hamp 27 1899. REPORT on the SANITARY CONDITION of the Parish of St. John, Hampstead, for the year 1898. by EDMUND GWYNN, M.D., Medical Officer of Health. REPORT OP THE MEDICAL OFFICER OF HEALTH. Vestry Hall, Hampstead, N.W. 19th June, 1899. To the Vestry of the Parish of St. John, Hampstead. Gentlemen, I have the honour to lay before you my Annual Report dealing with the vital statistics of the Parish of Hampstead for the registration year 1898. The estimated population in the middle of the year 1898 is 80,623 being an increase of 2,074 over the previous year. During 1898, 171 new houses and 175 new flats or separate suites of rooms, came into occupation, making a total of 346 new tenements. The growth of the flat system has been steady and progressive in this parish. Sufficient time has not yet elapsed to compare the relative healthiness of these dwellings with that of single houses, but a recent dangerous outbreak of fire in a large block of flats in a neighbouring parish points to a dangerous condition of things in these buildings not sufficiently recognized by architects when planning staircases, passages, and exits for these composite structures. Marriages.—The total number of marriages in 1898 was 613, an increase of 87 over the previous year. The marriage rate for London was the highest on record since 1877, an evidence of the prosperous condition of the country. Births,—The births registered during 1898 were 1,516, an increase 4 of 54 over the previous year. The birth rate was equal to 18.1. The birth rate for the Metropolis was 29.5 per 1000 population, which is stated by the Registrar-General to be the lowest on record. The natural increment of our population by excess of births over deaths was 599. Deaths.—The deaths registered in the year 1898 numbered 1,377. Of this total 460 were deaths within the district of non-parishioners who died in the various hospitals and institutions. The number of parishioners who died in Hampstead was 836, and to these we must add the deaths of 81 parishioners who died in institutions outside our parish, making a grand total of 917. The annual death rate will be equal to a ratio of 11.4, being slightly lower than that for the preceding year, which was equivalent to 11.6. The death rate for London corresponds to a rate of 18.7 per 1000 of the population, the average death rate in the previous ten years having been 19.7. Corrected Mortality of London Sanitary Areas.—Writing on this subject, the Registrar-General states that the rates of mortality in the Sanitary areas of the Metropolis, when calculated on the deaths locally registered, convey an erroneous idea of the relative healthiness of these areas. The presence of hospitals and other large public institutions in certain parts of London unduly raises the recorded death rates of the areas in which they are situated, whilst the mortality of other areas, from which the patients migrate to these institutions, is correspondingly lowered. Until the deaths occurring in public institutions have been distributed to the sanitary areas from which the patients originally came, no reliable rates of mortality for these areas can be calculated. Thus the death rate of Hampstead taken on the deaths registered before distribution would be over 16, and after distribution it falls to 11, whilst in the case of certain zymotic diseases the matter becomes still more serious, for owing to the presence of the North-Western Hospital the scarlet fever death rate, for example, would have appeared as more than thirty times the true rate if the hospital deaths had not been assigned to the areas to which they actually belonged. 5 Mortality at different Ages.—The deaths of children under one year of age were 198, or equal to 19.5 per cent. on total deaths, and equal to 13 per cent. on total births. At 65 years and upwards there were 326 deaths, and of these 96 reached ages between 70 years and 80, 45 between 80 and 90, and 11 attained to 90 years and upwards, the two greatest ages recorded being those of a widow at 96 and a single lady at 97. The superior longevity of the female sex is strikingly borne out in these 152 cases recorded, for whereas 50 of these were males, the females numbered 102, and of the 11 nonogenarians 9 were females, mostly widows, whilst only two males struggled on to 91 and 92 years respectively. Deaths in Public Institutions. Males. Females. Total. North-Western Fever Hospital 162 172 334 Hampstead Hospital 9 3 12 North London Hospital for Consumption 19 8 27 St. Peter's Home .. 14 14 Friedenheim 42 33 75 Workhouse 43 47 90 275 277 552 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 1.40. The ratio for London was 2·77. 6 The following table shows the diminution or excess of deaths in 1898 from the seven principal zymotic diseases:— Causes of death. 