FUL 16 Council of the Borough of Fulham. ANNUAL REPORT of the Medical Officer of Health, J. CHARLES JACKSON. FOR THE YEAR 1913. INDEX. page Antitoxin, Provision of 37 Age Distribution of Population 7 Bacteriological Examinations 57 Births and Birth-rates 15 Births, Notification of 26 Cancer, Deaths from 53 & 74 Census Returns 8 Cerebro-spinal Fever 39 Deaths and Death-rates 18 Deaths, Causes of 19 Deaths, Distribution of 21 Diagnosis, Errors of 39 Diarrhoea, Deaths from 53 Diphtheria 37 Disinfection 56 Drainage, Combined 69 Drainage of Buildings 69 Enteric Fever 38 Epidemic Diseases, Deaths from 29 Erysipelas 39 Factory and Workshop Act, Proceedings under 64 Heckfield Place, Report on 102 Illegitimate Children, Births of 16 Illegitimate Children, Deaths of 28 Infants, Causes of Deaths of 23 Infants, Insurance of 29 Infantile Mortality 22 Infantile Mortality, Prevention of 26 Infectious Diseases, Notification of 31 Infectious Diseases, Distribution of 79 Infectious Diseases in Metropolitan Boroughs 94 Influenza, Deaths from 53 Marriages 15 Measles 52 Meteorological Conditions 90 4 page Milk, Results of Analysis of 61 Milk and Cream Regulations, Proceedings under 62 Milk Shops 58 Mortuary 58 Occupations of Inhabitants 95 Ophthalmia 40 Poliomyelitis 39 Population 5 Population, Natural Increase of 16 Public Institutions, Deaths in 55 Puerperal Fever 39 Rag Flock Act, Proceedings under 64 Respiratory Diseases, Deaths from 54 Restaurants, Inspection of 59 Revenue Acts, Certificates under 70 Ringworm, Treatment of 70 Sale of Food and Drugs Acts, Proceedings under 60 Sanitary Work, General 70 Sanatoria Treatment of Tuberculosis 48 Scarlet Fever 36 School for Mothers, Work of 27 School Medical Treatment Centre 70 Seasonal Mortality 21 Slaughter Houses 59 Small pox 34 Still-born Children 16 Tenements, Number and Occupants of 10 Tuberculosis, Notification of 40 Tuberculosis, Treatment and Prevention of 43 Tuberculosis Dispensary, Work of 43 Tuberculosis, Infectivity of 49 Underground Rooms, Illegal Occupation of 69 Unsound Food 59 Vaccination 34 Venereal Diseases 53 Violence, Deaths from 54 Water Supply in Tenement Houses 69 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 21st Annual Report on the vital statistics and the conditions affecting the health of the borough for the year 1913. The statistics of births, deaths and infectious diseases relate to the fifty-three weeks ended January 3rd, 1914. POPULATION. The population of Fulham as enumerated at the Census taken on April 2nd, 1911, was 153,284, and in the middle of 1913, 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 157,117. The following table shows the increase of the population of the borough since 1851 :— 6 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 „ 15,539 30.9 9.1 55,916 1871 „ 23,378 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 „ 158,284 11.7 90.1 902,640 1913 Estimated 157,117 — 92.4 913,609 Population of the Wards. The population of and the number of tenements in the wards of the borough are shown in the subjoined table :— TABLE II. Showing the number of tenements in 1911 and the population of the wards in 1901 and 1911. Ward. Dwellings or Tenements. Population, 1911. Population, 1901. Inhabited. Uninhab ited. Males. Females. Total. Males. Females. Total. Baron's Court 3,091 320 4,758 7,695 12,458 4,570 7,591 12,161 Lillie 5,721 337 11,268 11,956 23,224 10,160 10,837 20,997 Walham 3,042 140 6,056 6,471 12,527 6,158 6,539 12,697 Margravine 3,896 136 8,362 8,558 16,920 7,612 7,865 15,477 Munster 8,970 426 18,334 19,323 37,657 13,889 14,527 28,416 Hurlingham 2,362 85 4,265 5,139 9,404 4,065 4,807 8,872 Sand's End 5,874 892 12,888 13,282 26,170 11,874 12,025 23,899 Town 3,471 276 5,921 7,252 13,173 5,576 7,357 12,933 Fulham Workhouse 1 - 363 295 658 334 392 726 Fulham Infirmary 1 - 252 249 501 247 310 557 Western Fever Hospital 1 - 191 402 593 163 387 550 Barges 2 — 4 - 4 4 - 4 36,432 2,112 72,662 80,622 153,284 64,652 72,637 137,289 7 Age Distribution. Table III. gives the number of each sex grouped according to ages as ascertained at the Census, and Table IV. the proportions of the population at different ages at the Censuses of 1891, 1901 and 1911. TABLE III. Ayes of Persons (male and female), in Fulham, 1911. Age Period. Males. Females. Total. Under 5 years 8,901 8,685 17,586 „ 5-10 „ 7,932 7,849 15,781 „ 10-15 „ 7,113 7,263 14,376 „ 15-20 „ 6,266 6,717 12,988 „ 20-25 „ 5,999 7,312 13,311 „ 25-35 „ 12,862 14,670 27,532 „ 35-45 „ 10,268 11,448 21,716 „ 45-55 „ 7,149 8,127 15,276 „ 55-65 „ 3,912 4,760 8,672 „ 65-75 „ 1,772 2,683 4,455 „ 75-85 „ 435 949 1,384 Over 85 „ 58 159 212 72,662 80,622 153,284 8 TABLE IV. Proportions of the population at different ages in Fulham in 1891, 1901 and 1911- (All ages taken as 1,000). Age Period. 1891. 1901. 1911. Under 5 years 141 130 115 „ 5-10 „ 124 109 103 „ 10-15 „ 101 96 94 „ 15-20 „ 83 88 85 „ 20-25 „ 89 90 87 ,, 25-35 „ 180 183 179 „ 35-45 „ 127 137 142 ,, 45-55 „ 78 86 100 „ 55-65 „ 45 48 57 ,, 65-75 „ 24 24 28 Over 75 „ 8 9 10 1,000 1,000 1,000 It will be noticed that there is a marked decrease in the proportion of children in the population, due to the fall in the birth-rate. House Accommodation. The following table shows the number of houses, separate occupiers and population in 1901 and 1911, distinguishing for 1911 the various kinds of buildings and the population enumerated therein, and also the buildings not used as dwellings. 9 TABLE V. 1901. 1911 Total. Total Cols. 4-11. Buildings used as Dwellings. Buildings not used as Dwellings. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Ordinary dwellings. Blocks of Flats. Shops. Hotels and Public-houses. Offices, Warehouses, Workshops and Factories. Institutions. Others. Vessels. Sheds. Separate Flats included in Col. 5. Kind of Building. Number. Number of inhabited houses 18,534 19,985 17,324 716 1,513 82 53 57 162 5 4,330 Places of Worship 34 Government and Municipal Buildings.. 28 Separate occupiers 32,137 36,432 29,533 4,397 2,116 86 6 3 ... 175 8 4,397 Shops 402 Population 137,289 153,284 124,293 16,318 8,516 613 225 2,588 751 8 16,318 Offices 57 Warehouses, Workshops and Factories 144 Uninhabited 833 842 672 6 113 ... 6 6 43 ... 705 Being built 299 3 4 ... 4 ... ... ... ... ... ... Theatres and other places of amusement 4 10 Classification of the population by the size of the family of which they are members, and by the number of rooms in the occupation of the family. At each of the last three censuses the schedule has contained a question as to the number of rooms in the occupation of the family enumerated thereon, but in 1891 and 1901 the enquiry was confined to such families as occupied less than five rooms; in 1911, however, every occupier was required to state the number of rooms in occupation of his family, and a definition of the term "room" was attempted, the instruction in the schedule reading: "Count the kitchen as a room, but do not count scullery, landing, lobby, closet, bathroom, nor warehouse, office, shop." Table VI. gives the tenements in Fulham in the occupation of private families classified by numbers of rooms and by numbers of occupants, distinguishing children under 10 years of age, and may be read as follows: "Of a total of 36,432 families or separate occupiers enumerated in Fulham 36,275 were private families, of which 2,631 were enumerated in tenements of one room, 4,692 in tenements of two rooms, and so on. The 2,631 enumerated in one-roomed tenements included 1,197 consisting of one person each, 845 of two persons each, 351 of three persons each, and so on, and contained an aggregate population of 4,981. Again in 1,197 of the 2,631 families in one-roomed tenements there were no children under ten years of age, in 359 there was one child, in 162 there were two children and so on. The lower portion of the table gives details with regard to children for those of the larger tenements only which contained more than two persons per room. It shows that there were 57 five-roomed tenements so occupied, 37 containing 11 persons each, 14 with 12 persons, and so on. Of the 37 with 11 persons each, two contained no child, three had one child, and 8, 6, 11 and 7, had 2, 3, 4 and 5 children respectively, making 116 children in all. 11 TABLE VI. 1901. 1911. Tenements with more than two occupants per room:— Total Population 137,289 153,284 Number, 3.199. Population, all ages 21,784 „ Families or Separate Occupiers, "Private" or Other 32,137 36,432 „ under 10 years of age 8,554 Population in "Private Families " 149,702 Percentage of Population in "Private Families " living more than two in a room 14.6 Number of Private Families — 36,275 No. of Rooms per Tenement. No. of Children under 10 years of age. Number of Persons in Private Families (or Tenements). Total Number of Private Families (or Tenements). Population. 1. 2. 3. 4. 5. 6. 7 8. 9. 10. 11. 12. 13. 14. 15 and upwards Number of Private Families (or Tenements). 1 0 1,197 783 64 10 3 - - - - - - - - - - 2,057 3,010 1 — 62 264 27 6 - - - - - - - - - - 359 1,054 2 — — 23 124 14 — 1 - - - - - - - - 162 642 3 — - — 7 31 4 1 1 - - - - - - - 44 222 4 — - — — 2 6 1 - - - - - - - - 9 53 5 - - - - - - - - - - - - - - - - - 1,197 845 351 168 56 10 3 1 - - - - - - - 2,631 4,981 2 I 0 460 1,310 419 167 63 14 5 1 - - - - 2,439 5,447 1 - 32 697 165 52 27 9 2 - - - - - - - 984 3,316 2 - - 25 473 111 54 22 12 1 - - - - - - 698 3,105 3 - - - 13 229 91 38 13 4 1 - - - - - 389 2,159 4 - - — — 3 90 28 20 4 2 - - - - - 147 967 5 - - — — — 1 23 2 5 1 - - - - - 32 238 6 - - - - - - - 2 1 - - - - - - 3 25 460 1,342 1,141 818 458 277 125 52 15 4 - - - - - 4,692 15,257 3 0 398 2,419 1,190 636 303 124 41 12 2 1 - - - - - 5,126 14,020 1 — 34 1,597 600 316 163 78 25 8 2 1 — — - — 2,824 10,666 2 - — 27 1,058 401 200 112 49 19 4 3 — — - — 1,873 8,938 3 - — — 13 550 242 170 101 38 13 5 — — - — 1,132 6,779 4 - — - — 4 225 118 91 56 19 5 — — - — 518 3,673 5 - - - - - 2 71 44 21 18 5 4 — - — 165 1,333 6 - - - - - - - 9 2 3 1 — — - — 15 131 7 - - - - - - - - 1 - 1* - 2† - - 4 46 398 2,453 2,814 2,307 1,574 956* 590 331 147 60 21 4 2 — — 11,657 45,586 4 0 245 1,020 1,018 725 403 204 85 25 11 5 - - - - - 3,741 12,422 1 - 17 435 381 303 202 123 62 20 3 1 — — - — 1,547 7,168 2 - - 7 281 233 192 150 101 46 13 1 1 1 - — 1,026 5,900 3 - 4 171 151 99 95 62 35 9 4 — — 630 4,285 4 3 73 68 74 65 46 17 6 352 2,825 5 - - - - - - 26 37 34 17 9 13 4 — — 140 1,261 6 - - - - - - - 7 10 6 1 4 3 - — 31 304 7 — — — — — — — — — — 1 1 — 1 — 3 37 245 1,037 1,460 1,391 1,113 822 551 401 248 125 39 29 8 1 — 7,470 34,202 Total 1—4 _ 2,300 5,677 5,766 4,684 3,201 2,065 1,269 785 410 189 60 33 10 1 26,450 100,020 5 100 422 526 566 511 376 278 199 99 66 37 14 3 2 1 3,200 15,343 6 47 318 450 546 507 431 301 183 130 80 34 17 9 5 1 3,059 15,659 7 21 123 242 236 233 179 120 90 56 25 16 7 5 6 2 1,361 6,929 8 8 87 145 179 167 124 97 45 41 21 19 11 4 2 1 951 4,966 9 - 12 42 105 108 120 74 60 43 26 14 11 1 2 — — 618 3,184 10 and upwards - 2 45 68 117 114 88 67 63 26 17 13 3 6 6 1 636 3,595 Totals — 2,490 6,714 7,302 6,436 4,853 3,337 2,192 1,408 788 412 190 86 39 22 6 36,275 149,702 Tenements of Five Rooms and upwards with more than Two Persons per Room. No. of Rooms per Tenement. No. of Persons per Tenement. Number of Children under 10 years of age in Private Families (or Tenements). Total Number of Private Families (or Tenements). Population. 0. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. All ages. Under 10. Number of Private Families (or Tenements). 11 2 3 8 6 11 7 - - - - - 37 407 116 12 - 4 2 3 4 1 - - - 14 168 52 5 13 — — - 1 - — 1 1 - - 3 39 16 14 — — — — 1 1 — — - - - 2 28 9 15 — — — — — — — 1 - - - 1 15 7 6 " 13 2 1 — 3 1 1 1 — - — - 9 117 25 14 — — 2 1 1 1 5 70 17 15 — — — — 1 — - 1 15 4 7 15 - - - - - 2 - - - - - 2 30 10 * This family included nine children under ten years of age. † Including one family with eight children under ten years of age. 13 Tenements in the Occupation of Private Families. It will be seen that three-roomed tenements predominate in Fulham, and the chief increase has been in this class which now comprises 32 per cent, of the tenements of all kinds compared with 26 per cent in 1901. The following table gives the numbers of tenements with less than five rooms in Fulham in 1891, 1901 and 1911 :— TABLE VII. Number of Tenements with less than 5 rooms. Number of Rooms in Tenements. 1891. 1901. 1911. Percentage Increase between 1901 & 1911. Tenements of one room 2,245 2,460 2,631 8.7 „ two rooms 3,200 4,360 4,692 7.2 ,, three rooms 5,028 8,309 11,657 40.3 „ four rooms 2,958 6,552 7,470 14.0 Room Accommodation.—Overcrowding. From the figures obtained at the Census some information may be gathered as to the amount of overcrowding in the borough; for although the number of rooms and occupants is not in itself an absolutely sure guide, as the statistics contain no information as to the size of the rooms occupied, still, as the rooms in the tenements in Fulham are seldom of large size, it may be taken that tenements which have more than two persons per room must be considered overcrowded. 14 TABLE VIII. Number of Persons living in Tenements of less than 5 rooms in 1891. 1901 and 1911. Number of Persons per Room. 1911. 1901. 1891. Total Persons. Percentage of Total Population. Total Persons. Percentage of Total Population. Total Persons. Percentage of Total Population. Four or more persons to a room. 1,706 1.1 943 0.7 1,579 1.7 Three and under four persons to a room 6,210 4.0 3,747 2.8 4,261 4.6 Over two and under three persons to a room 12,979 8.5 10,202 7.4 7,265 8.0 Two persons to a room 13,906 9.1 12,230 8.9 8,818 9.9 One and under two persons to a room 52,762 34.4 45,037 82.8 24,718 26.9 Less than one person to a room 12,463 8.1 9,305 6.7 4,497 4.9 100,026 65.2 81,464 59.3 51,138 55.7 It will be seen from the above that the number of persons living under overcrowded conditions, i.e., more than two to a room has increased from 10.9 per cent, of the population in 1901 to 13.6 per cent, in 1911. In all but eight London boroughs there is a similar increase in the proportions of the population living more than two in a room, and as suggested by the Registrar-General, it may be partly accounted for by the limitation of the inquiry in 1891 and 1901 to tenements of less than five rooms, and the absence of any definition of the word "room" having led to some amount of understatement in these years of the families occupying tenements of four rooms or less, and also to a tendency to stretch the term room to cover a scullery, a lobby, closet, or any other more or less distinct space within a building. This is rendered more probable by the fact that the 15 number of inhabited buildings in London increased between 1901 and 1911, while the population diminished. The relative position of Fulham, compared with other Metropolitan boroughs as regards overcrowding, was, however, less satisfactory in 1911 than in 1901, as in the latter year in only nine boroughs was the proportion of overcrowding lower than in Fulham, while in 1911 fourteen boroughs had less. MARRIAGES AND MARRIAGE-RATE. 1,382 marriages were registered during the year compared with 1,273, 1,353 and 1387 in the preceding three years. The marriage-rate, i.e., the number of persons married per 1000 inhabitants, was 17.3, the average rate for the previous ten years being 16.5. BIRTHS AND BIRTH-RATE. Excluding eight births among non-residents, but including 76 children born of Fulham mothers in lying-in institutions situate in others boroughs, the total number of births registered in 1913 were 4,302, of whom 2,172 were boys and 2,130 girls, representing a birth-rate of 26.9 per 1,000 inhabitants, which is the lowest recorded in Fulham, and 1.1 below the mean rate of the ten years 1901—1911. The birth-rate of the County of London was 24.5, 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 9.2 in the City of London, 14.2 in Westminster, and 15.1 in Hampstead, to 31.0 in Southwark, 31.5 in Shoreditch, and 32.0 in Poplar. The following table given the number of births and birth-rates in the various wards corrected by the distribution of the births in Fulham Infirmary to the 16 wards in which the mothers resided, and the inclusion of those occurring in outside Maternity Institutions:— TABLE VIIIA. Births in 1913. Ward. Males. Females. Total Births. Birth-rate. Barons Court 95 100 193 15.3 Lillie 372 377 479 29.4 Walham 179 171 350 27.5 Margravine 305 247 552 29.3 Munster 597 607 1,204 30.3 Hurlingham 111 95 206 20.8 Sands End 372 405 777 28.5 Town 141 128 269 20.0 The Borough 2,172 2,130 4,302 26.9 Illegitimacy. The illegitimates numbered 212, or 4.9 per cent, of the total births ; of these 185 were born within and 27 outside the Borough. Still-born Children. 153 still-born children were buried in Fulham Cemetery, being in the proportion of one still-born child to every 28 living. Excess of Births over Deaths. The natural increase of the population by the excess of births over deaths was 2,274, compared with 2,402, 1894 and 2,190 in the preceding three years. 17 TABLE IX. VITAL STATISTICS OF WHOLE DISTRICT DURING 1913 AND PREVIOUS YEARS. 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 Non- Residents registered in the District. of Resi- dents 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 5 6 7 8 9 10 11 12 13 1908 151,659 4,607 4,715 31.1 1,999 13.2 168 321 545 115 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 1,880 11.8 173 366 395 94 2,023 13.0 1913 157,117 4,234 4,302 26.9 1,833 11.3 212 407 412 96 2,028 12.7 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 cor rected 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. †Transferable 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 8 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 the 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 ordinary dwelling houses 17.324 At Census of 1911. Area of District in acres (exclusive of area covered by water), 1701. Average number of persons per house 7.2 18 Deaths and Death-Rate. During 1913, 1,833 deaths were registered in the borough, but of these 212 were of persons not belonging to the borough, while 407 inhabitants of Fulham died outside the borough, chiefly in various public institutions. There were, therefore, 2,128 deaths of persons (1,048 males and 980 females) having their usual residence in Fulham, representing an annual rate of 12.7 per 1,000 of the estimated population; the death-rate of males being 13.9, and of females 11.5. With the exception of that of 1910, which was 12.5 per 1,000, this is the lowest rate recorded in Fulham, and is 1.6 per 1,000 below the mean rate of the preceding ten years. The death-rate of the County of London was 14.3, and of the Metropolitan boroughs only three had lower rates than Fulham, viz., Lewisham 10.8, Wandsworth 10.8 and Hampstead 10.9, while the highest rates were 18.0 in Bermondsey, 18.5 in Finsbury and 18.8 in Shoreditch. In the following table the mortality of Fulham can be compared with that of the adjoining boroughs and of other groups of areas. TABLE X. Mortality in 1913. Area. Annual Rate per 1000 living. Fulham 12.7 Chelsea 13.9 Hammersmith 14.1 Kensington 13.8 County of London 14.3 96 Great Towns (including London) 14.3 145 Smaller Towns 12.8 England and Wales (less the 241 Towns) 13.1 England and Wales 13.7 BIRTHS AND DEATHS 1886-1913 Birth Rate per 1,000 of the population. Death Rate from all causes per 1,000 of the population. Death Rate from Epidemic Diseases per 1,000 of the population. 