .. Ringmer Avenue 3(2) .. .. .. Rock Avenue .. 3(3) .. 1 2 (2) I .. 2 (2) Rosaline Road 1 1 .. .. .. .. .. 1 Rosaville Road *4 (2) *2 (2) .. .. 1 .. .. .. Rosebank Terrace .. .. .. .. .. .. .. 1 Rosebury Road 2(2) 2(2) .. .. .. .. .. 1 Rostrevor Road . . . . .. .. .. .. .. 1 Rowallan Road 1 .. .. .. .. .. .. .. Roxby Place .. . . .. .. . . .. .. .. Rycroft Street 1 .. .. .. . . .. .. . . Rylston Road 2(2) 4 (2) .. .. •• .. .. 1 St. Alban's Terrace .. .. .. .. .. .. .. 2(2) St. Dunstan's Road 3(2) 1 .. .. 2(2) .. .. .. St. Maur Road 1 .. .. .. .. .. .. .. St. Olaf's Road 3(3) 1 .. .. .. 1 .. .. St. Peter's Terrace .. .. .. .. .. .. .. .. St. Thomas Road .. .. .. .. 1 .. .. .. Salisbury Mews .. 1 .. .. . . .. .. .. Sandilands Road 2(2) .. .. .. .. 1 l 3(3) Sands End Lane .. .. .. .. . . .. .. 1 Seagrave Mews .. .. .. .. . . .. .. .. Seagrave Road 3(3) .. .. .. .. .. • • 1 Sedlescombe Road .. . . .. .. .. .. .. .. Settrington Street 6(5) 1 .. .. .. .. .. .. Silverton Street 2(1) . . .. .. .. .. .. .. Sherbrooke Road 2(2) 4(3) .. .. 1 .. 1 1 Shorrolds Road 1 3(3) .. 1 .. 1 .. 4 (4) Shotley Road •• .. .. .. .. .. .. .. Shottendane Road •• .. .. .. .. .. .. .. Sotheron Road .. .. .. .. .. 1 .. .. Stamford Place . . . . .. .. .. .. .. .. Stamford Road . . .. .. .. .. 1 .. .. Stamford Street 1 .. .. .. .. 1 .. .. Stanley Road 1 .. .. .. 1 .. .. .. Stanwick Road .. .. .. .. .. .. .. .. 80  Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Deaths from Measles. Ueaths from Diarrhœa and Enteritis. Under 2 years Deaths from Phthisis. Star Road .. 2(2) .. .. .. 1 .. 1 Stephendale Road 10(7) *3 (2) .. .. 2(2) 2(2) .. 2(3) Stevenage Road .. .. .. .. .. .. .. .. Stokenchurcli Road 2 (2) .. .. .. .. .. .. 1 Stonor Road .. .. .. .. 1 .. .. .. Strode Road 1 1 .. .. .. .. 1 2(1) Studdridge Street 1 .. .. .. .. .. .. 2 (2) Swift Street .. .. .. .. .. .. .. .. Sylvio Street •• •• .. .. .. .. .. .. Talgart.h Road 2(2) 1 .. .. .. .. .. .. Tamworth Street .. .. .. 1 .. .. .. .. Tasso Road .. 1 .. .. .. .. .. 1 Tilton Street .. 1 .. .. .. .. .. .. Tournay Road 1 1 .. .. 1 .. .. .. Townmead Road .. .. 1 .. 2 (2) .. .. 2 (2) Trevanion Road .. .. .. .. .. .. .. .. Turneville Road 1 2(1) .. *1 .. 2(1) .. 1 Tynemouth Street 4(3) *2(2) .. .. 1 1 1 1 Tyrawley Road •• •• .. .. •• .. .. .. Vanston Place .. 1 .. .. .. .. .. .. Varna Road .. .. .. .. .. .. .. 1 Vera Road 3(3) 3(3) .. .. .. .. .. 1 Vereker Road .. .. .. .. .. .. .. .. Vernon Street •• •• .. .. .. .. .. 1 Waldemar Avenue 1 .. 1 .. .. .. .. 1 Walliam Avenue .. 1 .. .. .. 1 .. .. 1 Walham Grove 3(3) 2(2) .. 