AC 432(3)5 ST MARY ABBOTTS KEN 100 THE ANNUAL REPORT ON THE HEALTH OF THE Paris of St. Mary Abbotts KENSINGTON, DURING THE YEAR 1873. by T. ORME DUDFIELD, MD., MEDICAL OFFICER OF HEALTH. LONDON: Frederick Bell & Co., Steam Printers, King's Road, Chelsea. 1874. THE ANNUAL REPORT ON THE HEALTH OF THE Parish of St. Marg Abbotts, KENSINGTON, DURING THE YEAR 1 87 3. by T. ORME DUDFIELD, M.D., MEDICAL OFFICER OF HEALTH. LONDON: Frederick Bell & Co., Steam Printers, King's Road, Chelsea, 1874. aa CONTENTS. :o: page. Introductory Observations 5 Mortality in 1873 5 Deaths in Hospitals 5 Death Rate, Comparative 6 „ from Zymotic Diseases 6 Measles, Epidemic of 7 Fog's, great increase of Mortality after 8 Small Pox 8 Sore Throat, Endemic of 9 Sanitary Statistics, new forms for registering 10 Population 10 ,, and Rateable Value of property, rapid increase of 11 Marriages 11 Births 11 Deaths, from all causes 12 „ not certified 13 „ special causes of 13 Puerperal Mortality 14 Deaths in Public Institutions 17 Inquests 18 Meteorology 18 Vaccination 19 Sanitary Work 19 Dust Removal 20 The Law's delays 21 Slaughter Houses 21 Slaughter Houses, &c. (Metropolis), Act, 1874 22 Cow Sheds 26 Bakehouses 27 Offensive Trades 27 Unsound Meat 27 Gas Company, complaint against 27 Disinfection of Clothing 28 Mortuary 28 Jennings' Buildings 29 Sewer Ventilation 30 Water Supply 32 Gas 34 Concluding Observations 35 Appendix, Tables, &c. 37 aa 2 5 EIGHTEENTH ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, Being for the Year 1873. To the Vestry of the Parish of St. Mary Abbott's, Kensington. Gentlemen, The year 1873, healthy upon the whole, was most remarkable for the comparative abeyance of zymotic diseases of an infectious character. There were fewer deaths from these diseases in proportion to population than in any previous year in the decade. The diminished mortality was not confined to any one of them but extended to all. The only very fatal disease of the seven principal members of the group was Diarrhoea, the mortality from which was above the average. This disease is one of infancy however, and though the needless loss of infant life is to be deplored, it is not so great an evil as the premature death of adult persons from more or less preventable maladies. The Registration year 1873 comprised fifty-three weeks (371 days), and the deaths registered during that period were 2436. Of this number 96 took place in the Hospital for Diseases of the Chest, at Brompton, including three only of parishioners. Deducting the deaths of strangers in that institution, the annual death-rate in the parish was 17.6 per 1000 of the population. (The rate for all London was 22.5 per 1000.) It must be borne in mind, however, that if a certain number of strangers die within the limits of the parish, a good many parishioners die out of it— in the general hospital; and these deaths should be taken into account in estimating the mortality of the year. It is customary to add to the known mortality a proportion of all the deaths that take place in the Hospitals, relative to the population of the district. Thus, as Kensington comprises about one twenty-seventh of the population of the Metropolis, a twenty-seventh of the deaths in Hospitals, (4860), viz., 180, would, in accordance with the rule, be added to the 2343 deaths of parishioners registered in the 6 parish, thus raising the total deaths to 2526 and the rate to 19 per 1000. Desirous of ascertaining how near this rough estimate was to the fact, I made enquiries at many of the Hospitals and was surprised to find how few Kensington parishioners died in any of them, excepting the local Hospitals of St. George and St. Mary. I obtained information respecting 2600 deaths, of which 83 belong to Kensington; of these 39 took place in St. Mary's Hospital and 34 in St. George's. In Charing Cross, University, St. Bartholomew's, Westminster, and Middlesex Hospitals out of a total of 1300 deaths only seven belong to Kensington. In the London and St. Thomas's Hospitals out of nearly one thousand deaths not one belongs to Kensington. The conclusion I arrive at therefore is, that by including in the mortality returns a number of deaths equal to those that occurred at the Brompton Consumption Hospital, we shall get as fair an approximation as possible to the total deaths of Kensington parishioners in Hospitals, thus raising our deaths to 2436 and the rate of mortality to 18.3 per 1000. I need hardly say it would be satisfactory if an annual return were made, showing the cause of death and the previous residence of those who end their days in Hospitals, in order that each Medical Officer of Health might include the proper quota in his Annual Report. At present we can do nothing more than take credit for a gross number which may be very wide of the mark; for, not to enter upon other grounds of uncertainty, we know that many persons die in the Hospitals who have come to Town to obtain Medical or Surgical aid. The subjoined table shows the death-rate in the Parish, the Metropolis generally, and the great divisions into which it is mapped bv the Registrar General:— DEATH RATE, 1873. Kensington 18.3 per 1000 London 22.5 „ West Districts 20.5 „ North „ 21.2 „ Central „ 25.0 „ East „ 25.2 „ South „ 22.0 „ The deaths from the seven principal diseases of the zymotic class were 290, equal to 119 per 1000 deaths, viz.:— Small-pox 0.4 per 1000 Deaths Measles 15.6 „ Scarlet Fever 4.1 „ Diphtheria 4.5 Whooping Cough 18.0 ,, Fever 16.8 „ Diarrhoea 59.6 7 This mortality is equal to only 2.18 per 1000 of the population, the lowest on record. In 1872 the rate was 3, and in 1871, 4.5 per 1000. One hundred and forty-five of these deaths were due to Diarrhoea, and the remaining 155, little more than 1 per 1000 living, to the other six diseases. The deaths occurred in the Sub-districts as follows:— Kensington Town. Brompton. Total. Small-pox 1 — 1 Measles 28 10 38 Scarlet Fever 8 2 10 Diphtheria 8 3 11 Whooping Cough 37 7 44 Fever 33 8 41 Diarrhoea 121 24 145 236 54 290 Pulmonary diseases, excluding Phthisis, caused 483 deaths, equivalent to 200 per 1000 of the total deaths, and to 3.6 per 1000 of the population. The Tubercular diseases, including Phthisis, Scrofula, Rickets, and Tabes Mesenterica were fatal in 332 instances = 137 per 1000 deaths and 2.4 per 1000 living. The Wasting diseases of Infants (including Marasmus, Atrophy, Debility, want of breast milk, and Premature birth, as registered causes of death,) account for 186 deaths = 76 per 1000 deaths and 1.4 per 1000 living. The Convulsive diseases of infants (e. g. Hydrocephalus, Infantile Meningitis, Convulsions, and Teething,) caused 166 deaths = 71 per 1000 deaths and 1.2 per 1000 of the population. "Constitutional" diseases caused 468 deaths = 192 per 1000 deaths and 3 5 per 1000 living: and Developmental diseases, 306 deaths = 126 per! 000 deaths and 2.3 per 1000 living. The violent deaths were 59 in number = 24 per 1000 deaths and 0.4 per 1000 living, while the deaths, the causes of which were not specified or were ill-defined, were 34 = 15 per 1000 deaths and 0.2 per 1000 of the population. Details with regard to diseases will be furnished later on: the number of deaths from each may be seen at a glance in Table 3 in the Appendix. EPIDEMIC OF MEASLES. Towards the close of the year an epidemic of Measles commenced, and both during the months of November and December, and also during the first half of the current year proved remarkably fatal. The deaths during the year were 38, of which 29 occurred in the last two months. This rate of mortality was greatly exceeded in the current year, when in the first three 8 months 81 deaths from this disease were recorded : chiefly due to pulmonary complications naturally fostered by the season, favourable to the occurrence of Chest diseases, especially among the ill-kept children of the poor, its principal victims. GREAT INCREASE of MORTALITY AFTER FOGS. In the month of December there occurred some of the most remarkable and fatal fogs within living memory. They were followed by an immediate rise in the death rate, and their influence continued to be felt for some weeks. During the last four weeks of the year the mortality was 91 per cent. above that of the corresponding period of 1872; the increased number of deaths—due beyond question to the atmospherical condition referred to,— being chiefly from pulmonary diseases in the very aged and in the young. SMALL POX. One death only took place from this disease during the year, and it deserves special mention from the circumstances of the case. The victim was a young married woman on a visit to Town. Shortly after her arrival she sickened with the disease, lay ill for twelve days in a room lighted by a skylight and without any means of ventilation or heating (in the month of January), and then died, not having been attended or seen by a medical man throughout her illness. The body remained in the room for three days,—the parish having no mortuary—although there were some ten or eleven other persons living in two adjoining rooms, over a stable. The case was not reported till the woman was dead. I felt strongly that an inquest should have been hold in this case, and endeavoured, but unsuccessfully, to bring it about. Medical attendance might have been had for the asking, but was not applied for. It seemed to me, therefore, that a presumption of neglect was raised which made the case a proper one for inquiry, especially as in other parts of the Country members of the sect known as "peculiar people" have been put on their trial for "manslaughter" for corresponding neglect, based on (an absurd but as alleged) conscientious objection to the employment of human aid for the cure of the sick. No such objection was raised in the case under consideration. As the law now stands not only may a person ill of an infectious disease be kept in a totally unfit place to the common danger of the family and neighbours, but in afatal case no difficulty appears to be experienced in obtaining the burial of the body, as in this instance, without any medical certificate of the cause of death. A few other cases of smallpox occurred during the year, but so far as I am aware, were all removed to the Stockwell Hospital. The Sanitary history of the year would be incomplete without 9 some reference to an ENDEMIC OF SORE THROAT, which commenced at the middle of August, attained its height in September, and continued more or less to the end of the year.