HARRO 9 1907. 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. HARROW: Printed at the "Gazette" Printing Works, High Street. INDEX. Page General Statistics 1 Harrow half a century ago (1854) 2 Harrow of to-day (1907) 3 Birth-Rate 4 Death-Rate 4 Deaths at all Ages 4 Deaths in Harrow Hospitals 5 Deaths of Residents Outside the District 5 Deaths of Harrow Paupers 5 Corrected Death-Rate 5 Infantile Death-Rate 6 Infantile Mortality 6 Harrow Babies' Health League 6 Early Notification of Births 7 Infectious and other Diseases 7 Diphtheria Diphtheria Anti-Toxin 8 Enteric 8 Bacteriological Examinations Measles and Whooping Cough 8 Small-Pox 9 Joint Small-Pox Hospital 9 Isolation Hospital 9 Consumption 9 Prevention of Consumption 10 Disinfection of Rooms used by Consumptives 10 County Sanatorium for Consumption 10 Cottage Hospital 10 Mount Park District 11 New Houses, Buildings, &c. 11 Amendment of Building Bye-Laws 12 Inhabited Houses 12 Sewage Farms 12 House Numbering 12 Houses Let in Lodgings 12 Scavenging 13 Dairy Farms, Bake-houses, Slaughter-houses, &c. 13 Milk Supply 13 Public Slaughter-house 14 Factories and Workshops 14 Housing of the Working Classes 15 Water Supply 15 Public Elementary Schools used for Entertainments 15 Medical Examination of Elementary School Children 16 Public Urinals 16 Rainfall 16 HARROW-ON-THE-HILL URBAN DISTRICT COUNCIL. POPULATION (MIDDLE OF YEAR), 14,860. BIRTH-RATE, 23 5. DEATH-RATE, 6 5. CORRECTED DEATH-RATE, 6'9. HOUSES, 3,024; OCCUPIED, 2,740; UNOCCUPIED, 284. FLATS, 290; OCCUPIED, 232; UNOCCUPIED, 58. HOUSES AND FLATS OCCUPIED, 2,972; UNOCCUPIED, 342. AVERAGE NUMBER OF PERSONS PER HOUSE, 5. RATEABLE VALUE, £121,580. POPULATION, 1 854, 2,81 3. POPULATION, 1891 (Census), 5,725. AREA, 1,000 STATUTE ACRES. POPULATION, 1901 (Census), 10,220. AREA, 2,197 STATUTE ACRES. POPULATION, JUNE, 1 906 (Census), 1 3,697. ANNUAL REPORT, 1907. 125, Harley Strekt, London, W. January 31st, 1908. To the Chairman of the Harrow Urban District Council, Sir, I have the honour to present to you my Report for the year ending December 31st, 1907. A comparison of the Harrow of the middle of last century and the Harrow of to-day is not without instruction. 2 HARROW HALF A CENTURY AGO (1854). The hamlets of Harrow and Roxeth were Inspected in January, 1854, by Walter Lewis, Esq., M.B., Cantab., the Superintending Medical Inspector to the General Board of Health (the predecessor of the Local Government Board), and his report is both interesting and instructive. These hamlets formed a village containing 2,313 inhabitants, and 452 houses, with only one magistrate (Mr. Rotch), who was an invalid, so that all police cases were heard either at Edgware or at Hammersmith. The Public Health Act had been applied in 1850. A drainage system had been carried out, and a public water supply provided. There were cesspools all over the place, and many were uncovered. One cesspool at the Head Master's house was so large that a wagon could easily be hidden within it. The rich, who had hitherto drawn their supply of water from private wells, now benefitted by the public supply. The poor had access to the town pump, the lower way, or King Charles's Well, and a pump close to the Harrow pond. As the Inspector points out, this occasioning much loss of time—a poor man's only property." "The charge for water," he says, "was extremely high, viz., £6 per cent, on the rateable value of the houses, with an addition for each pupil living in the boarding houses." A great many of the water closets were unsupplied with water, which accounted for the small quantity of sewage that had to be disposed of at the oullet in Clayton's field, and also explained the reason why "the whole of the closets of the working class people were in a bad and unwholesome condition." There were no ashpits or dustbins, and the footpaths were unpaved in the poorer districts. "House refuse of all kinds was thrown into the street, or back premises directly under the windows of the houses, and the atmosphere rendered impure." He also points out the very insanitary state of the "highly ornamental National Schools," and says that" the atmosphere in and around them was highly charged with deleterious gases." He gives examples of the poisonous effects of cesspools, and the extremely unhealthy condition of the cottages, especially at London Hill and Roxeth. 