GRE 8 THE ANNUAL REPORT MADE TO THE COUNCIL of the Metropolitan Borough of Greenwich, For the Year 1904, By ERNEST GEORGE ANNIS, M.R.C.S., L.R.C.P., L.S.A., D.P.H., MEDICAL OFFICER OF HEALTH TO THE BOROUGH. Greenwich: EDWARD G. BERRYMAN & SONS, Steam Works, Blackheath Road. 1905. 3 INDEX OF CONTENTS. Pack. Analysis of Death Causes 18-19 Analysis of Vital Statistics, Metropolitan Boroughs 14 -15 Area of Borough 7 Articles and Rooms Disinfected 49 Articles Destroyed 48 Bakehouses.30-51 Births 7, 12 Births and Deaths—Returns of Appendix Cancer 25 Charts showing Weekly Notifications of Infectious Disease 22 Chicken-pox 43 Circulatory System 27 Common Lodging Houses 91 Conference of Metropolitan Sanitary Authorities 80 Congress of Royal Institute of Public Health Report on 75-80 Constitutional Diseases 25 Customs and Inland Revenue Act 57 Dairies, Cowsheds and Milkshops 54, 50, 84 Deaths, with Age Mortality 7, 12-13 Deaths—Tables showing Causes of, and Ages at Appendix Deaths of Residents—Table showing Districts, Ages and Institutions Appendix Deaths—Table of corrected rates for Metropolitan Boroughs Appendix Developmental Diseases 26 Diagram of Deaths from Zymotic Diseases 22a Diagram of Principal Death Causes 29-30 Diarrhœa 21 Dietetic Diseases 24 Digestive System 27 Diphtheria 20,38 Diphtheria Anti-Toxin 21 Disinfection 47-49,85 Duties and Powers of the Public Health Committee 5 Epidemic Diseases 19-22 Erysipelas 23, 38 External Causes 28 Factories and Workshops 51-54, 81-83 Food and Drugs—Samples of 66-69 Food—Premises for Preparation of 83 Horse Slaughterer 56 House Drainage 53 House-to-House Inspection 57-61 Houses Inspected for Infectious Disease 47 Houses Let in Lodgings 63, 80 Housing of the Working Classes 62-63 Ice Cream Stores, &c. 56 Infant Mortality 10-18,70-77 Infectious Diseases 33 49, 89 91, and Appendix- Infective Endocarditis 23 Influenza 22 Inhabited Houses 7 Introductory Review 8-10 Isolation Shelter 40-47,80 4 INDEX—continued. Page labour Bureau 92 Labour Colonies 93 Local Diseases 27 London County Council General Powers Bill 94 Malarial Fever 23 Maps of Borough, indicating Small-pox, Enteric Fever, Scarlet Fever, and Diphtheria Appendix Marriages 11 Measles 20, 43, 46-47 Meat—Inspection of 84 Milk Supply 75-76, 84 Mortuary 28, 31-32 Municipal Creches 88 Nervous System 27 Notifications 33 Offensive Trades 56, 87 Outworkers' Register 52 Population7,11 Public Health Department—Work of 95 Public Sanitary Conveniences 65 Puerperal Fever 23, 43 Pyaemia 23 Refuse Removal 64, 87 Reinterment of Human Remains 66 Reproductive System 27 Respiratory System 27 Sale of Food and Drugs Acts 85 Sanitary Work—Summaries, &c. 50, 74 Scarlet Fever 20, 38 -40 Septic Diseases 23 Sewerage 64 Slaughterhouses 54, 84 Sleeping Accommodation in Shops 83 Suicide 28 Syphilis 23 Small-pox and Vaccination 20, 33-37 Smoke Nuisances 65,88 Sporadic Diseases 23 Staff of Public Health Department 6 Statistical Summary 7 Statistical Tables Appendix Tubercular Diseases 23-25, 78-79, 86 Typhoid Fever 21,41-42 Underground Rooms 81 Urinary System 27 Vagrants 89-93 Venereal Diseases 23 Vital Statistics 14-15,97-98 Water Supply 65, 81-85 Whooping Cough 21 Workshops and Factories 51-54,81 5 Public Health Committee during the Year 1904. Charles Stone, Esq., J.P. (Mayor), and 9 Members. A. Burnett, Esq., Chairman. H. G. Hayter, Esq., Deputy Chairman. Councillors— R. Graf. C. Nixon. R. S. Jackson, L.C.C. W. F. Soames. J. H. Killick. Rev. R. C. Thurley. Henry Williams. Duties and Powers of the Public Health Committee. 1.—The Committee shall consist of ten members. 2.—To consider and report to the Council on all matters affecting the Public Health of the Borough not within the reference of any other Committee. 3. To exercise the powers of the Council under the Public Health (London) Act, 1891 (with the exception of all matters connected with the collection of House Refuse), and the Sale of Food and Drugs Acts. 4. -To exercise the powers of the Council in enforcing the By-laws and Regulations for the time being in force with respect to dairies, cowsheds, and milkshops, and with respect to slaughter-houses, knackers'-yards, and offensive businesses. 5.—The Committee shall report its proceedings to the Council. 6 Staff of the Public Health Department. Ebenezer Martin. Public Analyst- Robert H. Harland, F.I.C., F.C.S. Disinfector— James Forrest. Assistant Disinfectors— Frank Mears. A. Clay. Caretaker at Council's Shelter— Edward Jackson. Maria Jackson. Sanitary Inspectors— Charles Turle Wilson. Arthur E. Bache. Charles W. Nettleton. Thomas Clark. Clerks— T. V. Haigh. William Greenhill. Medical Officer of Health— Ernest G. Annis, M.R.C.S., L.R.C.P., D,P.H. 7 Statistical Summary. Elevation.—Varies from below high-water mark up to 249 feet above sea level. Area of the Borough and Districts— East Greenwich 1451.4 acres. West Greenwich 297.8 „ St. Nicholas 112.1 „ Charlton and Kidbrooke 1990.4 „ Borough 3851.7 „ Density of Population— East Greenwich 32.08 persons per acre. West Greenwich 83.54 St. Nicholas 69.38 Charlton and Kidbrooke 11.27 Average for the Borough 20.39 Number of Inhabited Houses— At Census, 1901 14,240 Population— At Census, 1901 95,770 Estimated 1904 101,651 Birth Rate, 1904 25.95 per 1,000 Death Rate, 1904 14.31 „ „ (Zymotic) 2.23 „ ,, (Infantile Mortality) 142 per 1000 Births. 8 Public Health and Housing Department, Royal Hill, Greenwich. March, 1905. To the Mayor, Aldermen, and Councillors of the Metropolitan Borough of Greenwich. Gentlemen, I have the honour to submit herewith, in accordance with the requirements of the Local Government Board, the Annual Report for the Medical Officer of Health, for the year 1904. The mortality statistics for the year are again of a very satisfactory character. The Birth Rate of 25.95 per 1,000 is slightly below that of the County of London as a whole, which is 27 8 per 1,000, this latter figure being 17 below the decennial average, and in fact, the lowest on record. This rate has been declining for many years, never having been below 30 per 1,000 until the year 1898; the highest rate (35.9 per 1,000) was recorded in 1876. The recorded Death Rate of 14.31 per 1,000 of the estimated population, compares favourably with 16.6, the Death Rate for the County of London, and with 17.24 per 1,000, the figure for the 76 Large Towns. The County Death Rate was 1.0 per 1,000 above that of 1903, which was the lowest on record, and is 1.8 below the decennial average. The Greenwich figure of 14.31 per 1,000, is 1.08 above that in 1903, and 0'22 below the average for the last four years. 9 Comparing Greenwich with the other Metropolitan Boroughs according to their corrected Death Rate, which is the fairest method of comparison, shows that Greenwich has the lowest Death Rate but four amongst the 29 Metropolitan Boroughs. The four Boroughs having a better Death Rate than Greenwich being Hampstead, Lewisham, Stoke Newington and Wandsworth. Full particulars of all the Boroughs are to be found in the table in Appendix. The Infantile Mortality Rate, measured by the number of deaths under one year to 1,000 births registered, was 142, or an increase of 14 per 1,000 in the Borough, as compared with the figure for 1903, comparing with 144, the figure for London as a whole, and with 134, the Borough average during the last 4 years. The Zymotic Death Rate of 2.23 per 1,000, is slightly above the County average, viz., 2.18 per 1,000, and is 0.54 per 1,000 above the corresponding figure for last year. The figures relating to the different constituent parts of the Borough are as follows:— Districts. Birth Rate. Death Rate. Percentage of deaths under one year of age. Infantile Mortality per 1,000 Births. Zymotic Death Kate. Diarrha. Death Rate. a Consumption Death Rate. Hast Greenwich 29.53 14.71 27% 132 2.59 1.27 1.21 West Greenwich 24.90 15.88 22% 142 1.93 0.88 1.28 St. Nicholas 28.92 17.94 31% 191 4.00 1.54 2.06 Charlton 20.81 11.56 26% 143 0.99 0.84 1.05 Kidbrooke 6.76 4.61 20% 136 — — 0.90 Whole Borough . 25.95 14.31 25% 142 2.23 1.07 1.25 Attack Rates of the various notifiable diseases per 1,000 living in the several districts :— Districts. Small-pox Diphtheria. Scarlet Fever. Erysipelas. Typhoid Fever. Puerperal Fever. Kast Greenwich . — .. 1-14 .. 2'20 .. 0'73 . 0-69 . — West Greenwich.. — .. 1'8.5 . 1-61 .. 108 . 0 40 . 004 St. Nicholas 0-12 .. 2-19 .. 2-19 .. 1-80 . 012 . — Charlton — .. 162 .. 2-46 .. 0-63 . 038 . 0'0o Kidbrooke .. 0'92 .. 2-45 .. — . 1-22 . — Whole Borough . o-oo .. 1-48 .. 2-11 .. 0-86 . 049 . 001 10 The chief matters requiring attention appear to be: firstly, the adoption of whatever measures are possible to check the infantile mortality; secondly, adopting whatever measures are practicable for. obviating the flooding with sewage of houses built on lowlying land; thirdly, the provision of more up-to-date arrangements for disposing of house refuse; fourthly, an increase in the staff of Inspectors in this Department. In conclusion, I have again to tender my best thanks to each and all Members of the Council, and the Public Health Committee in particular, for their continued kindness and support, and also to the Members of the Staff for the manner in which their duties have been performed. I am, Gentlemen, Yours respectfully, ERNEST G. ANNIS. 11 VITAL AND MORTAL STATISTICS, 1904. POPULATION. The number of persons estimated to be living at the middle of the year is 101,651. This estimate is an increase of 1,827 upon the corresponding figure of last year. The natural increase of the population during the year, or the excess of the number of births over the number of deaths, is 1,179, which therefore allows 648 as the balance of immigrants over emigrants. This estimated population is calculated on the lines indicated in the Annual Report for 1903, the Constant for the year 1904 being 1.0026687. The distribution of the population throughout the Borough is as follows:— Census estimation, 1901. Estimated Population at middle of year 1904. East Greenwich 43,859 46,552 West Greenwich 23,456 24,896 St. Nicholas 7,321 7,771 Charlton 18,065 19,167 Kidbrooke 3,069 3,265 Total 95,770 101,651 MARRIAGES. The Superintendent Registrar of the Greenwich Union has kindly furnished me with the following particulars relating to the number of marriages solemnised in the Parishes of Greenwich and St. Nicholas. The Superintendent Registrar for the Woolwich Union has also kindly supplied the particulars for the Parishes of Charlton and Kidbrooke. 12 Number of Marriages in Greenwich and St Nicholas, 1893 to 1904, inclusive:— Year. In Churches of England in Greenwich. In Churches of England in Charlton ant Kidbrooke. . In St. Nichola Parish Church. Marriages in Registrar's Office nd Chapels Greenwich. Total. Approximate Population of the districts concerned. 1893 295 — 49 94 438 66489 1894 299 — 44 100 443 67507 1895 246 — 52 102 400 68525 1896 282 — 61 96 439 69543 1897 287 — 40 119 446 70561 1898 309 — 45 119 473 71569 1899 343 — 46 158 547 72597 1900 359 — 46 140 545 73615 1901 354 — 52 147 553 74636 1902 — — — — 667 75969 1903 — — — — 675 77395 1904 324 129 48 174 675 101651 BIRTHS. The total number of Births registered during the year has been 2629, of which 1359 were males, and 1270 females. This gives a birth rate of 25.95 per 1000 of the population. The Birth Rate for the County of London equals 27.8 per 1000, and varies from 14.8 in the City of London, 16.4 in the City of Westminster, 16.6 in Hampstead, 19.3 in Kensington, 20.9 in Chelsea, and 21.8 in Stoke Newington, to 32.5 in Bermondsey, 32.7 in Poplar, 34.9 in Bethnal Green, 36.4 in Finsbury, and 37.0 in Stepney. DEATHS. The total number of Deaths registered during the period was 1,450, of which 748 were males, and 702 females. The crude death rate for the Borough of 14.31 per 1000, compares favourably with 16.6 the Death Rate for the County of London, and 17.2 the death rate for the 76 large towns. In the County of London the lowest Death Rates amongst the various Metropolitan Boroughs were 10.2 in Hampstead, 12.0 in Lewisham, 13.3 in Stoke Newington, 13.4 in Wandsworth, 13.5 in the City of Westminster, 13.8 in Paddington, while the highest rates were 19.3 in Bethnal Green, 19 4 in Stepney, 20.0 in Bermondsey, 20.1 in Southwark, 20.4 in Shoreditch, and 21.3 in Finsbury. Locally the Death Rate varied from 4.61 in Kidbrooke, 11.56 in Charlton, 14.71 in East Greenwich, and 15.88 in West Greenwich, to 17.94 in St. Nicholas. A comparison of the Death Rates for these different districts 13 for 1903 and 1904, shews that each district has slightly declined from the previous year, this decline being in Kidbrooke from 4.03 to 4.61, a falling off of 12 per cent. Charlton has declined from 10 50 to 11.56, a falling off of 9 per cent. East Greenwich has declined from 13.58 to 14.71, a falling off of 7 per cent. West Greenwich has declined from 14.96 to 15.88, a falling off of 5 per cent. St. Nicholas has declined from 16.54 to 17.94, a falling off of 8 per cent. This would appear to shew the measure of improvement which was due in the year 1903 to the unusual rainfall that occurred during the summer season. The Death Rate in St. Nicholas, viz., 17 94 per 1,000, is much higher than the figure 14.31 for the whole of the Borough; it is interesting to compare the Death Rates in St. Nicholas for several years past, which are as follows:— 1891 240 per 1,000. 1892 15.5 „ 1893 20.7 „ 1894 25.0 „ 1895 23.3 „ 1896 28.1 „ 1897 25.0 „ 1898 23.6 per 1,000. 1899 23.1 ,, 1900 18.2 ,, 1901 22.8 ,, 1902 23.6 ,, 1903 22.9 ,, 1904 17.9 ,, From which it will be seen that although there have been great fluctuations, yet on the whole the figures appear to be gradually tending towards improvement. The age mortality and the distribution of the deaths between the different quarters of the year is shewn by the following table Age Mortality. Deaths. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total. Under 1 year of age 98 67 134 74 373 Between 1 and 5 years 53 46 46 23 168 Between 5 and 15 10 11 15 13 49 Between 15 and 25 years 18 16 6 15 55 Between 25 and 65 145 104 105 145 499 65 years and upwards 85 62 60 99 306 Total 409 306 366 369 1,450 14 15 Analysis of the Vital Statistics of the Metropolitan Boroughs and of the City of London, after Distribution of Deaths occurring in Public Institutions, during the year 1904:— Boroughs. Estimated Population, middle of 1904. Births. Deaths. Annual rate per 1,000 Living. Deaths from principal Infectious Diseases. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus. Enteric Fever. Simple and Ill-defined Fever. Diarrhoea. Phthisis. Deaths of Children under 1 year of age to 1,000 births. Births. Deaths. Principal Infectious Diseases. County of London 4,648,950 129,335 74,555 27.9 16.1 2.14 9,906 25 2,256 365 723 1,495 ... 286 6 4,750 7,526 144 Paddington 146,975 3,295 2,017 22.5 13.8 1.56 229 2 40 10 19 16 ... 10 ... 132 176 136 Kensington 179,236 3,450 2,558 19.3 14.3 1.45 256 1 68 5 17 19 ... 6 1 139 257 150 Hammersmith 117,412 3,146 1,840 26.9 15.7 2.53 296 ... 106 6 22 36 ... 5 ... 121 161 152 Fulham 152,482 4,905 2,346 32.3 15.4 2.49 379 ... 64? 4 23 58 ... 6 ... 224 217 153 Chelsea 74,329 1,547 1,225 20.9 16.5 1.49 110 ... 25 6 5 26 ... 2 ... 46 135 156 City of Westminster 177,321 2,898 2,396 16.4 13.5 0.87 153 ... 23 9 7 18 ... 10 2 84 268 125 St. Marylebone 130,337 3,948 2,109 30.4 16.2 1.51 197 ... 50 9 14 13 ... 3 ... 108 218 94 Hampstead 86,663 1,431 884 16.6 10.2 0.66 57 ... 17 2 4 8 ... 5 ... 21 72 113 St. Pancras 235,936 6,116 4,102 26.0 17.4 2.01 474 ... 127 27 38 82 ... 17 ... 183 443 150 Islington 341,044 8,892 5,243 26.2 15.4 1.75 596 1 181 35 29 84 ... 18 ... 248 526 129 Stoke Newington 52,445 1,139 697 21.8 13.3 1.13 59 ... 7 3 8 12 ... 3 ... 26 90 114 Hackney 226,266 6,159 3,366 27.3 14.9 2.13 481 ... 76 20 55 55 ... 26 ... 249 314 142 Holborn 57,161 1,628 1,054 28.6 18.5 1.80 102 2 42 ... 4 9 ... 4 ... 41 163 109 Finsbury 98,958 3,593 2,100 36.4 21.3 2.57 254 3 58 17 16 28 ... 9 ... 123 236 140 City of London 23,482 346 390 14.8 16.7 0.60 14 ... ... 1 2 7 ... ... 4 37 104 Shoreditch 117,033 3,744 2,378 32.1 20.4 3.20 374 2 81 13 18 63 ... 8 ... 189 254 188 Rethnal Green 130,207 4,526 2,500 34.9 19.3 2.95 383 7 90 18 47 52 ... 6 1 162 280 157 Stepney 303,791 11,204 5,876 37.0 19.4 2.84 859 3 174 33 90 126 ... 30 ... 403 642 155 Poplar 169,905 5,543 3,149 32.7 18.6 3.35 568 3 91 24 84 81 ... 13 ... 272 295 154 South wark 207,937 6,557 4,169 31.6 20.1 3.13 649 1 191 12 26 118 ... 18 1 282 489 174 Bermondsey 129,397 4,192 2,582 32.5 20.0 3.52 456 ... 136 18 16 69 ... 16 1 200 274 172 Lambeth 310,359 9,059 4,884 29.3 15.8 2.10 650 ... 164 16 34 109 ... 11 ... 316 448 138 Battersea 175,465 4,849 2,541 27.7 14.5 2.02 353 ... 59 10 14 59 ... 13 ... 198 248 147 Wandsworth 257,448 6,928 3,435 27.0 13.4 1.73 448 ... 106 14 42 50 ... 11 ... 225 288 122 Camberwell 268,384 7,242 3,992 27.1 14.9 1.90 509 ... 110 17 21 99 ... 16 ... 246 368 144 Deptford 113,509 3,255 1,823 28.8 16.1 2.46 278 ... 76 10 16 49 ... 3 ... 124 161 145 GREENWICH 101,651 2,629 1,455 25.9 14.4 2.26 229 ... 40 3 11 56 ... 9 ... 110 135 142 Lewisham 140,401 3,579 1,681 25.6 12.0 1.41 198 ... 25 7 12 37 ... 2 ... 115 126 123 Woolwich 123,416 3,535 1,763 28.7 14.3 2.40 295 ... 29 16 29 56 ... 6 ... 159 205 135 1G INFANTILE MORTALITY. The Infantile Mortality, recorded by the proportion of deaths of children under one year of age to the number of births registered, was 142 per 1,000 births, there having been a total of 373 such deaths during the year, as compared with 345 the figure for the previous year, showing an increase of 28 actual deaths, the greater proportion of which were due to the increased number of fatalities from Diarrhoea during the summer quarter of the year. The lowest rates of Infantile Mortality amongst the Metropolitan Boroughs were 94 per 1,000 births in Marylebone, 104 in the City of London, 109 in Holborn, 113 in Hampstead, 114 in Stoke Newington, 122 in Wandsworth, 123 in Lewisham, whilst the highest were 156 in Chelsea, 157 in Bethnal Green, 172 in Bermondsey, 174 in Southwark, and 188 in Shoreditch. Locally the variations were from 132 per 1,000 births in East Greenwich, 136 in Kidbrooke, 142 in West Greenwich, 143 in Charlton, up to 191 in St. Nicholas. The following extract from a Report by the Medical Officer of Health upon the proceedings at the Congress of the Royal Institute of Public Health respecting the Milk question and Infantile Mortality received the special consideration of the Public Health Committee:— "In reference to the Milk question, papers were considered bearing upon the collection and transit of milk from a bacteriological point of view, the methods adopted by Railway Companies for conveying milk, the bacterial contents of milk, the conditions prevailing at the points of origin and distribution, veterinary control of dairy herds and upon a clean milk supply. It was pointed out that if the public would decline to buy milk unless it 17 was guaranteed to come from clean cows, kept under clean con ditions, milked only by clean men, or would at any rate take the trouble to enquire which milk-sellers in any immediate neighbourhood gave most attention to sanitary conditions, and would confine their patronage to such vendors, Sanitary Authorities would be greatly helped in their endeavours to obtain a clean milk supply. The need for reform in the conditions at present prevailing in reference to the transit of milk was urgently put forward, it being declared that special ice vans should be a sine qua non. It was pointed out again and again that the most important point in securing the purity and good quality of the milk was that it should be produced by healthy and clean cows, kept in healthy and clean surroundings, and periodical and frequent inspection of dairies was strongly recommended. A Resolution was passed urging the Council of the Royal Institute of Public Health to consider the whole question with a view to securing in the interests of the public health a clean milk supply for the consumer. "Hinging very much upon this question was the consideration of the excessive infantile mortality in large towns, and upon this point several papers were read, showing the good work that had been done amongst communities where Municipal Milk Depots for the supply of humanized milk had been inaugurated. It was shewn that both at Liverpool and Battersea the infantile mortality had been considerably reduced, and it was thought that the provision of these Milk Depots for the use of children who for one reason or another were deprived of the natural mother's milk, had been of great benefit. It is not in the slightest advocated that this milk should take the place of ordinary mother's milk, but should be only used to take the place of cow's milk, or other artificial 18 preparations used for the feeding of young children when the natural mother's milk is not obtainable. It may be pointed out that the Council of the Metropolitan Borough of Lambeth have been memorialized by local medical practitioners and the staff of large hospitals situated within the Borough, to take up this question, and I understand that although the Local Government Board's Auditor annually disallows the payments made by the Borough of Battersea in this connection, yet the Borough of Lambeth are proposing to go forward on the same lines. "The Committee will doubtless remember that I have on one or two occasions advocated the adoption of some such measure to deal with this problem as it presents itself in the poorer parts of this Borough, and would suggest in order to give a definite legal sanction for this work that the London County Council be approached with a view to their obtaining powers, in their next General Powers Bill, authorizing the provision of Municipal Milk Depots in suitable districts in Greenwich, also, if thought advisable, in other Metropolitan Boroughs." The result of this special consideration being that it was decided to recommend the Council to ask the London County Council to insert in their next General Powers Bill a clause authorizing Greenwich to expend money upon the provision of a Municipal Milk Depot; the recommendation was adopted by the Council, and the request has been made to the London County Council accordingly. AN ANALYSIS OF DEATH CAUSES. All death causes are conveniently arranged under various headings, and the following table, a summary of the larger tables 19 in the Appendix, shows the death rates for residents, and in fact all persons belonging to the Borough, although some of them may have died in Institutions in other Boroughs, or even outside the County of London altogether, per 1,000 of the population living in the Borough, according to the Registrar-General's classification of diseases. 