GRE 1 BOARD OF WORKS for the GREENWICH DISTRICT. Annual Report FOR THE YEAR ENDING 25th MARCH, 1894. List of Members of the Board, and of the several Officers and Committee; Report of Proceedings of the Board; Reports of Medical Officers; Statement of Engineer ; „ of Road Surveyor; ,, of Contracts entered into; ,, of Moneys received and expended during the Year; and „ of Arrears of Calls, and other Moneys and Liabilities of the said Board, on the 25th March, 1894. PRINTED BY ORDEROF THE BOARD Breenwich EDWARD G. BERRYMAN & SONS, Steam Works, 84\ Blackheath Road. BOARD OF WORKS for the GREENWICH DISTRICT. Annual Report FOR THE YEAR ENDING 25th MARCH, 1894. List of Members of the Board, and of the several Officers and Committee; Report of Proceedings of the Board; Reports of Medical Officers; Statement of Engineer; „ of Road Surveyor; „ of Contracts entered into; ,, of Moneys received and expended during the Year; and „ of Arrears of Calls, and other Moneys and Liabilities of the said Board, on the 25th March, 1894. PRINTED BY ORDER OF THE BOARD. Breenwich EDWARD G. BERRYMAN & SONS, Steam Works, 84, Blackheath Road. Board of Works for the Breenwich District. List of the Members and Officers of the Board, JUNE, 1894. MEMBERS ELECTED BY THE VESTRY OF GREENWICH. name. address. Mr. FREDERICK GEORGE COX 12, The Grove, Blackheath „ THOMAS PERCY EVANS 8, Halstow-road Dr. RALPH GOODING, B.A., J.P Heath Lodge, Gloucoster-terrace, Blackheath Mr. ALEXANDER JEANS 5, Church-street „ WILLIAM THOMAS MANNING 12, Nelson-street „ BENJAMIN MITCHELL 6, Vanbrugh-hill „ WALTER NEWTON Hillside, Ulundi-road, Blackheath Capt. FRANCIS METCALFE OMMANNEY, R.N .24, St. John's-park, Blackheath Mr. WALTER RICHARDSON 60, Annandale-road „ WILLIAM STIMSON 6, Woodlands-road „ HENRY TIPPING 38, South-street „ WILLIAM GEORGE WATTS 29, Blackheath-road „ CHARLES HENRY ALLWORTH, 57, London-street „ WILLIAM FOX BATLBY 12, Vanbrugh-park, Blackheath „ WILLIAM CHARLES BIRT 38, Devonshire-road Dr. GEORGE HUGHES CABLE 59, Royal-hill Mr. WILLIAM E. FELTHAM 58, Royal-hill „ ROBERT GIBBS Alma-villa, 38, Vanbrngh-hill „ G. W. GIFFARD HOOPER 28, Park-place ,, RICHARD S. JACKSON, L.C.C. Stobcross Lodge, Crooms-hill „ DONALD McCALL 32, South-street „ CHARLES OLIVER POOK 37, Blackheath-road „ ALFBEU JAMES RANDALL 23, Park-place „ WILLIAM STERNDALE SCARR . 17, Annandale-road „ FREDERICK CHARLES BINGHAM 12, South-street „ HENRY BRIDEL 3, Union Wharf „ GEORGE DAVIS Belle Vue House, Park-place „ ALFRED H. GARL1CK 14, Langdale-road ,, JOSEPH HEATH 22, Ashburnhara-road „ CHARLES JOHN HERYET 95, Blackheath-hill ,, LEWIS INCLEDON 2, West Grove-terrace Rev. BROOKE LAMBERT, M.A., B.C.L., The Vicarage Mr. GEORGE LEDGER 3, Mycenae-villas, Mycenae-road „ EDGAR SYDNEY 9, The Circus „ GEORGE USHERWOOD St. Clere.Ulundi-road, Blackheath „ GEORGE CHARLES WHIBLEY 82, South-street MEMBERS ELECTED BY THE VESTRY OF ST. NICHOLAS, DEPTFORD. name. address. Mr. JOHN DAVID URRY 198, Evelyn-street „ THOMAS E. ROBERTS 2, Wellington-street „ THOMAS REESON 6, Watergate-street „ GEORGE WARRY 4, Watergate-street „ ARTHUR GOLDING Church-street „ WILLIAM WALTER LOCKYER 208, High-street MEMBERS ELECTED BY THE VESTRY OF ST. PAUL, DEPTFORD (INCLUDING HATCHAM). name. address. Mr. JOSEPH ALWIN 23, Ashmead-road „ HENRY BARE 30, Endwell-road „ GEORGE BARSON 88, Drakefell-road „ WILLIAM H. BECK 45, Tressillian-road „ JOHN E. CHILD 130, Lewisham High-road „ HENRY G. DELATOUCHE 59, Erlanger-road „ WM. BENJN. EAST AWAY 76, Jerningham-road „ RICHARD HICK 18, Abinger-road „ BENJAMIN J.JACOB 29, Pepys'-road „ HENRY KEYLOCK, L.C.C 39, Pepys'-road „ THOMAS LAWRENCE 71, Cranfield-road „ WILLIAM STEVENSON MORLEY, 279, Lewisham High-road „ FREDERICK J. OLD MAN 1, Ommanney-road „ WILLIAM PIERPOINT 71, Lewisham High-road „ WALTER J. PURYER 6, Tyrwhitt-road „ JAMES G. THOMAS 70, High-street „ DAVID T. WHIBLEY 42, Ashmead-road „ WILLIAM WRIGHT 72, High-street „ JOHN VENN YONGE 182, Malpas-road Col. BLAIR ABBOTT 76, Wickham-road Mr. JOHN ANDERSON 30, Leylang-road „ BENJAMIN AVERY 24, Lewisham High-road „ ALEXANDER BEATTIE, R.N 57, Pepys'-road „ SAMUEL J. CLEGG 168, New Cross-road „ WILLIAM P. COOPER 36, High-street „ PERCY L. H. DAVIS 95, Cranfield-road „ CHARLES GALLEHAWK 72, Evelyn-street „ SAMUEL GILES 86, Tyrwhitt-road „ FREDERIC G. LANDON, M.A., F.R.A.S., J.P., 59, Tressillian-road „ GEORGE LEIDIG 48, The Broadway „ THOMAS DAWSON LENG 232, Evelyn-street „ GEORGE ROBERT MASON Lower-road „ HENRY GEORGE PITT 22, Evelyn-street „ ABRAHAM C. REES 438, New Cross-road „ SIDNEY SCHOLFIELD 42, Evelyn-street „ WILLIAM T. SMITH 2, Ommanney-road „ JOSEPH W. WINDRED 1, Dixon-road „ WILLIAM WHEATLEY 12, Zampa-road „ ALEXANDER ANDERSON 9, Penmartin-road „ JOHN HENRY BULMER 35, Amersham-road „ JOSEPH FIELD 77, Amersham-road „ JOHN HAMLYN 5, Jerningham-road „ BENJAMIN HILLS Regent-street ,, DANIEL HINES 123, Breakspears-road „ GEORGE KING 166, Queen's-road „ EDWARD J. KNIGHT 86, Manor-road Sir SAMUEL S. LEWES 163, Lewisham High-road Mr. HENRY NUDING 16, Clifton-road „ GEORGE RICHARDS 363, New Cross-road „ GEORGE SIMMONDS 58, Pepys'-road „ EDWARD SIMPSON 186b, New Cross-road „ WILLIAM RICHARD SMITH 19, Tressillian-crescent „ ROBERT SOPER 158, St. John's-road „ JAMES STAGG 11, Cliff-terrace „ FRIEND STOW, R.N 11, St. Donatt's-road ,, WILLIAM WALKER 123, Jerningham-road „ STEPHEN WINN 423, New Cross-road OFFICERS OF THE BOARD. Clerk, Mr. JAMES SPENCER 82, London Street, Greenwich. Treasurer, Mr. THOMAS MOTE London & County Bank, Church Street, Greenwich. Medical Officer of Health for Greenwich, Mr. CHARLES HENRY HARTT 80, London Street, Greenwich. Medical Officer of Health for Deptford, Mr. HENRY WILLIAM ROBERTS 166, Lewisham High Road. Engineer, Mr. JOHN NIDD SMITH 85, South Street, Greenwich. Road Surveyor, Mr. JAMES RICHARD HEWARD 52, Wickham Road, Brockley. Public Analyst, Mr. ROBERT HENRY HARLAND Plough Court, 37, Lombard Street, E.C. Auditor, Mr. R. HUGH SLOLEY 3, King Street, Cheapside, E.C. Accountant, Mr. F. DUDLEY KEEN 138, Lewisham Road, S.E. Assistant Clerk, Mr. VIVIAN ORCHARD 124, Blackheath Hill, S.E. Sanitary Inspectors, Greenwich, Mr. CHARLES TURLE WILSON 37, Burney Street, Greenwich. Mr. ROBERT FISHER 9, King William St., Greenwich. Mr. ARTHUR E. BACHE 7, Park Row, Greenwich. Sanitary Inspectors, Deptford, Mr. THOMAS BORSBERY 2, Florence Road, Deptford. Mr. THOMAS TURNER 24, Harcourt Road, Brockley. Mr. ROBERT D. J. SIMPSON 169, Manor Road, Brockley. Mr. CHARLES WILLIAM NETTLETON, 26, Rokeby Road, Brockley. Mr. ALFRED PRIEST 22, Batsford Road, St. John's. Caretaker and Messenger, Mr. SAMUEL SOLE Oificcs of the Board, 141,Greenwich Road, Greenwich. COMMITTEES OF THE BOARD. A Committee for the Parish of Greenwich, consisting of all the Members of the Board elected by the Vestry of Greenwich. A Committee for the Parish of St. Paul, Deptford, consisting of all the Members of the Board elected by the Vestry of St. Paul, Deptford. A Committee for the Parish of St. Nicholas, Deptford, consisting of all the Members of the Board elected by the Vestry of St. Nicholas, Deptford. FINANCE COMMITTEE. Mr. FREDk. CHAS. BINGHAM „ WILLIAM CHAS. BIRT „ LEWISINCLEDON „ HENRY TIPPING „ GEO. CHARLES WHIBLEY „ JOHN ANDERSON „ ALEXANDER BEATTIE, r.n. „ HENRY G. DELATOUCHE Mr. SAMUEL GILES „ JOHN HAMLYN „ DANIEL HINES „ WALTER J. PURVER „ WILLIAM RICHARD SMITH „ ARTHUR GOLDING „ JOHN DAVID URRY „ GEORGE WARRY Mr. FREDERIC GEORGE LANDON (Ex-Officio). DISTRICT COMMITTEE. Mr. CHAS. H. ALLWORTH „ ALFRED H. GARLICK „ CHARLES JOHN HERYET Capt. F. M. OMMANNEY, r.n. Mr. HENRY TIPPING „ JOHN ANDERSON „ ALEXANDER BEATTIE, r.n. Mr. SAMUEL GILES „ BENJAMIN J. JACOB „ HENRY KEYLOCK, L.c.c. „ HENRY NUDING „ WILLIAM RICHARD SMITE „ ARTHUR GOLDING „ GEORGE WARRY Mr. FREDERIC GEORGE LANDON (Ex-Officio). CHAIRMAN OF THE BOARD. Mr. FREDERIC GEORGE LANDON, M.A., F.R.A.S., J.P. BOARD OF WORKS for the GREENWICH DISTRICT. THIRTY-EIGHTH ANNUAL REPORT OF THE BOARD, FOR THE YEAR ENDING THE 25th MARCH, 1894, Of the Proceedings of the Board in the Execution of the Acts under which, it is constituted, and of the Proceedings taken by its Authority for the Removal of Nuisances, and the Improvement of the Sanitary Condition of the District. The works of Sewerage and Paving completed during the year are specified in the annexed Statements, signed by the Engineer and Surveyor, and Road Surveyor of the Board, respectively. The statistics relating to the health of the District to the 31st December, 1893, will be found in the accompanying Reports of the Medical Officers of Health. During the year, amongst other things, the Sanitary Inspectors inspected 6,963 houses. Notices to perform Sanitary 8 works were served as understated, viz.:—To provide proper and sufficient water supply and water supplying apparatus to and for water closets, 1,216; to renew the water supply to water closets, 59 ; to provide proper and sufficient water supply for domestic use, 108; to amend, repair and make good defective water fittings, 89; to provide new water receptacles, 44 ; to provide proper and sufficient covers to cisterns, 777; to cleanse foul and dirty cisterns, 187 ; to amend, repair and make good cisterns, 95; to open up, examine, amend, repair and reconstruct drains, 1,265; to clear, cleanse and purify drains, 203; to properly and sufficiently trap surface inlets to drains with gully traps, 1,474; to properly and sufficiently ventilate drains, 183; to construct proper and sufficient drains to carry off surface water from yards, 355 ; to construct proper and sufficient drains to carry off surface water from areas, 63 ; to construct proper and sufficient drains to stables, 14; to remove soil pipes to approved positions outside water closets, 67 ; to amend and repair soil pipes, 11; to properly and sufficiently ventilate soil pipes, 135; to properly and sufficiently ventilate water closets, 57; to provide proper and sufficient soil pans and traps to and for water closets, 1,148 ; to provide new soil pans to closets, 12; to amend and repair defective putty joint to water-closet, 1 ; to amend and repair defective flush pipes to water-closets, 10; to properly and sufficiently trap water closet pans, 10; to clear and cleanse foul and dirty water closet plans, 406 ; to amend and repair defective seats and risers of water closets, 132; to provide doors to water closets, 5; to disconnect sink waste pipes from drains, 622; to disconnect rain-water stack pipes from drains, 395 ; to disconnect bath waste pipes from drains, 25 ; to disconnect lavatory 9 waste pipes from drains, 14 ; to disconnect overflow pipes of cisterns from drains, 2 ; to provide and fix rain-water stack pipes, 41; to amend and repair defective rain water stack pipes, 206 ; to amend and repair defective waste pipes, 10 ; to provide and fix eaves guttering, 25; to amend and repair defective eaves guttering, 237 ; to amend and repair defective roofs, 160 ; to amend and repair defective flooring, 22; to amend and repair defective walls, 34; to amend and repair defective ceilings, 35; to amend and repair defective water closets, 51 ; to abolish water closets in unfit situations, and to provide proper and sufficient water closets in lieu thereof, 61 ; to abate the nuisance caused by the dampness of walls, 102; to abate the nuisance caused by overcrowding, 24; to abate the nuisance caused by the keeping of animals, 30: to abate the nuisance caused by the issue of black smoke from chimney shafts, 3; to provide proper and sufficient ash-pits, 825; to amend and repair defective ash-pits, 131; to cleanse, limewash and purify premises throughout, 401; to amend, repair, cleanse, limewash and purifypremises throughout, 489 ; to cleanse, limewash and purify rooms and water closets, 49 ; to cleanse, limewash and purify ceilings, 55; to cleanse, limewash and purify walls, 42; to pave yards with a hard, durable and impervious material, 1,052; to pave forecourts with a hard, durable and impervious material, 47; to pave areas with a hard, durable and impervious material, 5; to pave stables with a hard, durable and impervious material, 12; to provide proper receptacles for dung, 42; to remove accumulations of filth and manure, 82; to discontinue using underground rooms as living rooms, 8; to abolish drain in bakehouse, 1; to cleanse, limewash and purify bakehouses, 60; to provide proper, suitable and sufficient 10 accommodation in the way of sanitary conveniences for the use of the workpeople employed in or in attendance at workshops and buildings, 34; to make premises fit for human habitation, 48; to re-drain houses, 122; to abolish cesspools, 16; to cleanse and disinfect cesspools, 8; to provide proper means of ventilation to houses, 8; to cease occupying premises, as a dwelling-house, without water closet accommodation, 1. During the same period 1,416 rooms and the following articles were disinfected after cases of infectious disease, namely :— 1,205 beds, 2,286 pillows, 822 bolsters, 543 palliasses, 838 mattresses, 801 sheets, 1,206 blankets, and 5,420 odd articles, making 13,121 articles in all. It was found necessary during the same period to destroy 15 articles which had become contaminated by contact with cases of infectious disease. The above-mentioned Notices were, in most cases, complied with, but proceedings were taken against the owners of four houses in Greenwich for neglecting to execute such works and do such things as were necessary for the purpose of abating the nuisances arising upon the premises, which resulted, in three cases, in the Magistrate making orders for the execution of the required