3 Is it any wonder, then, we find a high mortality? He states that the death-rate for 1849, 1850 and 1851, as well as in 1853, amounted to 13.6 per thousand. The effect of the sanitary improvements was shown by the fall in the sickness rate from fever, diarrhoea, and influenza, from 10 per thousand inhabitants in 1851 to 5.7 per thousand of 1853."There was neither Cottage nor Isolation Hospital, no District Nurses, and no "Babies' Health League" watched over the infants. The Rev. Dr. Vaughan was Chairman of the Local Board, and Head Master of the Harrow School. The Rev. J.W. Cunningham was Vicar, and Mr. Thomas Hewlett, F.R.C.S., was District Medical Officer, Surgeon to the School, and a Member of the Local Board of Health. Their names should ever be held in honour as pioneers of sanitation in Harrow. HARROW OF TO-DAY (1907). The contrast between Harrow of half a century ago and Harrow of to-day is highly instructive. It proves the value of sanitation in preventing sickness and lowering the death-rate, and leads us to expect still further improvement from a sound sanitary policy. From a country village with less than 3,000 inhabitants Harrow has now become a town with 15,000. General physical conditions remain practically unchanged, but the sanitation is immensely improved. Whilst the average death-rate for the last ten years has been 9.7, the corrected rate for 1907 is only 6.9, and the uncorrected, which is calculated on the same basis as the rate for 1853, is only 6.5. Had the death-rate for 1907 been the same as it was in 1853, there would have been 105 more funerals in Harrow than there were in the past twelve months, and calculating the number of cases of sickness at ten times those of the deaths, there would have been 1,000 more sufferers. Many people still die in Harrow from preventable causes with which the Sanitary Authority can deal, such as Consumption, Influenza, Whooping Cough, Measles, etc., but there are also a large number of deaths for which individuals are solely responsible. Many tragedies recorded under other names are caused by a reckless disregard of the simplest laws of health. There is frequently an absence of healthy and wholesome views of life and duty. Unstable moral 4 and mental equilibrium are frequently upset by excess in drink, food, or work. When Sir Benjamin Richardson wrote his classical description of the City of Hygeia, his dreams were characterised as Utopian, and received with good-humoured laughter. But "all things are possible," and, judging by what has been accomplished in the past, the name of Harrow may one day become synonymous with Hygeia. The estimated population at the middle of the year 1907 was 14,860. BIRTH-RATE. The births of 165 boys and 185 girls were registered during the year, making a total of 350. This gives a birth-rate of 23.5 per thousand, which is slightly less than that of the previous year, which was 23.9. This is above the average for the previous 10 years, which was 22.6. The birth-rate for England and Wales was 26.3. DEATH-RATE. There were 98 deaths registered—54 males and 44 females—the death-rate being 6.5 per 1,000, which is nearly 22 per cent, less than that of 1906, when it was 8.3 per 1,000. Of these deaths 30 occurred in the March quarter, 19 in the June quarter, 23 in the September quarter, and 26 in the December quarter. There were 32 deaths in the parish of St. Mary, 32 in Roxeth, and 34 in Greenhill. There were 6 deaths in the Cottage Hospital. Three of these were cases admitted from Wealdstone. One of the Harrow cases came from St. Mary's, and two from Roxeth parishes. DEATHS AT ALL AGES. The distribution of the 98 deaths according to age is as follows:— Under 1 year 19 Under 5 years of age 25 Over 1 year and under 5 6 Over 5 years and under 15 Over 15 years and under 25 1 Over 5 years 73 Over 25 years and under 65 35 Over 65 30 98 98 5 DEATHS IN HARROW HOSPITALS. There were 6 deaths in the Harrow Cottage Hospital, and 3 deaths in the Isolation Hospital. They are included in the above table. DEATHS OF RESIDENTS OUTSIDE THE DISTRICT. Seven deaths were reported as having occurred in the following Institutions:— Napsbury Asylum.—Diffuse Cellulitis of Neck, Syncope, age 39. Napsbury Asylum.—Chronic Bright's Disease, age 66. Napsbury Asylum.—Cerebral Softening, age 73. Napsbury Asylum.—Pleuropneumonia, Influenza, age 74. 55, Beaumont Street, W.—Cancer, age 58. 5, Beaumont Street, W.—Cancer, age 75. Middlesex Hospital.—Cancer, age 65. DEATHS OF HARROW PAUPERS. Six deaths of Harrow paupers occurred in the Hendon Workhouse, 5 men and 1 woman. The causes of death and the ages are as follows:— Pulmonary Phthisis (46), Malignant Disease (50), Accident (inquest) (64), Pulmonary Tuberculosis and Syncope (64), Old Age and Syncope (65), and General Debility and Syncope (65). There were 33 paupers in the Hendon Workhouse belonging to the district on December 31st, 1907, but these are not included in the estimated population for the year. I have again to thank Mr. Strachan, your Clerk, for procuring me the above and other information. CORRECTED DEATH-RATE. The 7 deaths of residents outside the district, and the 6 deaths of Harrow paupers in the Hendon Workhouse, 6 added to the 98 deaths registered in Harrow, gives a total of III, and after deducting deaths of 3 Wealdstone residents in the Cottage Hospital, and 5 residents from other districts, gives a corrected death-rate of 6.9. This is about 26½ per cent, less than that of 1906, which was 9.4. The death-rate for England and Wales was 15, and for 142 of the smaller towns 14.5 per thousand. INFANTILE DEATH-RATE. The Infantile Death-rate for the year was 57.0 per 1,000 births, or about one-third less than that for 1906 when it was 88.6, and slightly less than that for 1905 when it was 57.6. The average for the previous 10 years was 89.8. It is