1904. 1904. Infective Diseases— Local Diseases—continued. Epidemic 2.43 Digestive System 0.88 Sporadic .02 Lymphatic 0.02 Venereal .03 Urinary System 0.33 Septic .08 Reproductive System 0.09 Malarial .05 Parturition 0.06 Tuberculosis 1.67 Bones and Joints 0.01 Parasitic Diseases Integumentary System — Dietetic Diseases 0.07 External Causes— Constitutional Diseases 0.98 Accidents 0.48 Developmental Diseases 2.28 Homicide — Local Diseases— Suicide 0.08 Nervous System 1.23 Ill-defined Causes — Organs of Special Sense .05 Circulatory System 1.36 Sudden Death — Respiratory System 2.11 Other ill-defined and not specified causes — REMARKS ON VARIOUS DEATH CAUSES. INFECTIVE DISEASES. Epidemic. The deaths due to this class of diseases have been 246, equalling a death rate of 2.43 per 1,000. This figure compares very badly with 168 the total deaths, and 1 69 the death rate, for the corresponding diseases last year. This falling off 20 being almost entirely due to the larger number of deaths in children under 5 years of age from Diarrhoea, during last year than the previous year. The Zymotic Death Rate for the County of London equals 2.14 per 1,000, wherein it varied from 0.60 in the City of London, 0.66 in Hampstead, 0.87 in the City of Westminster, 1.13 in Stoke Newington, and 1.41 in Lewisham, up to 2.84 in Stepney, 2.95 in Bethnal Green, 3.13 in Southwark, 3'20 in Shoreditch, 3.35 in Poplar, and 3.52 in Bermondsey. Locally the total Zymotic Death Rate varied from nil in Kidbrooke (nil 1903), 1.46 in Charlton (0.99 in 1903), 1 93 in West Greenwich (1.69 in 1903), 2.59 in East Greenwich (198 in 1903), to 4.00 in St. Nicholas (2.40 in 1903), from which it will be seen that each district, except Kidbrooke, has participated in this retrograde movement. Small-pox. During the year there have been no deaths from this disease. Measles. This disease has proved fatal in 40 cases, 36 of them being in children under 5 years of age. There were only 25 deaths due to this complaint in 1903. The distribution of these Measles fatalities was as follows:—3 in Charlton, 8 in St. Nicholas, 10 in West Greenwich, and 19 in East Greenwich. Scarlet Fever. Scarlet Fever is credited with a total of only 3 deaths during the year, all of which fatalities were patients resident in East Greenwich. Diphtheria. This disease has been the cause of 12 fatalities, giving a death rate of 0.12 per 1000: 7 of these deaths were in patients under 5 years of age. This compares favourably with 27 fatalities from Diphtheria last year. The local distribution was 1 21 in Charlton, 3 each in St. Nicholas and West Greenwich, and 5 in East Greenwich. Five of the patients died in the Brook Hospital, 2 in other Institutions, and the remaining 5 being under treatment in their own homes. There was a further number of 67 deaths from Diphtheria occurring amongst patients not resident in this Borough, but under treatment at the Brook Hospital, 1 also similarly in Greenwich Union Infirmary. Twenty-five tubes of Diphtheria Anti-toxin, containing a total of 100,000 units of serum, for the treatment of patients suffering from this disease, have been supplied by this Council during the year. Whooping Cough. This has been the cause of 54 deaths, comparing with 37 last year, and giving a death rate of 0.53 per 1,000. Twenty-seven of these deaths were in East Greenwich, 11 in West Greenwich, and 8 each in St. Nicholas and Charlton. I indicated in last year's Report that we were passing through a somewhat severe epidemic of this disease, and that the epidemic was still continuing; this has also been the case throughout the whole of this year, it having, however, now begun to decline. Typhoid Fever. This disease has been the cause of 8 deaths in the Borough during the year, comparing with only 1 such death during the previous year. Six of these deaths occurred in patients belonging to East Greenwich, and 2 in West Greenwich. In six of the fatal cases the patients were being treated in public institutions. Diarrhœa. This disease has occasioned 109 deaths, equalling a death rate of 1.07 per 1000, comparing with 67 in the preceding year. Fifty-nine of these deaths occurred in East Greenwich, 22 in West Greenwich, 12 in St. Nicholas, and 16 in 22 Charlton. Of the 59 deaths in East Greenwich, 58 were in children under 5 years of age; of the 22 in West Greenwich, 19 were under 5 years; of the 12 in St. Nicholas, 11 were under 5 years, and of the 16 in Charlton, 15 were also under 5 years of age; from which it will be seen how frequently this is a disease becoming fatal in young children, and hence shews how great care should be bestowed upon the feeding and clothing of young children. This disease is the one credited with the largest proportion of deaths, causing our increased Zymotic Death Rate as compared with last year. I have, on more than one occasion, indicated the necessity for more frequent cleansing of the surfaces of the yards, courts, and alleys in the poorer districts, together with a more thorough flushing and cleansing of the drainage systems connected with this class of property, and it seems to me that this suggestion received a considerable amount of support, from the facts which we have now before us, for, whereas during the year 1903, when the yards, courts, alleys and drainage systems generally received a more ' thorough cleansing by natural means, the total number of deaths from this class of disease were very much smaller than during the last year, when the natural flushing arrangements were considerably more in abeyance. We find that the fatalities due to diseases generally assumed to be connected with dirt and filth accumulations in the neighbourhood of dwellings, and deficient flushing of house drainage systems, such as Typhoid Fever and Diarrhoea, have been materially increased during the past year, as compared with the previous year. Influenza. Influenza has occasioned 18 deaths throughout the Borough during the year, comparing with 14 during the previous year. (38) Shewing the Number of Cases of these Diseases notified during each week throughout the year 1904. 23 Sporadic. Tetanus. Two deaths have been ascribed to this disease during the year, one of the patients being under 5 years of age, and one over that age. No source of infection could be found for the cause of the death of one child ; in the case of the other patient, there was a possibility that the home treatment of an ulcerated ankle was the source of the infection. Venereal. Syphilis. This disease has been ascribed as the cause of 3 deaths during the year, all being in children under 5 years of age, hence, undoubtedly, they were sufferers from hereditary conditions. Septic. Erysipelas. This was the cause of 2 deaths during the year. Puerperal Fever. Puerperal Fever has occasioned one death. In this case a nurse only was present at the birth, the medical attendant not arriving until later. No definite source of infection could be found. Pyemia and Septicemia caused 4 deaths. Infective Endocarditis is credited with one death, making altogether a total of 8, with a death rate of 0-08 to this class of disease. Malarial. Rheumatic Fever is credited with 5 deaths during the year, all of them being in children under 5 years of age. Tuberculosis. This class of disease has occasioned 169 deaths during the year, with a death rate of 1 "67 per 1000, comparing with 161 deaths and a death rate of 161 per 1000 during the previous year. 24 Consumption is credited with by far the largest proportion of this number, viz., 127 deaths, or a death rate of 1.25 per 1,000, comparing with 1.62, the Consumption death rate for the whole of London. Amongst the Metropolitan Boroughs the Consumption death rate ranged from 0'83 in Hampstead, 0.90 in Lewisham, 1.12 in Wandsworth, 1'20 in Paddington, 1.25 in Greenwich, to 2.12 in Stepney and Bermondsey, 2.16 in Bethnal Green, 2.18 in Shoreditch, 2.36 in Southwark, 2.39 in Finsbury, and 2.86 in Holborn. Locally, the deaths were 3 in Kidbrooke, giving a death rate of 0.9 per 1000; 16 in St. Nicholas, giving a death rate of 1.9; 20 in Charlton, giving a death rate of 1.0; 32 in West Greenwich, giving a death rate of 1.2; and 56 in East Greenwich, giving a death rate of 1.2 per 1000. The remaining forms of Tuberculosis were credited with 42 deaths, 19 being in East Greenwich, 12 in West Greenwich, 5 in St. Nicholas, and 6 in Charlton. Of these other forms of Tuberculosis, Tuberculosis of the Brain, or its Membrane, was credited with 11 deaths; Tubercule affecting the Larynx, 1; Tubercule affecting the Intestines, 11 (5 being in patients under 5 years); General Tuberculosis, 10 deaths (7 being in patients under 5 years of age). Voluntary notifications of cases of Consumption were received to the number of 123 during the year, which, by comparison with the number received during the preceding years, viz., 59 and 51, shews that medical men in the district are more thoroughly appreciating this arrangement. Fifty-four of these notifications were respecting patients residing in East Greenwich, 29 in West Greenwich, 29 in St. Nicholas, and 11 in Charlton. Dietetic Diseases. This class of disease is credited with a total of 7 deaths, giving a death rate of '07 per 1,000. One death 25 was attributed to Scurvy, the remaining 6 were certified as due to Alcohol. It is interesting to note, by the way, that the enlightened bench of Magistrates for this district are proposing to reduce the number of public-houses in certain parts of the Borough, which appear to be over supplied in this respect. Constitutional Diseases. These are credited with 98 deaths, giving a death rate of '98 per 1000. Two were ascribed as due to Gout, 9 to Diabetes, 4 to Anaemia of various forms, and 83to Cancer. The deaths from Cancer were distributed as follows 40 in East Greenwich, 25 in West Greenwich, none in St. Nicholas, 18 in Charlton, and none in Kidbrooke. The enquiries which were commenced two or three years since, have been continued during the year with a view, if possible, to determine any apparently pre-disposing cause, and wherever insanitary conditions have been noted in connection with these enquiries, steps have been taken to remedy the same. The only frequently noted complaint was dampness to some of the rooms, in varying degrees. Information has been obtained definitely in 41 cases, and a brief resume of this information is as follows :— Ages of Persons at Death. Under 20 years. 20-30 years. 30-40 years. 40-50 years. 50-60 years. 60-70 years. Over 70 years. Total. Males 0 0 0 5 7 6 2 20 Females 0 0 0 2 10 5 4 21 Sites of the Disease. Males. Females. Mouth and Annexa 4 0 Stomach 5 2 Rectum i 6 Other parts of Intestinal Canal 2 3 Genitalia 2 4 Liver and Appendages 5 2 Breast — 4 Head 0 0 Lung 1 0 26 The number of children born of females who died of cancer of womb. &c., are—4 and 6. The number of children born of females who died of cancer of breast, &c., are—1 and 0. Developmental Diseases. This class of disease is credited with 231 deaths, equalling a death rate of 2'28 per 1,000, this number being distributed as follows:—Atelectasis 3, Congenital Defects 11, Want of Breast Milk 1—which causes of death amongst this class would appear to be generally the unavoidable ones. The next subdivision of this developmental class might be described as the ideal cause of death, viz., Old Age, or Senile Decay, which was ascribed as the actual cause in 98 cases. The remaining number, which forms by far the largest proportion, we find to be due to causes which, in a greater or less degree, are preventible, and therefore steps should be taken to conserve our population in this respect, by as far as possible preventing death from these causes, which are—Premature Birth, to which was ascribed 56 deaths; Injury at Birth, 1; Debility at Birth, 1; Atrophy, Debility, and Marasmus, 39; Dentition, 12; and Rickets, 9; making a total of 118. When we come to look more closely into these avoidable causes we find that many of them point to want of care, insufficiency of food, or improper diet provided for young children, and it seems to me that this points the way in which steps could be taken to remedy these conditions, viz., by educating, by all means in our power, mothers and future mothers as to the proper way of attending to, and bringing up, young children. Doubtless this could be most satisfactorily carried out by means of lady health visitors. 27 Local Diseases. Nervous System. This class of disease is credited with having caused 125 deaths, giving a death rate of l-23 per 1,000. Of this number, 29 were ascribed to Convulsions, all of them being in young children, and this number should be further added to the class of preventible diseases requiring attention in a similar way to those previously mentioned. Meningitis is credited with having caused 17 deaths—Apoplexy, 36; Softening of the Brain, 4; Brain Paralysis, 6; General Paralysis, 9; Diseases of the Spinal Cord, 6; other diseases of the Brain and Nervous System 18. Circulatory System. This class of disease is credited with having occasioned 138 deaths. One hundred and sixteen of this number being ascribed to Valvular Diseases of the Heart. Respiratory System. This class of disease is credited with 214 deaths, givinga death rate of 2.11 per 1,000. Of this number, 43 were ascribed to Acute Bronchitis, 32 of the cases being in children under 5 years of age; 63 to Chronic Bronchitis; 97 to Pneumonia, 41 of which were in children under 5 years of age; other diseases of the Respiratory System, 11 deaths. Digestive System. This class of disease is credited as the cause of 89 deaths ; Enteritis being credited with 25, 20 being in children under 5 years of age; Obstruction of the Bowels, 18; Appendicitis, 9; Cirrhosis of the Liver, 12; Peritonitis, 9; and the remaining diseases of this system, 16. Urinary System. Thirty-four deaths were ascribed to this class of disease, 27 of these being due to Bright's Disease. Reproductive System. Nine deaths were ascribed to be due to diseases of generative organs, and 6 to various conditions attendant upon, and complicating, the parturient condition. 28 External Causes. Accidents or negligence in various ways have been ascribed as the cause of death in 49 cases, 11 of which were in very young children who had been suffocated by being overlain by their parents in bed. This also is a cause of death which is pre-eminently one of the preventible class, and the sooner that parents begin to realise, both that it is more healthy for their children, and more comfortable for themselves, that a young child should occupy a separate bed, whether in the shape of a homely clothes basket or large drawer, or similar article, so soon will this large number of deaths begin to decrease. Drowning was the cause of death in 7 cases; Suffocation, otherwise than being overlain in bed, in 5 cases; falls, accidents on railways, and building operations, &c., 20; whilst burns, scalds and poisons also occasion 6 deaths; suicide was ascribed as the cause of death in 8 cases. MORTUARY. During this year the long-continued discussion and consideration of the question of suitable Mortuary provision for the Borough has at last been consummated by the erection and opening for use of a Mortuary building on a site adjacent to the Coroner's Court provided by the London County Council, this Mortuary being provided with all the most modern and up-to-date appliances, and providing, in every way, most satisfactory accommodation. Shortly, it may be described as having its accommodation divided into two portions, viz. : one for the reception of infectious bodies, the other for the reception of general cases. The infectious diseases department is provided with catacombs for the reception of six bodies, and is adjacent to the common viewing corridor, being provided with a large plate-glass window, so that the jurymen and others whose duty it is to view [29-30 [31-32 GREENWICH MORTUARY. Alfred Hobkrts, F.R.I.B.A., Architect. Shewinq the Number of Cases of these Diseases notified during each week throughout the year 1904. 33 bodies need not come into contact, nor run any risk of infection thereby. The general Mortuary is provided with catacombs for the reception of twelve bodies, also with an air-tight container for the reception of any decomposing bodies, and this portion, again, is provided with a plate-glass window looking into the viewing corridor. There is also a well-lighted post-mortem room, provided with two pust-mortem tables and all appurtenances, a room for the use of the medical men who may be called upon to carry out their duties in this connection, accommodation for a small hand ambulance, and the usual offices. The walls of the building are faced internally with opalite tiling, the floors are of terrazo paving, the corners and angles are all rounded, hence the whole of the building can very readily be kept clean. It is well lighted by electricity, and ventilated by louvres alongside the lantern lights in the roof. The number of bodies dealt with in St. Alphege Mortuary since 1896, is shewn below : — Year. Drowned bodies from River. Other bodies. Totals. 1896 11 33 44 1897 11 47 58 1898 15 32 47 1899 17 45 62 1900 7 66 73 1901 13 126 139 1902 13 95 108 1903 20 118 138 1904 15 155 170 Notifications under the provisions of the Public Health (London) Act, 1891. There have been notified a total of 890 cases under the above Act. Small-pox. Only one case of this disease was notified throughout the year in a person residing in this Borough. This was in the St. Nicholas District. The infection was presumably caught by a visit paid to friends residing in a neighbouring 34 Borough, across the river, where it was found, as a result of enquiries made after the occurrence of the case in this Borough, that cases of illness had occurred, thought at the time to be Chicken-pox, but in view of the subsequent history, presumably they also were Small-pox. Another case of this disease was also brought to our knowledge, in the person of a man who was travelling about the country generally, having slept the previous night at the Rowton House, Hammersmith (hence this notification \yas forwarded to that Borough as being the district in which he had last resided). Travelling thence to Greenwich, via the Tube Railway from Shepherd's Bush to the Bank, walking thence over London Bridge, along Tooley Street, taking the tram down Deptford Lower Road to Deptford, calling at a Barber's on the way for a shave, and from Deptford he came along the Greenwich Road to the Miller Hospital, for treatment as an Out-patient. When seen at this Institution by your Medical Officer of Health, there could be no doubt whatever as to the character of the disease, for the rash was then very fully developed, and great credit is due to the Resident Medical Officers of that Institution for the supervision they kept over the patient until such time as he could be seen and removed. From the information one gathered, it would appear he had contracted the disease whilst staying at a house at Oxford, for, on communicating with the Medical Officer of Health for that city, it was found that Small-pox had been prevalent in the neighbourhood, if not actually in the house where this man had lodged. He had not been vaccinated at all, and although he suffered from a severe attack, yet he made a very satisfactory recovery, after a somewhat prolonged stay in the Hospital. The Vaccination Officer for the Greenwich Union has again very kindly supplied me with the usual particulars respecting the vaccination of children whose births were registered in his portion of this Borough up to June, 1904, from a perusal of which it will be readily seen that the condition of the infant population of this District with respect to primary vaccination, is very satisfactory indeed. 35 fteturn for the period July to December, 1903. Return made on or before the 8th of August, 1904, by Mr. A. E. Rossitkr, Vaccination Officer of the several Districts oj the Greenivich Union, respecting the vaccination of children whose births were registered in his District from 1st July to 31st December, 1903, inclusive :— Registration Sub-Districts comprised in the Vaccination Officer's District. No. of Births from 1st July to 31st Dec., 1903. No. of these Births duly entered by 31st July, 1904. No. of Births which on 31st July, 1904, remained unentered in the Vaccination Register on account of— No. of these births remain- ing on 31st July, 1904, not accounted for. Successfully Vaccinated. Insusceptible of Vaccination. Had Small-pox. Cf rtificate-. ofconscientiousobjectioil received. Dead, Unvaccinated. Postponement by Medical Certificate. Removal to Districts, V.O. of which apprised. Removal to places unknown, and cases not found. 