1 .. .. .. .. Wandon Road .. .. .. .. .. .. .. .. Wandsworth Bg. Rd. 14 (11) 4 (4) .. .. 1 .. .. 2(2) Wardo Avenue 2(2) .. 1 1 2 (2) .. .. 1 Waterford Road 1 .. .. .. .. .. .. 1 Welford Terrace .. .. .. .. .. 1 1 1 Werley Avenue .. .. .. .. .. .. .. 1 Westbury Terrace .. .. .. .. .. .. .. .. West Kensington .. Mansions .. .. .. .. .. .. .. .. Wheatsheaf Terrace 2(2) 1 .. .. .. 1 .. .. Whittingstall Road 2(2) .. .. .. .. .. .. .. Wigan Street .. .. .. .. 1 .. .. 1 William Street .. .. .. .. .. .. .. 2(2) 81  Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Deaths from Measles. Deaths from Diarrhœa and Enteritis. Under 2 years. Deaths from Phthisis. Winchendon Road .. .. .. .. .. .. .. .. Wyfold Road .. .. .. .. .. .. .. .. Woodlawn Road 2(1) 2(2) .. .. .. .. .. .. Whiteley's Cottages .. .. .. .. .. .. .. .. Woolneigh Street .. .. .. .. .. .. .. .. Yeldham Road 3(1) .. .. •• .. .. •• .. Fulham Union Inf. .. 3 • • .. .. .. .. .. Fulham Workhouse •• 2 .. •• 14 .. •• .. 82 83 TABLE C. Giving the Meterological Conditions of the 52 Weeks ended December 28th, 1912, together with the number of Deaths from certain Diseases and at certain Ages. Week Ending Mean Temperature. Highest Temperature. Lowest Temperature. Mean Temperature of the earth 3ft. 2in. below the surface. Mean Height of the Barometer. Rainfall in inches. Sunshine in hours. Prevailing Wind. Total Deaths. Deaths under 1 year. Deaths from Phthisis. Deaths from Epidemic Diseases, excluding Diarrhœa. Deaths from Diarrhœa & Enteritis, under 2 years. J anuary 6 45.7 61.3 37.1 46.6 29.8 0.76 3.8 wsw 50 13 4 4 1 ,, 13 41.9 51.0 29.1 45.8 29.7 0.45 8.2 SE & SW 32 9 3 — — ,, 20 40.2 48.4 31.4 45.2 29.8 0.93 0.6 SE 46 8 5 3 - ,, 27 38. 9 45.0 33.4 44.4 29.7 0.88 5.0 ENE 45 3 6 1 - February 3 30. 0 39. 0 19.1 42.3 29.7 0.02 13.4 SW & N 58 9 6 3 — ,, 10 39.0 53.0 20'2 40.4 29.1 0.52 9.7 Variable 70 12 7 3 — ,, 17 45.5 58.0 38.1 42.4 29.6 0.44 7.6 Variable 53 11 5 2 — ,, 24 47. 4 55.3 32.1 44.2 29.6 0.65 4.1 SW 38 8 4 1 1 ,, 2 49.8 59. 5 35.2 45. 8 98.7 0.59 15.6 SW 49 15 3 5 - March 9 44.6 54.1 34.0 46.1 29.4 0.79 24.1 SW 37 7 2 1 - ,, 16 45. 1 60.6 33.5 45.4 29.8 0.19 13.1 Variable 33 9 5 1 2 ,, 23 42 .7 55.1 31.3 45.5 29.1 1.08 12.7 SW 39 9 2 2 1 ,, 30 51.0 61.9 38.2 46.4 29.9 0.05 40.3 SW & W 46 12 1 4 2 Week Ending Mean Temperature. Highest Temperature. Lowest Temperature. Mean Temperature of the earth 3ft. 2in. below the surface. Mean Height of the Barometer. Rainfall in inches. Sunshine in hours. Prevailing Wind. Total Deaths. Deaths under 1 year. Deaths from Phthisis. Deaths from Epidemic Diseases, excluding Diarrhœa. Deaths from Diarrhœa & Enteritis, nnder 2 years. April 6 48.0 67.'7 32.5 46.8 29.9 0.07 39. 