KMP 5 1898. REPORT ON THE SANITARY CONDITION of the |3arisl} oi St itfljn, FOR THE YEAR 1897. by EDMUND GWYNN, M.D., Medical Officer of Health. REPORT OF THE MEDICAL OFFICER OF HEALTH. Vestry Hall, Hampstead, N.W. June 3Qth, 1898. To the Vestry of the Parish of St. John, Hampstead. Gentlemen, The estimated population of the Parish of Hampstead in the middle of the year 1897 is 78,549, being an increase of 2,333 over the previous year. During 1897, 395 houses and residential flats came into occupation, of which 83 were situated in the Town Ward, 104 in the Belsize Ward, 4 in the Adelaide Ward, 93 in the Kilburn Ward, and 111 in the West End Ward. Births.—The births registered during 1897 were 1,479, an increase of 17 on the previous year. The birth-rate was equal to 20, rather above that for the preceding year. The birth-rate for London was 30 per 1,000 population. This is the lowest London birth-rate on record. Marriages.—The number of marriages celebrated was 521, showing decrease of 5 on the previous year. Quarter ending 31st March 87 „ „ 30th June 149 „ „ 30th September 168 „ „ 31st December 117 Total 521 Deaths.—The deaths registered in the year 1897 numbered 1219. Of this total 397 were deaths within the district of non-parishioners who died in the various hospitals and institutions. The number of 4 parishioners who died in Hampstead during 1897 was 822, and to these we must add tho deaths of 89 parishioners who died in institutions outside our parish, making a grand total of 911. The annual death-rate will be equal to a ratio of 11.6, being lower than that for the preceding year, which was equivalent to 12, and also again being vhe lowest recorded death-rate for the year of any parish in the Metropolis. The death-rate for London corresponds to a rate of 18.2 per 1,000 of the population, the average death-rate in the previous ten years having been 19.9, With the exception of the rate in the year 1894, the rate in 1897 was the lowest hitherto recorded. Mortality at different Ages.—The deaths of children under one year of age were 193, or equal to 21.1 per cent. on total deaths, and to 13.3 per cent. on total births. At 65 years and upwards there were 276 deaths, and of these 56 died between 80 and 90 years of age, and 5 attained to 90 years and upwards. Deaths in Public Institutions. North-Western Hospital 290 Hampstead Hospital 16 North London Hospital for Consumption 20 St. Peter's Home 20 Friedenheim 63 Workhouse 63 472 Hospitals, Asylums, and other Institutions situated outside the parish at which residents died during the year:— St. Mary's Hospital 10 University 9 Middlesex 4 Royal Free „ 4 Temperance „ 4 St. Thomas' „ 4 St. Bartholomew's Hospital 4 Children's Hospital 5 St. George's „ 4 5 North-West London Hospital 3 Westminster, King's, Brompton, Charing Cross, Hospital for Women, Great Northern, Stone, and German Hospitals 9 Colney Hatch Asylum 6 Hanwell Asylum 4 Ilf'ord „ 4 7 8 Other Asylums „ Institutions and places 89 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 1.1 per 1,000 living inhabitants, and less than that for the preceding year, which was equivalent to l-8. The following table shows the diminution or excess of deaths in 1897 from the seven principal zymotic diseases :— Causes of Death. 1897. 1896. Diminution in 1897. Excess in 1897. Small Pox — — — — Scarlet Fever 5 7 2 — Diphtheria 17 2.9 12 — Measles 9 58 49 — Whooping Cough 25 22 — 3 Enteric and Typhoid Fever 5 7 2 — Diarrhoea 30 17 — 13 Total 91 140 65 16 6 Scarlet Fever.—The total number of cases of this diseass notified during the year was 22-5, against 291 for the previous year, and of these 119 were removed to hospitals. The fatal cases were five, or two less than for the preceding year. The cases appear to have been of a mild type, for the mortality reached only 2 "2 per cent. Diphtheria.—One hundred cases of this disease were notified, against 189 for 1896 and 112 for 1895. The deaths registered from this cause numbered 17, a decrease of 12 on the previous year, and equal to a mortality of 17 per cent, on registered cases. Thirty-six cases were sent into hospitals. Diphtheria in London is stated by the Registrar-General to be the assigned cause of 2,261 deaths in the course of the year 1897. These deaths were equal to a rate of 0-51 per 1,000, whilst the rate for Hampstead is stated by the same authority to be 0.22. With regard to insanitary conditions, a careful examination of the houses where the cases occurred was made in every instance, but frequently with the result of finding the drainage in good order. Infection by personal contact, especially by the agency of schools, is an active means of spreading this formidable disease, which shows, unfortunately, a tendency to increase year by year in the metropolis. Measles occasioned nine deaths, against 58 for the preceding year, the disease having been epidemic in the early months of 1896. It has been noticed that measles tends to become