HAMP 1 1894. REPORT ON THE SANITARY CONDITION OF THE Parish of St. John, Hampstead. For the Year 1893. BY EDMUND GWYNN, M.D., Medical Officer of Health. E. Mitchener, Printer and Stationer, 26, Eversholt Street, n.w. 1894. REPORT ON THE SANITARY CONDITION OF THE Parish of St. John, Hampstead. For the Year 1893. BY EDMUND GWYNN, M.D., Medical Officer of Health. REPORT of the MEDICAL OFFICER OF HEALTH. Yestry Hall, Hampstead, N.W., June 8th, 1894. To the Yestry of the Parish of St. John, Hampstead. Gentlemen, I have the honour to lay before you my Annual Report upon the vital statistics of the Parish of Hampstead for the registration year 1893. The ordinary sanitary statistics will, as before, be compiled for the parochial year, which terminated on the 25th March, 1894. The estimated population to the middle of the year is 72,608. During 1893, 229 new houses came into occupation, chiefly situated in the Kilburn Ward. Marriages. —The number of marriages celebrated was 476, showing a decrease of 33 on the previous year. Births.—The births registered during 1893 were 1,495, or 39 more than in the previous year. The birth-rate was equal to 20.5, or rather above that for the preceding year, which was 20.4. The birth-rate for London was 31. The natural excess of births over deaths was 547. 4 Deaths.—The total number of deaths registered in the Parish was 1,452. Of this total 605 were deaths, within the district, of non-parishioners —chiefly occurring in hospitals, and 91 deaths of Hampstead parishioners who died outside the district, making together 938 deaths. These 938 deaths are equivalent to a death-rate for the year of 12'9, being somewhat higher than that for the preceding year, which was 124. The death-rate for London was 21.3 per 1000 for the year. Mortality at Different Ages.—The deaths of children under one year were 151 (less non-parishioners in institutions), or equal to 13.9 per cent. on total deaths, and to 10 per cent. on total births. These figures show a considerable fall on those for the preceding years, the rates for 1892 being 159 and 12.7. At 65 years and upwards there were 259 deaths, and of these 135 died between 65 and 75; 96 between 75 and 85; 24 between 85 and 95; a widow died at 95; the widow of a greengrocer at 97 in the workhouse; a spinster, formerly a dressmaker, died at 99 in St. Peter's Home; whilst the widow of a labourer, who formerly had been a herb-gatherer, after 27 years sojourn in the workhouse, attained to the patriarchal age of 103. Deaths in Public Institutions. North-Western Fever Hospital 510 Hampstead Hospital 9 St. Peters Home 20 North London Hospital for Consumption 29 Freidenheim 66 Workhouse 61 695 5 Of these, 605 were non-parishioners; 20 parishioners died in the North-Western Hospital, and 60 in the Workhouse. Of the 91 parishioners who died in outlying Institutions, 55 succumbed in hospitals; 25 in asylums, and the remainder in institutions and other places. Special Causes of Death.—The deaths of parishioners from the seven principal zymotic diseases, after correction for those of our parishioners who died in hospitals outside our district, are equal to a ratio of 1*3 per 1000 living inhabitants against a ratio of 1.7 for the preceding year, whilst that for London was equivalent to 3.1, and for the Northern districts 2.86. The following table will show at a glance the diminution or excess of deaths in 1893 from the seven principal zymotic diseases:— Causes of death. 1893. 1892. Diminution in 1893. Excess in 1893. Small-Pox 2 – – 2 Measles 1 25 24 Scarlet Fever 20 5 15 Diphtheria 36 27 – 9 "Whooping Cough 6 22 16 — Enteric & Typhoid Fever 8 2 — 6 Diarrhœa 22 15 – 7 Total 95 96 40 39 Thus, whilst under the headings of Small-Pox, Scarlet Fever, Diphtheria, Enteric Fever, and Diarrhoea there has 6 been an excess, the loss has been more than compensated for by the diminution in Measles and Whooping Cough. Small-Pox.