1898. 1897. Diminution in 1898. Excess in 1898. Small Pox .. .. .. .. Scarlet Fever 3 5 2 .. Diphtheria 19 17 .. 2 Measles 26 9 .. 17 Whooping Cough 27 25 .. 2 Enteric and Typhoid Fever 10 5 .. 5 Continued Fever 1 5 .. 1 Diarrhæa 24 30 6 .. Total 110 91 8 27 Small Pox.—It is satisfactory to be able to report that no case of small pox was registered in the year, this making the third year since the disease visited our parish. There was only one death from this cause during the year in London, against 88, 55, 9, and 16 deaths in the four preceding years. In connection with the subject of small pox it is necessary to take note of the alteration effected in the law by the Vaccination Act which passed in 1898, and which will remain in force for five years. By this Act, "Conscientious objectors" are enabled to claim exemption from vaccination for their children. It must be remembered that before the passing of the Act some 17 per cent. of the children born in the kingdom managed by one device or another to escape the vigilance of the Yaccination Officer, and it has been calculated that every 10 years some 120,000 unvaccinated children arc added to the population 7 of London alone. The Act on the other hand provides for some improvements in connection with vaccination, and the whole measure undoubtedly partakes of the character of a "tremendous experiment," to use the expression of Lord Lister. * Already Mr. Chaplin is able to claim that the number of children vaccinated since the new law came into force shows a substantial, and, in some cases, a very large increase. These favourable results are attributed, in the main, to the introduction of a system of domiciliary vaccination, by which the time of the mother is saved in taking the child to the Vaccination Station first for vaccination, and secondly the following week for inspection, and also to the introduction of a lymph in which the public have confidence. The country has fortunately now for some time been comparatively free from small pox, but should an outbreak of this dread disease occur, it may require the utmost vigilance on the part of the Sanitary Authority, in the presence of so many unprotected people, to keep it within bounds or to stamp it out. Scarlet Fever.—Two hundred and thirty-eight cases of this disease were registered, against 225 for the previous year, and of these 134 were removed to isolation hospitals. The fatal cases were three, or two less than the previous year, the mortality from this cause falling to l.2 per cent. on cases registered. Diphtheria.—The total number of cases of this disease notified during the year was 131, against 189 for 1896, and 112 for 1895. The deaths registered from this cause were 19, equal to a mortality of 14.5 per cent on registered cases. The cases removed from their homes to isolation hospitals numbered 70. Diphtheria was the assigned cause of 1772 deaths in London during 1898. These deaths were, according to the Registrar-General, equal to 0.39 per 1,000 living inhabitants, against rates of 0.54, 0.60 and 0.51 in the three preceding years. The death rate for Hampstead from diphtheria, per 1,000 living, was 0.24. The part played by schools in spreading the infection of diphtheria is now generally recognized, and there appears to be good reason for * April 23rd, 1899. 8 thinking that children recovering from this disease are often allowed to return to school or to mix with others before their throats can be said to be free from the typical diphtheria bacillus. Measles.—The deaths from this cause numbered 26, against nine for 1897 and 58 for 1896, and proved to be the most fatal cause of death among the zymotic class, exceeding indeed the deaths from Scarlet Fever and Diphtheria put together. The epidemic commenced in London in the autumn of 1897, and attacked certain elementary schools in Hampstead about the end of the year. The Christmas holiday did not appear to have much effect in arresting the progress of the epidemic, so further steps were taken in February with regard to those schools most directly affected, and orders were made upon the Managers by the Sanitary Authority, in accordance with Art. 88 in the Code of Regulations, to close the Emmanuel Schools, West End ; the Infant department of St. Mary's Schools, Kilburn; the Infant department of St. Paul's Schools, Winchester Road; and the Infant department of the Broomsleigh Street School. This latter department alone consisted of 500 children, so that it can be readily seen that the aggregation of large numbers of young children affords a ready means of spreading this highly infectious complaint. The majority of the schools in question were directed to remain closed until the 5th of March, after which period we were not much troubled with the disease, which finally disappeared in