19 TABLE XI. Causes of, and Ages at Death during the Year 1913. Nett Deaths at the subjoined ages 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 1 and under 2 years 2 and under 5 years 5 and under 15 years 15 and under 25 years 24 and under 46 years 45 and under 65 years 65 and upwards Barons Court Ward Lillie Ward Walham Ward Margravine Ward Munster Ward Hurlingham Ward Sands End Ward Town Ward 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 All Causes Certified (c) 2026 410 108 84 73 79 300 509 464 694 169 353 224 255 446 120 323 136 Uncertified 2 2 ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... 1 —Enteric Fever 8 ... 1 ... 2 3 1 1 ... 3 ... 2 1 1 1 1 1 1 2—Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3—Measles 49 10 21 14 3 1 ... ... ... 115 5 5 12 5 16 1 4 1 4—Scarlet Fever 4 ... 1 2 1 ... ... ... ... 31 ... 1 ... ... 2 ... 1 ... 5—Whooping Cough 27 12 10 4 1 ... ... ... ... 15 2 7 2 4 10 ... 2 ... 6—Diphtheria and Croup 15 4 2 4 5 ... ... ... ... 48 ... 3 1 1 3 1 6 ... 7—Influenza 27 2 ... ... ... 2 4 11 8 ... 1 7 ... 2 6 2 7 2 8—Erysipelas 2 ... ... ... ... ... 1 1 ... 2 ... ... ... 1 1 ... ... ... 9—Phthisis (Pulmonary Tuberculosis) 215 3 2 3 13 27 86 70 11 84 20 38 22 27 47 15 29 17 10—Tuberculous Meningitis 26 5 4 8 7 1 ... 1 ... 2 1 4 4 3 6 1 4 3 11 — Other Tuberculous Diseases 23 7 4 2 3 2 4 1 5 1 2 4 ... 5 2 7 2 12—Cancer, malignant disease 176 ... ... ... 1 ... 25 91 59 39 21 32 25 22 30 15 21 10 13—Rheumatic Fever 5 ... ... ... 2 2 ... 1 ... ... 2 ... ... 1 1 ... 1 ... 14— Meningitis, Sec note (d) 9 3 ... 3 1 1 ... 1 ... 2 1 2 ... 1 2 1 2 ... 15— Organic Heart Disease 166 ... ... ... 2 4 28 65 67 33 13 25 16 16 36 15 35 10 16—Bronchitis 150 17 6 1 ... ... 10 35 81 44 11 36 18 21 27 4 24 9 17 —Pneumonia (all forms) 192 49 29 22 5 7 33 32 15 58 13 30 17 36 50 8 35 3 18 —Other diseases of Respiratory organs 29 4 1 2 ... 2 7 9 4 4 4 1 4 1 10 3 4 2 19—Diarrhœa and Enteritis 107 83 17 1 ... ... ... 1 5 35 6 25 13 21 24 2 14 2 20—Appendicitis and Typhlitis 11 ... ... ... 2 3 1 4 1 2 1 3 ... ... 3 ... 1 3 21—Cirrhosis of Liver 21 ... ... ... 1 ... 6 7 7 4 3 6 3 1 2 1 5 ... 21a-Alcoholism 5 ... ... ... ... 1 1 3 ... 1 1 1 2 ... ... ... 1 ... 22—Nephritis and Bright's Disease 57 ... ... ... 1 3 7 25 21 25 8 7 3 6 8 4 8 13 23—Puerperal Fever 4 ... ... ... ... 1 3 ... ... 2 1 ... 1 ... 1 ... 1 ... 24—Other accidents and diseases of Pregnancy and Parturition 2 ... ... ... ... ... 2 ... ... 1 ... ... 1 ... ... ... 1 ... 25—Congenital Debility and Malformation, in cluding Premature Birth 150 150 ... ... ... ... ... ... ... 20 6 21 18 23 39 8 24 7 26—Violent Deaths, excluding Suicide 59 6 1 7 11 3 16 9 6 5 3 9 8 6 14 2 13 4 27—Suicides 14 ... ... ... ... 2 7 5 ... 1 2 2 1 1 3 2 1 2 28 —Other Defined Diseases 471 56 9 9 12 14 58 134 179 113 43 85 48 55 97 32 66 45 29 —Diseases ill-defined or unknown 4 1 ... 2 ... ... ... 1 ... ... ... ... ... 1 2 ... 1 ... 2028 412 108 84 73 79 300 508 464 694 169 354 224 256 446 120 323 136 SubEntries included in above figures. 14 (a) Cerebro-spinal Meningitis 1 ... ... 1 ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... 28 (a) Poliomyelitis 1 ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 28 (a) Lead Poisoning (Occupational) 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... (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 "transferable deaths" see footnote to Table IX. (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 21 Seasonal Mortality. The mortality in the four quarters of the year was as under:— Deaths. Death Rate. First quarter 612 15.0 Second quarter 450 11.4 Third quarter 388 9.7 *Fourth quarter 578 13.4 *14 weeks. Mortality in previous years. In Table IX. will be found the number of deaths and death-rate in each of the preceding five years. The difference between the rate for 1913 and the average rate of the five years 1908-1912 represents a saving of 150 lives. TABLE XII. Distribution of Deaths. Table XI. gives the number and causes of deaths in the several wards of the borough, and in the following table will be found the death-rate of each ward for 1913 and the ten preceding Years. Death-rate per 1,000 persons in each Ward. Barons Court Ward. Lillie Ward. Walham Ward. Margravine Ward. Munster Ward. Hurlingham Ward. Sands End Ward. Town Ward. 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 1912 13.8 13.7 14.1 14.3 11.9 12.1 12.7 12.8 Average of 10 years, 1903-12. 12.5 14.5 17.3 16.8 13.1 12.9 13.4 12.6 1913 13.3 13.9 17.6 13.6 11.3 12.1 11.8 10.1 22 Mortality at Different Ages. Infantile Mortality. Of the 2,028 deaths, 412 or 20-3 per cent, were of infants under one year of age, and the rate of the infant mortality measured by the proportion of deaths under one year to registered births was 96 per 1,000, being two per 1,000 above that of 1912, but 28 per 1,000 below the average rate of the ten years, 1903-1912. The corresponding rates of the County of London, the adjoining boroughs, and certain groups of areas were as under. TABLE XIII. Infant Mortality in 1913. Area. Deaths under one year per 1,000 births. Fulham 96 Chelsea 90 Hammersmith 103 Kensington 112 City of London 105 96 Great Towns (including London) 117 145 Smaller Towns 112 England and Wales (less the 241 Towns) 96 England and Wales 109 INFANTILE MORTALITY, 1886 - 1913 23 TABLE XIV. INFANT MORTALITY DURING THE YEAR 1913. Nett Deaths from stated causes at various Ages under One Year of Age. Nett Deaths under One Year of residents in the Wards of the Borough whether occurring in or beyond the Wards. Deaths under One Year in previous years. CAUSE OF DEATH. Under 1 Week. 1—2 Weeks 2—3 Weeks. 3-4 Weeks. Total under 1 Month. 1—3 Months. 3—6 Months. 6—9 Months. 9—12 Months. Total Deaths under One Year. Barons Court Ward. Lillie Ward. Walham Ward. Margravine Ward. Munster Ward. Hurlingham Ward. Sands End Ward. Town Ward. Total Deaths under 1 year, 1912. Total Deaths under 1 year, 1911. Total Deaths under 1 year, 1910. Total Deaths under 1 year, 1909. Total Deaths under 1 year, 1908. Total Deaths under 1 year, 1907. Total Deaths under 1 year, 1906. All causes Certified 106 23 19 14 162 64 90 52 42 410 21 71 41 59 109 16 79 14 395 517 462 466 544 564 667 Uncertified 2 ... ... ... 2 ... ... ... ... 2 ... 1 ... 1 ... ... ... ... ... ... ... ... 1 1 2 Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... 5 5 10 ... 1 2 1 5 ... 1 ... 12 16 16 14 19 10 10 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 Whooping Cough ... ... 1 ... 1 2 2 2 5 12 2 2 1 4 2 ... 1 ... 23 11 27 21 14 41 11 Diphtheria and Croup ... ... ... ... ... ... ... 1 3 4 ... ...... ... 1 1 ... 2 ... 1 3 1 3 3 4 ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... 1 ... 1 Tuberculous Meningitis ... ... ... ... ... ... 1 2 2 5 ... 1 1 ... 1 ... 2 ... 3 9 6 4 8 4 10 Abdominal Tuberculosis (a) ... ... ... ... ... 3 ... 3 ... 6 ... ...... 1 1 ... ... 4 ... 4 3 2 2 6 3 3 Other Tuberculous Diseases ... ... ... ... ... ... 1 1 2 4 ... ... 1 ... 1 1 1 ... 2 7 7 10 11 17 12 Meningitis (not Tuberculous) ... ... ... ... ... ... ... 3 ... 3 ... ••• ... 1 ... ... 2 ... 5 3 7 3 8 7 10 Convulsions 2 3 ... 1 6 1 1 ... ... 8 1 2 l l 1 ... ... 2 14 8 9 10 10 7 20 Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ••• ... ... Bronchitis ... ... ... 2 2 3 10 2 ... 17 2 4 1 l 3 ... 5 1 35 18 30 24 21 50 19 Pneumonia (all forms) 1 1 ... ... 2 9 16 10 12 49 2 10 1 5 21 1 9 ... 66 45 62 53 74 67 52 Diarrhœa ... ... 2 2 4 7 20 9 5 45 3 12 5 8 13 1 3 ... 24 142 46 82 97 69 192 Enteritis ... ... 1 ... 1 6 19 7 5 38 2 11 4 6 6 1 7 1 9 38 21 16 21 26 34 Gastritis ... ... ... ... ... 2 1 ... 1 4 ... ... ... 1 2 1 ... ... 3 3 5 1 2 3 2 Syphilis 1 ... 1 ... 2 5 4 2 1 14 2 2 1 2 3 ... 3 l 6 16 13 23 16 8 9 Rickets ... ... ... ... ... ... 1 ... ... 1 ... ... ... 1 ... ... ... ... ... ... 2 5 2 3 2 Suffocation, overlying 1 ... ... ... 1 2 1 ... ... 4 ... ... ... ... 2 ... 2 ... 10 10 14 11 14 15 18 Injury at Birth 7 1 ... ... 8 ... ... ... ... 8 1 ... ... 1 1 2 2 l 8 8 11 8 8 8 11 Atelectasis 9 ... ... 1 10 ... ... ... ... 10 ... 2 1 2 2 ... 2 l 7 10 12 13 20 18 19 Congenital Malformations 8 ... 1 2 11 3 ... ... ... 14 ... 2 ... 2 5 1 4 ... 16 10 16 17 20 14 20 Premature Birth 67 14 11 2 94 8 ... ... ... 102 4 13 13 19 27 5 16 5 81 85 86 78 101 100 94 Atrophy, Debility and Marasmus 8 3 1 4 16 7 11 ... ... 34 2 7 5 2 5 2 9 2 47 55 48 49 47 59 50 Other causes 4 1 1 ... 6 6 2 5 1 20 ... 3 3 1 8 1 4 ... 17 16 21 18 22 31 49 108 23 19 14 164 64 90 52 42 412 21 72 41 60 109 16 79 14 395 517 462 466 545 565 649 Nett Births in the year—Legitimate, 4,090: Illegitimate, 212. Nett Deaths in the year of—Legitimate infants, 364; Illegitimate infants, 48. (a) Under Abdominal Tuberculosis are included deaths from Tuberculous Peritonitis and Enteritis and from Tabes Mesenterica. Want of Breast Milk is included under Atrophy and Debility. 25 Table XV. gives the infantile death-rates of the several wards of the borough. TABLE XV. Deaths under one year per 1,000 Births. Ward. 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 Average Ten Years 1902-1912 1913 Barons Court 98 181 108 88 146 91 75 122 70 148 113 108 Lillie 138 137 147 137 151 106 122 103 128 85 125 96 Walham 142 185 183 166 184 152 140 156 124 91 152 117 Margravine 144 179 153 171 136 129 133 135 154 112 145 102 Munster 125 140 137 142 116 120 102 103 137 91 121 91 Hurlingham 104 159 98 150 99 81 76 43 59 59 93 82 Sands End 121 156 168 127 107 136 94 109 138 97 125 102 Town 76 121 105 72 64 64 98 81 51 76 81 60 The Borough 127 152 144 133 122 115 108 107 128 94 123 96 The above table shows the great variation of infant mortality in different parts of the borough, that of Walham Ward, for instance, being nearly double that of the Town Ward, while if smaller areas are compared the variation is naturally more striking. If the report in the appendix on the condition of Heckfield Place be referred to, it will be seen that the average infant mortality during the five years 1908-1912, of that slum was 826 per 1,000 against 110 per 1,000 in the whole of the borough, and last year in the area comprising Heckfield Place, Walham Avenue, Rock Avenue, Lodge Avenue and Cassidy Road, which contains 27 per cent, of the population of Walham Ward, the infant mortality was 199 per 1,000 against 69 per 1,000 in the remainder of the Ward. 26 Causes of Infantile Mortality. Table XIV. gives the causes of the deaths at various periods under one year of age, and in the following table the mortality from certain groups of diseases will be found. TABLE XVI. Death-rates of Infants under one year of age from certain groups of diseases. Diseases. Deaths per 1,000 births. 1913. Average of 5 years 1908-12. Infectious Diseases 6.4 8.5 Tuberculous Diseases 3.5 3.9 Diarrhœal Diseases 19.4 22.8 Respiratory Diseases 15.5 20.0 Premature Birth, Congenital Defects and Debility 34.7 34.8 Other Causes 16.5 20.3 96.0 110.3 Notification of Births Act—Prevention of Infantile Mortality, 3,260 notifications of living, and 106 of stillborn children were received under the above Act, 77 per cent. of the births registered during the year being notified. Of these, 2,246 or 67 per cent. were notified by midwives, 954 or 28 per cent. by medical practitioners, and 166 or 5 per cent. by relatives. Visits were paid to 1,066 or 25 per cent. of the babies born in the borough either by your Sanitary Inspector or the Superintendent of the Fulham School for Mothers, and about one-half of these were visited again on one or more occasions, according to their needs, 2,520 visits being made. The want of a Health Visitor who would devote her whole time to this work is greatly felt, and I must again express regret that the Council have refused to appoint one, though repeatedly pressed to do so. The benefits resulting from the systematic visitation of infants and the instruction of mothers are unquestionable, and having regard to the excessive child mortality 27 shown in some parts of the borough, illustrations of which have been given above, it is in my opinion incumbent on the Council to omit no measures which may reduce it. In connection with infant welfare work, the efforts of the Fulham School for Mothers deserves cordial recognition, and its Committee's Report shows that there is an increasing appreciation of its work by those whom it is intended to benefit. The steady increase in the number of babies brought to the Consultations held by the Honorary Medical Officers will be seen from the following table, which gives the figures for the five years during which the School has been open:— TABLE XVII. Attendances of Infants at the Fulham School for Mothers. 1909 1910 1911 1912 1913 Number of Infants registered at the Consultations at 92, Greyhound Road. 255 326 365 409 456 Number of Infants registered at the Consultations in South Fulham - - 118 124 157 Total number of Infants registered 255 326 483 533 613 Number of Attendances, 92, Greyhound Road 1041 2287 3529 4202 4720 Number of Attendances, South Fulham - - 864 1295 1631 Total Attendances 1041 2287 4393 5497 6351 The growth of the combined Schools' work in five years is shown by the fact that the number of infants registered increased 140 per cent., and the number of attendances 510 per cent. during the period. Children are also now brought to the Consultations after they have attained the age of one year, as the necessity for continuing the supervision was in many cases very apparent, and in their report the Committee 28 state that they are very anxious, if sufficient financial support can be obtained, to develop further this side of the work by establishing a Medical Inspection Centre for .children under school age, so that skilled supervision may be continued during childhood. The need for bridging over the interval between infancy and school age is proved by the fact that the medical examination of "entrants" into infant schools shows that a great amount of undetected and neglected disease is rife among children between infancy and school age, implying a deplorable amount of neglected work in the prevention of disease by early treatment and advice. With proper care before school age, children would be saved much suffering, and much of the money now spent in treating preventible diseases at School Clinics and elsewhere would be saved. 164 or 40 per cent. of the deaths of infants under one year of age occurred in the first four weeks of life, and 108 or 26.4 per cent in the first seven days. The mortality rate of infants in the first month of life was in 1913, 39 per 1,000 births compared with an average rate of 36 per 1,000 in the five years 1908-12. The majority of these deaths, ascribed mainly to prematurity, congenital malformations, atelectasis, injury at birth and marasmus, were due to ante-natal causes which are but little affected by existing preventive methods, and the fact that in the six years under consideration the mortality at this age period has not fallen, indeed has slightly increased, whereas the mortality rate of infants between 1 and 12 months was in 1913, 16 per 1,000 below the average rate of the preceding five years, furnishes evidence of the success of those preventive methods of which a further extension is advocated. Deaths of Illegitimate Children. Of the 412 children who died before attaining the age of one year, 48 or 11.7 per cent. were illegitimate, the mortality among them being in the proportion of 227 deaths per 1,000 births against 89 per 1000 among children born in wedlock. 29 Insurance of Infants. Certificates under the Friendly Societies Act were issued in respect of 333 children under the age of five years, 55 per cent. of the children dying at the ages period being insured. Deaths at other age periods. Table XVIII. gives the number of deaths and the death-rate at certain other age periods. TABLE XVIII. Deaths at certain age periods. Age Period. Number of Deaths. Percentage of Total Deaths. Death-rate per 1000 of population living at age period. 1 and under 2 years 105 5.3 31.5 2 „ 5 „ 84 4.2 9.7 5 „ 15 „ 73 3.6 2.4 15 „ 25 „ 79 3.9 3.0 25 „ 45 „ 300 14.8 6.0 45 „ 65 „ 508 25.1 20.9 Over 65 „ 464 22.8 75.9 DEATHS FROM EPIDEMIC DISEASES. To the seven principal epidemic diseases 203 deaths were ascribed, representing a death-rate of 1.27 per 1,000, which is 0.26 per 1,000 above that of 1912, but 0.73 per 1,000 below the average rate of the ten preceding years. The following table gives the number of deaths in the borough from the principal epidemic diseases in 1913 and in the preceding ten years, together with the death-rates:— TABLE XIX. Deaths from the seven principal Epidemic Diseases. 1903. 1904. 1905. 1906. 1907. 1908. 1909. 1910. 1911. 1912. Mean number of Deaths 1903—1912. ... ... ... ... ... ... ... ... ... ... ... 62 64 85 53 69 71 74 65 64 65 67 8 4 23 18 14 17 10 7 6 6 10 48 58 82 31 75 34 48 60 28 45 51 24 24 24 33 38 32 39 14 27 15 27 16 6 10 13 8 10 4 2 8 8 9 165 235 202 275 115 130 105 74 211 34 155 323 391 426 423 319 294 280 222 344 173 319 31 SICKNESS FROM NOTIFIABLE INFECTIOUS DISEASES. Table XX. gives the number of cases of infectious diseases notified in Fulham since 1890, when compulsory notification came into force, excluding duplicate notifications, and Table XXI. gives the number of cases notified in each ward in 1913, with the ages of the patients. The chart shows the number of cases of scarlet fever and diphtheria notified in each week of 1913, together with the average number notified in the corresponding weeks of the ten years of 1903-1912. 