—This disease became epidemic in London during the early spring, being spread by means of tramps coming from the Northern Counties and Midlands, who appear to have infected a large number of workhouses and common lodging-houses. After enjoying an almost complete immunity from smallpox for many years, we have now to record the occurrence of 12 cases of this disease in this Parish during 189 J. The two first cases occurred in April within a day or two of each other. In one instance, the gentleman attacked had been attending a Night School for lads; and in the other, that of a tramp, aged 40, who was admitted to the Casual Ward of the Workhouse on April 7, after passing a night on the Heath, and who had previously been sleeping in various outhouses and sheds. It seemed to be clearly established that he had passed one night in the Salvation Army Shelter, Blackfriars Road—a centre of infection at that time to which many cases were subsequently traced. The fatal cases were those of an unvaccinated infant, aged one month, and a domestic servant, aged 26, removed to the Hospital Ship, Atlas. The arrangements of the Asylums Board for the conveyance and treatment of small-pox patients are as follows:— The cases are collected by a special branch of the Board's Ambulance Service and brought either to Poplar or Rotherhithe, at each of which places there is a wharf provided with examination and waiting-rooms, &c. By 7 means of ambulance steamers the patients are conveyed down the river to Long Reach, where the hospital ships are moored. This floating hospital has accommodation for 400 patients, and four miles inland there is a large convalescent hospital capable of holding 800 patients. One inconvenience in connection with this arrangement has been brought under my notice by which, in cases of doubtful or mistaken diagnoses, patients are mixed up with genuine small-pox cases at the Wharf pending the decision of Board's officer, who appears to be the sole arbiter of what is, or is not, a case of small-pox. Diphtheria.—The deaths from diphtheria were in excess for the whole of London, the rate for 1893 being again the highest yet recorded from this disease. The total number of cases notified during the year in this Parish was 158 against 136 for lb92 ; and of these, 60 were sent into hospitals. Including Membranous Croup (2), the total deaths of parishioners from this cause was 38 — being in the proportion to 0.51 per 1000 living against 0.76 for the whole of London. The death-rate from this cause was higher in all the neighbouring parishes than in Hampstead. To have reached the average of London our deaths should have been over 50—the number, indeed, returned for Lewisham, a parish almost identical in population with Hampstead. The danger of an upward flow of sewer air as a factor in the production of diphtheria has, at times, received undue importance, for there would be little difficulty in showing that in the crowded populations of the low lying parishes this disease was both more frequent and more fatal. I append a list of the fatal cases, with the address of the houses from which the patients came, by which it will be seen that the cases were pretty generally scattered 8 over the parish, no district heing exempt. A special report relating to the occurrence of scarlet fever and diphtheria in the neighbourhood of Mill Lane was submitted to the Vestry in June. Three fatal cases occurred in one family living in Loveridge Road, in March; and three children, members of one family, died in Ingham Road, in May, from this disease. There is no question that some families are very disposed to throat affections and easily succumb when attacked. Personal infection from communication in schools, and from returned cases from hospitals, was found to be one cause of the spread of disease. Complaints of sewer emanations, largely due to the want of flushing water in the closets, and to the prolonged drought, were carefully gone into by your officers at the time. Date. List of Fatal Cases of Diphtheria. Jan. 24. At N. W. Hospital, removed from New Buildings. „ 30. „ „ „ Kingsgate Road. „ 31. „ Lisburne Road. Feb. 4. „ „ „ 5. „ Loveridge Road. „ 8. „ Fleet Road (croup). „ 10. „ Narcissus Road ( „ ). „ 23. „ Providence Place, West End. „ 24. „ Workhouse, from Holly Place. Mar. 5. „ Elizabeth Mews. „ 9. „ Loveridge Road. „ 19. „ Lower Lawn Road. „ 22. „ N. W. Hospital, from Loveridge Road. „ 24. „ „ „ „ 25. „ Wildwood Grove, North End. 9 Mar. 25. At Messina Avenue. „ 28. „ Palmerston Road. April 17. „ N. W. Hospital, from Fairfax Mews. „ 28. „ Netherwood Street. May 4. „ Belsize Avenue (croup-diphtheritic). „ 14. „ Fleet Road. „ 20. „ Lower Lawn Road. „ 23. „ Western Fever Hospital, from Ingham Road. „ 27. „ N. W. Hospital, „ „ „ 28. „ „ „ „ „ 30. „ ,, from White Bear Lane June 3. „ Loveridge Road. „ 13. „ Oman Road. „ 30. „ Greville Road. July 