the month of April. The London County Council sought to learn the views of your Vestry on the proposal that the Council should include Measles in the term "Dangerous Infectious Disease " for the purposes set out in Section 68 of the Public Health Act, 1891, in order that the Sanitary Authority might have power to proceed, if necessary, against parents who send their children to school suffering from Measles. It is stated that without making Measles notifiable, it may yet be placed among the diseases mentioned in the Act. Your Board agreed that it was desirable to include Measles for this object. With regard to the question of notification, for which public opinion does not yet appear to be ripe, the difficulty of furnishing sufficient hospital accommodation for the 100,000 cases occurring bi-annually in London is, in face of the want of interest at present on the part of the public, an insurmountable barrier. Whooping Cough caused 27 deaths, all of which took place in the 9 early months of the year, and were for the most part of young children under two years of age. Enteric Fever.—Forty-nine cases of this disease were notified against 33 for the preceding year. The fatal cases were 10. There is always an increase of notifications from this disease after the termination of the summer holidays, accounted for in a great measure by the movement of all classes of people at this period of the year. In one or two instances there was evidence of the spread of the disease from one individual to another in the same house, occasioned in all probability by carelessness in nursing, or by partaking of food which had been previously tasted by the invalid or kept in the same room. Diarrhœa was the returned cause of 24 deaths, a dimunition of six on the preceding year. This disease caused over 4,000 deaths in London during 1898, which was equal to a rate of 0.97 per 1,000. The death rate from this cause in Hampstead was 0.32, whilst the rate for St. George's, Hanover Square, was 0.36, and in Shoreditch ranged as high as 1.58. Erysipelas.—The notifications from this disease numbered 41, and four of these cases terminated fatally. Applications are from time to time made to me by Medical practitioners to remove cases of erysipelas, but at present the Asylums Board has no power to receive these cases into their hospitals. General hospitals will not receive them on account of the danger of the tendency of this disease to attack surgical cases' and there is a great objection to remove them to the Infirmary or any near proximity to lying-in Wards, to which they offer great dangers. Therefore, these poor people are thrown back on their own resources, and such relief as can be obtained from the Guardians of the Poor through the agency of the Relieving Officer. Notification of Infectious Disease.—The total number of certificates received was 453, for notifying which the sum of £56 6s. 6d. was paid to Medical practitioners. This amount 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 234. 10 Influenza.—This highly infectious disease appears to have taken a permanent place in our mortality tables. The deaths attributed to this cause were 18, or one less than for the preceding year. The majority of cases occurred in the early months of the year, and affected subjects of all ages. After disappearing from the parish during the summer months, as early as October a further death was registered from this cause, and in the month of December this pest again became prevalent and continued its ravages during the winter quarter. There is no doubt that many deaths attributed to Pneumonia and other Chest diseases date their origin from an attack of Influenza. Local Diseases.—Diseases of the respiratory organs caused 119 deaths, of which 83 were attributed to Bronchitis, 31 to Pneumonia, and five to other forms of disease. Diseases of the nervous system caused 102 deaths, 48 of which were due to Apoplexy, 17 to Paralysis, 18 to Convulsions, and 5 to Epilepsy and Insanity. Eighty-seven persons died from diseases of the Heart, 50 from diseases of the digestive organs, 11 of which were due to Enteritis, 9 to Peritonitis, and 13 to diseases of the Liver. The deaths from diseases of the Urinary System were 36, of which 22 were due to Nephritis and Bright's Disease, and 7 to Diabetes. The deaths from the accidents and diseases of Child Birth were 4, of which one was referred to Puerperal Fever. Developmental diseases include 31 deaths of infants from premature birth, and 9 from malformations; 35 deaths were referred to Atrophy and Debility, and 41 to Old Age. Constitutional Diseases.