32 TABLE XX. 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 191 1 1912 1913 Smallpox - - 3 32 40 2 2 - - 1 9 16 94 11 - - - - - - - - - - Scarlet Fever 286 118 517 701 529 339 627 759 811 847 552 600 552 404 294 779 674 668 596 511 354 384 484 766 Diphtheria 70 69 96 230 329 368 341 378 465 514 630 636 417 286 299 285 403 603 400 322 257 311 231 270 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 34 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 19 Erysipelas 114 67 104 153 113 94 99 134 121 178 154 132 121 115 131 143 141 128 127 115 115 115 115 121 Epidemic Cerebrospinal Meningitis - - - - - - - - - - - - - - - - - 3 4 3 7 3 2 5 Ophthalmia Neonatorum - - - - - - - - - - - - - - - - - - - - - 15 13 23 Poliomyelitis - - - - - - - - - - - - - - - - - - - - - 1 5 2 Pulmonary Tuberculosis - - - - - - - - - - - - 137 171 165 152 148 151 179 279 326 613 1173 765 Other forms of Tuberculosis - - - - - - - - - - - - - - - - - - - - - - - 289 Anthrax - - - - - - - - - - - - - - - - - - - - - - - — Totals 573 327 786 1224 1073 887 1149 1354 1488 1683 1459 1534 1414 1093 939 1440 1428 1628 1362 1306 1099 1506 2080 2294 33 TABLE XXI. Cases of Infectious Diseases notified during the Year 1913. Notifiable Disease. Number of Cases Notified Total Cases Notified in each Ward of the Borough. Total cases removed to Hospital. At all Ages. At Ages—Years. Barons Court Ward. Lillie Ward. Walham Ward. Margravine Ward. Munster Ward. Hurlingham Ward. Sands End Ward. Town Ward. 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) 270 8 92 134 21 11 3 1 6 43 24 33 61 22 70 11 258 Erysipelas 121 2 8 7 9 38 38 19 2 23 10 30 25 6 23 2 64* Scarlet Fever 766 7 172 499 49 39 - - 29 108 64 79 205 36 200 45 721 Typhus Fever - - - - - - - - - - - - - - - - - Enteric Fever 34 - 1 9 10 10 3 1 3 3 1 6 8 2 5 6 25 Relapsing Fever (R) Continued Fever - - - - - - - - - - - - - - - - - Puerperal Fever 19 - - - 4 15 - - 2 1 2 3 3 1 5 2 17 Cerebro-spinal Meningitis 5 - 5 - - - - - 1 - - 1 1 - 1 1 4 Poliolyelitis 2 - 1 1 - - - - - 1 - 1 - - - - 2 Pulmonary Tuberculosis 765 2 22 181 113 289 146 12 30 118 72 99 206 35 150 55 - Other forms of Tuberculosis 289 4 54 160 29 27 14 1 9 40 24 35 78 15 72 16 - Ophthalmia Neonatorum 23 23 - - - - - - 2 6 1 8 3 1 2 - 9 Totals 2294 46 355 991 235 429 204 34 84 343 198 295 590 118 528 138 1100 * Removed to Fulham Infirmary. 34 Smallpox. There has been no case of smallpox in Fulham since 1903 and only 3 cases were notified in London during 1913. Primary Vaccination. The following tables, furnished by Mr. Davies, Vaccination Officer, gives the following returns for 1912 and the first six months of 1913. TABLE XXII. Supplemental Return for 1912 for the Borough of Fulham. No. of Births Registered from Jan. 1st, 1912. to Dec. 31st, 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. 4127 2622 8 279 69 654 46 399 50 TABLE XXIII. Return of the Vaccination for the period from January to June, 1913, for the Borough of Fulham. No. of Births Registered from Jan. 1st, 1913, to June 30th, 1913. 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. 2057 1202 — 140 73 410 25 186 21 The children exempted by statutory declaration of conscientious objection increased from 557 in 1911 to 654 in 1912 and 28 per cent. of those born in 1912 remain unvaccinated. 85 Scarlet Fever. Scarlet Fever in a very mild form was very prevalent throughout the borough in the late months of the year, and the notified cases numbered 766 compared with 354, 384, and 484 in the preceding three years. The returns for the four quarters were:— Cases. Deaths. First quarter 95 1 Second quarter 115 - Third quarter 190 8 Fourth quarter 866 - 766 4 The cases occurred in 560 houses as under:— Houses with one case 440 ,, ,, two cases 73 „ „ three cases 26 „ „ four „ 12 „ „ five „ 5 „ „ six ,, 2 „ „ seven „ 1 „ „ ten ,, 1 560 Owing to the light character of the attack there were many missed cases which were only discovered on the occurrence of subsequent cases in the house, and in addition to these there is no doubt that there were very many which entirely escaped recognition. Isolation. Of the patients notified, 722 or 94 per cent. were removed to hospital for treatment. In the autumn there was at times considerable delay in the removal of cases owing to the want of accommodation in the Metropolitan Asylums Board's hospitals. 36 Fatality. Among the notified cases there were three deaths, representing a case mortality of 0.4 per cent., the lowest previously recorded being 1.24 per cent. in 1912. In addition to the deaths among the notified cases, the death from scarlet fever of a Fulham child occurred in Hastings Borough Infectious Hospital. Distribution. In Table XXI. 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 1913, and the preceding ten years. TABLE XXIV. Number of cases of Scarlet Fever notified per 10,000 of the population. 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 Mean of 10 years 1903-12 1913 Barons Court Ward 9 20 52 25 17 23 32 7 6 14 21 23 Lillie Ward 18 11 54 63 47 36 33 22 21 10 32 42 Walham Ward 14 21 43 47 28 21 16 19 26 25 26 52 Margravine Ward 37 11 34 40 45 28 33 23 25 23 30 42 Munster Ward 27 26 64 41 35 39 40 29 31 41 37 52 Hurlingham Ward 22 12 40 42 44 43 14 10 20 38 29 36 Sands End Ward 46 24 54 41 64 60 42 24 40 44 44 73 Town Ward 32 23 43 29 32 23 19 19 25 29 28 34 The Borough 28 19 50 42 42 37 32 22 25 31 33 48 The County of London 28 29 42 43 52 46 38 23 23 25 35 39 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 53 Weeks ended January 3rd, 1914. 37 Diphtheria. The cases of diphtheria notified in the four quarters of the year were as under:— Cases. Deaths. First quarter 48 3 Second quarter 52 1 Third quarter 55 1 Fourth quarter 115 10 270 15 The attack-rate was 17 per 10,000 compared with 15 per 10,000 in 1912 and an average of 22 per 10,000 in the decennium 1903—1912. The cases occurred in 231 houses as under:— Houses with one case 205 ,, „ two cases 22 „ „ three cases 3 „ „ four cases 1 Eight cases occurred in Fulham Workhouse. Isolation. Of the patients notified, 258 or 95.6 per cent. were removed to hospital. Fatality. The 15 deaths represent a case mortality of 5.6 per cent., against 5.4, 8.7 and 6.5 per cent. in the preceding three years. Diphtheria Antitoxin. 134,000 units of antitoxic serum were supplied to medical practitioners for use in 16 cases. 38 Distribution. Table XXI. gives the number of cases notified in the several wards, and the following gives the proportional prevalence:— TABLE XXV. Number of cases of Diphtheria notified per 10,000 of the population. 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 Mean of 10 years 1903-12. 1913 Baron's Court Ward 9 10 20 17 7 13 10 14 14 15 10 5 Lillie Ward 23 13 14 17 38 24 16 10 9 16 18 17 Walham Ward 29 10 17 15 20 22 20 19 17 29 20 19 Margravine Ward 15 21 22 40 37 29 26 23 27 10 25 17 Munster Ward 15 24 17 24 38 25 22 14 26 19 23 16 Hurlingham Ward 27 20 22 16 41 27 23 22 19 8 23 22 Sands End Ward 31 34 22 36 68 28 21 20 27 14 30 26 Town Ward 17 13 12 20 21 23 21 10 13 8 16 6 The Borough 20 20 18 23 38 25 20 16 20 15 22 17 The County of London 17 16 14 18 19 17 14 8 8 16 15 17 Enteric Fever. The cases notified as enteric fever in 1913 numbered 34, representing an attack-rate of 2.1 per 10,000 of the population, the decennial average being 3.0 per 10,000. Three patients had eaten shellfish, two oysters and one whelks, within a fortnight of the commencement of the illness. In three instances the disease was contracted outside the borough. Fatality. There were 8 deaths, giving a case mortality, after excluding 5 cases in which the diagnosis was not confirmed, of 27.6 per cent. 39 Errors of Diagnosis in Notified Infectious Diseases. Of the patients certified as suffering from scarlet fever 39 or 5 per cent., from diphtheria 27 or 10 per cent., and from enteric fever 5 or 14 per cent. were subsequently ascertained to be not suffering from those diseases. Puerperal Fever. Of puerperal septicaemia 19 cases were notified during the year, or 4.5 per 1,000 births, of which 4 or 0.95 per 1,000 births proved fatal. Sixteen of the cases were attended by midwives and three by medical practitioners. Fifteen of the patients notified were removed to the Infirmary and two to the Western Fever Hospital. Erysipelas. 121 persons were notified as suffering from erysipelas, and 4 deaths were attributed to the disease. Cerebro-Spinal Fever. In three of the five cases notified the diagnosis was mistaken, the diseases from which the children were subsequently found to be suffering being respectively, suppurative meningitis consequent upon disease of the middle ear, tubercular meningitis, and acute poliomyelitis. Of the two children in whom the diagnosis was confirmed, one died in Fulham Infirmary. Poliomyelitis. Two cases were notified. Both patients are reported to be regaining power in the affected muscles. The 40 death of a child aged 12 months, who was not notified, was ascribed to infantile paralysis. Ophthalmia Neonatorum. 23 cases were reported, of which ten were removed to Fulham Infirmary. Tuberculosis. On February 1st, 1913, the order of the Local Government Board requiring the notification of all forms of tuberculosis, non-pulmonary as well as pulmonary, came into force. During the year 765 new cases of pulmonary and 289 of other forms of tuberculosis were notified. Table XXVI. gives the number of notifications of males and females at various age periods that were received from February 1st, 1913, when the regulations came into force, until January 3rd, 1914 and during January, 1913, 30 males and 32 females were notified as suffering from pulmonary tuberculosis. 41 TABLE XXVI. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of notifications during the period from 1st February, 1913, to the end of the week ending on the 3rd January, 1914. Age peiiods. Number of Notifications on Form A. Number of Notifications on Form B. Number of Notifications on Form C. Primary Notifications. Total Notifications (i.e. including cases previously notified by others doctors. Primary Notifications. Total Notifications (i.e. including cases previously notified by other doctors. Poor Law Institutions. Sanatoria. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 56 65 and upwards Total. Under 5. 5 to 10 10 to 15 Total. Pulmonary. Males 2 7 41 36 24 27 77 50 57 20 6 347 426 - - 2 2 2 107 98 Females - 11 45 41 23 31 81 58 35 20 6 351 395 1 2 2 5 5 69 32 Non-pulmonary. Males - 28 54 17 10 5 11 3 3 4 - 135 144 - 6 6 12 12 11 5 Females 4 25 40 23 7 7 10 3 6 1 1 127 132 1 5 9 15 15 5 4 42 Mortality from Tuberculosis. 215 deaths (126 of males and 89 of females) were registered from phthisis (tuberculosis of the lungs), representing a death-rate of 1.34 per 1,000 ; the average for the ten preceding years being 1.33. The distribution of the deaths was as under:— Males. Females. Deaths in Poor Law Institutions 62 25 Deaths in Hospitals 16 13 Deaths in Asylums 5 4 Deaths at Home 43 47 126 89 To other tuberculous diseases 49 deaths were ascribed, and the death-rate was 0.31 per 1,000 against an average of 0.46 during the ten years 1903-12. In the several wards of the borough the death-rates from phthisis and other tuberculous diseases were as under :— TABLE XXV„ . 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 all Tuberculous Diseases. Baron's Court Ward 1.57 0.16 1.73 Lillie Ward 1.49 0.24 1.73 Walham Ward 1.78 0.63 2.36 Margravine Ward 1.44 0.16 1.60 Munster Ward 1.19 0.28 1.47 Hurlingham Ward 1.52 0.30 1.82 Sands End Ward 1.06 0.40 1.46 Town Ward 1.27 0.37 1.64 The Borough 1.34 0.31 1.65 43 Treatment and Prevention of Tuberculosis.—Fulham Tuberculosis Dispensary. In May, 1913 the Borough Council, with the approval of the Local Government Board, entered into an agreement with the Committee of Management of the Fulham Tuberculosis Dispensary, under which the Council agreed to contribute for the financial year ending 31st March, 1914, the sum of £300 towards the maintenance of the Dispensary, and the Committee undertook : (1) To provide for the proper medical treatment at the Dispensary of all or any residents in the borough suffering from tuberculosis whose means are in the opinion of the Council insufficient to enable them to pay for such medical treatment. (2) To make suitable arrangements in co-operation with the Medical Officer of Health of the borough for the free medical examination of all contacts and suspects in connection with such patients. (3) To arrange that the place of residence of each patient shall be visited as often as may be necessary by one of the Medical Officers of the Dispensary, and also by one of the Nurses appointed by the Dispensary, and that all reports regarding any patient and the conditions existing at the place of residence of such patient shall be forwarded in duplicate to the Medical Officer of Health. (4) To provide and maintain in efficient condition to the satisfaction of the Council and the Local Government Board the said Dispensary at 632, Fulham Road, and also to provide all proper medical attendance and medicines required as aforesaid, and for such purposes to engage and retain the services of an experienced staff (5) That the Medical Officer of the Dispensary shall under the administrative directions of the Medical Officer of Health act as " Tuberculosis Officer 44 of the Borough," and assist in the carrying out of any necessary measures for the prevention of tuberculosis in the borough, but that the Tuberculosis Officer shall be independent of any control by the Medical Officer of Health in all matters relating to diagnosis and the treatment of patients, contacts and suspects. (6) That the Tuberculosis Officer shall furnish to the Medical Officer of Health full information regarding the sanitary conditions of all dwelling-houses within the borough in which cases of tuberculosis have been diagnosed or treated by him or his assistants. (7) That the Council shall be entitled to appoint three persons to act upon and be members of the Dispensary Committee, and that such persons shall have and exercise all the rights and powers appertaining to membership of the said Committee. The following summary of the work of the Dispensary during the year has been furnished by the Medical Officer, Dr. John Sullivan:— TABLE I (A). Statistics for the year 1913. New Patients. 1. Suffering from pulmonary tuberculosis 324 2. „ „ other forms „ 86 3. ,, „ suspected cases ,, 323 4. „ „ non-tuberculous 429 Patients actually attending (old and new) 1,800 1. Insured 263 2. Uninsured 1,537 Attendances at Dispensary— 1. Insured 2,361 2. Uninsured 11,967) 14,598 Doctor's home visits 2,175 Nurse's 1,517 Contacts examined at home 668 Patients who were contacts 443 Patients who had tuberculin treatment 162 1. Beraneck's tuberculin 60 2. P.T.O. followed by old tuberculin 95 3. B.E. 7 45 TABLE II (A). Sex and Age of Patients. Under 5 10 15 25 35 45 45 and over All Ages Males 92 171 94 41 43 40 24 505 Females 75 163 115 64 108 65 67 657 Total 167 334 209 105 151 105 91 1162 63.6 per cent. of the patients were under 16 years or age. The number of children of school age (4—14) was 570. TABLE III (A). Diagnosis of Male and Female Patients. Number of Patients. Pulmonary Tuberculosis Other Forms. Suspects NonTuber cular. Percentage Tuberculous Males 505 131 41 142 191 34.05 Females 657 193 45 181 238 36.2 Total 1162 324 86 323 429 35.2 TABLE IV (A). Diagnosis at various Age Periods. Age. Pulmonary Tuberculosis Other Forms. Suspects NonTuber culous Percentage Tuberculous Under 5 11 14 48 94 14.9 „ 5.10 48 51 106 129 29.6 „ 10.15 57 16 67 69 34.9 „ 15.25 41 3 35 26 41.9 ,, 25.35 77 2 31 41 52.3 ,, 35.45 46 0 26 33 43.8 45 and over 44 0 10 37 48.3 All ages 324 86 323 429 35.2 46 The diagnostic tables shew that 410 out of a total of 1,162 new patients (or 35.2 per cent.) were suffering from tuberculosis. Out of the total number of children of school age, viz., 570, 179 were tuberculous. The Source of Infection. Although in a certain percentage of cases of tuberculosis of bones and joints and glands the source of infection is the milk of tuberculous cows, and in a few instances the meat of tuberculous animals, in the vast majority of cases of pulmonary tuberculosis the infection is derived from another tuberculous patient (from the sputum, and in a few cases from human milk). It is generally believed that infection occurs in childhood in many cases, and this is borne out by our figures ; in the cases in which a source of infection was elicited this occurred in childhood in 61 instances. TABLE V (A). Source of Infections. The following table shows the number of cases in which there was a history of exposure to infection. Pulmonary Tuberculosis. Other forms of Tuberculosis. Exposure to infection from another member of the family. Probably infected in some other way. No history of exposure to infection. Exposure to infection from another member of the same family. Probably infected in some other way. No history of exposure to infection. 224 70 86 70 4 12 47 TABLE VI (A). Housing Conditions. Of the 410 tuberculous patients found in 1913:— 16 lived in the Basement 109 „ on the Ground Floor 85 ,, „ First „ 40 ,, „ Second „ 15 ,, „ Third ,, 59 ,, „ Top ,, 18 ,, „ more than one „ 68 „ in the whole house 410 Those living in a whole house nearly always shared it with lodgers. TABLE VII (A). The following table gives the number of rooms occupied by tuberculous patients, together with the number of persons living with them. No. of Patients occupying one room. No. of Persons occupying 2 rooms No. of Patients occupying 3 rooms. No. of Patients occupying 4 rooms. No. of Patients occupying 5 rooms. No. of Patients occupying 6or more rooms Living alone 7 1 — — — — „ with one other person 1 4 12 2 — 1 „ 2 other persons 5 8 16 15 1 1 „ 3 „ 3 12 19 27 5 6 „ 4„ — 13 30 23 10 2 „ 5„ — 8 29 24 14 4 ,, 6 „ — 4 21 15 4 5 „ 7 „ — — 12 9 6 3 „ 8 „ — — 11 5 3 2 ,„ 9 „ — — — 2 1 — „ 10 „ — — — — — 2 „ 11 „ — — — — — 2 Total 16 50 150 122 44 28 48 TABLE VIII (A). Sleeping A ccommodation. Of 410 tuberculous patients when visited The Patient slept In a separate room in 70 cases Alone in bed with one other in room „ 24 „ ,, ,, „ „ two others ,, ,, „ 32 „ ,, „ ,, „ three ,, „ ,, „ 7 „ „ „ „ „ four „ ,, „ „ 6 „ In bed with one person and no others in room „ 95 „ „ „ „ one other „ „ 57 „ „ „ „ two others ,, „ 30 „ „ „ „ three ,, „ „ 18 „ „ „ „ four „ ,, „ 3 „ In bed with two persons and no others in room „ 20 „ „ „ „ one other ,, „ 11 „ „ „ „ two others „ „ 9 „ „ „ „ three ,, ,, „ 7 „ „ „ „ four ,, ,, „ 6 „ In bed with three persons and no others in room in 9 „ ,, „ „ one other „ „ 5 „ One patient slept with another boy on the counter of the Pawnbroker's shop where he worked, and the only ventilation came through a fanlight. He was trying very hard to get more healthy work, but his family disappeared from Fulham and he has not been traced. Sanatorium Treatment. As the London County Council propose to provide residential treatment for persons suffering from tuberculosis, the Borough Council decided not to renew the arrangement under which they retained from April 1st, 1912 to March 31st, 1913, six beds at the National Sanatorium, Benenden, for the use of men resident in the Borough. Between January 1st and March 31st four patients were sent by the Council to Benenden and during the twelve months ended March 31st, 1913, 22 49 patients occupied the Council's beds for periods ranging from five weeks to six months. 