highly gratifying to be able to1 report the lowest death-rate on record for Harrow, and one that is one-third less than the average for the previous 10 years. The mortality of infants under one year of age for England and Wales was 118, and for 142 smaller towns 122 per 1,000 births. INFANTILE MORTALITY. Our rate of Infantile Mortality for 1907 is a matter for sincere congratulation, and several causes have contributed to this happy result. The cool and wet summer has largely assisted, and the work of the Babies' Health League, which only commenced operations on June 1st, has been already of great service, and should prove most valuable in the future. The result of its work will be more plainly visible during a hot summer, by helping to keep down the death-rate from diarrhoea and allied diseases, and will tend to prevent our average rate of infantile mortality reaching the deplorably high figure that it has done during the past. The work of Mrs. Owen, Dr. Edwards, Dr. Pennefather, and their patriotic and philanthropic helpers, will sow the seeds of health in soil where disease has flourished in the past. HARROW BABIES' HEALTH LEAGUE. This beneficent League commenced operations on June 1st, 1907, and has already done much excellent work. The number of babies visited up to December 28th 7 amounted to 94. Of these, 66 were thriving; unsatisfactory, 9; died, 3; visits unnecessary, 3; left the district, visited, but not seen or not reported on, or not traced, 13. The work of the League would be greatly facilitated, and rendered still more successful by the appointment of a Trained Health Visitor, whom the voluntary helpers could assist, and I recommend that this be done. EARLY NOTIFICATION OF BIRTHS. The Bill for the Early Notification of Births introduced into Parliament last Session has now become law, and, whilst the object is excellent, it contains some clauses which have excited a great deal of controversy which will doubtless lead to its amendment. Mr. Dudman, the Registrar of Births for Marylebone, has issued a circular letter pointing out the danger of the duplication of the work by calling on the parents and others to notify the births to the Medical Officer, and also to give information to the Registrar. He fears that this will interfere with the more perfect registration of births, as the parent, having notified the birth, is likely to consider that he is exempt from the duty of registering. An amendment compelling all births to be registered within 36 hours would avoid this danger, and information should be promptly sent by the Registrar to' the Medical Officer of Health of the district. The majority of the medical profession also feel that it is unjust to compel them to perform a duty to the State (under penalty) which involves the disclosure of professional secrets, and is unremunerated. I recommend that steps be taken to bring about this much-needed reform. INFECTIOUS AND OTHER DISEASES. Fifty-three cases of infectious disease were certified during the year (as compared with 32 in 1906). They are as follows:—Scarlet Fever, 30; Diphtheria, 6; Erysipelas, 8; Enteric, 5 ; Puerperal, 4. There were 3 deaths during the year from Scarlet Fever, and 3 from Puerperal Fever. There were no deaths from Enteric (Typhoid) Fever, or Diphtheria. 8 The following deaths occurred from Non-Notifiable Diseases:—Measles, I; Whooping Cough, 2; Influenza, 5; and Enteritis, 1. The Zymotic death-rate is *6 per 1,000 (as compared with 1.4 last year), or a reduction of more than 100 per cent. The rate for England and Wales was 1.26, and for 142 smaller towns, 1 29. DIPHTHERIA. Six cases of this disease have been certified during the year, which is the same as in 1906 and 1905. No death from this disease has occurred during the last 3 years, which happy result I attribute chiefly to the prompt administration of anti-toxin provided by the Council. DIPHTHERIA ANTI-TOXIN. A fresh supply of this valuable remedv has been kept, as usual, at the Council Offices day and night, and also at night at the Sanitary Inspector's house, I, Oakley Road, Greenhill. In cases of Diphtheria, if the anti-toxin is injected during the first 24 hours, the prospects of recovery are bright, and every hour that is lost involves grave danger. It is, therefore, of the greatest importance that a supply should always be at hand. On one occasion, a supply was obtained between 4 and 5 o'clock in the morning, and the patient was immediately injected. In the opinion of the medical man attending the case, the patient's life was saved owing to the promptitude of the administration. ENTERIC. Five cases were certified during the year, three of which were treated in the Hospital. No deaths occurred. BACTERIOLOGICAL EXAMINATIONS. As an aid to diagnosis there were 12 (7 Diphtheria and 5 Enteric) Bacteriological Examinations during the year, and the results were promptly telegraphed from London. MEASLES AND WHOOPING COUGH. Printed directions, for the guidance of parents and guardians when their families are attacked by these 9 diseases have been provided by the Council. They are being