GRE 2 BOARD OF WORKS FOR THE GREENWICH DISTRICT. Annual Report FOR THE YEAR ENDING 25th MARCH, 1896. List of Members of the Board, and of the several Officers and Committees; Report of Proceedings of the Board; Reports of Medical Officers; Statement of Engineer; ,, Road Surveyor; ,, Contracts entered into; ,, Moneys received and expended during the Year; and ,, Arrears of Calls, and other Moneys and Liabilities of the said Board, on the 25th March, 1896. PRINTED BY ORDER OF THE BOARD. Greenwich. EDWARDG. BERRYMAN & SONS, Steam Works, Blackheath Road. Gre 2 Board of Works for the Greenwich District. List of the Members and Officers of the Board, JUNE, 1896. MEMBERS ELECTED BY THE VESTRY OF GREENWICH. name. address. Mr. FREDERICKC HARLES BINGHAM 12, South-street „ HENRY BRIDEL 3, Union Wharf „ GEORGE DAVIS Belle Vue House, Park-place ,, ALFRED H. GARLICK 14, Langdale-road „ JOSEPH HEATH 22, Ashburnham-road „ CHARLES JOHN HERYET 95, Blackheath-hill „ LEWIS INCLEDON 2, West Grove-terrace Rev. BROOKE LAMBERT, M.A., B.C.L.,Tho Vicarage Mr. GEORGE LEDGER 3, Myceuiu-villas, Mycenae-road „ EDGAR SYDNEY 9, The Circus „ GEORGE USHERWOOD St. Clere, Ulundi-road, Blackheath „ GEORGE CHARLES WHIBLEY 82, South-street „ FREDERICK GEORGE BANKS 40, Blackheath-road „ GEORGE H. E. BISHOP 66, Blackheath-hill Col. CHARLES CHAUNCY 91, Shooters-hill-road, Blackheath Mr. FREDERICK GEORGE COX 12, The Grove, Blackheath „ THOMAS PERCY EVANS 8, Halstow-road Capt. FRANCIS METCALFE OMMANNEY, R.N 24, St. John's-park, Blackheath Mr. WALTER RICHARDSON 60, Annandale-road „ BARON SMALLWOOD 134, Trafalgar-road „ JAMES SMITH 14, Donzil-terrace, Westcombe-hill „ WILLIAM STIMSON 6, Woodlands-road „ JOHN FRANCIS URE Fairlight Villa,Vanbrugli-park-rd. „ JAMES PECHELL WATTS 26, Burney-street ,, CHARLES HENRY ALLWORTH 57, London-street „ WILLIAM FOX BATLEY "Oakdene," Vaubrugh - park, Blackheath ,, WILLIAM CHARLES BIRT 38, Devonshire-road Dr. GEORGE HUGHES CABLE 1, Gloucester-place Mr. FRANCIS ROBERT DUTTON 46, Walnut Tree-road „ WILLIAM EMMANUEL FELTHAM...58, Royal-hill „ G. W. GIFFARD HOOPER 28, Park-place „ RICHARD S. JACKSON Stobcross Lodge, Crooms-hill „ DONALD McCALL 32, South-street ,, CHARLES NEWBERY 32, Annandale-road „ ALFRED JAMES RANDALL 23, Park-place „ HARRY BOLTON SEWELL 26, Crooms-hill MEMBERS ELECTED BY THE VESTRY OF ST. NICHOLAS, DEPTFORD. name. address. Mr. ARTHUR GOLDING Church-street „ WILLIAM CRASTER MOWBRAY 88, Evelyn-street „ THOMAS EDWARD ROBERTS 2, Wellington-street ,, JOHN DAVID URRY 198, Evelyn-street „ ALBERT AKAM 73, Creek-road „ JOHN TORRANCE 18, Mornington-road MEMBERS ELECTED BY THE VESTRY OF ST. PAUL, DEPTFORD (INCLUDING HATCHAM). name. address. Mr. ALEXANDER ANDERSON 9, Penmartin-road „ JOHN HENRY BULMER 8, Erlanger-road ,, JOHN DIXON 81, Breakspears-road „ JOSEPH FIELD 77, Amersham-road „ JOHN HAMLYN 50, Bousfield-road ,, BENJAMIN HILLS Regent-street „ DANIEL HINES 123, Breakspears-road ,, GEORGE KING 196, Queen's-road Sir SAMUEL S. LEWES 163, Lewisham High-road Mr. HENRY NUDING 16, Clifton-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 „ JOSEPH ALWIN 23, Ashmead Road „ HENRY BARE 30, Endwell-road „ GEORGE BARSON 88, Drakefell-road „ WILLIAM H. BECK 45, Tressillian-road „ JAMES N. BUTLER 12, Sharratt-street „ JOHN E. CHILD 130, Lewisham High-road „ HENRY G. DELATOUCHE 59, Erlanger-road „ WILLIAM B. EASTAWAY 76, Jerningham-road ,, DAVID HARDY 160, Queen's-road Rev. JOHN HODSON, LL.D 186, Lewisham High-road Mr. BENJAMIN J. JACOB 29, Pepys'-road „ HENRY KEYLOCK 39, Pepys'-road „ THOMAS MULLOCK 71, Etta-street „ FREDERICK J. OLDMAN 1, Ommanney-road „ WILLIAM PIERPOINT 71, Lewisham High-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 „ CHARLES CHILDS 27, Cranbrook-road „ GEORGE CLARIDGE 259, Queen's-road „ SAMUEL J. CLEGG 168, New Cross-road „ HOWARD DEIGHTON 15, Wickham-gardens „ CHARLES GALLEHAWK 72, Evelyn-street „ SAMUEL GILES 86, Tyrwhitt-road „ FREDERICK WILLIAM HALL 32, Czar-street „ CHARLES HENRY HEARN 3, St. James „ HORATIO KEMP 179, Queen's-road „ FREDERIC G. LANDON, M.A., F.R.A.S., J.P 59, Tressillian-road „ WILLIAM PEROU 111 Gosterwood-street „ SIDNEY SCHOLFIELD 7, Scawen-road, Deptford-park „ WILLIAM THOMAS SMITH 2, Ommanney-road „ FREDERICK STEER 69, Etta-street ,, CHARLES WATKINS 92, London-street, Greenwich ,, JAMES WILLIAMS 121, Grove-street OFFICERS OF THE BOARD. Clerk, Mr. JAMES SPENCER82, London-street, Greenwich Treasurer, „ ALEXANDER WILLIAM LAIDLAW London & County Bank, Churchstreet, Greenwich Medical Officer of Health for Greenwich, „ CHARLES HENRY HARTT 80, London-street, Greenwich Medical Officer of Health for Deptford, „ HENRY WILLIAM ROBERTS 166, Lewisham High-road Engineer and Surveyor , „ ERNEST J. HEWARD 52, Wickham-road, Brockley Road Surveyor, „ JAMES RICHARD HEWARD 52, Wickham-road, Brockley Public Analyst, „ ROBERT HENRY HARLAND Plough-court, 37, Lombard-street, E.C. Auditor, „ R. HUGH SLOLEY 3, King-street, Cheapside, E.C. Accountant, „ P. DUDLEY KEEN 6, Egerton-road, Greenwich Assistant Clerk, „ VIVIAN ORCHARD 124, Blackheath-hill, S.E. Assistant Engineer, „ THOMAS CORFIELD 31, Howson-road, Brockley. Sanitary Inspectors, Greenwich, „ CHARLES TURLE WILSON 37, Burney-street, Greenwich „ ROBERT FISHER 9, King William-street, Greenwich „ ARTHUR E. BACHE 15, Dornberg-road, Blackheath. Sanitary Inspectors, Deptford, „ THOMAS BORSBERY 2, Florence-road, Deptford „ THOMAS TURNER 19, Gellatly-road, Nunhead „ ROBERT D. J. SIMPSON 10, Rokeby-road, Brockley „ CHARLES WILLIAM NETTLETON 26, Rokeby-road, Brockley ,, ALFRED PRIEST 22, Batsford-road, St. John's „ PHILIP SHELLEY 33, Knoyle-street, Deptford Caretaker and Messenger, „ SAMUEL SOLE Offices of the Board, 141, Greeu- wich-road, Greenwich. COMMITTEES OF THE BOARD. A Committee for the Parish of Greenwich, consisting of the Members of the Board elected by the Vestry of Greenwich. A Committee for the Parish of St. Paul, Deptford, consisting of the Members of the Board elected by the Vestry of St Paul, Deptford. A Committee for the Parish of St. Nicholas, Deptford, consisting of the Members of the Board elected by the Vestry of St. Nicholas, Deptford. FINANCE COMMITTEE. Mr. FREDK. CHAS. BINGHAM Mr. SAMUEL GILES „ WILLIAM CHARLES BIRT „ JOHN HAMLYN „ G. W. GIFFARD HOOPER „ DANIEL HINES „ JAMES PECHELL WATTS „ HORATIO KEMP „ GEO. CHARLES WHIBLEY „ WM. RICHARD SMITH „ JOHN ANDERSON „ ARTHUR GOLDING „ WILLIAM H. BECK „ THOMAS E. ROBERTS „ HENRY G. DELATOUCHE „ JOHN DAVID URRY MR. FREDERIC GEORGE LANDON (Ex-Oficio). DISTRICT COMMITTEE. Mr. ALFRED H. GARLICK Mr. HENRY KEYLOCK „ G. W. GIFFARD HOOPER „ GEORGE KING „ LEWIS INCLEDON „ HENRY NUDING Capt. F. M. OMMANNEY, R.N „ GEORGE SIMMONDS Mr. JAMES PECHELL WATTS „ WM. RICHARD SMITH „ JOHN ANDERSON „ ARTHUR GOLDING „ SAMUEL GILES „ JOHN DAVID URRY 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. Fortieth Annual Report of the Board, FOR THE YEAR ENDING THE 25th MARCH, 1896, 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 for the year ending the 31st December, 1895, will be found in the accompanying Reports of the Medical Officers of Health. During the year, amongst other things, the Sanitary Inspectors inspected 5,887 houses. Notices to perform Sanitary works were served as hereunder detailed, viz.:—To provide proper and sufficient water supply and water supplying apparatus to and for water closets, 1,562; to provide proper and sufficient water 8 supply for domestic use, 326; to amend, repair and make good defective water fittings, 257; to abolish cisterns in unsuitable positions, 131; to provide proper and sufficient covers to cisterns, 228; to amend and repair defective covers to cisterns, 87; to cleanse foul and dirty cisterns, 112; to amend, repair and make good cisterns, 45; to open up, examine, amend, repair and reconstruct drains, 1,050; to clear, cleanse and purify drains, 293; to trap drains by fixing an interceptor with chamber and fresh air inlet, 63; to properly and sufficiently trap surface inlets to drains with gully traps, 1,715; to properly and sufficiently ventilate drains, 232; to construct proper and sufficient drains to carry off surface water from yards, 530; to construct proper and sufficient drains to carry off surface water from areas, 77; to construct proper and sufficient drains to stables, 18; to provide and fix soil pipes to water closets, 111; to remove soil pipes to positions outside water closets, 64; to amend and repair soil pipes, 23; to properly and sufficiently ventilate soil pipes, 232; to properly and sufficiently ventilate water closets, 43; to provide doors to water closets, 11; to provide proper and sufficient soil pans and traps to and for water closets, 1809; to amend and repair defective putty joints to water closets, 4; to amend and repair defective flush pipes to water closets, 113; to properly and sufficiently trap water closet pans, 10; to clear and cleanse foul and dirty water closet pans, 70; to amend and repair defective seats and risers of water closets, 32; to disconnect sink waste pipes from drains, 331 ; to disconnect rain-water stack pipes from drains, 382; to disconnect bath waste pipes from drains, 31; to disconnect lavatory waste pipes from drains, 21; to disconnect overflow pipes of cisterns from drains, 4; to provide and fix rain-water stack pipes, 23; to amend and repair defective rain-water stack pipes, 217; 9 to amend and repair defective waste pipes, 216; to provide and fix eaves guttering, 65; to amend and repair defective eaves guttering, 192; to amend and repair defective roofs, 217; to amend and repair defective flooring, 158; to amend and repair defective walls, 128; to amend and repair defective ceilings, 55; to amend and repair defective water closets, 157; to amend and repair defective ventilating pipes to drains, 22; to abolish water closets in unfit situations, and provide proper and sufficient water closets in lieu thereof, 125; to abate the nuisance caused by the dampness of walls, 282; to abate the nuisance caused by overcrowding, 52; to abate the nuisance caused by the keeping of animals, 83; to abate the nuisance caused by the issue of black smoke from chimney shafts, 22; to provide proper and sufficient ash-pits, 980; to amend and repair defective ash-pits, 287; to cleanse, limewash and purify premises throughout, 236; to amend, repair, cleanse, limewash and purify premises throughout, 335; to cleanse, limewash and purify rooms, 158 ; to cleanse, limewash and purify ceilings, 241 ; to cleanse, limewash and purify walls, 329; to cleanse, limewash and purify water closets, 153; to pave yards with a hard, durable and impervious material, 1,463; to pave forecourts with a hard, durable and impervious material, 258; to pave areas with a hard, durable and impervious material, 64; to pave stables with a hard, durable and impervious material, 30; to provide proper receptacles for dung, 72; to remove accumulations of filth and manure, 116; to discontinue depositing manure upon premises, 4; to discontinue using underground rooms as living rooms, 10; to cleanse, limewash and purify bakehouses, 146; to cleanse floors of bakehouses, 4; to abolish opening to drain in bakehouse, 1; to provide proper, suitable and sufficient accommodation in the way of sanitary conveniences for the use of 10 the workpeople employed in or in attendance at workshops and buildings, 37; to cleanse workshops, 4; to abate the nuisance caused by the overcrowding of workshops, 2; to close an underground workshop (in a cellar) which was unfit for occupation, 1; to make premises fit for human habitation, 67; to re-drain houses, 181; to abolish cesspools, 25; to cleanse and disinfect cesspools, 8; to provide means of ventilation to houses, 17; to provide means of ventilation to rooms, 307; to provide means of ventilation to underground floors, 46; and to provide water supply to urinals, 8. The above-mentioned notices were, in most cases, complied with, but proceedings were taken against the owners of fifty-nine houses (five in Greenwich and fifty-four in Deptford), for neglecting to execute such works and do such things as were necessary for the purpose of abating the nuisances arising upon the premises. Upon the hearing of the summonses in relation to eleven of these