works, which were afterwards satisfactorily carried out; and in the fourth case, the owner, pending the adjourned hearing of the summons, caused the whole of the required works to be executed to the satisfaction of the Board's Inspector. Proceedings were also taken against the owner of a house, and the occupiers of two other houses, in the Parish of Greenwich, for neglecting to abate the nuisances arising upon those premises, and the Magistrate made orders prohibiting the use 11 of such houses for human habitation, and the premises were closed. In addition to making the Closing Order, the Magistrate also fined the owner above referred to the sum of £2. Proceedings were also taken against two persons for unlawfully removing or carrying by road through certain streets in the district faecal or offensive or noxious matter contrary to the byelaws made by the London County Council, under Section 16 of the Public Health (London) Act, 1891, and fines were inflicted, amounting together to £2. Proceedings were also taken against the owners of six newlyerected houses in the Parish of Greenwich, for permitting those houses to be occupied as dwelling-houses without it having been certified by the Sanitary Authority that such houses had a proper and sufficient supply of water from a Water Company, or by some other means, and fines were inflicted, amounting, in the whole, to £3 15s. The Medical Officer of Health for Deptford having represented to the Board, under the provisions of the Housing ot the Working Classes Act, 1890, that Nos. 1, 2, 3, 4, 5, 6 and 7 on the northern side of Martha Place, in the Parish of Saint Paul, Deptford, were in a state so dangerous or injurious to health as to be unfit for human habitation, the Board caused notices to be served requiring the owner, within fourteen days from the service of the notices, to make such houses fit for human habitation, and the owner failing to comply with such notices, proceedings were taken against her, and the Magistrate made an order prohibiting the using of the premises for the purposes of human habitation until, 12 in his judgment, they were rendered fit for that purpose. Under this order the whole of these houses were closed. The Medical Officer of Health for Greenwich also made representations under the same Act with reference to Nos. 2, 4, 6, 8, 10, 12, 14 and 16, Cold Bath Street, to Nos. 59, 61, 73, 75, 77 and 79, Church Street, to No. 12, Trinity Street, and to Nos. 6, 7 and 8, Wood Wharf, all in the Parish of Greenwich, and notices being served, the owners of the premises voluntarily closed them, and the houses referred to in Cold Bath Street, and the house in Trinity Street, were subsequently pulled down. Proceedings were taken against a lad for unlawfully damaging a tree in the St. Alphage Recreation Ground, also for throwing stones so as to endanger the public in that Ground, and for the first offence he was fined 6d., and ordered to pay 1s. for damage and 2s. costs, and for the second he was fined 6d. and 2s. costs. During the year Mr. Arthur Bache was appointed as an additional Sanitary Inspector for the Parish of Greenwich, and Mr. Charles William Nettleton as an additional Sanitary Inspector to act in the Parishes of Saint Paul and Saint Nicholas, Deptford; and Mr. Charles Turle Wilson, who was originally appointed an Inspector of Nuisances for the Parish of Greenwich, under the provisions of the Metropolis Management Acts and the Nuisances Removal Acts, and Mr. Thomas Turner, who was similarly appointed as an Inspector of Nuisances for the Parish of Saint Paul, Deptford, were re-appointed as Sanitary Inspectors for those Parishes, respectively, within the meaning of the Public Health (London) Act, 1891. 13 Two of the Sanitary Inspectors for the Parish of Saint Paul, Deptford, were, for the purpose of enabling them to get about that Parish with more expedition, and so carry out their duties with greater advantage, provided the one with a tricycle and the other with a bicycle. During the year the premises in East Street, Greenwich, acquired by the Board for the purpose of providing shelter and accommodation for the temporary use of such inhabitants of the district as might be compelled to leave their dwellings for the purpose of enabling such dwellings to be disinfected by the Sanitary Authority, were prepared and furnished for the reception of persons requiring the temporary use of them, and have been so used by three families. During the year the Board made Bye Laws, under the provisions of the Public Health (London) Act, 1891:— (а) For the prevention of nuisances arising from any snow, ice, salt, dust, ashes, rubbish, offal, carrion, fish, or filth, or other matter or thing in any street; (b) For preventing nuisances arising from any offensive matter running out of any manufactory, brewery, slaughter-house, knacker's yard, butcher's or fishmonger's shop, or dunghill, into any uncovered place, whether or not surrounded by a wall or fence ; (c) For the prevention of the keeping of animals on any premises in such place or manner as to be a nuisance or injurious or dangerous to health ; 14 (d) As to the paving of yards and open spaces in connection with dwelling-houses ; (e) For securing the cleanliness and freedom from pollution of tanks, cisterns, and other receptacles used for storing of water used or likely to be used by man for drinking or domestic purposes, or for manufacturing drink for the use of man. (f) With respect to the keeping of water closets supplied with sufficient water for their effective action; and such Bye Laws, having been duly confirmed by the Local Government Board, are now in operation throughout the district. The Board, at its meeting on the 23rd June, 1893, passed resolutions directing that an application be made to the London County Council, requesting that steps might be taken to obtain such an amendment of the London Council (General Powers) Act, 1891, as would enable the Board to charge the contribution of this Board to the formation of the New Street between Evelyn Street and Creek Road, Deptford, as follows:— One-third upon the Parish of Saint Nicholas, Deptford, and the remaining two-thirds upon the Parishes of Greenwich and Saint Paul, Deptford, in proportion to the respective rateable values of those two Parishes; and ordering the Common Seal of the Board to be affixed to the following consent:—"That this Board hereby "consents that the said New Street from Evelyn Street to Creek "Road, Deptford, shall be commenced by the London County "Council immediately after the said amendment is made," and the London County Council is now taking action to obtain the amendment above referred to. 15 During the year, the Sanitary Inspectors collected, and the Public Analyst analysed, 190 samples, consisting of the following articles :— Butter 83 Milk 65 Mustard 10 Pepper 10 Rum 6 Gin 5 Coffee 4 Vinegar 2 Liquorice Powder 2 Lard 1 Oatmeal 1 Sweets 1 190 Proceedings were taken with respect to twenty-one samples of Butter, certified to be admixed with foreign fat, not butter, and fines were inflicted, amounting in the whole to £39 10s. Proceedings were also taken against a person for unlawfully exposing for sale by retail, a parcel of Margarine, without there being attached to such parcel a label bearing the word " Margarine," and he was fined 5s. Proceedings were also taken with regard to nine samples of milk, certified to be adulterated, and penalties were imposed, amounting together to £32 15s. 16 Proceedings were also taken against the seller of a sample of Coffee, which was certified to be admixed with Chicory, and he was fined £1. During the year, there were 27 Ordinary and Special Meetings of the Board, and the undermentioned Committees and SubCommittees held meetings as follows:— Finance Committee 26 Greenwich Committee 22 Saint Paul, Deptford, Committee 22 Saint Nicholas, Deptford, Committee 8 District Committee 7 Joint Committee appointed to consider the applications received for the appointment of Sanitary Inspector to Act in the Parishes of Saint Paul and Saint Nicholas, Deptford 2 Special Committee appointed to consider the whole question involved in Mr. Jackson's motion with reference to the division of the District 1 Works and General Purposes Sub-Committee 30 Saint Paul, Deptford, Sanitary Sub-Committee 24 Greenwich Yard Sub-Committee 24 Greenwich Quarterly Accounts Sub-Committee 4 Greenwich Viewing Sub-Committee 2 Sub-Committee appointed to consider as to the practicability and cost of widening the roadway in front of Greenwich Hospital, to a fifty feet road 3 Sub-Committee appointed to consider the desirability of establishing a Dust Destructor for the Parish of Greenwich 2 Making a total of 204 meetings during the year. 17 RE PORT of the MEDICAL OFFICER OF HEALTH for GREB1TWICH. To the Greenwich District Board of Works. Gentlemen, I have the honour to present to you my Eleventh Annual Report for the 52 weeks ending December 30th, 1893. I have to report that 1,820 Births (930 Males and 890 Females) were registered in the Greenwich District, details of which appear in the tabulated form No. 1. The number of Deaths was 1,586 (832 Males and 754 Females) equivalent to an annual rate of 26.4 per 1,000 persons living (including the Greenwich Union and Infirmary, the Seamen's, Miller and Cottage Hospitals, the Royal Naval College, and Greenwich Hospital Schools and the outlying Public Institutions), and 16.2 excluding these Public Institutions, details of which appear in the tabulated form No. 2. B 18 The number of Deaths from the principal Zymotic Class was 187, equivalent to an annual rate of 3.1 per 1,000 persons living, details of which appear in the tabulated form No. 3. The Births were 1,820, being (234 in excess of the number of Deaths), equivalent to an annual rate of 30'3 per 1,000 persons living, details of which appear in the tabulated form No. 4. Table No. 5 will show the comparative Death Rate per 1,000 (excluding Hospitals and Schools), for the past ten years. Table No. 6 will show the comparative Death Rate per 1,000 from Diseases of a Zymotic Type for the last ten years. Table No. 7 will show the Population and Births and Deaths, in Registration Districts during the 52 weeks of 1893. Table No. 8 will show the number of cases of Infectious Disease reported to me under the provisions of the Public Health (London) Act, 1891, during the 52 weeks ending 1893. Table No. 9 will show the number of cases of Infectious Disease notified to the Metropolitan Asylums Board by the several Medical Officers of Health of the Metropolis, under the provisions of the Public Health (London) Act, 1891, in the 52 weeks ending 1893. Table No. 10 will show the number of Articles and Rooms disinfected from March 25th, 1893, to March 25th, 1894. Table No. 11 will show the number of articles destroyed during the same period. Table No. 12 will show the number of houses inspected with 19 inquiries in connection with Infectious Diseases, from March 25th 1893, to March 25th, 1894. Table No. 13 will show the work of Inspection from March 25th, 1893, to March 25th, 1894. Table No. 14 will show the Improvements effected during the same period. INFLUENZA. I regret to state that a very severe and fatal Epidemic of Influenza commenced in this district in the beginning of December, and lasted for about six weeks. It would be impossible for me to estimate the number of cases which occurred (as this disease is not one of those which has to be notified under the Public Health (London) Act, 1891), but from personal knowlege, and from information given to me by the different Medical Practitioners in the town, it would appear to have been very prevalent, and as fatal as the previous Epidemics. In all, there were twenty-eight deaths from Influenza (as a first cause), registered during the year, as compared with thirty-three in 1892, and in addition a very considerable increase in the number of deaths from diseases of the respiratory and circulatory organs (viz., Bronchitis, Pneumonia, and Failure of the Heart), which proves that there is an influence at work which has the power of making those diseases more fatal than at ordinary times. Reference to Table No. 1 will show the increase in the 20 number of deaths from diseases of the Respiratory and Circulatory systems during the month of December, 1893. The following Report was made to the Board when the Epidemic was at its height. REPORT ON INFLUENZA. November 29th, 1893. "I beg to report that another serious outbreak of Epidemic Influenza has occurred in the Greenwich District (in common with other parts of the country), and in consequence, a large number of people are suffering from its effects, and especially from Bronchitis and Pneumonia. "Sporadic cases occurred during the early part of November, but it was not till the present week that it became general in all parts of the district. "It may be interesting to the Members of the Board to be reminded that the first outbreak of Epidemic Influenza (since 1847), occurred in the latter part of December, 1889, and of the month of January, 1890. The second outbreak in the months of May and June, 1891. The third outbreak in January, 1892, all of which lasted about six weeks. "The present Epidemic may be said to be entering its sixth week. "I hope, and believe that the present Epidemic has reached its height, and is now declining, although many are suffering from the complications which arise during the process of the disease. 