distributed by Mr. Bone, the Registrar of Births, at the time of registration, and by the school teachers whenever an outbreak is feared. SMALL-POX. No case of Small-pox has occurred in the district, and London and Great Britain show a gratifying absence of the disease. There is, therefore, the danger that we may relax our precautions, and thereby open the door to an invasion. There have been severe outbreaks at Edinburgh and Leith, also on the Continent at Paris, Metz, and Marseilles (1,800 deaths), and in view of the vastly increased intercommunication. we should be always ready to deal with an outbreak. The precautions that the Council has taken, I believe, are adequate. JOINT SMALL-POX HOSPITAL. The Clare Hall Hospital at South Minims is now the property of the Joint Hospital Board, and is in thorough working order. The Board is negotiating for a motor ambulance, so as to be in touch with the more remote districts. ISOLATION HOSPITAL. There were 24 cases of Scarlet Fever, and 3 deaths. Three cases of Enteric (Typhoid), and 2 of Diphtheria were admitted, and all recovered. During the previous 9 years there have been 138 cases of Scarlet Fever in the district, and only one death. The occurrence of 3 deaths from a very malignant form of the disease should warn the public from, cherishing a false sense of security. The Enteric and Diphtheria cases were of a severe type, and their removal to the Hospital, where they could be properly treated, was a means of saving life. CONSUMPTION. Five deaths were caused by Phthisis, or 5 per cent. of the total mortality. The previous year the percentage was 8.6; in 1905, 7.6; and in 1904, 12.5. 10 The problem of stamping out Consumption will not be solved until compulsory notification is in force, and provision is made by the public for the support of all who suffer by the enforcement of the necessary measures of prevention and cure. When this is done, 50,000 lives will be saved and half a million cases of illness prevented every year in the United Kingdom. PREVENTION OF CONSUMPTION. Only 2 cases were notified. Applications for disinfection have been more frequent, with the result that 8 rooms and 187 articles were disinfected after the removal or death of the patient. Cards containing instructions, and disinfectants, have been distributed as required. DISINFECTION OF ROOMS USED BY CONSUMPTIVES. Disinfection of rooms whilst occupied by consumptives, and after their removal or death, should be systematically carried out. Unless the greatest care is taken to disinfect such rooms healthy people are liable to acquire the disease. Steps should be taken to bring this desirable sanitary reform into effect. COUNTY SANATORIUM FOR CONSUMPTION. It is much to be regretted that there is no County Sanatorium for Middlesex, and various causes have hitherto prevented its establishment. No further official steps have been taken, but it is rumoured that Colonel Gerard Clark has a scheme in hand by which he hopes to raise a large portion of the initial cost of a small establishment. Every county in England should have one or more of these institutions., which would receive cases in the earlier and curable stages, and thus restore many to health and usefulness, and prevent the infection being spread abroad. At present many patients have to remain for several months before they can be placed under sanatorium treatment, and the ravages of the disease not being arrested in time often render their cure impossible. COTTAGE HOSPITAL. The new Cottage Hospital is open, and has already admitted many patients. Its work has proved of 11 able benefit to the inhabitants of Harrow, and some of the neighbouring districts. The courage and public spirit of those who have brought about, its establishment deserve acknowledgment from all who are interested in the welfare of the Town. MOUNT PARK DISTRICT. This district has not yet been transferred to Harrow, to which it naturally belongs. I have repeatedly pointed out the utterly unsatisfactory condition of the present state of things, and would urge the Council to leave no means untried to bring about the inclusion of Mount Park with Harrow. NEW HOUSES, BUILDINGS, ETC. Mr. Percy Bennetts, your Surveyor, reports as follows:— The number of plans approved by the Council was:— New Houses, 166; Shops, 24; Alterations and Additions, 22; Buildings not Dwellings, 18; Hospital, x; Church, x; New Road, 2; 200 Houses and 10 Shops have been finished and approved. No plans of Flats have been submitted. The Mortuary has been used for 8 cases. The private streets, Greenhill Crescent and Wellesley Road, have been made up under Section 150 of the Public Health Act, 1875, and the following roads declared Highways repairable by the inhabitants at large:—Alma Road, Alma Crescent, Waldron Yard, Butler Road (Part 2), Bowen Road, Heath Road, Merivale Road, Vaughan Road (Part 2), and Parkfield Road. The number of inspections of houses, etc., in course of erection during the year amounted to 3,600, and the number of defects or contraventions of the By-laws found and remedied was 204. I am glad to say that no plans of Flats have been approved by the Council since 1903. Such dwellings are most undesirable in a place like Harrow. 