houses the Magistrate made orders, under the provisions of the Public Health (London) Act, 1891, prohibiting their use for human habitation, and the whole of these houses were accordingly closed. The proceedings in relation to twenty-one houses resulted in the Magistrate making orders for the abatement of the nuisances, and the necessary works were carried out in accordance with such orders, and the owners of the remaining twenty-seven houses, in consequence of the proceedings taken against them, executed the required works to each of such houses, to the satisfaction of the Sanitary Inspector making the complaint. Proceedings were also taken, under the Public Health (London) Act, 1891, against the occupier of a room over a stable in the Parish of Saint Paul, Deptford, and resulted in the 11 trate making an order prohibiting the use of such room for human habitation, and the room was closed accordingly. Proceedings were also taken against the occupiers of two factories or workshops in the Parish of Greenwich, for neglecting to provide sufficient sanitary conveniences for the use of the persons employed at such workshops, with the result that each of the two defendants complied with the Board's requirements. Proceedings were also taken against two persons for unlawfully removing or carrying by road through certain streets in the Parish of Saint Paul, Deptford, offensive or noxious matter not within the hours prescribed by the Bye-Laws made by the London County Council, under Section 16 of the Public Health (London) Act, 1891, and on the hearing of the summonses it being suggested that if the proceedings were adjourned the defendants would take care the offences were not repeated, the summonses were adjourned accordingly ; and at the termination of the period of adjournment, the defendants not having again offended, the summonses were withdrawn. Proceedings were also taken against a fishmonger and fish curer in the Parish of Greenwich, for carrying on a trade or business which caused effluvia, which was a nuisance, injurious or dangerous to the health of the inhabitants of the district, and he was fined £3, and 10s. 6d. costs. Proceedings were also taken against a firm in the Parish of Greenwich, for allowing a chimney at their works to send forth black smoke in such a quantity as to be a nuisance, and they were fined £2, and 2s. costs. Proceedings were also taken against a person in Deptford, for 12 keeping swine in a locality, premises, or place unfit for that purpose, and he was fined 3s., and 2s. costs, and the pigs were removed from such premises. During the year, 372 newly-erected houses in the district were inspected for the purpose of ascertaining if they were provided with a proper and sufficient supply of water, and such being found to be the case, the Sanitary Authority granted a certificate to that effect in respect of each of such houses. During the same period, 1,416 rooms and the following articles were disinfected after cases of infectious disease, namely: 1,021 beds, 1,904 pillows, 659 bolsters, 373 palliasses, 301 mattresses, 606 sheets, 787 blankets, and 4,801 odd articles, making 10,452 articles in all. It was found necessary during the same period to destroy 8 beds, 28 palliasses, 8 pillows, 8 mattresses, 4 bolsters, and 12 cushions, making, together, 68 articles which had become infected. 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 so used by eleven families. During the year, Mr. Phillip Shelley was appointed as an additional Sanitary Inspector for the Parish of Saint Paul, Deptford, at a salary of £125 per annum. In pursuance of resolutions passed by the Board, advertisements were inserted in the local newspapers, and bills issued, giving notice to tradesmen and others in the district that the throwing 13 or laying any dirt, litter, or ashes, or any carrion, fish, offal, or rubbish in any thoroughfare or uncovered place, and that depositing any refuse, or causing, or allowing any refuse produced upon premises to be deposited upon any footway, pavement, or carriage-way, were punishable offences, and that in future proceedings would be taken against any person committing any of such offences. A tricycle was obtained for the use of the Assistant Road Foreman when engaged upon his duties in the Parish of Greenwich, and one of the Sanitary Inspectors employed in that Parish was supplied with a bicycle to enable him to get about with more expedition and so carry out his duties with greater advantage. During the year, Mr. John Nidd Smith resigned his office of Engineer and Surveyor to the Board, and was granted a retiring allowance of £250 per annum. Mr. Thomas Boulton also retired from his office of Foreman of the Flushers employed in the Parishes of Deptford, and was granted an allowance of £75 per annum. An agreement was entered into with the Board of Works for the Lee District, giving that Board permission to connect the drains of Nos. 125, 127 and 129, Old Dover Road, and of the premises occupied by Mr. Garton, in the Shooters Hill Road, with this Board's sewer in the Old Dover Road, the Lee Board agreeing to pay to this Board, for such permission, annually the sum of 6d. in the pound upon the rateable value for the time being of such houses or other hereditaments so connected with this Board's sewer. During the year the Board made a Bye-law for regulating the 14 business and proceedings at its meetings, in the following terms:— "Any person not being a Member of the Board of Works for the Greenwich District, who shall be guilty of disorderly conduct, or who shall interfere with, or interrupt, the business or proceedings of the said Board, and who shall not withdraw when called upon by the Chairman to do so, shall be liable on summary conviction to a penalty not exceeding forty shillings," and such Bye-law having been confirmed, was submitted to, and approved by, one of Her Majesty's Principal Secretaries of State. The Board having considered a letter from the District Engineer of the London County Council, in which he stated that the Main Drainage Committee of the Council had instructed the Council's Engineer to consider and report as to the most suitable outlet that could be formed to act as a storm relief to the Southern Outfall at times of heavy rainfall, he (the Engineer) had come to the decision after carefully considering the matter, that a sewer ought to be constructed in Park Row, Greenwich, from the Outfall Sewer, Trafalgar Road, to the river Thames, which sewer he considered would, without doubt, act as a great relief to the Main Outlet Sewer at times of heavy rainfall or a disablement of the engines and pumps at Crossness; and further stated that before getting out working drawings, estimate, &c., the Engineer would be glad of the cooperation of this Board, not to the extent of a contribution towards the cost, but to assist in removing any local objections to the proposal; the Clerk was instructed to inform the London County Council that this Board had the gravest objection to such a proposal to discharge more sewage, coming from other parts of 15 London, into the Thames, at Greenwich, for the purpose of postponing the construction of an adequate sewer to take the sewage of the southern side of London to Crossness. During the year the Sanitary Inspectors collected, and the Public Analyst analysed 19G samples, consisting of the following articles:— Butter 79 Milk 60 Skim Milk 4 Mustard 20 Pepper 13 Coffee 7 Lard 3 Tea 2 Arrowroot 2 Sweet Spirits of Nitre 3 Flowers of Sulphur 2 Liquorice Powder 1 196 Proceedings were taken with respect to nine samples of Butter certified to be admixed with Margarine, and fines were inflicted amounting together to £15. Proceedings were also taken against the sellers of two samples of milk, one of which was certified to consist of milk, G5 parts, and skim milk, 35 parts, and the seller of this sample was fined £3; and the other to be milk admixed with 20 per cent. of added water, and the seller of this was fined £2. Proceedings were also taken with regard to a sample of coffee, which was certified to be admixed with 90 per cent. of chicory, and the seller was fined £6. 16 During the year there were 26 Ordinary and Special Meetings of the Board, and the undermentioned Committees and Sub-Committees held meetings as follows:— Finance Committee 23 Saint Paul, Deptford, Committee 25 Greenwich Committee 22 Saint Nicholas, Deptford, Committee 11 District Committee 8 Works and General Purposes Sub-Committee 33 Saint Paul, Deptford, Sanitary Sub-Committee 27 Greenwich Yard Sub-Committee 24 Greenwich Viewing Sub-Committee 4 Greenwich Quarterly Accounts Sub-Committee 4 Meeting of deputation appointed to wait upon the Main Drainage Committee of the London County Council, relative to nuisance arising from the Council's sewer in Waller Road, Deptford 1 Sub-Committee appointed to consider as to best means of promoting inter-communication between the North-West Ward and other parts of the Parish of Saint Paul, Deptford 3 Sub-Committee appointed to consider specification of proposed underground sanitary convenience at northern end of South Street, Greenwich 1 Sub-Committee appointed to consider the Schedule of Prices on which tenders were to be based for making entries into sewers, and jobbing works 1 Making a total of 213 meetings during the year. 17 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR GREENWICH. To the Greenwich District Board of Works. Gentlemen, I have the honour to present to you my Thirteenth Annual Report, for the 52 weeks ending December 28th, 1895. I have to report that 1,787 Births (897 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 1,497 (806 Males and 691 Females) equivalent to an annual rate of 23·9 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 12·6 excluding these Public Institutions, details of which appear in the tabulated form No. 2. The number of Deaths from the principal Zymotic Class was B 18 139, equivalent to an annual rate of 2·2 per 1,000 persons living, details of which appear in the tabulated form No. 3. The Births were 1,787, being 290 in excess of the number of Deaths, equivalent to an annual rate of 28·6 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 12 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 1895. 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 1895. Table No. 9 will show the number of cases of Infectious Disease and Deaths 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 1895. Table No. 10 will show the number of Articles and Rooms disinfected from March 25th, 1895, to March 25th, 1896. 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 inquiries in connection with Infectious Diseases, from March 25th, 1895, to March 25th, 1896. 19 Table No. 13 will show the work of Inspection from March 25th, 1895, to March 25th, 1896. Table No. 14 will show the Improvements effected during the same period. INFLUENZA. I regret to state that another severe and fatal epidemic of Influenza commenced in this district during the second week of February, 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 knowledge and from information given to me by the different medical practitioners in the town, it would appear to have been more prevalent, and certainly more fatal than in any of the recent epidemics. Reference to Table No. 1 will show the increase in the number of deaths from Diseases of the Respiratory and Circulatory Systems as well as those from Influenza during the height of the Epidemic. The following figures show the number of deaths that have been registered from Influenza in the Greenwich District since 1890:— 1890 4 1892 33 1894 11 1891 44 1893 28 1895 51 The following remarks upon Influenza are made by the Registrar-General in his Annual Report for 1895:— "The deaths referred to Influenza in the year 1895 were 2,156 in number, of which not fewer than 1,570 were registered between 20 the middle of February and the end of March. The deaths in London from diseases of the Respiratory Organs in 1895 were 790 below the average; this average, however, includes the excessive mortality from such diseases in 1890-93. The following table shows the registered deaths from Influenza for each of the last six years in the several sanitary areas of London:— DEATHS from INFLUENZA registered in the METROPOLITAN SANITARY AREAS in the Six Years 1890 to 1895. Sanitary Area. 1890. 