* The disease usually set in with shivering, headache, prostration, heat, quick pulse, malaise—the general symptoms of febrile disorders. The tonsils were found tumid, and the throat generally red and swollen from sub-mucous infiltration, with external swelling and tenderness oftened confined to one side, usually affecting the cervical glands, and, but rarely, the parotid. In the latter case the swelling was of stony hardness, and occasionally ended in abscess. In delicate strumous persons the tonsil now and then suppurated, but very slowly. There was an abundant glairy or frothy secretion clogging the fauces and producing a sense of suffocation in the recumbent position. There was much sharp pain also, especially in deglutition —which occurred often involuntarily, adding much to the distress, and excited by the secretion. Occasionally, it may be added, there was a slight measley rash, and an exudation on the tonsils not unlike Diphtheria. The tongue, however, was not that of Scarlatina, and there was no cuticular desquamation. Sometimes the appearance was that of follicular tonsillitis. In many cases the urine was albuminous, always scanty, and occasionally bloody. Robust people were often attacked, and several members of a family almost simultaneously, while in other instances the cases would occur in such a succession as to suggest infection as the origin of the latter cases, and this was especially so in cases resembling follicular tonsillitis. The disease was of an eminently asthenic type, suggestive of blood poisoning, and not seldom associated with Erysipelas. More ordinary throat affections were rife at the time. The disease often ran its course in from three to seven days, sometimes terminating rather suddenly. In suppurative cases the duration was longer—with prolonged debility, tardy convalescence, especially from the glandular enlargements. Relapses were not unknown. Some practitioners thought they had seen the disease before, but to many it presented features quite new to them. The principal sufferers were well-to-do people living near open spaces—large gardens, squares, the parks, and on a gravelly soil: the poor inhabitants of close, densely packed localities, and on clay oil, suffered little. The malady was not confined to Kensington. Among other places, Chiswick and Twickenham suffered severely, while Richmond escaped. By some the disease was ascribcd to ordinary malaria, and by others to sewer smells from open drains, or to a depressing influence of the air. Soothing remedies, suitable in cases of Quinsey, were useless; the disease called for tonics, stimulating gargles, ice, wine, and nourishing food. So far as I can ascertain, *For many of the facts in connection with this endemic, I am indebted to Dr. Pearson, of Kensington, who read a paper on the subject at the Medical Society of London. 10 the disease Was not fatal in any case, although many persons suffered severely; while in a large number of cases the malady set in with symptoms of such a severe and threatening type, as to forebode mischief far beyond that actually experienced. The disease appears now, and for many months past, to have wholly disappeared. NEW FORMS FOR RECORDING SANITARY STATISTICS. The Tables in the Appendix numbered 1 to 6, inclusive, have been drawn up by the Society of Medical Officers of Health for general use throughout the country, and with a view to facilitate comparison between different districts and with standard areas. The want of uniformity in the Statistical Returns of the Medical Reports had long been felt; I was induced, therefore, to bring the subject before the Society, which after a most careful consideration and having obtained the views of a great many Officers of Health, settled these forms, which, it is hoped, will supply all the information that is absolutely requisite without imposing an undue amount of work on those who may use them. Should the Tables come into general use they cannot fail to invest the vital statistics in the Reports of Medical Officers with a much greater and more universal interest than heretofore. POPULATION. The population of the parish estimated to July was 133,000, an increase of 5,500 during the year. The greater part of the increase, viz., 3,360, was due to immigration, as the births exceeded the deaths by 1,836 only. The inhabited houses numbered 16,920, an increase of 714 during the year: giving an average of 7.7 persons to each house. Building operations have not been so active as in the years immediately preceding the last census (1871). The population, nevertheless, appears to have increased nearly as rapidly as in the previous decade, mainly owing to immigration from other parts. The number of empty houses has considerably diminished and the rateable value of property has increased largely, being now over one million pounds. There remain several hundred acres as yet unbuilt over. The density of the population —assuming that 400 acres out of the 2,190 are still uncovered, would be 74 per acre. The parish for registration purposes is divided into two Sub-districts, viz.. Town (1497 acres) and Brompton (693 acres). The population of the Town District is estimated to be 102,000; and the Brompton District 31,000. The female inhabitants preponderate greatly. The excess in 1871 was 22,234, and no doubt the relative proportion of the sexes continues much the same. It may be estimated, therefore, that the males numbered 55,000 and the females 78,000. 11 The following information may be of interest as illustrating the growth of the parish in population and rateable value during the Century:— Population. Rateable Value. 1801 8,556 1823 (Michaelmas) £75,916 1821 14,428 1833 „ 93,397 1841 26,834 1843 „ 142,772 1851 44,053 1853 „ 257,103 1861 70,108 1860 „ 375,333 1871 120,234 1865 ., * 590,711 1873 (estimated) 133,000 1870 „ 817,326 1873 „ 1,005,794 MARRIAGES. The marriages celebrated last year were 1243, viz., in the churches 1,065, at other places of worship 107, including 63 at the Pro-Cathedral; and 71 at the Superintendent Registrar's Office. The marriage rate, therefore, was 9.3 per 1000: the rate for all London being 10.3, and for all England 8.32. There was, in other words, one marriage to 107 of the population. BIRTHS. The registered births in 1873 were 4182, or one birth to 31.8 of the population. This represents a birth rate of 31.4 per 1000: the rate for all London being 35.4, and for all England 35.3; 2105 males were born and 2077 females. The relative proportion of males born in all England is 104.1 to 100 females: but in this parish, in 1873, the excess of male births was less than 1 per cent. In the Town District the births were 3,339, and 843 in the Brompton District, 32.7 and 27.2 per 1000 respectively. The deficiency in the birth rate is accounted for by the great disproportion in the relative number of the two sexes before alluded to. But small as the birth rate now is it is considerably higher than formerly. In the census year 1861, the birth rate was only 27.3 per 1000, a rate not much exceeded in the following three years. In Tables 1 and 1 (Appendix) there will be found some interesting information on this head. The subjoined table supplies all further necessary details with regard to the births:— Births in 1873. Kensington Town Sub-District. Brompton Sub-District. Males. Females. Total. Males. Females. Total. Grand Total. 1st Quarter, 423 397 820 115 99 214 1034 2nd „ 418 388 806 87 118 205 1011 3rd „ 391 406 797 106 106 212 1009 4th „ 464 452 916 101 111 212 1128 1696 1643 3339 409 434 843 4182 12 DEATHS. The deaths of parishioners registered in the parish were 2,343, viz., males 1,122, and females 1,221; adding an estimated number of 93 deaths as having occurred outside the parish, in hospitals, the deaths were 2,436, equal to a rate of 18.3 per 1000 living or one death to 54.5 living. The death rate in London was 22.5; in 18 large Towns 24.1; in all England 22.6 per 1000. In England generally the mortality in the male and female sexes respectively was 23.7 and 21.4 per 1000. Subjoined is a statement of the deaths registered in the parish, in districts, and quarters, &c.:— Kensington Town Sub-District. Brompton Sub-District. Males. Females. Total. Males. Females. Total. Grand Total 1st Quarter, 218 247 465 57 72 129 594 2nd „ 210 198 408 51 56 107 515 3rd „ 238 220 458 39 47 86 544 4th 260 310 570 49 71 120 690 Total 926 975 1901 196 246 442 2343 Dealing only with these known deaths, it may be stated that the mortality in the male sex was at the rate of 20.4 per 1000, and in the female sex 15.6 per 1000. The mortality in the Town and Brompton Sub-districts respectively, with correction for the deaths in the Workhouse, was 18.3 and 15.3 per 1000. The deaths in the winter quarters exceeded those in the summer quarters by 125. Six hundred and fifty-six children died under one year of age, equal to 15.8 per 1000 registered births, (London 15.9), and to 26.3 per cent. of the total deaths, (London 25.1). Under five years of age there died 979 = 42 per cent, of the total deaths, (London 41.6). These per centages of deaths of children will be slightly different if calculated on the total estimated deaths, viz , 2,436, (vide Table 2, Appendix.) At 60 years of age and upwards there were 564 deaths = 24.4 per cent. of the total mortality, (London 21.9). It need hardly be stated that a low death rate in childhood and at the adult period of life, and a high one in old age, distinguish a healthy population in places where the conditions of life are favourable. The causes of death are recorded in Table 3 in the Appendix in 13 divisions according to age. The ages at death were as follows:— There died under one year of age 656 Between one year and two years 210 „ 2 years and 5 „ 113 ,, 5 „ 15 ,, 98 „ 15 „ 25 „ 90 13 Between 25 years and 35 years 166 „ 35 ,, 45 „ 181 „ 45 „ 55 „ 198 ,, 55 „ 65 „ 179 „ 65 „ 75 ,, 233 ,, 75 „ 85 ,, 179 „ 85 „ 95 „ 38 At 95 „ upwards 2 Total 2343 One alleged centenarian died at the parish Infirmary, a woman. Only one other person died above 95 years of age. In a supplementary Table (3a,) I have shown the quarterly number of deaths at all ages and in each Sub-district, with the view of illustrating the influence of season as a cause of disease and death. Thus it will be seen that nearly all the deaths from Diarrhoea occur in the hot summer months, while the fatality of Chest diseases is greatest in cold weather. DEATHS "NOT CERTIFIED." Twenty-one deaths were "not certified," i. e. the "medical" attendants were unqualified persons, whose certificates, nevertheless, were accepted as evidence of the cause of death. With reference to this subject I may mention that the Bill for Com- ulsory Registration of Births, &c., has been introduced into the House of Commons again this Session, and it is proposed to make it compulsory upon Medical men to give certificates of the cause of death of all persons whom they may attend in their last illness. It is to be hoped that none but qualified practitioners will be permitted to use the official certificate form: and, I am of opinion that the use of it by any other person, whether holding a foreign diploma, or otherwise incapable of registration, should be an offence under the Medical Registration Act, (Sect. 40). Such "medical" certificates are "invalid" and should be made "illegal" also by an amendment of the 37th Section of the same Act. Five persons died without having any medical attendance whatever,—this number is irrespective of cases enquired into in the Coroner's Court. CAUSES OF DEATH. In dealing with the special causes of death, the diseases of the zymotic