10. „ Belsize Road. „ 23. „ N. W. Hospital, from Alexandra Mews. „ 30. „ Workhouse, „ Fleet Road. Aug. 17. „ N. W. Hospital, „ Greville Road. „ 24. „ UniversityHospital „ Fleet Road. Oct. 4. „ Maygrove Road. „ 17. „ Fleet Road. Dec. 1. „ Middlesex Hospital, from Fordwych Road. „ 26. „ N. W. Hospital, „ Holly Mount. Scarlet Fever was the cause of 20 deaths, showing an excess of 15 over those of 1892. The total number of cases reported was 512 against 320 for the previous year. 214 of these were removed to isolation hospitals. The mortality of fatal cases, nearly 4 per cent., was higher than for the previous year. This disease became epidemic in London in the spring months , and continued to increase until the autumn, when the maximum number of cases was reached. About 10 the middle of the summer the Asylums Board's hospitals became full, and considerable difficulty and delay was occasioned in getting cases removed. It was necessary to make application by telegram, day by day, for each case delayed, otherwise they would have been passed over; but ultimately, as far as this Parish is concerned, every case was admitted. The epidemic which attacked the streets in the neighbourhood of Mill Lane appeared to be greatly disseminated by the agency of the Schools in the district. A weekly inspection of the sanitary state of all the elementary schools in the Parish was carried out by the Divisional Sanitary Inspectors by order of the Public Health Committee. Enteric and Typhoid Fever.—Thirty-seven cases of this disease were notified against 49 for the preceding year, but the number of fatal cases, eight, exceeded that of the previous year by six. Measles occasioned only one death, and was in abeyance during the year. Whooping Cough.—The six deaths from this disease show a great falling off from our annual average, attributable, in some measure, to the fine spring and summer. Erysipelas.— Seventy-five cases of this disease were notified against 52 for the previous year, with two fatal cases. Seven cases of Puerperal Fever were registered, three of which proved fatal. Diarrhœa caused 22 deaths. In accordance with the requirements of the Local Government Board, under the Public Health Act, tables Nos. I. and II. have been prepared. The first of these sets forth the 11 Population, Births, and number of new cases of Infectious Disease which have come to my knowledge during the year 1893; and also the number of cases removed from their homes for treatment in isolation hospitals. No. II. shows the deaths which have been registered in the Parish, including also the deaths of parishioners in hospitals and other institutions outside the sanitary district classified according to diseases, ages, and localities. The total number of certificates received during 1893 was 809, and the amount paid to medical practitioners for furnishing the Certificates was £95 2s. This sum is recouped to the Vestry by the Asylums Board out of the Metropolitan Common Poor Fund. The total number of cases removed to Fever Hospitals for treatment was 293. Influenza.—This disease, once more, was the cause of considerable loss of life during the year, 50 deaths being attributed to it chiefly in the spring months and late autumn. In London, deaths were recorded from influenza during every week in the year, and this disease appears to have taken a permanent place in our bills of mortality. Local Diseases.—Diseases of the respiratory organs caused 165 deaths, of which 48 were due to pneumonia and 84 to bronchitis. These deaths were again in excess, in relation to which the Registrar-General remarks that a large number of deaths, certified under the heads of pneumonia and bronchitis, were really due to influenza. Diseases of the nervous system caused 88 deaths, including 43 from apoplexy, 18 from convulsions, 3 from epilepsy, and 9 from inflammation of the brain. Heart diseases proved fatal to 80, and diseases of the digestive organs to 59, which latter 12 class includes 4 from dentition, 9 from enteritis, 14 from peritonitis, and 20 from diseases of the liver, together with those caused by habits of intemperance. Constitutional Diseases caused 154 deaths, including 45 from cancer ; consumption, 66 ; tubercular meningitis, 19 ; rheumatic affections, 5; and gout, 2. In the class of developmental diseases, premature birth carried off 24; and 45 deaths were directly attributed to old age. Cholera.