12 AMENDMENT OF BUILDING BY-LAWS. The By-laws Committee have been considering suggestions as to the amendment of the Building By-laws, and their views will be placed before the Council. INHABITED HOUSES. The number of houses at the middle of the year was 3,024. Of this number 284 were unoccupied. There were 290 Flats, and 58 of those were unoccupied. This gives a total of 3,314 houses and flats, of which 2,972 were occupied, and 342 were unoccupied. The supplemental valuation lists at the end of the year show that in addition to the above there are 48 houses, and of these 18 are unoccupied. If the 30 occupied houses are added to the number of those occupied at the middle of the year, there were at the end of the year, 3,002 occupied houses in the district, and allowing 5 inhabitants to each house shows that the population has now reached a little over 15,000. SEWAGE FARMS. The effluents have on the whole kept satisfactory. HOUSE NUMBERING. Mr. Kramm reports that during the year Vaughan, Grange and Kingsfield Roads have been numbered, making 280 houses in all. These added to the 887 already numbered gives a total of 1,157. Instructions have been given for the following roads to be numbered:—Heath, Merivale, Pinner, Sheepcote, St. John's, and Lowlands Roads, and the right-hand side of Butler and Drury Roads. Before long one-half of the houses in Harrow will be numbered, and I hope that in the near future all the houses will be distinguished in this way. When this is accomplished, the sanitary records can be kept with greater accuracy, and will be more valuable for reference. HOUSES LET IN LODGINGS. There are no houses of this description in the district, nor has any occasion arisen for the Council to call upon any owner to. be registered. 15 SCAVENGING. Mr. Kramm informs me that a weekly collection of refuse has been carried out, and 9 complaints of nonremoval were received. The question of the removal of house refuse is under the consideration of the Council, and the Surveyor and Sanitary Inspector have been instructed to draw up a report on the matter. A collection of refuse twice a week would greatly conduce to the public health. DAIRY FARMS, BAKE-HOUSES, SLAUGHTERHOUSES, ETC. There are Io Dairy Farms, 6 milk shops, 17 bakehouses (3 underground), 7 s1aughter- houses, 18 butcher's shops, 7 fish shops, and 7 laundries in the district. One underground bake-house has not been used during the year. These places have been carefully and regularly inspected, and are now, on the whole, fairly satisfactory. The sanitary standard of the dairy farms will have to be raised in some instances-, and I will offer suggestions to the Sanitary Committee on the subject. MILK SUPPLY. Such a large amount of the milk consumed in Harrow is imported that its quality should be carefully investigated. This can only be done by samples being taken at the railway stations by your Sanitary Inspector. I have, in my reports both annual and special, drawn attention to the filthy condition under which some of this milk is produced, and the insanitary manner in which it is conveyed. Milk is the staple food of infants and invalids, as well as being used in one way or another by all members of the community, and its purity should be above suspicion. I respectfully and urgently recommend that arrangements be made for samples of milk coming into the district being taken for investigation. I cordially endorse Mr. Councillor Hunt's recommendations in his paper read last summer at the District Councils' Association 14 ence at Ventnor. "It is manifest that the present regulations dealing with the supply of milk have failed in their object to ensure that this important food should reach the consumer in a pure condition; let us now consider the remedy. The bulk of the milk supply of all the great towns, and most of the smaller ones, is brought from outside their districts, and often from distant counties. It is, therefore, obvious that the area of a municipality, and even of a county, is too' small for the purpose of dealing effectually with its own milk supply, and the only remedy is that the Government should take charge of it, appoint qualified Inspectors (other than the local ones), and with the assistance of the County Medical Officers of Health, and the Borough and District Officers, secure a pure supply of milk that may be consumed raw with safety. Moreover, all imported milk should be sterilised before shipment, and tested at the port of entry." "Separated milk and margarine should not be sold in the same shops with whole milk and butter. The milk shops should remain under the control of the Borough and District Medical Officers of Health." PUBLIC SLAUGHTER-HOUSE. It is essential that a public slaughter-house should be provided either by Harrow itself, or in combination with the neighbouring districts. This would permit proper supervision of all meat killed in the district. Your Inspector has endeavoured to be present when slaughtering is