class first call for notice because of their importance and their more or less preventable character. A large number of diseases is included in this class besides the seven to which attention is more particularly called in the weekly and other 14 returns of the Registrar General. To some of these diseases no deaths were assigned last year, as may be seen by reference to Table 3 in the Appendix. Others require simple enumeration, viz., Croup 20, Want of Breast Milk 3, and Thrush (in infants) 5. Syphilis was returned in 11 cases, 9 of them being under one year of age. The number, probably, is understated, some of the infantile mortality registered under the heads of Atrophy, Premature Birth, &c., being due to this cause. Twenty-four deaths were caused by Erysipelas and Pyœmia. The latter disease does not figure in the Registrar-General's tables. It is a very important disease, and one of the most intractable. At least 10 cases which do not appear to have been connected with childbed, were fatal during the year. PUERPERAL MORTALITY. To all Puerperal or Childbed Diseases and Accidents 29 deaths were traced. I say traced, because sometimes the previous occurrence of parturition is not mentioned in the certificate of the cause of death in these cases. I may add, that my attention having been directed to the prevalence of Puerperal fever especially towards the latter part of the year, I made a special inquiry with the result of discovering several deaths undoubtedly due to this cause, but which had been registered under the vague description of "peritonitis" or "pyœmia," diseases which may and do exist quite independent of the puerperal state. The total number of fatal cases during the year was 23. Of these 14 occurred during the latter half of the year in the Notting Hill District,—all in private practices, for the Poor Law practice appears to have been singularly free from this trouble. In three cases infection as the origin of the disease was suggested by their occurrence within a limited period of preceding cases in the same practices. The first pair of cases was attended by a qualified practitioner, the other two pairs by an unregistered practitioner, and a midwife respectively. The midwife's cases and others of the deaths, I may add, were certified by Medical men, who informed me that they had been called in to see the patients in articulo mortis and were unable to account for the disease. One gentleman, indeed, stated that Erysipelas had been prevalent in his neighbourhood, and that diseases in general had shown a tendency to assume a typhoid form. He added that a former outbreak of Puerperal disease had been synchronous with an epidemic of Scarlet fever. ZYMOTIC DISEASES. The total deaths from all diseases of the "zymotic class," including, according; to the Registrar General's classification, the sub-orders Miasmatic, Enthetic, Dietio, and Parasitic, were 402; 269 having 15 occurred under five years of age. The deaths in the four quarters respectively were 70, 61, 166, and 105. Small-pox was fatal in one case only. Measles killed 38 children, of whom 35 were under 5 years of age. Scarlet Fever and Diphtheria were fatal in 10 and 11 cases respectively. Whooping Cough was the cause of 44 deaths; forty under five years of age. Fever.—The deaths recorded were 41, viz., Typhus 6, Enterio or Typhoid 27, amLsimple continued fever 8. I was unable to trace any cases of Typhoid fever to poisoning by milk. Diarrhœa was returned as the cause of death in 145 cases, or 51 above the (uncorrected) average in 10 years. One hundred and twenty-nine of the victims of this disease were infants under two years of age, 108 being less than a year old. Ten persons were above 65, and six between the ages of 5 and 65. The mortality in the four quarters was as follows:— first quarter 8, second 10, third 114, fourth 13. Twenty-four of the deaths occurred in the Brompton Registration Sub-District and 121 in the Kensington Town District. Diarrhœa, as so often before stated, is a summer and hot weather disease, and its victims are for the most part the neglected infants of the lower classes of the population. Constitutional Diseases, including the orders Diathetic and Tubercular, were returned in 468 cases; 115 under five years of age. The only disease of the first order calling for special notice is Cancer, which was fatal in 60 cases, of which 53 occurred between 35 and 85 years of age. The Tubercular diseases were fatal in 393 cases; 114 under five years of age. Scrofula was returned in 16 cases; Tabes mesenterica in 32 cases; Phthisis (consumption) in 284 cases; Hydrocephalus (water on the brain) and Tubercular meningitis in 61 cases. The quarterly mortality from these diseases was as follows:— first quarter 107, second 108, third 82, fourth 96. Local Diseases were returned as the causes of death in 1074 cases, 347 under five years of age. Diseases of the Nervous system were fatal in 261 instances,— including Apoplexy 69 (59 over 45 years of age), and Paralysis 51 (47 over 45 years of age). Epilepsy was fatal in 9 cases. "Brain disease" (so returned) in 41 cases, and Convulsions in 77 cases, all under five years of age, including 57 in the first year of life and 15 in the second. There is not a little difficulty, often, as to which of several assigned causes of death should be entered in Table 3 : and in no cases is this difficulty greater than with regard to the Diseases of Children such as Atrophy, Debility, Hydrocephalus, Teething, and Convulsions. Convulsions is returned, singly, in a very large number of cases: but it appears in combination with the other diseases named in an even larger number as a sequence of wasting diseases (tubercular), teething, hydrocephalus, &c. I regard the "fit" in such cases as a symptom of disease, and enter the death under the head of the primary disease. In Table 4 (Appendix) an attempt has been made to group the 16 more important infantile diseases so as to show their relative fatality— for there can be no doubt that the causes of death as returned are in many instances unsatisfactory because indefinite. Organs of Circulation.—The diseases of these organs are not very prevalent in the young. Of 150 deaths only seven occurred under five years of age. Seven each are ascribed to Pericarditis and to Aneurism. One hundred and thirty-six to "Heart disease" Eightyeight of the deaths took place in the two winter quarters. Respiratory Organs. — The diseases of these organs are most prevalent and fatal during the winter, and this is especially the case in old people, who are the principal sufferers from Bronchitis and Asthma. Bronchitis and Pneumonia are also very common and fatal diseases in infancy. The total deaths recorded in this group were 483 (222 under five years of age), viz., Laryngitis 12, Bronchitis 270, Pleurisy 8, Pneumonia 132, Asthma 22, and "Lung disease" 39. Of the Bronchitis cases 118 took place under five years of age, 84 at less than a year old, 123 at ages above 55. Pneumonia was fatal to 85 children under five, and to 15 persons above 55. The deaths in the two winter quarters were 338, in the two summer quarters 145. Diseases of the Digestive Organs were fatal in 102 cases, 21 under five years of age. The principal diseases were Enteritis 18, Peritonitis 16, "Liver disease" 28. Diseases of the Urinary Organs were fatal in 54 cases,mostly towards the latter period of life. "Kidney disease" was returned in 15 cases, and Bright's disease (Nephria) in 30 cases, probably an understatement of the actual number of deaths due to this insidious malady. Diseases of the Organs of Generation—Eight deaths were returned, viz., Ovarian Dropsy 6, "Uterus disease," &c., 2; irrespective of Cancerous affections of these organs. Diseases of the Organs of Locomotion were returned in two cases only, and Diseases of the Integumentary System in 12, viz., Phlegmon (abscess) 9, and Ulcer 3. The fourth great class of diseases, viz., the Developmental included 306 deaths, 217 under 5 years of age. The Diseases of Children (as returned) were 77, viz., Premature birth 42, all at a very early period of life; Teething 28, Malformation 7. Diseases of Adults include 12 returned as Childbirth. Deaths from Childbirth simply are due to the accidents of the puerperal state, as flooding, injuries, &c., and are quite distinct from puerperal fever and its congeners. Diseases of Old People (so called) include "Old Age" only, 76 deaths returned, 11 between 65 and 75; 46 between 75 and 85; 17 between 85 and 95; and two upwards of 95. One alleged centenarian died in the parish infirmary. Diseases of Nutrition viz., Atrophy and Debility caused 141 deaths, all but one under five years of age, 132 being in the first year of life. 17 Violent Deaths (59) are divided into 4 orders, viz., 1—Accident or Negligence, 48; 2—Homicide, 1; 3—Suicide, 10; 4—Execution, 0. The deaths registered from accident or negligence were Fractures and Contusions 23; Suffocation 16, (12 being infants); Burns and Scalds 5 ; Wounds and Drowning one each ; "Otherwise" 2. One case of manslaughter (between 1 and 2 years of age) was recorded; and 10 Suicidal deaths, viz., by wounds and poison, 3 each, and by drowning and hanging, 2 each. Causes not specified, or ill-defined. Thirty-four such deaths were registered during the year, including eleven of children under five years of age. DEATHS IN PUBLIC INSTITUTIONS. The "public institutions" of the Registrar General are two, viz., the parish Workhouse and the Hospital at Brompton for Diseases of the Chest. At the Workhouse, which is situated in the Town District, there were 176 deaths, 95 males and 81 females. Eighteen occurred under one year of age, three between 1 and 5 years, three between 5 and 20, 71 between 20 and 60, and 79 at 60 years and upwards. One death was recorded at the reputed age of 100 years. The causes of death were as follow:— Zymotic diseases 5 Diseases of the Nervous System 31 ,, Pulmonary System and Heart 42 Other Visceral Diseases 9 Tubercular, (Scrofulous) Diseases, including Phthisis 39 Atrophy of Children 12 Premature birth, &c. 6 Cancer 7 Violence 3 Old age 5 Parturition 1, Syphilis 1 2 Various 15 Total 176 At the Consumption Hospital 96 persons died (including a child newly bom in the institution). Of these 55 were males and 41 females. Only three including the child properly belong to the parish, while nearly 40 of the deceased came from the Country. St. Joseph's Home, a charitable institution of the Roman Catholics, in Portobello Road, Notting Hill, is not classed as a public institution, but contains some 220 poor persons of both sexes drawn from all parts, of whom 29 died last year. b b 18 INQUESTS. One hundred and eighty-one deaths were registered upon the Coroner's information. The inquests were held in 98 cases on account of the suddenness of the death, and in 47 cases because the deceased had been "found dead" in bed or otherwise. The violent deaths were 49, among which thirty were classed by verdict as accidental, ten as suicidal, and one as manslaughter. Ninety-one