HARRO 6 1898. HARROW=ON=THE=HILL URBAN DISTRICT COUNCIL. Annual Report of JOHN FLETCHER LITTLE, M B. Cantab. M.R.C.P. Lond., Medical Officer of Health for Harrow. H a k b o w: Printed by F. W. Provost, High Street. 1 8 9 9. HARROW-ON-THE-HILL URBAN DISTRICT COUNCIL Population (Estimated), 1898,9293. Area, 2197 Statute Acres. Population, 1891 (Census), 5,725. Area, 1,000 Statute Acres. ANNUAL REPORT, 1898. 32, Harley Street, Cavendish Square, W. The Chairman, Harrow Urban District Council. Sir, I have the honour to present to you my Annual Report for the year ending December 31st, 1898. The estimated population to the middle of the year was 9293. During the year the births of 100 boys and 95 girls were registered—total 195, showing a birth-rate of 22'0 per 1,000. There were 109 deaths registered—59 males and 50 females. The death-rate being 11.7 per 1,000. This is much higher than that of the previous year which was 8.03, and higher than the average for the preceding 5 years, which was 9.2 per 1,000. Of these deaths, 32 occurred in the March quarter; 15 in the June quarter; 30 in the September quarter, and 32 in the December quarter. To these may be added 8 deaths of Harrow paupers in the Hendon Workhouse, raising the total number of deaths to 117, and giving a death-rate of 12.5 per 1,000. 2 The following is the distribution of the 109 deaths registered in the district according to age:— Under 1 year20 .Over 1 year and under 5 8 under 5 year 28 „ 5 years „ 154 „ 15 „ „ 25 9 „ 25 „ 65 „ 39 Over 5 year 81 As I have not particulars of the ages of the Harrow paupers who died in the Hendon Workhouse, I am unable to classify them, and would therefore suggest that the Council should arrange for a return from the Registrar of the births and deaths in the Workhouse to be sent to me at the close of each year. The average number of Harrow indoor paupers was 22. I desire to thank Mr. Hawkins for these statistics. INFANTILE DEATH-RATE. Comparing the 20 deaths of infants under 12 months old with the 195 births, it appears that there were I02'5, such deaths to each 1,000 births, or in other words, of every 10 children born one died without seeing the anniversary of its birth; thus the infants of Harrow have been decimated during the year 1898. The figures per 1,000 for 1897 were 71, and the average for the previous 5 years 101, and for the previous 10 years 107. ZYMOTIC DISEASES. There was 1 death from Scarlet Fever, 2 from Typhoid Fever, 4 from Measles, 6 from Whooping Cough, total 13, or at the rate of 13 per 1,000. There were 8 deaths from Diarrhœa, 1 from Puerperal Fever, 8 deaths from Phthisis, and 3 from Influenza. There were certified during the 12 months 14 cases of Scarlet Fever, 6 cases of Diphtheria, 14 cases of Typhoid Fever, and 5 cases of Erysipelas. INCREASE OF THE DEATH-RATE. The figures I have laid before you deserve the grave consideration of the Council. The total death-rate is about 50 per cent. greater than that of 1897, so also is the infantile death-rate, whilst that from Zymotic Disease is 600 per cent, greater. Since 1890, when the deathrate was 169, the rate for 1898 has not been reached. The mortality has been greater at all periods of life from infancy to old age. The chief causes have been (1) the extreme heat that prevailed during a great portion of the year causing Diarrhœa and kindred diseases; (2) epidemics of Measles and Whooping Cough; 3 (3) the outbreak of Typhoid Fever; (4) the exceptional mortality in the Workhouse; and (5) the continued mortality from Consumption and other Tuberculous Diseases, and from Influenza. The extreme heat made apparent sanitary defects hitherto undiscovered, rendered food, especially milk, not produced and transmitted under perfect sanitary conditions, dangerous, and injuriously affected the feeble and the aged. The deaths from Measles and Whooping Cough occurred chiefly amongst the children of the poor. These diseases not being at present on your list for notification were not brought