0 SW & N 45 9 5 4 3 ,, 13 45.6 64.2 32.4 47.7 29.8 0.02 40.6 Variable 41 6 3 4 — ,, 20 50. 0 69.9 33.1 47.6 30.0 0.00 49.0 NE 37 6 — 5 — ,, 27 52.6 71.3 39.3 49.2 30.0 o.oo 76.6 ENE 49 11 4 8 — May 4 50.1 70.7 36.1 50.1 29.9 0.21 32.8 NE & SW 41 5 6 7 1 ,, 11 59. 82.6 46.1 51.9 29.9 0.06 31.1 Variable 39 11 3 6 1 ,, 18 55-2 72.0 43.2 54.4 29.7 0. 69 53.2 Variable 25 8 3 4 2 ,, 25 54. 1 72.0 38.6 54-9 29.7 0.19 42.3 SW 30 5 2 4 2 June 1 57.0 77.0 36.1 55.3 29.7 0.17 53. 2 sw & NE 35 5 5 — 1 ,, 8 54.2 69.5 41.5 56.2 29.5 0.99 40.4 SW 29 4 4 1 — ,, 15 48.7 71.0 44.5 56.7 29.7 0.39 55.7 SW & NE 35 10 5 3 1 ,, 22 61.7 84.3 48.2 58.1 29.8 0.65 64.6 WSW 30 4 4 3 — ,, 29 60.2 75.3 50.9 60.0 29.7 0.30 51.6 SW 25 3 4 — — 84 85 Week Ending Mean Temperature. Highest Temperature. Lowest Temperature. Mean Temperature of the earth 3ft. 2in. below the surface. Mean Height of the Barometer. Rainfall in inches. Sunshine in hours. Prevailing Wind. Total Deaths. Deaths under 1 year. Deaths from Phthisis. Deaths from Epidemic Diseases, excluding Diarrhœa. Deaths from Diarrhœa & Enteritis, under 2 years. July 6 58.7 74.0 51.1 59.7 29.8 0.36 17.3 NE & NW 33 7 1 3 — ,, 13 67. 0 90.0 49.6 60.8 29.8 0.20 52.6 Variable 34 4 3 1 — ,, 20 65.8 88.1 48.1 63.7 29.8 0.04 49.9 NE & N 36 4 4 4 1 ,, 27 64.8 81.6 49.2 63.2 29.7 0.16 34.4 SW & SE 27 6 5 1 — August 3 57.8 72. 0 42.2 63.1 295 0.54 35.7 SW 32 6 3 2 1 ,, 10 57.6 73.0 47.6 61.6 29.5 1.26 29.2 SW 20 3 3 4 — ,, 17 56.2 70.1 44.1 60.5 29.7 0.23 14.5 Variable 34 4 4 2 — ,, 24 57.2 70.0 47.1 60.2 29.6 1.27 24.3 SW 32 5 6 3 1 ,, 31 56.9 70.1 42.1 59.7 29.5 1.33 25.6 SW 29 6 4 _ 1 September 7 54.8 69.1 42.2 59. 1 29.8 0.21 33.7 W & NW 23 3 4 — — ,, 14 52.4 67.0 43.2 58.0 30.0 0.02 13.0 NW & NE 40 6 2 3 1 ,, 21 53.6 63.1 41.1 57.4 30.2 0.00 19.1 NE 34 2 4 2 — 28 51.5 64. 0 37.2 56.2 30.0 0.02 49.5 NE & SE 28 9 3 1 1 Week Ending Mean Temperature. Highest Temperature. Lowest Temperature. Mean Temperature of the earth 3ft. 2in. below the surface. Mean Height of the Barometer. Rainfall in inches. Sunshine in hours. Prevailing Wind. Total Deaths. Deaths under 1 year. Deaths from Phthisis. Deaths from Epidemic Diseases, excluding Diarrhœa. Deaths from Diarrhœa & Enteritis, under 2 years. October 5 48.8 63. 9 29.9 55.1 29.8 2.30 29.3 SE & NE 50 6 10 1 1 ,, 12 46. 0 63.0 29.4 52.6 30.1 0.00 40.9 Variable 34 10 4 — 1 ,, 19 49.8 65.7 34.3 51.9 30.0 0.13 28.4 SW 34 4 7 1 2 ,, 26 45. 4 59.0 33.0 51.4 29.3 0.88 16.4 SW 47 5 4 2 — November 2 49 1 60.3 32.1 61.2 29. 6 0.55 21 3 SW 41 7 4 1 1 ,, 9 47.2 56. 