both prevalent and fatal at periods of two years. In December of 1897, the expected recrudescence of this disease commenced, and. it spread with great rapidity among children attending elementary schools. The closing of the schools for the Christmas vacation did not seem to have much effect in checking the progress of the malady, probably because the mischief had already been done by the children taking the complaint home to the other young children. The further history of this epidemic belongs to the records of the year 1898, but I may state that during the first quarter of this year we lost 24 children from this cause. The London County Council has recently, in a circular letter, sought to learn the views of the London Sanitary Authorities, on the proposal that the London County Council should include measles in the 7 term "Dangerous Infectious Disease" for the purposes set out in Section 68 of the Public Health (London) Act, 1891, in order that the Local Sanitary Authorities may have power to proceed, if necessary, against parents who send their children to school suffering from measles. Whooping Cough caused 25 deaths. It has frequently been observed that Whooping Cough and Measles occasion more deaths than Small Pox, Diphtheria, Scarlet Fever, and Typhoid Fever combined, and yet the first two named diseases are regarded with comparative indifference by parents of the lower classes. That these two complaints are mostly fatal to children of the working or artizan classes points either to a want of care, or, we may add, means, in the nursing or medical care of the little sufferers, death being almost always the result of secondary affections such as bronchitis and pneumonia, &c. Fever, Enteric or Typhoid.—Thirty-three cases of this disease were notified, against 55 for the preceding year. The fatal cases numbered 5, against 7 for 1896. The majority of the 33 cases registered were contracted beyond the borders of this parish, a fact brought into striking notice after the close of the summer holidays. Among these cases were two patients who contracted typhoid from the Farleigh water at Maidstone. It should be remembered that this disease is rarely, if ever, communicated directly from parson to person, but usually by means of contaminated water or other fluid. Small Pox.—It is gratifying to be able to report that no case of Small Pox occurred during the year, this making the second year since the disease visited our parish. Small Pox caused 16 deaths in London, against 9 for the preceding year, and 206 in 1893. The comparative immunity of London from this dread disease during the last few years is no doubt largely due to the wise policy adopted by the Asylums Board in promptly removing cases, as they occur, to isolation hospitals outside London. A bill for effecting some alterations in our Vaccination Laws is now before Parliament. In regard to the question of the efficacy of vaccination in preventing Small Pox, it must be remembered that the mortality from this disease is much less now than in pre-vaccination 8 times, and that the greatest diminution in the Small Pox mortality is found in the early years of life in which there is most vaccination. In countries where there is much vaccination and re-vaccination relatively to the population there is little Small Pox. Small Pox attacks a much greater proportion of the unvaccinated than of the vaccinated. In houses invaded by Small Pox in the course of an outbreak not nearly so many of the vaccinated inmates are attacked as of the unvaccinated in proportion to their numbers, and the death rate among persons attacked by Small Pox is much greater, age for age, among the unvaccinated than among the vaccinated. The danger incurred by vaccination is trifling, and, as regards other objections, these can be met by the use of calf lymph, which is now available to boards of guardians and medical men for the vaccination of infants and others. Diarrhoea.—This disease caused 30 deaths, an excess of 13 over the previous year. Diarrhoea is always more prevalent in hot, dry summers No less than 4,089 deaths occurred from this cause in London during 1897, and equal to a rate of 0*92. This is the highest rate recorded in any year since 1887, and is considerably in excess of the average rate in the preceding ten years. Influenza was the assigned cause of 19 deaths, the disease being fatal in the early and latter part of the year. Erysipelas.—Thirty-seven cases of this disease were notified, against 61 for the preceding year, and three deaths were attributed to this cause. Notification of Infectious Diseases.