HAM 5 THE VESTRY OF THE PARISH OF HAMMERSMITH. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH, For the Year 1898. London : Printed by .J. W. Wakeham, 116, Uxbridge Road, and 4, Bedford Terrace, Kensington. mdcccxcix. 2 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH OF THE PARISH OF HAMMERSMITH, For the Year 1898. Public Health Department, Town Hall, Hammersmith. 25th March, 1899. Gentlemen,—I beg to present to you my Annual Report for last year. The Report will deal with the vital statistics, and with the Sanitary work carried out under the direction of your Vestry during the 52 weeks ending on December 31st, 1898. BIRTHS. During last year 3,026 births were registered in this Parish, against 3,139 in the previous year. Making due allowance for the increase of the population, the number of births registered last year was 142 below the average number registered during the last 10 years. On the population estimated up to the middle of the year, i.e., 107,352 inhabitants the number of births registered was equal to the annual rate of 28.2 births per 1,000 persons living. The birth-rate in London on the estimated population of London up to the middle of the year, i.e., 4,504,766 inhabitants, was equal to an annual rate of 29.5 births per 1,000 persons living. 3 DEATHS. During last year 1,670 deaths were registered in this Parish, against 1,570 in the previous year. Making due allowance for the increase of the population, the number of deaths registered in this Parish last year was 53 below the average number registered during the last 10 years. Adding 383 deaths of parishioners of this Parish which took place in general hospitals and other public institutions in other parishes of London, in London County Lunatic Asylums and Metropolitan Imbecile Asylums, and deducting 169 deaths of non-parishioners which occurred. 72 at the West London Hospital, 51 at Nazareth House, 6 at the Convent of the Good Shepherd, 6 at St. Joseph's Schools, 15 at H.M. Prison, Wormwood Scrubs, and 19 which otherwise occurred in the Parish, the corrected number of deaths of parishioners registered last year was 1,884. On the before mentioned estimated population, the corrected number of deaths of parishioners registered last year was equal to an annual rate of 17.5 deaths per 1,000 persons living; the death-rate in London on the estimated population of London up to the middle of the year was equal to an annual rate of 18.3 per 1,000 persons living. I observed that the Registrar-General in his annual summary gives the corrected number of deaths of parishioners of this parish as 1,964 and a mortality rate therefore of 18.3 per cent. The difference of 80 is accounted for as follows:—In the first place I make the deaths as registered in the Parish as one more than the Registrar-General. The difference of 79 is due to the fact that the RegistrarGeneral has made no allowance for 15 deaths that occurred at the Fulham Union Infirmary, and one at Chelsea Infirmary, which were reported to me from Somerset House, as of parishioners of this parish, and which upon inquiry I found were deaths of children who had been born in the Infirmaries, and although their mothers had been parishioners of Hammersmith, and they, the children, had actually never resided in Hammersmith at all. Besides the above there were 51 4 deaths of non-parishioners at Nazareth House, 6 at the Convent of the Good Shepherd, and 6 at St. Joseph's School. Allowance is only made by the RegistrarGeneral for the 72 deaths of non-parishioners which occurred at the West London Hospital, and 15 at H.M. Prison, Wormwood Scrubs. DEATHS OF INFANTS. The corrected number of deaths of parishioners under one year of age registered was 545 against 523 in the previous year. The number of deaths of infants under one year of age registered last year was eoual to 23.9 per Cent. of the total deaths of parishioners registered, and to 18.0 per cent. of the total registered births. The number of deaths of infants under one year of age in London last year was equal to 26.4 per cent. of the total deaths registered, and 16.7 per cent. of the total registered births. The mortality rate of infants under one year of age was, as compared with the total deaths of parishioners registered, 2.5 per cent. greater in this Parish than in London, and, as compared with the total births registered, 1.3 per cent. greater in this Parish than in London. DEATHS OF AGED PERSONS. The corrected number of deaths of parishioners at 60 years of age and upwards that were registered during last year was 449 against 438 in the previous year. These deaths last year were equal to 0.42 per cent. of the total persons living, and to 23.8 per cent. of the total deaths of parishioners registered. The percentage of deaths of persons registered at 60 years of age and upwards in London last year was equal to 0.42 per cent. of the total persons living, and 23.9 per cent. of the total deaths in London registered. This death-rate was, therefore, the same in this Parish as in London as compared with the total inhabitants living, and 0.1 per cent. less in this Parish than in London as compared with the total deaths. 