—Some alarm was created by the appearance, in August, of cases of Asiatic Cholera at Grimsby and Hull, but fortunately the prompt measures taken by the authorities succeeded in arresting the spread of infection. In London some suspicious cases were reported, which were fully investigated by the Medical Officer of the Local Government Board, and were reported to be indistinguishable from true cholera. However, no spread of disease took place from these cases, perhaps, we may venture to hope, because the water supply and sanitary conditions were not favourable to the growth of the germs of this dread disease. On September 14th the Local Government Board, in a circular letter, again reminded the Sanitary Authority of the responsibilities and duties devolving upon them in connection with the organization of measures of precaution, and requested that the Sanitary Authority would revise the arrangements which were contemplated by them in the event of the introduction of cholera into London. Inquests.—The number of inquests held was 50, and 37 of these were caused by violence. The cause of death was ascertained by post-mortem examination in 20 instances. 13 Among the deaths caused by violence and accident, 3 infants were suffocated in bed with parents; 3 people were run over by cabs and trains: 3 died from scalds and burns; fracture of the skull and falls caused 8 deaths; infanticide 3; suicide 7, the means of death being drowning 3, hanging 1, poisoning by strychnine, &c. Mortuary.—Fifty-seven bodies were received in the Public Mortuary, and 19 post-mortem examinations were made there. Most of the bodies were brought in by the police, or at the request of the Coroner for the purpose of holding inquests; very few bodies were deposited at the request of relatives of the deceased. Work of the Sanitary Department.—Table III. contains the summary of the work of the Sanitary Inspectors during the year ending March 25, 1894. Throughout the parish 3,020 houses and premises were inspected, and 1,687 orders were issued for sanitary amendments, the number of re-inspections reaching 4,868. This shows an increase on that for the previous year. The number of lodging-houses registered is now 1,107. 572 orders were made for cleansing, whitewashing, and repairs; 466 house drains required repairs, ventilation, or re-construction; 120 new closets were ordered to be provided, and 9 cesspools abolished. The paving of 135 yards was required to be repaired, or new provided; 79 new dust-bins were ordered, and 54 to be repaired, 270 cisterns required to be cleansed, repaired, and covered, and 21 new cisterns to be provided; 296 orders were made to provide suitable receptacles for manure, and 77 for removal of dung 14 and other accumulations. In nine instances animals were found to be improperly kept, and 9 cases of overcrowding were abated. The total number of complaints received during the year was 270, or 12 less than for the previous year. It was necessary to take legal proceedings in 17 instances (against 33 for the preceding year) to enforce certain sanitary works, and orders were made in all instances for giving effect to the notices previously served on the defendants. The number of applications to examine the drainage of private houses was 221, showing a considerable increase over the number for 1892—viz., 155. Slaughter-houses and Cowsheds.—The number of slaughterhouses remains the same as for last year—viz., 7, and in some of these comparatively little slaughtering is now carried on. The number of licensed cowsheds has now fallen to 3, your Yestry having successfully opposed the granting of a license in one instance last October. These premises were inspected by the Sanitary Committee on the annual visitation, besides receiving frequent visits from the Inspectors during the year. The several premises were mostly found in good order, but slight repairs and amendments were required in some instances, all of which were carried out before licensing day. Bake-houses.—These now number 41 and are regularly inspected with the result that the sanitary condition have been fairlv maintained—but orders for cleansing, white washing, &c., were sometimes required. 15 Disinfection.