inquests were held on very young children,—with few exceptions infants, seven being described as "newly born." In 25 cases the age exceeded 60 years. The cause of death was ascertained bv post mortem examination in 140 cases. The causes of death are subjoined:— Diseases of the Brain and Nervous System 39 „ ,, Heart, Lungs, &c. 70 ,, other internal organs 4 Scrofulous Diseases 3 Exposure, want of proper food 2 Various—indefinite 14 Violence 49 181 The violent deaths may be thus classified:— Burns and Scalds 3 Hanging 4 Drowning 1 Poison 3 Wounds 4 Falls 9 Suffocation, Choking, &c. 15 Run over 4 Accidentally buried in a grave 1 Manslaughter 1 Indefinite 4 49 In addition to the above, two deaths were registered from burns and scalds, and one from injury to hand. One woman was stated to have died from privation. METEOROLOGY. The mean temperature of the air at Greenwich during the year was 49°.1F., the average of 34 years being 49°.3. The averages of the four quarters in 1873 were 39°.5, 51°.5, 60°.6, and 47°.8. The hottest week was that ended on the 26th July, mean temperature 680.8, and the coldest week was that ended on the 19 8th February, mean temperature 32°.9. The highest reading of the thermometer was on the 26th July, 87°.F., and the lowest on the 15th February, 28°.F. The dryness of atmosphere (i.e. the difference between the dew point temperature and air temperature) was 5.4 (average in 33 years 5°.6). The rain-fall was 23.4 inches. VACCINATION. Table 9 (Appendix) shows the state of Infant Vaccination during the year, and presents, as usual, results very creditable to the Vaccination Officer, Mr. Shattock (to whom I am indebted for the returns,) only about 6 per cent. of Registered Births being unaccounted for, and that owing to causes beyond the Vaccination Officer's control. SANITARY WORK. Table 6 in the Appendix is a compendious statement of the principal Sanitary Work performed during the year ended 25th March, 1874. From this it will appear that 1467 complaints have been received and entered in the Complaint Book during the year, viz.:— 790 in the North District, and 677 in the South District. In the great majority of cases the complaints arose out of inspections. Nine thousand four hundred and seven houses and premises have been inspected, viz.:—4137 in the North and 5270 in the South. One thousand four hundred and thirty six orders have been issued for Sanitary amendments of houses and premises, viz.:— 773 in the North and 663 in the South. Houses, premises, &c., have been cleansed, repaired and white-washed, to the number of 897, viz. :—507 in the North, and 390 in the South. Twenty seven houses have been disinfected by order and under supervision after infectious diseases, viz. :—15 in the North, and 12 in the South. House drains have been repaired, cleansed, &c., in 467 cases, viz. :—211 in the North, and 256 in the South, and trapped or ventilated in 79 and 56 instances in the two districts respectively. Privies and water closets have been repaired, cleansed, or supplied with water, in 317 houses, viz.:—143 in the North, and 174 in the South: the number of new water closets provided in the two districts respectively being one and four. Thirty new dust-bins have been provided in the North, and 13 in the South, while old ones have been repaired, covered, &c., to the number of 15 and 9 in the several districts. With reference to the column for the "number of Lodging houses registered under the 35th Clause of the "Sanitary Act, 1866," I have only to state that your Vestry have not put the Act in force. bb 2 20 DUST REMOVAL. The supervision of the contracts for the removal of dust and ashes has taken up a large amount of valuable time as usual. The communications received and attended to during the year amounted to upwards of two thousand, and the notices issued to the contractors during 8 months, to March, 187), were 1031, viz.:—419 in the North District, and 612 in the South. One of the contractors was fined for neglect of duty in certain proved cases, but not heavily. It would be to the public advantage if those persons who make an improper use of their dust receptacles, or who refuse to have the contents of them removed, were also subject to some penalty. As I have so frequently pointed out the dust itself is not a nuisance in a Sanitary sense. It is the decomposing animal and vegetable matter deposited in the bins that is the cause of offence Occasionally the inspectors find the most serious nuisances arising from the presence of grease, pot liquor, bones, meat, &c , and in summer weather, too, when little dust is made. Naturally the greater the nuisance the more urgent the complaint, the more instant the demand for removal. It is only just in referring to this matter to mention that in many of these cases the greatest offenders are those who complain of the Vestry's "neglect." The moment the hot weather sets in, we are inundated with complaints which prove at once the contractor's negligence, and that the receptacles are used for purposes for which they were never intended, and for which their position, in a majority of cases, unfits them, if there were no other objection. But to continue. Accumulations of dung, stagnant water, animal and other refuse have been removed upon 79 occasions, viz:—48 in the North, and 31 in the South. With reference to this subject I am of opinion that in many parts of the parish the dung in mews, &c., is not removed so often or so regularly as might be desired, and that the regulations issued by your Yestry should be conspicuously and permanently exhibited in mews, and enforced. Under the head of "animals improperly kept and removed," I need hardly say that the principal work has been, as usual, in the Potteries, the "animals" dealt with being pigs. A great number have been "removed;" but very often only to be succeeded by others Nevertheless the number of places in which pigs are kept, and the number of pigs is greatly diminished; so that, in fact, the principal complainants are those persons who having got rid of their pigs, and abolished the styes, feel aggrieved that their neighbours are not more vigorously pursued. The fault does not rest with my department, but is due rather to the defects of the law. Legal proceedings in this and other matters were undertaken in the Police Court, in 61 cases (48 of them being in the North District) and with uniform success, but often with the loss of much valuable time. 21 THE LAWS DELAYS. A more summary method of procedure is eminently needed in sanitary cases No proceedings can be initiated until they have been authorised by the Local authority. Summonses are never made returnable in less than a week after being granted, however dangerous to health the nuisance may be. An unreasonable amount of time is generally allowed for the abatement of nuisances, even in cases capable of immediate remedy. Difficulties are sometimes experienced in serving notices upon the proper parties, and if a defendant proves recalcitrant, the same weary round of proceedings may have to be re-commenced. And suppose cumulative penalties are incurred by default, the Magistrates rarely inflict more than a nominal fine. In no case can they be induced to inflict the diurnal penalty unless proof is forthcoming by daily inspection of the continuance of the nuisance, although it is often most difficult to obtain entrance on the premises in such cases, and although at intervals, when entrance is obtained, the nuisance is found to be unabated. The country is not yet in earnest about Sanitary Reform, or such a state of things would not be tolerated by which a penurious owner of property may expose the lives of his tenants to grave danger, and materially interfere with their comfort and convenience for long periods, if not with entire impunity, at least at the risk of a mere nominal fine. LICENSED SLAUGHTER HOUSES. The Licensed Slaughter Houses are 54 in number, viz., 32 in the North Sanitary District and 22 in the South. They have been inspected as regularly as circumstances would allow. As usual, at the annual inspection in the month of September, I found the drainage of very many in an unsatisfactory condition. There were other sanitary defects also in a considerable number—recurring defects which year after year have been made the subject of report. From the fact that few if any of the Slaughter Houses have been specially constructed, the general unsuitability and deficiencies of the premises need not excite surprise: but considering the powers lodged in the hands of the Local Authority to oppose the renewal of Licenses, and the value which the butchers appear to attach to the Slaughter Houses, it is remarkable that more attention is not bestowed upon their condition. By direction of your Vestry the renewal of the license was opposed in nearly half the applications pending the completion of sanitary amendments for which orders had been issued. Three Licenses were refused altogether, viz.:—one in the Brompton Road, for premises which were simply an underground cellar, stable, kennel, and sausage manufactory combined; one in Talbot Mews, which was in the occupation of a draper, who was 22 not "a slaughterer of cattle or sheep," and therefore not a fit person to be entrusted with a license; and one in Lancaster Road, the holder choosing rather to relinquish the license than to carry out the necessary alterations for excluding a W.C. from the slaughter house. In a special report, in September last, I entered somewhat fully into the subject of the Slaughter Houses. I do not feel, therefore, that it is necessary to refer in any detail to the subject now. But I may remind you that in August next, the thirty years' grace given by the Building Act of 1844, will expire, and nearly all the Slaughter Houses will be closed unless they should be continued, permanently or temporarily, by express legislation. In the Report already mentioned, I alluded to the enquiry by the Select Committee of the House of Commons on "Noxious Businesses" (1873), and quoted the recommendations of the Committee in favour of the present system of private Slaughter Houses under "precise uniform and stringent regulations." The Secretary of State for the Home Department has recently announced in Parliament, that the Government intend to legislate on the subject this session, and, "speaking generally only" in the direction suggested by the Committee's Report, I regard this as a matter for regret. My own views are favorable to the abolition of private Slaughter Houses, and the substitution of a sufficient number of local public abbattoirs to supplement the larger establishments, which should be found near the markets. SLAUGHTER HOUSES, &c., (Metropolis) BILL, 1874 * This Bill, distributed to Members of Parliament, and read a second time, on the 3rd of July, 1874, excited no less surprise by its provisions than by the extraordinary rapidity with which its various stages were accomplished in the House of Commons—the only tribunal, where, under more favourable circumstances, it would have had a chance of rejection or of radical improvement. In saying this, I would not derogate from the credit due to the House of Lords for amendments which, at the urgent solicitation of myself and others, were moved and adopted. But to this I shall refer again. At present I cannot, perhaps, do better than quote a Report I addressed to your Vestry through your Law and Parliamentary Committee, briefly explaining the Bill as it first appeared in the House of Commons. "Slaughter Houses, &c., (Metropolis) Bill, 1874. 