1891. 1892. 1893. 1894. 1895. Paddington 45 67 79 64 30 106 Kensington 38 112 158 94 33 103 Hammersmith 11 34 57 28 11 48 Fulham 12 57 43 43 14 60 Chelsea 18 62 73 31 29 57 St. George, Hanover Square 33 48 79 25 18 60 St. Margaret & St. John, Westminster 8 21 19 20 11 20 St. James, Westminster 8 28 15 5 1 9 St. Marylebone 33 74 75 68 31 89 Hampstead 8 46 31 53 21 50 St. Pancras 36 153 137 58 42 98 Islington 42 189 181 128 51 156 Stoke Newington 8 19 27 7 7 22 Hackney 22 113 84 66 37 112 St.Giles 6 28 24 16 23 32 St. Martin-in-the-Fields 3 9 2 3 3 5 Strand 4 9 6 3 1 6 Holborn 2 16 15 11 6 18 Clerkenwell 11 30 33 34 15 22 St. Luke 7 15 13 11 3 5 City of London 15 21 27 17 4 17 Shoreditch 13 58 33 31 14 59 Bethnal Green 22 102 56 41 13 29 Whitechapel 4 49 52 33 13 16 St. George-in-the-East 6 19 20 17 11 14 Limehouse 3 17 22 18 3 10 Mile End Old Town 9 53 41 38 17 44 Poplar 9 77 42 35 16 35 St. Saviour 4 7 13 3 — 8 St. George-the-Martyr, Southwark 5 16 13 9 7 24 Newington 9 63 33 30 12 45 St. Olave 1 9 14 4 3 7 Bermondsey 2 39 40 17 9 28 Rotherhithe 1 24 29 9 6 10 Lambeth 50 135 140 85 47 143 Battersea 26 54 91 44 32 88 Wandsworth 34 70 91 57 37 121 Camberwell 34 133 124 82 40 137 Greenwich (including Deptford) 13 105 61 64 27 107 Lee 6 27 34 12 9 49 Lewisham (excluding Penge) 12 43 46 49 22 43 Woolwich 2 19 12 9 5 12 Plumstead 9 48 31 35 8 16 21 "In 12 of the 43 sanitary areas of the Metropolis the deaths referred to Influenza in 1895 exceeded those recorded in any of the five preceding years—Paddington, St. George-the-Martyr, Southwark, Wandsworth, and Lee showing the largest excess. Compared with the average in the five preceding years, 1890-94, the excess in 1895 was 3 per cent. in the East group of sanitary areas, 18 in the Central, 43 in the North, 47 in the West, and not less than 65 per cent. in the South. Among the sanitary areas in the last-mentioned group, the Influenza Deaths last year in St. George-the-Martyr (Southwark), Lambeth, Wandsworth, Camberwell, Greenwich, and Lee exceeded the numbers recorded in these districts respectively in any one of the preceding five years." CHOLERA. I am happy to state that during the year 1895 there was not a case of Cholera reported as having occurred in this district. 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 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 2.2 per 1,000 as against 2.5 of last year. Scarlet Fever. There were only six deaths registered from this Fever in the Parish of Greenwich, against 11 last year and 12 in 1893. 22 1893 417 Notified Cases 12 Deaths 1894 270 „ ,, 11 „ 1895 256 „ „ 6 „ Enteric or Typhoid Fever. Last year there were 68 cases of Enteric Fever reported, and 17 deaths. This year the number is only 38, the fatal cases being 7. Erysipelas shows a decrease of 31 cases compared with that of last year. 1893—140 cases. 1894—96. 1895—65. 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 25 deaths from Measles and its complications in 1895, against 38 last year. 1893—27. 1894—38. 1895—25. 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 state that there has been a considerable increase in the number of reported cases of Diphtheria in the Greenwich District, in common with other parts of London. Last year there were 139 cases notified, and 38 deaths. This year 215 cases, and 41 deaths. The greatest number of cases occurred during the last quarter of the year. The following extract is taken from the Registrar-General's Annual Summary :- "The deaths from Diphtheria amounted to 2,316, against 3,265 and 2,670 in the years 1893 and 1894 respectively. The diphtheria rate was equal to 0.53 per 1,000, against a decennial average rate of 0'38. The deaths in 1895 from diphtheria and croup, taken together, numbered 2,460. Although fewer by 376 than the number thus returned in 1894, these deaths were still 23 299 in excess of the average. The mortality from Diphtheria was considerably greater in the East group of sanitary areas than in any other, being equal to 0.81 per 1,000, the South group coming next with a rate of 0.51. The rates for the West, the Central, and the North groups were 0 48 and 0.40 respectively. "The following Table shews the deaths from Diphtheria for each of the last nine years in the several sanitary areas of London, after distribution of the deaths in public institutions:- DEATHS from DIPHTHERIA in the METROPOLITAN SANITARY AREAS in the Nine Years 1887 to 1895, after Distribution of Deaths occurring in Public Institutions. Sanitary Area. Enumerated Populatn. 1891. 1887 1888 1889 1890 1891 1892 1893 1894 1895 Paddington 117,846 29 76 42 40 24 28 70 93 47 Kensington 166,308 40 91 111 34 28 34 83 77 90 Hammersmith 97,239 44 38 45 49 73 73 53 50 44 Fulham 91,639 19 10 12 22 19 31 64 105 77 Chelsea 96,253 19 14 24 56 16 39 52 52 57 St. George, Hanover Sq 78,364 13 46 30 13 20 26 34 19 24 St. Margaret and St. John, Westminster 55,774 25 37 28 9 11 44 14 26 21 St. James, Westminster 24,995 3 5 2 3 7 6 14 15 4 St. Marylebone 142,404 14 23 34 27 26 48 94 72 35 Hampstead 68,416 13 16 8 21 13 27 38 20 14 St. Pancras 234,379 62 72 62 132 71 107 201 118 131 Islington 319,143 46 50 63 81 158 150 200 221 146 Stoke Newington 30,936 40 76 97 67 79 131 206 5 5 Hackpney 198,606 123 83 St. Giles 39,782 23 11 17 10 12 21 22 14 13 St. Martin-in-the-Fields 14,616 5 3 2 1 4 12 8 6 7 Strand 25,217 10 3 8 4 5 8 22 9 13 Holborn 33,264 9 5 17 18 9 17 22 20 7 Clerkenwell 66,216 17 26 24 19 28 28 76 34 34 St. Luke 42,440 12 10 13 16 12 14 46 15 20 City of London 38,320 5 11 12 11 13 24 11 6 8 Shoreditch 124,009 27 32 69 58 65 44 137 75 58 Bethnal Green 129,132 27 52 102 116 61 117 136 133 101 Whitechapel 74,462 6 24 34 51 54 59 61 46 58 St. George-in-the-East 45,795 15 15 43 30 19 33 62 51 50 Limehouse 57,376 14 25 47 28 16 25 61 51 45 Mile End Old Town 107,592 22 20 53 44 37 81 80 81 111 Poplar 166,748 30 42 64 70 55 78 168 108 152 St. Saviour 27,177 8 13 12 5 11 6 17 20 13 St. George-the-Martyr, Southwark 59,712 12 23 20 14 18 26 45 49 17 Newington 115,804 27 18 55 32 44 38 93 61 52 St. Olave 12,723 2 4 1 4 5 3 7 3 4 Bermondsey 84,682 16 14 23 19 16 20 80 66 29 Rotherhithe 39,255 6 8 16 8 4 11 31 31 31 Lambeth 275,203 105 107 156 76 78 130 184 141 112 Battersea 150,558 51 27 33 40 70 54 167 116 92 Wandsworth 156,942 65 44 22 36 65 114 80 46 Camberwell 235,344 65 64 70 51 47 78 130 192 179 GREENWICH inc. Dept'rd 165,413 37 34 30 47 46 52 147 132 184 Lee 36,103 8 5 5 5 3 6 20 21 11 Lewisham (exclud. Penge) 72,272 11 31 5 15 8 20 53 30 14 Woolwich 40,848 3 3 6 5 2 4 8 14 14 Plumstead 52,436 11 19 13 14 6 38 65 36 36 24 It is difficult to state the cause of so large an increase. The subject is receiving marked attention from all those who are engaged in Public Health work. The following table will show the number of notifications of Diphtheria that have been received by me since 1890, and also the number of deaths that have occurred from that disease during each year since:- Notified cases of Diphtheria. Deaths from Diphtheria. 1890 53 1890 26 1891 48 1891 21 1892 43 1892 9 1893 170 1893 51 1894 139 1894 38 1895 215 1895 41 In both England and London the mortality from Diphtheria was less in the decade 1871-80 than in 1861-70, but in the decade 1881-90 it was greater than in the second, and in London had increased to a higher ratio even than in the first decade. Comparing London to England in the first decade, the ratio of mortality was about 5 per cent. lower than that of England, in the second decade about equal, and in the third about 6 per cent. higher. It is strange that whilst formerly it was more prevalent in the rural districts, it now appears to affect the urban most. 25 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. Dr. Thorne Thorne (Medical Officer to the Local Government Board), in his Milroy Lectures on Diphtheria in 1891, showed that since 1871, whereas the annual death rates from all causes from the seven principal Zymotic diseases, and from Enteric Fever, have been steadily falling in England and Wales, in large towns, and in London, the annual death rates from Diphtheria have been rising, slightly in England and Wales, more markedly in the large towns, and most markedly in London. Whilst the mortality of Diphtheria is still steadily rising, that of Enteric Fever is equally steadily falling pari passu with improved sanitation, and the mortality of Scarlet Fever is also falling pari passu with increased hospital isolation; so that whereas the improvement of sanitation markedly decreases the mortality of Enteric Fever, it appears to have no effect on Diphtheria. To what cause may this increase of Diphtheria be due? Many have been suggested. 1. School influence. 2. Sewer ventilation and unsanitary conditions. 3. Alteration in classification (particularly with regard to membranous croup), now being classified with Diphtheria. 4. Connection with other throat affections. 26 School Influence. In 1870 the Elementary Education Act was passed for the establishment of School Boards and Elementary Schools. Now, whereas during the decade 1861-70 the number of deaths from Diphtheria decreased annually, during that of 1871-80 they increased annually. Dr. Thome Thome has so fully and so carefully entered into this subject of "School Influence" that his conclusion that increased school attendance has had a material influence in increasing the spread of Diphtheria is irresistible. Although I am of opinion that "School Influence" has been a potent cause of the spread of Diphtheria, I cannot charge "School Influence" with being the sole cause of the great increase that has occurred since the year 1893. I would rather suggest that the great increase is primarily due to one of those peculiar waves that come over us in the form of an epidemic, the cause of which is unknown at the present time. I have no doubt but that in the course of time much useful knowledge on the means of spread will be discovered both by the chemist and the bacteriologist. Whilst such men as Sir William Jenner and Dr. Wilkes on the one side believe that the disease is in the main independent of sanitary conditions or hygienic circumstances, and whilst Sir George Johnson is diametrically opposed to their particular views, it behoves us to look further afield for the cause. I am inclined to think that our main drainage is faulty. 27 The main drainage system was laid in 1863, and the engineer (the late Sir Joseph Bazalgette) made a statement at the time of its completion that it would last for 25 years, and at the end of that time (with the rapidly increasing population) it would be necessary to enquire closely whether it could not be capable of improvement. ANTITOXIC SERUM TREATMENT FOR DIPHTHERIA. It is gratifying to know that the mortality from Diphtheria is much lower since the use of the "Antitoxic Serum." The mortality from that disease has considerably diminished since its introduction and subsequent application. A very exhaustive report on the subject has recently been published by the Medical Superintendents of the Metropolitan Asylums Board's Hospitals, the summary of which I append:- "The improved results in the Diphtheria cases treated during the year 1895, which are indicated by the foregoing statistics and clinical observations, are- (i.) A great reduction in the mortality of cases brought under treatment on the first and second day of illness. (ii.) The lowering of the combined general mortality to a point below that of any former year. (iii.) The still more remarkable reduction in the mortality of the laryngeal cases. (iv.) The uniform improvement in the results of tracheotomy at each separate Hospital. (v.) The beneficial effect produced on the clinical course of the disease. 