to my notice until the death returns came in, and therefore I could take no measures to prevent the mortality. The outbreak of Typhoid was traced to milk imported from a distant county and from abroad. It is deplorable that the health and the lives of the people should be at the mercy of railway directors, who will not allow the churns to be sealed whilst in transit, and of careless English and French farmers, and of ignorant peasants. No milk should be allowed to enter a district unless brought in sealed vessels and accompanied by a certificate from the Medical Officer of Health of the district where it is produced. Until this is the law, all milk should be boiled before being consumed. The deaths from Tuberculous Diseases amount as usual to about 10 per cent. of the total mortality. CRUSADE AGAINST TUBERCULOSIS. Since my last report a national crusade against this insidious foe has been commenced under distinguished auspices. Your Council, as the Guardians of Health for the district, can help forward this good work by carrying out the following recommendations:— (1) by the provision of a public slaughter-house where all meat killed in the district and all meat imported may be inspected; (2) by the stringent enforcement of your by-laws for milk shops, dairies and cow sheds, and by requiring that all dairy cows be tested by Tuberculin; (3) by the frequent examination of the milk sold in the district to ascertain its freedom from the tubercle bacillus; (4) by arranging for the notification of all cases of Tubercular Disease; (5) by the disinfection of all rooms occupied by tuberculous patients; (6) by means of frequent periodic houseto-house inspections, raising the sanitary condition of all the houses in the district, and (7) by the distribution of appropriate literature. UNHEALTHY HOUSES. The basis of all sanitation is a healthy dwelling-house. My official duties have brought to my notice many houses, the state of which is most insanitary. I find in my notes on Elm Bank Cottages, where the typhoid outbreak commenced, the following entries: "parlour: damp wall, floor joists defective; kitchen: damp wall, floor joists defective; bedroom: damp wall, stair "wall defective; scullery: floor defective, walls dilapidated; 4 "w.c.: plaster off walls, ceiling damp; chimney cannot "be swept, but must be fired; yard surface defective; sewer "at back of cottages leaks; nothing done to house for "10 years." How can people living in such conditions be healthy? How can a town containing such places be secure from outbreaks of disease ? WORKMEN'S DWELLINGS. Why do the labouring classes live in such houses it may be asked? Often the reason is that they can get none other. By acting under the Housing of the Working Classes Act the Council, without cost to the ratepayers, could provide workmen's dwellings, which would act as a corrective to the negligent owners of small property, and in course of time become a valuable possession of the town. Richmond (Surrey) and many other places have shown the way in this great sanitary reform. COLNE VALLEY WATER. During the year the quality of the public water supply has not always been satisfactory, and in one case a fine was inflicted by the magistrates. This has not prevented the company from sending water containing matter in suspension into the district. When I was investigating the probable causes of the outbreak of Typhoid the company declared that samples should not be taken from their mains, but only from our taps. It was not for your officers to stand upon ceremony when disease was spreading in the town, and the samples were taken with the result already known to you. The hostile attitude then assumed by the company induces the reflection that, were the water supply controlled by a public body the first consideration would be whether Public Health could be secured by a pure supply. The directors of a company mainly aim at a high dividend. WATERLESS CLOSETS. I have still to regret the existence in the district of water closets without a water supply. How long will the Council permit this blot to rest on the sanitary reputation of the town ? INCREASED ISOLATION ACCOMMODATION. With the increase of population and of railways comes increased danger of outbreaks and of invasion of disease. A Typhoid and Diphtheria block is urgently needed at your hospital. 