21 "The prevalence of Epidemic Influenza has had the effect of very largely increasing the death rate, as shown by the returns of mortality presented to-night. "The following figures show the number of deaths from all causes, which have occurred during the six weeks of the respective Epidemics of 1890, 1891, 1892 and 1893. 1890—Deaths from all causes, for six weeks ending February 8th 217 1891 ditto ending June 6th 223 1892 ditto ending January 30th 280 1893 ditto ending January 6th, 1894 259 "Deaths certified from Influenza as a first cause—1890, 4 ; 1891, 44; 1892, 21 ;* 1893, 28. "Deaths from diseases of the Heart and Chest, including Phthisis, Pneumonia, and Bronchitis, occurring in six weeks of each Epidemic-1890, 115 ; 1891, 89 ; 1892, 165; 1893, 114. "The following account is copied from the Registrar General's Annual Summary "The deaths attributed directly to Influenza numbered 1,526 in the year 1893, having been 652 in 1890, 2,336 in 1891, and 2,264 in 1892 ; while the average in the ten preceding years 1880-89, had not exceeded 6 3. As in the preceding three years, the deaths from Pneumonia were again largely in excess of the average, and it is probable that to this cause have been assigned many deaths which were really due to Influenza. The deaths from Influenza in the first quarter of the year numbered 356, in * This number was afterwards increased to 33 for the year 1892. 22 the second quarter 354, in the third quarter 84, and in the fourth quarter 732, of which 546 were registered in the last four weeks of the year. February 3rd, 1893." ' The following account of the Epidemic which visited this country in 1847, is copied from the late Dr. Farr's Report upon Influenza:— "Notwithstanding the continued prevalence of Typhus and Scarlatina, the deaths in the last week of October were only 945, one person died of Influenza, 36 of Bronchitis, and 62 of Pneumonia. In the following weeks ending November 20th, the total deaths were 1,052, 1,098, 1,086, of which 2, 4, and 4, were by Influenza; 40, 58, and 61 by Bronchitis; 68, 79, and 95 by Pneumonia. The wind had generally been blowing S.S.W. and S.W. since the first week of October, the weather was unusually warm, a brilliant Aurora was observed and shook the magnets on October the 24th. It appeared eight times during the quarter. On Tuesday, November the 16th there was a remarkable darkness, the wind changed to N.W., and amidst various changes still blew from the north over Greenwich at the rate of 160 and 250 miles a day. The mean temperature of the air suddenly fell from eleven degrees above to ten degrees below the average. On Monday it was 54°, Friday 32°, the air on Friday night was 27°, the earth was frozen, the wind was calm three days, and on Saturday evening a dense fog lay over the Thames and London for the space of five hours. No electricity stirred in the air during the week. All was still, as if Nature held her breath at the sight of the destroyer come forth to sacrifice her children. On Sunday 23 the sky was overcast, the air damp, the wind changed in the night to S. by E., and passed for four days over Greenwich at the rate of 200 and 300 miles daily. The temperature suddenly rose and remained from 2 to 9 degrees above the average through the week ending November 27th, when the deaths of 1,667 persons were registered in London. "Influenza was Epidemic. In the first week of December, 2,454 persons died. In the week following, 2,416 persons died. The deaths in the weeks ending Saturday, December the 18th, 25th, and January 1st were 1,946, 1,247, and 1,599. 11,339 persons died in six weeks, and altogether the Epidemic carried off more than 5,000 souls over and above the mortality of the season. The Epidemic attained the greatest intensity in the second week of its course, raged with nearly equal violence through the third week, declined in the fourth, and then partly subsided, but the temperature falling, the mortality remained high, not only through December, but through the month of January." CHOLERA IN 1892. During the latter part of August, 1892, this country was much startled by the intelligence that a serious outbreak of Asiatic Cholera had occurred at Hamburg, and it was thought that the disease would, in all probability, spread to England by means of passengers, more especially by the importation of the destitute pauper aliens from Hamburg and other parts; but thanks to the prompt measures taken by the Local Government Board, the disease did not make any headway. Under an "Order," which applied to all ships infected with Cholera, no alien of the class indicated which arrived in English 24 Ports was allowed to land until they had furnished the proper Authorities with their full name, destination, and precise address, so they could be traced and kept under observation for such time as might be judged sufficient. After this, it was necessary that they must satisfy the Medical Officer of Health of their freedom from any suspicion of choleraic disease before they were allowed to leave the ship. On August 25th, a circular letter from the Local Government Board was sent to all the Local Sanitary Authorities, calling their attention to the necessity of being prepared for the appearance of this disease in their district, and in that event to issue their regulations as per Section 82 of the Public Health (London) Act, 1891, which would impose on the Local Authorities the necessity of making provision for the prevention and treatment of the disease. A few cases of Cholera were landed at Gravesend, which rapidly proved fatal, whilst others were detained and kept under observation till all suspicious symptoms had disappeared, and these were only allowed to land after giving their names and addresses. The Medical Officer to the Port of London furnished me with a memorandum, as below, of every person landing in Greenwich from an Infected Port, which necessitated a visit immediately after the certificate was received. Port Sanitary Offices. GREENWICH, S.E. 1893. To the Clerk, Sanitary Authority. Sir, 1 have to inform you that the following passengers have arrived 25 in apparently good health by the from, and are proceeding to your District, giving the following addresses. W. COLLINGRIDGE, Port Medical Officer. CHOLERA IN 1893. During the winter of 1892, the epidemic of Cholera declined, but did not wholly disappear in any part of Europe where it had previously prevailed. In January, cases were reported from Russia, from Hamburg, and Halle, in Germany ; from France, Holland, Gallicia, and Hungary. In England, the first case that attracted attention was that of a man who arrived in the Tyne from Nantes, on June 25th, on board the " Myrtle Branch," who died of Cholera the same day. On July 17th, a case arrived at Gravesend from Marseilles, and two days later, two more cases arrived at Cardiff from the same port. On August 24th, a boy was taken ill suddenly in Hull and died with all the symptoms of Cholera, and on August 30th, a suspicious case occurred at Grimsby, which was afterwards confirmed by bacteriological examination. On September 7th, a case was reported from Doncaster as having occurred on the receipt of a consignment of oysters from Cleethorpes, near Grimsby. On the 9th, another occurred at Leicester, and again oysters from Cleethorpes were concerned. During September and October, cases were reported from 26 26 different towns in England. I am happy to state that in Greenwich we escaped altogether. In other parts of the Metropolis there were four fatal cases. On September 5th, a case at Westminster attracted great attention because the patient happened to be a sweeper in the House of Commons. She died on September 6th, and a bacteriological examination was made, and drew from Dr. Klein the explicit declaration that in his opinion the case was one of true Asiatic Cholera. It was followed by a fatal case on September 11th, at Fulham Workhouse, and on the 12th, a third case occurred in Kennington Road, Lambeth, and on the 26th, a fourth at Southwark. The undoubted cases of Cholera in London, therefore, were as follows:— Date of Death. Locality. 1. September 6 Westminster. 2. „ 11 Fulham. 3. „ 12 Lambeth. 4. ,, 26 Southwark. The Medical Officer of the London County Council having written to me to ask "whether anything had been done to place this District in a state of preparedness against a possible outbreak of Cholera during the Summer of 1893," I submitted the following Report to the Greenwich Committee of the Board of Works:— " To the Greenwich Committee of the Board of Works for the Greenwich District. "Gentlemen, "In accordance with your instructions, I beg to submit the 27 following Report upon the precautions which should be taken by the Sanitary Authorities, in order (so far as is possible) to prevent the spread of Cholera, in case it should become epidemic in this District. "It will be within the recollection of the Members of the Board that during last Autumn several cases of Cholera were reported as having been landed in this country, but owing to the vigilance and great precautions taken by the Port Medical Officers the disease was principally confined to the ' first line of defence.' "If these precautions had not been taken, there can be no doubt that a very serious outbreak would have occurred, at a time when the several Sanitary Authorities throughout the Metropolis were unprepared to meet such an emergency, and it is in order to meet any further outbreak during the coming summer that I beg to make the following recommendations, should Cholera become epidemic. "That the town should be divided into four districts, and that the District Medical Officers should be asked if they will undertake the visitation of the poorer houses, for the purpose of detecting Cholera and Diarrhœa, and attendance on those cases that are too ill to be removed to Hospital, and that a corresponding number of Chemists be asked to undertake the supply of Medicines as ordered by the District Medical Officers. "That a plentiful supply of Disinfectants be kept in stock for distribution, should occasion require. "That leaflets be issued, containing simple instructions to be observed by the people for the prevention of the disease, by 28 attention to cleanliness, both in regard to cisterns, ash-pits, waterclosets, &c. "That the Public Urinals, Courts and Alleys be flushed with Disinfectants frequently. "That Fruit, Fish, Vegetable and Provision Shops be visited frequently, for the purpose of detecting food which is either unsound or unfit for consumption. "That disinfection be carried out by the Inspector at the earliest possible moment after any case of Cholera has been reported and removed to Hospital, and that in the event of a death from Cholera, the friends be advised to have the body buried with all possible despatch, taking such precautions as may be deemed necessary by the Medical Officer of Health. "It is quite evident that in the event of Cholera becoming epidemic in the Metropolis, the Metropolitan Asylums Board will be unable to admit Cholera patients, as they have only just a sufficient number of beds to accommodate ordinary Zymotic Diseases, and, besides, it is considered bad treatment to remove Cholera patients to any distance, therefore the onus of providing Hospital accommodation will fall upon the Sanitary Authorities. "I have made some enquiry respecting the number of beds that could be obtained for Cholera cases, and I find that at the Greenwich Union Infirmary 56 can be provided, 28 for males, and 28 for females, but this number will be for Greenwich and Deptford; and at the Seamen's Hospital, 30 beds, but these latter will be reserved for the use of seamen. 29 "The Metropolitan Asylums Board will undertake the removal of the infected persons from their homes to the district Hospitals by means of litters, and these litters will be accompanied by trained bearers. "Mr. Shirley Murphy, Medical Officer of the London County Council, has written to me respecting sites for Hospitals, thus:— "'If it occurs to you that the Council could give any assistance to your Authority by affording facilities for the erection of Hospitals on any land in the Council's possession, or in any other way, you will doubtless inform me.' " In making the above recommendations, I wish the Committee to understand that some of the suggestions are only in case of a severe epidemic, but it is better to be ready beforehand than to be unprepared when an outbreak does occur. "I strongly recommend that the leaflets should be printed for circulation, as soon as possible, so as to rouse the people to the importance of observing more strictly all those measures which are so necessary for the preservation of the public health. " I remain, "Your obedient Servant, "Charles H. Hartt, " Medical Officer of Health. " February 23rd, 1893." REPORT ON THE EPIDEMIC AT GREENWICH WORKHOUSE. During the month of October a very remarkable outbreak of 30 illness occurred at the Greenwich Union Workhouse, which had the appearance at first of being true Asiatic Cholera. There were upwards of 260 cases and eleven deaths. On October 18th I submitted the following report on the outbreak:— "I beg to report that a sudden and remarkable outbreak of illness has occurred at the Greenwich Union Workhouse during the past ten days. "The first two cases that were recognised occurred at about four o'clock a.m. on Monday, October 9th, in two different blocks of the Workhouse. "The symptoms are characterized by vomiting, diarrhœa, cramps in the feet and legs, and collapse. " There have been more females attacked than males. "The cases that have occurred within the last few days are of a milder type than the first. "In all, there have been over 200 cases, and nine deaths (including the case of the woman who left the Workhouse on Tuesday, October 10th, and died in the Parish of Lambeth.) "Post-mortem examinations have been made by Drs. Burney and Keats, in the presence of Dr. Bulstrode and myself, without revealing anything in particular which can throw light upon the cause of the disease. The viscera have been forwarded to Dr. Klein for bacteriological examination. " I have visited the Workhouse daily, and consulted with 31 Drs. Down and Bulstrode, of the Local Government Board, as to the advisability of adopting any special measures for protecting the public health. "The water which is used for domestic purposes, is drawn from a well situated in one of the courtyards of the Workhouse, is now undergoing examination, both chemical and bacteriological, and will be reported upon in a few days. "There is an old brick drain running through the courtyard, within fourteen feet of the well, which has been opened, and is now being tested with a view to find out whether leakage has occurred. "Meanwhile, proper sanitary measures are being taken to protect the health of the inmates. "The water of the Kent Water Company is now being used in place of the well water, and the drains have been well flushed with carbolic and sulphurous acids. "There is no evidence of any great amount of Diarrhœa existing in the district outside the Workhouse. "I have taken the precaution of having samples of water drawn from the Pump in the Market, and also from the Baths and Wash-houses, in order to have them forwarded for analysis. "The health of the district has not been affected by the outbreak in the Workhouse, and I believe that, so far as that Institution is concerned, the worst is over. " (Signed) Charles Henry Hartt, "Medical Officer. "October 18th, 1893." 