—Theepidemic of Scarlet Fever and Diphtheria has occasioned a heavy demand upon the disinfecting apparatus. No less than 10,618 articles having been submitted to disinfection, particulars of which will be found in Table III. The number of houses disinfected after infectious diseases was 602 or nearly 2 per day if we except Sundays. Complaints of Sewer emanations notwithstanding the dry summer have been somewhat less numerous than usual, and have all received the careful attention of the Sanitary Committee and Staff; additional ventilators have been provided in the streets, together with flushing tanks, reflux flaps, syphons, and special ventilating pipes at certain points, with beneficial effects. Local Wells.—The London County Council having requested to be furnished with a list of local wells, it was ascertained that four wells were still used for domestic purposes. Of these four wells, the waters of two were found, on the analysis of Professor Stokes, to be so polluted as to be unsafe for domestic use. Unsound Food.—Great care and attention was paid during the year to the question of unwholesome food, and the Inspectors were directed to occasionally visit the street markets after office hours, such as late on Saturday night, in order to prevent the sale of stale or unwholesome food. Bye-Laics.—Under the provisions of the Public Health (London) Act, 1891, sets of bye-laws have been made respectively by the Vestry and by the London County Council. Those by your Yestry are for the prevention of nuisances caused by matter in any street, such as snow, ashes 16 offal, filth, &c.; for the prevention of nuisances arising from any offensive matter running out of manufactory, fishmongers' shops, &c.; for the prevention of the keeping of animals on any premises in such a manner as to be a nuisance, &c.; for the paving of yards in connection with dwelling houses; for keeping water-closets supplied with sufficient water, and for securing the cleanliness and freedom from pollution of tanks, cisterns, and other receptacles used for storing water used by man for drinking or domestic purposes, &c. By these latter regulations it is required that cisterns shall be placed where they may be conveniently cleansed ; that the owner shall provide a proper cover and that the occupier shall empty or cause to be emptied every cistern at least onee in every six months. It is a fact that the cisterns of tenement houses are cleaner and better kept than those in good class houses, which latter are frequently found to have been neglected for years. The Bye-Laws made by the County Council to be enforced by the Sanitary Authority embrace a great variety of subjects, such as the removal of offensive matter, the closing and filling of cesspools, removal and disposal of refuse, construction of waterclosets, soil pipes, &c, ashpits and receptacles for manure. The abolition of the sunken dung-pit has no doubt caused a considerable amount of inconvenience to some owners of horses; but the principle is a sound one, and the substitution of the open metal cage is in every sense preferable. An extract from the bye-laws dealing with dung pits was ordered to be printed and circulated to all persons owning such places. Water Supply.—Notwithstanding the prolonged drought 17 very little inconvenience was caused by the absence or scarcity of water in the parish. The New River Company's supply was fully maintained, but a few complaints were received of short supply on houses situated on high ground supplied by the West Middlesex Company. In July I presented a report to your Vestry on the question of "the expediency or otherwise of constant water supply being afforded to the whole parish or to any portion or portions thereof." That report stated that 4,072 houses in the parish were on the constant supply system in the district furnished by the West Middlesex Company, and 300 nouses in the district served by the New River Company. Both companies now give constant supply as estates are laid out in all districts. By the various Acts and Regulations under which the companies derive their powers, the West Middlesex cannot be called upon to give constant supply under pressure to any higher level than 200 feet above the level of high water mark at Hammersmith Bridge, and the New River need not serve constant supply higher than the top of any house which shall be under the level of 300 feet above Trinity high water mark. The advantages of a constant supply are so obvious that I had no hesitation in expressing my opinion that the whole parish, where the levels would