28 "A consideration of the foregoing statistical tables and clinical observations, covering a period of 12 months, and embracing a large number of cases, in our opinion sufficiently demonstrates the value of antitoxin in the treatment of Diphtheria. "It must be clearly understood, however, that to obtain the largest measure of success with antitoxin it is essential that the patient be brought under its influence at a comparatively early date—if possible, not later than the second day of disease. From this time onwards the chance of a successful issue will diminish in proportion to the length of time which has elapsed before the treatment is commenced. This, though doubtless true of other methods, is of still greater moment in the case of treatment by antitoxin. "Certain secondary effects not infrequently arise as a direct result of the injection of antitoxin in the form in which it has at present to be administered, and even assuming that the incidence of the normal complications of diphtheria is greater than can be accounted for by the increased number of recoveries, we have no hesitation in expressing the opinion that these drawbacks are insignificant when taken in conjunction with the lessened fatality which has been associated with the use of this remedy." Whooping Cough. Reference to Table No. 3 will show that 11 children died from this disease in the District, being a decrease of 22 under 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. 29 Diarrhcea. There were 45 deaths from this disease (including Infantile Diarrhcea), being an increase of 27 over last year. 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. Eight cases only of Small Pox were reported to me during 1895. I am happy to state that none of these proved fatal. I notified every case to the Board of Guardians through their Vaccination Officer. 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. 30 GENERAL REMARKS. Sewer Ventilators. During the past year I have received frequent complaints from all parts of the Parish respecting the smell that arises from the Sewer Ventilators. I have on each occasion forwarded these complaints to the Medical Officer of the London County Council. In order to abate the nuisance there should be more ventilators erected, and they should be carried up to a considerable height, instead of being at ground level. In one case this has been done, viz., in the Trafalgar Road, near Christ Church, with considerable benefit to that locality. The following houses have been either closed or demolished during the year, owing to their being unfit for human habitation: 1, 2, 3, 4, 5, 6 and 7, Marlborough Demolished. Cottages, Gibson Street Wick Cottage, Woolwich Road Workshop, 1a, Blissett Street Closed, with consent of Owners. Temporary School, London Street Oak House, East Street. Under Section 60, Sub-section 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 31 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 11 families—Deptford, 2; Greenwich, 9. The number of deaths of infants under one year during 1895 was 266= to 4.2 per 1,000. Last year, 1894, there were 229, and the death rate was equal to 3.7 per 1,000. One hundred and eighty-four deaths of persons aged 80 and upwards were registered during the year, being an increase of 95 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 (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 32 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. TABLE No. 1. 1895. 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 80 80 and upwards. Scarlatina. Measles. Whooping Cough. Diarrhœa & Dysentery. Fever. Phthisis. Heart and Chest Diseases, beside Phthisis. Intestinal Affections. Brain Disease. Convulsions Childbirth and Puerperal Fever. Old Age. Diphtheria. Influenza. All other Diseases. Inquests. Total. January 95 91 186 75 65 140 19 15 1 16 76 13 ... 5 ... 1 ... 12 35 3 15 5 1 19 2 1 32 9 140 February 72 52 124 76 67 143 16 14 ... 11 74 28 ... 1 ... ... ... 13 48 7 16 4 ... 16 2 8 18 10 143 March 63 84 147 90 63 153 18 15 4 7 63 46 ... 1 ... ... ... 15 54 2 6 1 ... 15 ... 35 17 7 153 First Quarter 230 227 457 241 195 436 53 44 5 34 213 87 ... 7 ... 1 ... 40 137 12 37 10 1 50 4 44 67 26 436 April 76 69 145 63 53 116 15 11 1 9 65 15 ... ... 1 ... ... 12 37 3 13 ... 1 11 ... 3 28 7 116 May 96 80 176 61 47 108 14 9 4 13 47 21 1 ... ... 3 ... 13 21 5 9 ... ... 13 1 2 36 4 108 June 57 63 120 39 43 82 14 6 4 5 28 25 1 ... ... 1 ... 10 14 1 3 6 5 1 ... 33 7 82 Second Quarter 229 212 441 163 143 306 43 26 9 27 140 61 2 ... 1 4 ... 35 72 9 25 6 1 29 2 5 97 18 306 July 72 68 140 54 44 98 34 10 3 6 42 3 ... 1 1 18 ... 11 14 3 7 4 ... 4 3 1 26 5 98 August 87 82 169 66 70 136 40 12 2 8 68 6 1 ... 4 15 1 15 18 3 7 4 3 13 1 1 40 10 136 September 57 68 125 61 45 106 22 13 4 15 46 6 ... ... 2 11 ... 13 16 3 8 4 ... 12 3 ... 24 10 106 Third Quarter 216 218 434 181 159 340 96 35 9 29 156 15 1 1 7 44 1 39 48 9 22 12 3 29 7 2 90 25 340 October 71 70 141 48 39 87 17 8 2 12 46 2 ... 1 ... 2 ... 15 18 ... 6 ... ... 3 5 ... 36 1 87 November 88 103 191 65 56 121 28 12 2 7 64 8 ... 6 ... 2 1 10 36 1 11 4 2 10 2 ... 30 6 121 December 63 60 123 67 52 119 24 13 2 9 64 7 ... 10 3 ... 2 12 27 1 14 2 ... 8 4 ... 32 4 119 Fourth Quarter 222 233 455 180 147 . 327 69 33 6 28 174 17 ... 17 3 4 3 37 81 2 31 6 2 21 11 ... 98 11 327 Deaths that have occurred in the outlying Institutions during the year 1895 ... ... ... 41 47 88 5 18 4 15 42 4 3 ... ... 2 3 1 11 3 11 1 1 1 17 ... 25 9 88 TOTAL 897 890 1787 806 691 1497 266 156 33 133 725 184 6 25 11 55 7 152 349 35 126 35 8 130 41 51 377 89 1497 c 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 32,106 448 „ West 22,007 341 „ Workhouse 1,068 464 „ Infirmary 528 Royal Naval College 199 Greenwich Hospital Schools 1,081 0 23.9 12.6 2.2 4.2 28.6 Seamen's Hospital 255 132 Miller Hospital 24 Outlying Institutions 88 Estimated Increase of Population since 1891 (By Registrar-Genl's method) 4,235 Total 62,479 1,497 23.9 12.6 2.2 4.2 28.6 Table No. 3. ZYMOTIC DISEASES. 1895. Scarlet Fever. Measles. Whooping Cough. Small Pox. Diarrhœa and Dysentery. Enteric Fever. Diphtheria. Puerperal Fever. Total. January ... 5 ... ... 1 ... 2 1 9 February ... 1 ... ... ... ... 2 ... 3 March ... 1 ... ... ... ... ... ... 1 April ... ... 1 ... ... ... ... 1 2 May 1 ... ... ... 3 ... 1 ... 5 June 1 ... ... ... 1 ... 1 ... 3 July ... 1 1 ... 8 ... 3 ... 13 August 1 ... 4 ... 15 1 1 3 25 September ... ... 2 ... 11 ... 3 ... 16 October ... 1 ... ... 2 ... 5 ... 8 November ... 6 ... ... 2 1 ... ... 9 December ... 10 3 ... ... 2 4 ... 19 Outlying Institutions 3 25 11 ... 43 4 22 5 113 3 ... ... ... 2 3 17 1 26 6 25 11 ... 45 7 39 6 139 Zymotic Death-rate 2.2 per 1,000. D Table No. 4. 1895. Births. Deaths. January 186 140 February 124 143 March 147 153 April 145 116 May 176 108 Births 1,787 June 120 82 Deaths 1,497 July 140 98 Excess of Births 280 August 169 136 September 125 106 Birth Rate 28.6 per 1,000. October 141 87 November 191 121 December 123 119 Outlying Institutions ... 88 Total 1,787 1,497 Table No. 5. Death Rate per 1,000, excluding Hospitals and Schools=12.6. 1884 1885 1886 1887 1888 1889 1890 1891 1892 1893 1894 1895 17.6 17.6 16.7 16.6 16.6 14.2 16.6 15.9 14.2 16.2 11.69 12.6 Table No 6. ZYMOTIC DEATH RATE=22. 1884-5 1885-6 1886-7 1887-8 1888-9 1889-90 1890 1891 1892 1893 1894 1895 3.0 3.0 2.3 2.7 1.6 3.0 2.7 2.0 2.3 3.1 2.5 2.2 Table No. 7. LONDON. Population; and Births and Deaths in Registration Districts during the 52 Weeks of 1895. 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. LONDON. 4211743 133715 86937 22173 21554 55 2633 829 2316 1483 5 614 10 3600 74 3407 7516 23282 633 West Districts 740735 19777 14312 3394 4036 1 185 106 328 239 ... 84 4 601 7 539 1195 4079 27 North Districts 993884 29835 18840 4558 4915 2 540 237 612 294 3 160 3 765 7 684 1499 4709 23 Central Districts 247538 6972 5577 1355 1093 ... 274 14 104 92 1 54 ... 190 5 331 644 1919 28 East Districts 705114 26535 16615 4746 3549 1 800 76 409 319 ... 99 ... 730 16 763 2153 4827 6 South Districts 1524472 50596 29958 8103 7446 4 829 291 857 538 1 216 3 1306 39 1086 2015 6113 549 Metropolitan Hospitals and Asylums outside Registrytion London. ) ... ... 1635 17 515 47 5 105 6 1 ... 1 ... 8 ... 4 10 1635 ... West Districts. la. Paddington 117846 2977 2249 495 691 ... 19 1 38 21 ... 13 ... 93 1 125 228 554 3 1b. Kensington 166308 3619 3064 617 1025 ... 35 14 39 38 ... 15 2 121 1 75 204 1033 2 2. Fulham 188878 6839 3948 1210 898 ... 81 77 170 91 ... 29 1 214 2 145 333 806 7 3. Chelsea 96253 2734 2002 500 485 ... 10 9 26 35 ... 9 ... 90 1 49 138 634 3 4. St. Geo., Hanover Square 134138 2756 2547 452 789 1 36 4 51 43 ... 14 1 73 ... 123 246 933 5 5. Westminster 37312 852 502 120 148 ... 4 1 4 11 ... 4 ... 10 2 22 46 119 7 North Districts. 6. Marylebone 142404 4400 2484 621 663 2 24 2 21 39 ... 23 ... 99 ... 97 222 542 5 7. Hampstead 68416 1453 1259 203 292 ... 11 76 180 7 ... 23 1 28 1 31 52 470 7 8. Pancras 234379 7118 4896 1237 1185 ... 228 12 90 96 ... 32 ... 211 ... 227 449 1496 7 9. Islington 319143 9879 5732 1412 1585 ... 140 32 85 82 1 24 2 216 1 175 409 1169 1 10. Hackney 229542 6985 4469 1085 1190 ... 137 115 236 70 2 58 ... 211 5 154 367 1032 3 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 1120 715 167 208 ... 12 2 2 13 ... 1 ... 27 ... 27 62 190 1 12. Strand 27516 491 913 137 200 ... 7 1 23 8 ... 21 ... 12 ... 67 110 570 4 13. Holborn 141920 4808 2817 910 453 ... 239 10 46 63 1 12 ... 133 4 122 296 462 13 14. London City 38320 553 1132 141 232 ... 16 1 33 8 ... 20 ... 18 1 115 176 697 10 East Districts. 15. Shoreditch 124009 4352 2954 887 714 ... 106 15 44 82 ... 11 ... 153 1 94 282 813 2 16. Bethnal Green 129132 4771 2564 740 564 ... 112 13 58 34 ... 11 ... 137 4 92 297 628 ... 17. Whitechapel 74462 3130 2542 548 397 1 90 6 94 20 ... 38 ... 58 2 206 410 1497 ... 18. St. Geo.-in-the-East 45795 1972 1091 346 207 ... 85 5 19 20 ... 4 ... 54 ... 40 146 281 1 19. Stepney 57376 2035 1350 473 166 ... 80 3 32 42 ... 7 ... 66 ... 74 212 259 1 20. Mile End Old Town 107592 4204 2185 641 605 ... 105 14 62 40 ... 7 ... 112 3 62 228 389 1 21. Poplar 166748 6071 3929 1111 896 ... 222 20 100 81 ... 21 ... 150 6 195 578 960 1 South Districts. 22. St. Saviour, Southwark 202693 7252 3971 1401 665 ... 192 7 46 127 ... 14 1 196 5 121 301 298 79 23. St. Olave, Southwark 136660 4944 3226 818 647 3 134 9 38 35 ... 15 ... 131 ... 201 329 963 87 24. Lambeth 275203 9341 5857 1470 1503 ... 153 91 197 131 ... 42 2 267 13 234 421 1511 95 25. Wandsworth 307500 9985 5382 1510 1444 ... 129 74 206 74 1 32 ... 245 12 176 373 754 34 26. Camberwell 235344 7528 4921 1250 1369 ... 112 16 99 71 ... 26 ... 206 5 121 254 1235 65 27. Greenwich including Deptford 165413 5475 3369 814 838 ... 50 79 223 55 ... 58 ... 118 4 113 163 882 87 28. Lewisham 94335 2476 1449 346 523 ... 26 4 14 36 ... 10 ... 65 ... 43 59 215 37 29. Woolwich 107324 3595 1783 494 457 1 33 11 34 9 ... 19 ... 78 ... 77 115 255 65 Metropolitan Hospitals and Asylums outside Registration London. ... ... 1635 17 515 47 5 105 6 1 ... 1 ... 8 ... 4 10 1635 ... Table No. 8. INFECTIOUS DISEASES REPORTED UNDER THE PUBLIC HEALTH (LONDON) ACT, 1891. 1895. Scarlet Fever. Enteric Fever. Erysipelas. Diphtheria. Membranous Croup. Small Pox. Puerperal Fever. Typhus Fever. Continued Fever. Relapsing Fever. Total. January 8 3 5 5 ... ... ... ... ... ... 21 94 February 12 3 5 17 ... 1 ... ... ... ... 38 March 16 2 5 10 1 1 ... ... ... ... 35 April 21 ... 4 5 ... ... ... ... ... ... 30 144 May 38 3 4 10 ... 1 ... ... ... ... 56 June 39 ... 4 12 2 ... ... ... ... 58 July 46 2 4 21 ... ... ... ... ... ... 73 157 August 14 6 8 17 ... 2 ... ... ... ... 47 September 8 2 9 16 ... ... 2 ... ... ... 37 October 15 5 3 48 1 ... ... ... ... ... 72 192 November 16 6 7 19 1 ... ... ... ... ... 49 December 23 6 7 35 ... 1 ... ... ... ... 71 Total 256 38 65 215 3 8 2 ... ... ... 587 Table no. 9. ANALYSIS OF SICKNESS AND MORTALITY STATISTICS IN LONDON FOR THE YEAR 1895. (Specially compiled for "The Lancet".) Sanitary Areas. Estimated Population in the middle of 1895. 