2 3 4 5 6 7 8 9 10 11 2. North Deptford 702 541 ... 3 79 22 1 49 7 4. East Greenwich 626 460 6 ... 7 77 13 4 57 2 5. West Greenwich 348 272 ... 4 39 4 6 22 1 Total 1676 1273 6 ... 14 195 39 11 128 10 Dated August 3rd, 1904. 36 Return for the period January to June, 1904. Return made on or before the 8th of February, 1905, by Mr. A. E. Rossiter, Vaccination Officer of the several Districts of the Greenwich Union, respecting the vaccination of children whose births were registered in his District from 1st January to 30th June, 1904 inclusive:— Registration Sub-Districts comprised in the Vaccination Officer's District. No. of Births from 1st Jan. to 30th June, 1904. No. of these Births duly entered by 31st Jan., 1905. No. of Births which on 31st Jan., 1905, remained unentered in the Vaccination Register on account of— No. of these births remaining on 31st Jan., 1905, not accounted for. Successfully Vaccinated. Insusceptible of Vaccination. Had Small-pox. Certificates of conscientious objection received. Dead, Unvaccinated. Postponement by Medical Certificate. Removal to Districts, v.o. of which apprised. Removal to places unknown, and cases not found. 1 2 3 4 5 6 7 8 9 10 11 2. North Deptford 619 478 6 ... 3 65 10 5 51 1 4. East Greenwich 663 540 2 ... 9 52 9 1 49 1 5. West Greenwich 312 246 ... 3 22 1 3 34 3 Total 1594 1264 8 ... 15 139 20 9 134 5 Dated February 4th, 1905. Supplemental Return for 1903. Return made on or before the 8tli of February, 1905, by Mr. A. E. Rossiter, Vaccination Officer of the several Districts of the Greenwich Union, respecting the vaccination of children whose births were registered in his District from 1st January to 31st December, 1903, inclusive :— Registration Sub-Districts No. of Births from No. of these Births duly entered by 31st Jan. 1905. No. of Births which on 31st Jan., 1905, remained unentered in the Vaccination Register on account of— No. of these births comprised in the Vaccination Officer's District. 1st Jan. to 31st Dec., 1903. Successfully Vaccinated. Insusceptible of Vaccination. Had Small-pox. Certificates of conscientious objection received. Dead, Un vaccinated. Postponement by Medical Certificate. Removal to Districts, V.O. of which apprised. Removal to places unknown and cases not found. ing on 31st Jan., 1905, not accounted for. I 2 3 4 5 6 7 8 9 IO 11 2t North Deptford 1365 1080 3 5 142 9 2 119 5 4. East Greenwich 1304 1013 12 14 141 5 5 114 5. West Greenwich 653 522 1 7 66 3 2 52 Total ... 3322 2615 16 26 349 17 9 285 5 Dated February 4th, 1905. 38 Diphtheria. One hundred and fifty cases of Diphtheria, were notified during the year, as compared with 207 cases during the previous year. The distribution of these cases was as follows:—53 in East Greenwich, 46 in West Greenwich, 17 in St. Nicholas, 31 in Charlton, and 3 in Kidbrooke. Of this total number 112 were removed to the Hospital for treatment. There were 12 fatalities due to this disease, which gives a case mortality of 8 per cent. One hundred and twentyseven specimens were forwarded by medical practitioners for bacteriological investigation, from cases suspected to be Diphtheria. Of this number, 96 were reported to give negative results, and 31 positive. The large number of negative results is again a very satisfactory feature of these investigations, showing the care taken by medical practitioners in the District in satisfactorily dealing with cases of this disease. During the year 6 cases, which were notified as Diphtheria and removed to the Hospital, were afterwards returned as not being suffering from that disease, the diagnosis in these cases made by the Medical Officer to that Hospital being in 4 cases Tonsilitis, and 2 cases Measles. Erysipelas. Eighty-seven cases were notified during the year, 34 being in East Greenwich, 27 in West Greenwich, 14 in St. Nicholas, 12 in Charlton. Eight of the patients were under treatment in Public Institutions in the District. Scarlet Fever. Two hundred and fourteen cases of this disease were notified during the year, as compared with 164 cases in the previous year ; 102 cases were in East Greenwich, 40 in West Greenwich, 17 in St. Nicholas, 47 in Charlton, and 8 in I 39 Kidbrooke; 186 of these cases were removed to the Hospital for treatment. There were only 3 deaths from this disease during the year. Eight cases, notified as Scarlet Fever and removed to the Hospital, were afterwards returned as, in the opinion of the Medical Officer of that Institution, not suffering from this disease, the diagnosis being in 3 cases Rotheln, 1 Erythema, 1 Varicella, 2 Tonsilitis, and in one case the disease was not stated. There were only three of what are usually considered as return cases occurring during the year, which is very satisfactory, when we bear in mind that the average period of detention of patients in the Hospitals on account of this disease is being gradually shortened. Particulars respecting these cases are appended :— 40 Table shewing Return Cases of Scarlet Fever during Year 1904. No. of Case. Date of Removal of Primary Case. Date of Notification. Date of Discharge from Hospital. Date of Removal of Second Case. Time between discharge of Primary and Second Case. Remarks, &c. Appearance on discharge. 1 13th Dec., 1903 14th Dec., 1903 20th Jan., 1904 5th Feb., 1904 13 days Running at nose and ears. Slept with second case. 2 19th „ „ 21st „ ,, 26th Feb., „ 1st Mar., ,, 3 „ Slept together. 3 15th Feb., 1904 15th Feb., 1904 2nd May, „ 16th May, „ 11 „ Slept and played together. 41 Typhoid Fever. There were 50 cases of Typhoid Fever notified during the year, 32 being in East Greenwich, 10 in West Greenwich, 1 in St. Nicholas, 3 in Charlton, and 4 in Kidbrooke. The ages of the patients were: 3 between 1 and 5 years, 17 between 5 and 15, 10 between 15 and 25, 19 between 25 and 65, and 1, 65 and upwards. Of the total number of cases, 39 were removed to the Hospital for treatment. There were 8 fatalities from this disease during the year, 6 being persons belonging to East Greenwich, and 2 to West Greenwich. Thirty-five specimens were forwarded for bacteriological examination from cases suspected to be Typhoid Fever in character, and of this number 21 gave a negative report, and 14 positive. Five cases which were notified as suffering from this disease and removed to the Hospital for treatment, were after wards discharged said to be suffering from diseases other than Typhoid Fever, viz., 1 each Meningitis, Rheumatism, Pneumonia, Appendicitis, and Hepatic Abscess ; one of the cases of Enteric Fever was considered to have been contracted whilst the patient was away at the hop fields at West Mailing, Kent, and one other under similar circumstances at Faversham ; on enquiry it was found that 4 cases of this disease had previously occurred in the same huts at the hop fields occupied by these patients. In one case the most probable source of infection appeared to be ice cream which the patient had been in the habit of frequently purchasing from various itinerant vendors in the streets. Thirteen of the cases had at about the critical period partaken of fish in various ways, and the patients or their friends had in most of these cases considered the fish to be the source of infection, fuller details of these cases are appended. 42 Fish and Enteric Fever. No. of Case. Age. Sex. Date of Notification. How long 111 before Notification. Interval between Eating and Notification. Kind of Fish Eaten. Where Eaten. Source of Fish Supply. Result of Illness. 1 42 F. 28th May, 1904 19 days 21 days Mackerel aud Tinned Beef Home Local... Recovered. 2 2½ F. ,, ,, ,, ,, ,, ,, ,, ,, ,, ,, „ ,, ,, 3 28 F. 7th June, „ 14 „ 15 „ Cockles Southend Southend ,, 4 38 M. 6th July, „ 12 „ 16 „ Fried Fish Home Local ,, 5 26 M. 11th July, „ 16 „ 21 „ Mackerel ,, ,, ,, 6 28 M. 5th Aug., „ 21 „ 23 „ Eels and Haddocks ... ,, ,, ,, 7 33 M. 21st „ „ 4 „ 21 » Oysters Stall on Deptford Broadway Deplford ,, 8 28 M. 9th Sept., „ 10 „ 17 „ Fried Fish and Winkles Home Local ,, 9 15 M. 8th Oct., „ 14 „ 24 „ Oygters Southend Southend Died. 10 7 F. 11th „ „ 14 „ 21 „ Shrimps and Winkles Home Local Recovered. 11 26 F. 12th „ „ 16 „ 20 „ Fried Fish ,, ,, ,, 12 37 M. 13th Dec., ,, 20 „ 23 „ Stewed Eels and Fried Fish ,, ,, ,, 13 7 M. 15th „ „ 21 „ 24 „ Winkles ,, ,, ,, 43 Puerperal Fever. Two cases of this disease were notified during the year, one being in West Greenwich, and one in Charlton. One death occurred from this disease during the year, viz., at King William Street, Greenwich, and for death registration purposes, on account of an arrangement between the two District Registrars, this death is included in our death returns as having occurred in East Greenwich, but according to our notification returns it is really in the West Ward. Chicken-pox. Three hundred and eighty-four cases of this disease were notified during the year, 203 being in East Greenwich, 49 in West Greenwich, 54 in St. Nicholas, 74 in Charlton, and 4 in Kidbrooke. The notification of this disease was not in force during the first quarter of the year, but an order was made by the London County Council, and confirmed by the Local Government Board, requiring such notification throughout the whole of London during the remaining portion of the year, until November 7th, when notification of this disease again ceased. Measles. 1,185 cases of this disease were notified by parents, guardians, school teachers and others during the year, and in each case visits were paid to the infected premises, and the usual measures of disinfection generally carried out. There were 40 cases of Measles which proved fatal. I certainly think that the steps now adopted in reference to this disease, will help to educate the public up to understanding that this disease is really one of a very dangerous character, for whilst the Municipality took no steps to deal with this disease, the public 44 very naturally were inclined to think that the disease therefore was of a very trifling character, whereas all public health administrators have realised for some time the very dangerous character of this illness, and this is amply borne out by our own statistics, for we see that during the past year there have been more deaths from Measles alone than Small-pox, Scarlet Fever, Diphtheria, Typhoid Fever and Puerperal Fever all put together. The only defect, to my mind, is that the whole procedure of the Public Health Act Notification Clauses are not made applicable to this disease, and as medical men are not at present bound to notify these cases, it tends at times to cause a little feeling of resentment in the matter, although this is generally removed when the matter is fully explained, yet I think the whole administrative procedure would work more smoothly if Section 55 of the Public Health (London) Act, 1891, were made applicable to this disease in the same way as the other infectious diseases. I am bound to admit that the expense occasioned thereby would be somewhat considerable, but I think that if the information is worth having, as I believe all Authorities will admit that it is, then surely it is worth paying for in the usual way. The infant departments of several schools were closed for varying periods during the year on account of this disease, and I am still of opinion that the aggregation of such young children as are frequently found in attendance at the infant department of schools is almost criminal, as these young children are thereby very frequently exposed to infection from this and other diseases which it is a well known fact are specially fatal at these early ages, and I think that if children were not admitted to school until they were at least 6 years of age, instead of as at present time, 3 years 45 of age, many of these fatalities would be avoided. I also think that the best way to check an outbreak of this disease in connection with any infant department, is the immediate closure of that department so soon as the first cases appear. Particulars showing the ages and districts affected during the year are tabulated. Table shewing number of Measles Cases reported during the year 1904. 1st QUARTER. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. East Greenwich ... 14 15 ... ... West Greenwich ... 20 24 ... ... St. Nicholas 1 3 3 ... ... Charlton ... 9 7 1 Kidbrooke ... ... ... ... ... Total 1 46 49 ... 1 Total 97. 2nd QUARTER. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. East Greenwich 11 175 64 1 1 West Greenwich 4 38 16 1 ... St. Nicholas 15 115 33 ... ... Charlton 2 47 34 ... ... Kidbrooke ... ... ... ... ... Total 32 375 147 2 1 Total 557. 3rd QUARTER. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. East Greenwich 14 160 55 ... 1 West Greenwich 1 6 10 ... ... St. Nicholas ... 5 6 ... 1 Charlton ... 19 12 ... ... Kidbrooke ... ... ... ... ... Total 15 190 83 ... 2 Total 290. 46 4TH QUARTER. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. East Greenwich 3 33 27 ... ... West Greenwich 3 20 31 ... ... St. Nicholas ... 1 ... ... Charlton 3 59 60 ... ... Kidbrooke ... ... ... ... ... Total 9 113 118 ... 1 Total 241. Total cases in year = 1,185. Isolation Shelter. During the year this Shelter has only been occupied by two families, viz., 6 adults and 7 children, whilst their premises were being disinfected. Contacts. Information has been received at various times throughout the year from the different Port Authorities respecting 15 persons, residing in this Borough, who had been in contact with cases of Small-pox and Plague whilst they had been on board ship; these persons were kept under observation, but nothing further developed. Throughout the whole of the Metropolis there was a total ot 28,295 cases of infectious disease notified, giving an attack rate of 6.1 per 1,000 living. This attack rate varied throughout the whole of London from 3.2 in Chelsea, 3.7 in Kensington, City of Westminster, and Hampstead, 4.2 in Lewisham, 4.5 in Lambeth, 4.7 in Paddington and City of London, 4.8 in Holborn, 49 in Battersea, 5.0 in Greenwich, up to 7.l in Deptford, 7.2 in Bermondsey, 8.5 in Hackney, 9-3 in Poplar, 9.4 in Stepney, and 116 in Bethnal Green. In these figures the Chicken-pox notifications are not included. Consumption. During the year there were 123 cases of Consumption voluntarily notified, 54 being in East Greenwich, 29 in West Greenwich, 29 in St. Nicholas, and 11 in Charlton. Of 47 this number, 33 cases were under treatment in an Institution. The ages of the patients were 2 under 1 year of age, 2 between 1 and 5, 15 between 5 and 15, 16 between 15 and 25, 87 between 25 and 65, and 1 over 65 years. Disinfection has been offered and carried out in 85 cases; 200 bottles of disinfectants have been supplied to disinfect the sputum in these cases. HOUSES INSPECTED AND ENQUIRIES MADE IN CONNECTION WITH INFECTIOUS DISEASE. Excluding Measles. Number of Houses Inspected and Enquiries made 1,509 „ Revisits 5,323 Forty Rooms have been cleansed after disinfection by the Department. HOUSES INSPECTED AND ENQUIRIES MADE IN CONNECTION WITH MEASLES. Number of Houses Inspected and Enquiries made 1,079 „ Revisits 1,670 The undermentioned Schools have been disinfected, owing to the prevalence of infectious disease amongst the children attending :— Morden Terrace Infants' Department Measles. Lombard Wall „ „ „ Fossdene Road „ „ Hughes' Fields „ „ ,, Old Woolwich Road , ,, ,, 48 Number of Articles Destroyed in connection with the Undermentioned Diseases, from January 3rd, 1904, to December 31st, 1904. Total Destroyed. ... 11 1 ... 3 26 4 26 71 Odd Articles Destroyed. ... ... ... ... ... ... ... 6 6 Quilts Destroyed. ... ... ... ... ... 6 ... 6 12 Cushions Destroyed. ... ... ... ... ... ... ... ... Sheets Destroyed. ... ... ... ... ... 3 ... ... 3 Blankets Destroyed. ... ... ... ... ... ... ... ... ... Pillows Destroyed. ... 2 ... ... 1 4 ... 2 9 Bolsters Destroyed. ... 1 ... ... ... 1 ... 2 4 Mattresses Destroyed. ... 3 ... ... 1 1 ... 6 11 Palliasses Destroyed. ... 3 ... ... ... 5 2 1 11 Beds Destroyed. ... 2 1 ... 1 6 2 3 15 Infectious Diseases. Small-pox Scarlet Fever Enteric Fever Puerperal Fever Diphtheria Phthisis Measles Other Diseases Total 49 Number of Articles and Rooms Disinfected in connection with the Undermentioned Diseases, from January 3rd, 1904, to December 31st, 1904-. 'J otal No. Articles Disinfected. 98 1166 367 266 19 ... ... 77 8 ... 116 2117 Odd Articles Disinfected. 64 140 12 26 1 ... ... ... ... ... 17 260 Quilts Disinfected. 5 118 41 22 ... ... ... 8 ... ... 6 200 Cushions Disinfected. 1 60 21 7 ... ... ... 2 ... ... 8 99 Sheets Disinfected. 5 50 19 12 2 ... ... ... ... ... 3 91 Blankets Disinfected. 4 262 91 40 ... ... ... 7 ... ... 10 414 Bolsters Disinfected. 3 98 32 32 3 ... ... 10 2 ... 12 192 Pillows Disinfected. 8 235 87 76 6 ... ... 31 2 ... 29 474 Mattresses Disinfected. ... 53 20 8 3 ... ... 4 ... ... 20 108 Palliasses Disinfected. 3 23 1 11 1 ... ... 4 1 ... 4 48 Beds Disinfected. 5 127 43 32 3 ... ... 11 3 ... 7 1 231 Rooms Disinfected. 0 184 135 44 2 ... ... 45 846 10 27 1299 Premises Entered. 1 161 I 132 35 2 ... ... 35 1 835 10 24 11235 Infectious Diseases. Small-pox Scarlet Fever Diphtheria Enteric Fever Puerperal Fever Membranons Croap Erysipelas Phthisis Measles Chicken-pox Other Diseases Total 50 The Sanitary work of the Department shows that a total of 19,891 houses and premises have been inspected or reinspected during the year; 1,946 intimation notices have been served, and 378 statutory notices, whilst it was only found necessary to issue summonses and thus institute magisterial proceedings, when orders were obtained and enforced in four cases. The number of complaints received from the general public during the year was 248. Bakehouses. Two hundred and fifteen inspections have been paid to the Bakehouse premises in the Borough, and 7 cases of nuisance existing have been abated. The whole of the underground Bakehouses have also been inspected, and the necessary certificates obtained by the persons occupying the Bakehouses in all but two cases. At the end of 1903 there were 33 underground Bakehouses in use within the Borough, the use of 12 of these premises has been discontinued, 4 of the owners apparently themselves considered that their premises could not be rendered suitable, for they made no application for a certificate ; the other 9 made application for certificates, and were informed upon what conditions with respect to alteration such certificate would be granted; in one case the owner, rather than carry out the necessary works, which in this instance were, and still are, very necessary indeed, was able, by taking down the wall shutting off the Bakehouse from a lumber room at the rear, to thereby remove his premises altogether from the scope of these provisions relating to underground Bakehouses, for by this means the Bakehouse proper was made to be on a level with the ground at the rear ; the other 8 owners have decided not to carry out these works, and their premises have been closed, and in three of these cases, Bakehouses have been built above ground in substitution for 51 the underground premises. Of the 20 underground Bakehouse which are in use at the present time, 18 have the necessary certificate, whilst 2 have not. These two cases have received the special consideration of the Committee on various occasions, and action has been delayed in one case, to enable the owner to complete a very satisfactory bakehouse which he is building above ground, and in the other case to grant the occupier extended periods of time to enable him to complete the work required, and which he has already, for the greater part, carried out. In two cases it was thought advisable to take proceedings for the occupation of underground Bakehouses without certificates, and in each case the necessary works were thereupon carried out to enable the certificates to be granted. Factories and Workshops. Three hundred and twentyone visits of inspection have been paid to these premises within the Borough. There were 217 premises on the Register at the beginning of the year, 124 have been added during the year, 20 have been taken off, leaving a total now on the register of 321 premises, of which number 315 have now been properly measured up. The total number includes 37 laundries, 64 dressmakers, 8 fuel and firewood works, 10 milliners, 5 cycle works, 10 ladies' underlinen works, and various others, including 21 workplaces, such as blacksmiths, barge builders, builders' yards, &c. Notifications of 50 new workshops and workplaces, and 10 notifications of young persons or of females being employed on premises where no abstract is displayed, have been sent to H.M. Inspector of Factories, whilst one complaint has been received from H.M. Inspector of Factories. In the course of our inspections 106 sanitary defects were found, of which, up to the present time, 103 have 52 been remedied. Sixty-three written notices were served respecting these matters. There have been no prosecutions under the Act. Outworkers' Register. During the year 49 lists containing 122 names have been received from Medical Officers of Health for other districts, 17 lists containing 72 names have been received from employers within the District, from which list 29 names and addresses have been sent on to other Districts, leaving a total of 165 names and addresses of outworkers within the Borough. Inspection has been made from time to time at all these premises, and sanitary defects found in 5 ; 4 of them needed cleansing, and 1 improved ventilation. Difficulty still is experienced by the non-receipt of the required intimation from employers at the proper time as to their outworkers, in accordance with the requirements of the Act. FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. 1.—INSPECTION. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries.) 126 5 ... Workshops (Including Workshop Laundries.) 