5 THE STEAM DISINFECTOR. This welcome addition to your sanitary appliances will do much to check the spread of infectious diseases. LECTURES ON DAIRY MANAGEMENT. It would be of great service not only to the milk trade of the district but to the inhabitants if the Committee of the Technical School would arrange for courses of lectures on Dairying, open to the consumers as well as the producers of milk. DISTRICT NURSES. The people of Harrow have shown wisdom as well as charity in providing district nurses. When they commence work they will be invaluable aids towards diminishing the mortality amongst the poor. BACTERIA BEDS AT THE GREENHILL SEWAGE FARM. The bacteria beds have been a great success, and the effluent is highly satisfactory. One of the beds was opened out after being in use for seven months and there was no trace of sludge or offensive smell. The burnt ballast was so clean that it was used for making another bed. WATER EXAMINATION. The systematic examination of the public water supply by Dr. Wynter Blyth has proved highly useful, and it will add to the security of the health of the town. CEMETERY AT ST. DOMINIC'S CONVENT. This is the second private cemetery in Convent grounds in the district. It is undesirable from a sanitary point of view that such places should be multiplied in a district like Harrow, and as no religious principle is involved sentiment should yield to sanitation. NEW BUILDINGS, &c. During the year 71 new houses, 12 shops, 30 other buildings, and 18 additions have been erected in the town. 6 BAKEHOUSES, SLAUGHTER-HOUSES, &c. There are 12 bakehouses, 7 slaughter-houses, 9 butcher shops, 4 fish shops, 3 milk shops, 8 dairy farms, 3 laundries, 1 common lodging house, and 3 workrooms in the district. These have been periodically inspected, and I am able to report a considerable improvement in their condition. METEOROLOGICAL REPORTS. These have been kept by Mr. Charles with his usual care. The rainfall was the lowest since records have been kept by your Council, only 18 inches of rain fell during the year. The following are the figures for the previous 6 years:— 1892, 20.55; 1893, 21.04; 1894, 29.48; 1895, 25.21; 1896,26.88; 1897, 26.01, giving an average for those years of 24-86 inches. The summer and autumn were marked by high temperatures. The returns show that in April 66°, in May 720, in June 76°, in July 81°, in August 87°, in September 89°, October 69°, were recorded in the shade. The mileage of wind has been recorded during the past year for the first time. THE RESIGNATION OF MR. CHARLES. I feel deeply the loss I am about to sustain in my work by the resignation of Mr. Charles. During the years that we have been associated together he has performed his duties in a manner that deserves my hearty acknowledgment. The remarkable promptitude with which he has isolated infectious cases has often prevented the spread of disease. I have always found him a loyal and courteous colleague. The usual returns for the Local Government Board and the Meteorological returns are enclosed herewith. At the request of Dr. Sykes, Medical Officer of the County Council, I send a summary of Sanitary Statistics for the past 10 years. I remain, Sir, Your obedient servant, JOHN FLETCHER LITTLE, M.B. Cantab., M.R.C.P. Lond,, Medical Officer of Health for Harrow. TEN YEARS' SANITARY STATISTICS. Estimated Population. Number of Deaths. Death-rate. Zymotic Death-rate. Number of Births. Birth-rate. Number of Deaths under 1 year of age in 1,000 Births. 