—The total number of certificates received was 401, for notifying which the sum of £46 Is. 6d. was paid to medical practitioners. This amount is recouped to the Yestry by the Asylums Board out of the Metropolitan Common Poor Fund. The total number of cases removed to fever hospitals for treatment was 164. Local Diseases, so named after the systems or organs to which the diseases relate, were accountable for 349 deaths. In this class diseases of the respiratory organs alone caused 119 deaths, of which number 58 were due to Bronchitis, 37 to Pneumonia, 22 to Broncho-pneumonia, 2 to Pleurisy, 1 to Asthma, and 1 to Laryngitis. Diseases of the nervous 9 system were the registered cause of 70 deaths, including 23 from Apoplexy, 25 from Paralysis, 15 from Convulsions, and 5 from Inflammation of the Brain. Only one death was registered from insanity, and one from Epilepsy. Diseases of the Heart caused 77 deaths, a somewhat larger number than for the preceding year; diseases of the digestive organs 57 deaths, including 22 from enteritis, 8 from peritonitis, 4 from obstruction, and 23 from diseases of the liver, which includes the term cirrhosis applied to the diseases of the liver induced by habits of alcoholic excess. 26 deaths were referred to diseases of the urinary system, of which 10 were due to nephritis, 10 to "Bright's disease," and 4 to diseases of the bladder. Constitutional diseases.—This important class includes the causes of 184 deaths, the most fatal cause being cancer, which carried off 62 people; consumption was nearly as fatal and caused 54 deaths, tubercular meningitis 21, tabes mesenterica 8, scrofula and anaemia 8, diabetes 6, rheumatism and gout 6, and other causes 19. Developmental Diseases include the deaths of 26 infants from premature birth, 19 from debility, 3 from atelactasis, and 2 from congenital malformation. The deaths attributed to old age were 49, but the deaths of old people are frequently referred to other causes such as bronchitis, apoplexy, &c. Inquests.—The number of inquests held was 63, the deaths in 33 cases being caused by violence. There were 9 deaths from fractures and contusions caused by falls, by being run over in the street; 5 infants perished by infanticide, and 4 by asphyxia in bed with mothers; one case of murder by incised wound in the throat. There were 4 cases of suicide, one of which was caused by strangulation, one by poisoning with cyanide of potassium, one by drowning in a bath, and one by revolver wound in skull. Among other cases a male aged 9 died under the influence of chloroform, a female aged 22 in an epileptic fit in a bath, and a child, aged 11, by poisoning by belladonna given in mistake. Mortuary.—The total number of bodies received during the year was 72, of which 49 were admitted by order of the coroner; 45 postmortem examinations were made; 15 bodies were brought in by the 10 police, and eight by the request of friends. Although this last number is higher than in any previous year, it is to be regretted that so little use is still made of the mortuary as a place of deposit for bodies especially of those who have died from infectious disease. By Sec. 89 of the Public Health (London) Act, a Justice's Order may be obtained by medical men if people sleep in a room where an infectious body is retained. The mortuary at New End comprises two chambers, one for infectious and one for non-infectious bodies, both with separate entrances, as well as a well-appointed room for carrying out post-mortem examinations of bodies, whether ordered by the coroner or otherwise. The subject of the disposal of the dead by cremation was brought before your Vestry by a circular letter received from the Yestry of Islington, stating that they had under consideration the advisability of providing a crematorium in connection with their cemetery at Finchley, and that they were proposing to apply to the Home Secretary to promote legislation for extending the Burials Acts, so as to enable any Local Authority to construct and use a crematorium for the disposal of the dead. On the recommendation of the Sub-Committees of the Public Health Committee and Burials Committee appointed to consider the subject, your Yestry resolved to support the application of the Vestry of Islington. There is good reason for thinking that the interests of public health would be furthered by the more general use of the crematorium, especially in the case of bodies dead of infectious disease, in preference to burial in soils unfitted for the purpose. Cowsheds and Slaughter-houses.—The annual inspection of these premises by the Public Health Committee took place on October 4th, when they were mostly found to be in good order, so that it was not necessary to make any objection to the renewal of the several licences. In 1880 the number of cowsheds regularly inspected was 15, and the number of cows licensed between two and three hundred; now there remains but one cowshed in the parish, and that is licensed for 50 cows. The licensed slaughter-houses remain the same as last year, namely seven. 11 Bakehouses.—These now number 39, and are regularly inspected with reference to their cleanliness, ventilation, water supply, drainage, &c. By the new Factory and Workshop Act, no underground place (not so used before January 1st, 1896) shall be used as a bakehouse. Orders for cleansing and whitewashing were occasionally necessary. Work of the Public Health Department.