5 TABLE I. The following table shows the mean temperature, the estimated population, the number of persons to each acre, the number of births, the proportion of births to each 1,000 persons living, the deaths (uncorrected) as registered in the Parish, the proportion of uncorrected deaths to each 1,000 persons living in the Parish in the years 1889-1898, also the number of corrected deaths to each 1,000 persons living in the Parish in the years 1892-98. Year Mean Temperature Fahrenheit. Population estimated up to 3rd of July. Number of persons to each Acre. Number of Births. Proportion of Births to each 1000 Persons living. (The Uncorrected) Deaths as Registered in the Parish. The Proportion of (Uncorrected) Deaths to each 1000 Persons living. The Corrected Deaths (See Table A). The Proportion of Corrected Deaths to each 1000 Persons living. 1889 48°.8 93327 40.8 2831 30.3 1477 15.8 not available. not available 1890 48°.6 95915 41.9 2826 29.5 1703 17.8 „ „ 1891 48°.4 97867 42.8 2910 29.7 1726 17.6 „ „ 1892 48°.1 99203 43.4 2904 29.3 1754 17.7 1905 19.2 1898 51°.1 100539 44.0 2950 29.3 1642 16.3 1805 18.0 1894 49°.9 101875 44.5 2902 28.5 1510 14.8 1649 16.2 1895 49°.3 103211 45.0 2909 28.2 1611 15.6 1749 17.0 1896 60°.1 104547 45.7 3007 28.8 1556 14.9 1758 16.8 1897 50°.3 106016 46.7 3139 29.6 1570 14.8 1700 16.0 1898 51°.3 107352 46.9 3026 28.2 1670 15.6 1884 17.5 TABLE II. The following table marked (A.) has been prepared by one under an instruction of the Local Government Board. K 3 TABLE OF DEATHS during the year 1898, in the Metropolitan Sanitary District of Hammersmith, (A) classified according to Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics; public institutions being shown as separate localities. (See note 4 on back of sheet.) (Columns for Population and Births are in Table ft.) mortality from all causes, at subjoined ages. Mortality from subjoined causes, distinguishing Deaths of Children under five Years of age At all Ages. Under 1 year. 1 and under 5 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 15 17 18 19 20 21 22 Small-pox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea & Dysentery. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease. Injuries. All other Diseases. Total Typhus. Enteric or Typhoid. Continued Relapsing Puerperal (a) (a) (b) (d) (e) (f) (g) (h) (i) North District, Wards 4,5&G 643 230 115 24 19 153 102 Under 5 0 0 2 1 0 0 0 0 0 0 1 43 14 83 0 0 5 68 3 3 122 345 5 upwds 0 2 2 0 0 5 0 0 0 0 0 1 1 2 5 0 12 68 39 8 123 298 Centre District, Wards 2 & 3 574 183 92 11 18 142 125 Under 5 0 0 1 0 0 0 0 0 0 0 0 48 17 47 0 0 4 47 3 7 99 273 5 upwds. 0 0 1 0 0 2 0 0 0 0 2 3 0 8 1 0 40 63 42 10 129 301 South District, Ward 1 1231 69 35 8 4 66 49 Under 5 u 0 0 1 0 0 0 0 0 0 0 21 2 34 0 0 0 19 0 1 26 104 5 upwds. 0 1 0 0 0 l 0 0 1 0 1 0 0 1 0 0 15 27 17 9 54 127 West London Hospital 139 23 19 10 13 63 11 Under 5 0 0 1 0 0 0 0 0 0 0 0 1 1 7 0 0 1 9 0 5 15 40 5 upwds. 0 0 0 0 0 2 0 0 0 0 0 0 0 0 1 0 1 9 5 29 52 99 Nazareth House 55 0 5 9 1 8 38 U nder 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 3 5 5 upwds. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 5 10 5 0 29 50 Convent of the Good Shepherd 7 0 0 0 0 7 0 Under 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 upwds. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 2 7 St. Mary's Orphanage 0 0 0 ° 0 0 0 Under 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 upwds. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 St. Joseph's School 6 0 1 4 1 0 0 Unfler 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 5 upwds. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 1 5 Kensington and Chelsea District School 0 0 0 0 0 0 0 Under 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 upwds. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 H.M. Prison, Wormwood Scrubs . 15 8 0 0 5 6 2 Under 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 5 upwds. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 2 1 2 4 13 Totals 1670 507 267 63 61 445 7 Under 5 0 0 4 2 0 0 0 0 0 0 1 113 34 171 0 0 10 145 6 16 268 770 5 upwds. 0 3 3 0 0 10 0 0 1 0 3 4 1 2 7 0 116 179 109 58 394 900 The subjoined numbers have also to be taken into account in judging of the above records of mortality. 8ee Note 5 on back. Deaths occurring outside the district among persons belonging thereto 383 56 56 11 16 160 84 Under . 0 13 13 0 0 0 0 0 0 0 0 11 1 18 0 0 1 1 17 0 1 36 111 5 upwds. 0 5 3 0 0 4 0 0 0 0 1 0 0 1 2 0 43 46 30 12 125 272 Deaths occurring within the district among persons not belonging thereto 169 18 15 13 14 70 39 Under 5. 0 0 I 0 0 0 0 0 0 0 0 0 0 3 0 0 1 6 0 4 18 33 5 upwds. 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 18 14 91 29 | 64 136 7 NOTES ON TABLES A AND B. Note 1. Medical Officers of Health of "Combined Districts" must make a separate Return for the District of each Sanitary Authority. 