—The deaths from Cancer were 69, and show a rise of 7 on the preceding year. Rheumatism and Gout caused 8 deaths, whilst different forms of Tuberculous diseases caused 85 deaths, of which 54 were attributed to Consumption. It has now come to be recognized that Consumption and other forms of Tubercular disease are to a great extent preventible diseases. The subject has been very prominently brought before the public during the past year by the formation of the " National 11 Association for the Prevention of Consumption and other forms of Tuberculosis," under the Presidency of the Prince of Wales. The views formerly held in this country, which attributed the disease chiefly to a definite hereditary tendency, independent of external conditions, are found to be no longer tenable beyond the fact that inheritance involves an increased liability to infection. Dampness, dirt and darkness, as well as dusty occupations, and the breathing of re-breathed air, are all frequent predisposing causes. The mortality from consumption in this country has been reduced by half during the last 50 years, and the best results have been obtained wherever Sanitary improvements have been largely carried out by structural alterations, by drying the soil, by drainage, by ventilation, and by the free admission of sunshine to the dwellings. The Tuberculous diseases of children, known as Consumption of the Bowels, &c., are also believed to be largely due to the introduction of the bacillus into their systems by the medium of milk from infected cows taken as food. This latter danger can, to a great extent, be met by boiling milk for a few seconds. It is satisfactory to find, with regard to the presence of consumption in this Parish, that a marked decline in the death rate from this cause has now been in progress for the last 20 years. The death rate for the ten years, 1880—1890, averaged 0.99 per 1,000 living population, but in 1898 had fallen to 0.74, and for 1897 was 0.78. It is stated by the Registrar-General that the death rates from Phthisis ranged from 0.74 in Hampstead, 1.13 in Wandsworth, 3.17 in Holborn, 332 in Strand, to 3.34 in St. Giles. Inquests.—The number of inquests held was 72, the deaths in 39 cases being caused by violence. Three infants perished by infanticide, and one by asphyxia in arms of mother. Falls, fractures, and contusions caused 8 deaths. Cases of suicide were more common than usual, especially in the summer months, no less than 15 deaths being referred to this cause; six of these caused death by fire arms, four by drowning, two by wounds with razors, and three by poison, carbolic and nitric acid being the means employed. Three cases were recorded of death by misadventure, one of these latter being caused by a dose of hydrochloric acid given in mistake, one by an overdose of sulphoral 12 administered, and one died whilst under the influence of ether. Among other cases a child, aged two years, was murdered by strangulation and drowning ; person, aged 53, by clothes catching fire, and male, aged 70, a tramp, from pneumonia whilst suffering from exposure and want of nourishment. Mortuary.—The total number of bodies received during the year was 75, an increase of three on the previous year. Fifty-one of these were admitted by the Coroner's order, 16 were brought in by the police, and only eight at the request of friends and relatives. The number of post-mortem examinations made was 38. Work of the Public Health Department.—Full details as to the work carried out by the District Inspectors are to be found in Table IV. Three thousand two hundred and eighty-eight inspections of houses and premises were made during the year, an increase of 283 on the preceding year, and upwards of 6,000 re-inspections were made after order or notice had been served; 633 orders were made for the cleansing, white-washing, and repairs of houses, 398 for the repair, and 383 for the re-construction of house drains. The number of closets requiring attention, such as repair to water-supply and cleansing, was 373, and 321 required to be re-constructed. Yard pavings were repaired in 171 instances, and 55 orders made for new to be provided; 151 dustbins required renewal or repair, 312 cisterns were ordered to be cleansed and 36 new ones to be provided. Overcrowding was abated in 15 cases, and 7 rooms improperly used as dwellings ordered to be discontinued to be used. Owing to the hot and dry summer, complaints of the non-removal of Manure were more frequent than in any previous year, and no less than 304 orders were necessary for the removal of dung and other refuse. The use of peat litter in place of straw is becoming very common, from motives of economy, with those keeping horses and omnibus yards. This material when saturated with urine which quickly decomposes in hot weather, becomes extremely offensive when disturbed for removal. The County Council suggest that restrictions should be placed as to the hours during which it may be removed, but as the disturbance of the 13 material causes the nuisance, the better plan would be to insist upon its being at once placed on removal from the stable into the vehicle in which it is to be taken away from the premises. Houses Let in Lodgings.