HAMPT7 HAMPTON URBAN DISTRICT COUNCIL. Medical Officer's Annual Report. HAMPTON, MIDDLESEX, 12th February, 1906. Gentlemen, I herewith submit my Annual Report for the year ended 31st December, 1905. VITAL STATISTICS. Births and Birth Rate.—The total births registered in the district during the year was 231—128 males and 103 females—equal to a rate of 30'8 per thousand of the population. This is the second highest rate recorded in the district during the past fourteen years. Deaths and Death Rate.—The total number of deaths registered during the year from all causes was 92. This includes three non-residents whose deaths were due to drowning or accidents; four residents who died at the Union Infirmary at Kingston; three whose deaths took place at Teddington Cottage Hospital: and six who died at other institutions outside the district. After mating these corrections this brings the total number of deaths of persons belonging to the district to 89 ; the causes of whose deaths, together with the ages at death, are tabulated below:- Causes of Death. Deaths at the subjoined ages of " Residents" whether occuriing in or beyond the District. All ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Diphtheria 7 l 2 4 - - - Whooping Cough 3 2 1 - - - - Measles 1 1 - - - - - Diarrhœa 4 4 - - - - - Enteritis 2 2 - - - - - Phthisis 10 - 1 - - 7 1 Other Tubercular Diseases 1 - - 1 1 - - Cancer 1 . - - - - - 1 Bronchitis 4 1 - - - 1 2 Pneumonia 9 2 1 - 1 4 1 Alckolism, Cirrhosis of Liver 2 - - - - 1 1 Heart Diseases 9 - - - - 6 3 Premature Birth 1 1 - - - - - Accidents 3 - - 1 - 2 - Diseases and Accidents of Parturition 1 - - - - 1 - Erysipelas 1 - 1 - - - - Suicide 1 - - - - 1 - All other causes 29 6 2 1 l 13 6 Totals 89 20 8 7 3 36 15 I have estimated the population of this district at 7,500, calculated to the middle of 1905. Taking the number of deaths of residents belonging to the district at 89, as per table above, this gives a death rate of 11 "8 per thousand; an improvement on last year's rate, which was 13'3. Twenty-five of these deaths were of persons 60 years of age and upwards; of whom 17 were between 60 and 70; 7 between 70 and 80; and one was 90. 2 Twenty deaths occurred among children under one year of age from the following causes:—Diphtheria, 1 ; Whooping Cough, 1; Measles, 1; Diarrhoea and Enteritis, 6; Premature Birth, 1 ; Debility, 3; Convulsions, 3; Bronchitis, 1 ; Pneumonia, 1. This is equal to a mortality rate of 86'5 per thousand births; and is a decided improvement on the rate for 1904; which was 137'3 per thousand births. There have been fifteen deaths recorded from the principal zymotic diseases (Diphtheria, 7; Whooping Cough, 3; Measles, 1; Diarrhoea 4), equal to a rate of 2 per thousand of the population. Ten deaths were the subject of Inquests by the Coroner during the year, and the verdicts of the Juries were as follows:—Natural Causes, 4; Drowning, 3; Accidents, 2; and Suicide, 1. Infectious Diseases.—I append herewith a table showing the notifications received under the Provisions of the Infectious Diseases Notification Acts during the year, the ages of the patients, and the number removed to Hospital:— Disease. At all ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Removed to Hospital. Small Pox l - - - - l - 1 Diphtheria 36 2 13 19 - 2 - 28 Scarlet Fever 37 - 12 20 4 1 - 22 Enteric Fever 2 - 1 1 - - - 1 PuerperalFever 1 — — — 1 — — Erysipelas 11 — 2 2 — 6 l — Measles 31 2 10 13 2 4 — — Totals 119 4 38 55 7 14 1 52 In addition to the above, information was received from the Medical Attendant of a case of Diphtheria in premises which were Crown property, and therefore exempt from the provisions of the Notification Acts. Seven deaths were due to Diphtheria, of which six occurred in the Isolation Hospital, and the other at the patient's residence. One case of Diphtheria was treated in Hospital from the adjoining parish of Hampton Wick. Two other patients, certified as suffering from Diphtheria, were removed to the Isolation Hospital, but were found to be suffering from a disease other than Diphtheria, and were discharged after a short period of detention. One death took place from Erysipelas, and one from Measles. The case of Small-pox notified occurred early in the year, and was at once removed to the Joint Small-pox Hospital. Fortunately for the district, we still possessed an institution for the treatment of this disease. The case did well, and there was no further spread. Shortly after the discharge of the patient, the lease of the land upon which the Hospital stood terminated, and although the Council endeavoured to obtain an extension their efforts were unsuccessful. I was fortunately able to make an arrangement with the Croydon and Wimbledon Joint Hospital Board for the treatment of cases from this district in their Hospital at Cheam, and the arrangement was confirmed by the Council, thus relieving me of anxiety respecting the immediate removal of any patient suffering from thig disease in the future. In the early Spring there was a smart outbreak of Diphtheria in the Western portion of the district, the primary source of which was difficult to trace. The outbreak was soon checked by the prompt removal of patients to the Isolation Hospital, and the disinfection of infected premises. The Girls' and Infants' schools were closed for two days for cleansing, and the disinfection of apparatus used by the scholars. The early calling in of Medical advice in throat cases is most essential, so as to timely detect the non-infectious or infectious condition of the patients. 3 The Council have decided to allow the Medical Practitioners in the district to submit any doubtful swab for Bacteriological examination, which will have the effect of providing a means for the detection of cases of Diphtheria in the early stages. Two cases of Enteric Fever were notified in the Autumn, one of whom was removed to Hospital. Both cases were traced to contaminated shell-fish, and I am glad to report that both patients have recovered. Scarlet Fever in a mild type was prevalent during the Spring and Autumn. At the end of May I advised the closure of the Infant School at Hampton Hill owing to a severe outbreak of Whooping Cough and Mumps, as I found on enquiry that nearly 50 per cent, of the scholars were affected. The Council acted upon my advice, and the school was closed for three weeks. All rooms wherein infectious illness occurs are fumigated with Formalin, and in addition a considerable number were stripped and cleansed. Bedding and clothing are disinfected at the Isolation Hospital in a steam disinfecting apparatus. Isolation Hospital.