10th July, 1874.—The Medical Officer of Health attended the Law and Parliamentary Committee at the request of the Works, Sanitary, and General Purposes Committee with reference to the above Bill. * This section of the report was not written until after the preceding one was in type. 23 He stated that by the 13th section the 55th and 56th sections of the Building Act, 1844, were repealed so far as relates to the several businesses of a soap boiler, tallow melter, slaughterer of cattle, and other "noxious" businesses; that by section 2, the businesses of a soap boiler, tallow melter, and knacker, could not be established anew in the Metropolis, but that all existing businesses might continue, and that by section 12, an old business would not be deemed to be established anew unless the premises, on which it is carried on, are enlarged by more than one-half of their original extent in area. By section 3, the businesses of fellmonger, tripe boiler, or slaughterer of cattle, could not be established anew in the Metropolis without the sanction of the Local Authority, to wit, the Commissioners of Sewers for the City and the Metropolitan Board of Works for the rest of the Metropolis, but all existing businesses may be continued subject to Bye-laws to be framed by the Local Authority, within four months after the passing of the Act, and confirmed by the Local Government Board. The Local Government Board may frame Bye-laws if the Local Authority fail to do so. No Bye-law can be confirmed or take effect till after public notice of it, by advertisement, &c., in newspapers. The contemplated Bye-laws are for regulating the conduct of the business, and no provision appears to be made to ensure that the premises are suitably placed or suitably constructed. It is open to the Vestries, however, to oppose before the Justices the renewal of the license of any place that they may deem unfit for the business, viz., under the 93rd section of the Metropolis Management Act, 1862. Penalties are imposed for any breach of the prohibitory sections 2 and 3, and for breaches of the Bye-laws; and offences and penalties under the Bill or any Bye-law may be prosecuted and recovered before a Court of Summary Jurisdiction, in manner provided by the Summary Jurisdiction Act, i.e. any person may prosecute at his own risk, but no public prosecutor is appointed by the Bill. The Medical Officer of Health further stated that the effect of the Bill, if passed by the House of Lords, (for it had gone through all its stages in the Lower House) would be to perpetuate Tucker's Candle Factory with power to enlarge the premises to the extent of one-half beyond the existing area ; and that all the existing Slaughter houses in the Parish would be continued subject to the renewal of licenses; any new businesses that the Local Authority might sanction would still require to be licensed by the Justices. Thus the legislation of 1844 was repealed, and after 30 years' grace and a full expectation that they would have to close their premises in 1874, the proprietors of noxious businesses like soap boilers and tallow melters, found themselves in posession of a monopoly of trade that would add materially to their value. The Bill had taken all parties interested in sanitary affairs entirely by surprise. The outcome of the report 24 of the Select Committee of the House of Commons, 1873, on noxious businesses it even went beyond that report—whose recommendations were considered by far too lenient to the trades interested; and did not adopt the very moderate suggestions of the Committee for the protection of the Public Health. The measure, moreover, had been "hurried through the House at such a rate, that there had been no time to oppose it; and no one appeared to be acquainted, beforehand, with its provisions, excepting those interested in the affected trades, to whom alone it could be deemed acceptable. The Bill was ordered to be printed on the 15th June. It was read a second time on the 3rd July, but copies of it were not procurable by the public authorities or by private individuals until Monday, the 6th. It passed through Committee, apparently without opposition or comment, on the 7th, and had been read a third time and passed on that day (the 10th). The Medical Officer of Health informed your Committee that the Society of Medical Officers of Health had considered the measure, and had seen the Under Secretary of State, Sir H. Selwin-Ibbetson thereon, and that, finding there was no hope of the Government adopting their suggestion of withdrawing the Bill and passing a continuing Act for one year, with a view to deliberate legislation in 1875, they had proposed certain amendments, which Sir H. SelwinIbbetson had promised to take into consideration." The Chairman of your Law and Parliamentary Committee, upon the reading of the above report at the meeting of your Vestry, held July 22nd, moved that a petition be presented against the Bill, and this step was carried out on the following day at an adjourned meeting. The Chairman and several other Members of your Vestry accompanied by your clerk and myself, waited upon Lord Lawrence at the House of Lords the same day, and obtained his Lordship's consent to present the petition. We also addressed ourselves to other Peers with a view to amendments in the Bill —for it was hopeless to attempt to throw it out. Your clerk and myself had interviews subsequently with the Earl of Airlie and Lord Lawrcnce, and I had a correspondence with the Earl of Beauchamp, (the Lord Steward) who had charge of the Bill, the ultimate effect being to obtain some useful amendments, viz.:— Clause 2 was enlarged by including in the list of businesses, absolutely prohibited to be established anew, the several businesses of Blood Boiler, Bone Boiler, and Manufacturer of Manure. Clause 3 was also enlarged by adding to the list of businesses that may not be established anew without the sanction of the Local Authority, (all existing businesses to be made subject to Bye-laws) the following words:— "Any other business which the Local Authority may, with the sanction of the Local Government Board, declare by order published in the London Gazette, to be an offensive business." 25 The Earl of Beauchamp expressed to me Lis willingness not to oppose an amendment I suggested in the same clause, viz., that before the Local Authority gave their consent to the establishment anew of any of the businesses, notice should be given to the Vestry, &c., of the parish, &c., in which the premises are situated: and to the inhabitants in the locality, by a notice affixed to the premises : such local notice to be similarly affixed some days before the time appointed for the renewal of annual licenses in the case of Slaughter Houses. This amendment, Lord Beauchamp informed me subsequently, had been adopted. Clause 4 was much improved by power being given to the Local Authority to make Bye-laws, not merely for "regulating the conduct" of the specified businesses, but also "the structure of the premises on which such business is being carried on." A new Clause (10) was added to this Bill before it left the Commons, requiring the Justices to grant a first License for a Slaughter House as a matter of course to any premises "sanctioned" by the Local Authority and requiring, among other things, that 14 days' previous notice should be given to the Local Authority of the intention to apply for the renewal of a License, and a seven days' notice to the Licensee by the Vestry of their intention to oppose the renewal of a License. Clause 13 underwent improvement by a proviso that a business should be deemed to be "established anew" if the premises on which it is for the time being carried on, should be "enlarged without the sanction of the Local Authority." By the terms of the Clause, as originally printed, premises might have been enlarged by fifty per cent. at the discretion of the proprietor, without involving the "establishing anew" of the business. The Bill, with all these amendments, is by no means a satisfactory measure, but may be made useful for effecting improvements in the Slaughter Houses. It is a retrograde and disappointing measure at the best, and the utmost praise that can be awarded to it, is that of Earl Beauchamp, who stated in the House of Lords that "the Bill had been approved by the trades which would be affected by it"—trades, that is, which would have been abolished by the Act of 1844, but which this Act will perpetuate. The measure, however, has been made as little injurious as possible by great and sustained efforts, among which may be included the publication of a letter explanatory of the subject, and a history of the Bill which I drew up, and which, through the public spirited liberality of Mr. William Banting, was sent to the Peers, to a large number of the Members of the Lower House, and to the Press. In quitting the subject, I have the satisfaction of feeling that the Authorities of this Parish have done their duty, and that a bad Bill has been squeezed through Parliament in July, in spite of their utmost 26 opposition. I will only add, that having paid special attention to the subject, I shall continue to use my utmost exertions to minimize the evils of the Act by securing, so far as I am able, the adoption of an efficient code of Bye-laws. LICENSED COW SHEDS. The Licensed Cow Sheds are 36 in number, viz., 18 in the North Sanitary District, and 18 in the South. These premises have been duly inspected. The cow sheds differ widely in respect of size and suitability. A few of them are good, but the majority are small and defective. Several are stables with inhabited rooms over them, and therefore, in my judgment, unfit for the purpose, because they cannot be properly ventilated. At my suggestion and upon the recommendation of the Sanitary Committee, your Vestry resolved to oppose new applications for licences for such buildings. I believe this decision to be eminently proper. The ventilation of a cow-shed cannot be too perfect if the cows are to be kept in good health, and capable of giving milk fit for food. It must be remembered that, as a rule, they are constantly in the shed. They get no change of air, and the value of their secretion depends on the state of their health. Some dairymen would keep the sheds close and hot, because they find by experience that the cows under those circumstances yield a larger quantity of milk—as much as from 24 to 29 quarts per cow daily. It need hardly be said that the milk yielded under such circumstances, though "genuine" cannot