2. Medical Officers of Health, acting for a portion only of the District of a Sanitary Authority should write, in the heading of the Table, the designation of the Division for which they act. 2. The words "Urban" "Rural," or "Metropolitan" must be inserted in appropriate space in the heading, according as the Sanitary Authority for the District is Urban or Rural, or is within the. Metropolitan A rea. 3. The "Localities" adopted for the purpose of these statistics should be areas of known population; such as parishes, groups of parishes, townships, or wards. As stated at the head of the first column in each table, Public Jnst itutiont should be regarded as separate localities, and the deaths in them should be separately recorded. Workhouses, Hospitals, Infirmaries, Asylums, and other establishments into which numbers of people, and especially of sick people, are received, are Public Institutions for the purpose of these statistics. 5. The deaths which have to be classified in this Tabic (A ) and summed up in the horizontal line of Totals," are the whole of those registered as having actually occurred in the several localities comprised within the Division or District. But the registered number of deaths frequently requires correction before it can give an exact view of the mortality of a Division or District; and the two lowest horizontal lines are provided for the purpose of enabling Medical Officers of Health to indicate, to the best of their ability, what the extent of such corrections should be. Details concerning the corrective figures, e.g., the institutions that have been considered, or the particular localities to which the corrections apply, may appear in the text of the report or in supplementary tables. Area and Population of the District or Division to which this Return relates. Area in Acres 2,287 Population (Census 1896) 104,199 In recording the facts under the various headings of Tables A and B attention has been given to the notes endorsed on the Tables. N. C. COLLIER, Medical Officer of Health. March 25th, 1899. 8 DEATHS FROM THE 9 PRINCIPAL ZYMOTIC DISEASES. The total number of deaths of parishioners that were registered from the nine principal zymotic diseases was 420, against 284 in the previous year. The deaths of parishioners last year from these diseases were equal to 22.3 per cent. of the total deaths of parishioners registered, and were at the rate of 0.39 deaths per 100 persons living. The deaths from the 9 principal zymotic diseases in the whole of London were equal to 15.0 per cent. of the total deaths registered, and were at the rate of 0.28 deaths per 100 persons living. These deaths were therefore, as compared with the total deaths of parishioners registered 7.3 per cent. greater in this Parish than in London, and as compared with the population 0.11 greater in this Parish than in London. The considerable increase in the number of these deaths in this Parish was almost entirely due to Measles. TABLE III. The following table shows the deaths of parishioners registered from the 9 principal zymotic diseases which occurred in the 10 years 1889 to 1898. yeak. Smallpox. Measles. Scarlet Fever. Diphtheria and Membraneous Croup. Whooping Cough. Typhus Fever. Enteric Fever. Simple Continued Fever. Diarrhœa and Cholera. Total. 1889 0 23 16 46 0 15 2 53 192 1890 0 95 16 50 75 0 14 0 98 348 1891 0 10 9 72 50 0 5 3 74 223 1892 0 22 11 71 53 0 4 3 81 345 1893 0 1 4 32 56 51 0 15 2 126 286 1894 0 72 10 53 55 0 15 0 67 272 1895 1 28 14 47 42 0 14 0 104 250 1896 0 58 20 52 60 1 14 1 125 331 1897 0 4 10 30 28 0 8 0 204 284 1898 0 128 21 24 36 0 12 0 199 420 9 CASES OF ILLNESS REPORTED AS DUE TO INFECTIOUS DISEASE. There were 780 cases reported as due to notifiable infectious diseases in this Parish against 708 in the previous year. There were also 414 cases that were not notifiable under the Act, reported as due to infectious diseases, against 40 in the previous year. SMALL-POX. No case was reported as due to small-pox, against no case in the previous year. CHICKEN-POX. Ten cases of chicken-pox were reported against no case in the previous year. The 10 cases reported last year were treated at the homes of the patients. No death was registered. MEASLES. Three hundred and fifty-seven cases were reported as due to measles, against 11 cases in the previous year. 128 cases were not reported until after death, and in 229 cases the patients were suffering from the disease at the time when the information was received. One case was removed to the West London Hospital, thirteen cases were removed to, or occurred at the Fulham Union Infirmary, the remaining 343 cases were treated at the homes of the patients. 128 deaths were registered. As this is not a notifiable disease it is of no use my giving the mortality rate on the cases reported as, no doubt, only a very small proportion which occurred were reported to me. NOTIFICATION OF MEASLES. The Public Health Committee had during last year under consideration the question of declaring Measles a " dangerous infectious disease," under the provisions of the Public Health (London) Act, 1891, and a recommendation was sent up to your Vestry advising that you should pass a resolution so as to bring the disease under 10 the Act, in order that it might be dealt with in the same manner as the other notifiable infectious diseases. Your Vestry, I much regret, refused to adopt the advice of the Committee. I beg to point out to you that of the whole 