—Full details as to the work carried out by the District Inspectors are to be found in Table III. 3,005 inspections of houses and premises were made during the year, and 5,542 re-inspections were made after order or notice had been issued. Orders were made for the cleansing, whitewashing, and repairs of 579 houses; house drains were repaired, reconstructed, &c., in 637 instances. The number of closets required to be reconstructed was 221 and 251 to be repaired or cleansed. The paving of 158 yards of houses required to be repaired or renewed, dustbins required attention in 108 instances, and manure receptacles in 17, and animals were found to be improperly kept in 7 instances. The complaints of non-removal of manure were more numerous during the past than in any former year, and action had to be taken by the Inspectors in 261 cases. There are various establishments in this parish wherein large numbers of horses are kept and in which the use of peat litter, from motives of economy, is very general. This material becomes highly charged with urine and quickly offiensive, especially when disturbed for removal in hot weather. It is necessary to insist that this refuse should be placed at once, on removal from the stable, into the vehicle in which it is to be taken away from the premises. A more liberal use of the peat, where this material is used, is advised, it being the habit of the horsekeeper to remove only the soiled portion and to rake up the rest under the manger during the daytime for night use. Complaints have been from time to time received from the inhabitants of May grove Road, of manure awaiting removal by the Midland Railway Company. It did not appear, however, upon inspection that there had been any negligence or want of proper management on the part of the Company, and having regard to the fact that an outlet has to be provided for the prompt removal of manure into the country it did not seem advisable on the part of the 12 Sanitary Authority to take any action to interfere with the business. The Company on their part were to take every precaution to avoid accumulation, and to minimise any nuisance which might arise in connection with the removal. Overcrowding.—Only two cases of legal overcrowding were reported during the year. Our bye-laws require a provision of three hundred cubic feet of free air space for each person of an age exceeding ten years and of one hundred and fifty feet of free air space for each person of an age not exceeding ten 3'ears, to occupy as a sleeping apartment a room which is used exclusively for that purpose, but where such apartment is used also as a living room as well as sleeping room the requirements are four hundred feet for each person over ten years of age, and two hundred for each person not exceeding ten years of age. Overcrowding is of course a relative term ; many persons consider a tenement house to be overcrowded because it contains 30 or more inhabitants, and report such house to the sanitary authority as "swarming with children." It rarely turns out, however, upon measuring up the rooms that the legal amount of free air space has been encroached upon, in which latter case a notice would be at once served both upon the occupier and landlord to abate such overcrowding. Houses let in lodgings.—The number of houses registered under the Public Health (London) Act, now stands at 840. The London County Council having instructed their medical officer to make an enquiry at Midsummer, 1897, as to the extent to which bye-laws or regulations dealing with houses let in lodgings are enforced in the several sanitary districts of London, Dr. Hamar reported to the council that in the parish of Hampstead, " the beneficial operation of the bye-laws was strikingly apparent in the very fair condition of cleanliness and maintenance of the houses inspected." Our bye-laws provide for an annual cleansing and whitewashing in the spring of such houses as require it. It will be readily understood that it is extremely difficult, if not impossible, to keep up a high standard of cleanliness in a certain class of tenement houses inhabited by large families of the poorer class. The habits of the people themselves are often careless, when not actually dirty ; indifferent to cleanliness and disliking the disturbance created to their comfort by the process of whitewashing, &c., they readily agree with the landlord to put off the evil day as long as possible. 