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. Other Continued Fevers. Diarrhoea. Total. Annual Rate per 1000 persons living. LONDON 4,392,346 979 19,757 11,223 14 3506 105 236 5660 29 41,509 9·5 55 2628 829 2289 1480 5 596 10 3574 11,466 2·6 85,138 19·4 165 West Districts. Paddington 122,756 10 417 238 - 71 - 8 103 1 848 6·9 - 19 14 47 20 - 13 - 94 207 1·7 2107 17·2 164 Kensington 167,671 9 532 380 - 99 4 7 259 - 1290 7·7 - 34 28 90 38 - 15 1 116 322 1·9 2759 16·5 172 Hammersmith 108,429 8 379 205 - 57 5 2 88 - 744 6·9 1 27 17 44 43 - 12 - 81 225 2·1 1810 16·7 166 Fullham 117,745 2 344 393 - 58 3 6 98 904 7·7 - 51 21 77 50 - 12 1 130 342 2·9 2195 18·7 187 Chelsea 99,930 4 575 307 - 73 2 8 107 - 1076 10·8 1 11 25 57 35 - 13 - 79 221 2·2 1913 19·2 168 St. George, Hanover Square 74,037 4 303 96 - 39 3 1 68 - 514 7·0 1 10 10 24 26 - 9 1 36 117 1·6 1175 15·2 138 Westminster 54,003 6 179 105 - 27 — 2 30 — 349 6·5 - 25 6 21 15 - 3 - 41 111 2·1 1146 21·3 185 St. James, Westminster 23,149 82 — 11 1 1 16 - 155 6·7 — 2 3 4 10 — 6 — 6 31 1·3 411 17·8 144 North Districts. Marylebone 137,392 106 498 232 - 135 4 7 234 1 1217 8·9 9 25 14 35 39 23 1 93 239 1·7 2843 20·8 138 Hampstead 77.592 2 306 117 - 63 3 4 51 _ 546 7·1 - 9 8 14 7 1 9 1 29 78 1·0 931 12·0 135 St. Pancras 233,543 15 1082 555 - 153 4 18 413 - 2240 9·6 1 228 52 131 94 - 30 - 205 741 8·2 4778 20·5 174 Islington 335,929 25 1725 595 4 197 9 22 334 - 2911 8·7 1 141 67 146 79 1 30 2 219 686 2·0 5753 17·2 143 Stoke Newington 35,234 _ 131 60 - 30 - 1 28 — 250 7·1 - 7 1 5 5 - 4 - 17 39 1·1 471 13·4 116 Hackney 215,623 14 1037 501 1 257 6 13 288 1 2118 9·9 1 120 41 83 65 1 45 - 189 545 2·5 3735 17·4 154 Central Districts. St. Giles 37,654 13 149 63 - 26 - 1 59 — 311 8·3 2 13 6 13 13 - 2 - 28 77 2·1 859 22·9 160 St. Martin-in-the-Fields 13,536 3 40 18 - 14 - - 7 — 82 6·1 1 2 2 7 6 - 1 - 5 24 1·8 244 18·1 265 Strand 22,586 5 111 41 - 24 - - 17 — 198 8·8 2 6 9 13 3 - 5 - 11 49 2·2 569 25·3 715 Holborn 32,188 31 145 58 - 20 - 1 60 - 315 9·8 - 45 6 7 8 - - - 24 90 2·8 810 25·2 212 Clerkenwell 65,036 11 326 143 1 56 5 4 93 — 639 9·9 - 93 17 34 41 1 11 - 53 250 3·9 1491 23·0 192 St. Luke 40,763 3 149 95 - 33 1 2 82 - 365 9·0 - 106 5 20 21 - 6 - 66 224 5·5 1226 30·2 184 City of London 33,824 6 142 43 - 35 1 2 24 253 7·5 - 15 4 8 3 - 13 - 12 55 1·6 720 21·4 157 East District Shoreditch 122,932 16 584 251 - 105 4 2 184 1 1147 9·4 2 106 30 58 87 - 22 - 155 460 3·8 2856 23·3 199 Bethnal Green 130,061 94 752 474 — 122 2 7 310 - 1761 13·6 4 116 30 101 34 - 17 - 139 441 3·4 2769 21·4 162 Whitechapel 75,820 102 508 289 1 31 - 1 114 - 1046 13·8 4 82 23 58 19 - 10 - 54 250 3·3 1824 24·1 157 St. George-in-the-East 45,227 21 300 219 - 38 2 1 69 — 650 14·4 - 88 20 50 21 - 7 - 60 246 5·5 1330 29·5 196 Limehouse 56,885 21 401 190 - 54 1 2 74 — 743 13·1 1 86 20 45 40 - 10 - 59 261 4·6 1547 27·3 202 Mile End Old Town 108,443 54 671 483 — 78 - 3 205 — 1494 13·8 1 113 26 111 42 - 17 - 114 424 3·9 2436 22·5 165 Poplar 171,230 28 991 777 1 177 11 8 278 - 2271 13·3 1 216 48 152 80 - 33 — 147 677 4·0 3865 22·6 183 South Districts. St. Saviour, Southwark 26,570 4 104 67 _- 11 — 1 25 — 212 8·0 17 6 13 13 - 1 - 26 76 2·9 677 25·5 205 St. George, Southwark 60,168 48 185 105 —- 45 — 2 62 1 448 7·5 — 49 14 17 38 7 - 69 194 3·2 1524 25·4 198 Newington 119,358 20 423 279 - 84 1 9 142 - 958 8·0 4 132 16 52 71 - 15 1 110 401 3·4 2872 24·1 201 St. Olave, Southwark 13,065 1 31 22 - 2 - 1 7 64 4·9 - 3 - 4 7 - 2 - 15 31 2·4 314 24·1 206 Bermondsey 83,861 8 304 115 1 58 - 4 74 - 564 6·7 - 114 16 29 20 - 11 - 80 270 3·2 1869 22·3 162 Rotherhithe 40,713 38 257 144 1 32 - - 87 3 562 13·8 1 19 8 31 10 - 9 - 32 110 2·7 783 19·3 148 Lambeth 284,883 54 1416 657 1 215 20 16 372 17 2768 9·7 2 150 53 112 132 - 26 2 264 741 2·6 5567 19·6 152 Battersea 165,130 22 830 404 1 133 5 10 249 - 1654 10·0 1 98 30 92 53 - 22 - 145 442 2·7 2872 17·4 177 Wandsworth 185,956 15 654 286 - 134 3 7 220 2 1321 7·1 2 30 16 46 24 1 26 - 106 250 1·3 2747 14·8 132 Camberwell 252,737 86 874 903 237 2 16 313 2 2433 9·7 7 111 46 179 68 - 33 - 204 648 2.6 4610 18·3 164 Greenwich (including Deptford) 175,183 42 860 882 2 150 — 17 211 — 2164 12·4 3 49 36 184 55 - 17 - 121 465 2·7 3305 18·9 150 Lewisham (excluding Penge) 82,410 1 283 128 - 39 1 8 77 - 537 6·5 12 9 14 32 - 7 - 52 126 1·5 1187 14·4 135 Woolwich 42,768 1 188 67 - 50 - 2 31 - 339 7·9 6 11 14 3 - 9 - 30 73 1·7 748 17·5 153 Lee 38,832 5 164 46 - 14 - 3 41 - 273 7·0 18 5 11 5 - 3 - 12 54 1·4 561 14·5 140 Plumstead 61,494 18 325 143 - 215 2 6 55 - 764 12·5 2 24 10 36 5 - 30 - 46 153 2·5 929 15·2 133 Port of London - 2 - 4 - 4 - - 1 — 11 - - - - — - — - — - - - - - * Including 461 cases of Membranous Croup. † Including Deaths from Membranous Croup. Table No. 10. SHEWING THE NUMBER OF ARTICLES AND ROOMS DISINFECTED IN CONNECTION WITH THE UNDERMENTIONED DISEASES, FROM MARCH 25th, 1895, TO MARCH 25th, 1896. Infectious Diseases. Number of Cases. Number of Beds disinfected Pillows disinfected Bolsters disinfected Palliasses disinfected Mattresses disinfected Odd Articles disinfected No. of Rooms disinfected Total Premises. Scarlet Fever 179 185 341 120 112 112 1700 206 170 Enteric Fever 37 19 37 13 8 7 105 24 23 Small Pox 8 4 21 4 5 6 62 7 5 Diphtheria 294 181 360 129 72 72 979 257 242 Erysipelas 62 ... ... ... ... ... ... ... ... Membranous Croup 4 ... 1 3 ... ... 12 3 3 Puerperal Fever 1 1 1 1 ... 1 1 1 1 Continued Fever ... ... ... ... ... ... ... ... ... Total 585 390 761 270 197 198 2959 498 444 ARTHUR E. BACHE, Sanitary Inspector. Table No. 11. SHEWING THE NUMBER OF ARTICLES DESTROYED IN CONNECTION WITH THE UNDERMENTIONED DISEASES, FROM MARCH 25tb, 1895, TO MARCH 25th, 1896. Infectious Diseases. Number of Cases. Beds destroyed. Palliasses destroyed. Pillows destroyed. Mattresses destroyed. Bolsters destroyed. Cushions destroyed. Blankets destroyed. Odd Articles destroyed. Scarlet Fever 179 6 14 3 2 2 9 .. ... Enteric Fever 37 ... ... ... ... ... ... ... ... Small Pox 8 ... ... ... ... ... ... ... ... Diphtheria 294 2 14 5 2 2 3 ... ... Erysipelas 62 ... ... ... ... ... ... ... ... Membranous Croup 4 ... ... ... ... ... ... ... ... Puerperal Fever 1 ... ... ... ... ... ... ... ... Continued Fever 0 ... ... ... ... ... ... ... ... Total 585 8 28 8 4 4 12 ... ... D ARTHUR E. BACHE, Sanitary Inspector. Table No. 12. HOUSES INSPECTED AND INQUIRIES MADE IN CONNECTION WITH INFECTIOUS DISEASES, FROM MARCH 25TH, 1895, TO MARCH 25th, 1896. Number of Houses Inspected and Inquiries made 470 ,, Re-visits 2,281 Total 2,751 62 Rooms have been cleansed, after disinfection, by the Board's men. 11 Families have been to Oak House—17 Adults, 26 Children. Of these, 2 Adults and 1 Child came from Deptford. ARTHUR E. BACHE, Sanitary Inspector. Table No. 13. HOUSES INSPECTED FROM 25th MARCH, 1895, TO 25th MARCH, 1896. East District. West District. Total. Number of Houses Inspected 1,065 1,089 2,154 Re-inspections, Calls made, &c. 4,431 4,470 8,901 Visits to Slaughter-houses 6 8 14 „ Cow-houses 6 ... 6 „ Bake-houses 32 112 144 „ Stables and Yards 29 40 69 „ Fields, Lanes, &c. 10 10 20 „ Factories and Workshops 42 20 62 „ Piggeries 4 ... 4 „ Courts and Alleys 9 105 114 Total Inspections 5,634 5,854 11,488 N.B.— In addition, the various Fruiterers, Fishmongers and Provision Dealers and other places where food is prepared for human consumption, have been visited occasionally during the year. The following have been destroyed as unfit for food:— 2 boxes of Mackerel. 2 sacks of Mussels. 1 case of 50 Rabbits. 2 bushels of Winkles. 40 Lobsters. 114 baskets of Strawberries. 18 lbs. Fish. 1,200 Oranges. CHARLES TURLE WILSON, Sanitary ROBERT FISHER, Inspectors. Table No. 14. IMPROVEMENTS EFFECTED. From 25th March, 1895, to 25th March, 1896. IMPROVEMENTS. East District. West District. Total. Drains Constructed 48 17 65 Interceptor, chamber Afresh air inlet 63 36 99 Re-constructed 318 348 666 Cleansed and amended 59 55 114 Surface drains constructed 455 93 548 Traps fixed 484 472 956 New soil pipes 85 51 136 Drains and soil pipes ventilated 116 86 202 Cesspools Abolished 13 4 17 Cleansed and Disinfected 8 ... 8 Water Closets Closets erected 41 33 74 Pan, trap, and water supply provided 394 360 754 Pan and trap only furnished 39 95 134 Pan only furnished 18 22 40 Water supply apparatus only furn'shd 65 26 91 Water supply renewed 40 65 105 Sanitary conveniences for Workshops 4 3 7 Ash Pits Provided 81 104 185 Repaired 6 4 10 General Water Supply New receptacles provided 2 ... 2 Repaired and covers adapted 32 15 47 Water supply provided 55 65 120 Water fittings repaired 100 65 165 Pavings Pavings re-laid 267 334 601 Other Improvements Houses generally repaired 24 24 48 Houses, &c., cleansed & lime-washed 112 141 253 Ventilation improved 3 22 25 Dung receptacles provided 11 16 27 Overcrowding abated 3 4 7 Illegal use of underground rooms for sleeping ... 5 5 Other nuisances abated 176 228 404 Total Improvements 3122 2793 5915 Total Premises Improved 699 814 1513 CHARLES TURLE WILSON, ROBERT FISHER, Sanitary Inspectors. 49 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR.DEPTFORD. To the Greenwich District Board of Works. Gentlemen, I have the honour to present to you my Thirteenth Annual Report on the Vital Statistics and Sanitary Work for the year ending December 28th, 1895. POPULATION The population of Saint Paul's Parish, as estimated according to the Registrar-General's method, for 1895, amounted to 113,927, and that for Saint Nicholas Parish is estimated at 7,960, making a total estimated population for the two Parishes of 121,887. BIRTHS. The number of Births registered during the year 1895 was 3,685 (1,893 males, and 1,792 females), being a slight increase on 50 the two previous years, and equivalent to an annual rate of 30·2 per 1,000 persons living. The Birth Rate for London, during the same period, was 30·5, and for the thirty-two great towns 31·9. There were 3,440 Births registered in the Parish of Saint Paul (1,766 males, and 1,674 females), and 245 in Saint Nicholas Parish (127 males, and 118 females). DEATHS. The number of Deaths registered in Saint Paul's Parish was 1,559, in Saint Nicholas Parish 144, in the South-Eastern Metropolitan Asylums Board's Hospital 263, and in outlying Public Institutions 464, making a total of 2,430, being equivalent to an annual rate of 19·9 per 1,000 persons living. Of the 263 deaths registered as occurring in the Metropolitan Asylums Board's SouthEastern Hospital, 192 were of persons not residing in Deptford, but who had been taken to the Hospital from other parts of the Metropolis. If these deaths are deducted from the gross number occurring in my district it makes the number of deaths of parishioners only—including those dying at Outlying Public Institutions—2,238, equivalent to an annual death rate of 18·3 per 1,000 persons living. The death rate in the thirty-two great provincial towns during the year, averaged 21·2 per 1,000 persons living, whilst the death rate for the Metropolis was 19·8 per 1,000; that for Saint Paul's Parish, including all parishioners whether dying in or out of the Parish 18'0, and for Saint Nicholas Parish 30·7. Full details will be found in Tabular Forms Nos. 1 and 2, and Table No. 2 gives the Statistics of the Births and Deaths in the two Parishes during the year, showing the number of Deaths 51 which ocurred at the South-Eastern Metropolitan Asylums Board's Hospital, including non-parishioners, and at the Outlying Public Institutions. Table No. 3 shows the death rate in the two Parishes during the last 10 years. Table No. 4 shows the excess of births over deaths in the two Parishes of Saint Paul and Saint Nicholas, Deptford, and Table No. 5 gives a comparative analysis of the mortality in all London and in Deptford (parishioners only) in the year 1895. MORTALITY AT GROUPS OF AGES. The 2,430 deaths last year included 1,049 children under five years of age. The deaths of 144 children occurred between the ages of 5 and 10; 202 of persons between 10 and 30 years; 725 were of persons aged between 30 and 70; and 310 were of persons aged upwards of 70. INFANTILE MORTALITY. The deaths of young children always bear a high ratio to the total deaths; out of a total of 2,430 deaths registered during the year, there were no less than 583 infants under one year of age, being at the rate of 158 for every 1,000 births registered, whilst, in the Metropolis as a whole it averaged 165, and in the thirty-two great provincial towns it was 193 to every 1,000 births. ZYMOTIC DISEASES. The average death rate from the seven principal Zymotic diseases in the two Parishes, including the parishioners who died in the South-Eastern Metropolitan