10 diseases that are by law declared to be dangerous infectious diseases there were in the parish last year 57 deaths, whereas the deaths from measles alone were 128, or more than twice as many deaths from measles as from all the other 10 notifiable infectious diseases put together. Judging from the total number of deaths, measles as, as compared with the population, by far the most fatal infectious disease. I had the opportunity of seeing many cases of measles last year, and I have no hesitation in stating that some of the illnesses were as serious as ordinary cases of smallpox. I saw patients with the whole surfaces of their bodies swollen. I sent one case into a General Hospital, and I am informed that consultations were held by members of the staff, and that for several days they weie of opinion that the patient was suffering from smallpox. It appears to me that it is in the highest degree desirable that something should be done with the object of preventing so large a sacrifice of human life, and affliction that is caused to so many families. From what I have observed of the great progress of sanitation during the last 22 years, 1 have not the slightest doubt that the notification of measles will be eventually enforced. In London last year there were 3069 deaths registered from this disease. Is it likely that society will continue to be satisfied with so great a sacrifice of human life, with practically no efficient means being adopted by the Public Health Authorities to prevent it? I think not. I remember in the year 1877, when there were 2544 deaths from smallpox in London, when there was no notification of the disease and comparatively nothing was being done to prevent the disease spreading, I got Sir Charles Dilke to bring the questions before the House of Commons, and to 11 ask Her Majesty's Government to bring in a Bill for the notification of the disease. Everyone in the present day approves of and realizes the great advantage of the action which was subsequently taken, but society did not then seem to be roused at the state of affairs. In the present day with such a mortality from smallpox, every newspaper in the kingdom would be calling attention to the matter. I remember a medical man making a formal complaint against me to the Magistrate at the Hammersmith Police Court because I had removed a patient to an isolation hospital when suffering from smallpox, and had disinfected the infected room. No medical man could be found in the present day to disapprove of such a course. During last year there was only one death from smallpox in London. Future generations will look back to the statistics of the year 1898 and hardly believe it possible that 3069 deaths from measles should have occurred in the greatest and richest city in the world, with practically no effort being made by the Public Health Authorities to combat with the evil. Everyone knows that the illnesses in the greater majority of cases of measles are not of a serious character, but the whole question is, is it not an imperative duty that the disease should be made notifiable in order that premises might be disinfected, and as far as possible the disease prevented from spreading? SCARLET FEVER. Four hundred and fifty-eight cases were reported as due to scarlet fever, against 399 in the previous year, Two hundred and eighty-four cases reported last year were isolated at Isolation Hospitals, 281 at the Metropolitan Asylums Board's Western Fever Hospital, and 3 at the London Fever Hospital at Islington; 174 cases were treated at the homes of the patients. The mortality rate on the cases reported was 4.6 per cent. 12 DIPHTHERIA AND DIPHTHERITIC MEMBRANOUS CROUP. One hundred and sixty-three cases were reported as due to diphtheria or diphtheritic membranous croup, against 158 cases in the previous year. Eighty-seven cases reported last year were treated at the Metropolitan Asylum Board's Western Fever Isolation Hospital. Three by the West London Hospital, 1 at St. George's Hospital, 1 at the Fulham Union Infirmary and 71 at the homes of the patients. The mortality rate on the cases reported in the Parish was 14.1 per cent. WHOOPING COUGH. Forty-seven cases were reported as due to whooping cough, against 29 cases in the previous year. All of the cases reported last year were treated at home, 36 were not reported until after death, and 11 cases were not reported until after recovery. Thirty-six deaths were registered. As this is not a notifiable disease it is of no use my giving the mortality rate on the cases reported, as, doubtless, a very large number of cases occurred which were not known of in your Public Health Department. ENTERIC FEVER. Fifty-nine cases were reported as due to enteric fever, against 46 in the previous year. Sixteen of the cases reported last year were treated at the Western Fever Isolation Hospital of the Metropolitan Asylums Board, 3 at St. George's Hospital, 3 at the West London Hospital, 1 at the King's College Hospital, 1 at St. Mary's Hospital, 1 at Charing Cross Hospital, 1 at the Fulham Union Infirmary, and 33 at the homes of the patients. Twelve deaths were registered. The mortality rate on the cases