permit, should have constant supply, and that this should be undertaken by the respective companies in sections. To have the full benefit of constant supply, the drinking and cooking water should be drawn from the rising main or service pipe by a screw down drawoff tap, and a tap should be provided for turning off the water from the main in frosty weather. A communication was subsequently addressed by your Vestry to the London 18 County Council requesting them as the Metropolitan Authority under the Water Act, 187], to make application to the respective water companies supplying water within the area of this parish to give a constant supply in their respective districts. I have more than once drawn attention to the want of flushing water for closets in some roads, due mainly to the faulty action of the water waste preventors or intercepting cisterns, those of a cheap nature quickly getting out of order. The flush of two gallons in some cases appears to be inadequate, and the County Council has been approached with the suggestion that they should obtain an alteration of the Regulation by which the minimum flush should be raised to three gallons. Sanitary Staff.—Mr. W. H. Edmonds and Mr. Reginald Geary, who had been appointed as temporary additional inspectors in September, 1892, were appointed sanitary inspectors during the year, under the provisions of the Public Health (London) Act, 1891, and General Order, December 8th, 1891. The work of the department continues to expand with the growth of the parish, and to the constant increase iu legislation dealing with sanitary subjects, still the numerous duties devolving upon the Chief Inspector and the Divisional Inspectors have at all times been discharged with activity and success, and I have also to thank the various officers of the Vestry for the necessary information which I have received from them. I am, Gentlemen, Your obedient Servant, EDMUND GWYNN, M.D., Medical Officer of Health. 19 Table No. I. Table of POPULATION, BIRTHS, and of NEW CASES OF INFECTIOUS SICKNESS coming to the knowledge of the Medical Officer of Health during the year .1893, in the Metropolitan Sanitary District of Hampstead ; classified according to Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics; Public Institutions being shown as separate localities. 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 Cases Removed from their Homes in the Several Localities for Treatment in Isolation Hospital. Census, 1891. Estimated to middle of 1893. 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. | Smallpox. | Scarlatina. Diphtheria. | Membranous Croup. Fevers. Cholera. Erysipelas. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. Typhus. Enteric or Typhoid. Continued. Rlapsing. Puerperal. (a) (b to (d) (e) Hampstead ... ... ... Under 5 1 117 33 4 ... 2 ... ... ... ... 11 ... 34 13 ... ... ... ... ... ... ... ... 9 379 117 4 ... 31 3 ... ... ... 55 8 167 41 ... ... ... ... ... ... ... ... Campden Buildings, Holly Bush Yale ... ... ... Under 5 ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 5upwds. 1 3 1 ... ... ... ... ... ... ... ... 1 3 1 ... ... ... ... ... ... ... ... Hampstead Workhouse, New End ... ... ... Under 5 ... ... 3 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 5 upwds 1 2 2 ... ... 1 ... ... ... ... 7 1 1 3 ... ... 1 ... ... ... ... ... New Buildings, Flask Walk ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5upwds. ... 1 1 ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... Wells Buildings, Heath Street ... ... ... Under 5 ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 5upwds. ... 2 ... ... ... ... ... ... ... ... 1 ... 2 ... ... ... ... ... ... ... ... ... Trewint, Haverstock Hill ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... 1 ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... 1 Soldiers' Daughters' Home, Rosslyn Hill ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Hampstead Home Hospital, Parliament Hill R. ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... 2 ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... Field Lane School, Church Row ... ... ... Under 5 ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 5 upwds. ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... Totals 68425 72608 1495 Under 5 1 119 37 4 ... 2 ... ... ... ... 11 ... 36 15 ... ... ... ... ... ... ... ... 5 upwds. 11 393 121 4 ... 32 3 ... 7 ... 