13 Our experience in dealing with houses let in lodgings by means of bye-laws is entirely favourable, and on the whole a marked improvement is manifested in this class of house. The total number of complaints received during the year was 214, against 222 for 189fi. The number of applications to examine the drainage of private houses was 154. I may allude to the fact that a great deal of the Divisional Inspectors' time is taken up in overseeing the actual construction of drains called for by the Public Health Department. To attend upon the convenience of the Contractors who are laying drains, altering closets, or carrying out other sanitary improvements in their several districts, for the purpose of applying the water-test, must necessarily rather interfere with systematic work. The Public Health Committee has decided that no drain is, for the future, to be tested on the application of a private individual unless the applicant will open the ground where necessary, so that the water-test can be applied. The Sanitary Inspectors inspect the drain work ordered by the Department, and this portion of their work is entirely apart from that carried out guilder the Inspeotor for new properties, who is under the supervision of the Surveyor. The total number of orders made for sanitary amendments was 1,537, but it was only necessary to take legal proceedings in 9 instances. Unsound Food.—A few articles of fruit and fish have been brought to the Vestry Hall and condemned as unfit for food. The Inspectors have also visited the streets late on Saturday nights in order to prevent the sale of stale or unwholesome food. Samples of milk have also especially been directed to be taken for analysis at all public hospitals and institutions in the parish, a subject which will be further referred to in the report of the Public Analyst. Workshops.—Under the Factory and Workshop Act, 1895, a variety of duties is thrown upon the sanitary authority relating to cleanliness, ventilation, over-crowding, lime-washing, warming, and keeping the drains, closets, &c., of workshops, free from nuisance. We 14 have very few factories, that is, places where steam is used as the mechanical power, in this parish, but there are a considerable number of workshops, including laundries and dressmakers, which have all been regularly inspected, with the result that orders were made for the cleansing and lime-washing of 13 workshops, paving and draining of 3 washhouses, and for the cleansing and repair of 10 water-closets. I append a list of the factories and workshops in the parish. List of Trades, Sfc., under the Factory and Workshop Acts, 1878-1895. Laundries 40 Dressmakers 133 Tailors 24 Milliners 20 Upholsterers 7 Mineral Water Manufacturers 1 Manufacturing Stationers 1 Pianoforte Manufacturers 2 Pianoforte Key Makers 1 Engineers 1 Art Metal Workers 2 Photo-Zincographers 1 Photographic Paper Manufacturers 1 Window Blind Makers 2 Brass-finishers 1 Surgical Instrument Makers 1 Disinfection.—The number of houses disinfected after infectious disease was 333. The total number of articles disinfected reached 8614, a slight decrease on the number for the previous year. Water Supply.—Hampstead is supplied with water by the New River and West Middlesex Companies. Many parts of the parish now receive constant supply from both Companies, but other districts still await the convenience of the New River Company. With respect to the water delivered by the New River Company, Professor Frankland states that except in the first three months of the year, the supply was free from flood water and was substantially of the character of excellent spring water, being generally even better than the average of the deep 15 well waters. The Thames water delivered in London has also, as regards organic purity, greatly improved of late years, The average proportion of organic matter contained in the waters of the two companies was— New River l.6 West Middlesex 2.9 The two companies provide for a daily examination of the quality and composition of the water by Sir William Crooks, F.R.S., and Professor Dewar, and in no way interfere with their position as absolutely independent scientific authorities. These reports are afterwards sent to General II. de C. Scott, the water examiner appointed under the Metropolis Water Act, 1871, and these reports are published monthly, together with the analysis made by Professor Frankland on behalf of the Local Government Board. The attention of householders should be directed to the periodical cleansing of cisterns, and the providing of well fitting covers to exclude light and dirt. The numerous and important duties devolving upon the chief inspector and the divisional inspectors havo been carried out with energy, of which the best record is found in the account of the past year's work. I take this opportunity to thank the various officers of tho Vestry for the necessary information which I have received from them, and I gladly acknowledge the assistance I have derived from the late chairman of the Public Health Committee in carrying on the work of the Public Health Department. I am, Gentlemen, Your obedient servant, EDMUND GWYNN, M.D., Medical Officer of Health. 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 Tear 1897, in the Hampstead Sanitary District; 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, 1896. Estimated to middle of 1897. 