377 47 2 Workplaces 43 1 ... Homeworkers' Premises 141 10 ... Total 687 63 2 53 2.—DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. Nuisa?ices under the Public Health Acts :—* Want of Cleanliness 48 48 ... ... Want of Ventilation 8 7 ... ... Overcrowding ... ... ... ... Want of Drainage of Floors 1 1 ... ... Other Nuisances 34 34 ... ... Sanitary Accommodation— Insufficient 5 5 ... ... Unsuitable or defective 6 6 ... ... Not Separate for Sexes ... ... ... ... Offences under the Factory and Workshop Act :— Illegal ()ccupation of Underground Bakehouse (s. 101) 4 2 ... 2 Breach of Special Sanitary Requirements for Bakehouses (8S. 97 to 100) ... ... ... ... Failure as regard Lists of Outworkers (s. 107) ... ... ... Giving out Work to be done in Premises which are Unwholesome (s. 108) ... ... ... ... Giving out Work to be done in Premises which are Infected (s. 110) ... ... ... ... Allowing Wearing Apparel to be made in Premises Infected by Scarlet Fever or Small-pox (s. 109) ... ... ... ... Other Offences ... ... ... ... Total 106 103 ... 2 "Including those specified in Sections 2, 3, 7 and 8, of the Factory Act as remediable under the Public Health Acts. 54 3.—OTHER MATTERS. Class. Number. Matters notified to H.M. Inspectors of Factories :— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 10 Action taken in matters referred by H.M. Inspectors as remediable under the Public Health Acts, bnt not under the Factory Act (s. 5):— Notified by H.M. Inspector 1 Reports (of action taken) sent to H.M. Inspectors 1 Other 50 Underground Bakehouses (s. 101) :— In use during 1903 33 Certificates Granted in 1904 18 In use at the end of 1904 20 Homework :— Lists Received 66 Outworkers 194 Addresses of Outworkers— Forwarded to other Authorities 29 Received from other Authorities 122 Workshops on the Register (s. 131) at the end of 1904 :— No. Fuel and Firewood Works 8 Bakehouses 72 Laundries 37 Dressmakers 64 Milliners 10 Ladies' Underlinen 10 Other 119 321 Slaughter-Houses. The slaughter-houses have been visited on 33 occasions by the Inspectors, and have generally been found to be in satisfactory condition. Cowhouses. The four cowhouses have been visited by the Inspectors on 15 occasions, cleansing has been found to be not satisfactorily carried out on 6 occasions, and this matter has been attended to. The renewal license for these cowhouses was granted by the London County Council, in each case, one of the occupiers 55 however, rather than carry out alterations to one of his cowsheds, decided that it would be preferable to build a new cowshed, steps were taken to carry out this suggestion without giving the Loca Authority any notice or information respecting the proposed new cowshed. Objection was accordingly made to the London County Council against this proposal on those grounds, and the hearing of the matter was adjourned, in order that the necessary notice and information should be given to this Council. As soon as the plan and particulars were received, they were considered by the Public Health Committee, and certain improvements suggested, particulars of which were forwarded to the applicants and to the London County Council, but although the officials of the London County Council and the occupier of the premises admitted that the alterations suggested by this Council were eminently desirable, and would be an improvement upon the plan as presented, yet the County Council accepted the plan as presented, without alteration in the way suggested. I am accordingly very much afraid that, when this new cowshed is in occupation, and definitely comes within the purview of this Council to see that the various regulations respecting cowsheds are carried out, the occupier may be put to considerable additional and unnecessary expense, in order to abate, or obviate, serious nuisance which may arise. One occupier of premises, which some few years since were in use as a cowshed, made application for revival of this license, and was willing to carry out the necessary works suggested by this Council, but a license was not granted him. The inconvenience occasioned to the public generally by having two authorities in this way dealing with the same matter, appears to be at last realised by the County Council, who I 56 notice, in their Annual Report state, " That it would be preferable to have this dual control done away with, by the Local Government Board issuing a new Dairies, Cowsheds and Milkshops Order, applicable to London, and giving the control in this matter more definitely and distinctly, either to the London County Council, or the Borough Councils," and I think all who have had experience with this matter, will concur with this suggestion. Horse Slaughterer. The one horse-slaughtering premises within the Borough has been visited by the Inspector on 31 occasions. Other Scheduled Offensive Trades. The 63 other promises where these offensive trades are carried on have been kept under observation. Dairies, Cowsheds and Milkshops Order. At the commencement of the year, there were 161 premises on the Register of Dairies and Milkshops ; 29 new applications have been received during the year, and no names have been taken off, leaving a total of 190 premises now registered, and 275 visits of inspection have been paid to these premises. One person was prosecuted for carrying on the business of a milk purveyor without being registered, as required by the regulations. Ice Cream Premises. There were 118 premises known at the commencement of the year where the manufacture of this commodity was carried on, 5 have been added during the year, and 7 taken off, leaving a total of 116 premises. These have been inspected on 122 occasions, and whenever defects have been found, they have received attention, which was the case on 4 premises. No proceedings have been taken in this connection. 57 Other premises where food is prepared have been inspected on 162 occasions, and 17 were found to require attention or improvement, which works have been carried out. Customs and Inland Revenue Acts. Applications were received from 2 owners during the year for certificates under these Acts, for 14 and 30 tenements respectively. In neither case were the cases considered suitable, and accordingly the certificates were not granted. The chief objection at one place was that there was a lack of proper ventilation for the room which contained a gas stove, not provided with any hood or other means for allowing the escape of the fumes, which fumes were found to pervade the various rooms of the tenement. In the other case, which were recently-built London County Council dwellings, their attention was drawn to the fact of the totally inadequate accommodation provided for washing or laundry purposes, such provision being almost of a dangerous character at the present time, on account of the small floor space, so that the garments of the person standing at the wash-tub would be very liable to catch fire at the copper provided for boiling purposes. Some of the bedrooms also appeared to be deficient as far as ventilation was concerned, and very inadequate in size. House-to-House Inspection. This inspection has been continued more or less throughout the year, and at the present time, the scheme adopted by the Public Health Committee for paying one visit of inspection to all the houses occupied by persons of the working class throughout the Borough is nearing completion. Tables giving a resume of the results found during the year are appended. 58 Resume of House-to-House Inspection Results.—Houses, Rooms, Defects. WARD. Inspection Block No. No. of Houses. No. of Tenements. Total No. of Rooms in Houses Rooms in Tenements. No. of places having Lodgers. No. Rooms occupied by Lodgers. Total No. of Rooms. Number of Houses having Sanitary Defects. Total Defects. 1 Defect. 2 Defects. 3 Defects. 4 Defects. 5 Defects. 6 Defects. 7 Defects. Total Houses with defects Marsh Ward VIII. 1704 341 2045 10117 2415 533 1797 14329 543 337 168 56 17 6 1 1128 2073 North IX. 1000 84 1084 4786 394 251 688 5868 314 204 104 50 12 8 1 693 1349 59 Resume of House-to-House Inspection Results.—District of Occupation. WARD. Inspection Block No. PLACE OF OCCUPATION. Greenwich. Deptford. Lewisham. Woolwich. City. Millwall. Southwark. Westminster. Rotherhithe. Bermondsey. Poplar. Whitechapel. Sea and River. Various. Other Towns. Erith. Out of Work. No information gathered. Marsh Ward VIII. 1960 43 28 237 93 33 6 18 5 16 38 4 114 108 ... 9 131 909 North IX. 1256 18 53 69 82 41 10 12 3 22 11 3 87 115 ... 20 153 8 Resume of House-to-House Inspection Results.—Length of Residence, Rentals. Length of Residence in same House. Rentals under, per week— Lodgers' Rents, per week. WARD. Inspection Block No. Under 1 year. 1 to 2 years. 2 to 3 years. 3 to 5 years. 5 to 10 years. 10 to 15 years. 15 to 20 years. 20 to 30 years. | 30 to 40 years. 40 to 50 years. 50 to 60 years. Over 60 years. 5s. 6s. 7s. 8s. 9s. 10s. 11s. 12s. 13s. 14s. 15s. Over 15s. Occupiers being Owners. Yearly Tenants. 2s. 3s. 4s. 5s. 6s. 7s. 8s. 9 s. 10s. and over. Marsh Ward VIII. 988 383 274 352 594 268 198 78 12 4 .. .. 65 87 83 445 247 118 206 280 192 119 45 84 166 146 2 53 111 101 247 139 98 56 6 North IX. 434 196 132 138 221 146 96 96 33 11 5 .. 132 71 99 122 176 112 80 37 63 16 4 33 55 97 11 68 88 53 80 33 21 15 3 61 Resume of House-to-House Inspection. WARD. Inspection Block No. Total Inmates. Total. Discoveries. Houses Let in Lodgings. Adults. Children. New Workshops. Outworkers. Marsh Ward VIII. 8888 4730 13618 10 6 533 North IX. 4019 2087 6106 2 6 251 62 Housing of the Working Classes Acts. No special action has been taken under these Acts during the year. The Greenwich Market Area, which has been under the consideration of the Committee from time to time, was visited on one occasion by the Committee, with a view to taking some immediate action, but it was then found that the Admiralty Authorities had already commenced the demolition of their insanitary property in this area, and accordingly, for the time being, the matter stands in abeyance, as the demolition of this property has very considerably improved the condition of the adjacent property, particularly by letting in much more light and air. Resolutions passed by a Public Meeting, held for the consideration of this question within the Borough, were considered by the Public Health Committee, and whilst they heartily concurred with practically the whole of the Resolutions, yet, seeing that there was such a large amount of empty working-class house property in the Borough, it was deemed inopportune to take any further action. One of the Resolutions urged "that no time should be lost in adopting and putting into practice Part III. of the Housing Act, that without assistance from the rates, but to their ultimate relief, proper houses may be erected for people at rents within their means." Unfortunately, the Public Health and Housing Committee were unable to find instances of this work having been carried out without assistance from the rates, and, therefore, it seemed that however laudable this Resolution might be in its aim and object, yet, up to the present, it has been found impossible to carry out. Overcrowding has received attention, and been abated in 20 cases. Six hundred and twelve houses, generally, have been 63 r repaired; 389 premises have been cleansed, lime-washed, and repaired; in 111 cases the ventilation has been improved; in 220 cases the walls and ceilings have been cleansed throughout; in 234 cases the cleansing has been carried out in a portion of the premises; in 397 cases leaky house roofs and gutters have been repaired. Sinks, lavatories, bath waste-pipes have been attended to in 256 cases; 281 stack pipes have also been amended; 111 nuisances from dampness generally have been abated; dampness of the house walls remedied in 103 cases; other nuisances, principally of dilapidations and want of under floor ventilation, have been attended to in 69 cases; whilst one house has been abolished as unfit for habitation. Houses Let in Lodgings. In consequence of recent decisions bearing upon these By-laws, it was found necessary to have new By-laws drafted, and accordingly this question has occasioned considerable correspondence with the Local Government Board, and once more these By-laws have been duly sanctioned by the Local Government Board. No special work has been carried out under these By-laws during the year, and, although we are now fully aware of a large number of properties which come within the scope of these By-laws, in many of which cases the occupiers would be considerably benefited by the imposition of the requirements specified under the By-laws, yet, with the present staff, I do not see how any of this very necessary work can be attempted, much less carried out satisfactorily. House Drainage. Four hundred and thirty-five house drainage systems have been reconstructed or repaired; 220 also have been opened, cleansed and amended; 91 new systems and 590 surface drains have been constructed; 164 drains have been 64 tested by smoke, and 536 by water, in 313 of which cases defects were found; 173 new soil pipes and 944 traps have been fixed; whilst 439 drains and soil pipes have been ventilated. Four cesspools have been abolished, and 72 new water closets erected. The sanitary conveniences at 15 workshops and factories have received attention; 68 public-house urinals also have been cleansed and repaired, 1 has been erected and 1 reconstructed, and 1 other urinal reconstructed. In 35 cases the water supply has been disconnected from the drinking-water system; in 105 cases proper water supply apparatus has been provided, and in 148 cases this has been renewed. Sewerage. Complaints have still been somewhat numerous respecting the flooding of houses with sewage water in the low lying districts, and the completion of the relief sewer, in process of construction by the London County Council, is anxiously awaited. Refuse Removal. House refuse is collected by the Council throughout the Borough generally on a weekly system. In a few special parts it is, however, more frequently, whilst on the other hand in a few districts it is less frequently collected. The method adopted by the Council for disposing of their refuse when collected cannot be considered to be a commendable one, at any rate in London, and complaints as to the objectionable smells, smoke and fumes given off by the burning of the waste paper and lighter portion of this refuse have been very frequent. The question of the collection and removal by the Council of offensive trade refuse, such as fish offal and the like, has again been considered, but up to the present the Public Health Committee have not seen their way to make any definite proposal to the Council for taking up this matter. One prosecution was 65 undertaken during the year against a person for conveying offensive material through the streets at other than the time prescribed by the By-laws; he was fined 20s. and costs. Water Supply. The water supplied throughout the whole of the district by the Kent Water Works Company and the Metropolitan Water Board has again maintained its high standard of purity. Three hundred and twelve Certificates have been granted under Section 48 of the Public Health (London) Act, 1891, during the year, which certificates are to the effect that the new house in question is supplied with a proper water supply. In one case proceedings were taken against the owner for allowing the house to be occupied without obtaining such certificate, when a fine of 10s. and 2s. costs was imposed. Public Sanitary Conveniences. During the year a new Sanitary Convenience at the junction of Blackwall Lane and Woolwich Road has been opened. This convenience has accommodation for both sexes, and is much appreciated and used in the district. There is still a need for further accommodation of this sort within the Borough, and, as pointed out in the last Report, this appears to be especially the case near the Entrance to the Park, from King William Street, and as, in all probability, this open space will be patronised much more during the coming than it has been in recent years, this accommodation is particularly needed. Smoke Nuisances. Three hundred and sixty-nine observations have been taken for smoke nuisances during the year, and on 11 occasions, when black smoke was found to be emitted in such quantity as to be a nuisance, the matter was reported to the 66 Committee, who authorised the service of a statutory notice, which in every instance ensured the abatement of the nuisance. On one occasion proceedings were taken against the South-Eastern and Chatham Railway Company, on account of the emission of black smoke from one of their engines, coming into Greenwich Station, and a fine of £3 and 23s. costs was imposed. Several complaints have been received from time to time respecting the quantities of smoke emitted by engines near to, or whilst passing through, the different tunnels in the Borough. Observations have been made, but sufficient evidence, up to the present, has not been obtained to warrant proceedings being taken. Re-interment of Human Remains. During the progress of the work in connection with the enlargement of the County Council Sewage Pumping Station, Norman Road, a quantity of human remains were disturbed. It would appear that the ground where they were found had not been disturbed for at least 45 to 50 years, and no evidence was obtained as to how and when these remains were deposited there. The matter was reported to the Home Office, who issued a licence to the Medical Officer of Health for the re-interment of these remains in the Shooters Hill Cemetery. This was accordingly carried out under the direction and to the entire satisfaction of your Medical Officer of Health. Food and Drugs Acts. Three hundred and ten samples have been purchased under the provisions of the Sale of Food and Drugs Acts, of which 291 were certified to be genuine, and 19 adulterated, which is equivalent to 6 per cent. adulterated samples. Of this total number of samples, 118 were milk, and 91 butter, of which number. 9 samples of milk and 5 of butter were certified to be adulterated; the remaining adulterated samples were, 2 coffee and 3 67 Demerara sugar. Of this total number of samples, 37 were taken in course of, and at the place of, delivery, by an Officer of this Council directly, and all these samples were genuine; one was taken otherwise by an Officer of this Council directly, and was found to be adulterated ; the remaining 272 samples were taken by agents employed by the Officers of this Council. One case of somewhat particular interest occurred during the year. A sample of milk had been purchased and was certified to be adulterated; the vendor thereupon desired that a sample should be taken in course of, and at the point of, delivery of the milk to him by the wholesale firm. He at this time stated that he had no warranty with his milk supply. The sample taken in the course of delivery was found to be genuine. At the hearing of the case, in June, the vendor produced a warranty dated in the April previous, and covering the supply from which the sample was taken and found to be adulterated. On cross examination, it turned out that his previous statement had been quite correct, that he had no warranty, but that on a subsequent date, in fact, after the service of the summons, he obtained from the wholesale firm a warranty, which, in the ordinary course of events, would have ensured his acquittal from the offence. In this case, however, he was fined £10 and 22s. costs. The point of interest in the matter being, the readiness with which these warranties are apparently given by the wholesale firm, which seems to show that these firms are fully aware of the legal difficulties which present themselves before anyone endeavouring to take proceedings against the warrantor, and it further makes one wonder whether there have not been other occasions when the warranty is produced which has exempted the actual vendor from a penalty, and yet this warranty has been obtained subsequent to the purchase of the sample. 68 A feature which is becoming noticeable in this district is, that not only are the public-houses and restaurants exhibiting a notice which, whilst to the general public it appears to praise the quality of the article sold, is well-known and understood by the official purchaser to be a notice disclosing adulteration, under the Acts, but milk sellers, buttermen and grocers are also adopting this form of notice, thereby being enabled to palm off on the general public adulterated articles without fear of a prosecution. 69 Sale of Food and Drugs Acts.—Number and Description of Samples purchased for Analysis under the above Acts during the Year 1904 Description of Samples. Number of Samples Purchased. Number Genuine. Number Adulterated. Remarks. Milk 118 109 9 MILK. Butter 91 86 5 1 36½ % milk fat abstracted; £3 Fine and 22s. Costs. Coffee 26 24 2 1 30 % milk fat abstracted; £1 Fine and 22s. Costs. Mustard 1 1 1 23½ '/, milk fat abstracted; £10 Fine and 22s. Costs. Pepper 4 4 1 22⅓% milk fat abstracted; £20 Fine and 22s. Costs. Margarine 1 1 1 30°/o milk fat abstracted ; £2 Fine and 22s. 6d. Costs. Lard 8 8 1 14°/o added water; £3 Fine and 22s. Costs. Demerara Sugar 22 19 1 7½°/o added water ; £3 Camphorated Oil 4 4 Fine and £1 5s. Costs. 1 11¾°/o added water; £4 Vinegar 1 1 Fine and £1 10s. Costs. 1 03°/o Boric Acid; Cheese 6 6 cautioned. Sweets 2 2 BUTTER. Baking Powder 2 2 94 per cent. Margarine; £3 Fine and 17s. Costs. Jam 2 2 92 per cent. Margarine; £1 Fine and 12s. Costs. Olive Oil 3 3 91 per cent. Margarine; £2 Fine and 22s. 6d. Costs. Boracic Acid Ointment 4 4 33 per cent. Margarine; £2 Fine and 22s. Costs. Tea 2 2 55 per cent. Margarines £2 Fine and £2 2s. Costs. Amber Syrup 1 1 COFFEE. Cod Liver Oil 3 3 65 per cent. Chicory; £2 Cocoa Extract 1 1 Fine and £2 3s. 6d. Costs. 