32 Since writing the above Report, I have received the following Official Statement from the Local Government Board, the result of Dr. Klein's examination :— "Whilst microscopically there is much resemblance between the organisms found and the ordinary 'comma bacilli,' yet cultivations have in all cases failed to respond to the tests for true Cholera, hence Dr. Klein assumes that the material sent to him have not been derived from cases of Asiatic Cholera." After a long and exhaustive enquiry by the Coronor, aided by the Officials of the Local Government Board (including Drs. Bulstrode and Klein), the Jury returned a verdict "That death was due to Infective Diarrhœa, and added a rider to the effect that the Coroner should have been allowed a free hand in dealing with the viscera, and that, as there was no evidence that the epidemic was not caused by the well water, the Workhouse well should be permanently closed." The evidence of Drs. Bulstrode and Klein is given, in extenso, below. "Dr. Bulstrode, of the Local Government Board, expressed the opinion that the epidemic was that of an infectious disease. He had ascertained that there had been, antecedently to the outbreak at the Workhouse, cases manifesting similar symptoms outside the Workhouse, in Greenwich. In his opinion the disease was introduced from outside, but he could not trace the medium. He was of opinion that the epidemic was not due to the Workhouse water. The conclusion at which he had arrived was that it was a form of infectious Diarrhcea, which was shown bacteriologically not 33 to have been Asiatic Cholera, but which, having regard to its distribution in Greenwich, and to its seasonable incidence, was probably related to those forms of diarrhceal sickness that especially tend to prevail in seasons when Cholera is prevalent in Europe." "Dr. Klein said he had received materials from the viscera of the deceased persons, and had made a bacteriological examination. He had come to the conclusion that the disease was not Asiatic cholera. In all the materials there was a microbe present, which, not occurring under ordinary conditions in normal intestines, might possibly be connected with the disease from which the persons died. If he had to give a certificate of death in these cases, he should say ' Infective Diarrhoea.' The water from the Workhouse contained microbes not found in wholesome drinking water, and was such as ought to be condemned for drinking purposes. The Infirmary water was satisfactory. The water did not contain the microbe which he found in the viscera of the deceased persons. That microbe was, as far as he knew, peculiar to this outbreak." As a result of the enquiry, the Workhouse in future will be supplied with water from the Kent Waterworks Co., and an entire new system of Drainage is now in process. ZYMOTIC DISEASES. I stated in my Annual Report of 1888-9, that it was customary to regard the absence or prevalence of disease of a Zymotic type as a test of the Sanitary condition of a district, and I was justified in congratulating the Board upon the satisfactory state of the C 34 Parish of Greenwich, as the Death Rate amounted to only 1*6 per 1,000 from that class of disease. This year the Death Rate amounts to 3-1 per 1,000 as against 2-3 of last year. Scarlet Fever. Last year there were 417 cases of Scarlet Fever reported in the Greenwich district, 80 of which occurred during the first two weeks in April. Twelve proved fatal. This year (1893) shews a considerable decrease in the number, there being only 302, of which 13 were fatal. Enteric or Typhoid Fever. Last year there were 55 cases of Enteric Fever reported and 13 deaths. This year the number is reduced to 39, the fatal cases being 17. Erysipelas shows an increase of 18 cases compared with that of last year. 1892—122 cases. 1893—140. Measles. This disease used to be looked upon as one of the most simple of the Zymotic class, but of late years the complications (principally of the Respiratory Organs) arising therefrom have been so numerous as to suggest that it is more fatal than Scarlet Fever. There were 27 deaths from Measles and its complications in 1893, against 43 last year. In the opinion of many Medical Officers of Health, Measles should be reported under the Public Health (London) Act, 1891, in the place of Erysipelas. Diphtheria and Membranous Croup. I regret to report 35 there has been a very considerable increase in the number of cases of Diphtheria, not only in the Greenwich District, but over the whole of the Metropolis. Last year there were 43 cases only reported, and 9 deaths. This year 170 cases and 51 deaths. The greatest number (36) occurred in October, and the smallest (4) in February. It is difficult to state the cause of so large an increase. The subject is receiving marked attention from scientific men. It is strange that whilst formerly it was more prevalent in the rural districts, now it appears to affect the urban most. Dampness and stagnant water appear to be "the chief causes, and it is largely spread by means of School influence. In the Greenwich District most of the cases were confined to young children of school age. Some years ago this disease used to be confined to the eastern part of the Parish, especially in the Marsh district, but this year it has visited every part. I believe that, owing to the highly infectious character of this disease, it is largely spread in Schools, and an example of that kind occurred quite recently, in which a large number of cases were traced to a particular School in the district, and it was not till the School was closed that the number of cases diminished. The following extract is taken from the Registrar-General's Annual Summary:— "The deaths attributed to Diphtheria numbered 3,265, and were in the proportion of 0.76 per 1000 living, this being by far the highest rate yet recorded, and exceeding the average in the previous decennium by no less than 0.46 per 1000. The 36 mortality from this disease, which for several years has shown a tendency to increase, had been in the last four years, respectively, 0.33, 0.34, 0.46, and 0.76 per 1000. The deaths from Diphtheria and Croup, taken together, amounted in 1893 to 3,482, while the average number in the preceding decennium, corrected for increase of population, had not exceeded 1,861. Distribution of the London Hospital deaths to their appropriate sanitary areas, shows the East group of these areas to have suffered the highest Diphtheria mortality, viz., TOO per 100, the Central group coming next with a rate of 0.82, then the North and South groups with a rate of 0.73 in each case, and lastly the West group with a rate of 0.52." Whooping Cough. Reference to table No. 3 will show that 30 children died from this disease in the District, being a decrease of 1 over last year. Whooping Cough is a disease peculiar to young children, and it is difficult to suggest any particular Sanitary measures which, in the absence of isolation, would tend to lessen its spread. Infantile Diarrhœa. There were 40 deaths from this disease, being an increase of 10 over last year. Seven of these were registered as Choleric Diarrhœa, but, upon enquiry of the Medical Attendants it was found that the deaths were from Infantile Diarrhœa. This disease is accelerated by bad feeding and it is most fatal during the hot weather, and more especially so during the period of Dentition. Small Pox.—On February 1st, I had occasion to report that five cases of Small Pox had occurred in the District, two of which were sailors who had come from the Docks to be treated at the Seamen's Hospital. 37 The other three cases occurred in Blackwall Lane, and were the means of spreading the disease to the surrounding streets. Mrs.—, who was vaccinated in infancy, appears to have taken the disease first, and had such a mild attack that she did not recognize it, and went about her work as usual. In a short time two of her young children (who were unvaccinated) took it, and it was not till they were far advanced in confluent Small Pox that she sent for a doctor. These cases were at once removed to Hospital, and one of them died the next day. In a short time 75 cases were reported as occurring in the streets adjoining Blackwall Lane, principally amongst children attending the Board School in that locality, many of which could be traced to the Blackwall Lane cases. I at once communicated with the Medical Officer to the London School Board, and during the Easter holidays the School was fumigated by the disinfector. I also notified every case to the Board of Guardians through their Vaccination Officer, and also examined many of the school children to see if they had been vaccinated during infancy. In one School alone I found 34 children, and in another 27, without any visible mark of Vaccination. It was found that, in the majority of cases, the unvaccinated child first contracted the disease, and then brought it home and infected the other members of the family, many of whom had been vaccinated. These latter cases were of a mild type. 38 The necessary Sanitary precautions were observed in every case by Inspection, Disinfection, Destruction of Bed, Bedding, &c., and the serving of Notices to abate Nuisances. Under the Public Health (London) Act, 1891, the following diseases are scheduled :— Scarlet Fever, Diphtheria, Membranous Croup, Small Pox, Cholera, Erysipelas, and Puerperal, Typhus, Enteric, and Relapsing Fevers. Under this Act it is compulsory for the Medical Attendant and the householder (in which the case occurs) to notify to the Medical Officer of Health of the District immediately upon the outbreak of any of the above diseases. Reference to Table No. 8 will show the number of cases reported during the year. GENERAL REMARKS. The following houses (23 in all) have been either closed or demolished during the year, owing to their being unfit for human habitation:— 6, 7, and 8, Woods Wharf; 59 and 61, Church Street; Closed. 12, Stockwell Street; 2, 4, 6, 8,10,12,14 & 16, Cold Bath Street; 73, 75, 77, and 79, Church Street; Demolished. 61, 63, and 65, Marlborough Street; 6, Stockwell Street; Oak House, East Street. Under Section 60, Sub-section 39 4, of the Public Health Act, 1891:—"The Sanitary Authority shall provide, free of charge, temporary shelter or house accommodation, with any necessary attendants, for the members of any family, in which any dangerous infectious disease has appeared, who have been compelled to leave their dwellings for the purpose of enabling such dwellings to be disinfected by the Sanitary Authority." The above house was purchased by the Board for the use of the Greenwich District (which includes the Parish of Deptford), and a caretaker was engaged to take charge. The house has been partly furnished, and during the year was inhabited by three families from Greenwich. One of the families occupied the house for two nights, and the others for one night only. No case has been admitted from Deptford. The number of deaths of infants under one year was 290 = to 4.8 per 1,000. One hundred and eight deaths of persons aged 80 and upwards were registered during the year, being an increase of 18 as compared with that of last year. During the year I visited the Slaughter-houses and Cow-sheds, and found them in a satisfactory condition. The Bakehouses were also inspected, and those that were in an unsanitary condition reported to the Board. I have much pleasure in stating that your Sanitary Inspectors 40 (Messrs. Wilson and Fisher), have been of great assistance to me. They have discharged their onerous duties with zeal, intelligence, and success. The appointment of a Sanitary Inspector to carry out the duties in connection with the Notification of Infectious Disease under the Public Health (London) Act, 1891, has been of much service, and I have pleasure in stating that Mr. Bache has conducted the work to my entire satisfaction. In conclusion, I desire to thank the Members of the Board for their uniform courtesy, and their willingness at all times to assist me by adopting any suggestions that I have made tending to improve the Sanitary condition of the District. I have the honour to remain, Gentlemen, Yours faithfully, CHARLES HENRY HARTT, Medical Officer of Health. TABLEo. 