taking place at the private slaughter-houses, but owing to their number and the distance between them it is manifestly impossible for the supervision to be effective. Three parcels of diseased organs were surrendered. I recommend the Council again to consider the problem with a view to its early solution. FACTORIES AND WORKSHOPS. There are 62 workshops, and 9 home-workers' premises. During the year periodical inspections have been 15 made, and where sanitary defects were found attention was called to them, and at the end of the year they had all been remedied. It became necessary to send to the occupiers of the various workshops a circular letter respecting the necessity of the lists of out-warkers being sent in, and the indormation was readily given. The out-workers' homes were accordingly inspected, and all were found in a sanitary condition. HOUSING OF THE WORKING CLASSES. The house-rent paid by the Working Classes in Harrow is still too high, and cheaper accommodation should be provided. At present so much is subtracted from their wages for rent that the balance is insufficient for the maintenance of their families, and the making of a suitable provision for sickness and old age. They pay fully one-third out of their wages, and this proportion is far greater than that paid by the more prosperous classes. The Hendon Council is about to erect 50 houses for working people, and such provision is equally necessary in Harrow. WATER SUPPLY. The public supply is from the Colne Valley Water Company, and two analyses have been made during the year. The first sample showed that the water was of a high standard of purity. The second showed that the water was one of moderate organic purity, as judged by the chemical analysis. The question of making bacteriological examinations, therefore, arises, and I recommend the Council to have this done. I also recommend that analyses be made more frequently. PUBLIC ELEMENTARY SCHOOLS USED FOR ENTERTAINMENTS. The practice of letting Public Elementary Schools for entertainments and dinners is one that should be 16 carefully supervised. If this is not done, the rooms will not be perfectly ærated when the children have to use them:. MEDICAL EXAMINATION OF ELEMENTARY SCHOOL CHILDREN. The arrangements for putting into operation this wise measure have reached such a stage that two medical men have been appointed by the County Council to do the work under the supervision of the County Medical Officer of Health. They will watch over the growth and development of all the children, and will take steps to remedy defects of sight and hearing, and, as far as possible, mental deficiency. The effect of this work should be to raise the standard of health and efficiency in the children to-day who will be the men and women of to-morrow. PUBLIC URINALS. A rapidly increasing town of the size and importance of Harrow ought to be supplied with these sanitary conveniences, and I recommend that one be placed in each of the three parishes. RAINFALL. The rainfall for the year was 25.37 inches, which is .96 less than in 1906, when it was 26.33, or about one inch above the average for the previous 10 years. The number of days on which .o1 or more inches of rain fell was 20 in October, 18 in June, 17 in May and December, 16 in April, July and August, 15 in November, and 8 in June and September. On October 14th 1.11 inches of rain fell. I think it only right to say that the careful supervision of new buildings by Mr. Bennetts, your Surveyor, is preventing jerry-building, and that Mr. Kramm, your Sanitary Inspector, has succeeded in bringing many of the older premises up to a much higher sanitary standard. 17 The work of these gentlemen has gone far towards reducing the death-rate. Allow me to thank your Council for their unvarying kindness, and to express my indebtedness to your Officers, Mr. Strachan, your Clerk, Mr. Percy Bennetts, your Engineer, and Mr. Kramm, your Sanitary Inspector, for the cordial and loyal manner in which they have always aided me in my work. I remain, Sir, Your obedient Servant, J. FLETCHER LITTLE, M.B. Cantab., M.R.C.P. Lond. Medical Officer of Health for Harrow. January 31st, 1908. 18 TABLE I. VITAL STATISTICS OF WHOLE DISTRICT DURING 1907 AND PREVIOUS YEARS. Year. Population estimated to Middle of each year. Births. Total Deaths Registered in the District. Total Deaths in Public Institutions in the District. Deaths of Nonresidents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all Ages belonging to the District. Number. Rate. Under 1 year of Age. At all Ages. Number. Rate per 1,000 Births registered. Number. Rate. Number. Rate. 1897 8,777 196 22.3 14 71 72 803 2 2 74 8.5 1898 9,293 195 22.0 20 102.5 109 11.7 17 8 117 12.5 1899 10,077 221 21.9 29 131 108 10.7 14 11 119 11.8 1900 10,540 238 22.5 20 84 103 9.7 4 6 109 10.3 1901 10,540 238 22.5 29 121.8 90 8.5 6 96 91 1902 10,850 251 23.1 17 67.7 88 8.1 3 6 94 8.6 1903 11,337 255 22.4 17 66.6 87 7.6 6 3 2 96 84 1904 12,313 277 22 .4 30 108 104 8.4 6 10 114 9.2 1905 13,000 313 24.0 17 57 6 104 8.0 13 1 19 123 9.3 1906 13,697 327 23.2 29 88.6 115 8.4 3 15 130 9.4 Averages for years 1897.1906 11,042 253 22.6 222 9.8 98 8.9 6 7 107 9.7 1907 14,860 350 23.5 21 600 98 6.5 9 3 13 111 6.9 Area of District in acres (exclusive of area covered by water)2,197 Total population at all ages, 10,220. ) At Census Number of inhabited houses, 1,893. !