40 per cent. Chicory; £1 Lump Sugar 1 1 Fine and 22s. 6d. Costs. Yeast 2 DEMERARA SUGAR. Coffee and Chicory 1 1 1 Dyed Sugar, other than Demerara; 5s. Fine and 22s. 6d. Costs. Ground Rice 1 1 1 Dyed Sugar, other than Tapioca 1 1 Demerara; £3 Fine and 17s. costs. Sago 1 1 1 Dyed Sugar, other than Demerara; £2 Fine and 22s. Costs. Caraway-seeds 1 1 Total 310 291 19 70 Summary of Sanitary Work performed during the Year 1904. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total. Inspections. Honses Inspected 1099 1171 732 861 3863 Reinspections, Calls made, &c. 3577 3716 3198 3860 14351 Inspections of Bakehouses 57 36 49 73 215 ,, Factories and Workshops 78 84 48 111 321 „ Slaughter-houses 4 12 6 11 33 „ Cow-houses 3 2 5 5 15 „ Stables and Yards 32 25 37 26 120 „ Piggeries 3 3 5 ... 11 „ Courts and Alleys 27 29 23 17 96 „ Fields, Lanes, &c. 20 47 21 24 112 „ Urinals 20 66 28 21 135 „ Gipsy Vans 8 2 3 5 18 „ Horse Slaughterhouses 6 8 8 9 31 „ Dairies, Cowsheds, and Milkshops 35 94 26 120 275 „ Soap Boilers ... ... 5 1 6 „ Other Offensive Trades ... ... ... 5 5 „ Ice Cream Places 5 93 16 8 122 „ Other places where Food is prepared 45 77 32 8 162 Total 5019 5465 4242 5165 19891 71 SUMMARY OF SANITARY WORK—continued. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total. Drains. Constructed 16 23 26 26 91 Intercepter Chamber, and Fresh Air Inlet 29 53 25 23 130 Reconstructed or Repaired 145 114 98 78 435 Opened, Cleansed and Amended 63 52 58 47 220 Surface Drains Constructed 148 143 162 137 590 Traps Fixed 233 277 215 217 944 New Soil Pipes 26 62 41 44 173 Drains and Soil Pipes Ventilated 104 126 107 92 429 Drains Tested—by Smoke 55 57 31 21 164 ,, ,, by Water 149 147 124 116 536 Found Defective 108 84 58 63 313 Yards Drained 83 53 39 22 197 Mews and Stables Drained 1 1 4 3 9 Washhouses Drained ... ... ... ... ... Forecourts Drained ... 2 ... 3 5 Areas Drained 32 62 31 35 160 Cesspools Abolished 1 1 1 1 4 Cleansed and Disinfected 3 3 3 9 Water Closets and Urinals. Closets Erected 26 23 8 15 72 Sanitary Conveniences or improvements effected to Factories and Workshops 5 3 5 2 15 Pan, Traps and Water Supply furnished 111 113 66 75 365 Pans and Traps only furnished 86 94 117 67 364 Paus only furnished 11 12 12 7 42 Water Supply Apparatus provided 33 31 19 22 105 Water Supply renewed 31 43 38 36 148 Water Supply disconnected from Drinking Water Cistern 18 1 1 15 35 Soil Pans properly Trapped 48 51 40 45 184 Cleansed and Repaired 40 26 30 25 121 Newly constructed or better situated 21 3 6 30 Ventilation Improved 31 57 29 36 153 Public-house Urinals Cleansed or Repaired 11 31 13 13 68 Other Urinals Altered 1 ... ... ... 1 Repaired or Water laid on 1 2 1 1 5 Public-house Urinals Erected ... ... 1 ... 1 Public - house Urinals Reconstructed ... ... ... 1 1 72 SUMMARY OF SANITARY WORK—continued. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total. Ashpits. Provided 155 211 117 166 649 Pavings. Yards 181 168 131 98 578 Forecourts 1 2 1 16 20 Areas 37 67 33 51 188 Washhouses 4 9 10 10 33 Mews and Stables 1 1 3 3 8 General Water Supply. Covers to Cisterns Adapted 30 36 18 14 98 Water Supply Provided 2 1 3 Water Fittings Amended 93 63 54 41 251 Cisterns Cleansed and Repaired 25 ... 2 1 28 Water Services Altered so as to draw direct from main 41 73 38 19 171 Water Supplies Reinstated where cut off through defective fittings 12 9 6 12 39 Defective Water Fittings (causing nuisance from dampness) repaired 25 15 27 11 78 Water Supply Certificates granted (Section 48) 54 96 101 61 312 Cisterns provided ... ... 1 ... 1 Other Improvements. Houses Generally Repaired 146 222 127 117 612 Premises Cleansed, Limewashed and Repaired 73 164 94 58 389 Ventilation Improved 51 34 13 13 111 Leaky House Roofs and Gutters Repaired 81 174 77 65 397 Walls and Ceilings of Premises Cleansed throughout 79 61 28 52 220 Ditto, ditto, partially 51 67 55 61 234 Cow-houses cleansed ... ... 2 4 6 Horse Slaughter-houses cleansed ... ... ... 1 1 Ice Cream Places cleansed or improved ... 2 ... 2 4 Other Places where Food is prepared 5 8 ... 4 17 73 SUMMARY OF SANITARY W0RK—continued. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total. Other Nuisances Abated. Illegal use of Underground Room Discontinued ... ... 2 ... 2 Overcrowdings Abated 4 6 7 3 20 Sink, Lavatory and Bath Waste Pipes Disconnected, Trapped and Amended 75 76 51 54 256 Stack Pipes Disconnected, Trapped and Amended 84 76 41 81 281 Nuisances from Dampness Abated 28 44 17 22 111 Animals kept in Unfit Places Discontinued or Removed 1 3 2 1 7 Dung Receptacles Provided 1 ... 2 ... 3 Bakehouse Nuisances Abated ... ... 1 6 7 Houses Abolished, unfit for Habitation 1 ... ... ... 1 Accumulations of Manure and other obnoxious matter Removed 14 12 13 3 42 Dampness of Walls Remedied 28 43 17 15 103 Inundations Abated Other Nuisances, principally of Dilapidations and want of Under-floor Ventilation 31 12 12 14 60 Smoke Nuisances. Observations 100 117 83 69 369 Statutory Notices served (Sees. 23 and 24) 5 2 3 1 11 Food and Drugs. Samples taken 84 128 33 65 310 Found Adulterated 7 9 2 1 19 Unwholesome Food. Seizures made ... ... bushel ... 1 bushel Apples Apples 74 SUMMARY OF SANITARY W ORK—continued. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total- Unwholesome Food—contd. aboat 1 ton of Potatoes about 7 cwt. of Potatoes 100 tons Indian Corn, Flour & Grain 17 boxes Kippers 2 cwt. of Potatoes 1 barrel Apples 240 lbs. Tom 'to's 1 bushel Apples, 28 lbs. Beef & Mutton, 1 box Fish about 1 ton of Potatoes 7 cwt. of Potatoes 2 cwt. of Potatoes 100 tons Indian Corn, Flour & Grain, 17 boxes Kippers, 1 box Fish, 1 barrel Apples, 1 bushel Apples, 28 lbs. Beef A Mutton 240 lbs. Tom'to's Voluntarily surrendered Notices, Ac. Intimations Served under Public Health (London) Act, 1891 (Section 3) 562 632 311 441 1946 Complaints Received 56 65 78 49 248 Complaints Attended to 56 65 78 49 248 Statutory Notices Served under Section 4 61 190 58 69 378 Statutory Notices re Ashpit provision 39 102 28 64 233 Letters Written relating to Abatement of Nuisances 1185 1512 1252 1698 5647 Summonses Applied for and Issued 2 4 4 ... 10 Magisterial Orders Obtained and Enforced ... 2 2 ... 4 Drainage Plans received and examined 53 33 54 35 175 75 REPORT re CONGRESS OF THE ROYAL INSTITUTE OF PUBLIC HEALTH. Public Health and Housing Department, Royal Hill, Greenwich, S.E. The Annual Congress of this Institute was opened at Folkestone on Thursday, July 21st, and was attended by a large number of delegates, representing most of the Municipal Authorities and Scientific Institutions in the Kingdom. The Earl of Radnor was installed as the President of the Congress, and he delivered a very able Presidential Address. Amongst the large number of papers read and discussed, the papers referring to the milk supply of large communities, the question of vaccination or isolation, the usefulness or otherwise of infectious hospitals, and infantile mortality, appear to have special import for us, whilst among the Lectures or Addresses given by . celebrities, those of Professor W. J. Simpson and Dr. W. J. Tyson upon "Preventive Work"; that by Sir George Kekewick, K.C.B., formerly Secretary of the Board of Education, on "Physical Education of Children"; that by Surgeon-General Evatt, on the "Personal Health of the Citizen in relation to National Efficiency"; and last, but not least, that of Doctor Ferdinald Hueppe, Professor of Hygiene at the German University of Prague, upon the fight against Tuberculosis, contained much useful information. In reference to the milk question, papers were considered bearing upon the collection and transit of milk from a bacteriological point of view, the methods adopted by Railway Companies for conveying milk, the bacterial contents of milk, the conditions prevailing at the points of origin and distribution, veterinary 76 control of dairy herds, and upon a clean milk supply. It was pointed out that if the public would decline to buy milk unless it was guaranteed to come from clean cows, kept under clean conditions, milked only by clean men, or would at any rate take the trouble to enquire which milk-sellers in any immediate neighbourhood gave most attention to sanitary conditions, and would confine their patronage to such vendors, Sanitary Authorities would be greatly helped in their endeavours to obtain a clean milk supply. The need for reform in the conditions at present prevailing n reference to the transit of milk, was urgently put forward, it Deing declared that special ice vans should be a sine qua non. It was pointed out again and again, that the most important point in securing the purity and good quality of the milk was that it should be produced by healthy and clean cows, kept in healthy and clean surroundings, and periodical and frequent inspection of Dairies was strongly advocated. A Resolution was passed urging the Council of the Royal Institute of Public Health to consider the. whole question, with a view to securing in the interests of the public health a clean milk supply for the consumer. Hinging very much upon this question was the consideration of the excessive infantile mortality in large towns, and upon this point several papers were read showing the good work that had been done amongst communities where Municipal Milk Depots for the supply of humanized milk had been inaugurated. It was shown that both at Liverpool and Battersea the infantile mortality had been considerably reduced, and it was thought that the provision of these Milk Depots for the use of children who, for one reason or another, were deprived of the natural mother's milk, had been of great benefit. It is not in the slightest advocated that this 77 milk should take the place of ordinary mother's milk, but should be only used to take the place of cow's milk or other artificial preparations used for the feeding of young children when the natural mother's milk is not obtainable. It may be pointed out that the Council of the Metropolitan Borough of Lambeth have been memorialized by local medical practitioners and the staff of large Hospitals situated within the Borough, to take up this question, and I understand that although the Local Government Board's Auditor annually disallows the payments made by the Borough of Battersea in this connection, yet the Borough of Lambeth are proposing to go forward on the same lines. The Committee will doubtless remember that I have on one or two occasions advocated the adoption of some such measure to deal with this problem as it presents itself in the poorer parts of this Borough, and would suggest, in order to give a definite legal sanction for this work, that the London County Council be approached with a view to their obtaining powers in their next General Powers Bill, authorising the provision of Municipal Milk Depots in suitable districts in Greenwich, also, if thought advisable, in other Metropolitan Boroughs. In reference to vaccination or isolation, it was pointed out that if they did not have vaccination, they had to fall back on the second line of defence by trying to isolate every case of Small-pox as it arose. It was shewn that, in Germany, where there is regular systematic vaccination and re-vaccination, there were no Small-pox Hospitals provided, and that the cost of re-vaccination at school age would compare very favourably with the cost of 78 provision and maintenance of Small-pox Hospitals. It was also pointed out that while cases of infection spreading to the Staff in Scarlet Fever, Diphtheria, and Typhoid Wards were frequent, no cases occurred amongst the Staff in Small-pox Wards, because the nurses and servants were well vaccinated As a result of the Address upon "Preventive Medicine," and it having been shewn how much India and some of the Colonies were lacking in preventive work, it was decided to approach the Secretary of State for India, and lay before him and Lord Curzon the necessity for a largely increased sanitary service for India. In the Address on " The Physical Education of our Children," it was stated that the subject comprised not merely physical exercises and training, but the conditions under which children lived, both at school and at home. With regard to the Schools, Sir George Kekewick said that the Board of Education had not done, and was not now doing, its full duty in regard to seeing that suitable buildings were provided, tenderness for the pockets of the owners of schools meant cruelty to children. With regard to the expenditure, although there may be no return in actual coin of the realm, it would be a good outlay, inasmuch as the Hospitals and Infirmaries would be less crowded, and it was resolved that, being impressed with the necessity for the adoption of all proper steps for the improvement of the physique of the nation, it was desirable to impress upon public authorities, central and local, the urgent importance of greater attention to the surroundings of the child, whether in the home or at school. Professor Hueppe gave some very striking figures, comparing the spread of Tuberculosis in towns and country districts, and also between industrial and agricultural areas; and yet, in 79 tion to their general experience, both England and Germany have some agricultural districts shewing more deaths from Tuberculosis than had some industrial districts. It was pointed out that favourable conditions for decreasing the death rate from Tuberculosis were clean dwellings, with well lighted and pure air, good nourishment, and regular hours of work, and it was shewn that in some country districts the dwelling apartments were kept in conditions of great uncleanliness, which uncleanliness paralyzes the pure fresh air and favours the infection by decreasing the resisting power of the body. It was shewn that success in the fight against Tuberculosis depends, in the first place, on the practical destruction of the excretion, containing as it did the tubercular bacilli in large numbers. The connection between Tuberculosis and dust is everywhere well known, it being conclusively proved that the inhalation of dust predisposes to the infection of Tuberculosis, and besides dust, intoxication, as Alcohol; constitutional illness, as Diabetes; slight illness, as Catarrh; severe infectious diseases, as Whooping Cough, Measles, and Influenza, all meant the predisposition to Tuberculosis. On the other hand, a man who is slightly infected with Tuberculosis can die of another infection, such as Influenza, which he otherwise would have recovered from. It was stated that if we prevent the breaking out of Tuberculosis, or if we, after curing, make a man having Tuberculosis capable of work, we do a good social work, and benefit the human race. It was also stated that the infection of children by infected milk has been very much under-estimated, and accordingly all measures that will improve the milk supplied to children will be of practical benefit. 80 There were many other Papers of much interest, but the points mentioned above are, in my opinion, the points having special interest for us at the present time in connection with our Public Health work in this Borough. In conclusion, I beg to thank you for so kindly appointing me as your Delegate, and I feel sure that the unique opportunity thus afforded me for discussing various points of practice with colleagues from all parts of the kingdom, will be of ultimate practical benefit to this Metropolitan Borough. I am, Gentlemen, Yours respectfully, E. G. Annis. Medical Officer of Health. September 26th, 1904. CONFERENCE ON THE ADMINISTRATION OF THE PUBLIC HEALTH (LONDON) ACT, 1891. A Conference of the various Metropolitan Sanitary Authorities was held at the County Hall, in July, and Representatives from most of the Metropolitan Borough Councils were present, many matters of great importance with reference to the administration of sanitary procedure were considered and discussed, and the following Resolutions were passed by the Conference:— Housing. Houses let in Lodgings. (6.) That the efficient administration of Section 94 of the Public Health (London) Act, 1891, relating to the registration and regulation of houses let in lodgings is a matter of extreme importance to the public health of London. i 81 (7.) That it is advisable that in By-laws made in respect of houses let in lodgings there should be no rental limit of exemption, but that they should be so framed as to apply only to such houses as are registered by the Sanitary Authority. (8.) That the efficient enforcement of By-laws relating to houses let in lodgings is the most effective method of dealing with overcrowding, but that inspections should from time to time be made during the early hours of the morning at other houses where overcrowding within the meaning of Section (2), (1), (e) of the Public Health (London) Act, 1891, is suspected. Underground Rooms. (9.) That a single angle of light and air to underground dwelling rooms should be adopted in the enforcing of Section 96 of the Public Health (London) Act. (10.) That this Conference is of opinion that no underground room not complying with the conditions laid down by Section 96 of the Public Health Act, 1891, should be used for sleeping. Water Supply. (11.), That a draw-off tap from the rising main and a sink should be provided on every floor of a tenement house. Factories and Workshops. (12.) That it is desirable that the Sanitary Authorities in enforcing Section 38 of the Public Health (London) Act, 1891, should adopt the following standards:— I. In factories and workshops where females are employed or in attendance, there shall be one sanitary convenience for 82 every 25 females, provided that in factories or workshops where the number of females employed or in attendance does not exceed 75, the following shall be the standard:— One sanitary convenience where no more than 15 females are employed or in attendance. Two sanitary conveniences where from 15 to 40 females are employed or in attendance. Three sanitary conveniences where from 40 to 75 females are employed or in attendance. II. In factories or workshops where males are employed or in attendance there shall be one sanitary convenience for every 25 males ; provided that: — (a) In factories or workshops where the number of males employed or in attendance does not exceed 50, and sufficient urinal accommodation is also provided, there shall be one sanitary convenience where no more than 20 males are employed or in attendance, and two sanitary conveniences where from 20 to 50 males are employed or in attendance. (b) In factories or workshops where the number of males employed or in attendance exceeds 100, and sufficient urinal accommodation is also provided, it shall be sufficient if there is one sanitary convenience for every 25 males up to the first 100, and one for every 40 after; (c) In factories or workshops where the number of males employed or in attendance exeeds 500, and the 83 District Inspector of Factories certifies in writing that, by means of a check system, or otherwise, proper supervision and control in regard to the use of the conveniences are exercised by officers specially appointed for that purpose, it shall be sufficient if one sanitary convenience is provided for every 60 males, in addition to sufficient urinal accommodation. Any certificate given by an Inspector shall be kept attached to the general register, and shall be liable at any time to be revoked by notice in writing from the Inspector. (In calculating the number of conveniences required, any odd number of persons less than 15, 20, 25, 40, or 60, as the case may be, shall be reckoned as 15, 20, 25, 40, or 60.) Shops. (13.) That it is desirable that power should be given to Local Authorities to inspect the sleeping accommodation in shops where the assistants are boarded-in. Food. Premises where Food is Prepared for Sale. (14.) That the London County Council be requested to insert in their General Powers Bill for the Session of 1905 a clause enabling them to make By-laws for the regulation of the structure of premises where food is prepared for sale, and that no such premises should be used unless certified by the Borough Council to be suitable for the purpose. (15.) That the London County Council be requested to insert in their General Powers Bill for the Session of 1905 a 84 clause enabling them to make By-laws for the regulation of the conduct of the business carried on in premises where food is prepared for sale, such By-laws to be enforced by the Borough Councils. Abolition of Private Slaughter-houses. (16.) That the time has arrived when private slaughterhouses should cease to exist in London. Inspection of Meat Killed in Private Slaughter-houses. (17.) That it is desirable that Borough Councils should endeavour to have all meat that is killed inspected. Inspection of Slaughter-houses, Cow-houses, Dairies, Milkshops and Milk Stores. (18.) That slaughter-houses, cow-houses, dairies, milkshops and milk stores should be frequently inspected. Registration of Milkshops. (19.) That the London County Council be requested to take powers to enable the Metropolitan Borough Councils to refuse registration of premises as milkshops, where, in their opinion, the premises are unfit for the purpose. Sale of Milk. (20.) That the London County Council be requested to introduce legislation providing for the penalising of persons selling filthy milk in London. Municipal Milk Depôts. (21.) That, having regard to the declining birth rate, and the large infantile mortality rate of the Metropolis, it is desirable that the Metropolitan