85 persons notified as tuberculous received treatment in Sanatoria as patients of the London Insurance Committee, their average stay in Sanatoria being eleven weeks. Eighteen insured persons were sent by the Committee to Brompton Hospital and fourteen to other hospitals, the average duration of their treatment as in-patients being ten weeks. Of the patients treated at the Dispensary 45 uninsured were sent to Sanatoria or Homes through the efforts of the Dispensary Care Committee, who co-operate with the Charity Organization Society, the Invalid Children's Aid Society, and others. After Care. Under the Tuberculosis Regulations, 1912, the discharge of tuberculous patients from Sanatoria and Poor-law Institutions is notified to the Medical Officer of Health, though for some obscure reason the notification of their discharges from hospital is not required. The patients discharged are visited by the Dispensary nurses and efforts are made to secure the continuance of suitable treatment. A serious problem is the difficulty experienced in finding light and healthy work for discharged patients, partly due to the exaggerated fear of infection from cases of pulmonary tuberculosis now entertained by the public. In view of this the Royal College of Physicians, with the hope of rendering assistance to those who have administrative duties in connection with the disease, have recently issued the following statement:— THE INFECTIVITY OF TUBERCULOSIS. 1. Tuberculosis is an acquired disease, but certain constitutional types may be inherited which render the patient specially susceptible to infection and there is reason to think that such susceptibility is an inherited character. 2. The infective agent is the tubercle bacillus. This may be contained in the various discharges and excreta of the patient. 50 and especially in the sputum of those suffering from pulmonary tuberculosis. No discharge is effective unless it contains the tubercle bacillus. 3. Cases of tuberculosis of bones, glands, and internal organs from which there is no discharge or which do not furnish any excretion, and cases of arrested pulmonary tuberculosis, have never been proved to be infectious. (By arrest is here meant that all the symptoms and physical signs of activity have disappeared, and the sputum has either ceased or no longer contains tubercle bacilli). 4. The means by which tubercle bacilli may enter the body are:— (a) By inoculation through a wound or abrasion of the skin. This has occasionally occurred to workers in laboratories, post-mortem attendants and others dealing with tuberculosis material, and is presumably the way in which lupus is acquired. (b) By inhalation. Susceptible animals are readily infected by the inhalation of air containing tubercle bacilli, whether in droplets or suspended as fine dust, but in the spread of the disease among human beings the latter appears to be the more important means of infection. The sputum or other discharges, whether on soiled handkerchiefs, linen, garments, or elsewhere, when dried, may become pulverised, and in this condition may be readily dispersed in the air of a room. That droplets of sputum are less important agents of infection is suggested by the fact that the incidence of consumption upon the staff, nurses, and others engaged in hospitals for the treatment of tuberculous disease, where all discharges are carefully disposed of, is not above the average in the general population. (c) By swallowing. Dust infected by the tubercle bacillus may be conveyed to food and so enter the alimentary canal; or infection may occur more directly in the act of kissing, or by consumptive and healthy persons using the same food utensils. As about 10 per cent. of the milk supplied to large cities contains tubercle bacilli derived from infected cows, this avenue of infection is particularly important in the case of children. The bovine tubercle bacillus is more commonly responsible for tuberculosis in young children than in adults, but the proportion of cases due to it varies very much in different localities. There is no evidence that tuberculosis can be conveyed to others either by the breath alone, or by emanations from patients, or by their garments, unless soiled by dried sputum or discharges. 5. The spread of tuberculosis is favoured by uncleanliness, overcrowding, and imperfect ventilation, and is hindered by the opposite conditions. Experience in hospitals and other 51 institutions where the following precautionary measures have been thoroughly carried out indicates that by such measures the risk of infection is reduced to a minimum, namely— (a) The careful disposal and disinfection of the sputum and other discharges. (b) The disinfection or destruction of soiled handkerchiefs, clothes and linen. (c) The removal of dust by frequent moist cleansing of the floors, walls, etc., of the rooms. (d) The supply of abundant air space, and free ventilation with fresh air. No risk is incurred by living in the immediate neighbourhood of Institutions for the treatment of tuberculosis which are properly conducted. On the other hand there is great difficulty at present in dealing with persons suffering from chronic and advanced phthisis who are unquestionably a source of danger to those living with them, owing to the inadequate accommodation for such cases in London. Practically the only institutions to which they can be admitted are the Workhouse Infirmaries, and these it is often very difficult to persuade them to enter, and still more so to induce them to remain. The administrative obstacles which interfere with the prevention of infection may also be illustrated by the following case. It was ascertained that a woman had been registered by the London County Council under the Infant Act as having care of a nurse child who had herself been notified as suffering from pulmonary tuberculosis, together with her husband and three of their children. That the nurse child would be infected if it remained with her was reasonably certain, but no representation could be made to the London County Council that she was unfit to have the care of the child, in view of the Tuberculosis Regulations of the Local Government Board, Clause 16 of which prescribe that "nothing in these regulations shall have effect so as to apply, or so as to authorise a Medical Officer of Health or a Local Authority, or any other person or authority, directly or 52 indirectly, to be put into force with respect to any person in relation to whom a notification in pursuance of these Regulations has been transmitted to a Medical Officer of Health any enactment which renders the person, or anyone in charge of the person, or any other person, liable to a penalty, or subjects the person to any restriction, prohibition, or disability affecting himself or his employment, occupation or means of livelihood, on the ground of his suffering from tuberculosis." DEATHS FROM NON-NOTIFIABLE INFECTIOUS DISEASES. Measles. The deaths from measles in the four quarters of the year were:— 1st Quarter 26 2nd „ 20 3rd „ 2 4th „ 1 49 The death-rate was 031 per 1,000, being 0.13 per 1,000 below the average rate of the preceding ten years. 521 cases reported by the Schools were visited by the Sanitary Inspectors. Disinfection was carried out after 319 cases. Whooping Cough. The deaths from whooping cough in the four quarters of the year were:— 1st Quarter 11 2nd ,, 6 3rd ,, 7 4th ,, 3 27 The death-rate from the disease was 0.7 per 1,000, or being half of the average rate for the ten years 1903-12. 53 DiarrhŒa. The deaths from diarrhœa and enteritis in the four quarters of the year were:— 1st Quarter 8 2nd ,, 9 3rd ,, 44 4th ,, 46 107 Of these 83 were of children under one, and 17 of children beween one and two years of age. Though more prevalent than in 1912, when there were only 34 deaths of children under two, the amount of diarrhoea in 1913 was well below the average, the death-rate being 0.64 per 1,000 against a decennial average of 103 per 1,000. Influenza. Twenty-seven deaths were certified to be due to influenza, the numbers for the preceding three years being 25, 19 and 16. DEATHS FROM OTHER DISEASES. Cancer. To the various forms of cancer 176 deaths were referred, 69 of males and 107 of females, representing a death-rate of 1.10 against a decennial average of 1.01. The death-rate of males was 0.92, and of females 1.27 per 1,000 Venereal Diseases. From syphilis 18 deaths were registered, 14 being of infants under one year of age. Much attention has of late been drawn to the prevalence of syphilis and the serious extent to which it affects the national health. The deaths directly attributed to the disease represent but a small proportion of those which are in reality due to it. It is an important 54 cause of arterial degeneration, and the chief if not the only cause of many nervous diseases such as locomotor ataxy and general paralysis of the insane, and as it is transmitted from the parents to the children, a large number of deaths of infants are due to it, and in later years inherited syphilis may cause blindness, deafness, and various bone, skin, and other lesions. As it is obvious that if the disease can be recognised and effectively treated in the early stage the sources of infection must be lessened the Public Health Committee were urged to make arrangements to have specimens of the blood of patients, when desired by their medical attendants, tested for the Wassermann reaction, which when positive denotes syphilitic infection, but the Committee resolved not to carry out the recommendation. Diseases of the Respiratory System. From these diseases there were 373 deaths or 18.4 per cent. of the deaths from all causes, being 20 below the average number in the ten years 1903-12. Violence. The deaths of Fulham residents from various forms of violence numbered 73, of which 14 were due to suicide. Other diseases caused the following deaths:— Diseases of the Circulatory System 206 Diseases of the Nervous System 197 Diseases of the Digestive System 88 Diseases of the Urinary System 67 Senile Decay 58 CERTIFICATION OF THE CAUSES OF DEATH. Of the 2,028 deaths registered 1,858 or 91.6 per cent. were certified by registered medical practitioners and 168 by Coroners after inquests; the deaths of two infants being uncertified. 55 DEATHS IN PUBLIC INSTITUTIONS. Fulham Infirmary and Workhouse. The deaths of 434 persons, 237 males and 197 females, occurred in Fulham Infirmary, and of 52, 33 males and 19 females in the Fulham Workhouse Of these 469 belonged to Fulham and 17 to other districts. Western Fever Hospital. In the Western Fever Hospital there were 208 deaths, 113 males and 95 females, of whom 27 lived in Fulham and 181 in other districts. Deaths occurring outside the Borough among persons belonging thereto. The deaths of Fulham residents in public institutions and elsewhere outside the borough numbered 407, and occurred in the following institutions:— St. George's Hospital 62 West London „ 42 Other General Hospitals (Metropolitan) 44 Victoria Hospital for Children 29 Other Hospitals for Children 12 Lying-in and other Hospitals for Women 3 Brompton Hospital 8 Cancer Hospital 12 Other Special Hospitals (Metropolitan) 3 Homes for Incurables 8 Fever Hospitals of Metropolitan Asylums Board 10 Other Hospitals of Metropolitan Asylums Board 11 Provincial Hospitals and Sanatoria 12 Lunatic Asylums 92 Workhouses and Poor Law Infirmaries 11 In private houses and elsewhere 48 407 56 Of the deaths registered 855 or 42.2 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 23·7 „ Metropolitan Asylums Board Hospitals 2·4 „ other Hospitals 11·6 „ Public Lunatic and Imbecile Asylums 4·5 42·2 GENERAL SANITARY ADMINISTRATION. Disinfection. The following articles were disinfected at the Council's Disinfecting Station, Townmead Road, during the year. Beds 1946 Mattresses 2471 Pillows 5781 Bolsters 1784 Blankets 5708 Sheets 2706 Covers 3379 Curtains 3201 Carpets 2019 Articles of Clothing 7930 Sundries 9465 Spring Beds 77 Cushions 1138 47605 The total cost of the station for the year, including £49 for interest on loans for the building and plant, and £216 for repayment of principal, was ,£1,044. 57 The following rooms were disinfected and cleansed:— After Scarlet Fever 743 „ Diphtheria 222 „ Enteric Fever 27 „ Puerperal Fever 12 „ Erysipelas 81 „ Phthisis 315 „ Measles 319 „ Poliomyelitis 2 „ Other Diseases 47 Verminous rooms fumigated and cleansed 309 School Class Rooms sprayed 20 2,097 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. True diphtheria bacillus isolated 121 Negative result 364 485 Blood from suspected cases of enteric fever:— Widal or typhoid reaction obtained 17 „ „ not obtained 21 38 Sputa from cases of suspected tuberculosis:— Tubercle bacillus found 129 „ „ not found 540 669 Other examinations 7 Total 1,199 58 Public Mortuary. 149 bodies were removed to the mortuary during the year and were admitted as follows:— At Coroner's request 95 Brought by Police 19 At request of Medical Officer of Health 1 At request of Relieving Officer 2 For convenience till funeral 32 149 Inquests were held on 114 and post mortem examinations were made in 76 of the above cases. 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. 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. 59 Slaughterhouses. Premises. Licensee. 611, Fulham Road T.S. Payne 640, King's Road E. Vaughan 603, King's Road S. Stone. Unsound Food. The stalls and shops where food is sold or prepared for sale were regularly inspected by your Sanitary Inspectors. The following articles examined at the request of the owners were condemned and destroyed:— 8 boxes of Fish 2 sacks of Shellfish 3 boxes of Fruit 26 Geese. Kitchens of Restaurants and Coffee Houses. These have been systematically inspected and 14 notices were served on the occupiers on account of want of cleanliness. Sanitary Regulations for premises used for sale or preparation for sale of food. Proceedings under section 8 of the County Council (General Powers) Act, 1908, which prescribes sanitary regulations for premises used for the sale, etc., of food, were taken against a butcher in Town mead Road, in respect of the filthy condition of a room in which meat and bread intended for the manufacture of sausages were stored, and the defendant was fined £1 and 2s. costs. 60 Proceedings under the Sale of Food and Drugs Acts. The undermentioned samples were purchased for analysis in 1913:— Article. Number of Samples taken Officially. Number Adulterated. Number of Samples taken Unofficially. Number Adulterated. Total Samples. Total Adulterated. Percentage of Adulteration. Milk 416 18 6 3 422 21 4.9 Separated Milk 13 ... ... ... 13 ... ... Cream 14 10 14 12 28 22 78.5 Butter 10 3 241 9 251 12 4.7 Lard ... ... 8 ... 8 ... ... Cheese ... ... 30 ... 30 ... ... Coffee ... ... 24 1 24 1 6.1 Cocoa 1 1 45 2 46 3 6.5 Coffee and Chicory ... ... 1 ... 1 ... ... Mustard ... ... 16 ... 16 ... ... Pepper ... ... 10 ... 10 ... ... „ (Cayenne) ... ... 6 ... 6 ... ... Dripping ... ... 6 ... 6 ... ... Preserved Peas ... ... 1 ... 1 ... ... Self Raising Flour ... ... 13 ... 13 ... ... Arrowroot ... ... 6 ... 6 ... ... Rice ... ... 5 ... 5 ... ... Sago ... ... 5 ... 5 ... ... Tapioca ... ... 6 ... 6 ... ... Oatmeal ... ... 3 ... 3 ... ... Liqorice Powder 1 ... 1 1 2 1 50.0 Syrup of Squills and Paregoric 2 1 1 1 3 2 66.6 Honey ... ... 16 1 16 1 6.2 Jam ... ... 12 ... 12 ... ... Whiskey ... ... 6 1 6 1 16.6 Meat Pastes 2 ... 10 2 12 2 16.6 Ginger Beer ... ... 39 27 39 27 69.2 Malt Vinegar ... ... 8 ... 8 ... ... Epsom Salts ... ... 6 ... 6 ... ... 459 33 545 60 1004 93 92 61 In the preceding ten years the samples purchased for analysis were as under:— Number of Samples. Samples Adulterated. Percentage of Adulteration. 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 16.3 1909 1,000 81 8.1 1910 999 127 12.7 1911 1,035 90 8.7 1912 999 86 8.6 Of the milk samples 4.9 per cent. were certified as adulterated, compared with 12.2, 5.7 and 7 per cent. in the preceding three years. The average composition of the samples purchased as new milk in each of the four quarters was as under:— Period. Number of Samples. Solids other than Fat. Fat. Water. First Quarter 84 8.77 3.41 87.82 Second „ 118 8.92 3.58 87.50 Third „ 105 8.67 3.79 87.54 Fourth „ 115 9.01 3.6787 .32 All the samples of gingerbeer reported as adulterated contained salicylic acid, but in no sample did the amount present exceed half a grain to the pint. Public Health (Milk and Cream) Regulations, 1912. The following particulars of proceedings taken in 1913 under the above regulations made in pursuance of the Public Health (Regulation of Food) Act, 1907, are given in the form suggested by the Local Government Board in their circular letter of October 27th, 1913. 