1. BIRTHS. DEATHS. AGES AT TIME OF DEATH. CAUSES. 1893. M. F. Total. M. F. Total. 0 to 1 1 to 5 5 to 10 10 to 30 30 to 80 80 and upwards. Fever. Measles. Whooping Cough. Small Pox. Diarrhœa Dysentery. Fever. Phthisis. Heart andChest Diseases,beside Phthisis. Intestinal Affections. Brain Disease. Convulsions. Childbirth and Puerperal Fever. Old Age. Diphtheria Influenza. All other Diseases. Inquests. Total. January 82 67 149 60 62 122 20 12 3 9 64 14 1 2 ... ... ... 1 15 47 2 6 2 ... 20 2 1 15 8 122 February 78 80 158 56 64 120 20 17 2 9 63 9 ... ... 2 ... 1 ... 15 34 4 10 2 1 13 1 1 24 12 120 March 94 77 171 57 73 130 19 15 3 9 63 21 ... 1 3 ... 3 ... 14 37 2 5 2 2 15 3 4 29 10 130 First Quarter 254 224 478 173 199 372 59 44 8 27 190 44 1 3 5 ... 4 1 44 118 8 21 6 3 48 6 6 68 30 372 April 59 50 109 59 36 95 19 13 5 7 48 3 ... 5 3 ... 1 ... 11 32 6 3 3 ... 5 5 3 13 5 95 May 86 87 173 57 39 96 13 14 ... 14 52 3 ... 1 ... ... ... ... 14 21 2 6 3 ... 7 2 3 29 8 96 June 77 79 156 77 50 127 28 11 4 15 65 4 1 7 1 1 6 1 20 25 7 9 ... ... 11 1 ... 25 12 127 Second Quarter 222 216 438 193 125 318 60 38 9 36 165 10 1 13 4 1 7 1 45 78 15 18 6 ... 23 8 6 67 25 318 July 62 81 143 76 52 128 38 10 5 9 59 7 ... 5 ... ... 8 3 7 14 3 20 1 ... 11 2 ... 42 12 128 August 75 68 143 57 64 121 26 13 6 13 55 8 ... 1 5 1 6 3 10 13 4 8 2 4 16 2 1 36 9 121 September 94 87 181 74 68 142 33 22 10 15 55 7 1 1 9 ... 12 4 17 16 5 5 5 4 18 7 ... 29 9 142 Third Quarter 231 236 467 207 184 391 97 45 21 37 169 22 1 7 14 1 26 10 34 43 12 33 8 8 45 11 1 107 30 391 October 74 71 145 60 54 114 25 11 7 9 56 6 2 ... 4 ... ... 1 6 29 8 8 6 2 11 5 ... 24 8 114 November 84 65 149 51 47 98 21 10 4 7 50 6 1 ... 1 ... 2 2 6 36 3 6 3 2 10 6 ... 17 3 98 December 65 78 143 106 108 214 24 25 3 22 121 19 1 4 2 ... ... 1 16 81 3 12 ... 2 15 3 15 42 17 214 Fourth Quarter 223 214 437 217 209 426 70 46 14 38 227 31 4 4 7 ... 2 4 28 146 14 26 9 6 36 14 15 83 28 426 Deaths that have occurred in the outlying Institutions during the year 1893 ... ... ... 42 37 79 4 17 9 16 32 1 6 ... ... 7 1 1 11 11 1 15 ... ... 1 12 ... 8 5 79 TOTAL 930 890 1820 832 754 1586 290 190 61 154 783 108 13 27 30 9 40 17 162 396 50 113 29 17 153 51 28 333 118 1586 D Table No. 2, Districts. Population. Deaths. Death-rate per 1,000, including Hospitals and Schools and Greenwich Union and Infirmary. Death-rate per 1,000, excluding Hospitals and Schools and Greenwich Union and Infirmary. Zymotic Death-rate. Infantile Mortality. Birth-rate. Greenwich, East 32,106 510 ,, West 22,007 465 ,, Workhouse 1,068 398 „ Infirmary 528 Royal Naval College 199 Greenwich Hospital 26.4 16.2 3.1 4.8 30.3 Schools 1,081 Seamen's Hospital 255 115 Miller Hospital 19 Outlying Institutions 79 Estimated Increase of Population since 1891 2,713 4.8 30.3 Total 59,957 1,586 26.4 16.2 3.1 Table No. 3. ZYMOTIC DISEASES. 1893. Scarlet Fever. Measles. Whooping Cough Small Pox. Diarrhoea and Dysentery. Enteric Fever. Diphtheria. Total. January 1 2 ... ... ... 1 2 6 February ... ... 2 ... 1 ... 1 4 March ... 1 3 ... 3 ... 3 10 APril ... 5 3 ... 1 ... 5 14 May ... 1 ... ... ... ... 2 3 June 1 7 1 1 6 1 1 18 July 5 ... ... 8 3 2 18 August ... 1 5 1 6 3 2 18 September 1 1 9 ... 12 4 7 34 October 2 4 ... ... 1 5 12 November 1 ... 1 ... 2 2 6 12 December 1 4 2 ... ... 1 3 11 Outlying Districts 6 ... ... 7 1 1 12 27 Total 13 27 30 9 40 17 51 187 Zymotic Death-rate 3.1 per 1,000. Table No. 4. 1893. Births. Deaths. January 149 122 February 158 120 March 171 130 April 109 95 Births 1820 May 173 96 Deaths 1586 June 156 127 Excess of Births 234 July 143 1820 128 1586 August 143 121 Birth Rate 30.3 per 1,000. September 181 142 October 145 114 November 149 98 December 143 214 Out-lying Institutions ... 79 Table No. 5. Death Rate per 1,000, excluding Hospitals and Schools= 16.2. 1884 1885 1886 1887 1888 1889 1890 1891 1892 1893 17.6 17.6 16.7 16.6 16.6 14.2 16.6 15.9 14.2 16.2 Table No. 6. ZYMOTIC DEATH RATE = 3.1. 1884.5 1885.6 1886.7 1887.8 1888.9 1889.90 1890 1891 1892 1893 3.0 3.0 2.3 2.7 1.6 3.0 2.7 2.0 2.3 3.1 E Table No. 7. LONDON. Population; and Births and Deaths in Registration Districts during the 52 Weeks of 1B93. REGISTRATION DISTRICTS. En time rated POPULATION, 1891. Total Births in 52 Weeks. Total Deaths in 52 Weeks. The Deaths registered in 52 Weeks include Deaths of Deaths from Inquest Cases. Deaths in Public Institutions. Uncertified Causes of Death. Infants under 1Year of Age. Persons aged 60 years and upwards. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric (or Typhoid) Fever. Simple continued Fever. Diarrhoea. Cholera. Violence. LONDON. 4211743 132975 91536 21845 21815 206 1661 1596 3265 2330 5 693 21 3446 133 3425 7432 24598 794 West DistRicts 740735 19919 14866 3277 3974 5 102 223 366 366 ... 110 8 543 21 579 1153 4401 64 North Districts 993884 29591 20391 4665 4995 11 385 437 1043 553 1 181 3 694 23 699 1486 5082 43 Central Districts 247538 6953 6154 1323 1294 ... 170 35 192 136 ... 61 1 181 2 333 636 2178 21 East Districts 705114 26285 17555 4615 3808 1 371 188 519 368 1 133 1 826 34 723 2140 5243 20 South Districts 1524472 50227 30862 7930 7275 15 633 538 1139 904 3 206 8 1191 53 1075 1998 5986 646 Metropolitan Hospitals and Asylums outside Registration London ... ... 1708 35 469 174 ... 175 6 ... ... 2 ... 11 ... 16 19 1708 ... West Districts. la. Paddington 117846 3010 2279 460 651 ... 30 10 63 61 ... 23 ... 61 ... 122 190 592 ... 1b Kensington 166308 3671 3221 602 1051 3 20 12 38 66 ... 12 ... 100 5 76 203 1026 4 2. Fulham 188878 6677 3887 1125 864 1 14 180 157 131 ... 30 2, 209 10 142 322 838 10 3. Chelsea 96253 2854 2127 497 490 1 25 8 27 67 ... 9 2 83 2 64 139 714 7 4. St. Geo., Hanover Sqnare 134131 2854 2774 471 754 ... 7 12 75 30 ... 33 3 76 4 149 253 1128 24 5. Westminster 37312 853 578 122 164 ... 6 1 6 11 ... 3 1 14 26 46 103 19 North Districts. 6. Marylebone 142404 4379 2650 649 677 ... 33 33 66 77 ... 11 1 77 4 84 194 493 6 7. Hampetead 68416 1507 1452 166 294 1 3 132 248 6 ... 40 23 ... 32 55 698 6 8. Pancras 234379 7044 5209 1197 1218 ... 151 47 164 105 ... 25 ... 167 7 240 429 1571 20 9. Islington 319143 9750 6315 1588 1582 10 137 63 133 201 1 37 1 259 5 185 458 1166 10 10. Hackney 229542 6911 4765 1065 1224 ... 61 162 335 167 ... 68 1 168 7 158 350 1154 1 Table No. 7.—(continued). REGISTRATION DISTRICTS. Enumerated POPULATION, 1891. Total Births in 52 Weeks. Total Deaths in 52 Weeks. The Deaths registered in the 52 Weeks include Deaths of Deaths from Inquest Cases. Deaths in Public Institutions. Uncertified Causes of Death. Infants under 1 Year of Age. Persons aged 60 years and upwards. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric (or Typhoid) Fever. Simple continued Fever. Diarrhœa. Cholera. Violence. Central Districts. 11. St. Giles 39782 1094 709 128 212 ... 6 2 3 17 ... 5 ... 23 1 21 59 177 1 12. Strand 27516 492 957 143 203 .... 2 4 26 11 ... 10 ... 10 ... 76 129 568 3 13. Holborn 141920 4740 3096 926 599 ... 147 22 100 96 ... 22 ... 132 1 100 254 590 8 14. London City 38820 627 1392 126 280 ... 15 7 63 12 ... 24 1 16 ... 136 194 843 9 East Districts. 15. Shoreditch 124009 4450 3195 807 839 ... 129 19 106 78 ... 8 1 167 3 83 259 862 1 16. Bethnal Green 129132 4756 3031 812 640 ... 80 36 83 57 ... 10 ... 144 5 91 285 722 2 17. Whitechapel 74402 3096 2686 560 416 1 42 13 86 30 ... 45 ... 62 9 219 414 1600 2 18. St.Geo.-in-the-East 45795 1966 1151 366 248 ... 30 5 16 20 ... 2 ... 77 1 36 182 303 3 19. Stepney 57376 1953 1396 491 182 ... 23 19 52 65 ... 17 ... 76 1 66 198 320 3 20. Mile End Old Town 107592 4146 2169 596 568 ... 35 27 50 43 ... 16 ... 116 7 53 244 384 9 21. Poplar 166748 5918 3927 983 915 ... 32 69 126 75 1 35 ... 184 8 175 558 1052 ... South Districts. 22. St. Saviour, Southwark 202693 7294 4074 1293 772 ... 67 52 96 214 ... 15 ... 207 12 124 326 359 103 23. St. Olave, Southwark 136660 4983 3461 836 659 5 47 28 112 79 1 22 ... 103 5 179 309 940 87 24. Lambeth 275203 9222 6165 1415 1523 ... 115 130 358 147 2 58 4 203 7 236 377 1698 111 25. Wandsworth 307500 9794 5090 1473 1257 ... 125 47 155 193 ... 28 1 231 12 168 363 467 38 26. Camberwell 235344 7472 5024 1192 1356 2 88 26 90 110 ... 23 ... 191 7 97 235 1203 108 27. Greenwich including Deptford 165413 5377 3691 881 854 5 108 214 212 101 ... 41 1 140 8 145 209 912 86 28. Lewisham 94335 2477 1383 311 418 2 20 9 55 12 ... 10 1 39 1 49 65 152 36 29. Woolwich 107324 3648 1974 529 436 1 63 32 61 48 ... 9 1 77 1 77 114 255 77 Metropolitan Hospitals and Asylums outside Registration London. ... ... 1708 35 469 174 ... 175 6 ... ... 2 ... 11 ... 16 19 1708 ... Table No. 8. INFECTIOUS DISEASES REPORTED UNDER THE PUBLIC HEALTH (LONDON) ACT, 1891. 1893. Scarlet Fever. Enteric Fever. Erysipelas. Diphtheria. Croup. Small Pox. Relapsing Fever. Continued Fever. Puerperal Fever. Typhus Fever. Total. January 26 3 10 6 1 5 ... ... ... ... 51 February 19 ... 7 4 ... 7 ... ... ... ... 37 March 25 ... 11 6 1 22 ... ... 2 ... 67 April 19 ... 3 5 3 49 ... ... ... ... 79 May 11 1 9 6 1 8 ... 1 ... ... 37 June 19 5 9 7 ... 10 ... ... ... ... 50 July 26 3 12 8 ... 5 ... ... ... ... 54 August 24 7 10 13 2 ... ... ... 1 ... 57 September 33 5 11 23 2 ... ... ... 2 ... 76 October 47 4 25 36 1 2 ... ... ... ... 115 November 35 6 16 30 1 4 ... ... ... ... 92 December 18 5 17 26 1 10 ... 1 1 ... 79 Total 302 39 140 170 13 122 ... 2 6 ... 794 Table No. 9. Cases of Infectious Disease notified to the several Metropolitan Medical Officers of Health, under the provisions of the Public Health (London) Act, 1891, in the Fifty-two Weeks ended Saturday, 30th December, 1893. Name of District. Small Pox. Scarlet Fever. Diphtheria Enteric Eever. Typhus Fever. Other Continued Fevers Puerperal Fever. Erysipelas. Croup. Cholera. Totals. Population in 1891. Greenwich (including Deptford) 190 1503 479 118 ... 5 22 368 23 ... 2708 165,417 Battersea 124 1504 650 131 3 9 20 454 37 1 2933 150,458 Bermondsey 56 577 209 50 1 1 5 192 24 ... 1115 84,688 Bethnal Green 89 1519 723 140 ... 4 18 435 44 4 2976 129,134 Camberwell 142 1883 500 142 ... 5 24 440 24 8 3168 235,312 Chelsea 46 603 236 80 ... 1 5 220 8 1 1200 96,272 Clerkenwell 16 774 337 71 ... 8 1 240 30 3 1450 65,885 Fulham 31 721 240 61 1 6 18 167 19 5 1269 91,640 Hackney 67 2568 932 369 ... 7 18 522 43 5 4531 229,681 Hammersmith 18 687 278 68 ... 4 18 195 6 1 1275 97,237 Hampstead 14 540 164 36 ... 3 5 80 5 ... 847 68,425 Holborn 35 329 105 41 1 ... 2 103 3 . . . 619 33,248 Islington 130 3083 904 270 1 8 41 717 32 1 5187 319,433 Kensington 96 957 368 102 1 8 9 285 15 2 1843 166,308 Lambeth 106 2276 803 160 3 63 27 591 57 30 4116 275,202 Lewisham 26 571 202 45 ... ... 9 189 6 ... 1048 65,112 Limehouse 84 721 237 115 3 1 6 189 11 ... 1367 57,599 Mile End 116 1203 352 151 1 ... 6 280 9 ... 2118 107,565 Newington 76 1134 472 68 ... 1 6 295 27 2 2081 115,663 Paddington 72 823 291 71 1 5 18 247 9 ... 1537 117,838 Plumstead 60 769 217 43 ... 3 10 132 21 ... 1255 95,699 Poplar 226 1911 1111 396 1 37 10 588 46 ... 4326 166,697 Rotherhithe 92 306 102 28 ... 3 5 83 6 ... 625 39,074 Shoreditch 33 1062 511 121 1 4 10 334 33 5 2114 124,009 St. George-in-the-East 52 519 250 47 ... 1 8 124 6 1 1008 45,546 St. George, Hanover Sq. 24 630 122 72 ... 2 3 87 7 2 949 78,362 St. George-the-Martyr 86 605 183 43 2 2 3 157 12 1 3094 59,712 St. Giles, Bloomsbury 77 252 81 33 ... ... 3 107 6 ... 559 39,778 St. James, Westminster 56 126 49 22 ... 3 3 35 ... ... 294 24,993 St. Luke, Middlesex 17 379 160 32 ... 1 2 180 13 ... 784 42,411 St. Martin-in-the-Fields 11 102 24 6 ... ... ... 9 2 ... 154 14,574 St. Marylebone 186 948 393 99 2 3 11 403 19 2 2066 142,381 St. Olave, Southwark 12 124 35 6 ... ... 3 34 1 ... 215 12,694 St. Pancras 127 2679 790 184 ... 3 26 706 22 5 4542 234,437 St. Saviour, Southwark Strand 20 33 219 140 87 78 . 21 13 1 56 23 4 2 408 289 27,162 25,201 Wandsworth 34 1290 410 115 ... 6 19 406 34 2 2316 156,931 Westminster 49 428 85 45 ... ... 5 91 2 2 707 55,760 Whitechapel 103 863 215 65 1 ... 9 232 7 ... 1495 74,462 Woolwich 63 258 26 29 ... 2 4 49 1 2 434 40,848 City of London ... 27 331 70 28 1 1 79 3 2 542 38,345 Port of London... 11 2 ... 20 ... ... ... 2 ... 35 2933 37919 13451 3757 24 210 413 10126 679 87 69599 * * Two cases of " Relapsing Fever" were notified in London, viz. I each in Holborn and Mile End. Table No. 10. SHEWING THE NUMBER OF ARTICLES AND ROOMS DISINFECTED IN CONNECTION WITH THE UNDERMENTIONED DISEASES, from 25th MARCH, 1893, to 25th MARCH, 1894. Infections Diseases. Number of Cases. N umber of Beds Disinfected. Pillows Disinfect'd Bolsters Disinfect'd Palliasses Disinfect'd Mattresses Disinfect'd Odd Articles Disinfected. Number of Rooms Disinfected. Total Premises. Scarlet Fever 285 193 394 141 123 110 1417 246 219 Enteric Fever 35 17 38 18 8 7 121 19 17 Typhoid Fever 21 17 34 12 7 9 89 20 20 Small Pox 106 96 160 55 65 22 720 118 87 Erysipelas 148 2 5 3 2 ... 13 3 2 Diphtheria 192 81 162 58 50 40 604 159 134 Membranous Croup 11 3 2 1 1 1 9 11 11 Puerperal Fever 7 4 4 2 3 1 11 4 4 Continued Fever 2 ... ... ... ... ... ... 