reported was 20.3 per cent. TYPHUS FEVER. No case was reported as due to typhus fever, against no case in the previous year. SIMPLE CONTINUED FEVER. Five cases were reported as due to simple continued fever, against 3 cases in the previous year. All of the cases reported last year were treated at the homes of the patients. No death occurred from this disease. RELAPSING FEVER. No case was reported as due to relapsing fever against no case in the previous year. PUERPERAL FEVER. Four cases were reported as due to puerperal fever against 8 cases in the previous year. All of the cases reported last year was treated at the homes of the patients. One death was registered. The mortality on the cases reported was 25.0 per cent. CHOLERA. No case was reported as due to cholera against one case in the previous year. ERYSIPELAS. Ninety-one cases were reported last year as due to erysipelas, against 93 cases in the previous year. Of the 91 cases reported last year 7 were treated at the Fulham Union Infirmary, 1 at the West London Hospital, and 83 at the homes of the patients. Five deaths were registered. The mortality rate on the cases reported was 5.5 per cent. TABLE IV. The following table shows the number of cases that were reported as due to the undermentioned 13 zymotic diseases during the years 1889to 1898. Year. Small-pox. Scarlet Fever. Diphtheria or Diphtheritic Croup. Typhus Fever. Enteric Fever. Simple Continued Fever. Relapsing Fever. Puerperal Fever. English Cholera. Erysipelas. Chicken-pox. Measles. Whooping Cough. Total. *1889 0 221 90 0 41 2 0 0 1 13 2 63 37 479 1800 0 334 218 0 67 1 0 1 3 81 4 122 75 906 18111 0 233 272 0 42 4 0 5 4 61 1 37 50 709 1892 3 462 322 0 46 8 0 6 0 124 6 167 53 1197 1898 21 673 282 0 68 4 0 19 1 184 0 6 51 1309 1894 7 332 189 0 52 4 0 8 0 92 1 86 55 826 1895 7 382 202 0 57 5 0 3 0 89 2 30 42 819 1896 1 528 217 1 53 4 0 8 0 121 5 74 61 1073 1897 0 399 158 0 46 3 0 8 1 93 0 11 29 718 1898 0 458 163 0 59 5 0 4 0 91 10 357 47 1194 "These statistics must not be taken as a true comparison, as the Infectious Diseases Notification Act, 1889, only came into force October 31st, 1889. 14 I append a table giving statistics of cases of Infectious Diseases notified in certain Western Districts of London during the Year 1897-98. London. Kensington. Paddington. Fulham. Hammersmith. Chelsea Population in 1896: 4.5 millions. 170,465 124,506 113,781 104,199 96,646 Notifications, 1897-8. Small Pox 140 0 1 1 0 0 Scarlet Fever 39,793 1,223 793 1,572 857 825 Diphtheria 24,372 537 570 843 310 575 Typhoid F. 6,145 221 120 124 105 107 Typhus F. 21 8 0 0 0 0 Other C. F. 120 9 2 6 8 2 Puerperal F. 514 27 13 19 12 9 Erysipelas 10,981 417 267 228 184 192 Croup 698 17 14 21 11 11 Cholera 61 2 1 1 1 0 Total 82,845 2,461 1,781 2,815 1,488 1,721 From this, taking account of the respective populations, it will be seen that in the last two years Hammersmith has been the most, and Fulham the least, healthy of the above districts, as far as prevalence of notifiable infectious diseases is concerned. 15 TABLE V. The following Table marked (B) has been prepared by me under an instruction of the Local Government Board. NOTES ON TABLE B. (See also Notes on back of Table A.) Note 1. The present Table B is concerned with population, births, and sickness (not with mortality) in the Sanitary district or division to which the table relates. 2. As stated in the heading of Col. (a), Public Institutions should be regarded as separate localities, and the new cases of sickness in them should be separately recorded. Workhouses, Hospitals, Infirmaries, Asylums, and other establishments into which numbers of people, aud especially of sick people, are received, are Public Institutions for the purpose of these statistics. 3. Comments on any unequal incidence of notifiable disease upon the several localities, and considerations as to the local incidence of consumption and other prevalent diseases, should be made in the text of the Report. K211 TABLE oF population. births, and of new cases of infectious sickness, coming to the knowledge of the Medical Officer of Health, during the year 1898, in the Metropolitan Sanitary District of Hammersmith; classified (b) according to Diseases, Ages and Localities. Names of Localities adopted for the purpose of these Statistics; Public Institutions being shown as separate localities. (See Note 2 on back of sheet.) population at all ages Registered Births. Aged under 5 or over 5. New Cases of Sickness in each Locality coming to the knowledge of the Medical Officer of Health. Number of such Oases Removed from their Homes in the several Localities for Treatment in Isolation Hospital. Census 1896. Estimated to middle of 1898. 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11 Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Small-pox Scarlatina. Diphtheria, Membranous Croup. Fevers. Cholera. Erysipelas. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a) (a) (c) (d) (e) North District, Wards'4, 5 & 6 43,382 44,715 1391 Under 5 0 64 25 1 0 1 0 0 0 0 2 0 40 10 2 0 0 0 0 0 0 0 5 upwds. o 154 57 0 0 28 2 0 1 0 44 0 88 29 0 0 7 0 0 0 0 0 Centre District, Wards 2 & 3 42,293 43,592 1159 Under 5 0 32 7 1 0 1 1 0 0 0 1 0 20 2 0 0 1 0 0 0 0 0 5 upwds 0 118 35 0 0 22 2 0 1 0 27 0 72 15 0 0 7 1 0 0 0 0 South District, Ward 1 15,929 16,418 465 Under 5 0 29 11 0 0 0 0 0 0 0 0 0 21 9 0 0 0 0 0 0 0 0 5 upwds. 