—The number of houses registered under the Public Health (London) Act remains at 840. These houses were regularly inspected, and orders made for cleansing where necessary. Overcrowding was met with in 15 instances. Our bye-laws require a provision of 300 cubic feet of free air space for each person of an age exceeding 10 years, and of 150 feet of free air space for each person of an age not exceeding 10 years, to occupy as a sleeping compartment a room which is used exclusively for that purpose, but where such apartment is used also as a living room, the requirements are 400 feet for each person over 10 years of age, and 200 feet for each person not exceeding 10 years of age. The number of applications to examine the drainage of private houses was 151, and the total number of complaints received during the year was 199, a decrease of 15 on the preceding year. The total number of orders made for sanitary amendments was 1274, but it was only necessary to take legal proceedings in 25 instances. Cowsheds find Slaughterhouses.—There are now no remaining licensed cowsheds in the parish, and the number of slaughterhouses has fallen to 7. No objection was raised to the renewal of the licences of these latter. Bakehouses.—The number of bakehouses remains the same as that for last year, 39. The sanitary condition of these premises was found to be satisfactory, but cleansing and whitewashing orders were occasionally required. Disinfection.—The total number of houses disinfected after infectious diseases was 358. The total number of articles disinfected reached 8,286, a decrease on the number for the previous year. Workshops.—Under the Factory and Workshop Act, 1895, 262 premises were inspected. The majority of these were Dressmakers, 14 Laundries, Milliners, and Tailors. The following works were executed under order during the year : 34 workshops cleansed and whitewashed, 4 washhouses repaired and drained, 11 closets repaired and 2 new provided, and overcrowding abated in one instance. Unsound Food.— Some few articles, chiefly rotten fruit and stale meat, have been seized and condemned. The inspectors have also visited the streets late on Saturday night in order to prevent the sale of stale or unwholesome food. They report that matters have much improved in this respect, and that the stall-holders and barrow-men who formerly required watching have almost disappeared from the streets. Samples of milk for analysis have been taken at stations, public institutions, and hospitals in the parish, a subject which will be further referred to in the report of the Public Analyst, Sewer Emanations.—The complaints of sewer emanations have all received the careful attention of the Public Health Committee as well as of the Sanitary staff and that of the Surveyor's department. Owing to the long dry summer a great deal of flushing became necessary, and disinfectants were very freely used. Water Supply.—Hampstead is supplied for domestic purposes by the New River and West Middlesex Companies. Constant supply is now pretty general, and it is hoped that before the end of 1899 the whole of the parish will enjoy that advantage. 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 Year 1898, 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 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. Relapsing. Puerperal. (a) (b) (c) (d) (e) North Western Hospital Haverstock Hill ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... 2 5 ... ... ... ... ... ... ... ... ... 2 5 ... ... ... ... ... ... ... ... Sailors' Orphan Girls' Home, Fitzjohns Avenue ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... 16 ... ... ... ... ... ... ... ... ... ... 16 ... ... ... ... ... ... ... ... ... Hampstead Workhouse ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... 3 ... ... ... ... 4 ... ... ... ... ... ... ... ... ... ... ... Hampstead 75449 80623 1516 Under 5 ... 53 37 2 ... ... ... ... ... ... 2 ... 34 20 ... ... ... ... ... ... ... ... 5 upwds. ... 167 89 1 ... 46 ... ... 1 ... 35 ... 86 45 1 ... 25 ... ... ... ... ... Totals 75449 80623 1516 Under 5 ... 53 37 2 ... ... ... ... ... ... 2 ... 34 20 ... ... ... ... ... ... ... ... 5 upwds. ... 185 94 1 ... 49 ... ... 1 ... 39 ... 104 50 1 ... 25 ... ... ... ... ... Table No. II. Table of DEATHS during the Year 1898, 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 fkom 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. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhæa & Dysentery. Rheumatic Fever. Influenza. Phthisis. Bronchitis, Pneumonia, & Pleurisy. Heart Disease Injuries. All other Diseases. Total. Typhus. Enteric or Typhoid Continued. Relapsing. Puerperal. (a) (b) (c) (d) (e) (f) (g) (h) (i) Sub-district 739 175 81 12 15 244 212 Under 5 ... ... 