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 1 6 1 7 1 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. Kelapsing. Puerperal. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. («) (b) (c) (d) (e) Hampstead Workhouse ... ... ... Under 5 5 upwds. ... 1 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 2 ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... North Western Hospital ... ... ... Under 5 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 3 ... ... ... ... ... ... ... ... ... 4 3 ... ... ... ... ... ... ... ... Hampstead ... ... ... Under 5 5 upwds. ... 49 30 2 ... 2 ... ... ... ... 2 ... 25 14 ... ... 1 ... ... ... ... ... ... 170 64 1 ... 30 2 ... 3 ... 31 ... 89 19 ... ... 8 ... ... ... ... ... Totals 75449 78549 14791 Under 5 5 upwds. ... 50 31 2 ... 2 ... ... ... ... 2 ... 26 14 ... ... 1 ... ... ... ... ... ... 175 69 1 ... 31 2 ... 3 ... 35 ... 93 22 ... ... 8 ... ... ... ... ... Table No. II. Table of DEATHS during the Year 1897, in the Hampstead District, 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. Aged under 5 or over 5. Mortality from subjoined causes, distinguishing Deaths of Children under Five Years of Age. 1 2 3 4 5 6 1 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. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea & Dysentery. Rheumatic Fever. Influenza. Phthisis. Bronchitis, Pneumonia, & Pleurisy. Heart Disease Injuries. All other Diseases. Total. Typhus. Enteric or Typhoid| Continued. Relapsing. Puerperal. (a) (b) (e) (d) (e) (/) (g) (h) (i) Sub-district 745 184 71 21 13 247 2091 Under 5 5 upwds. ... 1 4 ... ... 1 ... ... ... 1 2 9 22 24 ... 1 2 42 i 10 135 ?55 ... ... 3 ... ... 4 ... ... 5 ... ... ... 3 2 2 18 39 66 81 15 25? 490 W orkhouse 63 1 1 ... 1 26 34 Under 5 5 upwds. ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... 9 4 9 ... 35 61 N. W. Hospital 292 8 164 86 13 20 1 Under 5 5 upwds. ... 59 108 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ? 172 ... 21 62 ... ... 25 ... ... ... ... ... ... ... ... ... ... 1 1 1 ... 9 1;'0 Friedenheim 63 ... 1 8 9 44 1 Under 5 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 36 ... ... ... 22 62 St. Peter's Home 20 ... ... 3 3 10 4 Under 5 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... i ... 3 2 ... ... 9 20 N. L. Consumption Hospital 20 ... ... 1 4 15 ... Under 5 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 15 1 1 ... 2 20 Hampstead Hospital 16 ... 3 1 1 10 1 Under 5 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ...... i ... ... ... ... 4 8 13 Totals 1219 193 240 120 44 372 250 Under 5 5 upwds. ... 60 113 ... ... 1 ... ... ... 1 2 10 23 25 ... 1 2 42 1 11 141 483 ... 21 65 ... ... 29 ... ... 5 ... 1 3 4 4 19 103 74 99 22 337 786 The subjoined numbers have also to be taken into account in judging of the above records of mortality. j-'eatns occurring outside the district among persons 89 3 10 4 10 44 18 Under 5 5 upwds. ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... 3 6 13 longing thereto. Deaths occurring within the district among persons not belonging thereto. ... 1 1 ... ... ... ... ... ... ... ... ... ... ... 1 4 4 7 7 51 76 397 8 159 97 29 99 5 Under 5 5 upwds. ... 56 103 ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... 1 5 167 ... 20 60 ... ... 25 ... ... ... ... ... ... ... 1 1 1 53 4 10 7 48 230 18 Table No. III. PARISH OF ST. JOHN, HAMPSTEAD. Inspector's Report of the Sanitary Work, Sfc., completed in the year ending 316^ Decemler, 1897. Number of complaints received during the year '214 Number of Houses, Premises, &c., inspected 3005 Number of Re-inspections after order or notice 5542 Number of Applications to examine private house drains, &c. ,. 154 Results of Inspections. Orders issued for sanitary amendments of houses and premises 1537 Houses and premises, &c., cleansed, repaired, and whitewashed 579 Yard paving repaired, renewed, &c. 133 ,, ,, new provided 25 Houses disinfected after infectious diseases 333 House Drains:— Repaired, trapped, &c. 317 Ventilated 142 Disconnected from the sower 152 Reconstructed 320 Water Closets:— Repaired, cleansed, &c. 251 Ventilated 31 Reconstructed 21 Dust-bins :— New provided 81 Repaired, covered, &c. 37 19 Table No. III. (continued). Water supply :— Cisterns cleansed, repaired, and covered 227 New cisterns provided 15 Miscellaneous:— Overcrowding abated 2 Removal of accumulations of dung, stagnant water, animal and other refuse 264 Removal or animals improperly kept 7 Manure receptacles reconstructed or new provided 17 Regularly Inspected. Houses registered under Public Health (London) A.ct, 1891 840 Bakehouses 39 Licensed Cowhouse 1 Licensed Slaughter-houses 7 Legal proceedings 9 Articles Disinfected in Apparatus. Beds 207 Palliasses 123 M attresses 417 Bolsters 342 Pillows 818 Blankets 1220 Sheets 502 Counterpanes 396 Articles of Clothing 1686 Carpets 205 Miscellaneous Articles 2698 8614