0 54 15 9 6 0 0 2 0 14 0 36 7 0 0 1 0 0 0 0 0 West London Hospital 134 142 1 Under 5 0 4 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 5 upwds. 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 Nazareth House 584 608 0 Under 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 upwds. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Convent of the Good Shepherd 246 260 0 under 5 0 0 0 u 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 upwds. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 St Mary's Orphanage 64 65 0 Under 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 upwds. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 St. Joseph's School 188 185 0 under 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 upwds. 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 Kensington and Chelsea District School 123 114 0 Under 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ft upwds. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 H.M. Prison, Wormwood Scrubs 1,256 1,253 10 Under 5 0 1 2 0 0 0 0 0 0 0 0 0 1 2 0 0 0 0 0 0 0 0 ft upwds. 0 1 6 0 0 1 0 0 0 0 2 0 1 6 0 0 0 0 0 0 0 0 totals Under 5 5 upwds. 104,199 107,352 3026 Under 6 0 130 45 5 0 2 1 0 0 0 3 0 86 28 2 0 1 0 0 0 0 0 5 upwds. 0 328 113 0 0 57 4 0 4 0 88 0 198 57 0 0 15 1 0 0 0 0 Note.-State here whether "Notification of Infectious Disease" is compulsory in the District -yes. Since when? October 30th, 1889. Besides the above-mentioned Diseases, insert in the columns with blank headings the names of any that are notifiable in the District, and fill the columns accordingly. State here the name of the Isolation Hospital used by the sick of the District. Mark (H) the localitv in which such Hospital is situate; and if not within the District, state where it is situated - Western District Hospital at Fu ham and occasionally other Hospitals under the Metropolitan Asylums Board,and exceptionally the London Fever Hospital at Islington. 17 INFLUENZA. Thirty-two deaths were registered as due to influenza, against 14 deaths in the previous year. No official action was taken in reference to this complaint except in a few cases in which application was made by inhabitants for the disinfection of premises. HOUSES LET IN LODGINGS. During last year the Public Health Committee registered 218 "houses let in lodgings or occupied by the members of more than one family," making a total with those previously registered of 434 premises. Upon the registration of the premises a copy of the Byelaws of your Vestry under which such houses are registered, was forwarded to the landlord (within the meaning of the Bye-laws), for his guidance. At the meeting of your Public Health Committee held on June 28th, 1897, I advised "that the District Inspectors be instructed to visit and inspect the registered premises once in each quarter, and to report to your Committee as to whether they are kept in accordance with the Bye-laws." Your Public Health Committee decided not to adopt my advice. On July 11th, 1898, in consequence of a communication from the London County Council your Committee had the question again under consideration, when it was decided to instruct the District Inspectors to visit and report as far as they were able, on the condition of the registered premises at each meeting of the Committee. Since that order was given, with only one exception, your Inspectors have reported that pressure of other duties has prevented them from visiting and reporting upon any of the registered premises. If this work is to be carried out, and there can be no doubt it ought to be, it is absolutely necessary to appoint another Inspector for the purpose. VESTRY'S DUST SHOOT AT THE WHARF CHANCELLORS. No complaint was made of a nuisance from the depositing of the refuse at your Vestry's wharf during 18 last year. The plan adopted of sprinkling the refuse with a solution of permanganate of potash was continued during the hot weather. NUISANCE AT THE ROAD CAR COMPANY'S STABLES, HAMMERSMITH ROAD. During last year no complaint was received in reference to the nuisance from the premises of the Road Car Company in the Hammersmith Road, but I have, at times, noticed a very offensive odour emitted from the windows of the stables abutting on the main road. LICENSED SLAUGHTER HOUSES. The whole of the 16 licensed slaughter houses in the Parish were under regular fortnightly inspection by the four District Inspectors. At the annual inspection of slaughter houses in October, 1898, I had received notices that 16 licenses were to be applied for. They were all reported as far as your Vestry's requirements are concerned, to be in a satisfactory condition. At the Special Sessions at the London County Council, held 24th October, 15 licenses were granted without opposition by your Vestry. The remaining one was refused being opposed by the inspector of the London County Council. The following is a list of the licensed slaughter houses in the parish:— NORTH DISTRICT. Wards Nos. 4, 5 and 6. address. name of licensee. 