Asylums Board's Hospital, was 2·3 per 1,000, as against 2·6 per 1,000 in London generally. The number of deaths from all Zymotic diseases registered as occurring at the houses of the parishioners was 282, as against 330 52 and 356 for the two previous years, whilst in the South-Eastern Metropolitan Asylums Board's Hospital 242 were registered; of these, 71 were parishioners. A full detailed account of the deaths from all the Zymotic diseases which occurred in the two Parishes, as well as in the Hospital, will be found in Tables Nos. 6 and 7, and a full account of the Infectious Diseases which have been notified (1,560 in all) in Deptford, under the Public Health (London) Act, 1891, will be found in Table No. 8. Table No. 9 shows the cases notified and deaths from principal Infectious Diseases in London, during the year ending December 28th, 1895. The Metropolitan Asylums Board experienced some difficulty in providing accommodation for the great increase in Scarlet Fever and Diphtheria cases, and in the month of July a letter was received, pointing out that new cases could only be admitted as vacancies occurred by discharges and deaths. A communication was also received from the Secretary of the Local Government Board, calling attention to the considerable increase in the number of Small Pox cases which had occurred in London during September, and asking to be informed of the measures which had been taken by this Board. The following reply was sent:—"That, whenever a case of Small-pox occurred in this Board's District, and which was notified to the Medical Officers of Health, the following measures had for some time been, and would continue to be taken, viz.:—Intimation of the outbreak is immediately given to the Metropolitan Asylums Board, and notice of the same is at once given to the Vaccination Officer for the Greenwich Union, and to the head teacher of the School attended by the patient (if a child), or by any child who is 53 an inmate of the same house as the patient. The Sanitary Inspector is directed to at once proceed to the premises where the case has occurred, and, as soon as the patient has been removed to the Hospital, to take the necessary steps for disinfecting the premises, the bedding and other infected articles being taken by this Board's men and cart to this Board's premises, for the purpose of being either destroyed or disinfected, the Inspectors being required to make a report to the Medical Officers of the steps taken. The inmates of the house where the case occurred, and of those adjacent thereto, are also strongly urged to be re-vaccinated, although the Medical Officers of Health, or other Officers of this Board, have no power to enforce it." Also that this Board would be pleased to furnish the Local Government Board with copies of the reports made by this Board's Medical Officers of Health as to the measures which those Officers had taken. In the month of July, I also received the following letter from the Medical Officer of Health to the London County Council, with reference to Asiatic Cholera. " London County Council. "Public Health Department, "Spring Gardens, S.W. "13th July, 1895. "ASIATIC CHOLERA. " Dear Sir, "The Public Health Committee of the Council is of opinion that, since cases of Asiatic Cholera may possibly be imported into London during the ensuing season, there would be advantage in continuing the arrangements with Dr. Klein which have been in force for the last few years, for the examination of material from any persons who may be suspected to be suffering from Asiatic F 54 Cholera. The Committee has, therefore, authorized me to send to Dr. Klein any such material whenever the circumstances of the case make it desirable it should be examined by him. "I am, therefore, to invite you to inform me of any case of suspected Asiatic Cholera which may occur in your district. " I am, Dear Sir, " Yours faithfully, "SHIRLEY F. MURPHY, " Medical Officer of Health. "H. W. Roberts, Esq., M.R.C.S., " Medical Officer of Health, " Deptford Small Pox showed a decline in London during the past year. In this District there were reported 35 cases; only 3 deaths were recorded in the Outlying Institutions, whilst none were registered in the District. Scarlet Fever. There was a considerable diminution in the number of cases reported during the past year; 608 cases were notified in my District, as against 789 and 1,244 for the two preceding years; 11 deaths were recorded in the District, and 69 in the South-Eastern Metropolitan Asylums Board's Hospital; in the previous year 12 deaths were registered in the District, and 108 in the Hospital, as against 39 in the District, and 164 in the Hospital in the year 1893. Diphtheria. I regret to state that this disease has shewn a marked increase over the previous years. For the year 1895 there were registered 636 cases; 1894, 433; 1893, 329; 1892, 125; and during the year 1891 only 100 cases were notified. The number 55 of deaths was 63 in the District, and 126 in the South-Eastern Metropolitan Asylums Board's Hospital, as against 45 in the District, and 128 in the Hospital, in the year 1894. Fevers. This term includes Typhus, Typhoid or Enteric, Simple, Continued, and ill-defined forms of Fever, to which 8 deaths were attributed in the District during the year; 45 deaths were registered in the Hospital; 119 cases were reported under the Public Health (London) Act, 1891. For the year 1894, 106 cases were reported, whilst 15 deaths were registered in the District, and 14 in the Hospital. Puerperal Fever. There were 13 cases of this disease notified, and 3 deaths were registered; of these, 1 occurred in the District, and 2 in Outlying Public Institutions. Measles is not a notifiable disease under the Public Health (London) Act, 1891, therefore it is impossible to say how many cases occurred in the two Parishes, but only 25 deaths were registered during the year, giving a death rate of 0·20 per 1,000, whilst in London generally, it was 0·60, and in the 32 great provincial towns 0·48. For the previous year no less than 107 deaths were referred to Measles alone. Whooping Cough caused 45 deaths, as against 78 and 64 in the two preceding years. Diarrhcea is a disease which proves most fatal to infants, from improper artificial feeding. During the year 67 deaths were registered, as against 50, 66, and 81 for the three previous years. The death rate from this disease was equivalent to an annual death rate per 1,000 of 0·54, whilst for London generally, it was 0·83 per 1,000, and for the 32 great provincial towns, it was 1·46. 56 Respiratory Diseases. Under this heading are included Bronchitis, Pneumonia, and Pleurisy; 453 deaths were referred to these diseases, as against 402 and 487 in the two previous years. Phthisis, or Pulmonary Consumption, caused 177 deaths, as against 168 and 179 for the two previous years. Influenza was again epidemic during the early part of the year. 59 deaths were recorded, of these 55 alone were registered during the first three months. A memorandum on epidemic Influenza was issued March 6th, 1895, by Dr. R. Thorne Thome, Medical Officer, Local Government Board, which contains so much useful information that I give it in extenso. MEMORANDUM ON EPIDEMIC INFLUENZA. "Influenza became epidemic in England in the winter of 1889-90; it recurred in epidemic form in the spring of 1891, and was maintained up to June of that year; a third epidemic took place in the winter of 1891-92, and after a minor recrudescence in the spring of 1893, a fifth prevalence on a wide scale took place in the winter of 1893-94. England is now passing through a sixth epidemic period. Two detailed reports have been issued by the Board on the subject. The first was by Dr. Parsons, 'On the Influenza Epidemic of 1889-90,' with an Introduction by Sir George Buchanan, M.D., F.R.S., the Board's Medical Officer at that date.* The second was a 'Further Report on Epidemic Influenza, 1889-92, by Dr. Parsons, with papers on the Clinical * Report on the Influenza Epidemic of 1889-90, by Dr. Parsons, with an introduction by the Medical Officer of the Local Government Board. [C.—6387], pp. 324.— Eyre and Spottiswoode, East Harding Street, E.C. 57 and Pathological aspects of the Disease, by Dr. Klein, F.R.S.,and an Introduction by myself.† "A 'Provisional Memorandum upon Precautions advisable at times when Epidemic Influenza threatens, or is prevalent,' was also drawn up by me in January, 1892, and was issued by the Board to local sanitary authorities. "The further study made by the Medical Department as to the natural history of Influenza, and as to its clinical and bacteriological characteristics, goes to show that it is a disease against which it is most difficult to apply measures of prevention with any substantial prospect of success. "Influenza is highly infective from person to person; its infectious quality is often manifested before the disease is fully recognised; its incubation period is one of the shortest of all infectious diseases; it varies so much in intensity that many cases are never diagnosed at all; one attack confers no marked immunity against another; and the infection is largely eliminated by means of the lungs, the sputa of the sick being invariably charged, during the acute stage of the disease, with its pathognomonic micro-organism. The disease calls primarily for measures of isolation and of disinfection, but there are difficulties in making any such measures universally applicable. Wherever they can be carried out, the following precautions should, however, be adopted:— "1st. The sick should be separated from the healthy. This is especially important in the case of first attacks in a locality or household. †Further Report and Papers on Epidemic Influenza, 1889-92, with an introduction by the Medical Officer of the Local Government Board. [C.—7051], pp. 151—Eyre and Spottiswoode, East Harding Street, E.C. 58 "2nd. The sputa of the sick should, especially in the acute stage of the disease, be received into vessels containing disinfectants. Infected articles and rooms should be cleansed and disinfected. "3rd. When Influenza threatens, unnecessary assemblages of persons should be avoided. "4th. Buildings and rooms in which many people necessarily congregate should be efficiently aerated and cleansed during the intervals of occupation. "It should be borne in mind that the liability to contract Influenza, and also the danger of an attack, if contracted, are increased by depressing conditions, such as exposure to cold, and to fatigue whether mental or physical. Attention should hence be paid at epidemic periods to all measures tending to the maintenance of health, such as the use of clothing of suitable warmth, and a sufficiency of wholesome food. "Persons who are attacked by Influenza should at once seek rest, warmth, and medical treatment, and they should bear in mind that the risk of relapse, with dangerous complications, constitutes a chief danger of the disease. "R. THORNE THORNE. "Local Government Board, "Medical Department, "March 6th, 1895." GENERAL REMARKS. It will be seen by the returns* furnished by the Sanitary Inspectors, the amount of sanitary work that has been done during * The returns above referred to follow Table No. 12. 