■ of Average number of persons per house, 53. ) 1901. 19 TABLE III. CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1907. Notifiable Disease. Cases notified in whole District. Total Cases notified in each locality. No of Cases removed to Hospital from each locality. At all Ages. At Ages—Years. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 8. Mary's Roxetll. Greenhill. 8. Mary's Roxeth. Greenhill. Diphtheria 6 4 2 3 1 2 1 1 Erysipelas 8 8 3 1 4 Scarlet Fever 30 5 16 6 3 10 8 12 7 8 9 Enteric Fever 5 1 2 2 2 2 1 1 2 Puerperal Fever 4 1 3 1 2 1 Totals 53 5 21 11 16 19 14 20 8 11 10 Isolation Hospital, Newton Fields, Harrow. 20 TABLE IV. CAUSES OF, AND AGES AT, DEATH, DURING YEAR 1907. Causes of Death. Deaths at the subjoined ages of " Residents " whether occurring in or beyond the District. Total Deaths whether of ''Residents" or " NonResidents" in Public Institutions in the District. All Ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwaids. Measles 1 1 Scarlet Fever 3 1 2 Whooping-Cough 2 1 1 Epidemic Influenza 5 1 2 2 Enteritis 1 1 Puerperal Fever 3 3 Phthisis 5 1 1 3 Cancer, Malignant Disease 4 2 2 Other Diseases of Respiratory Organs 17 3 2 1 7 4 1 Premature Birth 8 8 Heart Diseases 14 1 6 7 Accidents 5 1 3 1 2 Suicides 2 2 1 All other causes 28 4 3 8 14 2 All causes 98 19 6 7 1 36 30 6 2 I TABLE V. INFANTILE MORTALITY DURING THE YEAR 1907 Cause of Death. Deaths from stated Causes in Weeks and Months under One Year of Age. Total Deaths under One Year. Under 1 Week. 2-3 Weeks 3-4 Weeks Total under 1 month. 1-2 Months. 2-3 Mouths. 6-7 Months. 8-9 i Months. 11-12 Months. All Causes Certified 8 1 1 10 1 2 2 1 1 17 Uncertified 1 1 2 "Whooping Cough 1 Enteritis 1 Premature Birth 8 Atrophy 1 Convulsions 1 Bronchitis 1 1 1 Other Causes 1 1 1 1 9 1 1 11 2 2 2 1 1 19 Population estimated to middle of 1907, 14,860. legitimate 345 Births in the year illegitimate 5 Deaths in the year of legitimate infants 19 illegitimate infants - 22 METEOROLOGICAL OBSERVATIONS TAKEN AT HARROW DURING THE YEAR ENDING DECEMBER 31ST, 1907, By J. PERCY BENNETTS, Engineer and Surveyor. 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. Prevailing Wind. 1ft. 4ft. Depth. Date. January. Means 36.51 35.43 37.41 33.00 38.25 44.25 0 86 0.49 1st. 8 N.W. Highest 44.00 42 00 50.00 42.00 42.00 45.00 W. Lowest 23.00 23.00 27.00 22.00 35.00 43 00 N.E. February. Means 35.39 34.31 42.03 31.67 36.67 41.64 1.31 0.34 12 th. 12 N.W. Highest 47.00 45.00 51.00 40.00 41.00 43.00 S.W. Lowest 27.00 26.00 32.00 25.00 35.00 40.00 S.E. March. Means 42.42 39.71 52.87 34.97 40.58 42.90 1.00 0.22 12th. 12 N.W. Highest 56 00 5000 69.00 45.00 44.00 4400 S.E. Lowest 29.00 29.00 41.00 25.00 38.00 42 00 N.E. April. Means 45.93 43.43 55.33 39.10 45 .7.3 45.50 3.86 0.67 6th. 16 N.W. Highest 61.00 57.00 71.00 5.2.00 49.00 47 00 S.E. Lowest 36.00 35.00 46.00 30.00 44.00 44 00 S.W. May. Means 52.84 49.26 59.84 44.81 51.16 48 68 1.56 0 28 7th. 17 N.E. Highest 70.00 60.00 79.00 56.00 56.00 47.00 S.E. Lowest 4000 38.00 50.00 34.00 46.00 51.00 N.W. Tune. Means 55.93 52.46 64.30 48.53 55.83 52.40 1.95 0.49 1st. 18 S.W. Highest 67.00 60.00 73.00 57.00 58.00 54.00 N.W. Lowest 43.00 49.00 56.00 42.00 54.00 51.00 N.E. July. Means 58.53 54.45 66.97 50.29 58 19 52.06 1.73 0.55 22nd. 16 N.W. Highest 63.00 61.00 78.00 60.00 61.00 57.00 S.W. Lowest 52.00 50.00 59.90 41.00 55.00 54.00 S.E. August. Means 59.77 55.77 68.03 51.2.2 59.03 57.00 1.80 0.46 2nd. 16 S.W. Highest 65.00 63.00 75.00 59.00 61.00 57.00 N.W. Lowest 48.00 46.00 60.00 42.00 57.00 57.00 23 METEOROLOGICAL OBSERVATIONS TAKEN AT HARROW DURING THE YEAR ENDING DECEMBER 31st, 1907. By J. PERCY BENNETTS, Engineer and Surveyor. Month. Hygrometer. Temperature. Rainfall. Wind. Dry Bulb. Wet Bulb. Max. Min. Earth. Total Depth. Greatest Fall in 24 liourg. No. of days on which 01 or more fell. Prevailing Wind. 1ft. 4ft. Depth. Date. September Means 57. 16 54.76 67.76 49.26 57.13 57.23 0.85 0.30 2nd. 8 N.E. Highest 65.00 62.00 78.00 61.00 60 00 58.00 N W. Lowest . 49.00 46 00 58.00 35.00 54.00 56.00 S.E. October. Mentis 50.26 48.77 57.25 43.54 52.36 55.26 4.55 1.11 14th. 20 S.E. Highest 60.00 59.00 67.00 52.00 57.00 56.00 S.W. Lowest 39.00 39 00 49.00 30 00 49.00 54 00 N.VV. November. Means 43.36 4216 50.36 38.43 45.65 53.40 2.45 0.44 26th. 15 N.W. Highest 52 00 50.00 6100 47.00 50.00 54.00 S.E. Lowest 33.00 3.2 00 42.00 30.00 42.00 49.00 N.E. Means 40.09 39.00 46 09 36.00 41 90 47.09 3.45 0 50 12th. 17 S.W. Highest 54.00 53.00 56 00 46.00 45.00 49.00 N.W. Lowest 32.00 32 00 36.00 31.00 38.00 46.00 N.E. 24 FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. 1.—INSPECTION. including inspections made by sanitary inspectors or inspectors of nui8ances. Premises. Number of Inspections. Written Notices Prosecutions. Factories (Including Factory Laundries.) 