1 1 Total 807 413 799 290 259 190 2984 581 495 ARTHUR E. BACHE, Sanitary Inspector. Table No. 11. SHEWING THE NUMBER OF ARTICLES DESTROYED IN CONNECTION WITH THE UNDERMENTIONED DISEASES, PROM 25th MARCH, 1893, TO 25th MARCH, 1894. Infectious Disease. Number of Palliasses destroyed. Beds destroyed. Mattresses destroyed. Pillows destroyed. Bolsters destroyed. Cushions destroyed. Blankets destroyed. Odd Articles destroyed. Scarlet Fever 30 20 6 6 3 12 2 3 Enteric Fever 5 1 2 1 ... ... ... 2 Typhoid Fever 4 3 ... 2 1 1 ... ... Small Pox 18 17 ... 2 2 1 ... ... Erysipelas ... ... ... ... ... ... ... ... Diphtheria 13 11 1 5 2 3 ... 1 Membranous Croup ... ... ... ... ... ... ... ... Puerperal Fever 1 ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... Total 71 52 9 16 8 17 2 6 ARTHUR E. BACHE, Sanitary Inspector. Table No. 12 HOUSES INSPECTED AND INQUIRIES MADE IN CONNECTION WITH INFECTIOUS DISEASES, FROM MARCH 25th, 1893, TO MARCH 25th, 1894. Number of houses inspected and inquiries made 820 „ re-visits 3,283 Total 4,103 On April 1st, 3rd, and 4th, 1893, 23 rooms and 2 staircases at the Marsh Lane Board School were disinfected during the Small Pox Epidemic. May 23rd and 26th, 1893, 142 blankets belonging to the East Greenwich Congregational Mission were disinfected after the Small Pox Epidemic. October 16th, 1893, a number of premises visited by inmates of Greenwich Union during the outbreak of Infective Diarrhoea were disinfected. 69 rooms have been cleansed, after disinfection, by the Board's men. ARTHUR E. BACHE, Sanitary Inspector. Table No. 13. HOUSES INSPECTED, FROM 25th MARCH, 1893, TO 25th MARCH, 1894. East District. West District. Total. Number of Houses Inspected 940 988 1,928 Re-inspections, Calls made, &c. 3,917 5,171 9,088 Visits to Slaughter-houses 6 12 18 „ Cow-houses 8 ... 8 „ Bake-houses 25 71 96 „ Stables and Yards 17 62 79 ,, Factories and Workshops 28 14 42 „ Fields, Lanes, &c. 14 ... 14 ,, Piggeries 2 ... 2 „ Courts and Alleys ... 87 87 Total Inspections 4,957 6,405 11,362 N.B.—In addition, the various Fruiterers', Fishmongers', and Provision Dealers', and other places where food is prepared for human consumption, have been visited during the year. The following have been destroyed as unfit for food:— 1681bs of Pears. 561bs of Tomatoes 161bs of Cherries. CHARLES TURLE WILSON, Sanitary ROBERT FISHER, Inspectors. Table No, 14. IMPROVEMENTS EFFECTED. From 25th March, 1893 to 25th March, 1894. IMPROVEMENTS. East District. West District. Total. Drains Constructed 71 95 166 Interceptor, chamber, and air inlet 50 37 87 Re-constructed or repaired 275 318 593 Cleansed and disinfected 44 56 100 Surface drains constructed 296 80 376 Traps fixed 453 593 1046 Drains and soil pipes ventilated 111 89 200 Cesspools Abolished 1 4 5 Cleansed and disinfected 8 ... 8 Water Closets Closets erected 27 39 66 Pan, trap, and water supply provided 165 2 167 Pan and trap only furnished 260 329 589 Pan only furnished 12 125 137 Water supply apparatus furnished 181 374 555 Water supply renewod 59 166 225 Ash Pits Provided 96 181 277 Repaired 2 3 5 Pavings Paving of yards and areas re-laid 240 200 440 General Water Supply 'New receptacles provided 44 59 103 Repaired and covers adapted 116 228 344 Water snpply provided 10 18 28 Other Improvements Houses generally repaired 19 35 54 Houses cleansed and limewhited 82 176 258 [Ventilation improved 8 ... 8 Overcrowding abated 5 5 10 Illegal nse of underground rooms for sleeping discontinued 1 ... 1 Other Nuisances abated 173 367 540 Total Improvements 2809 3579 6388 Total Premises improved 647 607 1254 CHARLES TURLE WILSON, Sanitary Inspectors. ROBERT FISHER, 55 REPORT OF THE MEDICAL OFFICER OF HEALTH for DEPTFORD. To the Board of Works for the Greenwich District. Gentlemen, I have the honour to present to you my Eleventh Annual Report on the Vital Statistics and Sanitary Work for the 52 weeks ending December 30th, 1893. POPULATION. The population for Saint Paul's Parish, as enumerated at the Census in April, 1891, was 101,252, and Saint Nicholas, 6,828, the estimated population for the middle of the year 1893, arrived at on the basis of the 1891 Census, and in accordance with the plan suggested by the Registrar-General, is for Saint Paul, Deptford, 107,378, and the estimated population for Saint Nicholas, 7.078, making a total estimated population for the two Parishes of 114,456. BIRTHS. The number of Births registered during the year 1893 was 3,651 (1,871 males, and 1,780 females), being slightly in excess of the previous year, and equivalent to an annual rate of 310 per 56 1,000 persons living. There were 3,383 Births registered in the Parish of Saint Paul, and 268 in the Parish of Saint Nicholas. Table No. 1 gives a statement of the Births and Deaths in the two Parishes, and also shows the Deaths which occurred of inhabitants of such two Parishes at Institutions outside those Parishes. DEATHS. The number of Deaths registered in Saint Paul's Parish was 1,756, in Saint Nicholas Parish 147, in the Metropolitan Asylums Board's Hospital 312, and in the Outlying Institutions 413, making a total of 2,628, being equivalent to an annual rate of 22.9 per 1,000 persons living. The Death rate in the thirty-three great towns of England and Wales, during the year, averaged 21.6 per 1,000 persons living, whilst the Death rate for the Metropolis was 21.3 per 1,000. Full details will be found on Tabular Forms Nos. 1 and 2, and Table No. 3 gives the statistics of the Births and Deaths in the two Parishes during the year, showing the number ot Deaths which occurred at the Metropolitan Asylums Board's SouthEastern Hospital and the Outlying Institutions. Table No. 4 shows the Death rate in the two Parishes, from from 1884 to 1893, both inclusive, the period during which I have been Medical Officer of Health. This return excludes the Deaths which occurred in the South-Eastern Hospital and in the Outlying Institutions. BIRTHS AND DEATHS. The total number of Births registered during the year 57 ending December 31st, 1893, was 3,651 (1871 males and 1,780 females), being an excess of 1,748 of the deaths, excluding the South-Eastern Hospital and Outlying Public Institutions; the births being equivalent to an annual rate of 31.0 per 1,000 persons living, that of London being 30.9 per 1,000. There were 3,383 births registered in the Parish of Saint Paul, and 268 in the Parish of St. Nicholas, Deptford. Table No. 5 gives a comparative statement of the births and deaths in the two Parishes. INFANT MORTALITY. The deaths of young children always bear a high ratio to the total deaths; out of a total of 2,628 deaths registered during the year there were 638 infants under one year of age, being an increase over previous years. Infantile Mortality, measured by the proportions of deaths under one year of age to registered births, was equal to 172 per 1,000, as compared with 159 per 1,000 for the previous year. In the thirty-three large towns of England, the rate of Infantile Mortality last year averaged 181 per 1,000. MORTALITY AT GROUPS OF AGES. The 2,628 deaths last year, included 1,199 of children under five years of age, or nearly one half the total deaths. The deaths of 172 children occurred between the ages of 5 and 10; 231 of persons between 10 and 30 years; 713 were of persons aged between 30 and 70; and 312 were of persons aged upwards of 70. THE ZYMOTIC DISEASES. The number of deaths from Zymotic Diseases show a considerable increase over previous years. This year there were 58 registered in the two Parishes 356 deaths, as against 243 the previous year, and 184 for the year 1891. In the Metropolitan Asylums Board's Hospital 299 deaths were registered, where for the two preceding years they were respectively 266 and 192. The average Death Rate per 1,000 was 3.0 (that is excluding the deaths which occurred in the Hospital) as compared with 2.2 per 1,000 for the previous year, whilst the Zymotic Rate in the thirty-three great towns of England averaged 3.2, and in London 31. Measles, Whooping Cough, and Diarrhoea were, as usual, the principal causes of death in this class of disease; 70 were due to Measles, whereas in the two previous years they were respectively 54 and 23. Whooping Cough caused 64 deaths, and 63 the year before, whilst Diarrhoea showed a total of 66, as compared with 81 for the preceding year. There were during the past year 299 deaths in the Metropolitan Asylums Board's South-Eastem Hospital from Zymotic Diseases, as compared with 266 for the previous year. Scarlet Fever was the cause of 164 deaths during the year, and 160 the previous year. Measles, 5 deaths were registered, and 16 the year before. Diphtheria was greatly in excess this year, 114 deaths were recorded, as against 72 and 64 for the two previous years respectively. The number of deaths from Enteric Fever was 14, and 15 for the year before. Small Pox was the cause of 2 deaths only. A full detailed account of the deaths from Zymotic Diseases will be found in Tables Nos. 6 and 7, and a full account of the Infectious Diseases which have been notified in Deptford under 59 the Public Health (London) Act, 1891, will be found in Table No. 8, while Table No. 9 shows the cases notified to the several Metropolitan Medical Officers of Health during the year ending December 30th, 1893. Table No. 10 shows the deaths from all causes, and also from the principal Zymotic Diseases in the various Metropolitan Districts during the year 1893. Table No. 11 gives an analysis of the Vital and Mortal Statistics of the thirty-three great towns during the year 1893. Table No. 12 gives an analysis of Sickness and Mortality Statistics of London during the same period. Scarlet Fever was very prevalent during the year throughout the whole of the Metropolis, no less than 1,244 cases were reported in my District, as against 862 and 421 for the two previous years. Great difficulty was experienced at one time in obtaining admission to the Hospital; many were compelled to remain at their own homes until vacancies occurred, and in some instances cases of an urgent character, which I considered should have had priority, were passed over (although I had communicated with the Authorities), for others reported at a later date. We had recorded 39 deaths in the District, and 164 in the South-Eastern Metropolitan Asylums Board's Hospital; in the previous year 8 deaths were registered in the District and 160 in the Hospital. Diphtheria shows a considerable increase in the District, as, indeed, it does through the whole of the Metropolis. In my District as many as 329 cases were notified, as against 125 and 100 for the two previous years. The number of deaths was 59, and 60 114 deaths occurred in the Hospital; whilst the year before, 30 deaths were registered in the District, and 72 in the Hospital. Small Pox. Only one death was recorded in the District, and 2 in the Hospital, whilst 53 cases were reported under the Public Health (London) Act, 1891, against 9 for the previous year. Fever. This term includes Typhus, Typhoid or Enteric, Simple, Continued and ill-defined forms of Fever, to which only 10 deaths were referred to in the District during the year, and 14 deaths occurred in the Hospital, and 86 cases were reported under the Act. Cholera made its appearance during the months of August and September, at Hull and Grimsby, and was carried from thence to different places in Yorkshire Lancashire, Derbyshire, and Lincolnshire. In London, a number of suspicious cases were notified, but only 4 proved to be true Cholera, 1 in Westminster, 1 in Fulham, 1 in Lambeth, and 1 in Southwark. I am glad to say there were none in Deptford. All severe cases of Diarrhoea occurring among the sick poor were, by the courtesy of the District Poor Law Medical Officers, reported to me and carefully investigated. Measles. Seventy deaths were registered in the District during the year, as against 54 and 23 for the two preceding years; 5 deaths occurred in the Hospital. Whooping Cough was the cause of 64 deaths, and 63 the previous year. 61 Diarrhoea. During the year only 66 deaths were reported, as against 81 for the year before. Respiratory Diseases. Under this heading are included Bronchitis, Pneumonia, and Pleurisy, 487 deaths were referred to these diseases, and 168 deaths from Phthisis or Pulmonary Consumption, as against 179 and 187 for the two previous years. GENERAL REMARKS. During the past year the Sanitary work carried out has been very considerable, as shown by the Inspectors' Books. Particular attention has been paid to house drainage, which has required the closest supervision on the part of the Inspectors, who have, I am pleased to say, carried out their duties in a most conscientious manner. The work thus done is of a permanent character. Much, however, still remains to be done in this respect. An order was obtained from the Magistrate to close 15 houses in the District. The Mill Lane Area Scheme had the sanction of the Home Secretary, and I trust the time is not far distant now, when that most unsightly and insanitary part of the District will be swept away, and the 810 inhabitants housed in proper dwellings. The Cholera attracted a great deal of attention, and every arrangement was made in case it should appear amongst us. The question of disinfectants occupied the attention of the Sanitary Sub-Committee, and I presented a report thereon. The Slaughter-houses and Cow-sheds were all duly inspected, and such defects as existed were remedied. F 62 The Bakehouses have excited an immense deal of attention