59 the past year. A very considerable portion of this work is of a permanent character, such as taking up old and defective drains, and relaying new in beds of concrete, the ventilation of drains, reconstruction of water closets, and filling up old cesspools, &c., and the Board has shown its earnest endeavours at all times to further the work of sanitation in Deptford, and appointed an additional Sanitary Inspector for the District during the past year. House-to-house inspection has been carried out in some portions of the District, and overcrowding, &c. abated. Magistrates' orders were obtained to close Nos. 40, 42, 44, 46, 48, 50, and 52, Queen Street, also Nos. 1, 2, 3, and 4, Slow Grove Cottages, Charles Street, as houses unfit for human habitation. In New Town, a large number of houses have been demolished and rebuilt, and the roads widened. The whole of the houses in the Mill Lane Area have now been demolished. Workshops and Factories have continued to receive careful attention as to cleansing, ventilation, closet accommodation, and overcrowding, 125 were visited during the year. Bakehouses have received frequent and careful inspection. The total number of bakehouses is 91 in Deptford, of these 51 are above ground, 38 below the ground level, and 2 partially so. They are all well maintained, and in a cleanly condition, both as regards the lime washing of the walls, and the sweeping of the floors, &c. The new Act of 1895 prohibits the construction of any further underground bakehouses. Cowsheds and Slaughterhouses have been regularly inspected, and all the cowsheds were found to be in good repair, and well 60 kept. The slaughterhouses were also found in a cleanly condition, and were in good repair. The manufacture and sale of Ice Cream has occupied the attention of several Sanitary Authorities during the year, and Dr. Klein's investigations conclusively prove that the Ice Creams sold in the streets, for the most part, are manufactured and stored under the most abominable conditions. I would strongly urge that this Board should unite with other Sanitary Authorities to memorialize the Local Government Board to introduce legislation which will empower local Authorities to register the vendors of Ice Cream, and to make bye-laws for regulating the conditions under which it is made and sold. The Inspectors, acting under instructions, made frequent examinations of articles of food submitted for sale, and in consequence of these inspections, a quantity of articles were voluntarily destroyed by the persons exposing them for sale. Table No. 10 gives an analysis of the Vital and Mortal Statistics of thirty-three of the largest English towns during the year 1895. Table No. 11 gives a return of the rooms and articles disinfected by the Board's Officers after cases of infectious disease occurring in the District. Several infected rooms were disinfected to the satisfaction of the Medical Practitioner attending upon the case, and his giving a certificate to that effect, as provided by the Public Health (London) Act, 1891, precludes the Board carrying out this work. The premises provided for the use of those persons who require the same during the time that their homes are being disinfected, was only used by one family from the Parish of St. Paul, Deptford, during the year. 61 Table No. 12 gives the Meteorological Statistics for London, for the year 1895. The Members of the Sanitary Sub-Committee for the Parish of St. Paul, Deptford, prove by their constant and regular attendance at the fortnightly meetings, the great interest they take in all sanitary matters affecting the District, and I am greatly indebted for their combined support. I desire to express my entire satisfaction at the zeal and energy with which the Sanitary Inspectors have discharged their duties during the year. I have the honour to remain, Gentlemen, Your obedient Servant, HENRY WILLIAM ROBERTS, Medical Officer of Health, Deptjord. January, 1896. TABLE No. 1. 1895. BIRTHS. DEATHS. AGES AT TIME OF DEATHS. CAUSES. M. F. Total. M. F. Total. 0 to 1 1 to 5 5 to 10 10 to 30 30 to 70 70 and upwards. Small Pox. Cholera. Diphtheria. Membranous Croup. 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 187 193 380 91 107 198 53 41 6 15 59 24 ... ... 13 1 1 9 ... 8 4 4 ... 9 58 14 7 2 6 1 10 51 6 198 February 165 160 325 111 93 204 37 37 10 18 65 37 ... ... 13 1 6 5 ... 4 4 12 ... 14 69 10 10 1 10 1 11 33 6 204 March 149 132 281 119 128 247 56 55 12 9 71 41 ... ... 15 2 3 2 ... 2 8 39 2 7 102 12 6 3 7 ... 9 28 4 247 First Quarter 501 485 986 321 328 649 146 133 28 42 195 105 ... ... 41 4 10 16 ... 14 16 55 2 30 229 36 23 6 23 2 30 112 16 649 April 154 140 294 73 92 165 47 38 10 11 41 18 ... ... 12 ... 7 2 ... 1 11 2 ... 15 47 6 15 5 5 ... 6 31 8 165 May 179 180 359 66 100 166 35 40 11 18 44 18 ... ... 28 ... 4 7 ... 1 5 1 ... 14 25 10 17 9 7 ... 3 35 6 166 June 151 119 270 54 55 109 36 21 9 6 27 10 ... ... 6 ... 5 7 ... 2 2 1 ... 5 12 4 12 3 6 ... 6 38 4 109 Second Quarter 484 439 923 193 247 440 118 99 30 35 112 46 ... ... 46 ... 16 16 ... 4 18 4 ... 34 84 20 44 17 18 ... 15 104 18 440 July 166 149 315 110 91 201 101 29 12 15 39 5 ... ... 19 ... 6 1 ... ... 2 ... 38 12 14 10 13 22 3 ... 1 60 8 201 August 149 143 292 63 67 130 50 24 6 11 27 12 ... ... 10 2 10 6 ... 2 3 ... 16 10 8 4 3 4 ... ... 9 43 4 130 September 142 140 282 61 59 120 35 21 10 21 24 9 ... ... 14 ... 9 3 ... ... 4 ... 8 14 2 2 5 ... ... ... 3 56 5 120 Third Quarter 457 432 889 234 217 451 186 74 28 47 90 26 ... ... 43 2 25 10 ... 2 9 ... 62 36 24 16 21 26 3 ... 13 159 17 451 October 193 171 364 81 69 150 39 40 14 10 37 10 ... ... 20 3 15 3 ... ... 1 ... 2 8 20 3 7 ... ... ... 3 65 4 150 November 131 142 276 68 68 136 33 39 10 12 30 12 ... ... 15 2 6 7 1 ... ... ... ... 9 36 6 5 1 ... ... 2 46 7 136 December 124 123 247 75 65 140 37 35 14 7 27 20 ... ... 24 ... 8 1 ... 1 ... ... ... 5 36 10 4 2 ... ... 5 44 14 140 Fourth Quarter 451 436 887 224 202 426 109 114 38 29 94 42 ... ... 59 5 29 11 1 1 1 ... 2 22 92 19 16 3 ... ... 10 155 25 420 TOTAL 1893 1792 3685 972 994 1966 559 420 124 153 491 219 ... ... 189 11 80 53 1 21 44 59 66 122 429 91 104 52 41 2 68 130 76 1966 Deaths of Inhabitants ,of St. Paul, Deptford, at outlying Institutions. Deaths of Inhabitants of St. Nicholas, Deptford, at outlying Institutions. ... ... ... 237 185 422 22 38 19 46 212 85 1 ... 21 ... 3 2 2 2 1 11 1 53 23 38 21 1 1 2 50 189 50 422 ... ... .. 22 20 42 2 8 1 3 22 6 2 ... 3 ... 2 ... ... 2 ... 1 ... 2 1 3 2 ... ... ... 3 21 3 42 GRAND TOTAL 189 1792 3685 1231 1199 2430 583 166 144 202 725 310 3 ... 213 11 85 55 3 25 45 71 67 177 453 132 127 53 45 4 121 740 129 2430 Table No. 2. ST. PAUL. ST. NICHOLAS. Births. Deaths in St. Paul. Total Deaths in S.E. Hospital. Deaths in Outlying Institn'ns. Grand Total. Births. Deaths. Deaths in Outlying Institn'ns. Grand Total. 1895. M. F. Total. M. F. Total. M. F. Total. M. F. Total. M. F. Total M. F. Total M. F. Total. January 176 179 355 71 95 166 14 7 21 28 18 46 233 11 14 25 6 5 11 2 4 6 17 February 153 147 300 90 77 167 15 9 24 33 14 47 238 12 13 25 6 7 13 4 2 6 19 March 133 119 252 102 107 209 3 13 16 19 20 39 264 16 13 29 14 8 22 4 0 4 26 April 148 138 286 61 78 139 8 11 19 18 21 39 197 6 2 8 4 3 7 2 0 2 9 May 171 172 343 47 74 121 12 21 33 20 19 39 193 8 8 16 7 5 12 0 2 2 14 June 131 109 240 46 39 85 5 14 19 12 6 18 122 20 10 30 3 2 5 2 1 3 8 July 158 139 297 84 79 163 11 7 18 24 22 46 227 8 10 18 15 5 20 3 2 5 25 August 138 131 269 52 55 107 7 11 18 17 11 28 153 11 12 23 4 1 5 0 1 1 6 September 132 132 264 39 40 79 15 12 27 17 17 34 140 10 8 18 7 7 14 2 2 4 18 October 180 163 343 58 51 109 13 11 24 21 14 35 168 13 8 21 10 7 17 1 1 2 19 November 127 131 258 51 52 103 10 9 19 8 8 16 138 7 11 18 7 7 14 2 2 4 18 December 119 114 233 59 52 111 14 11 25 20 15 35 171 5 9 14 2 2 4 0 3 3 7 Total 1766 1674 3440 760 799 1559 127 136 263 237 185 422 2244 127 118 245 85 59 144 22 20 42 186 Table No. 3. DEATH RATES, 1885—1895. 1885 1886 1887 1888 1889 1890 1891 1892 1893 *1894 *1895 St. Paul 19.6 15.9 16.9 14.2 15.6 17.1 16.3 15.6 16.0 17.1 18.0 St. Nicholas 20.2 17.2 17.9 13.5 16.9 15 .5 24.0 15.5 20.7 25.0 30.7 London 20.3 20.5 20.3 19.3 18.3 21.5 21.4 20.4 21.3 17.8 19.8 *The death rates given above for the years 1885-93, were calculated on the number of deaths which occurred in the District, excluding those taking place in the S.E. Hospital and outlying Public Institutions. The death rates for 1894 and 1895 include all deaths of parishioners occurring in the S.E. Hospital and at outlying Public Institutions. Table No. 4. Saint Paul. Saint Nicholas. Total. BIRTHS 3440 245 3685 DEATHS (Including 71 Parishioners in S.E. Hospital and 464 in outlying Institutions.) 2052 186 2238 Excess of Births over Deaths 1388 59 1447 H Table No. 5. COMPARATIVE ANALYSIS OF THE MORTALITY IN ALL LONDON, AND IN DEPTFORD (PARISHIONERS ONLY) IN 1895. PARISHIONERS. Annual Death-rate per 1,000, from all Causes. Annual Death-rate per 1,000 living, from seven principal Zymotic Diseases. Percentage of Deaths under 1 year to Births Registered. Percentage of Deaths to Total Deaths. Under 1 year of age. From seven principal Zymotic Diseases. Registered upon information of Coroners (Inquests). Registered at Public Institutions.* London 19.8 2.6 16.5 ... ... ... ... Deptford 18.9 2.3 15.8 23.5 18.6 5.3 22 * Viz.:—South-Eastern Metropolitan Asylums Board's Hospital, so far as relates to Deaths of Parishioners only therein, and Outlying Public Institutions, i.e., General and Special Hospitals, &c. Table No. 6. DEATHS FROM ZYMOTIC DISEASES IN THE TWO PARISHES, EXCLUDING DEATHS FROM ZYMOTIC DISEASES IN THE METROPOLITAN ASYLUMS BOARD'S SOUTH-EASTERN HOSPITAL, DURING THE YEAR 1895. 1895. Diphtheria. Membranous Croup. Erysipelas. Scarlatina or Scarlet Fever. Enteric Fever. Measles. Whooping Cough. Influenza. Diarrhœa and Dysentery. Puerperal Fever. January 2 1 ... ... 1 8 4 4 ... ... February ... 1 ... 1 1 4 4 12 ... ... March 4 2 ... 1 ... 2 8 39 2 ... April 2 ... ... 1 1 1 11 2 ... ... May 6 ... ... ... 1 1 5 1 ... ... June 1 ... ... ... ... 2 2 1 ... ... July 9 ... ... 1 ... ... 2 ... 38 ... August 5 2 ... 2 2 1 3 ... 16 ... September 4 ... ... 1 ... ... 3 ... 8 ... October 18 3 ... 2 1 ... 1 ... 2 ... November 7 2 ... 1 1 ... ... ... ... 1 December 10 ... ... 1 ... 1 ... ... ... ... 63 11 ... 11 8 20 43 59 66 1 Total 282. Table No. 7. DEATHS FROM ZYMOTIC DISEASES IN THE METROPOLITAN ASYLUMS BOARD'S SOUTH-EASTERN HOSPITAL, DURING THE YEAR 1895. 1895. Diphtheria. Scarlatina or Scarlet Fever Typhoid or Enteric Fever Measles. Whooping Cough. January 11 1 8 ... ... February 13 5 4 ... ... March 11 2 2 ... ... April 10 6 1 ... ... May 22 4 6 ... ... June 5 5 7 ... ... July 10 5 1 ... ... August 5 8 4 1 ... September 10 8 3 ... 1 October 7 13 2 ... ... November 8 5 6 ... ... December 14 7 1 ... ... 126 69 45 1 1 Total 242 Table No. 8. SHEWING NUMBER OF CASES OF INFECTIOUS DISEASE NOTIFIED IN DEPTFORD IN 1895. 1895. Small Pox. Diphtheria. Membranous Croup. Erysipelas. Scarlatina or Scarlet Fever. Typhus Fever. Typhoid or Enteric Fever. Puerperal Fever. Total. January 3 25 1 10 45 ... 6 1 91 February 1 20 1 13 43 ... 1 1 80 March 6 45 3 8 20 ... 3 ... 85 April 2 23 1 3 29 2 12 2 74 May ... 28 1 3 43 ... 9 1 85 June ... 32 1 10 35 ... 3 ... 71 July 1 84 1 14 71 ... 2 ... 173 August ... 37 2 6 51 ... 5 3 104 September 3 74 ... 16 66 ... 10 ... 169 October 3 126 2 16 88 ... 23 4 262 November 6 92 2 19 57 ... 30 1 207 December 10 50 ... 26 60 ... 13 ... 159 Total 35 636 15 144 608 2 117 13 1560 Table No. 9. ANALYSIS OF SICKNESS AND MORTALITY STATISTICS IN LONDON FOR THE YEAR 1895. (Specially compiled or "The Lancet".) Sanitary Areas. Estimated Population in the middle of 1895. 