Borough Councils should be empowered, at 85 their discretion, to provide in their respective districts, depots for the preparation and sale of sterilized and humanized milk for the food of infants, and that the London County Council be requested to insert a clause in its General Powers Bill for the Session of 1905 to confer such power upon the said Borough Councils. Sale of Food and Drugs Acts. (22.) (a) That, in the opinion of this Conference, the provisions of Section 25 of the Food and Drugs Act, 1875, and of Section 20 of the Food and Drugs Act, 1899, operate to the prejudice of the purchaser and of public health, and should be repealed; (b) That the London County Council be requested to make a communication, conveying the Resolution of the Conference, to the President of the Local Government Board, with a view of his promoting legislation for this purpose. (23.) That the Local Government Board and the Board of Agriculture be asked to take such steps as may be necessary in order that a limit may be fixed as to the amount of boracic acid —that is, free or combined boracic acid—or other preservatives which may be mixed with food other than milk. (24.) That every registered milk-seller in a Borough shall have his milk tested frequently. Cisterns. (25.) That, in cases where there is a constant water supply, cisterns should only be used in connection with hot-water services and sanitary conveniences. Prevention of Disease. Disinfection. (26.) That this Conference is of opinion that disinfection 86 should be carried out by the responsible officers of the Sanitary Authority without the intervention of a contractor. (27.) That the London County Council be asked to take measures to amend the law with regard to disinfection, so that disinfection should be carried out by the responsible officers of the Sanitary Authority without the intervention of a contractor, and that in all cases, the disinfection should be to the satisfaction of the Medical Officer of Health. Provision of Laundry. (28.) That the provision of a laundry for use in connection with the disinfection of infected articles is essential. Provision of Permanent Shelter Accommodation. (29.) That at least one permanent shelter for temporary use should be provided in each Borough, for the accommodation of persons during the disinfection of their homes. (30.) That the word "accommodation" mentioned in Section 60, Sub-section 4 of the Public Health (London) Act, 1891, should, if and when necessary, include the expense of the supply of food. Precautionary Measures against Phthisis. (31.) That the system of voluntary notification of phthisis is desirable, and should be made general throughout London. (32.) That the Sanitary Authorities should disinfect the premises in which a person suffering from phthisis has died, or from which such a patient has removed or has been removed. Hospital Accommodation. (33.) That it is desirable to make provision of sanatoria for the isolation and treatment of persons suffering from consumption, 87 for the Metropolis as a whole, and under one authority; and that, in the opinion of this Conference, the Metropolitan Asylums Board should be such authority. (34.) That the foregoing Resolution be sent to the Local Government Board with the request that they give the matter their immediate consideration. Offensive Trades. (35.) That the business of a marine store dealer should be added to the list of offensive businesses specified in Section 19 of the Public Health (London) Act, 1891. (36.) That the business of a fried fish shopkeeper should be added to the list of offensive businesses specified in Section 19 of the Public Health (London) Act, 1891. (37.) That the London County Council be requested to make an order to carry out these Resolutions. House Refuse. (38.) That this Conference is of opinion that dust collection should be carried out by the responsible officers of the Sanitary Authority without the intervention of a contractor. (39.) That the daily removal of house refuse in suitable districts is advisable. (40.) That improved dust carts should be adopted, so covered as to minimise annoyance caused to passers-by during collection of house refuse, especially in crowded thoroughfares. (41.) That the method of destruction of house refuse by fire should be universally adopted in London. 88 Collection of fish offal and other offensive trade refuse. (42.) That the collection of fish offal and other offensive trade refuse should be undertaken by the Sanitary Authorities at the expense of the producers. Sanitary Inspection. (43.) That female Inspectors should be employed in each Borough. Miscellaneous. Municipal Creches. (44.) That, having regard to the declining birth-rate and the large infantile mortality rate of the Metropolis, it is desirable that the Metropolitan Borough Councils should be empowered, at their discretion, to establish Creches for the reception of young children during the hours their mothers are employed in work away from home, and to make reasonable charges for the accommodation so provided and for the food of the children, and that the London County Council be requested to insert in their General Powers Bill for the Session of 1905, a clause to confer such power upon the said Borough Councils. Smoke Nuisances. (45.) That in the opinion of this Conference it is desirable that the provisions of the Public Health (London) Act, 1891, as to nuisances arising from the emission of smoke, should be applied to property in the possession of the Crown. Metropolitan Ambulance Service. (46.) That the Conference, taking note that the Metropolitan Asylums Board are prepared to extend the operations of their ambulance service so as to include the transport of medical, surgical, and mental cases, respectfully requests the Local 89 ment Board to obtain for the Managers the requisite legal authority to enable them to do so. (47.) That the Conference desires to express the opinion that should the London County County not be able to provide for a street ambulance service, the duty should be undertaken by the Metropolitan Asylums Board. Application of Acts to Government Property. (48.) That all provisions of the Public Health and Sanitary Acts should apply to Government property. Vote of Thanks. (49.) That the Conference do pass a hearty vote of thanks to its Chairman for his able conduct of the business of the Conference. CONFERENCE ON THE SPREAD OF INFECTIOUS DISEASE BY VAGRANTS. A Conference upon the above subject was held at the County Hall, in November, representatives from most of the County Councils, Corporations, City and Borough Councils, in the country being present. The discussion showed that very great danger was occasioned at certain times by the amount of freedom with which persons of the vagrant class were allowed to tramp about the country generally, and the following Resolutions bearing upon the question were adopted by the Conference. General Measures for the Prevention of the Spread of Infectious Disease by Vagrants. (1.)(a) That this Conference of Urban and Sanitary Authorities of England and Wales recognises the increasing 90 amount of habitual vagrancy as the cause of wide-spread and disastrous consequences to the public health, and is of opinion that much more effective measures than are at present adopted, should be taken for preventing the spread of infectious disease by vagrants, and for effectually dealing with this great and growing danger. (b) That the evil can only be met by conferring further powers upon the Local Authorities, viz., the Sanitary Authority, the Board of Guardians, and the Magistracy. (2.) That means should be provided for the detention and isolation of any vagrant found wandering in a public place, if reasonably suspected of being liable to convey infectious disease. (3.) That this Conference is of opinion that it is desirable that— (a) Parliamentary powers should be sought for the compulsory vaccination and re-vaccination of all vagrants unable to produce proof of being sufficiently protected against small-pox on entering casual wards or common lodging-houses, who, in the opinion of the Sanitary Authority, have been exposed to the infection of small-pox, and also that Sanitary Authorities should have power to grant such compensation as they think necessary to persons vaccinated or re-vaccinated at their request who may be prevented on that account from work. (b) It should be an offence to withhold information or make false statements to the Sanitary Authority in carrying out its powers with respect to the disease. (4.) That in order to deal effectually with the transmission of notifiable infectious disease by tramps, power should be given 91 to County Councils to enforce the existing laws in all cases where Sanitary Authorities in the county refuse or neglect to do so. (5.) That the Local Government Board should obtain powers to secure weekly returns of all cases of infectious disease from all Central Authorities throughout the country, and circulate the same. (6.) That it is desirable that in districts comprising groups of Counties and County Boroughs, intelligence bureaux should be established, to which information should be sent from Sanitary Authorities and Workhouses in the district, of persons of the wandering class who have been exposed to the infection of smallpox; and that a printed copy of such information should be distributed from the bureau to every Sanitary Authority and Board of Guardians in the district, and that the expense of working the bureau should be met by contributions from the County Councils and County Boroughs forming the district. (7.) That this Conference is of opinion that the Port Sanitary Authorities should be authorised to take more stringent precautions to prevent the importation of disease by persons arriving by vessel at the ports who are suffering from small-pox, or who have been exposed to infection by that disease. Common. Lodging-Houses and Casual Wards. (8.) That the Local Authority should have increased control over common lodging-houses, their keepers, and occupants. Thus the Local Authority should have power— (a) To medically examine the inmates. 92 (b) To detain and isolate persons exposed to infection, and to disinfect them and their clothes. (c) To temporarily close a common lodging-house in whole or in part; compensation to be given to the keeper of the house. (9.) That the Local Authority should have power to order the keeper of a common lodging-house in which there has been infectious disease to refuse fresh admissions for such time as may be required by the authority. (10.) That the Local Authority should be empowered to require medical examination and disinfection of all persons entering casual wards. (11.) That the Local Sanitary Authority should have power to require the removal and isolation of any inmate of a casual ward who may reasonably be suspected of being liable to convey infectious disease. (12.) That the Local Authority should have full power to require the cleansing of the person and the disinfection of the clothes of any person in a casual ward, whether infected or exposed to infection. Labour Bureaux. (13.)(a) That the time has arrived when the Local Government Board should promote legislation for the establishment of labour bureaux in the areas of every County Council and every County Borough Council. (b) That this Conference is also of opinion that it is desirable that a national voluntary agency should be formed for assisting bond fide working men while travelling through the country in 93 search of work, and that such agency should be worked on the same lines as the Inter-Cantonal Union of Switzerland for the relief of poor travellers. (14.) That the unemployed travelling bona fide in search of work, not being habitual vagrants, should not be treated as vagrants, but as far a possible be assisted to obtain employment. Labour Colonies. (15.) That the time has arrived when the Local Government Board should promote legislation for the establishment of labour colonies for the compulsory detention of habitual vagrants until they have acquired power to work and self-restraint. (16.) That this Conference approves and affirms the Resolutions passed by the Executive Council of the Assocation of Poor Law Unions in England and Wales at their Meeting in September, 1903, as follows:— (а) That Boards of Guardians should be grouped in suitable areas to provide labour colonies for vagrants. (b) That such colonies should be established and governed by Joint Committees of the Boards of Guardians of the Unions in the said areas. (c) That habitual vagrants should be sent to such labour colonies by magistrates. (d) That the expenses of such colonies should be spread over the Unions in the areas served by such colonies. Children of Vagrants. (17.) That the powers of the Poor Law Guardians under the Poor Law Acts of 1889 and 1899 to assume and exercise, in 94 tain circumstances, parental rights over the children of pauper parents, should be extended so far as to confer similar rights over the children of habitual vagrants. Generally. (18.) That, in order to give practical effect to the foregoing Resolutions, this Conference is in favour of uniting with the County Councils Association, the Association of Municipal Corporations, the Association of Metropolitan Borough Councils, the Magistracy, and the Association of Poor Law Unions of England and Wales for the following purposes, viz.:—(a) To enlist the sympathy and co-operation of members of Parliament; (b) to appoint representatives to wait on the Local Government Board; (c) to give evidence before the Inter-Departmental Committee of the Government on the Vagrancy Question; (d) to take such other measures as may be thought desirable in support of the Resolutions arrived at by the Conference. LONDON COUNTY COUNCIL GENERAL POWERS BILL, 1904. This Bill, in its sanitary portion, contains several proposals likely to be of great benefit to London generally, many of these proposals being inserted in the Bill on the request of various Borough Councils. The County Council however, in their wisdom, saw fit to incorporate a clause practically giving them the power of acting both as judge and advocate, when considering as to the default or otherwise of the various Metropolitan Borough Councils. This clause was particularly objected to by several Councils, including Greenwich, and the Parliamentary Committee saw fit to alter this control section to the power of control given by Section 95 101 in the Public Health (London) Act, 1891, which makes the Local Government Board the judge between the County Council and the Metropolitan Borough Councils. This was the form of control suggested by the opposing Borough Councils, whereupon, for some reason or other best known to the County Council or their advisors, one of the most necessary clauses of the Bill was also not proceeded with in the House of Lords, although it had passed the Commons. This clause is the one authorising sanitary regulations for premises used for the sale or preparation for sale of food for human consumption. The sanitary powers obtained under this Act, as it was passed, are briefly as follows:— Section 19, which gives power to the Sanitary Authority to require filthy, dangerous, or unwholesome articles in a house to be purified or cleansed. Section 20, which provides that houses infested with vermin may also be required to be cleansed. Section 22 gives power to the Sanitary Authority to require removal or alteration of sanitary conveniences accessible from any street, which are so placed or constructed as to be a nuisance or offensive to public decency. Section 23 empowers the Sanitary Authority to require fixed ashpits to be removed where movable ashpits have been provided. REPORT RESPECTING THE WORK OF THE PUBLIC HEALTH DEPARTMENT. During the year the question of the enlargement of the staff of the Public Health Department has been under consideration at various times, several reports upon the matter have 96 been presented, showing the amount of work that has been done with the existing arrangements, the amount of work which still awaits our attention, and the large areas with proportionate houses and population at present allotted to the District Inspectors, and, as pointed out in my last report upon the matter, there are many important duties, such as regular house-to-house inspection, tenement lodging inspection, &c., which are hardly carried out at all, some not even being attempted, and until some increase in the staff is effected, I do not see how it would be possible to cope with the work. Unfortunately, at the present time, the Committee and Council have not seen their way to fall in with my views upon the matter, and increase the staff. METROPOLITAN BOROUGH OF GREENWICH. Vital Statistics of separate Localities in 1904 and previous years. Names of Localities. 1. TOTALS. 2. EAST GREENWICH. 3. WEST GREENWICH. 4. ST. NICHOLAS. 5. CHARLTON. 6. KIDBROOKE. Year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. 1891 61072 2081 1685 257 32106 504 22007 407 6828 247 164 1892 66414 1997 1573 258 32106 464 22007 365 8108 234 126 1893 67035 2088 1733 290 32106 510 22007 465 7078 268 147 1894 68283 2012 1487 229 32106 432 22007 284 7078 259 177 1895 70439 2032 1683 266 32106 448 22007 341 7960 245 186 1896 68501 2163 1695 283 32106 447 22007 333 7722 303 217 1897 69643 2153 1621 293 32106 404 22007 331 7946 268 199 1898 70564 2159 1813 372 32106 505 22007 362 8122 252 192 1899 71590 2239 1791 327 32106 523 22007 313 8394 288 194 1900 75698 2146 1754 361 40266 578 23455 329 8394 251 153 58 16679 446 232 77 Averages of Years 1891 to 1900 69224 2107 1683 294 32922 481 22152 353 7763 261 175 58 1901 96188 2775 1468 362 44090 1347 671 190 23581 635 398 71 7295 251 166 45 18131 520 222 55 3091 22 11 1 1902 98013 2802 1522 387 44687 1368 639 166 23899 600 420 89 7383 264 177 58 18838 493 266 73 3206 17 20 1 1903 99824 2702 1317 345 45525 1297 616 172 24350 650 363 83 7520 272 124 39 19196 469 201 51 3233 14 13 0 1904 101651 2629 1450 373 46552 1367 681 181 24896 618 394 88 7771 224 139 44 19167 398 221 57 3265 22 15 3 Averages of Years 1901 to 1904. 98919 2727 1439 367 45214 1345 652 177 24181 640 394 83 7492 253 151 47 18833 470 217 59 3199 19 15 1 Deaths of residents occurring in public institutions beyond the district are included in sub-columns c of this table, and those of non-residents registered in public institutions in the district excluded. Deaths of residents occurring in public institutions, whether within or without the district, are allotted to the respective localities according to the addresses of the deceased. All Particulars for the years 1891-1900 inclusive, are taken from the several reports for those years. I. II. III. Institutions within the District receiving sick and infirm persons from outside the District. Institutions outside the District receiving sick and infirm persons from the District. Other Institutions— the deaths in which have been distributed among the several localities it the District. Miller Hospital Seamen's Hospital Woolwich Union Workhouse and Infirmary Cottage Hospital, Kidbrooke Greenwich Union Workhouse and Infirmary Varions Hospitals throughout the Metropolis Herbert Hospital M.A.B. Brook Hospital The various London County Asylums, &c. METROPOLITAN BOROUGH OF GREENWICH. Vital Statistics of Whole District during 1904 and Previous Years. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the Distract. Total Deaths in Public Institutions in the District. Deaths of Nonresidents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all Ages belonging to the District. Under 1 Year of Age. At all Ages. Number. Rate* Number. Rate.* Number. Rate per 1,000 Births registered. Number. Rate.* 12 13 1 2 3 4 5 6 7 8 9 10 11 Greenwich Parish only, from Annual Reports for respective years. 1891 57344 1834 32.0 257 1521 26.5 609 1892 58306 1763 30.2 258 1447 24.8 626 1893 59957 1820 30.3 290 1586 26.4 611 1894 61205 1753 28.6 229 1310 21.4 594 1895 62479 1787 28.6 266 1497 23.9 708 1896 60779 1860 30.6 283 1478 24.3 698 1897 61697 1885 30.5 293 1422 23.0 687 1898 62442 1907 30.5 372 1621 25.9 651 1899 63196 1951 30.8 327 1597 25.2 661 1900 67304 1927 28.6 308 1623 24.1 617 Averages for years 1891-1900 61470 1848.7 30 07 288 1510 24.55 646 Whole Borough. 1901 96188 2775 28.94 389 140 1898 19.80 786 532 102 1468 15.31 1902 98013 2802 28.13 420 149 2138 21.81 876 616 148 1522 15.28 1903 99824 2702 27.15 372 137 1741 17.49 778 550 126 1317 13.23 1904 101651 2629 25.95 394 150 1945 19.20 864 594 99 1450 14.31 # Rates in Columns 4, 8, and 13 calculated per 1,000 of estimated population. The deaths included in Column 7 of this table are the whole of those registered during the year as having actually occurred within the district or division. The deaths included in Column 12 are the cumber in Column 7, corrected by the subtraction of the number in Column 10 and the addition of the number in Column 11. By the term "Non-residents" is meant persons brought into the district on account of sickness or infirmity, and dying in public institutions there ; and by the term " Residents " is meant persons who have been taken out of the district on account of sickness or infirmity, and have died in public institutions elsewhere. Area of District in acres Total population at all ages 95,770 At Census (exclusive of area 3,849 acres. Number of inhabited houses 14,240 of covered by water). Average number of persons per house 1901. BOROUGH OF GREENWICH. SUMMARY RETURN OF BIRTHS AND DEATHS Registered during the 13 weeks ended 2nd April, 1904. districts. Births Registered during the 13 weeks ended 2nd April, 1904. Deaths registered during the 13 weeks ended 2nd April, 1904. age mortality. seven zymotic diseases. Phthisis. All other forms of Tuberculosis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Cancer. All other Diseases. Rate op Mortality per 1,000. ??? Over 1 and under 5 years. Persons aged 65 years and upwards. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers. All Causes. Seven Zymotics During the corresponding period ' year previous. During thel3 weeks ended 2nd April, 1904. During the corres. ponding period year previous. During the 13weeks ended 2nd April, 1904. Typhoid. Puerperal. Diarrhoea. F. M F. Greenwich East 43859 46552 184 153 95 5105 47 26 39 1 1 3 14 1 18 8 34 19 14 87 13.58 17.24 1.23 1.72 Do. West 23456 24896 84 74 55 44 22 11 23 2 7 1 1 9 4 17 5 3 50 15.98 15.96 1.65 1.77 St. Nicholas, Deptford 7321 7771 29 37 17 27 14 10 5 2 1 5 2 2 2 9 5 16 19.21 22.73 2.67 5.16 Charlton 18065 19167 52 48 30 33 14 6 17 1 4 5 14 10 1 28 12.75 13.19 0.84 1.05 Kidbrooke 3069 3265 4 1 3 0 1 1 1 2 6.20 3.69 Miller Hospital— Residents 4 1 3 Non-Residents 5 1 1 1 3 Seamen's Hospital — Residents 5 1 1 1 4 Non-Residents 28 1 ... 1 5 4 6 12 Greenwich Union— Workhouse and Infirmary Residents 56 4 3 19 8 3 4 3 5 33 Non-Residents 78 5 8 23 2 15 1 9 7 7 37 Herbert Hospital— Residents Non-Residents 8 1 1 1 M.A.B. Brook Hospital— Residents 4 4 1 3 Non-Residents 33 4 18 13 17 1 2 Cottage Hospital,Kidbrooke Residents ... 3 1 1 1 Non-Residents 1 1 Outside Institutions— Residents ... 37 2 2 10 1 1 1 5 4 3 22 Borough 95770 101651 353 313 200 209 98 53 85 4 1 6 30 1 4 34 14 74 40 18 183 Rate per 1,000 of Estimated Population 26.29 16.15 0.16 0.04 0.24 1.18 0.04 0.16 1.34 0.55 2.92 1.58 0.71 7.22 14.19 16.15 1.33 1.82 Deaths of Children under one year per 1,000 births 147 previous corresponding 100 period " " " " County of London 133 Death Rate of 76 large English Towns 18'7 of the County of London 17.8 Death Rate (Zymotic) „ 1.'66 „ „ 1.61 Birth Rate „ 29'7 „ ,, 28.7 BOROUGH OF GREENWICH. SUMMARY RETURN OF BIRTHS AND DEATHS Registered during the 13 weeks ended 2nd july, 1904. DISTRICTS. Census Population, 1901. Estimated Population at the middle of the Year 1904. Births Registered during the 13 weeks ended 2nd July, 1904. Deaths registered dur. ing the 13 weeks ended 2nd July, 1904. AGE MORTALITY. SEVEN ZYMOTIC DISEASES. Phthisis. All other forms of Tuberculosis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Cancer. All other Diseases. Rate of Mortality per 1,000. Under 1 year. Over 1 and under 5 years. Persons aged 65 years and upwards. Small. pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers. All Causes. Seven Zymotics. During the corresponding period year previous. During thel3 weeks ended 2nd July, 1904. During the corresponding period year previous. During the 13weeks ended 2nd July, 1904. Typhoid. Puerperal. Diarrhoea. M. F. M. F. Greenwich East 43859 46552 163 164 68 63 25 20 31 5 1 1 8 1 1 5 14 4 16 11 7 57 11. 55 11.29 1.85 1.90 Do. West 23456 24896 75 78 48 50 21 13 22 5 I 2 1 10 2 8 14 9 46 13.18 15.80 0.82 1.45 St. Nicholas, Deptford 7321 7771 26 23 12 16 10 8 1 5 2 3 1 1 3 4 9 11-74 1446 373 516 Charlton 18065 19167 47 58 25 20 10 5 7 1 2 9 1 2 4 3 23 10.45 9.42 0.63 0.63 Kidbrooke 3069 3265 3 5 3 1 1 1 2 2 4.96 4.92 Miller Hospital— Residents 6 1 1 5 Non-Residents 4 1 1 3 Seamen's Hospital — Residents 5 1 1 1 1 4 Non-Residents 23 1 1 8 1 4 3 2 4 Greenwich Union— Workhouse and Infirmary Residents 41 2 1 15 1 9 5 4 4 18 Non-Residents 72 4 5 29 1 1 11 2 7 2 6 42 Herbert Hospital— Residents 1 Non-Residents 5 2 1 2 M.A.B. Brook Hospital— Residents 2 2 1 1 Non-Residents 23 1 14 11 7 1 2 1 1 Cottage Hospital,Kidbrooke Residents 2 2 N on-Residents 1 1 Outside Institutions— Residents 15 2 2 1 2 2 2 8 Borough 95770 101651 314 328 156 150 67 46 62 16 1 4 15 1 1 6 36 8 29 33 19 137 Rate per 1,000 of Estimated Population 25 .35 1 2.08 063 004 016 059 004 004 0.24 1.42 0.31 1.14 1.30 0.75 5.41 11.54 12.08 1.45 1.70 Deaths of Children under one year per 1,000 births 104 „ ,, ,, „ previous corresponding period 90 » » » County of London 107 Death Rate of 76 large English Towns 15'3 ; of the County of London 14.3 Death Rate (Zymotic) „ 1.73 „ „ 1.71 Birth Rate „ 29.5 „ „ 28.1 BOROUGH OF GREENWICH. SUMMARY RETURN OF BIRTHS AND DEATHS Registered during the 13 weeks ended 1st October, 1904. DISTRICTS. Census Population, 1901. Estimated Population at the middle of the Year 1904. Births Registered dur.- ing The 13 weeks ended 1st October, 1904. Deaths registered during the 13 weeks ended 1st October, 1904. AGE MORTALITY. SEVEN ZYMOTIC DISEASES. Phthisis. All other forms of Tuber. culosis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Cancer. All other Diseases. Rate of Mortality per 1,000. Under 1 year. Over 1 and under 5 years. Persons aged 65 years and upwards. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers. All Causes. Seven Zymotics During the corresponding period year previous. During thel3 weeks ended 1st October, 1904. During the corresponding peiiod year previous. During the 13weeks ended 1st October, 1904. Typhoid. Puerperal. Diarrhoea. M. F. M. F. Greenwich East 43859 46552 178 180 104 89 76 28 22 12 i 5 2 51 6 6 12 ii 8 79 13.93 16.64 3 .53 6.12 Do. West ... 23456 24896 71 82 39 53 28 9 24 4 19 6 2 5 8 7 41 12.09 14.83 2.31 3. 71 St. Nicholas, Deptford 7321 7771 26 21 14 8 6 3 3 8 4 1 1 2 6 12.27 11.36 2.67 4.13 Charlton 18065 19167 55 55 38 18 23 6 9 1 16 1 1 5 4 7 21 899 11 73 104 356 Kidbrooke 3069 3265 2 1 1 1 2 3 248 3-69 Miller Hospital— Residents 6 • 1 5 Non-Residents 3 1 1 1 1 Seamen's Hospital — Residents 7 1 2 1 6 Non-Residents 19 1 8 2 1 2 6 Greenwich Union— Workhouse and Infirmary Residents 41 6 2 13 2 3 5 2 2 4 3 20 Non-Residents 64 6 3 23 1 2 13 1 7 1 4 35 Herbert Hospital— Residents ... 1 ] 1 Non-Residents 8 3 5 M.A.B. Brook Hospital— Residents 3 1 1 2 Non-Residents 41 3 18 12 16 8 2 3 Cottage Hospital,Kidbrooke Residents 3 1 1 1 Non-Residents 1 1 I Outside Institutions— Residents 24 3 2 2 1 2 1 2 1 3 14 "... Borough 95770 101651 332 339 197 169 134 46 60 16 1 6 2 94 17 10 23 25 22 150 Rate per 1,000 of Estimated Population 26.49 14.45 0.63 0.04 0.24 0.08 3.71 0.67 0.39 0.91 0.99 0.87 5.92 12.18 14.45 2.57 4.70 Deaths of children under one year per 1,000 births 200 previous corresponding " " " " period 154 „ „ „ „ County of London 208 Death Rate of 76 large English Towns 17.5 ; of the County of London 15.8 Death Rate (Zymotic) „ 5.02 „ „ 4.20 Birth Rate „ 29.0 „ „ 27.6 BOROUGH OF GREENWICH. SUMMARY RETURN OF BIRTHS AND DEATHS Registered during the 13 weeks ended 31st December, 1904. DISTRICTS. Census Population, 1901. Estimated Population at the middle of the Year 1904. Births Registered during the 13 weeks ended 31st December, 1904. Deaths registered during the 13 weeks ended 31st December, 1904. AGE MORTALITY. SEVEN ZYMOTIC DISEASES. Phthisis. All other forms of Tuberculosis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Cancer. All other Diseases. Rate ok Mortality per 1,000. Under 1 year. Over 1 and under 5 years. Persons aged 65 years and upwards. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers. All Causes. Seven Zymotics. During the corresponding period year previous. During thel3 weeks ended 31st December, 1904. During the conesponding period year previous. During the 13weeks ended 31st December, 1904. Typhoid. Puerperal. Diarrhoea. M. F. M. F. Greenwich East 43859 46552 197 148 82 75 33 10 37 i i 3 2 18 1 36 11 11 73 15. 26 13.53 1.32 0. 60 Do. West 23456 24896 78 76 55 50 17 5 37 i 2 1 1 7 4 21 15 6 47 17.96 16.93 1.98 0 .81 St. Nicholas, Deptford ... 7321 7771 34 28 24 21 14 3 11 i 2 9 1 8 2 22 22 .95 23.24 0.53 1. 55 Charlton 18065 19167 46 37 32 25 10 5 10 i i 1 5 4 12 6 7 20 983 11 93 1 46 063 Kidbrooke 3069 3265 5 1 2 3 4 1 1 3 248 615 Miller Hospital— Residents 4 1 4 Non-Residents 8 1 1 1 1 1 5 Seamen's Hospital— 5 1 1 1 4 Non-Residents 30 1 2 10 1 3 4 4 8 Greenwich Union— Workhouse and Infirmary Residents ... 64 5 1 30 1 1 12 1 7 2 40 Non-Residents 50 5 40 10 1 8 4 3 54 Herbert Hospital— Residents Non-Residents 1 8 1 5 1 1 1 M.A.B. Brook Hospital— Residents 5 I 1 1 1 2 Non-Residents 56 2 25 7 16 27 5 1 Cottage Hospital,Kidbrooke Residents 1 1 Non-Residents Outside Institutions— Residents 23 3 1 5 ... 5 3 1 2 12 Borough 95770 101651 360 290 195 174 74 23 99 4 1 1 3 4 5 40 10 78 37 24 162 Rate per 1,000 of Estimated Population 25.66 14.57 0.16 0.04 0.04 0.12 0.16 0.20 1.58 0.39 3.08 1.46 0.95 6.39 15.01 14.57 1.41 0.71 Deaths of Children under one year per 1,000 births ... ... ... 114 (previous corresponding^ " " " " \ period ) „ „ ,, „ County of London ... 128 Death Rate of 76 large English Towns .... 17'5 ; of tho County of London ... 16'4 Death Rate (Zymotic) „ ... 1*57 „ „ ... 104 Birth Rate „ ... 281 ,, ,, ... 272 BOROUGH OF GREENWICH. RETURN OF BIRTHS AND DEATHS Registered during the 52 weeks ended 31 st December, 1904. DISTRICTS. Census Population, 1901. Estimated Population at the middle of the Year 1904. Births Registered during the 52 weeks ended 31st December, 1904. Deaths registered during the 52 weeks ended 31st December, 1904. AGE MORTALITY. SEVEN ZYMOTIC DISEASES. Phthisis. All other forms of Tuberculosis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Cancer. All other Diseases. Rate of Mortality per 1,CKi0. Under 1 year. Over 1 and under 5 years. Persons aged 65 years and upwards. iSmall-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers. All Causes. Seven Zymotics. During the corresponding period year previous. During the52 weeks ended 31st December, 1904. During the conesponding period year previous. During the 52weeks ended 31st Decem. ber, 1904. Typhoid. Puerperal. Diarrhcea. M. F. M F. Greenwich East 43859 46552 722 645 349 332 181 84 129 19 3 5 27 6 1 59 56 19 98 52 40 296 13 .58 14.71 1.98 2 .59 Do. West 23456 24896 308 310 197 197 88 38 106 10 3 11 2 22 32 12 51 42 25 184 14.96 15.88 1.69 1.93 St. Nicholas, Deptford 7321 7771 115 109 67 72 44 24 20 8 3 8 12 16 5 21 13 53 16.54 17.94 2.40 4.00 Charlton 18065 19167 200 198 125 96 57 22 43 3 1 8 16 20 6 33 24 18 92 10.50 11.56 0.99 1.46 Kidbrooke 3069 3265 14 8 10 5 3 8 3 1 4 7 4.03 4.61 Miller Hospital— 20 1 1 1 Non-Residents 20 1 3 1 1 2 1 2 2 12 Seamen's Hospital— Residents 22 1 4 5 2 2 18 Non-Residents 1 00 1 5 2 31 2 9 12 14 30 Greenwich Union— Workhouse and Infirmary Residents 02 17 7 77 2 2 4 34 6 18 13 12 III Non-Residents 94 20 16 115 2 1 2 2 49 5 31 14 20 168 Herbert Hospital— Residents 3 1 1 2 Non-Residents 24 9 4 2 1 8 M.A.B. Brook Hospital— Residents 14 8 2 3 5 4 Non-Residents 53 10 75 7 52 67 1 16 5 1 4 CottageHospital, Kidbrooke Residents 9 2 1 Non-Residents 3 1 1 2 OUtside Institutions— Residents 99 10 7 17 2 2 8 8 5 8 10 56 Borough 95770 101651 1359 1270 748 702 373 168 306 40 3 12 54 8 1 109 127 42 204 135 83 632 Rate per 1,000 of Estimated Population 25.95 14.31 0.39 0.03 0.12 0.53 0.08 0.01 1.07 1.25 0.41 2.01 1.33 0.82 6.24 13.23 14.31 1.69 2.23 Deaths of Children under one year per 1,000 births 142 previous corresponding " " " " period 128 " " " „ County of London 146 Death Rate of 76 large English Towns 17'2 ; of the County of London 16.6 Death Rate (Zymotic) „ 2.5 „ „ 2.2 Birth Rate „ 29.1 „ „ 27.9 BOROUGH OF GREENWICH. SUMMARY. Causes of, and Ages at, Death during the 13 weeks ending 2nd April, 1904. Causes of Death. Deaths in whole District at subjoined Ages. Deaths in Localities (at all Ages). Deaths in Public Institutions (Residents). Total Deaths in Public Institutions in the District. All Ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke. Gr'nwich Union Workhouse and Infirmary. Seamen's Hospital. Miller Hospital. Herbert Military Hospital. Brook Hospital, M.A.B. Cottage Hospital. Outside Institutions. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 4 2 2 ... ... ... ... 1 ... 2 1 ... ... ... ... ... ... ... ... ... Scarlet Fever 1 ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... 14 Whooping Cough 30 10 20 ... ... ... ... 14 7 5 4 ... ... ... ... ... ... ... ... 3 Diphtheria and Membranous Croup 6 ... 5 1 ... ... ... 3 2 1 ... ... ... ... ... ... 3 ... 1 20 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric 1 ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... 2 Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 5 ... ... ... ... 4 1 2 ... ... 3 ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... v ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea 4 2 2 ... ... ... ... 1 1 2 ... ... ... ... ... ... ... ... ... 1 Enteritis 2 2 ... ... ... ... ... 1 ... 1 ... ... 1 ... ... ... ... ... ... 2 Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... .. ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Other Septic Diseases ... 2 ... ... ... 1 1 ... 2 ... ... ... ... ... ... ... ... ... ... 1 1 Phthisis 34 ... ... 5 27 2 18 9 2 5 ... 8 1 ... ... ... ... 1 31 Other Tubercular Diseases 14 5 4 2 1 2 ... 8 4 2 ... ... 3 ... ... ... ... 1 1 6 Cancer, Malignant Disease 18 ... ... ... ... 12 6 14 3 ... 1 ... 5 ... 1 ... ... 1 3 21 Bronchitis 40 13 3 1 ... 9 14 14 12 7 7 ... 1 ... ... ... ... ... 2 9 Pneumonia 34 7 10 1 4 9 3 20 5 2 7 ... 3 ... ... ... ... ... 3 5 Pleurisy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Respiratory Organs ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Alcoholism Cirrhosis of Liver 2 ... ... ... ... 2 ... 1 1 ... ... ... ... ... ... ... ... ... ... 1 Venereal Diseases 1 1 ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... 2 Premature Birth 20 20 ... ... ... ... ... 8 6 4 2 ... 1 ... ... ... ... ... ... 2 Diseases and Accidents of Parturition 2 ... ... ... ... 2 ... ... 2 ... ... ... ... ... ... ... ... ... ... 1 Heart Diseases. 40 1 ... 1 1 29 8 19 5 5 10 1 3 ... ... ... ... ... 4 14 Accidents 19 9 ... ... 1 7 ... 10 4 ... 4 1 ... 2 1 ... ... ... 1 7 Suicides 1 ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 Murder ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... All other causes 129 26 4 4 5 40 50 62 36 11 19 1 30 2 2 ... ... 1 20 74 All causes 409 98 53 10 18 145 85 200 99 44 63 3 56 5 4 ... 4 3 37 220 BOROUGH OF GREENWICH. SUMMARY. Causes of, and Ages at, Death during the 13 weeks ending 2nd July, 1904, Causes of Death. Deaths in whole District at subjoined ages. Deaths in Localities (at all Ages). Deaths in Public Institutions (Residents). Total Deaths in Public Institutions in the District. All Ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke. Gr'nwich Union Workhouse and Infirmary. Seamen's Hospital. Miller Hospital. Herbert Military Hospital. Brook Hospital. M.A.B. Cottage Hospital. Outside Institutions. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 16 3 12 1 ... ... ... 5 5 5 ... ... ... ... ... ... ... ... ... 1 Scarlet Fever 1 ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... 12 Whooping Cough 15 4 11 ... ... ... ... 8 2 3 2 ... ... ... ... ... ... ... ... ... Diphtheria and Membranous Croup 4 1 1 1 ... ... ... 1 1 2 ... ... ... ... ... ... 1 ... ... 9 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fever- Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric 1 ... ... 1 ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... 2 Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 7 ... ... ... ... 1 6 2 ... ... 4 1 ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea 6 4 2 ... ... ... ... 5 1 ... ... ... ... ... ... ... ... ... ... 1 Enteritis 2 1 ... ... ... 1 ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... Puerperal Fever 1 ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Septic Diseases 1 ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... 3 Phthisis 36 2 1 1 6 26 ... 14 10 1 9 2 9 ... ... ... ... ... 1 28 Other Tubercular Diseases 8 2 3 ... ... 3 ... 4 2 1 1 ... ... ... ... ... ... ... 2 6 Cancer, Malignant Disease 19 ... ... ... ... 12 7 7 9 ... 3 ... 4 ... ... ... ... ... 2 12 Bronchitis 17 2 2 ... ... 6 7 8 7 ... 2 ... 4 ... ... ... ... ... 7 Pneumonia 11 1 4 ... ... 5 1 7 1 3 ... ... 1 1 ... ... ... ... ... 13 Pleurisy 1 ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Respiratory Organs 2 1 ... ... ... 1 ... ... 1 1 ... ... ... ... ... ... ... 1 ... Alcoholism Cirrhosis of Liver 2 ... ... ... ... ... 1 1 2 ... ... ... ... 1 ... 1 ... ... ... ... 4 Venereal Diseases 1 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... Premature Birth 7 7 ... ... ... ... ... 3 3 ... 1 ... ... ... ... ... ... ... ... ... Diseases and Accidents of Parturition 1 ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... Heart Diseases 33 1 ... 1 5 15 11 11 14 4 4 ... 4 ... 1 ... ... ... 2 11 Accidents 9 2 ... 1 ... 6 ... 6 ... 1 2 ... 1 1 ... ... 1 ... 9 Suicides 2 ... ... ... ... 2 ... ... 2 ... ... ... ... 1 1 ... ... ... ... 2 Murder ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... All other causes 103 35 9 5 2 23 29 43 38 6 15 1 16 2 3 ... ... 1 7 65 All causes 306 67 46 11 16 104 62 131 98 28 45 4 41 5 6 1 2 2 15 185 BOROUGH OF GREENWICH. SUMMARY. Causes of, and Ages at, Death during the 13 weeks ending 1st October, 1904. Causes of Death. Deaths in whole District at subjoined ages. Deaths in Localities (at all. Ages). Deaths in Public Institutions (Residents). Total Deaths in Public Institutions in the District. All Ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke. Gr'nwich Union Workhouse and Infirmary. Seamen's Hospital. Miller Hospital. Herbert Military Hospital. Brook Hospital, M.A.B. Cottage Hospital. Outside Institutions. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 16 4 10 2 ... ... ... 12 4 ... ... ... 2 ... ... ... 1 ... ... 4 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12 Whooping Cough 6 5 1 ... ... ... ... 5 ... ... 1 ... ... ... ... ... ... ... ... ... Diphtheria and Membranous Croup 1 ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 16 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric 2 ... ... ... ... 2 ... 2 ... ... ... ... ... ... ... ... 2 ... ... 10 Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea 04 72 17 ... ... 2 3 51 19 8 16 ... 3 ... ... ... ... ... 2 5 Enteritis 15 9 3 ... ... 2 1 8 5 ... 2 ... 1 ... ... ... ... ... ... 3 Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Septic Diseases 1 ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 Phthisis 17 ... ... 2 1 13 1 6 6 4 1 ... 5 ... ... ... ... ... 1 29 Other Tubercular Diseases 10 1 3 1 I 4 ... 6 2 1 1 ... 2 ... ... ... ... 1 2 6 Cancer, Malignant Disease 22 ... ... ... ... 16 6 8 7 ... 7 ... 3 ... 1 ... ... ... 3 11 Bronchitis 7 2 ... ... ... 1 4 3 2 1 1 ... 2 ... ... ... ... ... ... 5 Pneumonia 16 2 3 1 ... 6 4 9 3 ... 4 ... ... 1 ... ... ... 1 ... 8 Pleurisy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Respiratory Organs 4 ... ... 1 ... 2 1 2 ... 1 1 ... 1 ... ... ... ... ... ... 2 Alcoholism Cirrhosis of Liver 6 ... ... ... ... 5 1 1 3 ... 2 ... 1 ... ... ... ... ... 1 5 Venereal Diseases 1 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 2 Premature Birth 15 15 ... ... ... ... ... 11 2 ... 1 ... 2 ... ... ... ... ... ... 4 Diseases and Accidents of Parturition 1 ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 Heart Diseases 25 2 ... 1 1 15 6 11 8 2 4 ... 4 ... ... ... ... ... 1 7 Accidents 10 1 ... 2 1 4 2 4 5 1 ... ... 1 1 ... ... ... ... 1 7 Suicides 2 ... ... ... ... 2 ... 1 ... ... 1 ... ... ... ... ... ... ... ... 1 Murder ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... All other causes 95 20 9 1 4 2 29 31 51 25 4 13 2 14 5 4 ... ... ... 12 58 All causes 366 134 46 15 6 105 60 183 92 22 56 3 41 7 6 1 3 3 24 197 BOROUGH OF GREENWICH. SUMMARY. Causes of, and Ages at, Death during the 13 weeks ending 31st December, 1904. Causes of Death. Deaths in whole District at subjoined ages. Deaths in Localities (at all Ages). Deaths in Public Institutions (Residents). Total Deaths in Public Institutions in the District. All Ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke. Gr'nwich Union Workhouse and Infirmary. Seamen's Hospital. Miller Hospital. Herbert Military Hospital. Brook Hospital, M.A.B. Cottage Hospital. Outside Institutions. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 4 3 1 ... ... ... 1 1 1 1 ... ... ... ... ... 1 ... ... 8 Scarlet Fever. 1 ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... 17 Whooping Cough 3 1 2 ... ... ... ... ... 2 ... 1 ... ... ... ... ... ... ... ... ... Diphtheria and Membranous Croup 1 ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... 28 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric 4 ... ... 2 2 ... ... 3 1 ... ... ... 1 ... ... ... 2 ... ... 8 Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 6 ... 1 2 i 2 5 1 ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea 5 4 ... ... ... ... 1 2 1 2 ... ... 1 ... ... ... ... ... ... 1 Enteritis 6 5 ... ... ... 1 ... 2 2 2 ... ... 1 ... ... ... ... ... ... 2 Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 2 ... ... ... ... ... 2 ... 2 ... ... ... ... ... ... ... ... ... ... ... Other Septic Diseases ... 1 ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 Phthisis 40 ... 1 1 8 28 2 18 7 9 5 1 12 1 1 ... ... 5 39 Other Tubercular Diseases 10 2 2 2 2 2 ... 1 4 1 4 ... 1 ... ... ... ... ... 3 5 Cancer, Malignant Disease 24 ... ... ... ... 19 5 11 6 ... 7 ... ... ... ... ... ... ... 2 8 Bronchitis 42 9 1 ... ... 13 19 17 13 5 6 1 6 ... ... ... ... ... ... 12 Pneumonia 36 8 6 ... ... 15 7 19 8 3 6 ... 1 ... ... ... ... ... ... 7 Pleurisy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Other Diseases of Respiratory Organs 4 1 1 ... ... 1 1 2 1 ... 1 ... 1 ... ... ... ... ... 2 1 Alcoholism Cirrhosis of Liver 8 ... ... ... ... 6 2 3 3 1 1 ... 2 ... ... ... ... ... ... 4 Venereal Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 14 14 ... ... ... ... ... 8 4 ... 2 ... 1 ... ... ... ... ... ... 1 Diseases and Accidents of Parturition 2 ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ...... ... Heart Diseases 37 ... ... ... 2 17 17 11 15 2 6 3 2 ... ... ... ... ... 