be rich; and as the price of milk has lately been enhanced 25 per cent., it is not unreasonable to insist upon conditions necessary to ensure the health of the cows, and such as are recognised and practised in some of our largest and best dairies. Several prosecutions for keeping cows without licenses were undertaken by order of your Vestry, and convictions obtained. One cowkeeper who failed to comply with the orders issued for the reparation of his premises, and for the provision of a proper water supply, and whose license was temporarily withheld, was fined in the sum of Five pounds, for keeping cows without a license. In several of the cow-sheds the water supply was formerly obtained from shallow wells. With two or three exceptions, I succeeded in getting the pumps removed upon the ground of the danger of using, in a dairy, Well-water which is liable to be contaminated by sewage; and in the excepted cases the Bench gave the licensees to understand that if they used the well-water for any dairy purpose their licenses would not be renewed. The danger of the admixture of impure water, in any quantity, with milk was forcibly illustrated by the outbreak of typhoid fever in Marylebone, to which public attention was drawn a few months ago. With reference 27 to that outbreak I may state that I failed to trace any connection between fever and the milk supply in this parish, THE BAKEHOUSES Have been systematically inspected, and the provisions of the Act relating thereto duly carried out. There are 108 bakehouses in the parish, viz., 60 in the North .District, and 48 in the South. OFFENSIVE TRADES. Trades, that is, in which nuisances may be created; such as marine store shops, greengrocers, fried fish shops, &c., have been, to a certain extent, inspected during the year. UNSOUND MEAT. A large seizure of "American bacon and pork," amounting to 182 lbs in weight, was made at a cheesemongers shop, at Notting Hill,in the month of March. The magistrate who condemned the meat, passed severe and well-deserved strictures upon the conduct, not so much of the retailer as of the wholesale dealer and his agent. It should, however, have been obvious to the retailer that sound food could not be had at the low price paid for this parcel. Understanding that a similar class of food was being sold in two adjoining parishes, I put myself in communication with the respective Medical Officers of Health, as well as with the Medical Officer of the parish in which the wholesale dealer carried on his business. No other actual seizure of food was made; but in numerous cases poor purchasers of indifferent meat and fish, tainted or stale, have been assisted by the inspectors in the recovery of their expenditure. COMPLAINT AGAINST THE GAS COMPANY. For many years complaints have been made from time to time by inhabitants in the Northern parts of the parish of offensive smells like "gas" both in their houses and in the streets. 1 hese smells, there could be no doubt, arose from some refuse products of gas-making, which, proceeding from the works at Kensal New Town, by way of the open ditches at Salter's Farm, entered the sewer in Aldermaston Street. Fresh complaints having been made, communications were addressed to the Secretary of the Company, who admitted the nuisance and announced their intention of abating it forthwith. To this end they set about the formation of new drains so as to divert their drainage from the Counter's Creek sewer into the middle level sewer. We were after a time informed that the nuisance had been abated, and yet the inhabitants continued to complain, and not without reason. Legal proceedings were 28 Commenced against the Company, and two months time was given them to abate the nuisance. After an inspection of the premises by myself, your clerk, and Inspector Langman, it was resolved by the engineer of the Company to carry the new sewer right through the works, so as to completely intercept the drainage, especially from that part of the premises from which the offending material appeared to be derived. In making the excavation for this further length of sewer, the cause of the nuisance was discovered and removed. No complaint has been made since, and I am sanguine that no further cause of complaint will arise. The nuisance proved to be due to the escape, into an old brick drain, of gas tar with which the ground all round the drain for a considerable distance was saturated in consequence of the tar (a "waste product") having been allowed in the early days of the old Company, as I was informed, to run away on the depressed surface of the premises. In a cutting some 16 feet deep, long after the new drains were completed, I myself saw tbis treaclylooking stuff oozing out of the ground. It is hardly necessary to say that gas tar and the other products of gas manufacture are too valuable to be wasted now-a-days. The Company must, I think, be acquitted of any intentional offence in this matter. There is reasonable ground to believe that they were as ignorant as ourselves of the origin of the nuisance, which doubtless would have been in existence still but for the proceedings taken by your Vestry, which led to the construction of the new drain, and the consequent discovery of the origin of the mischief. The annoyance to the inhabitants was intermittent, probably because in dry weather there would be only a trifling escape of the offensive stuff into the drains, whereas it would pass freely in a state of solution after rain. The new drain, I may add, has been left open at various points to facilitate inspection. DISINFECTION OF CLOTHING, &c. In consequence of the comparatively small amount of fever, small pox, &c., not many articles have been sent for disinfection. The work is still done at a private establishment at Notting Hill, no steps having been taken with a view to provide a public disinfecting chamber. Plenty of useful work might be found for a chamber, even in the absence of epidemics, if it were only for the purpose of purifying the beds of the poor, which are often found in a dirty and unwholesome state, injurious to health, from long usage and neglect. MORTUARY. The parish is still without a Mortuary. It is difficult to form an opinion to what extent a mortuary would be used if provided; but as we know that several hundred poor persons are buried 29 every year at the cost of the public, and that in many if not the majority of these cases the corpse remains in the single room occupied by the living members of the family; there can be no doubt that great use ought to be made of it, and if a suitable building were erected on a convenient site, I cannot think it would remain unused. The law might reasonably, upon Sanitary grounds, require the removal of the dead to a mortuary, when the living would otherwise, occupy the same room with the corpse; and especially in a country like this, where the custom is to keep the dead unburied for many days. Several Metropolitan parishes are now provided with mortuaries, and the number is on the increase. Kensington, I trust, will not be last in this matter. A difficulty has been raised about a site; but I venture to believe that if the erection of a mortuary were resolved upon, the site would be forthcoming. I have always urged that one site would suffice for both mortuary and disinfecting chamber—a plan that would be economical in management. A room for holding inquests and accommodation for post mortem examinations should be added. A considerable outlay would be required, but one that this rich and populous parish could well bear. Were the Mortuary alone in question it might be placed in the disused parish Churchyard, which could not be turned into any use more beneficial to the living or more reverent to the dead. There are two Cemeteries in the parish—at Brompton and Kensal Green—where possibly accommodation might be obtained but that the parish possesses a Cemetery of its own at Hanwell where the poor are interred. Let us hope that the difficulties may be overcome, and Mortuary and Disinfecting chamber provided, before the Law steps in and makes them compulsory ! JENNINGS' BUILDINGS. In my last Annual Report I had the satisfaction of stating that the populous locality known by the name of Jennings' Buildings was in course of demolition. The work has been completed, and the place is now a thing of the past. It may not be uninteresting to state that this cul de sac, which comprised five divisions known as Tavern Yard, New Court, Palace Place, Cooper's Gardens, and Jennings' Buildings proper, contained a population at the census, 1871, of 876 souls inhabiting 83 houses, many of them sadly defective in construction, dilapidated, and otherwise inconvenient and overcrowded. A dood deal of consideration was shown to the inhabitants by the purchaser, pecuniary compensation being given to every tenant, besides the privilege of removing "firewood" from their doomed dwellings, which, under this grant, were very soon gutted—I might say wrecked. Had not a stop been put to the proceedings, Jennings' 30 Buildings would have been carried away bodily. Having entered into a somewhat full history of the vital statistics of the place in my April report, I need say little here except that the deaths in 1872 were 29 in number = 33 per 1000 (rate in the whole Parish 17 per 1000). Fifteen children died under five years of age, and nine persons at ages above sixty. Two deaths were due to Measles, the only fatal disease of the Zymotic class. On five of the deceased, inquests were held—all deaths from disease. As might be expected, Tubercular diseases were rife, and were fatal in ten cases. The demolition of this place relieves the Sanitary Inspector of a considerable source of work and trouble, and myself of not a little anxiety; for such a crowded population wedged into the centre of the High Street, must always have been a source of danger. Your Vestry, however, did what was possible to reduce to a minimum any danger that might arise. The roadways were specially and frequently cleansed and flushed, as well as the water closets, which for the most part were "public." The difficulty was to get the inhabitants to use them as ordinary persons would. As for "fittings," it would have been absurd to provide them; the experiment had often been tried, but as fast as they were put up they were looted. The water supply was abundant, being obtained from a large common cistern. Altogether the "Buildings" were well looked after, and if they were objectionable, it was by reason both of the bad class of houses, for which the present generation is not responsible, and the habits of the people who inhabited them, and for whose moral and physical improvement great philanthropic efforts were made by numerous benevolent persons of various religious persuasions. SANITARY NOTICE. A Sanitary notice, with respect to the use of dust bins, and the condition of water cisterns, &c., was issued to every householder in the month of May. It is reproduced in the Appendix. SEWER VENTILATION. The usual crop of complaints of bad smells proceeding from the sewer ventilators have been received, and each case dealt with, as far as possible, to the satisfaction of the complaining parties. Numerous letters, &c., came to hand with respect to the main sewer in Neville Terrace belonging to the Metropolitan Board of Works. With respect to this; and with respect also to a side entrance into the sewer in Pembridge Square, I placed myself in communication with the Engineer to the Board, who took steps for the immediate removal of the ground of complaint. 