62 1. Milk and Cream not sold as Preserved Cream. Articles. (a) Number of samples examined for the presence of a preservative. (b) N umber in which a preservative was found to be present. Milk 435 None Cream 21 5 Nature of preservative in each case in column (b) and action taken under the Regulations in regard to it. 1. Boric Acid 0·08% Vendor cautioned 2. ditto 0·08% ditto 3. ditto 0·06% ditto 4. ditto 0·09% ditto 5. ditto 0·17% ditto 2. Cream sold as Preserved Cream. (a) Instances in which samples have been submitted for analysis to ascertain if the statement on the label as to preservatives were correct. (1) Correct statements made 7 (2) Statements incorrect — Total 7 (b) The examination made of milk fat in cream sold as preserved cream. (1) Above 35 per cent.7 (2) Below 85 per cent. — 7 (c) Instances where (apart from analysis) the requirements as to labelling of preserved cream in Article 5 (1) and the proviso in Article 5 (2) of the Regulations have not been observed. None (d) Particulars of each case in which the Regulations have not been complied with and action taken. None 3. Thickening substances. Any evidence of their addition to cream or preserved cream. No evidence of their addition to cream or preserved cream 4. Other observations. None 63 Prosecutions under the Sale of Food and Drugs Acts were instituted in the following cases:— Defendant. Offence. Result. Penalty. Costs. £ s. d. £ s. d. William John Winter, 7, Delvino Road, Fulham, S.W. Selling milk adulterated with 26 per cent. of added water. Ordered to pay costs. - 0 11 6 Thomas Setchfield, 134, Estcourt Road, Fulham, S.W. Selling milk from which 70 per cent. of the original fat had been abstracted. Convicted. 10 0 0 0 12 6 George Harris, 42, Southerton Road, Hammersmith, W. Refusing to sell Inspector sample of milk. Convicted. 5 0 0 0 12 6 John Maldwyn Evans, 135, Dawes Road, Fulham, S.W. Selling butter adulterated with 30 per cent of margarine. Convicted. 2 0 0 0 14 6 Arthur Marriott-Matthews, 797, Fulham Rd., S.W. Selling milk adulterated with 25 per cent. of added water. Ordered to pay costs. — 0 12 6 Alfred Jones, 66, Waldemar Avenue, Fulham, S.W. Selling milk adulterated with 10 per cent. of added water. Convicted. 1 0 0 0 12 6 Thomas Andrews, 126, Stephendale Road, Fulham, S.W. Selling a mixture purporting to contain paregoric and syrup of squills which contained no paregoric. Convicted. Ordered to pay costs. - 0 12 6 Alfred Waterfield, 6, Masborough Road, Hammersmith, W. Selling milk from which 7 per cent. of the original fat had been abstracted. Convicted. 1 0 0 0 12 6 Joseph Hickman, 359, Fulham Palace Rd., Fulham, S.W. Selling milk from which 16 per cent. of the original fat had been abstracted. Dismissed. (Warranty proved) — — Belgravia Dairy Co., 4 & 6, Exhibition Road, S. Kensington, S.W. Selling milk which contained 11 per cent. of added water. Dismissed. — — Charles Wheeler, 56, Boscombe Road, Hammersmith, W. Selling milk which contained 6 per cent. of added water. Convicted. 2 0 0 1 3 0 Arthur Marriott-Matthews, 797, Fulham Rd., S.W. Selling milk which contained 3 per cent. of added water. Convicted. 0 2 6 0 12 6 Elizabeth Jones, 203, Munster Road, Fulham, S.W. Selling margarine for butter. Convicted. 1 0 0 0 12 6 Edward Francis, 574, Fulham Rd., S.W. Selling milk from which 38 per cent. of its original fat had been abstracted. Dismissed. (Warranty proved) - — Rees Price, 275, Wandsworth Bridge Rd., Selling margarine for butter. Convicted, 0 10 0 0 14 6 £22 12 6 £7 3 6 64 Rag Flock Act. Eight samples were procured under the above Act, and examined by the Public Analyst. Of these, five were certified to comply with the standard of cleanliness prescribed by the regulations of the Local Government Board, viz., " that the amount of soluble chlorine in the form of chlorides removed by washing with distilled water at a temperature not exceeding 25 degrees centigrade from not less than 40 grammes of a well mixed sample of flock shall not exceed 30 parts of chlorine in 100,000 parts of flock." The other samples contained respectively 72, 216 and 285 parts of chlorine per 100,000 of flock. Proceedings were instituted against the vendor of the sample containing 216 parts of chlorine per 100,000 which had been taken by the Inspector from a coverlet, but the summons was dismissed, the magistrate holding that the Act did not apply to flock taken from a manufactured article, but only to loose flock. Administration of the Factory and. Workshop Act, 1901. The factories and workshops where women are employed were inspected by your Sanitary Inspector, Mrs. Davies. The other factories and workshops are kept under observation by the District Sanitary Inspector. 65 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:— I.—Inspection of Factories, Workshops and Workplaces. Including Inspections made by Sanitary Inspectors, or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Lanundries) 158 9 — Workshops (Including Workshop Laundries) 375 32 — Workplaces (Other than Outworkers' premises included in Part 3 of this Report.) 191 14 — Total 724 55 — 66 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 42 42 ... ... Want of ventilation ... ... ... ... Overcrowding ... ... ... ... Want of drainage of floors ... ... ... ... Other nuisances 5 5 ... ... Sanitary accommodation— Insufficient 6 6 ... ... Unsuitable or defective 12 12 ... ... Not separate for sexes ... ... ... ... 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) 7 ... ... ... Other offences (Excluding offences relating to outwork whichn are included in Part 3 of this Report) ... ... ... ... Total 72 72 ... ... * Including those specified in sections 2, 3, 7 and 8 of the Factory and Workshop Act as remediable under the Public Health Acts. 3.— Home Work. RK. OUTWORKERS' LISTS, SECTION 107. OUTWORK IN UNWHOLESOME PREMISES. SECTION 108. 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 Outworkers. Outworkers. Lists. Contractors. Workmen. Lists. Con- tractors, Workmen. 16 14 44 5 6 16 ... ... ... 8 8 ... shing ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... nets ... ... ... ... ... ... ... ... ... ... ... ... angings ... ... ... ... ... ... ... ... ... ... ... ... y ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... s ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... s ... ... ... ... ... ... ... ... ... ... ... ... r bags ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... etc. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... eats ... ... ... ... ... ... ... ... ... ... ... ... 16 14 44 5 6 16 ... ... ... 8 8 ... 68 4. — Registered Workshops Class. Number. Workshops on the Register (s. 131) at the end of the year:— Bakehouses 72 Laundries 39 Dressmakers, Milliners, Blousemakers 80 Tailors, Outfitters, etc. 20 Bootmakers 36 Motor and Cycle Makers 30 Cabinet Makers, etc. 22 Other Trades 115 Total number of workshops on Register 414 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 6 Reports (of action taken) sent to H.M. Inspector — Other — Underground Bakehouses (s. 101):— Certificates granted during the year — In use at the end of the year 48 HOUSING. Housing, Town Planning, etc., Act, 1909, The number of dwelling-houses inspected under and for the purposes 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. 80 — — 62 — - 18 (69) Underground Rooms used as Sleeping Places. Closing Orders were made in respect of six rooms, four in Heckfield Place, one in Lillie Road, and one in New King's Road, used as sleeping places which did not comply with the regulations made by the Council pursuant to Section 17 (7) of the above Act. Drainage of Buildings. During the year the following drainage plans were submitted to and approved by the Public Health Committee : — Plans of drainage of new houses 50 „ „ „ „ workshops, etc. 20 „ „ „ „ additions to existing buildings 17 „ „ the reconstruction of the drainage of existing buildings 114 201 Combined Drainage. Six systems of combined drainage for which the Council was liable, were reconstructed at a cost of £150 5s. 5d., by the Council's contractor. The sum of £71 10s. was also paid to the owners of 15 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 29 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. 70 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 512 tenements, of which 420 were granted, 89 were given after certain specified works had been completed, and 103 were refused. Certificates in respect of 665 dwellings, which had been granted for a limited period, were renewed. Cleansing of Children. The names and addresses of 833 school children were forwarded to the Public Health Department during the year, whose homes were visited by your Sanitary Inspector, and if found verminous, cleansed under the powers given by the London Council (General Powers) Act, 1904, their bedding, clothing, etc., being dealt with at the Council's disinfecting station. 2,321 baths were given to 844 children at the London County Council's cleansing station in Sedlescombe Road. School Medical Treatment Centre. An X-ray plant for the treatment of ringworm has been installed at the School Medical Treatment Centre, 18 and 20, Bagley's Lane. GENERAL SANITARY WORK. 2,396 complaints were received and dealt with by your Sanitary Inspectors, and 1,736 intimation and 510 statutory notices were served. Summonses for failing to comply with the Council's notice were issued in eight cases. In six cases abatement orders were made, in two with £1 1s. costs, and in four with 2s. costs. In two cases the summonses were withdrawn, the necessary work having been completed. 71 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, 1913. Number of Notices 1913. Number of Prosecutions, 1913. On register at end of 1912. Added in 1913. Removed in 1913. On register at end of 1913, Milk premises 197 14 5 206 660 ... ... Cowsheds ... ... ... ... ... ... ... Slaughter houses 4 ... 1 3 45 ... ... Other offensive trade premises ... ... ... ... ... ... ... Ice cream premises 140 2 9 133 152 6 ... Registered houses let in lodgings 114 ... ... ... ... ... ... Total number of intimation notices served for all purposes 1,736 Overcrowding, 1913. Number of dwelling rooms overcrowded 38 Number remedied 38 Number of prosecutions — Underground rooms— Illegal occupation dealt with during year 6 Number of rooms closed 6 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 232 72 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 1,277 Number of tenements for which certificates were— (a) granted 420 (b) refused 103 (c) deferred 89 (d) Certificates previously granted for limited period renewed 665 SANITARY STAFF. An additional clerk, who was much needed, was appointed in the Public Health Department in October last, and the Council have resolved to appoint an additional Sanitary Inspector to deal with certain selected areas as recommended in my report on the condition of Heckfield Place. The need for the appointment of a Health Visitor has been urged in my remarks dealing with infant mortality. I again wish to express my high appreciation of the assistance I have received from all the members of the staff of the Public Health Department. I am, Sir and Gentlemen, Your obedient Servant, J. CHARLES JACKSON, Medical Officer of Health. April, 1914. 78 APPENDIX I. TABLE A. DEATHS REGISTERED FROM ALL CAUSES DURING THE YEAR 1913. (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. 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 .. .. .. 1 .. 2 3 1 .. .. 1 .. .. 2 6 8 Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 10 21 12 1 1 45 3 .. 1 .. .. .. .. .. .. 25 24 49 Scarlet Fever .. 1 .. 2 .. 3 1 .. .. .. .. .. .. .. .. 4 .. 4 Whooping Cough 12 10 2 2 .. 26 1 .. .. .. .. .. .. .. .. 13 14 27 Diphtheria 4 2 1 1 2 10 4 1 .. .. .. .. .. .. .. 12 3 15 Croup .. .. 1 .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. 1 Influenza 2 .. .. .. .. 2 .. .. 2 1 3 5 6 4 4 16 11 27 Erysipelas .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. 2 .. 2 Dysentery .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. 1 Other Epidemic Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Malaria .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pyæmia and Septicæmia .. .. .. .. .. .. .. .. .. .. 1 1 1 .. .. 2 1 3 Tetanus .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Actinomycosis .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. 2 .. 2 Tuberculosis:- Pulmonary Tuberculosis 3 2 2 .. 1 8 4 11 27 50 36 48 20 9 2 126 89 215 Tubercular Meningitis 5 4 4 2 2 17 4 3 1 .. .. .. 1 .. .. 9 17 26 Abdominal Tuberculosis 5 1 2 .. .. 8 .. 1 .. 2 .. .. .. .. .. 7 4 11 Tuberculosis of the Spine .. .. .. .. .. .. .. .. .. 1 1 1 .. .. .. 2 1 3 74 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 the Joints .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. 2 .. 2 Tuberculosis of other organs 1 1 .. .. .. 2 .. .. 1 .. .. .. .. .. .. 1 2 3 Disseminated Tuberculosis 1 2 .. .. .. 3 1 .. .. .. .. .. .. .. .. 2 2 4 Rickets 1 3 .. .. .. 4 .. .. .. .. .. .. .. .. .. 3 1 4 Syphilis 14 .. .. 1 .. 15 .. .. .. .. 1 1 1 .. .. 8 10 18 Other Venereal Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cancer of the Buccal Cavity .. .. .. .. .. .. .. .. .. .. .. 5 3 4 .. 10 2 12 Cancer of the Stomach, Liver, etc. .. .. .. .. .. .. .. .. .. 1 6 15 15 13 7 28 29 57 Cancer of the Peritoneum, Intestines and Rectum .. .. .. .. .. .. 1 .. .. .. 1 4 11 7 4 15 13 28 Cancer of the Female Genital organs .. .. .. .. .. .. .. .. 1 6 12 7 6 1 .. 33 33 Cancer of the Breast •• .. .. .. .. .. .. .. .. 1 4 1 2 7 1 .. 16 16 Cancer of the skin .. .. .. .. .. .. .. .. .. .. 2 1 2 1 .. 4 2 6 Cancer of other or fied organs .. .. .. .. .. .. .. .. .. 2 1 3 9 5 4 11 13 24 Other Tumours .. .. .. .. .. .. .. .. .. .. 1 1 .. 1 .. 1 2 3 Rheumatic Fever .. .. .. .. .. .. 1 1 2 .. .. 1 .. .. .. 3 2 5 Chronic Rheumatism and Rheumatoid Arthritis .. .. .. .. .. .. .. .. .. .. .. 1 4 3 2 6 4 10 Diabetes .. .. .. .. .. .. .. .. 2 .. 1 3 3 4 •• 7 6 13 Exophthalmic Goitre .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. 1 Anæmia, Leucocythœmia .. .. .. .. 2 2 2 .. .. 1 1 2 1 2 .. 7 4 11 Purpura .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 Other General Diseases .. .. .. .. 2 2 .. .. .. .. .. .. .. 2 .. 3 1 4 Alcoholism .. .. .. .. .. .. .. .. 1 .. 1 2 1 .. .. 2 3 5 Lead Poisoning (Occupational) .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. 1 Food Poisoning .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Encephalitis .. .. 1 .. .. 1 .. .. .. .. .. .. .. 1 .. 1 1 2 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. Cerebro-Spinal Fever .. .. 1 .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 1 Simple Meningitis 3 .. 2 .. .. 5 .. 1 1 .. .. 1 .. .. .. 2 6 8 Loccmotor Ataxy .. .. .. .. .. .. .. .. .. .. .. 4 1 .. .. 4 1 5 Other Diseases of Spinal Cord .. .. .. .. .. .. .. .. 1 1 .. 1 1 3 2 5 4 9 Cerebral Hæmorrhage, piexy .. .. .. .. .. .. .. .. .. 2 7 16 17 26 20 43 45 88 Softening of Brain .. .. .. .. .. .. .. .. .. .. .. 3 1 4 3 1 10 11 Paralysis, without* specified cause .. .. .. .. .. .. .. .. .. .. .. 5 4 4 3 8 8 16 General Paralysis of the Insane .. .. .. .. .. .. .. .. .. 2 3 10 2 .. .. 13 4 17 Other forms of Mental ation .. .. .. .. .. .. .. .. .. 2 2 1 .. .. .. 3 2 5 Epilepsy .. .. .. .. .. .. .. .. 2 3 3 .. 2 1 .. 6 5 11 Infantile Convulsions 8 .. .. .. .. 8 .. .. .. .. .. .. • • .. .. 4 4 8 Poliomyelitis .. 1 .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. 1 Peripheral Neuritis .. .. .. .. .. .. .. .. .. .. 3 .. .. .. .. .. 3 3 Other Diseases of Nervous System .. .. .. .. .. .. .. .. 2 1 2 3 3 .. 1 5 7 12 Diseases of the Ear .. 1 .. .. .. 1 .. .. 1 .. .. 1 .. .. .. 2 1 3 Pericarditis .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. 2 .. 2 Acute Endocarditis .. .. .. .. .. .. .. 3 2 .. .. 1 .. .. .. 3 3 6 Organic Disease of Heart .. .. .. .. .. .. 2 1 5 9 19 24 40 41 25 72 94 166 Angina Pectoris .. .. .. .. .. .. .. .. .. .. 1 2 .. .. 1 4 .. 4 Disease of the Arteries .. .. .. .. .. .. .. .. .. .. 1 2 6 7 4 15 5 20 Embolism and Thrombosis (including Cerebral) .. .. .. .. .. .. .. .. .. .. .. .. 1 1 1 1 2 3 Disease of the Veins .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 1 2 Diseases of the Lymphatic System 2 .. .. .. .. 2 .. .. .. .. .. .. .. 1 .. 1 2 3 75 76 77 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. Diseases of the Thyroid .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. 2 .. 2 Diseases of the Larynx 1 2 .. .. .. 3 .. .. .. .. 1 .. .. .. .. 3 1 4 Bronchitis 17 6 1 .. .. 24 .. .. .. .. 10 14 21 35 46 57 93 150 Broncho Pneumonia 35 22 8 8 .. 73 2 1 2 1 1 2 3 2 2 47 42 89 Lobar Pneumonia 2 5 3 .. .. 10 1 .. 3 10 10 7 8 5 2 29 27 56 Pneumonia (type not distinguished) 12 2 1 1 1 17 1 .. 2 4 7 7 5 2 2 30 17 47 Pleurisy 1 1 .. .. .. 2 .. .. 2 l 1 1 1 .. .. 7 1 8 Pulmonary Congestion, Pulmonary Apoplexy 2 .. .. .. .. 2 .. .. .. 3 .. 1 1 .. 3 4 6 10 Other Diseases of Respiratory System .. 1 .. 1 .. 2 .. .. .. .. 1 4 2 1 .. 7 2 9 Diseases of Pharynx, sillitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of Stomach 6 .. .. .. .. 6 .. .. .. l 1 5 4 3 2 14 8 22 Diarrhœa and Enteritis 83 17 1 .. .. 101 .. .. .. .. .. .. 1 2 3 57 50 107 Appendicitis and Typhlitis .. .. .. .. .. .. 2 .. 3 .. 1 2 2 .. 1 6 5 11 Hernia and Intestinal Obstruction 1 .. 1 .. .. 2 .. .. .. .. 1 3 3 1 1 5 6 11 Cirrhosis .. .. .. .. .. .. 1 .. .. 4 2 3 4 7 .. 11 10 21 Other Diseases of Liver .. .. 1 .. .. 1 .. .. .. 2 1 3 2 2 .. 3 8 11 Peritonitis (cause unknown) .. .. .. .. 1 1 .. 1 .. .. 1 .. .. .. .. 1 2 3 Other Diseases of Digestive System 1 1 .. .. .. 2 1 1 1 2 1 .. 1 .. .. 6 3 9 Acute Nephritis .. .. .. .. .. .. .. .. 2 1 .. 2 .. 3 1 5 4 9 Chronic Bright's Disease .. .. .. .. .. .. 1 .. 1 2 4 12 10 9 9 29 19 48 Other Diseases of the Kidney .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 Urinary Calculi .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. 1 Diseases of the Bladder .. .. .. .. .. .. .. .. .. .. .. .. 2 .. 2 4 .. 4 Diseases of the Urethra .. .. .. .. .. .. .. .. .. .. .. 1 1 2 .. 4 .. 4 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 ous) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ovarian Tumour .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of the Female General Organ .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. .. 2 2 Other Diseases of Genito- Urinary System) .. .. .. .. .. .. .. .. .. .. 1 .. 1 1 .. 3 .. 3 Puerperal Fever .. .. .. .. .. .. .. .. 1 3 .. .. .. .. .. .. 4 4 Other causes incident to Childbirth .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. .. 2 2 Diseases of Skin and Cellular Tissue 1 .. .. .. .. 1 .. .. .. .. .. 2 3 3 1 3 7 10 Diseases of Locomotor System .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. 1 Congenital Malformation 14 .. .. .. .. 14 .. .. .. .. .. .. .. .. .. 9 5 14 Atelectasis 10 .. .. .. .. 10 .. .. .. .. .. .. .. .. .. 5 5 10 Premature Birth 102 .. .. .. .. 102 .. .. .. .. .. .. .. .. .. 53 49 102 Injury at Birth 8 .. .. .. .. 