1889 6,006 76 12.6 2.8 148 24.6 168 1890 6,132 104 16.9 1.3 154 25.0 143 1891 6,675 72 10.7 .4 149 22.3 47 1892 6,876 84 12.2 .8 142 20.6 112 1893 6,979 72 10.3 .7 144 20.6 97 1894 7,118 70 9.8 .28 161 22.6 124 1895 7,807 73 9.3 .13 169 21.6 106 1896 8,373 71 8.5 .7 194 23.7 113 1897 8,777 72 8.03 .22 196 22.3 71 1898 9,293 109 11.7 1.3 195 22.0 102.5 117 12.5 Averages for 5 years, 1889 to 1893 6,533 81 12.5 1.2 147 22.6 113 Averages for 5 years, 1894 to 1898 8,293 79 9.5 .5 183 22.4 103 (A) TABLE OF DEATHS DURING THE YEAR, 1898, 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. 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. Scarlatina. Enteric or Typhoid. Puerperal Fevers. Measles. Whooping Cough. Diarrhœa & Dysentery Phthisis. Bronchitis, Pneumonia, & Pleurisy. Heart Disease. Influenza. Injuries. All other Diseases. Total. Harrow 100 20 8 3 7 24 38 Under 5 1 1 1 2 6 7 6 3 18 8 3 2 10 28 5 upwds. 2 1 29 74 Isolation Hospital 1 1 2 5 1 „ 1 2 2 2 2 1 Cottage Hospital 8 „ 8 Total 109 20 8 4 9 29 39 Under 5 1 2 1 2 6 7 8 3 8 3 4 10 28 5 upward 2 1 20 31 81 (B) TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, 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 knowledge of Medical Officer. Number of such Cases removed from their Homes in the several Localities for treatment in Isolation Hospital. Last Census (1891) Estimated to middle of 1898. Scarlatina. Diphtheria. Enteric or Typhoid Fever. Puerperal. Erysipelas. Scarlatina. Enteric or Typhoid Fever. Harrow 5,725 9,293 195 Under 5 2 2 1 2 2 2 5 upwds. 1 4 10 3 10 9 METEOROLOGICAL OBSERVATIONS TAKEN AT HARROW DURING THE YEAR ENDING DECEMBER 31ST, 1898. By T. CHARLES, Surveyor to the Council. Month. Hygrometer. Temperature. Rainfall. Wind. Dry Bulb. Wet Bulb. Max. Min. Earth. Total Depth Greatest fall in 24 hours. No of Days on which .01 or more fell. Total Mileage of Wind. Prevailing Winds. 1ft. 4ft. Depth Date January. Means 41.7 40.6 46.9 37.03 43.1 46.03 0.84 0.27 5th 11 5255 s.w. Highest 51 50 54 50 45 47 .. .. .. .. .. .. Lowest 31 31 40 25 42 46 .. .. .. .. .. .. February. Means 38.32 37.10 45.75 34.14 41.82 45.53 1.17 0.20 5 th 12 7395 N.W. Highest 51 50 55 43 45 46 .. .. .. .. .. W. Lowest 31 29 41 22 39 45 .. .. .. .. .. .. March. Means 38.54 36.45 46.93 33.29 40.51 42.12 1.24 0.25 26th 13 6400 N.E. Highest 51 49 58 48 44 45 .. .. .. .. .. .. Lowest 33 31 38 26 39 44 .. .. .. .. .. .. April. Means 47.13 44.5 52.9 38.56 45.3 44.9 1.27 0.20 9th 12 4280 N.E. Highest 53 51 66 48 48. 46 .. .. .. .. .. S.E. Lowest 34 32 48 27 41 44 .. .. .. .. .. S.W. May. Means 52.12 48.61 59.38 44.38 50.48 47.93 2.42 0.40 19th 25 4570 N.E. Highest 66 59 72 52 54 49 .. .. .. .. .. .. Lowest 46 43 51 33 48 47 .. .. .. .. .. .. June. Means 54.4 55.36 66.53 49.16 56.3 51.73 1.55 0.45 27th 13 4985 S.W. Highest 69 68 76 60 59 54 .. .. .. .. .. .. Lowest 49 45 55 38 53 49 .. .. .. .. .. .. July. Means 60.70 58.74 71.25 52.0 59.67 55 0.57 0.21 1st 7 4270 N.W. Highest 71 69 81 60 61 54 .. .. .. .. .. .. Lowest 54 52 59 41 58 56 .. .. .. .. .. .. August. Means 63.45 61.38 70.16 54.38 61.70 56.45 1.21 0.50 7th 10 4765 N.W. Highest 75 74 87 65 65 59 .. .. .. .. .. .. Lowest 53 51 63 47 58 56 .. .. .. .. .. .. 10 Meteorological Observations (continued.) Month. Hygrometer. Temperature. Rainfall. Wind. Dry Bulb. Wet Bulb. Max. Min. Earth. Total Depth Greatest Fall in 24 Hours. No. of Days on which '01 or more fell. Total Mileage of Wind Prevailing Wind. 1ft. 4ft. Depth Date. September. Means 58.7 57.06 72.2 50.02 61.76 58.63 0.53 0.35 29th 3 3375 s.w. Highest 77 77 89 61 62 59 .. .. .. .. .. .. Lowest 50 47 56 33 55 58 .. .. .. .. .. .. October. Means 54.5 52.76 60.23 49.3 54.64 72.77 2.90 0.59 29th 13 4125 N.E. Highest 60 58 69 57 57 58 .. .. .. .. .. S.E. Lowest 44 43 52 39 53 56 .. .. .. .. .. S.W. November. Means 34.53 42.4 50.8 39.03 49.0 54.26 2.04 0.36 24th 18 5725 S.W. Highest 58 57 59 52 52 56 .. .. .. .. .. .. Lowest 32 30 41 26 43 52 .. .. .. .. .. .. December. Means 44.16 42.38 46.16 39 45.70 51.90 2.26 0.79 6th 15 9115 S.W. Highest 54 53 56 53 49 52 .. .. .. .. .. .. Lowest 32 31 41 24 41 49 .. .. .. .. .. ..