4 ... ... ... ... ... ... ... ... 25 26 22 ... 1 4 22 1 6 145 256 5 upwds. ... ... 2 ... ... 5 1 ... 1 1 3 1 ... 2 2 14 41 60 77 25 248 483 Workhouse 90 10 1 ... ... 37 42 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 2 ... ... 8 11 5 upwds. ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... 1 3 7 6 13 2 45 79 N. W. Hospital 339 12 193 86 26 22 ... Under 5 ... 66 122 ... ... 1 ... ... ... ... ... 5 ... ... ... ... ... 4 1 ... 6 205 5 upwds. ... 30 56 ... ... 44 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 3 134 Friedenheim 75 ... ... 6 10 55 4 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 46 1 2 ... 26 75 St. Peter's Home 14 ... ... 3 1 9 1 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 4 ... 7 14 N.L. Consumption Hospital 27 ... ... 1 5 21 ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 22 ... 2 ... 3 27 Hampstead Hospital 12 1 1 1 1 7 1 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 2 5 upwds. ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 6 2 10 Totals 1296 198 276 109 58 395 260 Under 5 ... 66 126 ... ... 1 ... ... ... ... ... 30 27 22 ... 1 4 29 2, 6 160 474 5 upwds. ... 30 58 ... ... 51 1 ... 1 1 4 1 ... 2 3 17 119 69 98 33 334 822 The subjoined numbers have also to be taken into account in judging of the above records of mortality. Deaths occurring outside the district among persons belonging thereto Deaths occurring within the district among persons not belonging thereto 81 3 5 3 7 51 12 Under 5 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7 8 5 upwds. ... 1 2 ... ... 3 ... ... ... ... ... ... ... ... ... ... 5 ... 11 10 41 73 460 12 186 93 41 118 10 Under 5 ... 64 115 ... ... 1 ... ... ... ... ... 5 ... ... ... ... ... 4 1 2 6 198 5 upwds. ... 30 53 ... ... 44 ... ... ... ... ... ... ... ... ... ... 70 2 10 10 43 262 17 Table No. III CAUSES OF DEATH IN HAMPSTEAD. Measles 26 Whooping Cough 27 Enteric Fever 10 Diarrhœa 24 Diphtheria 19 Scarlet Fever 3 Puerperal Fever 1 Erysipelas 4 Influenza 18 Phthisis 54 Tabes Mesenterica 7 Brain Tubercle 20 Other Tubercular diseases 5 Cancer, Malignant disease 69 Gout, Rheumatism 8 Dietetic 10 Nervous diseases 84 Convulsions 18 Circulatory 87 Respiratory 119 Digestive 50 Generative 5 Urinary 36 Locomotary 7 Integumentary 1 Premature Birth 31 Congenital Defects, Malformations 9 Old Age 41 Violence 39 All others, &c , and those dying outside Parish 85 917 18 Table No. IV. PARISH OF ST. JOHN, HAMPSTEAD. Inspector's Report of the Sanitary Work, &c., completed in the year ending 31 at December, 1898. Number of complaints received during the year 199 Number of Houses, Premises, &c., inspected 3288 Number of Re-inspections after order or notice 6043 Number of Applications to examine private house drains, &c. 151 Results of Inspections. Orders issued for sanitary amendments of houses and premises 1274 Houses and premises, &c., cleansed, repaired, and whitewashed 633 Yard paving repaired, renewed, &c 171 „ „ new provided 55 Houses disinfected after infectious diseases 358 House Drains:— Repaired, trapped, &c. 389 Ventilated 269 Disconnected from the sewer 220 Reconstructed 383 Water Closets:— Repaired, cleansed, &c. 373 Ventilated 79 Reconstructed 321 Dust-bins:— New provided 101 Repaired, covered, &c 50 19 Table No. IV. (continued). Water supply:— Cisterns cleansed, repaired and covered 312 New cisterns provided 36 Miscellaneous:— Overcrowding abated 15 Removal of accumulations of dung, stagnant water, animal, and other refuse 304 Removal of animals improperly kept 7 Manure receptacles reconstructed or new provided 22 Underground rooms discontinued to be used as dwellings 7 Regularly Inspected. Houses registered under Public Health (London) Act, 1891 840 Bakehouses 39 Licensed Slaughter-houses 7 Legal proceedings 25 Articles Disinfected in Apparatus. Beds 215 8286 Palliasses 87 Mattresses 449 Bolsters 376 Pillows 900 Blankets 1156 Sheets 620 Counterpanes 479 Articles of Clothing 1829 Carpets 156 Miscellaneous Articles 2019 - 20 Table No. V. List of WORKSHOPS, &c., under the Factory and Workshop Acts, 1878—1895, inspected during the Year ending 31st December, 1898. Laundries 46 Dressmakers 142 Tailors 24 Milliners 22 Upholsterers 9 Mineral Water Manufacturers 1 Manufacturing Stationers 1 Pianoforte Manufacturers 3 ,, Key Makers 2 Engineers 2 Art Metal Workers 1 Photographic Paper Manufacturers 1 Window Blind Makers 3 Brass Finishers 1 Surgical Instrument Makers 1 Corset Makers 3 Work executed during the Year ending 31st December, 1898. Workshops cleansed, limewashed, &c. 34 Washhouses repaved and drained 4 Water-closets, cleansed, repaired, &c 11 „ new provided 2 Overcrowding abated 1