8 Workshops(Including Workshop Laundries.) 128 12 Workplaces 52 10 Total 188 22 2.—DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied Referred to H.M. Inspector. Nuisances under the Public Health Acts:— Want of Cleanliness 1 1 Want of Ventilation 2 2 Overcrowding 1 1 Other Nuisances 18 18 Sanitary accommodation insufficient unsuitable or defective 4 not separate for sexes 4 Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) Sec. 22, P.H.A., 1890, adopted one w.c. for every twenty workers is insisted upon. Breach of special sanitary requirements for bakehouses (SS. 97 to 100) Other offences Total 26 26 25 3.—HOME WORK. Nature of Work. Lists received from Employers. Addresses of Outworkers Inspections of Outworkers' premises. Twice in the Year. Once in the Year. Received from other Councils. Forwarded to other Councils. Lists. Outworkers. Workmen Lists. Outworkers. Workmen Wearing apparel— (1) making, &c. 4 9 2 2 4 2 12 (2) cleaning and washing 1 Total.... 4 10 2 2 4 2 12 4—REGISTERED WORKSHOPS. Workshops 011 the Register (S. 131) at the end of the year Number. Dressmakers and Milliners. 16 Tailors 7 Important classes of workshops, such Laundries 8 as workshop bakehouses, may be Bakehouses 17 enumerated here. Cycle Makers, Carpenters, &c 7 Workplaces 7 Total number of workshops on Register 62 Underground Bakehouses (s. 101):— In use at the end of the year1 SANITARY WORK, 1907. No. 1. Inspections. Notices. Dwelling Houses. Houses let in Lodgings. (Tenement Houses.) Common Lodging Houses. Number of Premises Inspected on Complaint. Number of Premises Inspected in connection with Infectious Diseases. Number of Premises under periodical Inspection. Houses Inspected from Houseto-House. Total Number of Inspections and Re-inspections made. Cautionary or Intimation Notices given. Statutory Orders Issued. Summonses served Convictions obtained. Houses, Premises, &c., Cleansed, Repaired, &c. Number Registered under Bye-laws. Number of Contraventions. Number Registered under Bye-laws. Number of Inspections made. Number of Contraventions. 112 47 105 32 1121 95 3 nil nil 7 nil nil 1 4 '5 SANITARY WORK—1907. No. 2. Canal Boats used as Dwellings. Moveable Dwellings, Caravans, Tents, &c. Bakehouses. Slaughterhouses. Cow-sheds. Dairies and Milkshops. Unsound Food. Water Supply and Water Service. Percentage of Houses supplied from Public Water Service. Cisterns. Draw-Taps placed on Mains. Percentage of houses supplied on Constant System. Number of Samples obtained for analysis from Public Supply. Number Registered under the Acts Number of Contraventions of Regulations. Number Observed during the Year. Number of Nuisances thereby abated. Number Removed from District. Number in District. Contraventions of Factory Acts. Number on Register. Number of Inspections made and frequency of inspections. i Contraventions of Bye-laws. Number on Register. Number of Inspections made and frequency of Inspections. Contraventions of Regulations. Number of Milch Cows in District. Number on Register. Number of Inspections made and frequency of inspections. Contraventions of Regulations Animals seized (b) Articles or Parcels seized. Condemned by Magistrate (a & b.) Articles or Parcels surrendered. New Provided. Cleansed, Repaired, Covered, &c. nil. nil nil. nil. nil. 17 nil. 7 110 15 10 47 12 117 7 23 nil. nil. nil. 3 100% nil. 23 3 100% 8 Each slaughter house once every two weeks during the process of slaughtering. Quarterly. One cow-shed closed at end of year owing to being unfit for keeping cows. Quarterly. i SANITARY WORK, 1901. N°" 3" Drainage and Sewerage of existing Buildings. Disinfection. Dust. Sundry Nuisances Abated. jtvemarKS as 10 any other matters or in explanation of previous columns. Water Closets Percentage of Houses provided with Water Closets. Drains. Cesspools. Percentage of Houses Draining into Sewers. Rooms Disinfected (a) Ordinary infectious diseases, (b) Phthisis. Rooms stripped and cleansed. Articles Disinfected or destroyed, (a) Ordinary infectious disease, (£) Phthisis. New Bins provided. How frequently is dust removed from | each house ? Number of Complaints of NonRemoval received. Method of Disposal (a) Destructor, (b) by tipping), (c) Other, state method. Overcrowding. Smoke. Accumulations of Refuse. Foul Ditches, Ponds, &c., and Stagnant Water. | Foul Pigs and other Animals. Dampness. Yards repaved or repaired. Other Nuisances. * Re-testing made by builders during structural alterations to drains are not included in this total Number of Water Closets substituted for Dry Receptacles. Repaired, Supplied with Water, or otherwise Improved. Examined, Tested, Exposed, &c. Unstopped, Repaired, Trapped, See. Waste Pipes, Rain Water Pipes Disconnected, Repaired, &c. New Soil Pipes or Ventilating Shafts fixed. i Existing Soil Pipes or Ventilating Shafts repaired. Disconnecting Traps or Chambers Inserted. Reconstructed. Rendered Impervious, Emptied Cleansed, &c. Abolished, and Drain connected to Sewer. 66 99% 30 104 34 48 68 31 1 nil 99 % Ill 19 823 59 weekly 9 Refuse tipped in heap at Sewage farm burnt. 1 1 29 1 40 28 40 30 8 1 197