8 .. .. .. .. .. .. .. .. .. 3 5 8 Diseases of Umbilicus 4 .. .. .. .. 4 .. .. .. .. .. .. .. .. .. 2 2 4 Debility, Atrophy, Marasmus 34 .. .. .. .. 34 .. .. .. .. .. .. .. .. .. 24 10 34 Other Diseases peculiar to Early Infancy 1 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 1 Old Age .. .. .. .. .. .. .. .. .. .. .. .. .. 10 48 20 38 58 Accident. Poisons, Poisonous Vapours .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. 1 Conflagration .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Burns and Scalds .. .. 4 .. 1 5 1 .. .. 1 .. 1 .. .. 1 5 4 9 Drowning 1 .. .. .. .. 1 .. .. 1 .. 1 .. 1 .. .. 4 .. 4 Suffocation in bed 4 .. .. .. .. 4 .. .. .. .. .. .. .. .. .. 3 1 4 Other Deaths by Accident 1 1 .. 2 .. 4 8 2 2 6 8 3 3 4 1 29 12 41 Total Deaths from Accidents 6 1 4 2 1 14 9 2 3 7 9 4 4 4 3 42 17 59 78 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. Included in above are Deaths in connection with— Railways .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. 1 Vehicular and Horses .. .. .. 1 .. 1 8 1 2 3 3 1 2 2 .. 16 7 .. Ships, Boats, Docks .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Building operations .. .. .. .. .. .. .. .. .. 1 1 .. 1 .. .. 3 .. 3 Violence, other than Accidental— Homicide .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Suicide .. .. .. .. .. .. .. .. 2 3 4 3 2 .. .. 10 4 14 Execution .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. From ill-defined causes .. .. .. 1 1 2 .. .. .. .. .. .. 1 .. .. 3 .. 3 412 108 48 22 14 604 46 27 79 130 170 259 249 253 211 1048 980 2028 79 TABLE B. Showing the localities in which the cases of Notifiable Infectious Diseases and Deaths from Measles, Diarrhœa 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 Diarrhœa and Enteritis. Under 2 years. Deaths from Phthisis. Acfold Road .. .. .. .. .. .. .. 1 Ackmar Road 1 2(2) .. .. .. .. .. .. Adeney Road 4(4) .. .. .. 2(2) 3(1) l 3(3) Aintree Street 1 *l .. .. .. .. .. 1 Alderville Road 3(1) .. .. .. .. .. .. 2(2) Allestree Road 3(2) 1 2(2) .. .. .. 1 1 Althea Street 2(2) 2(2) .. .. .. .. .. 2(2) Ancill Street 2(2) 2(2) .. .. 2(2) 1 4(3) 1 Anselm Road 1 1 .. .. 1 .. 1 2(2) Archel Road 2(2) .. .. .. 1 .. .. 2(2) Argon Mews .. .. .. .. .. .. .. .. Armadale Road 4(2) 3(2) .. .. 1 .. .. .. Ashcombe Street .. .. .. .. .. .. .. .. Ashington Road .. 1 .. .. .. .. .. .. Ashton Terrace 1 .. .. .. .. .. .. 1 Aspenlea Road 2(2) .. .. .. .. .. .. 2(2) Atalanta Street 3(2) 2(1) .. .. .. .. .. .. Auriol Road 1 .. .. .. .. .. .. .. Avalon Road 2(2) .. .. 1 1 .. .. 1 Averill Street . . 3(1) 1 .. 1 .. .. 1 Avonmore Gardens . . .. 1 .. . . .. .. .. Avonmore Road .. .. •• .. .. .. .. •• Bagley's Lane 1 2(2) .. .. 2(2) .. .. .. Barclay Road 7(2) 1 . .. 1 .. .. .. Baron's Court Road 1 .. .. .. .. .. .. .. Barton Street .. . . . . .. .. .. .. .. Basuto Road 3(2) .. .. . • .. .. .. .. Bayonne Road 4(4) .. 1 1 .. .. .. .. Bearcroft Buildings .. 2(1) .. .. .. .. .. .. Beaufort Mews .. .. .. .. .. .. .. .. 80  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. Beaumont Crescent .. 1 .. .. .. .. .. 1 Beltran Road 4(3) 2(1) 3(2) .. .. .. .. .. Beryl Road .. 1 .. .. .. .. . .. Bettridge Road 2(2) .. .. .. .. .. .. .. Biscay Road ... 2(2) .. .. .. .. .. 1 Bishop King's Road .. . . .. *1 . .. .. .. Bishop's Pk. Mans. . . .. .. .. .. .. .. .. Bishop's Road 4(2) 3(2) .. .. 1 .. .. 2(2) Blake Road 1 1 .. .. .. .. .. .. Bloompark Road . . .. .. .. .. .. .. .. Bothwell Road .. .. .. .. .. .. .. .. Bovingdon Road .. .. .. .. .. .. .. .. Bowerdean Street .. .. .. .. .. .. .. .. Bradbourne Street .. .. .. .. .. .. .. .. Bramber Road 4(4) .. .. .. .. .. .. 44) Brandenburgh Road .. 1 .. .. .. .. .. .. Branksea Street .. .. .. .. .. .. .. .. Brecon Road 1 1 .. .. 1 .. .. .. Breer Street 1 .. .. .. .. .. . .. Britannia Road 1 .. .. .. .. 1 .. 4(4) Brookville Road .. .. .. .. .. .. .. .. Broomhouse Road .. .. *l .. .. .. .. .. Bronsart Road 6(6) 1 .. .. .. .. .. 1 Broughton Road 8(4) 5(5) .. .. .. .. .. .. Buer Road .. .. .. .. .. .. .. .. Bulow Road 2(2) *3(2) .. .. .. .. 1 1 Burlington Gdns. .. .. .. .. .. .. l .. Burlington Road 1 .. .. .. .. .. .. .. Burnfoot Avenue 6(3) ... .. .. .. .. .. .. Burnthwaite Road 2(1) 1 .. .. .. .. l .. Byam Street 8(4) 4(3) .. 1 .. .. .. .. Cambria Street .. .. .. .. .. .. .. .. Campbell Street 2(1) .. .. .. .. .. .. .. Campana Road 4(2) 1 .. .. 3(3) .. .. .. Carlton Mews .. .. .. .. .. .. .. 1 Carnworth Street 3(2) .. .. .. .. .. .. 1 Caroline Place .. .. .. .. 1 .. 2(2) 1 Cassidy Road 1 4(4) .. 1 .. 1 3(3) 2(2) Castletown Road 1 .. .. .. .. .. .. 2(2) Cedar Road 1 .. .. .. .. .. .. .. Chaldon Road 4(4) .. .. .. .. .. .. .. Challoner Street .. .. .. .. .. .. .. .. Chancellor's Road 1 .. .. .. .. .. .. .. 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. Charleville Road 1 1 .. .. .. .. .. .. Chelmsford Street 2 (2) 1 .. .. 1 .. 1 2(2) Chesilton Road 2(2) .. 1 .. .. .. .. 2(2) Chesson Road 2(2) 1 .. .. 1 .. 1 .. Chiddingstone Street 23) 2(2) .. .. .. .. .. .. Chipstead Street 1 .. .. .. .. .. .. .. Church Path .. .. .. .. .. 1 1 2(2) Clancarty Road 3(2) .. .. .. .. .. .. .. Claxton Grove 9(6) 2(2) .. 1 .. .. 1 1 Claybrook Road 3(3) .. .. .. 1 .. 1 .. Cloncurry Street .. .. .. .. .. .. .. .. Clonmel Road .. 1 1 .. .. .. .. .. Colehill Lane 13(8) .. .. .. .. 2(1) .. .. Comeragh Mews .. .. .. .. .. .. .. .. Comeragh Road .. .. .. .. .. .. .. .. Conan Street .. .. .. .. .. .. .. .. Coniger Road .. 1 .. .. .. .. .. 1 Coomer Road 2(1) .. .. .. 1 .. .. .. Cornwall Street .. .. .. .. .. .. .. .. Cortayne Road .. .. .. .. .. .. .. .. Crabtree Lane .. 1 .. .. .. .. .. .. Cranbury Road 4(3) .. .. .. 2 (2) .. 1 .. Crefeld Road 3(2) .. .. .. 1 .. 1 .. Cresford Road .. .. .. .. .. .. .. .. Crookham Road .. .. .. 1 .. .. .. .. Cristowe Road .. .. .. .. .. .. .. .. Crondace Road .. .. .. .. 1 .. .. 1 Crown Mews .. .. .. .. .. .. .. .. Cumberland Cres. .. .. .. .. .. .. .. .. Dancer Road 4(2) .. .. .. .. .. .. 1 Danehurst Street 6(5) .. .. .. .. .. .. .. Darlan Road 2(2) .. 1 .. .. .. .. .. Dawes Road 1 3(2) .. .. .. .. .. 1 Dawson Street 1 .. .. .. 1 1 1 1 Delaford Street 4(3) .. .. .. .. .. .. 1 Delorme Street 3(2) .. .. .. .. .. .. 2(2) Delvino Road 2(2) 1 .. .. .. .. .. .. De Morgan Road 7(5) 1 .. .. .. .. .. .. Devonshire Street .. .. .. .. .. .. .. .. Dieppe Street 3(2) 2(1) .. .. .. .. 1 1 Dimsdale Road 2(2) 1 .. .. .. .. 2(2) 1 Disbrowe Road .. .. *1 .. 1 .. 1 1 82  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. Distillery Lane .. .. .. .. 2(2) .. .. .. Dolby Road .. .. .. .. .. .. .. l Doneraile Street . . .. .. .. .. .. .. .. Doria Road .. .. .. .. .. .. .. .. Dorncliffe Road .. .. .. .. .. .. .. .. Dowell Mews .. .. .. .. .. .. .. .. Durrell Road .. .. .. .. .. .. .. 1 Dymock Street 3(3) 1 .. .. 1 .. .. .. Eddiscombe Road 1 .. .. .. .. .. .. 1 Edenhurst Avenue 1 .. 1 .. .. .. .. .. Edenvale Street 2(1) *1 .. .. 1 .. .. .. Edgarley Terrace 6(2) .. 1 1 .. .. .. .. Edith Road .. .. .. .. .. .. .. 2(2) Edith Row .. .. .. .. .. .. .. .. Edith Villas .. .. 1 .. .. .. .. .. Eelbrook Terrace .. .. .. .. .. .. .. .. Effie Road 1 *1 .. .. .. .. .. 1 Elbe Street 5(2) .. .. *1 2(2) .. .. .. Eli Mews .. .. .. .. .. .. 1 .. Eli Street .. .. .. .. .. .. .. .. Ellaline Road .. .. .. .. .. .. .. 1 Ellerby Street .. .. .. .. .. .. .. .. Elmdale Street 5(2) 1 .. .. .. .. .. 1 Elmstone Road 1 .. .. .. .. .. .. .. Elthiron Road .. .. .. .. .. .. .. .. Elswick Street 2(2) .. .. .. .. .. .. .. Elysium Mews .. .. .. .. .. .. .. .. Epirus Mews .. .. .. .. .. .. .. .. Epirus Road *1 1 .. .. .. .. .. .. Epple Road 2(1) .. 1 .. .. .. .. .. Estcourt Road 7(6) 2(2) 1 .. 1 .. 1 2(2) Eustace Road 1 .. .. .. .. .. .. 1 Everington Street .. 1 .. .. l .. 2(2) 2(2) Ewald Road .. .. .. .. .. .. .. .. Fabian Road 2(1) .. .. .. .. .. .. 1 Fairholme Road 1 .. .. .. .. .. .. .. Fane Street 1 .. .. .. l .. .. .. Farm Lane 9(5) 2(2) .. .. .. .. 1 1 Favart Road .. .. .. .. .. .. .. .. Felden Street .. .. .. .. .. .. .. .. Fernhurst Road .. l .. .. .. .. .. .. Field Road 7(5) *2(2) .. .. 1 .. 1 1 83  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. Filmer Road 1 .. .. .. .. .. .. 1 Finlay Street .. .. .. .. .. .. .. .. Firth Gardens 1 .. .. .. .. .. .. .. Fitzgeorge Avenue .. .. .. .. .. .. .. 1 Fitzjames Avenue .. .. .. .. .. .. .. .. Foskett Road .. .. .. .. .. .. .. .. Francis Street 1 1 .. .. .. .. 1 .. Friston Street .. .. .. .. .. 1 .. .. Fulham Palace Road 12(9) 3(3) .. .. .. .. .. 3(3) Fulham Pk. Gardens .. .. .. .. .. .. .. 1 Fulham Pk. Road .. 1 .. .. .. .. .. .. Fulham Road 11(8) 2(2) .. 1 2(2) 1 .. 2(2) Furness Road 4(2) *4(4) .. .. 1 .. 1 .. Garvan Road 1 1 .. .. 1 .. .. .. Gastein Road 2(2) .. 1 .. .. .. .. .. Gilstead Road 5(4) *3(3) .. .. .. .. .. .. Gironde Road .. .. .. .. 1 .. .. .. Glazbury Road 1 .. .. .. .. .. .. .. Gledstanes Road .. .. .. .. .. .. .. .. Glenrosa Street 7(4) .. .. .. .. .. 1 .. Gliddon Road .. .. .. .. .. .. .. .. Goodson Road .. .. .. .. .. .. .. .. Gorleston Street 3(2) .. .. .. .. .. .. .. Gowan Avenue 2(2) .. 1 .. 1 .. .. 2(2) Greswell Street 5(3) 1 .. .. .. .. .. .. Greyhound Road 4(3) 1 .. .. 2(2) 3(3) 3(3) 3(3) Grimston Road .. 1 .. .. .. .. .. .. Grove Terrace .. 1 .. .. .. .. .. .. Guion Road .. .. .. .. .. .. .. .. Gunterstone Road 1 .. .. .. .. .. .. .. Gwendyr Road 1 .. .. .. .. .. .. .. Haldane Road .. .. * .. 1 .. .. 1 Halford Road 12(8) 1 .. .. .. .. .. 1 Hamble Street *10(9) 1 .. .. .. 2(1) .. 1 Hammersmith Road 2(1) .. .. .. .. .. .. 1 Hannell Road 5(4) .. .. .. 1 .. 2(2) .. Harbledown Road .. .. .. .. .. .. .. .. Harbord Street .. 1 .. .. .. .. .. .. Hartismere Road . . .. .. .. .. .. .. 1 Hartopp Avenue 3(3) 1 .. .. .. .. 1 2(2) Harwood Road 13(4) 1 .. .. 1 .. 1 1 Harwood Terrace .. .. .. .. .. .. .. .. 84  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. Hatfield Street .. .. .. .. .. .. l .. Hawksmoor Street .. .. .. .. .. .. .. .. Hazlebury Road 4(3) 2(2) .. .. 2 (2) 1 l .. Heckfield Place 2(2) 4(4) .. *1 5(4) 5(4) 2(2) 5(4) Hestercombe Avenue 1 .. *1 .. .. .. .. 1 High Street 1 1 .. .. .. .. .. .. Hilmer Street .. .. .. 1 .. 1 2(2) 3(3) Hildyard Road .. .. .. .. .. .. .. .. Holyport Road 2(2) .. .. .. 3(3) .. .. 1 Homestead Road .. .. *1 .. .. .. .. .. Horder Road 4(3) .. 1 .. .. .. .. 1 Hugon Road 3(3) 2(2) .. .. .. .. .. .. Humbolt Road 3(3) 3(3) 1 .. 2(2) .. .. 1 Hurlingham Gardens .. .. .. .. .. .. .. 1 Hurlingham Road 5(3) 4(2) .. .. .. .. .. 1 Imperial Cottages .. .. .. .. .. .. .. .. Inglethorpe Street 1 .. .. *1 .. .. .. .. Irene Road .. .. .. .. 1 .. .. .. Ismalia Road .. .. .. .. .. .. .. 1 Jerdan Place 1 .. .. .. .. .. .. .. Jervis Road 2(1) .. .. .. 2(2) .. .. 1 Kelvedon Road .. 1 .. .. .. .. .. .. Kempson Road .. .. .. .. .. .. .. .. Kenneth Road 2(1) .. .. .. .. .. .. .. Kensington Hall Gardens .. .. .. .. .. .. .. .. Kenyon Street 3(2) 3(3) .. .. .. .. .. .. Kilkie Street 4(3) 6(5) .. .. 1 .. 1 .. Kilmaine Road 2(2) .. .. .. .. .. .. .. Kimbell Gardens .. .. .. .. .. .. .. .. King's Road 4(2) 1 .. .. .. .. .. 1 Kingwood Road *3(3) .. .. .. 1 .. 1 1 Kinnoul Road 2(2) 1 .. .. .. .. .. .. Knivet Road .. .. .. .. .. .. .. .. Lalor Street .. .. .. .. .. .. .. .. Lambrook Terrace 4(1) 2(1) .. .. .. .. .. .. Landridge Road .. .. .. .. .. .. .. .. Lanfrey Place 1 .. .. .. 1 .. .. 1 Langford Road 1 1 .. .. .. .. 2(2) 1 Langthorn Street 4(3) .. .. .. .. .. .. .. 85  Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Deaths from Measles. Deaths from Diarrhoea and Enteritis. Under 2 years. Deaths from Phthisis. Laundry Road 4(4) .. .. .. .. .. 1 .. Lawn Terrace .. 1 .. .. .. .. .. .. Letterstone Road 10(8) 1 .. .. 1 .. .. 1 Lettice Street .. .. .. .. .. .. .. .. Lillie Road 12(9) *5(2) *1 1 1 .. 2(1) 2(2) Lillie Yard .. .. .. .. .. .. 2(2) 1 Lilyville Road .. .. .. .. .. .. .. .. Lindrop Street 15(7) 1 1 .. .. .. .. 1 Lintaine Grove 3(3) 4(3) .. .. 1 .. 2(2) 1 Linver Road 2(2) .. .. .. .. .. 1 .. Lisgar Terrace .. .. .. .. .. .. .. .. Lodge Avenue 2(1) .. .. .. .. .. 1 1 Lochaline Street 6(4) 1 .. .. .. .. .. .. Lundy Street .. .. .. .. 1 .. 1 .. Lurgan Avenue 2(2) .. .. 1 .. .. .. .. Lysia Street 5(2) 3(2) .. .. .. .. .. .. Mablethorpe Road 7(4) *3(3) .. .. .. .. .. . . Macmurdo Road .. .. .. .. .. .. .. .. Margravine Gdns. .. .. .. .. .. .. .. .. Margravine Road 2(2) l .. .. .. 1 .. .. Marinefield Road 7(3) .. • • .. .. .. .. .. Marville Road 1 1 .. .. .. .. 1 .. Matheson Road 1 . . .. .. .. .. .. 1 Maxwell Road 3(3) 4(2) .. .. .. .. .. .. May Street .. .. .. .. .. .. .. .. Melmoth Place .. .. .. .. .. .. .. .. Melton Street .. .. .. .. .. 1 .. .. Mendora Road 4(4) 5(2) .. .. .. .. .. 3(8) Merrington Road .. .. .. .. .. .. .. .. Micklethwaite Road 2(2) 1 .. .. .. .. .. 1 Mimosa Street 2(2) .. .. .. .. .. .. .. Mirabel Road 3(2) 4(2) .. .. 2(2) .. .. 1 Mitford Buildings .. 1 .. .. .. .. .. .. Molesford Road .. .. .. .. .. .. .. .. Mooltan Street .. 2(1) .. .. .. .. .. .. Moore Park Road 1 2(2) .. .. 1 .. .. 1 * Mornington Avenue .. .. .. .. .. .. .. .. Moylan Road .. .. .. .. .. .. .. .. Mulgrave Road 5(3) 1 .. .. .. .. 1 .. Mund Street .. .. .. .. .. 1 .. .. Munden Place .. .. .. .. .. .. .. .. Munden Street 3(2) .. .. .. .. 1 1 .. Munster Road 9(8) .. .. .. .. .. .. .. 86  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. Musard Road 8(5) 1 .. .. .. .. .. .. Musgrave Crescent 1 .. .. .. .. .. .. .. Napier Avenue .. .. .. .. .. .. .. .. Napier Court 1 . . .. .. .. .. .. .. Narborough Street 1 .. .. .. . . .. .. .. New King's Road 5(5) 5(4) .. 1 .. .. .. 2(2) Niton Street 3(1) .. .. .. .. .. .. .. Norfolk Terrace .. • • .. .. .. .. .. .. Normand Gdns. .. .. .. .. .. .. .. .. Normand Mews .. .. .. .. .. .. .. 1 Normand Road . . .. .. .. .. .. .. .. Northampton Place . . , . .. .. .. .. .. .. North End Road 3(3) 2(1) .. .. .. 1 .. 1 Novello Street .. 2(2) .. .. 1 1 1 2(2) Oakbury Road 2(1) 1 .. .. .. .. .. .. Ongar Road 1 .. .. .. 1 .. 4(1) 1 Orbain Road *12(7) 1 .. .. .. 3(2) 1 2(2) Orchard Place , . . . .. .. .. .. .. .. Orchard Street , , . . .. .. .. .. .. .. Oxberry Avenue .. .. .. .. .. .. .. 1 Palliser Road .. .. .. .. .. .. .. .. Parfrey Street 4(1) . . .. .. .. .., .. .. Parkville Road .. 2(1) .. .. .. .. .. .. Parsons Green 5(2) 3(2) .. .. .. .. .. 1 Parson's Green L. .. *1 .. .. .. .. .. 1 Parthenia Road . . , . .. .. .. .. .. 2(2) Peabody Buildings 6(6) 1 .. .. 1 .. 1 1 Pearscroft Road . . 1 .. .. .. .. .. 1 Pellant Road 2(2) *2 (2) 1 .. .. 1 1 .. Perrymead Street 1 .. .. .. .. .. .. 1 Perham Road 1 1 .. .. .. .. .. .. Peterborough Road .. . . .. .. .. , . .. 1 Peterborough Villas .. .. .. .. .. .. .. .. Petley Road 2(1) 2(2) .. .. .. .. .. .. Playfair Street 4(1) .. .. .. .. .. 2(1) 2(2) Portland Place . . . . .. .. .. .. .. .. Pownall Road 2(2) , . .. .. 1 .. .. .. Prince of W. Mews .. . . .. .. .. .. .. .. Protheroe Road 3(3) 1 .. .. 2(2) 1 .. 2(2) Purcell Crescent 1 2(2) .. .. 1 .. .. .. Purser's Cross Road .. 1 .. .. .. 1 1 .. 87  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. Quarrendon St. .. .. .. .. .. .. .. .. Queen's Club Gdns. 1 .. .. .. .. .. .. .. Querrin Street 11(5) *3(3) .. . .. .. .. .. Queensmill Road 4(2) .. .. . . . .. .. 1 Radipole Road 2(2) .. .. .. .. .. .. .. Racton Road 2(2) .. .. • • .. .. .. .. Rainville Road 2(2) 1 .. .. .. .. .. .. Ranelagh Avenue .. .. .. .. .. .. .. .. Ranelagh Gdns. .. .. .. .. .. .. .. 1 Rannoch Road 2(2) 1 *1 .. 2(2) .. .. 2(2) Rectory Road 2(2) 2(2) .. .. .. .. .. 2(2) Reporton Road 3(3) 2(2) .. .. 1 .. .. .. Richmond Place .. .. .. .. .. .. .. .. Rickett Street .. .. .. .. .. .. 1 .. Rigault Road .. 1 .. .. .. .. .. .. Ringmer Avenue 4(3) .. .. .. .. .. .. .. Rock Avenue .. 1 .. .. .. .. 2(2) 2(2) Rosaline Road 2(2) .. .. .. .. .. .. .. Rosaville Road 5(4) 1 .. .. 1 1 .. .. Rosebank Terrace .. .. .. .. .. .. .. .. Rosebury Road 2(2) 1 .. .. .. .. 1 1 Rostrevor Road 1 1 .. .. .. .. .. 1 Rowallan Road 1 .. .. .. .. .. 1 .. Roxby Place 3(1) .. .. .. .. .. .. .. Rycroft Street .. 1 .. .. .. .. .. .. Rylston Road 1 .. 1 .. 1 .. 1 1 St. A1ban's Terrace .. .. .. .. .. .. .. 1 St. Dunstan's Road .. .. .. .. 1 .. .. 2(2) St. Maur Road 4(3) 1 .. .. .. .. .. .. St. Olaf's Road 52) 1 .. .. 2(2) 1 1 1 St. Peter's Terrace .. .. .. .. .. .. .. .. St. Thomas Road 1 .. .. .. .. .. .. .. Salisbury Mews .. .. .. .. .. .. .. .. Sandilands Road 1 4(4) .. .. 1 .. 1 .. Sands End Lane . .. .. .. .. .. 1 .. Seagrave Mews .. .. .. .. .. .. .. .. Seagrave Road .. *1 .. .. .. .. .. 1 Sedlescombe Road 4(3) 2(2) 1 .. 1 .. .. .. Settrington Street 5(4) 4(4) .. .. .. .. 1 .. Silverton Road .. 1 .. .. .. .. .. .. Sherbrooke Road 4(3) 2(1) .. .. 1 .. 1 .. Shorrolds Road 3(3) 2(2) .. .. 2(2) .. .. 3(3) 88  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. Shotley Street .. .. .. .. 1 .. .. .. Shottendane Road .. .. .. .. .. .. .. .. Silvio Street .. .. .. .. .. .. .. .. Silvio Mews 2(2) .. .. .. .. .. .. .. Snowbury Road 3(3) .. .. .. .. .. .. .. Sotheron Road .. .. .. .. .. .. .. .. Stamford Place .. .. .. .. .. .. .. .. Stamford Road 1 .. .. .. 1 .. .. .. Stamford Street .. .. .. .. .. .. .. .. Stanley Road 5 (5) .. *1 .. .. .. 1 3 Stanwick Road .. .. .. .. .. .. .. .. Star Road .. *1 .. .. 1 .. 1 .. Stephendale Road 14(11) 4(4) .. .. 6(6) .. .. 2(2) Stevenage Road 1 .. .. .. .. .. .. .. Stokenchurch Road 2(1) 1 .. .. .. .. .. .. Stonor Road .. .. .. .. .. .. .. .. Strode Road 1 1 .. .. .. 1 .. 2 Studdridge Street 2(1) .. .. .. .. .. .. .. Swift Street .. .. .. .. .. .. .. .. Talgarth Road 2(2) .. 1 .. .. .. .. 1 Tamworth Street 3(2) .. .. .. 1 .. .. 1 Tasso Road 3(3) 1 .. .. .. 1 .. 1 Tilton Street .. .. .. .. .. .. 1 .. Tournay Road .. .. .. .. .. .. .. 1 Townmead Road 16(8) .. .. 1 .. .. .. 2(2) Trevanion Road .. .. .. .. .. 1 .. .. Turneville Road 3(2) .. .. .. .. .. 1 1 Tynemouth Street 1 .. .. .. 1 .. 2(2) 1 Tyrawley Road .. .. .. .. .. .. .. .. Vanston Place 1 .. .. .. .. .. .. .. Varna Road .. .. .. .. .. .. .. .. Vera Road 2(2) .. .. .. .. .. 1 1 Vereker Road .. .. .. .. .. .. .. 1 Vernon Street 1 .. .. .. .. .. .. .. Waldemar Avenue 2(1) .. 1 .. .. .. .. 2(2) Walham Avenue 1 1 .. .. .. 3(3) 2(2) 4(4) Walham Grove 1 .. .. .. .. .. .. 1 Wandon Road .. .. .. .. .. .. .. .. Wandsworth Bg. Rd. 9(8) 6(6) .. 1 1 .. .. 4(4) Wardo Avenue 2(2) .. .. .. .. .. .. 1 Waterford Road 1 1 .. .. 1 1 .. .. 89  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. Welford Terrace .. .. .. .. .. .. .. .. Werley Avenue 2(1) .. .. .. .. .. 2(2) 2(2) Westbury Terrace .. .. .. .. .. .. .. .. West Kensington .. .. .. .. .. .. .. .. Mansions Wheatsheaf Terrace .. .. .. .. .. .. .. .. Whittingstall Road .. .. .. .. .. .. .. .. Wigan Street .. 