31 SANITARY INSPECTION OF NEW HOUSES. The necessity of sanitary inspection of new houses before occupation, was strikingly illustrated by a case that came under my notice in the month of September. A gentleman who occupied a newly-built residence, complained of constant bad smells, the origin of which baffled research for some little time. At last it was discovered that the plumbers in putting up the best W.C., had carried a lead pipe from the soil pipe, below the D trap, into the tray which is usually provided to receive any trifling overflow. This pipe was completely open, and admitted the foul smells from the soil pipe, the drains generally, and the main sewer into the house. It is simply marvellous that this extraordinary arrangement did not cause serious illness—it might have been, and in some seasons probably would have been, the cause of fatal disease. It is sad to contemplate the amount of preventible illness that arises from mere structural defects in our houses, and which, as regards new houses, might be prevented if they were not suffered to be inhabited until certified by competent authority to be in a fit condition. ARTIZANS' & LABOURERS' DWELLINGS ACT, 1868. Having inspected certain houses in Thomas Street and Thomas Mews, the Potteries, Notting-dale, and finding them unfit for human habitation, by reason of their dilapidated, dirty and generally unwholesome condition, I gave a certificate to that effect to your Clerk pursuant to the provisions of the above named Act. One or two of the said houses remain in the same condition: others have been repaired or pulled down. Many of the houses in the locality are miserable places, badly constructed, incapable of being made decently habitable, and might with advantage be dealt with under the Act. BATH CHAIRS. The use of Bath Chairs on the foot-ways being illegal, it was formerly the custom to take proceedings against offending wheelchairmen. The hardship of compelling invalids to ride in the roadway having been taken into consideration, your Vestry passed a resolution to the effect that the Inspectors were "not to interfere with invalids, certified as such by me, using Bath Chairs when such did not cause any obstruction or inconvenience to foot passengers." A considerable number of persons have applied to me for the quasi permission to use their chairs on the foot-ways implied in the above extract from the resolution passed on the 22nd November, 1872, and it has been given in each case when accompanied by a Certificate from the medical attendant of the applicant. The effect of the resolution however, has been wider than expected, for no 32 ceedings have been taken against any person drawing a Bath Chair on the footway, the use of the vehicle being taken to imply an invalid condition of its occupant. The Police proceeded against one gentleman who had my certificate, but your clerk by your direction attended before the Magistrate at the Police Court and explained the circumstances, with the effect of obtaining the dismissal of the summons. This happened in the month of November. No similar proceedings have been instituted up to the present time. WATER SUPPLY. It was anticipated that long before the present time the constant service system would have been generally introduced; but by far the greater part of London is still dependent for its water upon an intermittent supply. In this Parish few houses have a constant supply; and, in all London, only about one tenth of the houses aro so served, and this to a large extent by means of standpipes. The general introduction of the system of constant supply is retarded, almost prohibited, indeed, by the excessive costliness and stringency of the regulations framed by the Water Companies, and approved by the Secretary of State, which must be complied with before the Companies will give a constant service. But for these regulations, the general introduction of the constant supply might be looked forward to at no distant date, for there are now about 650 miles of mains constantly charged—upwards of a fourth of the total length. It is from these mains, and by the use of water-waste preventers, that so many poor houses in courts, &c., at the East End are now supplied. With reference to the quality of the water in this Parish, Dr. Frankland, F.R.S., reports that the water supplied by the West Middlesex Company was clear upon all occasions when examined during the past year; and, upon no occasion, were "living organisms" found in it. The Chelsea Company's water was "slightly turbid" twice, "turbid" once, and contained "living organisms" at two out of twelve examinations. The Grand Junction Company's water was slightly turbid and contained living organisms on three occasions; the examinations in the case of each water being made monthly. The turbidity of the water is due to suspended matters, and occurs especially at flood times; and, when it occurs, the suspended matters are found almost invariably to contain large numbers of "living and moving organisms." The clearness bf the water supplied by the West Middlesex Company is due to efficient filtration. The Company possess large intake reservoirs, and, thus being able to store an ample supply of water, they are independent of floods. The proportion of organic elements in the water supplied by the several Companies is given by Dr. Frankland as below, the very 33 pure water of the Kent Company, derived from the chalk, being taken as unity. Maximum. Minimum. Average. Kent 1. 1. 1. West Middlesex 7.4 2.0 3.5 Grand Junction 8.5 1.8 3.8 Chelsea 8.1 2.1 4.0 Dr. Frankland states that the Thames, at its chief sources, is as free from organic pollution as the deep well water from the chalk, but on its way to the intakes of the Companies it is largely contaminated by sewage and the drainage from fields dressed with animal manure, and this especially in the winter months. With regard to the pollution due to sewage that may be expected to decline from year to year, as the Thames Conservancy Commissioners interfere to prevent Towns from making use of the river for draining purposes; the other kind of pollution will necessarily be always present. The hardness of Thames water last year was 21 degrees or parts in 100,000, that is to say it contained 21 parts by weight of carbonate of lime, or other equivalent soap-destroying substances in 100,000 parts of water. "The use of these waters (i.e. of the Thames and the Lea) for washing, entails a yearly loss of vast quantities of soap or soda necessary to soften them before they can be used, but any of them could be softened to nearly the necessary extent by the use of lime an operation Avhich is employed at Aylesbury, Canterbury, Caterham, and Tring, to soften similar waters before they are distributed to the public." The temperature of the water varied from 36°1 Fahrenheit, in February, to 70°3 in July—a range of 34°3, whereas the range of the deep well water of the' Kent Company, was only 4°3 F., viz. from 53°8 to 58°1. Practically this latter water is unaffected by variation of season, a point of no mean importance, as the water is less liable to freeze in winter and does not attain an unpleasant temperature or mawkish taste in summer. It is worthy of notice that Diarrhoea —essentially a summer disease—becomes fatally prevalent in London when the Thames water reaches a temperature of 60°.8 F. Water may become a cause of disease in two ways, which cannot be too often mentioned, namely: 1, by retention in dirty cisterns; and 2, by contamination from drainage. With regard to the former, it is simply astonishing to see the dirty and disgusting condition in Avhich cisterns are allowed to become and remain. It would appear not to be known, or to be generally forgotten, that the cisterns in which potable Avater is stored require frequent cleansing. It must be admitted, however, that some excuse for the neglect of them is often to be found in their faulty position, an evil which the Water Companies might diminish, and in future prevent, if so minded, under the " Regulations." In the majority cc 34 of cisterns the overflow of water, in the case of accident to the supply apparatus, is prevented by means of a waste-pipe, which in many cases is in direct communication with the house drains, without the intervention of any trap. The waste-pipe then serves as a ventilator, often the only one, to the drains and the common sewer; and the use of the water, impregnated with sewer gases, may occasion Diarrhœa and, in special circumstances, Typhoid Fever. If the Water Companies would exercise the sanitary powers conferred on them by the "Regulations," they would confer a great boon on the metropolis. It is in their power to direct the removal of waste-pipes from cisterns, and the substitution of "warning" pipes. But the Companies, which throw difficulties in the way of a system of constant supply out of an excessive dread of waste, appear regardless of the enormous loss of water by means of waste-pipes, and which must amount to at least a third of the very ample supply now afforded to all houses that possess adequate storage. Nothing indeed is wanted but an honest application of the constant service system, to render the water supply of the Metropolis as good as it is ever likely to be, for the quality of the water is not bad by any means when properly treated, and might be made good enough for all practical purposes without much additional expense or labour, and the quantity is ample, amounting last year to an average of 220 gallons daily to each house, equivalent to 33 gallons for every individual. The Companies, however, do not purpose to give such a kind of constant supply as sanitarians desire and deem necessary, such, namely, as would enable us, if so disposed, to do away with cisterns. On the contrary, they supply the water by means of a ferrule of such small dimensions, that cisterns are just as necessary as on the intermittent system; in this respect differing, I believe, from the water Authorities of some of the large Towns, where the constant system has been long in operation, with much benefit and satisfaction to the consumers. GAS. The average lighting power of the Cannel Gras, supplied by the Chartered Company during the year, was up to the required standard on all occasions. The nominal power during the first half of the year was 23 candles, during the latter half of the year 20 candles. The amount of sulphur impurity was below the permitted amount (30 grains in 100 cubic feet of Gas) on all occasions. As a rule, the ammonia, also, was less than the Referees' maximum allowance 2½ grains in 100 feet; but for some weeks in the months of October, November, and December, the quantity was excessive, often rising above 20 grains. 