61 10 178 45 ... ... 7 1 ... ... ... 1 Tabi.e No. II. Table of DEATHS during the year 1893, in the Metropolitan Sanitary District of Hampstead, classified according to Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics; public institutions being shown as separate localities. Mortality from all causes at subjoined Ages. Mortality from subjoined causes distinguishing Deaths of Children under Five Years of .Age 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 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 Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. 1 Cholera. Erysipelas. Measles. Whooping Cough Diarrhoea & Dysentery. Rheumatic 1 Fever. Ague. Phthisis. Bronchitis, Pnuemonia, & Pleursy. Heart Disease. | Injuries. All other Diseases. Total. Typhus. Enteric or Typhoid Continued. Relapsing. Puerperal. (a) (6) (c) (d) (e) (f) (g) (h) (i) District (less Institutions) 757 14s 71 32 32 258 216 Under 5 1 3 11 1 ... ... ... ... ... ... ... ... 6 17 ... ... ... 42 1 10 127 219 5 upwds. ... 5 6 ... ... 7 ... ... 3 ... 1 1 ... 4 5 ... 54 88 74 16 274 538 Workhouse 61 2 3 2 4 20 30 Under 5 ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 3 5 5 upwds. ... ... 1 ... ... 1 ... ... 1 ... 1 ... ... ... ... ... 8 3 7 2 32 56 N. W. Hospital 510 16 285 159 20 30 ... Under 5 ... 80 214 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 3 301 5 upwds. ... 44 114 ... ... 32 ... ... ... ... ... ... ... ... ... ... 2 7 1 ... 9 209 Home Hospital 9 ... ... 1 1 5 2 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwrds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 5 9 St. Feter's Home 20 ... ... 1 5 12 2 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 10 2 ... ... 7 20 N. L. Consumption 29 ... ... ... 8 21 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 26 1 2 ... ... 29 Friedenheim 66 ... ... 4 16 36 10 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 49 2 5 ... 10 66 (Registered in the Dia trict), totals .. 1452 166 359 199 86 382 260 Under 5 1 83 226 1 ... ... ... ... ... ... ... 2 6 19 ... ... ... 42 1 11 133 525 •5 upwds. ... 49 121 ... ... 40 ... ... 4 ... 2 1 ... 4 6 ... 149 104 89 21 337 927 The subjoined numbers have also to be taken into account in judging of the abnve records of Mortality. Deaths occurring outside the Distriot among persons belonging thereto 91 3 7 10 10 50 11 Under 5 1 1 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 10 5 upwds. ... 3 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 8 7 15 8 38 81 Deathsocourringwithin the District among persons not belonging thereto 605 15 277 157 48 96 12 Under 5 ... 75 207 ... ... ... ... ... ... ... ... 2 ... 1 ... ... ... ... ... 1 6 292 5 upwds. ... 41 108 ... ... 32 ... ... ... ... ... ... ... ... 1 ... 72 12 8 7 32 313 21 Table No. III. PARISH OF ST. JOHN, HAMPSTEAD. Inspector's Report of the Sanitary Work, dc., completed in the year ending 25th March, 1894. Number of Complaints received during the year 270 Number of Houses, Premises, &c., inspected 3020 Number of Re-inspections after order or notice 4868 Number of Applications to examine private house drains, &c. 221 Results of Inspection. Orders issued for sanitary amendments of houses and premises 1687 House and premises, &c., cleansed, repaired, and white washed 572 Yard paving repaired, renewed, &c 116 ,, ,, new, provided 19 Houses disinfected after infectious diseases 602 House Drains. Repaired, trapped, &c. 466 Ventilated 153 Disconnected from the sewer 132 Re-constructed 152 New provided 27 Cesspools abolished 9 Water Closets. Repaired, cleansed, &c 467 Ventilated 19 New provided 120 Dust-bins. New provided 79 Repaired, covered, &c 54 Water Supply. Cisterns cleansed, repaired, and covered 270 New Cisterns provided 21 Miscellaneous. Number of Lodging-houses registered under the 35th Clause of Sanitary Act, 1866 1107 Removal of accumulations of dung, stagnant water, animal and other refuse 77 Removal of animals improperly kept 9 Manure receptacles reconstructed or new provided... 296 Regularly Inspected. Bakehouses 41 Licensed Cowhouses 3 Licensed Slaughter-houses 7 Overcrowding 9 Other proceedings, e.g., legal proceedings 17 22 Table No. III. (continued). Articles Disinfected in Apparatus. Beds 366 Palliasses 416 Mattresses 590 Bolsters 490 Pillows 1106 Blankets 1650 Sheets 544 580 Counterpanes Articles of Clothing 2284 Carpets 154 Miscellaneous Articles 2488 10618