—The Hospital, which is situated within the district, comprises a pavilion with four wards; kitchens; bathrooms and lavatories; an administrative block; laundry and steam disinfecting apparatus; mortuary and coach house. The Council are at present considering a proposal to increase the efficiency of the Hospital by the erection of a porter's lodge, and discharging wards. A fitted ambulance is provided for the removal of patients, and is kept iu readiness at the Hospital. The residence of the Medical Superintendent is connected to the Hospital by telephone. The total number of cases from the district treated at the Isolation Hospital during the year was 51. Water Supply and Service.—The whole of this district is supplied on the constant service system from the mains of the Metropolitan Water Board, and the service has been well maintained. Several pumping stations belonging to the Board are situated in the district, and it was found necessary to serve notices for the abatement of the nuisance caused by the black smoke from the chimneys. Trade Premises.—The various trade premises, comprising slaughterhouses, bakehouses, cowsheds and dairies, have been inspected at intervals during the year by myself and the Inspector. It was found necessary in the case of certain bakehouses, slaughterhouses and cowsheds, to require cleansing and limewashing, and the works were carried out without delay. Regulations under the dairies, cowsheds and milkshops Order have been made by the Council, and came into force in the district on September 1st. I would again urge upon the occupiers of these trade premises, who deal with a very considerable proportion of the food of the people, the great importance of paying strict attention to the absolute cleanliness of their respective premises. I have visited the Soap Works at intervals, and found the general conduct of the business satisfactory. Dwelling Houses.—One house which was in an unsatisfactory condition was closed by the owner, and after considerable repairs, has been re-opened. A considerable number of dwelling houses have been inspected, and sanitary improvements have been effected in a large proportion of these premises. Seven houses were found to be overcrowded and were promptly dealt with. A further number of houses have been connected to the public sewer during the year, involving the entire re-construcion of the drainage. 92 per cent, of the houses in the district are now connected to the sewer. 4 In two cases it was found, necessary to take Magisterial proceedings for the abatement of nuisances, and Orders were made in each case. Two summonses were issued for offences against the Bye-Laws for the Prevention of Nuisances and convictions were obtained. One person was summoned for costs of carrying out improvements, and the Justices made an order for payment, and for the payment of costs. Dust Removal and Scavenging.—There is a weekly collection of house refuse in the district, which is carried out satisfactorily by the Council's staff. The refuse is at present deposited in worked-out gravel pits in various places in the district. At times this has given rise to a nuisance, and. I think that with the development of the district at its present rate, the time is not far distant when a Refuse Destructor will be a necessity to deal with the increasing amount of refuse, and to obviate the evils which may arise from the present system of disposal. Private Streets.—Acacia and Buckingham Roads, and a portion of Nightingale Road, have been made up under the Private Street Works Act, and the remaining unmade portion of Park Road, Hampton Hill, is now in the contractors' hands. Old Farm and Dean Roads are still requiring attention. Sewage Works.—I have visited the Sewage Works on several occasions during the year. The works are conducted in an efficient manner, and are remarkably free from nuisance of any kind. Factory and Workshops Act, 1901.—The bakehouses, workshops and laundries in the district have been inspected from time to time during the year by myself and the Inspecctor, and a register is kept of these premises required by section 131 of the Act. Two workshops ceased to be used for the purpose, and eight new ones were registered, leaving a total of 83 premises on the register at the close of the year. Two reports have been sent to the Home Office respecting the failure to affix the Abstract of the Act in workshops. The lists of out-workers have been obtained from those persons who employ such outworkers (making wearing apparel), and the lists have been forwarded to the Authorities in whose districts the out-workers resided or were employed. No case of overcrowding was found on any of the premises inspected. Six bakehouses and six work-rooms required cleansing, and, with one exception, the works have been carried out. Improved ventilation has been provided to one workshop. Nine nuisances have been remedied in connection with these premises, mainly arising from drains and sanitary conveniences. A serious nuisance was caused during the summer by the discharge of waste chemicals from a factory into the storm water sewers, which in turn discharged into an open ditch. The matter was reported to the Council, and measures were taken which has prevented a recurrence of the nuisance. I enclose the returns for the Local Government Board and the County Council, together with a list of' the sanitary work carried out by the Inspector of Nuisances. This, Gentlemen, terminates my Annual Report, which I think you will consider a satisfactory one, and in conclusion I have again to express my great thanks for the assistance I always receive from my Inspector of Nuisances, Mr. A. Shail, in carrying out the important duties of my office, which has always been rendered with great promptness and skill by him. I have the honour to remain, Gentlemen, Your obedient servant, WENTWORTH TYNDALE. To the Chairman and Members of the Hampton Urban District Council.