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. Other Continued Fevers. Diarrhœa. Total. Annual Rate per 1000 persons living. LONDON 4,392,346 979 19,757 11,223 14 3506 105 236 5660 29 41,509 9.5 55 2628 829 2289 1480 5 596 10 3574 11,466 2.6 85,138 19.4 165 West Districts. Paddington 122,756 10 417 238 71 8 103 1 848 6.9 — 19 14 47 20 — 13 — 94 207 1.7 2107 17.2 164 Kensington 167,671 9 532 380 — 99 4 7 259 — 1290 7.7 — 34 28 90 38 — 15 1 116 322 1.9 2759 16.5 172 Hammersmith 108,429 8 379 205 — 57 5 2 88 — 744 6.9 1 27 17 41 43 — 12 — 81 225 2.1 1810 16.7 166 Fulham 117,745 2 344 393 58 3 6 98 — 904 7.7 — 51 21 77 50 — 12 1 130 342 2.9 2195 18.7 187 Chelsea 99,930 4 575 307 — 73 2 8 107 — 1076 10.8 1 11 25 57 35 — 13 — 79 221 2.2 1913 19.2 168 St. George, Hanover Square 74,037 4 303 96 — 39 3 1 68 — 514 7.0 1 10 10 24 26 — 9 1 36 117 1.6 1175 15.9 138 Westminster 54,003 6 179 105 — 27 — 2 30 — 349 6.5 — 25 6 21 15 — 3 — 41 111 2.1 1146 21.3 185 St. James, Westminster 23,149 1 82 43 — 11 1 1 16 — 155 6.7 — 2 3 4 10 — 6 6 31 1.3 411 17.8 144 North Districts. Marylebone 137,392 106 498 232 135 4 7 234 1 1217 8.9 9 25 14 35 39 — 23 1 93 239 1.7 2843 20.8 138 Hampstead 77,592 2 306 117 — 63 3 4 51 — 546 7.1 — 9 8 14 7 1 9 1 29 78 1.0 931 12.0 135 St. Pancras 233,543 15 1082 555 — 153 4 18 413 — 2240 9.6 1 228 52 131 94 — 30 — 205 741 3.2 4778 20.5 174 Islington 335,929 25 1725 595 4 197 9 22 334 — 2911 8.7 1 141 67 146 79 1 30 2 219 686 2.0 5753 17.2 143 Stoke Newington 35,234 131 60 30 — 1 28 — 250 7.1 — 7 1 5 5 - 4 — 17 39 1.1 471 13.4 116 Hackney 215,623 14 1037 501 1 257 6 13 288 1 2118 9.9 1 120 41 83 65 1 45 — 189 545 2.5 3735 17.4 154 Central Districts. St. Giles 37,654 13 149 63 — 26 — 1 59 — 311 8.3 2 13 6 13 13 — 2 — 28 77 2.1 859 22.9 160 St. Martin-in-the-Fields 13,536 3 40 18 — 14 — — 7 — 82 6.1 1 2 2 7 6 — 1 — 5 24 1.8 244 18.1 265 Strand 22,586 5 111 41 — 24 — — 17 — 198 8.8 2 6 9 13 3 — 5 — 11 49 2.2 569 25.3 175 Holborn 32,188 31 145 58 20 1 60 — 315 9.8 — 45 6 7 8 — — — 24 90 2.8 810 25.2 212 Clerkenwell 65,036 11 326 143 1 56 5 4 93 — 639 9.9 — 93 17 34 41 1 11 — 53 250 3.9 1491 23.0 192 St. Luke 40,763 3 149 95 33 1 2 82 — 365 9.0 — 106 5 20 21 — 6 — 66 224 5.5 1226 30.2 184 City of London 33,824 6 142 43 — 35 1 2 24 — 253 7.5 — 15 4 8 3 — 13 — 12 55 1.6 720 21.4 157 East Districts. Shoreditch 122,932 16 584 251 — 105 4 2 184 1 1147 9.4 2 106 30 58 87 — 22 — 155 460 3.8 2856 23.3 199 Bethnal Green 130,061 94 752 474 122 2 7 310 — 1761 13.6 4 116 30 101 34 — 17 — 139 441 3.4 2769 21.4 162 Whitechapel 75,820 102 508 289 1 31 — 1 114 — 1046 13.8 4 82 23 58 19 — 10 — 54 250 3.3 1824 24.1 157 St. George-in-the-East 45,227 21 300 219 — 38 2 1 69 — 650 14.4 — 88 20 50 21 — 7 — 60 246 5.5 1330 29.5 196 Limehouse 56,885 21 401 190 — 54 1 2 74 — 743 13.1 1 86 20 45 40 — 10 59 261 4.6 1547 27.3 202 Mile End Old Town 108,443 54 671 483 — 78 — 3 205 — 1494 13.8 1 113 26 111 42 — 17 — 114 424 3.9 2436 22.5 165 Poplar 171,230 28 991 777 1 177 11 8 278 — 2271 13.3 1 216 48 152 80 — 33 — 147 677 4.0 3865 22.6 183 South Districts. St. Saviour, Southwark 26,570 4 104 67 _ 11 1 25 — 212 8.0 — 17 6 13 13 — 1 — 26 76 2.9 677 25.5 205 St. George, Southwark 60,168 48 185 105 — 45 — 2 62 1 448 7.5 — 49 14 17 38 — 7 — 69 194 3.2 1524 25.4 198 Newington 119,358 20 423 279 — 84 1 9 142 — 958 8.0 4 132 16 52 71 — 15 1 110 401 3.4 2872 24.1 201 St. Olave, Southwark 13,065 1 31 22 — 2 — 1 7 — 64 4.9 — 3 — 4 7 — 2 — 15 31 2.4 314 24.1 206 Bermondsey 83,861 8 304 115 1 58 — 4 74 — 564 6.7 — 114 16 29 20 - 11 - 80 270 3.2 1869 22.3 162 Rotherhithe 40,713 38 257 144 1 32 — — 87 3 562 13.8 1 19 8 31 10 — 9 - 32 110 2.7 783 19.3 148 Lambeth 284,883 54 1416 657 1 215 20 16 372 17 2768 9.7 2 150 53 112 132 - 26 2 264 741 2.6 5567 19.6 152 Battersea 165,130 22 830 404 1 133 5 10 249 — 1654 10.0 1 98 30 92 53 1 22 - 145 442 2.7 2872 17.4 177 Wandsworth 185,956 15 654 286 — 134 3 7 220 2 1321 7.1 2 30 16 46 24 — 26 — 106 250 1.3 2747 14.8 132 Camberwell 252,737 86 874 903 — 237 9 16 313 2 2433 9.7 7 111 46 176 68 — 33 - 204 648 2.6 4610 18.3 164 Deptford (including Greenwich) 175,183 42 860 882 2 150 — 17 211 — 2164 12.4 3 49 36 184 55 - 17 - 121 465 2.7 3305 18.9 150 Lewisham (excluding Penge) 82,410 1 283 128 — 39 1 8 77 — 537 6.5 — 12 9 14 32 — 7 - 52 126 1.5 1187 14.4 135 Woolwich 42,768 1 188 67 — 50 — 2 31 — 339 7.9 — 6 11 14 3 — 9 — 30 73 1.7 748 17.5 153 Lee 38,832 5 164 46 — 14 — 3 41 — 273 7.0 - 18 5 11 5 - 3 - 12 54 1.4 561 14.5 140 Plumstead 61,494 18 325 143 — 215 2 6 55 - 764 12.5 2 24 10 36 5 - 30 - 46 153 2.5 929 15.2 133 Port of London - 2 - 4 - 4 - - 1 - 11 - - - - - - - - - - - - - - - * Including 451 cases of Membranous Croup. † Including Deaths from Membranous Croup. Table No. 10.—Analysis of the Vital and Mortal Statistics of Thirty-three of the Largest English Towns during the Tear, 1895. Towns. Estimated Population middle of 95. 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 Deaths. Births. Deaths. Principal Zymotic Diseases. 33 Towns 10,591,530 330,896 218,165 31.3 20.7 2.8 29,957 120 5,623 1,883 3,735 3,888 2,115 12,593 182 1.5 32 Provincial Towns 6,199,184 197,181 131,228 31.9 21.2 3.0 18,413 65 2,991 1,054 1,419 2,405 1,486 8,993 193 2.2 London 4,392,346 133,715 86,937 30.5 19.8 2.6 11,544 55 2,632 829 2,316 1,483 629 3,600 166 0.7 West Ham 249,473 8,541 4,447 34.3 17.9 3.2 805 10 227 45 192 57 65 209 168 2.7 Croydon 114,923 2,896 1,658 25.3 14.4 1.3 151 .. 19 4 22 28 14 64 134 .. Brighton 119,604 3,057 2,252 25.6 18.9 1.8 209 .. 26 5 18 42 14 104 164 0.6 Portsmouth 174,751 4,868 3,108 27.9 17.8 2.1 371 .. 39 7 19 63 35 208 175 0.8 Plymouth 89,096 2,551 1,787 28.1 20.1 1.9 171 .. 77 2 10 28 7 47 178 0.3 Bristol 228,139 6,579 4,109 28.9 18.1 1.3 295 .. 8 16 34 45 21 171 143 1.1 Cardiff 155,637 5,321 2,826 34.3 18.2 2.4 377 .. 47 8 56 52 15 199 179 1.0 Swansea 97,008 3,231 1.767 33.4 18.3 1.7 163 .. 46 5 12 20 20 60 178 1.1 Wolverhampton 85,780 3,027 2,086 35.4 24.4 4.2 362 .. 41 33 84 53 17 134 218 0.6 Birmingham 496,751 16,026 10,048 32.4 20.3 2.7 1,321 8 136 127 183 171 81 615 183 4.8 Norwich 107,127 3,398 2,066 31.8 19.3 2.7 291 .. 27 10 19 53 26 156 190 1.6 Leicester 193,839 5,954 3,333 30.8 17.2 3.0 577 .. 32 16 35 85 39 370 203 3.1 Nottingham 226,658 6,718 4,299 29.7 19.0 2.2 505 .. 1 51 10 31 54 358 190 1.3 Derby 100,272 2,909 1,670 29.1 16.7 2.0 195 8 7 8 6 21 18 127 161 0.5 Birkenhead 107,469 3,288 2,093 30.7 19.5 2.4 252 .. 3 16 45 41 42 105 174 1.1 Liverpool 503,967 18,525 14,469 36.9 28.8 4.0 2,016 13 359 144 120 372 187 821 210 3.0 Bolton 119,337 3,921 2,852 32.9 24.0 4.5 530 1 124 23 16 67 53 246 212 0.3 Manchester 524,865 17,624 13,205 33.7 25.2 3.7 1,950 2 509 169 108 250 99 813 203 1.2 Salford 208,253 7,154 5,327 35.9 25.6 5.0 1,031 .. 213 97 62 133 88 438 231 2.3 Oldham 141,079 3,873 3,091 27.5 22.0 2.8 393 22 98 15 26 54 26 152 190 3.2 Burnley 99,591 3,189 2,322 32.1 23.4 3.9 383 .. 25 22 43 54 30 211 242 1.9 Blackburn 127,615 3,899 3,093 30.6 24.3 5.6 716 .. 323 8 9 75 29 272 236 2.8 Preston 112,638 3,753 2,684 33.4 23.9 3.8 423 1 47 4 8 50 22 291 248 3.6 Huddersfield 99,482 2,150 1,675 21.7 16.9 1.2 119 .. 12 19 15 20 6 47 158 3.3 Halifax 93,813 2,193 1,805 23.4 19.3 1.3 122 .. 9 5 14 23 16 55 158 2.0 Bradford 226,384 5,890 4.482 26.1 19.9 2.5 566 .. 18 25 20 106 40 357 203 1.0 Leeds 395,546 12,479 8,083 31.6 20.5 2.7 1,062 .. 134 51 65 112 82 618 191 0.6 Sheffield 342,768 11,913 6,994 34.6 20.5 3.2 1,085 .. 187 33 52 71 97 645 197 3.1 Hull 216,722 7,392 4,504 34.2 20.8 3.3 718 .. 19 39 37 44 48 531 205 4.0 Sunderland 137,705 4,819 2,992 35.1 21.8 3.5 481 .. 9 11 8 63 132 258 189 1.2 Gateshead 95,871 3,306 1,812 34.6 19.6 2.6 251 .. 28 14 19 62 15 113 186 0.8 Newcastle-on-Tyne 207,021 6,437 4,229 31.2 20.5 2.5 520 .. 141 22 52 59 48 198 186 1.1 Table No. 11 .—disinfection report for the year 1895. Date. Rooms disinfected Beds disinfected Pillows disinfected Bolsters disinfected Palliasses disinfected Mattresses disinfected Sheets disinfected Blankets disinfected Odd Articles disinfected Rooms stripped. Articles destroyed January 64 54 79 30 14 23 50 52 93 3 2 Beds February 44 25 63 21 7 15 27 45 68 1 3 Mattresses March 46 33 58 16 21 6 33 52 132 9 April 41 38 60 26 29 14 48 38 127 4 May 72 45 75 32 9 6 40 48 122 3 June 46 24 48 17 9 13 27 25 57 3 July 69 46 94 34 15 24 27 60 110 2 August 75 49 84 27 15 9 47 38 80 ... September 74 59 89 29 15 12 45 47 130 ... October 117 76 136 40 8 6 90 83 127 12 November 122 84 155 49 13 ... 91 117 309 5 December 94 73 136 38 16 ... 59 113 184 6 Total 864 606 1077 359 171 128 584 718 1539 48 5 SUMMARY.—Rooms disinfected 864, Beds 606, Pillows 1077, Bolsters 359, Palliasses 171, Mattresses 128, Sheets 584, Blankets 718, Odd Articles 1539, Rooms stripped 48, Articles destroyed 5. I Table No. 12. METEOROLOGICAL TABLE FOR LONDON, 1895. (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.) Winter Jan., Feb., March. Spring April, May, June. Summer July, Aug., Sept. Autumn 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 124 Years. Diff. from Average of 54 Years. Mean. Diff. from Average of 54 Years. Mean. Diff. from Average of 54 Years. Mean. Diff. from Average of 54 Years. Mean. 1Diff. from Average of 54 Years. Mean. Diff. from Average of 54 Years. Mean (Satn = 100). Diff. from Average of 54 Years. Mean. Diff. from Average of 54 Years. Mean. Diff. from Average of 54 Years. Amount. Diff. from Average of 80 Years. At or below 30°. Between 30° and 40°. Above 40°. 1895. º º º º º º º º º in. in. grs. gr. ins. in. grs. grs. Sums. Sums. º º ins. ins. YEAR 49.3 +0.7 -0.1 15.9 -0.5 42.3 -1.2 16.2 +0.4 .284 -.009 3.2 -0.2 78 -4 29.748 - .026 541 0 19.73 -5.33 88 130 147 6.9 59.1 Winter Qr. 35.2 -3.7 -4.6 33.3 -4.6 29.5 -5.7 11.8 0.0 .167 -.039 2.0 -0.5 81 - 3 20.664 - .109 556 +4 3.27 -1.68 55 33 2 6.9 42.5 Spring do. 55.1 +2.8 +2.2 50.1 + 1.0 45.5 +0.2 20.9 +0.8 .306 - .001 3.4 -0.1 71 -7 29.846 + .064 537 -1 1.91 -3.79 6 43 42 25.3 54.3 Summer do. 62.3 +2.7 +2.2 57.6 +1.3 53.4 +0.4 20.7 + 1.0 .409 +.005 4.5 -0.1 73 - 5 29.812 + .019 528 -2 6.46 -0.83 0 7 85 30.8 59.1 Autumn do. 44.7 +1.0 +0.4 42.8 +0.3 40.7 +0.2 11.5 -0.3 .255 -.001 2.9 -0.2 87 -3 29.671 -.079 545 -2 8.09 + 0.97 27 47 18 20.0 50.1 ANNUAL REPORT OF SANITARY INSPECTORS, ST. PAUL, DEPTFORD. January 1st, to December 31st, 1895. Table I. Number of District. 1 2 3 4 5* Totals. Complaints received 176 87 78 132 48 521 Total Premises inspected 880 846 805 872 332 3735 Re-inspections, Calls, Service of Notice, &c, &c 3512 3817 4317 4360 2548 18554 Inspections under Notice from Contractors, per Bye-Laws 95 20 19 9 1 144 Number of Cases in which proceedings have been taken 5 15 5 8 ... 33 "Intimations" served 432 414 269 390 198 1703 "Statutory Notices" served 117 56 50 173 18 414 Table II. Bakehouse Inspections 50 34 36 40 17 177 ,, Lime-washed 23 26 16 8 5 78 „ Drains abolished 1 ... ... ... ... 1 Slaughter House Inspections 5 2 3 2 ... 12 Cowhouse „ 3 4 4 2 3 16 Workshop and Factory Inspections ... 19 ... ... 3 22 Unsound Meat destroyed 1 rabbit 3lbs beef (after sale.) 1 barrel of herrings 14 pcs. of fish. 56 lbs. of beef, pork & mutton; 24 pomegranates ... ... * From August 6th, 1895. Table No. 3. District 1. District 2. District 3. District 4. District 5.* Totals. Water Closets :— Old Closets abolished 16 ... 4 2 1 23 New Closets provided 14 ... 11 13 1 39 „ „ in Workshops ... 4 ... ... ... 4 Basin and Trap provided 276 207 176 274 108 1041 Water Supply „ 90 60 32 39 ... 221 „ „ Apparatus provided 85 112 9 305 16 527 Limewashed 82 69 3 ... 54 208 Walls repaired 38 ... ... ... ... 38 Doors provided 8 ... ... ... ... 8 Ventilated 22 ... ... ... ... 22 Drains:— Drains re-constructed 145 123 57 127 83 535 Cleansed and amended 103 56 133 72 32 396 Gully Traps fixed 310 195 226 91 123 945 New Soil Pipes and Vent Pipes fixed 102 19 4 22 23 170 Chambers built, and Interceptors provided 49 36 11 35 10 141 Interceptors only, fixed ... ... ... ... 4 4 Ventilated 42 107 31 127 72 379 Sinks, Bath and Lavatory Wastes, and Rain Water Pipes:— Disconnected from Drains 200 127 149 36 11 523 Cesspools:— Abolished ... 4 11 2 ... 17 Dustbins:— Provided 131 180 186 97 71 665 Yards:— Paved 88 120 79 154 73 514 Surface repaired 15 108 101 65 45 334 Scullery and Washhouse Floors:— Paved 37 ... ... ... ... 37 Forecourts:— Paved 14 153 2 ... 20 189 Surface repaired 108 ... ... ... 108 Gutters and Rain Water Pipes:— Provided and repaired 102 233 ... ... ... 335 Water Supply:— Store Cisterns provided ... ... ... ... ... ... „ Covers provided 14 28 16 3 ... 61 „ abolished 66 79 18 82 ... 245 Supply re-instated 96 26 36 31 ... 189 *From August 6th, 1895. TABLE No. 3—continued. District 1. District 2. District 3. District 4. District 5.* Totals. Water Supply—continued. Fittings repaired 8 6 58 22 24 118 New Houses inspected for Certificate before occupation 112 13 ... 32 ... 157 Potable water provided from service ... ... 125 ... 16 141 Cleansing and Repairs:— Houses cleansed and limewashed 91 215 45 57 64 656 ,, repaired, and ventilation improved 80 1 80 23 House roofs repaired ... 45 13 ... ... 58 Workshops cleansed 3 ... ... ... ... 3 Dung Receptacles:— Abolished ... 2 ... 1 ... 3 Provided 4 9 1 1 ... 15 Underground Rooms:— Use as dwelling abolished ... ... 6 ... 6 Overcrowding:— Cases abated 19 4 9 13 ... 45 Accumulations:— Removed 15 4 12 15 ... 46 Animals — Ceased keeping as a nuisance 5 5 3 32 3 48 No. of premises under notice on December 31st 32 ... 56 39 37 164 No. of nuisances awaiting abatement 126 ... ... ... 47 173 *From August 6th, 1895. District No. 1 Inspector Turner. „ 2 ,, Simpson. ,, 3 „ Priest. „ 4 „ Nettleton. „ 5 „ Shelley. K