throughout the whole of the Metropolis, but I am glad to say no great fault can be found with those in my district. The workshops and factories have also been inspected, and many sanitary improvements have been carried out. It will be seen that the estimated population of the Parish of Saint Nicholas, which was estimated by me last year to be 8,108, is this year returned as only 7,078. The result of the 1891 Census showed that there was a decrease in the population of that Parish as compared with the Census of 1881. This decrease was caused, in a great measure, by the demolition of the houses in the Hughes' Fields area. During the year 1892 some of the vacant sites were built upon and the houses occupied, and from enquiries I made at that time, I was led to believe that the population had risen up to the number (8,108) I then estimated. I have, however, during the year 1893 gone very carefully into this question. It is impossible, when a Parish shows a decrease of population, and that decrease is known to have been caused by the removal of buildings, and in the course of time other buildings are erected to take the place of those houses which have been demolished, to estimate with any exactitude the present population; and, indeed, only the taking of a Census would furnish it. In the case of Saint Nicholas, Deptford, from the enquiries I have made, and the information received, I am convinced that the population for that Parish was estimated too highly for the year 1892; and I am of opinion the estimated population, as given for this year, is as near correct as it is possible under the circumstances to be ascertained. I draw attention to 63 this matter because it is well understood that with a larger population the Death rate is necessarily smaller. The Sanitary Sub-Committee has continued to meet fortnightly during the past year, and every case reported in the Sanitary Inspectors' books has been most carefully considered by them. Thus it will be seen that their labours have been of no small importance, and my personal thanks are due to them for the great interest they have taken in all sanitary matters and the support they have at all times accorded to me. Of the Sanitary Inspectors themselves, I am pleased to say they have always discharged their duties to my entire satisfaction, and I trust that our combined efforts will continue to merit the approval of the Board. I have the honour to remain, Gentlemen, Your obedient Servant, HENRY WILLIAM ROBERTS, Medical Officer of Health, Deptford. 1894. G TABLE No. 1. 1893. BIRTHS. DEATHS. AGES AT TIME OF DEATH. CAUSES. M. F. Total. M. F. Total. 0 to 1 1 to 5 5 to 10 10 to 30 30 to 7 0 70 and upwards. Small Pox. Diphtheria Membranous Croup. Erysipelas. scarlatina or Scarlet Fever. Typhoid or Enteric Fever Puerperal Fever. Measles. Whooping Cough. Influenza. Diarrhœa& Dysentery. Phthisis. Diseases of the Respiratory Organs. Heart Disease. Brain Disease. Intestinal Affections Convulsions. Parturition Old Age. All other Diseases. Inquests. Total. January 143 138 281 103 108 211 43 47 14 19 56 32 ... 8 ... 1 17 ... 1 8 13 ... ... 11 67 13 10 4 3 ... 10 45 7 211 February 147 150 297 73 92 165 40 44 8 7 47 19 ... 11 ... ... 14 1 ... 7 10 1 ... 7 37 12 9 4 10 1 8 33 6 165 March 158 178 336 115 98 213 50 58 22 15 47 20 1 13 ... ... 18 3 ... 11 8 10 1 12 52 10 12 4 9 ... 5 44 8 213 First Quarter 448 466 914 291 298 589 133 149 44 41 150 71 1 32 ... 1 49 4 1 26 31 11 1 30 156 35 31 12 22 1 23 122 21 589 April 179 145 324 95 95 190 49 49 15 16 43 18 ... 17 2 ... 15 2 ... 18 9 1 ... 17 31 6 8 2 8 4 8 43 11 190 May 135 116 251 75 70 145 39 38 7 14 34 13 ... 9 3 ... 11 1 ... 12 3 1 3 10 22 3 2 ... 12 ... 4 49 7 145 June 138 124 262 91 76 167 62 35 9 14 30 17 2 13 ... ... 17 1 ... 7 1 ... 15 7 21 10 8 ... 15 ... 9 41 6 167 Second Quarter 452 385 837 261 241 502 150 122 41 44 107 48 2 39 5 ... 43 4 ... 37 13 2 18 34 74 19 18 2 35 4 21 133 24 502 July 143 128 271 80 93 173 66 37 11 10 33 16 ... 12 ... ... 14 2 ... 4 4 1 25 7 9 12 13 ... 10 ... 5 53 8 173 August 141 146 287 75 68 143 42 32 6 9 43 11 ... 6 ... ... 14 1 ... 1 1 ... 17 10 20 15 11 2 12 ... 3 30 5 143 September 191 182 373 80 77 157 54 33 16 13 33 8 ... 21 1 ... 16 4 ... 1 2 1 23 7 11 4 5 6 8 2 3 42 7 157 Third Quarter 475 456 931 235 238 473 162 102 33 32 109 35 ... 39 1 ... 44 7 ... 6 7 2 65 24 40 31 29 8 30 2 11 125 20 473 October 144 134 278 75 72 147 35 41 6 12 47 6 ... 19 3 ... 17 ... ... ... ... ... 3 9 18 8 4 3 4 1 4 54 6 147 November 203 164 367 100 123 223 71 52 14 20 33 23 ... 22 ... ... 28 3 ... 2 2 1 2 12 62 11 8 4 12 1 7 46 11 223 December 149 175 324 128 153 281 61 68 13 18 93 28 ... 22 2 ... 22 5 ... 4 12 20 ... 15 89 12 ... ... 6 3 14 46 5 281 Fourth Quarter 496 473 969 303 348 651 167 161 33 50 173 57 ... 63 5 ... 67 8 ... 6 14 21 5 36 169 31 12 7 22 5 25 146 22 651 TOTAL 1871 1780 3651 1090 1125 2215 612 534 151 167 539 211 3 173 11 1 203 23 1 75 65 36 89 124 439 116 90 29 109 12 90 526 87 2215 Deaths of inhabitants of St. Paul, Deptford, at outlying Institutions ... ... ... 210 167 377 23 24 20 58 162 90 4 11 ... ... 2 3 2 1 ... 4 6 40 42 41 27 16 1 1 71 105 35 377 Deaths of inhabitants of St. Nicholas, Deptford, at outlying Institutions. ... ... ... 18 18 36 3 3 1 6 12 11 ... 1 ... ... ... 1 ... ... ... ... ... 4 6 5 8 ... ... ... 7 4 ... 36 GRAND TOTAL ... ... ... 1318 1310 2628 638 561 172 231 713 312 7 185 111 1 205 27 3 76 65 40 95 168 487 162 125 45 110 13 168 635 122 2628 Table No. 2. District. Population Census 1891. Estimated Population 1893. Deaths. Death-rate per 1,000, including S.E. Hospital. Death-rate per 1,ooo, including S.E. Hospital and outlying Institutions. Death-rate per 1,000, excluding S.E. Hospital and outlying Institutions. St. Paul, Deptford 101252 107378 1756 S.E. Hospital ... ... 312/2068 2445 19.0 22.1 16.0 Outlying Public Institutions ... ... 377 St. Nicholas 6828 7078 147 Outlying Public Institutions ... ... 36 183 ... 25.1 20.7 Total 108080 114456 2628 19.0 229 18.3 Table No. 3. 1893. Saint Paul. Saint Nicholas. Births. Deaths in St. Paul. Deaths in S.E. Hospital. Deaths in Outlying Institutions. Births. Deaths. Deaths in Outlying Institutions. January 261 168 25 27 20 18 3 February 278 130 26 33 19 9 2 March 319 166 32 41 17 15 1 April 294 150 32 29 30 8 0 May 227 111 22 24 24 12 3 June 245 130 27 39 17 10 2 July 253 144 22 31 18 7 3 August 271 117 19 35 16 7 2 September 340 110 33 23 33 14 6 October 248 116 22 25 30 9 7 November 344 179 25 26 23 19 4 December 303 235 27 44 21 19 3 Total 3383 1756 312 377 268 147 36 Table No. 4. 1884 1885 1886 1887 1888 1889 1890 1891 1892 1893 St. Paul 20.3 19.6 15.9 16.9 14.2 15.6 17.1 16.3 15.6 16.0 St. Nicholas 21.4 20.2 17.2 17.9 13.5 16.9 15.5 24.0 15.5 20.7 London 208 20.3 20.5 20.3 19.3 18.3 21.5 21.4 20.4 21.3 Table No. 5. Saint Paul. Saint Nicholas. Total. BIRTHS 3383 268 3651 DEATHS (excluding S.G. Hospital and outlying Institutions). 1756 147 1903 Excess of Births 1627 121 1748 Table No. 6. DEATHS FROM ZYMOTIC DISEASES IN THE TWO PARISHES, EXCLUDING DEATHS FROM ZYMOTIC DISEASES IN THE METROPOLITAN ASYLUM BOARD'S SOOTH-EASTERN HOSPITAL, DURING THE YEAR 1893. 1893. Scarlet Fever. Measles. Whooping Cough. Typhoid or Enteric Fever. Diphtheria. Diarrhoea. Small Pox. Cholera. Influenza. Erysipelas. Membranous Croup. January ... 8 13 1 2 ... ... ... ... 1 ... February ... 4 10 1 2 ... ... ... 1 ... ... March 4 11 8 1 2 1 ... ... 10 ... ... April 1 18 9 1 1 ... ... ... 1 ... 2 May ... 11 3 ... ... 3 ... ... 1 ... 3 June 4 7 ... ... 4 15 1 ... ... ... ... July 1 3 4 ... 6 25 ... ... 1 ... ... August 1 1 1 1 2 17 ... ... ... ... ... September 2 1 2 ... 7 ... ... ... 1 ... 1 October 6 ... ... ... 8 3 ... ... ... ... 8 November 15 2 2 2 11 2 ... ... ... ... December 5 4 12 3 14 ... ... ... 20 ... 2 39 70 64 10 59 66 1 ... 35 1 11 Total 356. Zymotic Death-rate per 1,000, 3.0. Zymotic Death-rate, for London generally, per 1,000, 3.1. H Table No. 7. DEATHS FROM ZYMOTIC DISEASES IN THE METROPOLITAN ASYLUMS BOARD'S SOUTH-EASTERN HOSPITAL, DURING THE YEAR 1893. Scarlet Fever. Measles. Typhoid or Enteric Fever. Diphtheria. Small Pox. Cholera. January 17 ... ... 6 ... ... February 14 3 ... 9 1 ... March 14 ... 2 11 ... .... April 14 ... 1 16 ... ... May 11 1 1 9 ... ... June 13 ... 1 9 1 ... July 13 1 2 6 ... ... August 13 ... ... 4 ... ... September 14 ... 4 14 ... ... October 11 ... ... 11 ... ... November 13 ... 1 11 ... ... December 17 ... 2 8 ... ... 164 5 14 114 2 ... Total 299. Table No.8. Shewing the Number of Cases of infectious Dissease Notified in Deptford, and in London,in 1893, Arranged in four-weekly periods. Date of Report. For Four Weeks ended DEPTFORD. Weeks of the Year. LONDON. Weeks of the Year. Date of Report. For Four Weeks ended Small-Pox. Scarlet Fever. Diphtheria. Enteric Fever. Typhus Fever. Other Continued Fever Puerperal Fever. Erysipelas. Membranous Croup. Cholera. Total. Small-Pox. Scarlet Fever. Diphtheria. Enteric Fever. Typhus Fever. Other Continued Fever Puerperal Fever. Erysipelas. Membranous Croup. Cholera. Total. January 1893 .. 63 15 4 .. .. 2 18 .. .. 102 1.4 86 1717 612 201 1 12 31 599 56 3 3318 1.4 January 1893 February ,, 2 36 11 2 .. .. .. 11 .. .. 62 5.8 159 1601 703 183 1 16 30 531 67 1 3292 5.8 February ,, March 29 ,, 7 30 13 1 .. .. .. 11 .. .. 62 9.12 256 1428 649 150 2 9 25 459 49 .. 3027 9.12 March 29 ,, April 26 ,, 12 27 16 6 .. .. 1 13 1 .. 76 13.16 421 1559 615 149 1 3 23 427 53 .. 3251 13.16 April 26 „ May 24 ,, 11 40 6 2 .. .. .. 7 2 .. 68 17.20 528 2149 867 183 2 11 19 579 54 3 4395 17.20 May 24 „ June 14 ,, 6 69 15 .. .. .. .. 10 .. .. 100 21.24 483 2799 966 194 3 14 27 648 40 3 5177 21.24 June 14 „ July 12 ,, 9 84 17 4 .. .. 1 19 .. .. 134 25.28 327 3772 1199 397 2 27 35 773 49 9 6590 25.28 July 12 „ August 9 ,, 1 104 41 1 .. .. 1 12 1 .. 161 29.32 173 3927 1119 313 4 15 34 807 33 7 6432 29.32 August 9 „ September 5 ,, .. 73 12 5 .. .. 2 7 .. .. 99 33.36 107 3502 1153 336 .. 16 27 869 32 23 6065 33.36 September 5 ,, October 3 ,, .. 152 40 15 .. .. .. 31 1 .. 239 37.40 82 4966 1645 362 3 20 27 1163 53 33 8354 37.40 October 3 „ November 1 ,, 1 271 70 9 .. 1 2 39 4 .. 397 41.44 90 4811 1530 374 1 24 57 1245 55 5 8192 41.44 November 1,, N ovember 28 ,, 1 159 30 16 .. .. 2 16 3 .. 227 45.48 130 3473 1325 555 4 21 30 1105 80 .. 6723 45.48 November 28 „ December 31 ,, 3 136 43 19 .. 1 3 20 .. .. 225 49.52 91 2215 1068 360 .. 22 48 921 58 .. 4783 49.52 December 31 „ Totals 53 1244 329 84 .. 2 14 214 12 .. 1952 2933 37919 13451 3757 24 210 413 10126 679 87 69599 * Two.cases of Relapsing Fever were notified in addition. Table No. 9. Cases of Infectious Disease notified to the several Metropolitan Medical Officers of Health, under the provisions of the Public Health (London) Act, 1891, in the Fifty-two Weeks ended Saturday, 30th December, 1893. Name of District. Small Pox. Scarlet Fever. Diphtheria Enteric Eever. Typhus Fever. Other Continued Fevers Puerperal Fever. Erysipelas.. Croup. Cholera. Totals. Estimated Population in the middle of 1893. Battersea 124 1504 650 131 3 9 20 454 37 1 2933 160,633 Bermondsey 56 577 209 50 1 1 5 192 24 ... 1115 84,244 Bethnal Green 89 1519 723 140 .... 4 18 435 44 4 2976 129,625 Camberwell 142 1883 500 142 .... 5 24 440 24 8 3168 246,837 Chelsea 46 603 236 80 .... 1 5 220 8 1 1200 98,114 Clerkenwell 16 774 307 71 .... 3 1 240 30 3 1450 65,163 Fulham 31 721 240 61 1 6 18 167 19 5 1269 103,075 *Greenwich 190 1503 479 118 .... 5 22 368 23 2708 173,349 Hackney 67 2568 932 369 .... 7 18 522 43 5 4531 240,177 Hammersmith 18 687 278 68 .... 4 18 195 6 1 1275 103,674 Hampstead 14 540 164 36 .... 3 5 80 5 .... 847 73,949 Holborn 35 329 105 41 1 .... 2 103 3 .... 619 32,646 Islington 130 3083 904 270 l 8 41 717 32 1 5187 328,608 Kensington 96 957 368 102 1 8 9 27 285 15 2 1843 167,038 Lambeth 106 2276 803 160 3 63 591 57 30 4116 280,567 Lewisham 26 571 202 45 .... .... 9 189 6 .... 1048 76,593 Limehouse 84 721 237 115 3 1 6 189 11 .... 1367 57,386 Mile End Old Town 116 1199 356 152 .... .... 6 280 9 .... 2118 108,006 Newington 76 1134 472 68 .... 1 6 295 27 2 2081 117,430 Paddington 72 823 291 71 1 5 18 247 9 .... 1537 120,277 Plumstead 60 769 217 43 .... 3 10 132 21 .... 1255 94,192 Poplar 226 1911 1111 396 1 37 10 588 46 .... 4326 168,876 Rotherhithe 92 306 102 28 .... 3 5 83 6 .... 625 39,764 Shoreditch 33 1062 511 121 1 4 10 334 33 5 2114 123,425 St. George-in-the-East 52 519 250 47 .... 1 8 124 6 1 1008 45,182 St. George, Hanover Sq. 24 630 122 72 .... 2 3 87 7 2 949 75,825 St. George-the-Martyr 86 605 183 43 2 2 3 157 12 1 3094 59,952 St. Giles, Bloomsbary 77 252 81 33 .... .... 3 107 6 .... 559 88,611 St. James, Westminster St. Luke, Middlesex 56 126 49 22 .... 3 3 35 .... .... 294 23,873 17 379 160 32 .... 1 2 180 13 .... 784 41,406 St. Martin-in-the-Fields 11 102 24 6 .... .... .... 9 2 .... 154 13,911 St. Marylebone 186 948 393 99 2 3 11 403 19 2 2066 139,546 St. Olave, Southwark 12 124 35 6 .... .... 3 34 1 .... 215 12,861 St. Pancras 127 2679 790 184 .... 3 26 706 22 5 4542 243,025 St. Saviour, Southwark 20 219 87 21 .... .... 1 56 4 1 .... 408 26,823 Strand 33 140 78 13 .... .... .... 23 2 .... 289 23,508 Wandsworth 34 1290 410 115 .... 6 19 406 34 2 2316 169,379 Westminster 49 428 85 45 .... .... 5 91 2 2 707 54,761 Whitechapel 103 863 215 65 1 .... 9 232 7 .... 1495 75,163 Woolwich 63 258 26 29 .... 2 4 49 1 2 431 41,794 City of London 27 331 70 28 1 1 .... 79 3 2 542 35,383 Port of London 11 2 .... 20 .... .... .... 2 .... .... 