1 12 Accidents 11 3 ... ... ... 3 5 2 4 1 4 ... 4 1 ... ... ... 1 14 Suicides 3 ... ... ... ... 3 ... 2 ... ... 1 ... 1 ... ... ... ... ... ... 1 Murder ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... All other causes 105 27 5 2 1 34 36 48 28 18 11 ... 30 2 4 ... ... 1 9 92 All causes 369 74 23 13 15 145 99 157 105 45 57 5 64 5 4 1 5 1 23 262 BOROUGH OF GREENWICH. SUMMARY. Causes of, and Ages at, Death during the 52 weeks ending 31st December, 1904. Causes of Death. Deaths in whole District at subjoined Ages. Deaths in Localities (at all. Ages). Deaths in Public Institutions (Residents). Total Deaths in Public Institutions in the District. All Ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Greenwich East. Greenwich West. .St. Nicholas, Deptford. Charlton. Kidbrooke. Gr'nwich Union Workhouse and Infirmary. Seamen's Hospital. Miller Hospital. Herbert Military Hospital. Brook Hospital, M.A.B. Cottage Hospital. Outside Institutions. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 40 9 27 4 ... ... ... 19 10 8 3 ... 2 ... ... ... 2 ... ... 13 Scarlet Fever 3 ... 2 1 ... ... ... 3 ... ... ... ... ... ... ... ... 3 ... ... 55 Whooping Cough 54 20 34 ... ... ... ... 27 11 8 8 ... ... ... ... ... ... ... ... 3 Diphtheria and Membranous Croup 12 1 6 4 1 ... ... 5 3 3 1 ... ... ... ... ... 5 ... 2 73 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric 8 ... ... 3 2 2 1 6 2 ... ... ... 2 ... ... ... 4 ... ... 22 Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 18 ... 1 2 ... 6 9 9 1 ... 7 1 ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea 103 82 21 ... ... 2 4 59 22 12 16 ... 4 ... ... ... ... ... 2 8 Enteritis 25 17 3 ... ... 4 1 12 7 4 2 ... 3 ... ... ... ... ... ... 7 Puerperal Fever 1 ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... Erysipelas 2 ... ... ... ... ... 2 ... 2 ... ... ... ... ... ... ... ... ... ... 1 Other Septic Diseases. 5 ... 1 ... 2 2 3 1 ... 1 ... ... 1 ... 1 ... ... 1 6 Phthisis 127 2 2 4 20 94 5 56 32 16 20 3 34 2 1 ... ... 8 127 Other Tubercular Diseases 42 10 12 5 4 11 ... 19 12 5 6 ... 6 ... ... ... ... 2 8 23 Cancer, Malignant Disease 83 ... ... ... ... 59 24 40 25 ... 18 ... 12 ... 2 ... ... 1 10 52 Bronchitis 106 26 6 1 ... 29 44 42 34 13 16 1 13 ... ... ... ... ... 2 33 Pneumonia 97 18 23 2 4 35 15 55 17 8 17 ... 5 2 ... ... ... 1 3 33 Pleurisy 1 ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 Other Diseases of Respiratory Organs 10 2 1 1 ... 4 2 4 2 2 2 ... 2 ... ... ... ... ... 3 5 Alcoholism Cirrhosis of Liver 18 ... ... ... ... 14 4 7 7 1 3 ... 4 ... 1 ... ... ... 1 14 Venereal Diseases 3 3 ... ... ... ... ... ... 2 ... 1 ... 1 ... ... ... ... ... ... 4 Premature Birth 56 56 ... ... ... ... ... 30 15 4 6 1 4 ... ... 1 ... ... ... 7 Diseases and Accidents of Parturition 6 ... ... ... 1 5 ... 1 5 ... ... ... ... ... ... ... ... 1 ... 2 Heart Diseases 135 4 ... 4 9 76 42 52 42 13 24 4 13 ... 1 ... ... ... 8 44 Accidents 49 15 2 3 2 20 7 22 13 3 10 1 6 5 2 ... ... 1 3 37 Suicides 8 ... ... ... ... 8 ... 4 2 ... 2 ... 1 1 1 ... ... ... ... 5 Murder ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... All other causes 432 108 27 15 10 126 146 204 127 39 58 4 90 11 13 ... ... 3 48 289 All causes 1450 373 168 49 55 499 306 681 394 139 221 15 202 22 20 3 14 9 99 864 BOROUGH OF GREENWICH. Summary of Cases of Infectious Disease notified during the 13 weeks ending 2nd April, 1904. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Locality. No. of Cases removed to Hospital from each Locality. At all Ages. At Ages—Years. Greenwich East. j Greenwich West. St. Nicholas, Deptford. Chari.ton. Kidbrooke.* Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Under 1. 1 to 6. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera .. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 44 ... 17 22 2 3 ... 11 16 9 6 2 4 14 7 3 2 Membranous Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 23 ... ... 3 5 12 3 7 11 2 3 ... 1 1 ... ... ... Scarlet Fever 41 ... 10 19 8 4 ... 12 9 9 6 5 11 9 7 5 5 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 12 ... ... 7 2 2 1 10 2 ... ... ... 7 1 ... ... ... Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Phthisis 43 1 ... 4 6 31 1 17 . 16 7 3 ... 4 7 3 3 ... Totals 163 1 27 65 23 52 5 57 54 27 18 7 27 32 17 11 7 * Cases of Infectious Disease are treated in the Hospitals of the Metropolitan Asylums Board, whose Brook Hospital is situated in Kidbrooke. BOROUGH OF GREENWICH. Summary of Cases of Infectious Disease notified during the 13 weeks ending 2nd July, 1904. Notifiable Diseases. Casks Notified in Whole District. Total Cases Notified in each Locality. No. of Cases removed to Hospital from each Locality. At all Ages. At Ages—Years. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Under 1. 1 to 6. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox 1 ... ... ... ... 1 ... ... ... 1 ... ... ... ... 1 ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... .... Diphtheria 53 ... 20 23 6 3 ... 19 16 6 12 ... 10 16 3 11 .... Membranous Croup 1 ... 1 ... ... ... ... 1 ... ... ... 1 ... ... ... ... Erysipelas 17 ... ... ... 2 13 2 7 5 3 2 ... 1 ... 1 ... ... Scarlet Fever 42 3 17 16 4 2 ... 18 6 5 13 ... 13 5 3 13 ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 8 ... 2 2 1 3 ... 7 1 ... ... ... 7 1 ... ... ... Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 1 ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox 247 30 130 82 5 ... ... 130 30 39 44 4 2 1 ... ... ... Phthisis 32 ... ... 7 3 22 ... 12 6 10 4 ... 1 1 2 ... ... Totals 402 34 170 130 21 45 2 194 65 64 75 4 35 24 10 24 ... * Cases of Infectious Disease are treated in the Hospitals of the Metropolitan Asylums Board, whose Brook Hospital is situated in Kidbrooke. BOROUGH OF GREENWICH. Summary of Cases of Infectious Disease notified during the 13 weeks ending 1st October, 1904. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Locality. No. of Casks removed to Hospital from each Locality. At all Ages. At Ages—Years. Greenwich East. Greenwich West St. Nicholas, Deptford. Charlton. Kidbrooke.* Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Under 1. 1 to 6. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 34 ... 8 18 5 3 ... 15 10 1 8 ... 10 8 1 6 ... Membranous Croup 1 ... 1 ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... Erysipelas 11 ... ... 2 ... 8 1 5 2 4 ... ... ... ... ... ... ... Scarlet Fever 40 ... 12 24 2 2 ... 24 7 ... 9 ... 20 6 ... 8 ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 15 ... ... 3 3 9 ... 9 1 1 1 3 6 1 1 1 3 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 1 ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox 71 10 32 ... 2 ... ... 41 9 6 15 ... ... ... ... ... ... Phthisis 17 ... ... 2 2 13 ... 5 3 6 3 ... 2 2 ... ... ... Totals 190 10 53 76 14 36 1 100 32 18 37 3 39 17 2 15 3 * Cases of Infectious Disease are treated in the Hospitals of the Metropolitan Asylums Hoard, whose Brook Hospital is situated in Kidbrooke. BOROUGH OF GREENWICH. Summary of Cases of Infectious Disease notified during the 13 weeks ending 31st December, 1904. Notifiable Disease. Casks Notified in Whole District. Total Cases Notified in each Locality. No. of Casks removed to Hospital from each Locality. At all Ages. At Ages—Years. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 19 ... 2 12 2 3 ... 8 4 1 5 1 7 4 ... 5 1 Membranous Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 36 1 ... 8 3 17 7 15 9 5 7 ... ... ... 3 1 ... Scarlet Fever 91 2 39 39 5 6 ... 48 18 3 19 3 43 15 3 17 3 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 15 ... 1 5 4 5 ... 6 6 ... 2 1 5 5 ... ... 1 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... †Chicken-pox 66 9 35 22 ... ... ... 32 10 9 15 ... 9 ... ... ... ... Phthisis 31 1 2 2 5 21 ... 20 4 6 1 ... 4 2 1 1 ... Totals 258 13 79 88 19 52 7 129 51 24 49 5 68 26 7 24 5 * Cases of Infectious Disease are treated in the Hospitals of the Metropolitan Asylums Board, whose Brook Hospital is situated in Kidbrooke. † Not Notified since 7th November. BOROUGH OF GREENWICH. Summary of Cases of Infectious Disease notified during the 52 weeks ending 31st December, 1904. Notifiable Disease. Casks Notified in Whole District. Total Cases Notified in each Locality. No. of Casks removed to Hospital from each Locality. At all Ages. At Ages—Years. Greenwich East. Greenwich West. St. Nicholas, Deptford. Chari.ton. Kidbrooke.* Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox 1 ... ... ... ... 1 ... ... ... 1 ... ... ... ... 1 ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 150 1 47 75 15 12 ... 53 46 17 31 3 31 42 11 25 3 Membranous Croup 2 ... 2 ... ... ... ... 2 ... ... ... ... 2 ... ... ... ... Erysipelas 87 1 ... 13 10 50 13 34 27 14 12 ... 2 1 4 1 ... Scarlet Fever 214 5 78 98 19 14 ... 102 40 17 47 8 87 35 13 43 8 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 50 ... 3 17 10 19 1 32 10 1 3 4 25 8 1 1 4 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 2 ... ... ... ... 2 ... ... 1 ... 1 ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox 384 49 197 131 7 ... ... 203 49 54 74 4 11 1 ... ... ... Phthisis 123 2 2 15 16 87 1 54 29 29 11 ... 11 12 6 4 ... Totals 1013 58 329 349 77 185 15 480 202 133 179 19 169 99 36 74 15 * Cases of Infectious Disease are treated in the Hospitals of the Metropolitan Asylums Board, whose Brook Hospital is situated in Kidbrooke. BOROUGH OF GREENWICH. Recorded and Corrected Death Rates per 1,000 persons living in London and in the Metropolitan Boroughs, 1904, as estimated by the Registrar-General. Metropolitan Boroughs arranged in the Order of their CORRECTED Death Rates. Standard Death Rate. Factor for correction for Sex and Age Distribution.* Recorded Death Rate for 1904. Corrected Death Rate, 1904. Comparative Mortality Figure, 1904. England and Wales 18.194 1.0000 16.23 16.23 1,000 London 17.81 1.0511 16.63 17.48 1,077 Hampstead 16.13 1.12???0 10.23 11.54 711 Lewisham 17.46 1.0420 12.01 12.51 771 Stoke Newington 17.43 1.0438 13.33 13.91 857 Wandsworth 17.25 1.0547 13.38 14.11 869 GREENWICH 17.82 1.0210 14.35 14.65 903 Paddington 17.04 1.0677 13.76 14.69 905 City of Westminster 16.22 1.1217 13.55 15.20 937 Woolwich 17.02 1.0690 14.32 15.31 943 Kensington 16.88 1.0778 14.31 15.42 950 Camberwell 17.54 1.0373 14.92 15.48 954 Hackney 17.46 1.0420 14.92 15.55 958 Battersea 16.96 1.0728 14.52 15.58 960 Islington 17.51 1.0391 15.42 16.02 987 Falham 17.39 1.0462 15.43 16.14 994 Lambeth 17.63 1.0320 15.78 16.28 1,003 Hammersmith 17.47 1.0414 15.71 16.36 1,008 Deptford 17.31 1.0511 16.10 16.92 1,043 Chelsea 17.56 1.0361 16.53 17.13 1,055 St. Marylebone 17.08 1.0652 16.23 17.29 1,065 St. Pancras 17.40 1.0456 17.43 18.22 1,123 City of London 16.55 1.0993 16.65 18.30 1,128 Poplar 17.64 1.0314 18.58 19.16 1,181 Bethnal Green 18.01 1.0102 19.25 19.45 1,198 Holborn 16.90 1.0766 18.49 19.91 1,227 Stepney 17.41 1.0450 19.40 20.27 1,249 Bermondsey 17.76 1.0244 20.01 20.50 1,263 Southwark 17.41 1.0450 20.10 21.00 1,294 Shoreditch 17.34 1.0493 20.37 21.37 1,317 Finsbury 17.57 1.0355 21.28 22.04 1,358 *In calculating the Factors for correcting the Death Rates of the several Boroughs, account has been taken of the Inmates of the large Poor Law Institutions situated outside the Boroughs from which they receive paupers. ■ DEATHS OF RESIDENTS OF THE BOROUGH FOR THE YEAR 1904. G ree nw ch F.as . Greenwich Wcs St. Nicholas, Deptford. Charlton. Kidbrooke. Totals for the Borougl Greenwich Unio W orkhouse and Infirmary n c , Seamen s Hospital. Royal Hospita Schools. Miller Hospital Herbert Military Hospital. M.A.B. Brook Hospital Cottage Hospital, Kidbrooke. I Outside Institutions. % NFECTIVE DISEASES. Epidemic. 1. Smallpox (total) ... (а) Vaccinated (б) Unvaccinated (c) No statement 2. Measles .. 3. Scarlet Fever 4. Typhus Fever 5. Epidemic Influenza 6. Whooping Cough 7. Diphtheria, Membranous Croup ... 8. Enteric Fever 9. Asiatic Cholera ... 10. Diarrhoea, Dysentery 11. Epidemic or Zymotic Enteritis 12. Other Allied Diseases Sporadic. 13. Hydrophobia 14. Glanders, Farcy ... 15. 1 etanus 16. Anthrax, Splenic Fever ... 17. Cowpox, Accidents of Vaccination... Venereal. 18. Syphilis .. 19. Gonorrhoea Septic. 20. Phagedena, Hospital Gangrene ... 21. Erysipelas 22. Puerperal Fever ... 23. Pyaemia, Septicemia 24. Infective Endocarditis 25. Other Allied Diseases Malarial. 26. Malarial Fever ... 27. Rheumatic Fever... 28. Rheumatism of the Heart .. Tuberculosis (total). 29. Tuberculosis of Brain or Meninges, Acute Hydrocephalus 30. Tuberculosis of I .arynx 31. Tuberculosis of I.ung 32. Tuberculosis of I ntestines, Tabes Mesenterica 33. General Tuberculosis, Tubercular Disease of undefined position 34. Other forms of Tuberculosis, Scrofula 35. Other Infective Diseases ... U nder Over • Under Over Under Over 5 U nder Under 5 Over 5 Over 5 Under Over Under Under 5 Over Under 5 Over 5 Over 5 Under 5 Over 5 Over 5 Over 5 Under 5 Over 5 Over 5 Under 5 Over 5 Under 5 Over 5 Under 5 Over 5 Over 5 0 O O j; s-o ^ ^ ^ * = £ i-< 53 CO ■»< 1 4 11 1 17 1 1 2 1 1 2 1 1 1 1 2 2 4 8 14 8 5 27 3 3 1 1 2 12 3 6 1 5 50 2 58 1 1 1 1 1 1 1 1 1 1 1 1 2 2 3 1 4 2 2 4 1 1 1 1 18 14 6 17 55 2 1 3 1 1 2 2 13 1 1 2 12 5 O ® ® O i." - "S *9 -s § Co ^ to ' H d CO ^ ^ 5 3 8 112 1 1 7 2 2 11 2 1 3 1 "l2 1 1 17 19 2 13 1 1 1 1 2 2 2 i" 1 1 1 11114 1 1 9 9 6 7 31 1 1 1 1 2 1 1 1 1 12 3 oj <5 Qf <5 ./ -S "S "§ 5 .2 I—1 <"M CO ^ -*"< 2 5 18 5 3" 8 1 1 1 1 2 2 7 2 11 1 1 1 1 2 2 14 9 16 1 1 1 1 2 q, <5 Q( c5 ^ rl fM 5C -rf< ^ 11 13 3 4" 7 4 2 118 1 1 15 15 1 1 1 1 1 1 1 1 2 2 5 7 1 5 18 i 2 3 1 1 1 1 .- SS > Of ® ® ~ "S <0 H d CO 1 2 1 O *5: -to V 1 3 36 4 2 I 1 17 54 7 5 8 103 6 2 ( 1 1 < 3 2 1 1 3 I t 5 10 1 1 4 123 5 6 7 3 9 . • v v C 0 0 0 0 ■«* "S "9 c § rH <M CO 1 1 1 1 1 1 2 1 1 2 13 I 1 1 1 8 9 5 12 34 1 1 1 1 2 1 113 .• C sC V £ Of Ot O) k- •s ~ "5 2 H (M CO ^ ^ 1 1 1 12 O So rH C Of O O 5^- ^ ^ ? 2? rs. So CM CO ^ ^ .- v" s." C (5 Qf O ^ ts "§ "S 5 T-H <M CO -3" <5 <5 or cy ^ is "S 2 So So \ H (M CO ^ ^ 1 1 1 1 Or So l 3 0 "S cS 1 1 Or 2 CO 1 2 <5 1 1 1 2 ■i <3 2 2 1 4 1 4 .* i.' V V ,5 C* © Qf ,>o -O -v So H CM CO Tp 1 1 a 1 1 . • v" C k la T3 -SS So T—1 CM CO ^ 1 1 2 1 1 1 1 1 1 1 1 1 5 1 1 2 :s a *u Si 1 1 2 1 1 3 1 1 7 1 1 2 PARASITIC DISEASES. 36. Thrush ... 37. Actinomycosis 38. Hydatid Diseases DIETIC DISEASES. 39. Scurvy 40. Other Diseases due to altered Food 41' Acute Alcoholism, Delirium Tremens 42. Chronic Alcoholism 43. Chronic Industrial Poisoning 44. Other Chronic Poisonings Over 5 Over 5 Over 5 1 1 1 1 i" 1 2 1 1 1 1 1 1 1 2 4 1 1 1 1 2 1 1 CONSTITUTIONAL DISEASES. <45. Osteo-arthritis, Rheumatoid Arthritis Over 5 Over 5 Over 5 Under 5 Over 5 i \ 1 > i it i I V 47. 48. 49. 50. 51. 52. Cancer Diabetes Mellitus Purpura Hemorrhagica ... Hemophilia Anemia, Leucocythemia .. Lymphadenoma, Hodgkin's Disease 14 2 7 8 1 117 1 1 40 4 1 3 9 7 2 6 1 25 2 1 1 ... * •1 1 3 1 2 7 7 18 1 2 2 N 1 1 S3 9 1 4 •5 2 4 3 If- 1 12 4 r 1 1 1 T2 1 1 3 1 2 3 2 10 ,1 1 1 1 DEVELOPMENTAL DISEASES. 53. Premature Birth ... 54. Injury at Birth ... 55. Debility at Birth... 56. Atelectasis 57. Congenital Defects 58. Want of Breast Milk 59. Atrophy, Debility, Marasmus 60. Dentition 61. Rickets 62. Old Age, Senile Decay ... Under 5 Under 5 Under 5 Under 5 Under 5 8 2 1 6 1 3 15 3 11 1 3 2 7 2 2 2 8 8 8 1 1 5 2 1 8 30 1 1 6 1 20 5 8 39 6 3 2 1 1 2 2 4 2* 1 4 1 8 9 9 4 1 2 8 15 1 1 3 10 5 1 34 4 1 5 1 2 4 1 1 i 3 6 1" 7 15 2 1 • 1 1 1 1 1 4 12 6 1 1 i" 1 3 2 3" 2 9 1 i" 1 1 56 1 1 3 11 1 39 12 9 98 1 1 5 2 1 1 12 3 7 6 15 4 2 6 43 1 1 1 1 1 1 1 1 1 5 1 1 2 1 2 1 8 LOCAL DISEASES. Nervous System. 63. Convulsions 64. Meningitis 65. Encephalitis 66. Apoplexy 67. Softening of Brain 68. Hemiplegia, Brain Paralysis 69. General Paralvsis of Insane 70. Other forms of Insanity ... 71. Chorea 72. Cerebral Tumour 73. Epilepsy .. 74. Laryngismus Stridulus 75. Locomotor Ataxy 76. Paraplegia, Diseases of the Spinal Cord 77. Other and Ill-def. Dis. of Brain or Nervous System Organs of Special Sense. 78. Otitis, Otorrhoea 79. Diseases of Nose.. 80. Diseases of Eyes, Ophthalmia Circulatory System. 81. Pericarditis 82. Endocarditis, Valvular Diseases of the Heart 83. Hypertrophy of Heart 84. Angina Pectoris ... 85. Aneurism 86. Senile Gangrene 87. Embolism, Thrombosis 88. Phlebitis 89. Varicose Veins ... 90. Other and Ill-def. Dis. of Heart and culatory System Respiratory System. 91. Laryngitis 92. Croup 93. Other Diseases of Larynx and Trachea 94. Acute Bronchitis... 95. Chronic Bronchitis 96. Lobar Croupous Pneumonia 97. Lobular. Broncho-Pneumonia 98. Pneumonia, form not stated 99. Emphysema, Asthma 100. Pleurisy 101. Other and Ill-def. Dis. of Respiratory System Digestive System. 102. Diseases of the Mouth and Annexa 103. Diseases of Pharynx 104. Diseases of (Esophagus ... 105. Ulcer of Stomach and Duodenum ... 106. Other Diseases of Stomach 107. Enteritis 108. Appendicitis 109. Obstruction of Intestine ... 110. Other Diseases of Intestine 111. Cirrhosis of Liver 112. Other Diseases of Liver ... 113. Peritonitis ... ... , Under 5 Under 5 Over 5 Over 5 Under 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 Under 5 Over 5 Under 5 Under 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 Under 5 Over 5 Under 5 Over 5 Under 5 Over 5 Over 5 Under 5 Over 5 Under 5 Over 5 Under 5 Over 5 Over 5 Over 5 Under 5 Over 5 Over 5 Over 5 Under 5 Over 5 Over 5 Under 5 Over 5 Over 5 Over 5 Over 5 Under 5 Over s Under 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 Under 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 Under 5 Over 5 Over 5 Over 5 Over 5 Under 5 Under 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 Over 5 13 5 2 1 2 1 1 1 1 6 4 4 2 2 1 1 1 2 2 1 3 i" 1 3 1 2 1 19 11 6 10 1 1 1 4" i" 6 2 14 2 6 6 2 13 1 2 4 2 5 7 2 2 5 13 3 2 2 2 14 7 1 1 1 1 1 2 1 1 6 1 1 2 1 1 2 1 1 2 4 3 1 1 12 1 I • 1 » 11 3 2 1 1 16 3 1 5 1 3 2 3 1 3 46 1 1 1 4 1 13 2 27 1 13 11 9 7 14 1 1 1 1 3 1 8 4 3 2 9 5 2 1 3 4 11 3 2 1 1 4 2 12 1 1 111 1 1 1 I 1 1 1 1 5 14 312 2 1 1 4 1 1 II 2 2 11 6 2 9 1 1 2 111 1 1 1 1 2 1 1 2 " 1 1 1 4 2 1 1 2 1 1 1 2 1 1 2 2 9 5 1 1 9 2 3 1 1 1 2 1 1 1 34 2 1 1 5 1 4 2 28 2 5 2 2 2 4 1 2 6 1 4 1 3 1 5 1 1 1 I 5 6 1 1 1 1 1 1 3 1 1 1 1 1 1 2 3 1 2 2 2 1 1 1 1 1 1 i" 1 i 2 1 1 2 11 1 1 3 9 1 2 1 1 2 1 1 1 2 4 1 1 1 2 2 4 1 " 1 1 > V 2 1 3 1 1 2 1 1 9 4 1 3 1 2 1 2 1 4 2 1 1 1 1 2 16 3 1 2" 2 7 1 1 1 1 1 1 1 1 1 6 20 1 1 1 1 1 1 1 1 1 116 1 4 4 6 1 2 2 4 10 1 1 2" 4 1 1 1 2" 2 1 1 1 1 2 1 1 1 1 i" 1 3 1 1 1 3 1 29 13 4 1 2 34 4 6 9 3 1 1 3 2 6 7 1 4 1 2 114 2 1 4 1 1 2 10 2 I 32 11 63 4 21 27 12 10 23 3 1 1 3 6 1 20 5 9 4 14 1 12 3 1 1 1 1 1 2 3 1 1 1 1 1 1 1 1 2 1 i 1 4 12 1 2 1 4 2 5 1 1 1 1 1 1 1 1 i 1 2 1 2 1 3 1 2 1 1 3 10 1 2 1 12 1 1 1 2 2 1 3 1 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 3 ... ^ T 1 1 1 1 1 1 1 1 1 1 2 1 1 1 1 J • 1 1 1 1 1 1 1 1 2 1 1 3 4 2 1 1 1 1 1 1 1 1 1 3 1 2 2 1 1 1 1 1 1 1 1 1 1 1 2 1 1 7 1 1 5 7 1 2 1 1 1 1 1 1 2 2 1 1 1 114. Other and Ill-def. Dis. of Digestive Organs Lymphatic System. 115. Diseases of Lymphatic System and Ductless Glands. Urinary System. 116. Acute Nephritis ... 117. Brignt s Disease ... 118. Calculus 119. Diseases of Bladder and Prostate ... 120. Other and Ill-def. Dis. of Urinary System ... Reproductive System. Generative Organs. 121. Diseases of Testis and Penis 122. Diseases of Ovaries 123. Diseases of Uterus and Appendages 124. Diseases of Vagina 8c External Genital Organs 125. Diseases of Breast Parturition. 126. Abortion, Miscarriage 127. Puerperal Mania .. 128. Puerperal Convulsions 129. Placenta Previa, Flooding 130. Puerperal Thrombosis 131. Other and Ill-def. Accidents of Pregnancy and Child Birth Bones and Joints. 132. Arthritis, Ostitis, Periostitis 133. Other and Ill-def. Dis. of Osseous System ... Integumentary System. 134. Ulcer, Bedsore ... 135. Eczema ... 136. Pemphigus 137. Other and Ill-def. Dis. of Integumentary System EXTERNAL CAUSES. Accidents and Negligence (total). 138. In Mines and Quarries 139. In Vehicular Traffic 140. On Railways 141. On Ships, Boats & Docks, excluding drowning 142. In Building Operations ... 143. By Machinery 144. By Weapons and Implements 5 1 1 1 4 3 1 1 1 1 1 l" 1 1 •» 1 1 1 1 1 0 1 2 1 1 13 1 2 1 1 2 1 1 I 1 1 1 5 2 1 1 1 - 1 1 1 1 1 1 1 1 1 1 2 1 1 1 1 9 * 1 1 2 1 1 1 2 1 2 1 1 1 2 1 1 1 1 1 1 1 2" 5 1 1 1 1 1 1 8 2 3 2 2 27 1 2 2 2 1 5 1 1 1 1 3 1 2 1 I 3 1 2 1 2 "2 1 1 1 1 1 1 1 1 1 7 1 1 2 1 1 1 ... | « 1 1 1 1 ... 1 1 1 2 f 3 1 1 1 1 2 1 1 1 1 1 1 2 1 1 1 1 1 1 1 1 1 1 4 1 1 140. 146. 1 17. 148. 149. 150. 151. 152. 153. 154. 155. 156. 157. 158. 159. 160. 161. 162. 163. 164. 165. 166. nurns ana acaias Poisons, Poisonous Vapours Surgical Narcosis Effects of Electric Shock ... Corrosion by Chemicals ... Drowning Suffocation, overlaid in bed Suffocation, otherwise Falls, not specified Weather Agencies Otherwise and not stated ... Homicide Suicide (total). By Poison By Asphyxia By Hanging and Strangulation By Drowning By Shooting By Cut or Stab ... By Precipitation from elevated places By Crushing By other and Unspecified Methods Execution 1 1 1 3 3 2 1 1 2 1 1 1 1 1 1 1 1 1 1 1 1 1 4 5 4 1 2 2 1 2 1 1 1 3 2 1 1 1 2 1 1 3 2 3 1 1 1 1 1 1 1 2 1 1 1 2 1 3 1 3 1 1 1 1 l" 1 1 •2 T 3 1 7 11 4 1 8 1 0 2 1 2 1 1 1 1 2 1 1 3 1 1 1 1 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ILL- 167. 168. DEFINED CAUSES. Sudden Death (cause not ascertained) Other Ill-defined and Not Specified causes... TOTALS Under 5 73 45 104 43 265 33 34 37 >2 126 24 18 9 17 68 20 15 29 15 79 1 1 1 3 541 7 3 8 6 24 12 11 5 1 1 1 l 4 2 1 1 8 4 4 5 4 17 Over 5 127 86 89 114 416 66 64 55 83 268 20 10 13 28 71 43 30 27 42 142 2 3 2 5 2 909 19 38 33 58 178 4 3 6 4 17 4 5 6 4 19 1 1 2 0 4 6 3 2 3 1 9 33 11 19 19 82 1450 lne Deaths occurring in the various Public Institutions in this Table are Residents, a7id are allocated to the respective districts in the Borough.