172, Uxbridge Road Henry Healey 47, Norland Road Thomas Down 2 , Askew Road T. Bates 185, Uxbridge Road William Matthew East 49, Goldhawk Road Benjamin Holton 138„ „ Frederick Kerven 131, Latimer Road Unoccupied Sheep House, Farm Cottage, Old Oak Lane Edward Wiggins 19 CENTRE DISTRICT. Ward* 3 and 3. address. name of licensee. 158, King Street Thomas Holtun 247, Goldhawk Road William Burge 41, Dalling Road Frederick Wright SOUTH DISTRICT. Ward No. 1. address. name of licensee. 35, Queen Street Payne Bros. 49, King Street Benjamin Holton 65, „ „ George Meacock 321, „ „ Thomas Jasper Wheeler LICENSED COW-HOUSES. The two licensed cow-houses in the Parish were under regular fortnightly inspection by the District Sanitary Inspector. At the annual inspection in October, one of the premises was found not to be occupied, the other was in a satisfactory condition. At the Special Sessions of the London County Council, held on 24th October, one only was renewed, the license for 115, Glenthorne Road was refused, being opposed by the Inspector of the London County Council. The following is the only licensed cow-house in this Parish:— CENTRE DISTRICT. address name of licensee 15, Brook Green Road Walter Glover 20 BAKEHOUSES. The whole of the 60 bakehouses in the Parish were under regular quarterly inspection by the Factory Inspector. In 6 instances it was reported that the premises were not in a proper sanitary condition. Notices were at once served upon the bakers calling upon them to comply with the regulations of your Vestry. In each instance the notice was complied with. The following is a list of the bakehouses in the Parish:— NORTH DISTRICT. Wards No8. &, 5 and 6. address. name. 356, Uxbridge Road J. Platt *+125, „ H. S. Bingham 121, Askew Road E. Bliss *242, Goldhawk Road W. Cuff *32, Norland Road P. Franks *142, Goldhawk Road E. Holman 74, „ N. Hutter 122, Askew Road F. Faubel *75, Uxbridge Road J. J. Sauer *216, „ F. C. Stiles *74, Askew Road J. Wackerbath †324, Uxbridge Road R. & T. Whiteside *1, Kenmont Terrace, Harrow Road W. Voight *276, Latimer Road Albert Rose *2, Hunt Street Wm. Burt *4, St. Helen's Terrace C. Smith *55, Melina Road C. Gordon *167, Askew Road Peter Schlegel 21 CENTRE DISTRICT. Wards Nos. 2 and 3. address. name. *54, Richmond Road J. Alderton *13, Shepherd's Bush Green J. Breton *87, Masboro' Road F. J. Brown 348, King Street R. Bedster *75, Blythe Road J. Coutts 31, Goldhawk Road J. Anderson *11, Lamington Street Milsom & Pitt 258, King Street P. Erbach *94, Shepherd's Bush Road H. Elkins *82, Glenthorne Road W. A. Davey *85, The Grove H. W. West *102, Dalling Road W. H. Howard *84, Shepherd's Bush Road R. Cant †70, Glenthorne Road Woolmore & Heading SOUTH DISTRICT. Ward No. 1. address. name. 24, Bradmore Park Road G. Klein *77, Brackenbury Road W. Jennings *134, Shepherd's Bush Road C. Jacobs *6, Beconsfield Terr. Road A. Voituret *1, Masboro' Road F. J. Roos *98, Blythe Road P. Phiil *17, Kilmarsh Road Devonshire Bread Co. Ltd., Head Office *7, Shepherd's Bush Road A. Royston *192, Dalling Road N. Hutter *1, Aldensley Road W. Tyler *67, Masboro' Road F. Wyle *47, Milson Road A. Webb *33, Glenthorne Road E. Winstone †West Kensington Stores West Kensington Stores 22 ADDRESS. NAME. †Lyons & Co., Hammersmith Road Lyons & Co. 65, Bridge Road W. Bass 88, Queen Street H. Young †Eyot Gardens J. R. Chibnall, Limited 2 and 4, Queen's Road Gottig, Mrs. 93, Black Lion Lane A. Gurney Palmer's Stores, Limited 43, King Street *118 „ J. A. Hohman *182, Great Church Lane R. Minson 209, King Street J. Hall 216, Black Lion Lane A. Mulford *213, Hammersmith Road O. Shornsheim 163, King Street J. A. West *1, The Grove Palmer's Stores, Limited SEIZURE OF UNWHOLESOME FOOD. On Friday, November 25th, at about 6 o'clock p.m., Sanitary Inspector W. Brown, reported to me that he had noticed at No. 158, King Street West, in the occupation •of Mr. Thomas Holton, there was some pork which he thought I ought to inspect. I at once visited the premises and found in a small room, in connection with the shop, two pieces of pork consisting of the whole of the vertebral column, including a portion of the ribs and adjacent parts. The pork was of a livid colour on the skin, such livid colour being produced, in my opinion, from the toxic poison of a zymotic disease, and being totally inconsistent with a healthy condition of the animal from which the pork was taken. I ordered the pork to be seized, and it was conveyed the following morning to the West London Police Court and ordered by the magistrate to be destroyed. * Underground Bakehouses. † Factory Bakehouses. 