5 28.7 49.5 30.1 0.18 3.6 SW 40 9 4 3 1 ,, 16 43.3 50.9 36.4 49.3 29.6 0.17 1.8 W & N 43 8 1 4 — ,, 23 46.2 55.8 34.2 48.3 30.0 0.31 3.7 W 54 14 3 9 2 ,, 30 40.4 52. 9 29.3 48.0 29.5 1.06 76 SW & N 47 15 3 3 1 December 7 42. 4 52 .1 26.2 45. 7 29.8 0.31 4.9 SW 49 9 8 4 — ,, 14 49.0 56.5 40.2 46.6 29.8 0.62 1.1 SW 51 13 7 3 1 ,, 21 44.4 55.0 34. 4 47.1 29.7 0.59 10.3 W & SW 33 9 6 — — ,, 28 48.1 56. 3 38.2 46.9 29.6 1.22 4.5 SW 41 9 4 3 — 86 TABLE D. Showing the number of Cases of Infectious Diseases notified to the several Metropolitan Medical Officers of Health during the Year 1912. Cities and Boroughs, Estimated population in the middle of 1912. Notified Cases of Infectious Disease. Small-pox. Scarlet fever. Diphtheria. Typhus fever. Enteric fever. Other continned fevers. Puerperal fever. Erysipelas. - Cerebro-spinal meningitis. Poliomyelitis. Total. Annual rate per 1,000 persons living. West Districts. Fulham 155,402 - 484 231 - 26 - 30 115 2 5 893 5.7 Paddington 149 ,362 - 269 254 - 15 - 11 117 7 6 679 4.8 Kensington 171,746 - 304 180 - 15 2 8 116 - 1 626 3.7 Hammersmith 122,750 - 333 176 - 11 - 7 102 2 2 633 5.2 Chelsea 65,397 — 126 89 - 10 7 30 - 1 263 4.0 City of Westminster 157,248 — 238 160 — 17 — 19 92 3 6 535 3.4 North Districts. St. Marylebone 116,155 - 259 149 - 11 - 5 89 1 3 517 4.5 Hampstcad 85,966 - 107 161 - 10 - 3 44 1 2 328 3.8 St. Pancras 216,145 - 597 550 - 29 - 20 189 3 3 1391 6.5 Islington 326,398 - 811 517 - 49 - 16 186 13 11 1603 4 .9 Stoke Newington 50,581 - 90 55 - 3 - 3 33 1 5 190 3.8 Hackney 222,986 — 515 252 — 27 — 27 210 7 8 1046 4.7 Central Districts. Holborn 49,026 - 114 89 - 12 - - 47 1 - 263 5.5 Finsbury 86,130 - 157 144 1 8 - 12 144 1 3 470 5.5 City of London 18,695 — 33 17 - 2 — - 14 1 1 68 3.6 East Districts. Shoreditch 110,430 — 153 139 1 14 8 148 5 468 4.3 Bethnal Green 127,985 — 283 220 — 30 16 192 6 7 754 5.9 Stepney 277,315 - 929 363 56 1 31 342 11 12 1745 6.3 Poplar 161,597 1 314 253 — 36 - 20 198 6 5 833 5.2 South Districts. Southwark 190,017 - 500 283 - 39 - 18 265 8 6 1119 5.9 Bermondsey 125,260 - 418 218 1 37 - 19 164 4 7 868 6.9 Lambeth 297,550 — 596 336 — 61 — 24 223 7 9 1256 4.2 Battersea 167,589 — 462 232 — 21 — 7 133 2 2 859 5.1 Wandsworth 321,881 812 428 69 2 29 207 3 5 1555 4 .8 Camberwell 261,591 634 318 - 29 1 17 216 5 1 1 1231 4.7 Deptford 109,377 — 404 169 9 1 8 191 4 4 790 7.2 Greenwich 95,994 — 439 254 — 11 5 98 2 809 8.5 Lewish 1m 165,249 457 436 26 7 103 1 2 1032 6.3 Woolwich 121,932 3 472 424 — 20 — 3 90 — 3 1015 8.4 Port of London - - 1 2 - 1 - - - - - 4 - County of London 4,519,754 4 11,311 7099 3 704 7 380 4098 105 132 23,843 5.3