1 .. .. .. .. .. .. William Street .. .. .. .. .. .. .. 1 Winchendon Road 1 .. .. .. .. .. .. 2(2) Wyfold Road .. .. .. .. .. .. .. .. Woodlawn Road 2(2) .. .. .. .. .. .. .. Whiteley's Cottages .. .. .. .. .. .. .. .. Woolneigh Street .. .. .. .. .. .. .. .. Yeldham Road 3(2) 1 .. .. 1 .. .. .. Fulham Union Inf. .. .. .. .. .. .. .. .. Fulham Workhouse 1 8 1 .. 13 .. .. .. Western Hospital 1 .. .. .. .. (a)4 .. .. (a) No fixed abode. 90 91 TABLE C. Giving the Meterological Conditions of the 53 Weeks ended January 3rd, 1914, 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 over 60. Deaths from Phthisis. Deaths from Epidemic Diseases, excluding Diarrhœa. Deaths from Diarrhœa & Enteritis, under 2 years. January 4 44.6 51.2 32.1 46.8 29.8 0.15 15.9 SW 40 6 11 6 5 — „ 11 42.1 51.4 33.1 46.2 29.8 0.66 11.3 SW & SE 46 16 12 6 4 1 ,, 18 38.5 45.9 26.2 44.5 29.4 0.66 17.8 SW & SE 40 6 12 5 1 1 „ 25 42.3 52.1 32.0 43.6 29.5 0.70 2.2 SW 55 13 15 8 3 2 February 1 39.6 50.2 28.1 43.6 29.7 0.78 16.6 SE & SW 42 4 13 6 1 — ,, 8 46.7 55.0 33.3 43.8 29.9 0.26 9.3 WSW 43 6 14 3 2 — ,,15 40.6 53.5 30.2 44.5 30.3 0.19 5.7 SW 44 7 10 5 3 - ,, 22 36.0 46.0 27.8 42.9 30.1 0.04 26.2 ENE 55 8 17 6 3 2 March 1 41.3 53.0 24.2 41.9 29.8 0.08 16.9 SE & N 56 13 13 9 6 — ,, 8 46.7 58.3 33.4 43.4 29.9 0.24 27.2 WSW 45 6 12 8 6 — „ 15 45.4 56.2 29.0 44.3 30.0 0.28 23.0 WSW 54 9 22 5 2 — ,, 22 43.0 56.8 28.2 44.2 29.3 1.42 26.3 WSW 48 8 15 4 3 — ,, 29 43.4 56.7 29.0 44.1 29.6 0.49 13.3 Variable 44 5 17 2 3 - 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 over 60. Deaths from Phthisis. Deaths from Epidemic Diseases, excluding Diarrhœa. Deaths from Diarrhœa & Enteritis, under 2 years. April 5 45.5 57.0 33.0 44.7 29.7 0.33 20.9 SW & NE 29 4 10 3 1 - ,, 12 42.0 55.0 33.2 45.2 29.8 0.53 19.7 NE 41 8 15 2 4 - „ 19 44.4 57.9 29.0 44.9 29.6 0.50 26.3 SW 39 9 5 6 4 1 ,, 26 50.6 67.2 33.1 46.5 29-6 0.32 40.5 Variable 37 4 12 6 6 1 May 3 52.0 64.9 39.6 48.6 29.6 0.60 29.2 SW 41 5 15 5 3 — ,, 10 49.9 63.2 36.3 49.4 29.4 0.62 20.5 Variable 42 7 15 6 1 4 ,, 17 53.7 70.6 41.0 50.5 29.8 0.05 48.6 Variable 43 9 13 6 2 — ,, 24 54.4 74.9 37.1 51.7 29.9 0.02 53.7 NW & SW 28 4 6 2 3 1 ,, 31 64.9 84.1 45.2 55.1 29.8 0.40 65.2 SW 40 6 11 4 1 — June. 7 58.0 79.1 42.2 57.2 29.8 0.12 53.7 SW 27 7 5 5 - — ,, 14 56.9 70 7 43.1 57.1 29.9 0.14 35.5 WSW 36 7 13 2 - 1 ,, 21 62.3 87.1 43.8 58.5 29.9 0.41 67.3 Variable 28 4 9 3 - — ,, 28 59.2 78 .3 47.1 59.3 30.0 0.06 33.1 Variable 19 4 4 1 1 — 92 93 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 over 60. Deaths from Phthisis. Deaths from Epidemic Diseases, excluding Diarrhœa. Deaths from Diarrhœa & Enteritis, under 2 years. July 5 59.9 72.1 49.1 59.8 30.0 0.21 25.6 NE 26 2 11 3 — — ,, 12 57.2 75.8 46.2 59.4 29.8 1. 33 20.7 NE & SW 27 7 5 2 — 1 ,, 19 55.3 73.8 51.2 59.6 29.8 0.52 6.2 SW & N 18 2 5 3 3 1 ,, 26 57.7 71.3 48.7 59.5 29.9 0.05 27.1 NE 27 1 9 2 1 — August 2 59.5 75.0 50.1 59.7 30.0 0.00 40.4 NE & SE 21 5 5 2 2 1 ,, 9 57.1 75.2 45.4 60.2 29.8 0.09 37.0 Variable 24 6 5 1 2 ,, 16 60.7 75.0 49 .3 60.1 29.9 0.14 15.5 Variable 30 11 2 1 1 5 ,, 23 60.9 80.0 49.2 60.6 29.9 0.36 35.0 NE & SW 21 6 6 3 2 3 ,, 30 62.8 76.5 45.0 60.6 29.9 0.51 44.5 E 40 12 8 6 - 10 September 6 59.1 68.0 53.5 60.6 29.9 1.43 4.4 NE 35 9 10 2 — 5 ,, 13 58.0 71.6 45.3 60.0 29.9 0.06 46.0 NE & SW 40 12 9 3 2 5 „ 20 54.9 70.9 42.1 59.0 29.5 0.60 33.6 Variable 37 12 11 5 1 3 ,, 27 60.2 77.4 46.0 58.5 29.8 0.13 39.8 S 42 11 9 3 - 7 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 over 60. Deaths from Phthisis. Deaths from Epidemic Diseases, excluding Diarrhœa. Deaths from Diarrhœa & Enteritis, under 2 years. October 4 58.5 70.9 48.1 58.8 29.7 0.22 40.1 ESE 34 8 9 1 2 ,, 11 52.9 63.2 42.1 57.8 29.5 1.28 21.3 Variable 42 12 8 2 3 8 ,, 8 52.8 64.2 38.9 56.3 30.1 0.12 32.0 SW 33 10 10 1 1 8 ,, 25 49.3 61.9 36.1 55.3 29.7 0.69 21.0 SSW 41 10 11 7 1 3 November 1 54.1 64.2 43.6 54.3 29.4 1.27 22.9 SSW 53 9 18 2 2 3 ,, 8 48.3 56.7 36.1 53.5 29.6 0.40 22.7 WSW 40 10 13 8 1 3 ,, 15 49.0 59.1 36.0 51.9 29.3 1.50 17.7 SE &SW 42 8 14 6 — 2 ,, 22 48.9 59.5 31.7 51.2 29.9 0.63 15.6 SW & NE 35 10 9 3 - 4 ,, 29 46.3 57.0 27.6 50.0 30.1 0.03 13.8 SW & NW 34 4 16 3 - 1 December 6 46.8 54.0 35.0 49.9 29.7 0.31 4.6 w 44 5 19 2 1 1 ,, 13 46.2 54.6 36.9 48.8 30.0 0.02 2.6 w 33 8 4 5 1 3 ,, 20 42.8 50.5 321 48.1 30.2 0.00 7.9 W & NE 49 7 10 4 1 3 ,, 27 39.2 51.0 30.2 46.2 29.9 0.53 3.4 Variable 45 10 10 5 3 1 January 3 35.2 45.2 27.3 44.4 30. 0 0 .02 8.7 NW & NE 53 20 14 7 3 1 94 TABLE D. Showing the number of Cases of Infectious Diseases notified to the several Metropolitan Medical Officers of Health during the Year 1913. Cities and Boroughs. Estimated population in the middle of 1913. 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 157,117 - 766 270 - 34 - 19 121 5 2 1217 7.6 Paddington 142,210 - 487 304 - 25 - 8 112 - 2 938 6.5 Kensington 171,284 - 558 145 - 28 - 13 112 3 4 863 5.0 Hammersmith 123,745 - 537 138 - 13 - 8 101 - 1 798 6.3 Chelsea 64,598 - 206 61 - 7 - 8 35 - 3 320 4.9 City of Westminster 154,810 — 379 192 — 29 — 6 75 — 4 685 4.4 North Districts. St. Marylebone 114,532 1 417 130 - 19 - 4 78 3 1 653 5.6 Hampstead 86,346 - 208 128 - 15 - 1 33 - 4 389 4.4 St. Pancras 214,830 - 565 438 - 41 1 11 215 5 9 1285 5.9 Islington 325,585 - 1315 551 - 50 - 28 228 8 19 2199 6.6 Stoke Newington 50,518 - 109 84 - 9 - 2 35 1 5 245 4.8 Hackney 223,353 — 821 331 — 39 1 19 184 8 15 1418 9.2 Central Districts. Holborn 46,949 - 132 60 - 7 - 1 29 - 2 231 4.8 Finsbury 81,679 - 274 107 - 15 - 14 125 5 3 543 6.6 City of London 17,916 — 47 30 — 6 — - 8 - 2 93 5.1 East Districts. Shoreditch 109,654 - 354 185 - 15 1 9 159 4 8 735 6.6 Bethnal Green 127,824 - 411 223 - 23 - 13 265 1 3 939 7.2 Stepney 275,300 - 820 471 2 68 1 34 364 10 14 1784 6.4 Poplar 160,913 2 754 345 - 40 1 26 173 5 3 1349 8.2 South Districts. Southwark 188,487 1 880 327 1 39 2 15 260 6 - 1531 8.0 Bermondsey 124,739 - 731 243 1 27 1 14 130 3 3 1153 9.1 Lambeth 297,139 - 1397 408 - 39 2 25 219 7 8 2105 7.0 Battersea 167,464 — 949 288 - 20 2 10 123 3 5 1400 8.2 Wandsworth 330,395 - 1007 447 - 52 2 32 206 9 14 1769 5.3 Camberwell 261,805 - 1155 403 - 23 1 12 257 6 5 1862 7.0 Deptford 109,280 - 625 245 - 1 7 - 1 232 - - 11 20 10.1 Greenwich 96,015 - 330 267 - 8 - 5 112 - - 722 7.4 Lewisham 168,822 — 670 431 — 34 - 3 84 — 5 1227 7.2 Woolwich 122,382 — 645 402 — 14 — 8 74 — 1 1142 9.2 Port of London - - 2 - - 2 - - 1 - - 5 - County of London 4,518,191 3 17,567 7665 - 762 15 354 4139 92 143 30,763 6.8 95 TABLE E. OCCUPATIONS OF MALES AND FEMALES AGED 10 YEARS AND UPWARDS, 1911. Males. Occupied and Unoccupied. Females. 72,662 All ages 80,622 16,833 Under 10 years 10 years and upwards 16,534 55,829 64,088 Males. Females. Unmarried. Married. Widowed Total Females. Retired or unoccupied (Order xxiii.) 9,081 12,068 26,827 4,099 42,994 Engaged in occupations (Orders i.-xxii.) 46,748 15,809 3,106 2,179 21,094 OCCUPATIONS AT AGES 10 YEARS AND UPWARDS. Males. Females. Unmarried. Married. Widowed Total Females. I. General or Local Government of the country. 1. National Government 1,614 233 10 14 257 2. Local Government 765 130 6 19 155 (Police) 440 ... ... ... ... II. Defence of the Country. 1. Army (at home) 236 ... ... ... ... 2. Navy and Marines (ashore and in port) 59 ... ... ... ... 96  Females. Males. Unmarried. Married. Widowed Total Females. III. Professional Occupations and their subordinate services. I. Clerical— Clergymen, Priests, Ministers 78 ... ... ... ... Others 69 44 1 3 48 2. Legal— Barristers, Solicitors 135 ... ... ... ... Law Clerks 272 14 ... ... 14 3. Medical— Physicians, Surgeons, Registered Practitioners 98 4 ... ... 4 Midwives, Sick Nurses, Invalid Attendants 8 321 60 109 490 Others 93 33 7 8 48 4. Teaching 371 601 82 27 710 5. Literary, Scientific and Political 271 65 10 5 80 6. Engineers and Surveyors 135 ... ... ... ... 7 & 8. Art, Music, Drama, &c. 1,244 451 151 58 660 IV. Domestic Offices or Services. 1. Domestic Indoor Service— In Hotels, Lodging and Eating Houses 26 106 10 13 129 Other Domestic Indoor Servants 357 4,314 279 445 5,038 2. Domestic Outdoor Servants 384 ... ... ... ... 3. Other Service— Hospital, Institution and Benevolent Society Ser¯ vice 77 186 7 10 201 Day Girls, Day Servants ... 239 16 23 278 Charwomen ... 91 337 338 766 Laundry Workers, Washers, Ironers, Manglers, &c. 174 1,120 813 324 2,257 Others 788 72 86 76 234 V. Commercial Occupations. 1. Merchants, Agents, Accountants 916 16 10 3 29 2. Commercial or Business Clerks 2,762 1,148 29 16 1,193 97  Males. Females. Unmarried. Married. Widowed Total Females. 3 & 4. Dealers in money; Insurance 814 36 1 ... 37 VI. Conveyance of Men, Goods and Messages. 1. On Railways 1,372 5 1 8 14 2. On Roads— Coachmen (not Domestic), Cabmen 318 ... ... ... ... Horsekeepers, Stablemen (not Domestic), Grooms 280 ... ... ... ... Motor Car Drivers (not Domestic), Motor Cab, Motor Van, &c.—Drivers 782 ... ... ... ... Carmen, Carriers, Carters, Wagoners (not Farm) 1,639 ... ... ... ... Van, &c.—Guards, Boys 270 ... ... ... ... Others 1,364 3 2 2 7 Omnibus and Tramway Service 984 1 ... 1 2 3. On Seas, Rivers and Canals 121 ... ... 1 1 4. In Docks, Harbours, &c 49 ... ... ... ... 5. In Storage, Porterage and Messages— Messengers, Porters, Watchmen (not Railway or Government) 1,790 14 ... ... 14 Others 480 62 2 ... 64 VII. Agriculture (on Farms, Woods and Gardens). Farmers, Graziers, Farm Workers 31 ... ... ... ... Gardeners (not Domestic), Nurserymen, Seedsmen 269 4 ... 2 6 Others 2 ... ... ... ... VIII. Fishing. 2 ... ... ... ... IX. In and About, and Working and Dealing in the Products of Mines and Quarries. 1. Workers 45 ... ... ... ... 2. Dealers 60 ... 1 ... 1 98  Males. Females. Unmarried. Married. Widowed Total Females. X. Metals, Machines, Implements and Conveyances. 1. & 2. Iron, Steel, &c., Manufacture 7 ... ... ... ... 3. General Engineering and Machine Making— Ironfounders 78 ... ... ... ... Blacksmiths, Strikers 282 ... ... ... ... Erectors, Fitters, Turners (including Labourers) 391 ... ... ... ... Others 460 1 ... ... 1 4. Electrical Apparatus 757 268 6 ... 274 Electric Lamp Manufacture 35 264 5 ... 269 5 to 8. Tools, Dies, &c., Arms, Miscellaneous Metal Trades 350 25 2 ... 27 9. Ships and Boats 16 ... ... ... ... 10. Vehicles— Cycle and Motor Car— Makers, Mechanics 939 1 1 ... 2 Others 398 ... ... ... ... 11. Dealers 226 10 7 2 19 XI. Precious Metals, Jewels, Watches, Instruments and Games. Workers 455 30 3 1 34 Dealers 156 16 6 1 23 XII. Building and Works of Construction. 1. House Building— Builders 236 ... ... 1 1 Builders' Labourers 988 ... ... ... ... Carpenters, Joiners (including Labourers) 1,150 ... ... ... ... Bricklayers, Bricklayers' Labourers 655 ... ... ... ... Masons, Masons' Labourers 202 ... ... ... ... Painters, Decorators, Glaziers 2,131 ... ... ... ... Plumbers 482 ... ... ... ... Others 889 ... ... 1 1 99  Males. Females. Unmarried. Married. Widowed Total Females. 2. Other Works of Construction, and Roads— Navvies, &c., Paviours, Road Labourers 103 ... ... ... ... Others 8 ... ... ... ... XIII. Wood, Furniture, Fittings, Decorations. Cabinet-makers, French Polishers, Upholsterers 355 76 20 17 113 Other Workers in Furniture, Fittings, &c. 298 12 8 1 21 Workers in Wood and Bark 396 4 5 1 10 Dealers 348 22 11 2 35 XIV. Brick, Cement, Pottery and Glass. Workers 126 17 1 ... 18 Dealers 49 23 2 1 26 XV. Chemicals, Oil, Grease, Soap, Resin, etc. 1 & 3. Colouring Matter, Drugs, Chemicals, &c.— Chemists, Druggists 133 12 2 I 15 Others 69 26 ... 2 28 2. Explosives and Matches 3 ... ... ... ... 4. Oil, Grease, Soap, Resin, &c.— Workers 76 7 ... 1 8 Dealers 117 3 3 ... 6 XVI. Skins, Leathers, Hair and Feathers. 1. Skins and Leathers 60 23 4 3 30 2. Saddlery and Harness 85 2 ... 1 3 3. Hair and Feathers 7 8 1 2 11 4. Dealers in Skins, Leather, Hair and Feathers 36 14 1 15 100  Males Females. Unmarried. Married. Widowed Total Females. XVII. Paper, Prints, Books and Stationery. Paper, Box,Bag—Makers, Stationery Manufacture 27 54 7 5 66 Printers, Lithographers 519 35 4 1 40 Bookbinders 65 90 5 6 101 Other Workers 169 8 2 ... 10 Publishers, Booksellers, Stationers, Newsagents and other Dealers 331 97 30 5 132 XVIII. Textile Fabrics. 1 to 5. Textile Manufactures.. 41 65 11 5 81 6. Bleaching, Printing, Dyeing, &c 45 11 4 6 21 7. Dealers (Drapers & others) 442 416 32 14 462 XIX. Dress. Tailors 444 156 45 21 222 Milliners 4 416 16 10 442 Dressmakers 15 2,480 303 215 2,998 Shirt-makers, Seamstress 17 99 35 76 210 Boot, Shoe, Slipper, Pattern, Clog—Makers 456 9 9 1 19 Wig-makers, Hairdressers 317 67 5 4 76 Other Workers 43 46 9 3 58 Dealers 434 167 43 11 221 XX. Food, Tobacco, Drink and Lodging. 1. Food— Milk-sellers, Dairymen ... 479 33 29 3 65 Butchers, Meat Salesmen 559 7 13 ... 20 Bread, Biscuit, Cake, &c., Makers 784 160 8 1 169 Bakers, Confectioners (Dealers) 282 191 76 25 292 Grocers, Tea, Coffee, Chocolate—Dealers 759 116 34 10 160 Other Workers 246 137 26 7 170 Other Dealers 1,023 43 55 8 106 2. Tobacco— Tobacco Manufacture ... 42 19 3 ... 22 Tobacconists 114 31 15 5 51 101  Males. Females. Unmarried. Married. Widowed Total Females. 3. Makersof Spirituous Drinks 153 ... ... ... ... 4. Board, Lodging, & Dealing in Spirituous Drinks— Coffee, Eating, Lodging, Boarding—House Keepers 148 110 101 130 341 Inn, Hotel—Keepers, Publicans, &c. 173 18 42 15 75 Cellarmen, Beer Bottlers. 84 6 ... ... 6 Barmen 266 98 12 8 118 Waiters (not Domestic) 338 282 11 9 302 Others in Inn, Hotel, Eating Houses, &c.— Service 418 95 18 6 119 Wine and Spirit—Merchants, Agents 67 7 4 1 12 XXI. Gas, Water and Electricity Supply, and Sanitary Service. 1. Gas, Water, Electricity ... 685 6 ... ... 6 Gas Works Service 434 6 ... ... 6 2. Sanitary Service 164 ... ... ... ... XXII. Other, General and Undefined Workers and Dealers. General — Shopkeepers, Dealers, Pawnbrokers.. 392 190 49 13 252 Costermongers, Hawkers, Street Sellers ... 216 8 20 10 38 News—Boys,Vendors(undefined or Street) 108 1 ... ... 1 General Labourers 1,144 ... ... ... ... Engine- Drivers,Stokers, Firemen (not Railway, Marine or Agricultural) 288 ... ... ... ... Others 310 122 24 3 149 XXIII. Without Specified Occupations, or Unoccupied. Retired (not Army or Navy) Pensioners 1,192 130 37 224 391 Private means 316 944 2 44 985 2,173 Others aged 10 years and upwards (including Scholars and Students) 7,573 10,994 26,546 2,890 40,430 102 APPENDIX II, REPORT ON HECKFIELD PLACE. Presented to the Public Health Committee, November, 1913. To the Chairman and Members of the Public Health Committee. Gentlemen, I have on several occasions brought under your notice the unsatisfactory conditions, both social and hygienic, prevailing in Heckfield Place, and particulars as ascertained at the last Census having now been obtained relating to it, and certain other areas in Fulham mainly inhabited by persons in very poor circumstances, a comparison may be made between the health and wellbeing of the several populations. The areas selected are :— 1. Walham, Rock and Lodge Avenues. These immediately adjoin Heckfield Place, and the houses much resemble those in it. The populations of the two areas are practically the same, viz :—Heckfield Place, 1,249. The Avenues, 1217. 2. Cassidy Road. Population 902. A cul-de-sac situated on the south side of Fulham Road opposite the Avenues. Consists of tenement houses occupied mainly by the very poor. 3. Field Road Area, comprising Field Road and the streets opening into it, viz :—Chelmsford Street, Dawson Street, Francis Street, Lundy Street, Prince of Wales Mews, Shotley Street, Norfolk 103 Terrace, Hatfield Street and Melton Street, all cul-de-sacs except Chelmsford Street. Population 1,983. Probably the poorest area in Fulham. 4. Church Path. A narrow court occupied largely by costers. Population 406. 5. Lintaine Grove. Mainly tenement houses let out to many families. Population 802. Dealing first with the amount of overcrowding in the areas, and taking rooms occupied by more than two persons as being overcrowded, it will be seen from the subjoined table that in Heckfield Place over 76 per cent, of the population are living under overcrowded conditions, or nearly 20 per cent, more than in any other area, and that when we come to more gross forms of overcrowding Heckfield Place compares still more unfavourably with the other areas, as 21 per cent, of the population live four or more in a room against 9 per cent, in the Avenues and 8 per cent in the Field Road area. 104 TABLE 1. Classification of the Population of Heckfield Place and five selected areas according to the number of persons per room. Area. Less than one persons to a room. One and under two persons to a room. Two persons to a room. Under three and over two persons to a room. Three & under four persons to a room. Four & under five persons to a room. Five or more persons to a room. Per cent of overcrowding, i.e. more than two persons to a room. No. of Persons. • Per cent, of total population. No. of Persons. Per cent, of total population. No. of Persons. Per cent, of total population. No. of Persons. Per cent, of total population. No. of Persons. Per cent, of total population. No. of Persons. Per cent, of total population. No. of Persons. Per cent, of total population. Heckfield Place 5 0.4 108 8.6 182 14.6 298 23.9 392 31.4 154 12.3 110 8.8 76.4 Walham, Rock,) and Lodge Avenues) 43 3.5 290 23.8 176 14.5 307 25.2 289 23.8 91 7.5 21 1.7 58.2 Field Road Area 46 2 3 513 25.8 346 17.4 464 23.4 451 22.8 130 6.6 33 1.7 54.5 Church Path 6 1.5 142 35.0 56 13 8 107 26.3 75 18.5 20 4 9 — — 50 3 Cassidy Road 62 6.9 366 40 6 120 13.3 179 19.7 144 16.0 21 2.5 10 1.1 39 2 Lintaine Grove 31 3.8 317 39.5 150 18.7 189 23 6 115 14.4 - 0.0 — 0.0 38.0 105 Mortality Rates. In the following table are given the mortality rates of Heckfield Place and the other selected areas, together with those of the whole Borough for the five years 1908-1912. The most striking point in the table is the enormous infantile mortality in Heckfield Place, which is thrice that of the whole Borough, and more than double that of the adjoining Avenues, which are similar in the character of the houses, and in the lack of open space around, to Heckfield Place, while the inhabitants are certainly as poor. The excessive mortality from epidemic diseases in Heckfield Place is due almost entirely to diarrhoea and measles; the excess in notifiable diseases such as scarlet fever and diphtheria not being very noticeable. 