23 On the 7th December, the magistrate, sitting at the West London Police Court ordered to be destroyed a piece of pork, [having certified the same to be diseased, unsound, and unfit for the food of man. The pork was alleged to have been purchased by a person named Usher at Mr. Thomas Holton's, No. 158, King Street, W. By order of your Vestry two summonses were applied for against Mr. Holton, and at the hearing of the same convictions were obtained, and penalties of £20 with £2 2s. costs inflicted in the first case, and a penalty of £30 with £3 3s. costs inflicted in the second case. SANITARY NOTICES AND ADMINISTRATION. During last year 3,415 notices were reported as having been served by your Sanitary Inspectors, having for their object the removal or prevention of nuisances or insanitary conditions, against 3,188 in the previous year, and during last year 3,394 notices were reported as having been complied with, against 3,218 in the previous year. The wise course adopted by your Vestry in appointing a House-to-House Inspector has been continued during the year. This Inspector reports that during the year he has inspected 3,574 houses and other premises in the parish. The defects in premises discovered as the result of his inspection were as usual dealt with by the four District Sanitary Inspectors. The House-to-House Inspection of the district is now nearly completed, and has taken six years to accomplish. The result of the inspection is in the highest degree satisfactory when one takes into consideration the great decrease in the number of cases of diphtheria, nevertheless, it cannot be contended that inspecting the district once in six years is properlv carrying out the 1st Section of the Public Health London Act, 1891. Your Factory Inspector has during the year served 229 notices under the Factory and Workshop Acts, and during the same period 228 notices have been complied with. A very large proportion of this Inspector's time is 24 occupied in making observations on chimney shafts, and he has consequently not been able to carry out his duties as a Factory Inspector at all to the extent that is necessary or was intended by your Vestry when you appointed him for that duty. SUMMONSES ORDERED. During last year your Vestry and the Public Health Committee gave authority for 13 summonses to be taken out against persons for having failed to comply with the requirements of your Vestry or the Public Health Committee. In most cases before summonses were taken out a letter was written to the person in default, informing him that the Vestry or Public Health Committee had ordered the summons, and asking him if he were willing to give an undertaking in writing that he would forthwith comply with the notice which had been served. In nearly all instances the undertaking was at once given, and it was not found to be necessary to apply for a summons. It has been the object of the Department to take out as few summonses as possible, but at the same time in no single instance to allow anyone to defy the authority of your Vestry. SUMMONSES TAKEN OUT. During last year only 6 summonses were taken out through the Public Health Department. The following is a list of the premises in reference to which summonses were issued, with a statement as to the nature of the complaint and the result of the proceedings. 25 TABLE VI. Situation of Premises. Nature of Offence. t of Proceedings. 120, Blythe Road No proper & sufficient water supply to premises Defendant fined 10s. and 2s. costs. Warrant to distrain returned, no goods. Defendant committed for 7 days 40. Batoum Gardens do. do. Closing order made East India Products Company, Upper Mall Nuisance from smoke from chimney shaft Defendants ordered to pay costs, £5 5s., and prohibitory order made Artizan's Dwellings, Olaf Street Neglecting to comply with order to pave the yard Work done and summons withdrawn on payment of costs 158, King Street Exposing for sale unsound meat Defendant fined £20 and £2 2s. costs 158, King Street Sale of unsound meat Defendant fined £30 and £3 3s. costs PUBLIC MORTUARY During last year your Vestry removed to the mortuary at the Wharf, Chancellors, 5 bodies of persons who had died of infectious diseases, and 3 bodies of persons for whom no proper accommodation could be found at their late residences. There were 162 bodies brought to the new mortuary by order of the Coroner or the Police, 51 of these were taken from the West London Hospital, and included 34 parishioners and 17 non-parishioners. The new mortuary and Coroner's court ordered by your Vestry was erected during the year, and was opened on January 2nd, 1899. PUBLIC NUISANCES. During last year I brought before your Public Health Committee complaints received by me in reference to the following alleged public nuisances:— I. Nuisance from black smoke in neighbourhood of Beavor Lane. 26 II. Nuisance from Piggeries, Old Oak lane. III. Nuisance from smoke from Messrs. J. Lyons & Co.'s premises, Cadby Hall. IV. Nuisance from London General Omnibus Company's Stables, Stamford Brook Road METEOROLOGY. The average mean temperature registered in London during last year was 51°.3 Fahrenheit. The highest temperature registered was 92°.1 in September. The lowest temperature was 26°.1 in February. Rain fell on 142 days. The total amount of rainfall was 18'85 inches. It has been my object as heretofore to condense this report as much as possible, and not to trouble your Vestry with a detailed report in reference to the enormous amount of routine work which is carried out through your Public Health Department. I am, Gentlemen, Your obedient Servant, N. C. COLLIER, Medical Officer of Health-