35 2933 37915 13455 3758 23 210 413 10126 679 87 69599 * This refers to the whole of the District, and includes the Parish of Greenwich as well as the Parishes of St. Paul and St. Nicholas, Deptford. Table No. 10. Shewing Deaths from all causes, and also from the principal Zymotic Diseases, in the various Metropolitan Districts during the year 1893. Name of District. Total Deaths from all causes. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus. Enteric Fever. Simple and undefined Fever Diarrhoea. Deaths of Infants under one year of age. Deaths under one year to 1,000 Births registered. Registration London 90060 186 1658 1587 3196 2327 5 675 21 3432 21746 164 Paddington 2141 4 30 33 70 60 ... 21 .... 57 451 150.5 Kensington 2942 10 21 52 83 65 ... 17 .... 100 620 162.75 Hammersmith 1872 3 4 36 53 50 ... 15 .... 83 474 160.75 Fulham 2024 2 12 33 64 82 ... 17 132 653 175.75 Chelsea 1966 1 23 32 52 68 ... 17 2 73 482 158 St. George, Hanover Sq. 1228 3 2 25 34 14 .. 12 2 26 199 134 Westminster 1290 ... 5 25 14 15 ... 7 1 43 255 18925 St. James, Westminster 474 1 4 2 14 8 ... 6 1 7 77 1485 Marylebone 3192 5 32 68 94 78 ... 20 1 84 660 151.25 Hampstead 948 2 1 20 38 6 ... 8 1 22 154 102.25 St. Pancras 5138 9 104 100 201 106 ... 27 ... 164 1118 172.5 Islington 6405 2 129 96 200 197 1 47 1 259 1603 165 Hackney 4832 4 57 74 206 167 ... 53 1 164 1049 152.5 St. Giles, Bloomsbury 925 4 6 14 22 18 ... 6 ... 23 143 134.5 St. Martin-in-the-Fields 298 2 1 2 8 2 ... 1 ... 5 42 187.25 Strand 713 1 2 19 22 11 ... 1 ... 12 130 218.5 Holborn 886 1 18 12 22 16 ... 13 ... 27 185 218.25 Clerkenwell 1745 79 30 76 51 ... 10 ... 73 425 200 .25 St. Luke, Middlesex 1282 1 58 28 46 40 ... 12 ... 47 308 174.25 City of London 844 3 11 8 11 4 ... ... 1 10 84 132.5 Shorediteh 3153 3 129 39 137 80 ... 16 1 161 791 180.5 Bethnal Green 3257 7 83 71 136 60 ... 25 ... 145 844 175.5 Whitechapel 1916 5 37 32 61 26 .... 8 .... 66 52.0 171 St. George-in-the-East 1403 1 30 14 62 23 ... 4 ... 85 410 209.75 Stepney 1576 8 23 35 61 64 1 18 ... 61 401 208.5 Mile End Old Town 2430 8 39 40 80 47 ... 29 ... 113 619 150.25 Poplar 3905 12 32 105 168 74 1 62 ... 185 1003 171.75 St. Saviour, Southwark 649 6 18 17 20 ... 3 ... 18 120 153.5 St. George, Southwark 1700 7 35 42 45 74 ... 13 ... 63 385 204.5 Newington 2856 6 34 51 93 109 ... 13 ... 126 763 177.25 St. Olave, Southwark 312 1 1 6 5 3 2 9 58 144 .25 Bermondsey 2004 4 36 30 80 46 1 8 ... 70 537 168.5 Rotherhithe 927 13 10 16 31 33 ... 8 ... 25 227 167 Lambeth 5749 5 113 69 185 151 1 36 4 197 1371 161.5 Battersea 2980 12 93 40 170 114 ... 22 ... 122 878 170 Wandsworth 2617 1 36 53 113 81 ... 18 1 119 650 141.25 Camberwell 4311 10 54 62 149 120 ... 23 l 146 1061 158 *Greenwich 3510 13 103 68 147 100 ... 28 l 143 887 164.75 Lewisham 1133 5 19 11 53 8 ... 9 l 29 244 129.75 Woolwich 842 4 14 16 8 20 ... 5 l 33 208 159.75 Plu instead 1547 2 53 48 85 32 ... 11 ... 54 394 137.75 * This refers to the whole of the District, and includes the Parish of Greenwich as well as the Parishes of Saint Paul and Saint Nicholas, Deptford. Table No. 11.—Analysis of the Vital and Mortal Statistics of Thirty-three of the Largest English Towns during the Year 1893 Towns. Estimated Population middle of '93. Births. Deaths. Annual Rate per 1000 living. Deaths from Principal Zymotic Diseases. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fever. Diarrhœa. Deaths of Children under 1 year of age to 1,000 Births. Rate per cent, of Uncertified Death. Births. Deaths. Principal Zymotic Diseases. 33 Towns 10,327,846 328,342 222,178 31.9 21.6 3.2 32,797 732 4,559 3,015 4,423 4,977 2,493 12,598 181 1.8 32 Provincial Towns 6,021,435 195,377 130,642 32.5 21.8 3.3 19,574 526 2,898 1,419 1,158 2,647 1,774 9,152 193 2.4 London 4,306,411 132,965 91,536 31.0 21.3 3.1 13,223 206 1,661 1,596 3,265 2,330 719 3,446 164 0.9 West Ham 227,405 8,083 4,288 35.6 18.9 3.4 768 55 36 80 95 154 68 280 170 4.5 Croydon 108,997 2,852 1,772 26.2 16.3 2.2 240 1 20 11 85 27 12 84 155 — Brighton 117,833 2,981 2,165 25.4 18.4 1.8 217 .. 13 12 33 56 15 88 169 2.7 Portsmouth 167,277 4,709 3,039 28.2 18.2 2.8 469 .. 113 33 29 37 52 205 164 0.8 Plymouth 86,781 2,590 1,839 29.9 21.2 2.8 240 .. 85 22 14 46 10 63 169 0.5 Bristol 225,028 6,814 4,249 30.4 18.9 1.7 371 17 25 35 49 77 25 143 141 1.6 Cardiff 142,435 5,121 2.796 36.1 19.7 3.3 469 .. 100 39 98 40 27 165 179 1.0 Swansea 93,816 3,285 1,836 35.1 19.6 1.8 172 .. 17 33 5 30 19 68 170 2.0 Wolverhampton 84,298 2,902 1,956 34.5 23.3 2.8 239 1 21 26 5 4 28 154 208 1.0 Birmingham 487,891 15,916 10,693 32.7 22.0 3.0 1,481 71 50 68 63 320 98 811 198 4.9 Norwich 101,184 3,210 2.003 30.9 19.3 3.1 317 .. 61 20 23 66 37 110 195 1.1 Leicester 184,547 6,006 3,683 32.6 20.0 4.0 727 15 52 80 20 113 46 401 220 3.7 Nottingham 220,551 6,642 4,061 30.2 18.5 2.6 577 4 25 81 15 59 69 324 170 1.7 Derby 97,341 3,123 1,771 32.2 18.2 2.1 201 7 17 14 7 44 22 90 156 0.8 Birkenhead 103,817 3,431 2,127 33.1 20.5 2.8 292 1 15 12 16 69 27 152 196 1.1 Liverpool 510,514 18,322 13,919 36.0 27.3 3.9 1,987 9 273 231 63 279 269 863 211 3.7 Bolton 117,278 3,874 2,821 33.1 24.1 4.7 544 7 166 34 12 77 36 212 199 0.8 Manchester 515,598 17,268 12,801 33.6 24.9 3.7 1,911 48 296 138 165 241 129 894 203 1.3 Salford 203,431 7,047 4,886 34.7 24.1 4.1 839 22 92 41 58 99 100 427 210 3.3 Oldham 136,469 3,896 2,860 28.6 21.0 2.5 338 65 29 16 18 55 26 129 187 1.1 Burnley 93,462 3,161 2,039 33.9 21.9 3.8 354 6 27 51 14 34 28 194 223 1.4 Blackburn 124,005 3,822 2,879 30.9 23.3 4.1 504 7 144 5 2 33 30 283 241 3.4 Preston 110,225 3,855 2,899 35.1 26.4 6.0 661 .. 179 27 14 47 51 343 269 3.8 Huddersfield 97,549 2,313 1,673 23.8 17.2 1.2 121 .. 23 25 3 13 12 45 141 2.9 Halifax 91,918 2,253 1,591 24.6 17.4 1.7 157 35 5 3 23 32 13 46 173 4.3 Bradford 221,611 6,132 4,632 27.7 21.0 3.4 757 115 69 70 23 110 49 321 197 1.5 Leeds 382,093 12,349 8,493 32.4 22.3 3.5 1,322 20 341 31 62 166 110 592 206 1.0 Sheffield 333,922 11,591 7,428 34.8 22.3 3.5 1,172 5 176 90 61 128 90 622 191 3.0 Hull 208,709 7,125 4,545 34.2 21.8 4.1 862 8 128 33 22 80 99 492 206 3.3 Sunderland 134,515 4,771 3,022 35.6 22.5 3.4 451 5 17 26 11 24 131 237 188 0.9 Gateshead 90,938 3,309 1,750 36.5 19.3 3.5 314 2 71 9 19 53 21 139 170 2.5 Newcastle-on-Tyne 196,997 6,624 4,126 33.7 21.0 2.5 500 .. 212 23 31 34 25 175 174 0.9 Table No. 12. ANALYSIS OF SICKNESS AND MORTALITY STATISTICS OF LONDON DURING 1893. Sanitary Areas. Estimated Population in the middle of 1893. notified Cases of infectious disease deaths from principal Infectious Diseases. Deaths from all causes Death Rate per 1000 living. Deaths of Infants under one year to 1000 Births. Small Pox. Scarlet Fever. Diphtheria.† Typhus Fever. Enteric Fever. Other Continued Fevers. Puerperal Fever. Erysipelas. Cholera. Total. Annual Rate per 1000 persons living. Small Pox. Measles. Scarlet Fever. Diphtheria.‡ Whooping Cough. Typhus Fever. Enteric Fever. OtherContinued Fevers. Diarrhœa. Total. Annual Rate per 1000 persons living. LONDON 4,306,411 2813 36,901 13,694 22 3663 205 397 9700 86 67.4 15.7 186 1658 1587 3196 2327 5 675 21 3436 13,091 3.0 90,060 20.9 164 West District Paddington 120,421 68 778 289 1 5 18 240 140 12.2 4 30 33 70 60 .. 21 .. 57 275 2.3 2141 17.8 150 Kensington 167,029 102 943 373 1 97 11 9 273 2 181 10.8 10 21 52 83 65 .. 17 .. 100 348 2.1 2942 17.6 169 Hammersmith 103,044 17 665 279 .. 67 .. 18 183 1 123 12.0 3 4 36 53 50 .. 15 2 83 246 2.4 1872 18.2 160 Fulham 104,735 30 706 251 1 59 5 18 156 5 123 11.8 2 12 33 64 82 .. 17 .. 132 342 3.3 2024 19.3 176 Chelsea 98.182 43 589 236 .. 76 1 5 206 1 115 11.8 1 23 32 52 68 .. 17 2 73 268 2.7 1955 19.9 158 St. George, Hanover Square 76,043 23 591 123 .. 68 2 3 82 2 89 11.8 3 2 25 34 14 .. 12 2 26 118 1.6 1228 16.1 133 Westminster 54,829 47 420 83 .. 41 .. 5 84 2 68 12.4 5 25 14 15 .. 7 1 43 110 2.0 1290 23.5 188 St. James, Westminster 24,000 52 113 46 .. 22 3 3 33 27 11.3 1 4 2 14 8 .. 6 1 7 43 1.8 474 19.8 146 North Districts. Marylebone 139,726 179 913 401 2 94 3 10 379 2 198 14.2 5 32 68 94 78 .. 20 1 84 382 2.7 3192 22.8 151 Hampstead 73,380 14 516 166 .. 35 3 5 78 81 11.1 2 1 20 38 6 .. 8 .. 22 97 1.3 948 12.9 102 St. Pancras 233,936 120 2589 784 .. 169 3 24 656 5 435 18.6 9 154 100 201 106 .. 27 .. 164 761 3.3 5138 22.0 172 Islington 327,919 122 2989 901 1 263 7 40 702 1 502 15.3 2 129 94 200 197 1 47 1 259 930 2.8 6405 19.5 164 Hackney 240,584 65 2505 965 .. 363 7 18 499 4 442 18.4 4 57 74 206 165 .. 53 1 164 724 3.0 4532 18.8 152 Central Districts. St. Giles 38,641 73 238 78 .. 32 .. 2 98 52 13.5 4 6 14 22 18 .. 6 .. 23 93 2.4 925 23.9 131 St. Martin-in-the-Fields 14,034 11 102 27 .. 6 .. .. 9 15 11.1 2 1 2 8 2 .. 1 .. 5 21 1.5 298 21.2 188 Strand 23,788 32 140 76 .. 11 .. .. 22 28 11.8 1 2 19 22 11 .. 1 .. 12 68 2.9 713 30.0 219 Holborn 32,690 30 311 98 1 41 .. 2 95 51 17.7 1 18 12 22 16 .. 13 .. 27 109 3.3 886 27.1 214 Clerkenwell 65,589 17 731 304 .. 68 8 1 229 3 136 20.8 .. 79 30 76 51 .. 10 .. 73 319 4.9 1745 26.6 202 St. Luke 41,577 16 361 155 .. 32 1 2 168 73 17.7 1 58 28 46 40 .. 12 .. 47 232 5.6 1282 30.8 174 City of London 35,870 27 299 68 1 27 1 .. 76 3 50 14.0 3 11 8 11 4 .. 1 10 48 1.3 843 23.5 132 East Districts. Shoreditch 123,440 28 1008 514 1 117 4 10 317 4 200 16.2 3 129 39 137 80 .. 16 1 161 566 4.6 3153 25.5 178 Bethnal Green 129,620 79 1488 746 .. 138 4 18 426 4 290 22.4 7 83 71 136 60 .. 25 .. 145 527 4.1 3257 25.1 177 Whitechapel 75,178 99 811 208 1 62 .. 9 216 140 18.7 5 37 32 61 26 .. 8 .. 66 235 3.1 1916 25.5 168 St. George-in-the-East 45,493 53 485 240 .. 44 1 5 112 1 94 20.7 1 32 14 62 23 .. 4 .. 85 221 4.9 1403 30.8 209 Limehouse 57,115 80 710 240 3 115 1 6 186 134 23.5 8 21 35 61 64 1 18 .. 61 269 4.7 1613 28.2 205 Mile End Old Town 108,041 115 1179 352 .. 146 .. 5 282 207 19.2 8 39 40 80 44 .. 29 .. 121 361 3.3 2430 22.5 149 Poplar 169,141 217 1883 1149 1 390 36 10 566 1 25.1 12 32 105 168 74 1 62 .. 185 639 3.8 3905 23.1 169 South Districts. St. Saviour, Southwark 26,854 18 210 89 .. 91 .. 1 54 3??? 14.6 .. 6 18 17 20 .. 3 .. 18 82 3.1 649 24.2 154 St. George, Southwark 59,953 80 594 189 1 46 2 4 144 1 106 17.7 7 35 42 45 74 .. 13 .. 70 286 4.8 1700 28.4 206 Newington 117,672 64 1101 478 .. 66 1 6 284 1 200 17.0 6 34 51 93 109 .. 13 .. 126 432 3.7 2856 24.3 176 St. Olave, Southwark 12,903 11 117 32 .. 6 .. 1 36 20 15.7 1 1 6 7 3 .. 2 .. 9 29 2.2 312 24.2 141 Bermondsey 84,246 55 570 229 1 47 1 5 188 13.0 4 36 30 80 46 1 8 .. 70 275 3.3 2004 23.8 168 Rotherhithe 40,020 90 302 106 . 29 3 4 80 15.3 13 10 16 31 33 .. 8 .. 25 136 3.4 927 23.2 165 Lambeth 280,284 103 2247 829 3 159 59 27 581 30 403 14.4 5 113 69 185 151 1 36 4 197 761 2.7 5749 20.5 149 Battersea 158,105 116 1491 660 2 128 9 19 432 1 283 18.1 12 93 40 167 114 .. 22 .. 122 570 3.6 2980 18.9 169 Wandsworth 172,143 34 1291 453 1 118 5 20 380 2 230 13.4 1 36 53 113 81 .. 18 1 119 422 2.5 2617 15.2 142 Camberwell 245,143 143 1854 515 .. 141 5 23 436 8 312 12.8 11 83 73 130 109 .. 27 .. 186 619 2.5 4724 19.3 161 *GREENWICH 171,120 183 1469 491 .. 115 5 22 357 264 15.4 13 103 71 147 100 .. 28 1 143 606 3.5 3510 20.5 165 Lewisham (excluding Penge) 77,473 26 567 207 .. 45 .. 8 171 102 13.2 5 19 11 53 8 .. 9 1 29 135 1.7 1133 14.6 128 Woolwich 41,854 61 258 27 .. 28 2 1 50 2 42 10.2 4 14 16 8 20 .. 5 1 33 101 2.4 842 20.1 160 Plumstead 94,596 60 765 237 .. 44 3 10 132 125 13.2 2 53 48 85 32 .. 11 .. 54 285 3.0 1547 16.4 137 port of London ... 10 2 .. .. 20 .. .. 2 2 .. .. .. .. .. .. .. .. .. .. .. .. .. .. * This refers to the whole of the District. † luding 668 cases of Membranous Croup. ‡Including Deaths from Membranous Croup. K Table No. 13. METEOROLOGICAL TABLE FOB LONDON, 1893. (Deduced from Observations, at Greenwich, under the Superintendence of the Astronomer-Royal, and compiled from Quarterly Tables, furnished to the Registrar-General by fames Glaisher, Esq., F.R.S.) Jan., Feb., March. April, May, June. July, Aug., Sept. Oct., Nov., Dec. Temperature of Elastic Force of Vapour. Weight of Vapour in a Cubic Foot of Air. Degree of Humidity. Reading of Barometer. Weight of a Cubic Foot of Air. Rain. Reading of Thermometer on Grass. Air. Evaporation. Dew Point. Air— Daily Range. Number of Nights it was Lowest Reading at Night. Highest Reading at Night. | Mean. Diff. from Average of 122 Years. Diff. from Average of 52 Years. Mean. Diff. from Average of 52 Years. Mean. Diff. from Average of 62 Years. Mean. Diff. from Average of 52 Years. Mean. Diff. from Average of 52 Years. Mean. Diff. from Average of 52 Years. Mean (Satn. =100). Diff. from Average of 52 Years. Mean. Diff. from Average of 52 years. Mean. Diff. from Average of 52 Years. Amount. Diff. from Average of 78 years. At or below 30°. Between 30° and 40°. Above 40*. Winter Spring Summer Autumn 1893. º º º º º º º º º in. in. grs. gr. ins. in. grs. grs. Su ins. T1S. ins. Sums. º º YEAR 61.1 +2.5 + 1.9 47.1 +0.8 43.3 —0.2 17.8 +2.3 .290 —.004 3.3 —0.2 76 —7 29.815 +.•042 541 —1 2013 -4.98 79 154 132 13.9 58.1 Winter Qr. 40.9 +2.1 + 1.2 38.6 +0.8 35.8 +0.6 13.5 +1.8 .211 +.005 2.4 0.0 84 —1 29.797 + .025 552 0 4.60 —0.35 37 47 6 13.9 43.1 Spring do. 57.0 +4.7 +4.2 50.9 + 1.9 45.3 o.o 24.8 +4.8 .305 —.002 3.4 —0.1 65 —13 29.905 + .126 535 -3 1.47 —4.31 8 44 39 24.7 52.0 Summer do. 61.9 + 2.2 +1.8 56.7 +0.4 52.3 —0.7 20.6 +1.0 .395 —.009 4.4 —0.2 71 —7 29.764 -.029 628 -2 5.87 —1.44 1 16 75 29.0 58.1 Autumn do. 44.6 + 1.0 +0.4 42.3 —0.1 39.8 —0.7 12.4 +1.7 .248 —.009 2.8 —0.3 84 —6 29.794 +.045 547 0 8.19 + 1.12 33 47 12 17.1 55.0 In this Table + and — respectively signify that the number in the preceding column is above or below the average to the amount of the quantities to which these signs are affixed.