106 TABLE II. Vital Statistics of Heckfield Place compared with those of the whole Borough and certain selected areas.—1908-1912. Area. Average annual Birth Rate, 1908—1912. Average annual Death Rate at all ages, 1908—1912. Average annual number of Deaths of Infants under one year per 1,000 births, 1908—1912. Average annual Death Rate from principal epidemic diseases, 1908—1912. Average annual Death Rate from Tuberculous diseases, 1908—1912. Average annual number of Deaths of Children under 5 years of age per 1,000 of the population at that age period. Average annual number of cases of infectious diseases notified per 1,000 of the population, 1908—1912. Heekfield Place 43 2 26.7 326 8 7 3 8 100 0 8 2 Walham, Rock, and Lodge Avenues 42.9 19.4 150 51 2 5 61.1 62 Field Road area 39.2 20 9 178 4.9 3.3 80 0 6 2 Church Path 43 4 21 2 136 5.4 2 0 66 6 5 1 Cassidy Road 36 9 17 1 139 30 1.4 50 0 4 2 Lintaine Grove 37 4 17 2 167 3 0 3.2 50 4 9 5 The Borough 28.2 13 6 110 1.7 1.8 40.1 60 107 With the assistance of some members of the Special Care Committee dealing with Heckfield Place and the other Avenues, a detailed inquiry into the general conditions of living in Heckfield Place has lately been made, and the more detailed knowledge obtained has fully confirmed the previous opinion held by all workers in the district as to its lamentable character. Unlike some slum areas, however, it is less characterised by extremes of poverty and vice than by a uniformly low standard of living, the inhabitants generally being mentally, morally and physically below the standard of the ordinary working class population. Few of the men are in regular employment, many probably as the result of vicious habits or heredity, are of such poor calibre as to be unable to do steady work. Quite a third of the married men live habitually on the earnings of their wives and children, only picking up sufficient to enable themselves to spend most of their time lounging near the public house. Among the older men and women drink is almost the universal evil; gambling is also prevalent, and is common even among the boys and girls. In one house a widow with records of drink and immorality is said to let her room to young people of both sexes for betting and gambling, and other houses are believed to be used for the same purpose. In a neighbourhood of this description, however, it is not always possible to locate the evils even when known to exist. The population is both stable and shifting. Families frequently move, although often only to another number in the same street, in order to avoid paying rent, or for other reasons. They also go to equally unsatisfactory streets in Chelsea or Notting Dale, only to move back again to this area at a later date. There is much intermarriage, children when grown up tending to remain in the area, and, although the records of infantile mortality are abnormally high, it is interesting to note that the children who survive, although often of a degenerate type, cannot be said to 108 be unhealthy or ill-nourished. This is probably due to the fact that there is little want of food, and that the children are out late and early in the streets. This state of things continues to exist, even although numerous relief agencies, charitable indviduals and churches are at work in the district, and it would appear that the un-coordinated help given hampers the work of the official bodies, and tends to aggravate existing evils by encouraging the parasitic tendencies of the inhabitants. The existence of such areas is undoubtedly a greater source of danger to the community than has yet been fully realised, and the cost to the charitable public and to the ratepayer is difficult to estimate, Housing. Appended are the statistics of the population as ascertained at the Enquiry and at the Census taken about two years before, in April, 1911. It will be seen that the figures relating to one and two room tenements agree fairly closely, but there is a considerable discrepancy between the Enquiry and Census results in the three room tenements. This is partly accounted for by five houses being closed at the time of the Enquiry, but the difference in the number of persons said to be living in them is no doubt owing to the incorrect information, with regard to the number of occupiers, given to the Sanitary Inspector. 109 TABLE III. Classification of Tenants in Heckfield Place as ascertained at the Census taken in 1911 and the Enquiry in 1913. Number of Persons. Number of Families Persons occupying tenements one room Enquiry 270 Census. 245 (a) Families occupying one room tenements Enquiry 84 Census. 71 Persons occupying tenements two room 482 522 (b) Families occupying two room tenements 97 99 Persons occupying tenements three room 242 439 (c) Families occupying three room tenements 40 G2 Persons occupying tenements four room 65 28 (d) Families occupying four room tenements 8 4 Persons occupying House the whole 15 15 (e) Families occupying the whole House 2 2 110 Overcrowding, of course, cannot be accurately defined, as cleanliness and open windows make all the difference, but having regard to the size of the rooms and the habits of the occupiers, tenements with more than two occupiers to a room must be considered overcrowded, and the proportion of the population living under these conditions is given in the first table of this report. The condition of these various tenements and that of the people themselves has been carefully noted and three divisions have been made—(1) clean, (2) medium, (3) dirty. Under Division (1) clean, were 34 tenements. Under Division (2) medium, were 78 tenements. Under Division (3) dirty, were 90 tenements, of which 9 were especially filthy. Some of the tenements at the time of the Enquiry were comparatively clean, yet subsequently the children from them were found to have been more than once compulsorily cleansed. These tenements, therefore, have been re-classified as dirty. Where, however, most of the houses are verminous, it is not possible to make any arbitrary standard. Structurally, the houses are not so bad, though all wanting in open space at the rear, but owing to the habits of the tenants, and to the dirt and vermin, some have become almost uninhabitable. In these circumstances it is difficult for the landlords to keep their property in any state of repair, and premises put in order in the course of this enquiry have already become as bad as before. Employments. Although in some cases it has not been easy to determine the past or present occupations of some 111 of the 220 Heads of families, they may be roughly classified as follows:— Men 125 in unskilled labour (of whom few are in regular employment. 19 in skilled trades. 21 costers or general dealers. 10 organ grinders or professional beggars. 12 no occupation or unknown. 2 agents for the property. 189 Total As quite a number of these men are from various causes habitually out of work, or do only occasionally wood chopping or costering, there are in consequence 47 married women who either supplement their wages or who are the real wage earners of the family. About half of these women work at laundries and the rest are employed charring, or similar work. There are also 36 widows or deserted wives who support their families in the following ways:— 18 work in laundries or do charing, etc. 2 have small shops. 5 are costers or professional beggars. Thus out of 226 families, 93 are seen to be mainly, if not entirely dependant on the work of the women. Police Records, &c. The records of police convictions have not been supplied from the Police Station and are necessarily incomplete. The information has been obtained from the local Press, the School Attendance Officer, etc., and even so there are to be found convictions against one or more members of 121 families. The majority of these convictions are for drunkenness, 112 gambling, disorderly behaviour and obscene language, although many are for larceny and felony. Fines under Children and Education Acts. In addition, few families where there are children of school age have escaped being summoned under School attendance and cleansing bye-laws of the Children and Education Acts. Use of Cleansinq Station. During a period of eight months of which there are records, 136 children (coming from 84 families and from 54 of the 77 houses in question) have been compulsorily, and many repeatedly, cleansed, and as the families with children of school age number 176, it will be seen that every other family has been found to be exceptionally dirty. Drink as a demoralising factor. In all but one of these families there is a known record of drink against one or both parents, and the children of 81 of the 84 families are in receipt of school meals. But where "money is not forthcoming for bread let alone soap," police court fines are nevertheless paid for drunken and disorderly conduct. I he demoralising effect of drink is further shown by contrast, for some tenements have been found clean and the children well nourished, although convictions for larceny, felony or gambling have been frequent. Children in Industrial, Physically Defective and Mentally Defective Schools. At the present time there are 78 children from the street in Industrial Homes. These come from 45 families. 113 It is not easy to determine the number of mentally deficient children, records of those provided for in Institutions or by the Guardians not being available. There are, however, 24 children at present attending L.C.C. Mentally Deficient Schools, from 20 families, and two only attending schools for the Physically Defective. Allowing even for the probability of some physically defective children being provided for in Institutions, this would seem to bear out the previous statement that children who survive infancy in this area, are not below the average standard of physique. Relief Agencies. The following are some of the agencies known to be at work in this area:— 1. 22 School Care Committees. 2. 6 different Churches. 3. 5 Hospitals (of which 4 have Samaritan or Relief Funds). 4. The Church Army. 5. The Salvation Army. 6. The Charity Organisation Society. 7. The Invalid Children's Aid Society. 8. The League of the Friends of the Poor. 9. District Nurses. 10. The Ragged School Union. 11. Cripple Children's Society. 12. Children's Help Societv. 13. Children's Country Holiday Fund. 14. School for Mothers. 15- Personal Service Association. 16. Soldiers and Sailors Families Association. 17. Ladies of Charity. 18. Catholic Prisoners Aid. 19. St. Vincent de Paul. 20. Nazareth House. 21- Home of Help. 114 22. Bishop King's Charity. 23. Barclay Road Mission. 24. Twynholm Hall. 25. National Society for the Prevention of Cruelty to Children. 26. Society for the Protection of Women and Children. 27. Rescue Workers. 28. German Mission. 29. The Distress Committee. 30. The Poor Law Guardians. To which may be added a considerable amount of sporadic and individual charity. The number of families found to be in touch with one or more of these agencies was 163. The Board of Guardians has recently dealt with 119, about half of these being for medical relief only, the remainder being almost chronically in receipt of some form of Poor Relief. Also during the past year out of 176 families who, as we have noted, have children of school age, 114 families have had school dinner at one or other of 22 schools. Several of those received both breakfasts and dinners, and many have been almost continuously on the feeding list. One woman whose children are dirty and ill-disciplined, in expressing her appreciation of this form of help, explained that she found the saving of their food useful in paying school fines. If, then, we include the Police, School Attendance Officer, Special Officer, Sanitary Inspector and Tuberculosis Visitor, and if we allow but one visitor only from the official and unofficial bodies above enumerated, we have at least 65 representative visitors dealing with this area. The problem of dealing with the evils I have enumerated is indeed difficult, but must be faced by the Sanitary Authority. It is, in my opinion, much to be regretted that the whole of this area, comprising Heckfield Place and the Avenues, together with the houses in Fulham Road backing on them, was not 115 dealt with under the Housing of the Working Classes Act, as I strongly urged in 1901, but now the erection of a Police Station and Barracks in the gardens of the houses in F ulham Road, which back on Heckfield Place, interferes, I vam afraid with any general reconstruction scheme, as it would hardly be practical to rehouse those displaced. Failing a complete scheme of this nature, we must, I think, look to what is known as the Octavia Hill method, to effect a gradual improvement in the character of the area, that is for the houses to be acquired by those who, in addition to keeping the houses in good condition and not allowing overcrowding, will, by constant supervision, improve the character of the tenants, and enforce as far as possible decent and cleanly living. This has been done successfully in similar areas, where it has been found that, although a certain proportion of the occupiers are irreclaimable, and can only be dealt with by ejectment, a fair number can with firmness and encouragement be converted to a decent life. As I was pleased to be able to report to you early in the year, 23 houses have been acquired by Dr. Schuster, and these methods are being tried. The latest report is encouraging. The lady who looks after the houses says: "Heckfield Place is at last showing slight signs of improvement, no less than six of the tenants having started scrubbing their stairs and rooms. The tenants remaining seem to realise that rent is a thing that must be paid, and though there are still lapses, the average on the whole is much better, and as the tenants I speak of are old Heckfield habitues, it is distinctly hopeful. Evictions, or rather notices, have had to be much in evidence, but of the 22 tenants left, only one is a non-Heckfield resident, brought in from another street." 116 There are some hopes of acquiring other houses and treating them in the same way, but though as was to be expected, owners now open their mouths wider, thinking they see a prospect of their property being improved. This is doubly unfortunate, as one of the difficulties experienced is that evicted tenants are taken by other landlords and no questions are asked, and the new methods of management are freely criticised. The improvement of the area would, in my opinion, be materially expedited if Heckfield Place could be opened up to the world. At present it is completely hemmed in and hidden away, and nobody, excepting the occupiers, the police, a few official and social workers, see anything of it, and it is probably owing to this that the conditions in it are worse than in the adjoining Avenues, which all open directly into the Fulham Road. The opening up could be effected by removing the block of houses forming the east side of Lodge Avenue and the west side of Walham Avenue, and continuing the road formed through into Burnthwaite Road, or the houses on the east side of the western arm of Rock Avenue might be similarly treated. This might be done under Section 38 of the Housing of the Working Classes Act, 1890, which gives power to the local authority under certain conditions to demolish any building, which though not in itself unfit for habitation, is so situated that by reason of its proximity to any other buildings, it prevents proper measures being carried into effect for remedying any nuisance injurious to health, or other evils complained of in resDect of such other buildings. The persons displaced could, I think, be re-housed on the vacant land at the corner of Lillie Road and Jervis Road, which is now used by travelling shows, round-a-bouts, etc., and is generally more or less a nuisance. 117 I would strongly urge the careful consideration of this scheme by the Council, as combined with the efforts now being made by private individuals, it should go far in removing a state of things discreditable to the Sanitary Authority. More, too, should be done by the Council in the direction of sanitary supervision, and the stringent enforcement of all enactments dealing with overcrowding and other insanitary conditions, as this cannot be done with the existing sanitary staff. It must be remembered that there are only five District Inspectors to deal with some 20,000 houses, occupied by 157,000 persons, and as their duties have been much increased of late, it is not possible to exercise the constant supervision which districts like this require to produce satisfactory results. Tenements, such as I have described, should be visited systematically at least every three months, and in my opinion an additional Inspector should be appointed to deal with Heckfield Place, the Avenues, Cassidy Road, and any other area that may appear to require special attention. In considering any recommendation, the Committee will not, I am sure, pay too great a regard to the bugbear of expense, for setting aside the clamant nature of the evil they have to contend with, the cost to the community of an area like this is enormous. One item I have mentioned, viz., 78 children from Heckfield Place in Industrial Schools, means an expenditure of about £1,500 a year, and when we think of all the others supported by the community in the workhouses, infirmaries, and asylums, and realise that unless the conditions can be altered the area will continue to be a fertile breeding place of similar encumbrances, the Committee will recognise that expenditure incurred in the reasonable hope of minimising the evils is amply justified. 118 There is one other matter I may mention. Attention has been drawn in this report to the number of charitable agencies working in this district, and to the mischief caused by the overlapping of their efforts, and I am glad to be able to report that a Special Committee, of which I am a member, ha? been formed of representatives of the chief Societies engaged to deal with all applications for assistance made to any of the agencies by which it is hoped that the trouble caused by indiscriminate and un-co-ordinated charitable efforts may be prevented. I am, Sir and Gentlemen, Your obedient Servant, J. CHARLES JACKSON, Medical Officer of Health. October 11th, 1913.