35 Several communications on the subject passed between the Secretary to the Gas Company and myself, the explanation given being that the excess was due to a temporary derangement of the purifying apparatus, consequent on alterations and additions being made at the Kensal "Works. No steps, therefore, were taken to enforce the penalties of the Act. During the current year I may mention there has been no cause of complaint. Sulphuretted hydrogen was twice found in "traces" in the gas in the month of November, and its presence doubtless was due to the same accidental cause. The price of the 23 candle Gas at the commencement of the year was five shillings and five pence per 1000 cubic feet. Towards the end of the month of January, the Company applied to the Board of Trade for a revision of the price. Commissioners were appointed as by law directed, and they decided that the maximum price to be charged for the Gas during the year should be six shillings and three pence, an increase of ten pence. Great dissatisfaction was caused by this rise; and a good deal of opposition being made, the Company determined to reduce the illuminating power of the gas to 20 candles, and to charge five shillings and five pence per 1000 feet for it. It may be added that at the beginning of the current year (1874), the Company applied again to the Board of Trade for a revision of price, and the Commissioners again raised the price by the sum of ten pence per 1000 feet, making the charge, for 1874, six shillings and three pence for 20 candle Gas—just fifteen pence (an increase of 25 per cent.) above the charge made for the same quality of Gas by the Western Company, prior to the amalgamation of the Companies. The Company having expressed their willingness to supply Common Gas of 16 candle power after the month of June, 1874, your Vestry approved the change, which has now come into operation; whether the results will be satisfactory remains to be seen, and may reasonably be doubted. The price charged for this 16 candle Gas in 1874, will be five shillings per 1000 feet, or just the sum charged by the Western Company for 20 candle Cannel Gas. In conclusion, I have to express my satisfaction at the manner in which the several important duties of their office have been performed by the Sanitary Inspectors—satisfaction tinctured with regret, that, owing to the enormous increase in the number of houses, and the great extent and irregular configuration of the parish, they are unable to make such regular and systematic inspections of all houses in streets occupied by the poor as I could wish. The inspection is, to a large extent, of a "hand to mouth" description, rarely a day passing which does not call for special visits to distant portions of the unwieldy districts of the officers, which necessarily occupy a good deal of time. The only remedy is an increase in the number of the staff, rendered more than ever cc2 36 necessary by the recent appointment of the inspectors to be the inspectors under the Food, &c., Adulteration Act. I cannot conclude without a word of thanks to the several Parochial Officers, to whom I am indebted for an ever ready and courteous willingness to assist me by any information in their power. And I would especially refer to the Poor Law Medical Officers; to the Clerk to the Guardians (E. Herbert Draper, Esq.); to the Relieving Officers; the Sub-District Registrars of Births and Deaths (Messrs. Barnes and Hume); and to Mr. Shattock, the Vaccination Officer. I am also greatly indebted to many Members of the Medical profession, for an obliging promptitude in affording me information respecting cases of infectious disease occurring in their practice. I have the honor to be, Gentlemen, Your very obedient Servant, T. ORME DUDFIELD, M.D., July, 1874. Medical Officer of Health. APPENDIX. Note.—The forms for Tables I.—VI. have been settled by the Society of Medical Officers of Health to ensure formity of Statistical returns. 39 TABLE I. Estimated population 1873, at the middle of the year, and in 10 previous years; number of inhabited houses ; Births, Deaths, and Marriages (gross numbers). Year. Estimated Population.* Number of Houses. Registered Births. Deaths. Marriages. 1873. 133,000 16,920 * 4,182 2,436 1,243 1872 127,400 16,206 4,041 2,171 1,132 1871 121,500 15,394 3,804 2,328 1,131 1870 116,350 15,279 3,705 2,473 Information incomplete. 1869 111,350 14,654 3,625 2,249 „ 1868 106,350 14,029 3,522 2,232 „ 1867 101,350 13,404 3,158 1,933 „ 1866 96,350 12,779 3,080 1,966 „ 1865 91,350 12,154 2,619 1,733 „ 1864 86,350 11,529 2,494 1,849 „ 1863 81,350 10,904 2,330 1,628 „ Average of 10 years, 1863-1872 103,970 13,633 3,238 2,056 „ Notes.—Population at Census, 1871, 120,234. Area in Statute Acres, 2,190. Average number of persons in each house at Census, 1871, 7.8. * The population is estimated to the middle of the year. Between 1863 and 1871 inclusive, a yearly addition has been made to the population based on the total increase between the Censuses of 1861 and 1871. The same principle has been adopted with regard to the number of inhabited houses, in the absence of specific information on the subject, such as has been forthcoming since 1871. Some of the figures in this and subsequent Tables differ from those in former reports, as the result of a revision of the estimated population, based upon the best attainable information. The population at the Census 1861 was 70,108. TABLE II. Showing Birth, and Death-rate: Deaths of Children, and Deaths in Public Institutions 1873, and 10 previous years. The Year. Births per 1000 of the Population. Death rate per 1000 living. Deaths of Children under 1 year per cent. to Total Deaths. Deaths of Children under 1 year per cent. to Registered Births. Deaths of Children under 5 years per cent. to Total Deaths. Deaths in Public Institutions.* 1873 31.4 18.3 27.0 15.9 40.0 272 1872 32.1 17.0 28.9 15.6 44.2 264 1871 31.3 19.1 25.0 15.0 41.6 252 1870 32.1 21.2 24.4 16.4 42.9 330 1869 32.6 20.2 † † † 313 1868 33.1 21.0 † † † 303 1867 31.2 19.0 † † 40.6 221 1866 32.0 20.4 † † 41.6 248 1865 28.7 19.0 † † † 250 1864 28.9 21.4 † † 41.6 281 186:4 28.6 20.0 † † 42.0 255 Average of 10 Years, 1863-1872 31.0 19.8 † † 42.0 271 * Viz. The Workhouse and the Hospital for Chest Diseases at Brompton. † No information. 40 TABLE III. Deaths Registered from all causes during the year 1873. (The Deaths in Public Institutions of non-residents being excluded.) TABLE III A. Deaths Registered in each Sab-district, from all causes, and in each of the four Quarters, 1873. (Deaths of non-residents in Hospitals excluded.) CAUSES OF DEATH. AGES. Total deaths under Five. Grand Total. Kensington Town. Brompton. Total 1st Quarter. Kensington Town. Brompton. Total 2nd Quarter. Kensington Town. Brompton. Total 3rd Quarter. Kensington Town. Brompton. Total 4th Quarter. Under 1. 1 to 2. 2 to 5. 6 to 15. 15 to 25. 25 to 35. 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 86. 85 to 95. 95 and upwards (classes) I. ZYMOTIC DISEASES 168 65 36 31 13 24 14 17 9 14 9 2 ... 269 402 49 21 70 52 9 61 138 28 166 88 17 105 II. CONSTITUTIONAL 48 42 25 27 46 79 75 57 38 16 15 ... ... 115 468 99 24 123 98 31 129 78 20 98 101 17 118 III. LOCAL 222 84 41 29 25 47 80 113 123 188 106 16 ... 347 1074 238 67 305 188 48 236 154 25 179 288 66 354 IV. DEVELOPMENTAL 196 14 7 1 2 6 4 ... ... 11 46 17 2 217 306 60 13 73 52 16 68 70 10 80 69 16 85 V. VIOLENT DEATHS 14 3 3 6 2 6 5 7 6 2 2 3 ... 20 59 12 1 13 11 ... 11 15 2 17 15 3 18 (Not specified). 8 2 1 4 2 4 3 4 3 2 1 ... ... 11 34 7 3 10 7 3 10 3 1 4 9 1 10 656 210 113 98 90 166 181 198 179 233 179 38 2 979 2343 465 129 594 408 107 515 468 86 544 570 120 690 I. ZYMOTIC DISEASES Order 1.—miasmatic. Small-pox ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... Measles 8 16 11 3 ... ... ... ... ... ... ... ... ... 35 38 2 1 3 1 ... 1 1 1 2 25 7 32 Scarlet Fever (Scarlatina) 1 ... 4 3 1 1 ... ... ... ... ... ... ... 5 10 1 1 2 3 1 4 1 ... 1 3 ... 3 Diphtheria 2 1 2 1 ... 1 1 1 1 ... 1 ... ... 5 11 1 ... 1 1 3 4 2 1 3 3 ... 3 Quinsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Croup 5 4 6 5 ... ... ... ... ... ... ... ... ... 15 20 2 1 3 5 1 6 2 1 3 8 ... 8 Whooping-cough 18 16 6 4 ... ... ... ... ... ... ... ... ... 40 44 14 5 19 13 1 14 4 1 5 6 ... 6 Typhus ... ... 2 ... ... 2 ... ... ... 2 ... ... ... 2 6 1 ... 1 1 ... 1 2 ... 2 2 ... 2 Enteric or Typhoid Fever 1 2 2 11 3 4 ... 3 1 ... ... ... ... 5 27 6 4 10 4 1 5 6 ... 6 3 3 6 Simple continued Fever l 2 3 1 1 ... ... ... ... ... ... ... ... 6 8 2 ... 2 1 ... ... ... ... 2 ... ... ... Erysipelas 3 ... ... ... ... 1 3 6 4 5 1 1 ... 3 24 8 1 9 5 ... 5 4 ... 4 7 ... 7 Puerperal Fever (Metria) ... ... ... ... 4 8 5 ... ... ... ... ... ... ... 17 ... 1 1 2 ... 2 6 1 6 7 1 8 Carbuncle ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Dysentery 2 1 ... ... ... ... ... 2 ... ... 1 ... ... 3 6 ... ... ... 2 ... 2 2 ... 2 2 ... 2 Diarrhoea 108 21 ... 1 ... 1 ... 2 2 4 5 1 ... 129 145 5 3 8 9 1 10 95 19 114 12 1 13 Simple Cholera 2 1 ... ... 1 ... ... 1 ... ... ... ... ... 3 5 ... ... ... ... ... ... 4 1 5 ... ... ... Ague ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... 1 ... ... ... Remittent Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rheumatism ... ... ... 2 3 3 2 ... 1 2 1 ... ... ... 14 1 1 2 2 ... 2 ... 2 2 3 5 8 Other Zymotic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Order 2—enthetic. Syphilis 9 1 ... ... ... ... 1 ... ... ... ... ... ... 10 11 2 ... 2 2 1 3 3 ... 3 3 ... 3 Stricture of Urethra ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Glanders ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Order 3.—dietic. Privation ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... Want of Breast-milk 3 ... ... ... ... ... ... ... ... ... ... ... ... ...3... 3 1 1 2 ... ... ... ... 1 1 ... ... ... Purpura and Scurvy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Alco- a Del. Tremens ... ... ... ... ... 1 ... 2 ... 1 ... ... ... ... 4 1 ... 1 ... ... ... 1 ... 1 2 ... 2 holism b Intemperance ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... 1 1 ... ... ... ... ... ... ... ... ... Order 4.—parasitic. Thrush 5 ... ... ... ... ... ... ... ... ... ... ... ... 5 5 1 1 2 ... ... ... 3 ... 3 ... ... ... Worms, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 168 65 36 31 13 24 14 17 9 14 9 2 ... 269 402 49 21 70 52 9 61 138 28 166 88 17 105 II. CONSTITUTIONAL DISEASES. Order 1.—diathetic. Gout ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... 2 ... ... ... 2 ... 2 ... ... ... ... ... ... Dropsy ... ... ... ... ... ... ... ... ... ... ... ... ... 1 7 2 ... 2 1 ... 1 4 ... 4 ... ... ... Cancer ... ... ... ... 1 6 7 13 14 10 9 ... ... ... 60 10 1 11 12 6 18 7 4 11 17 3 20 Cancram Oris (Noma) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Mortification ... ... ... ... ... ... ... ... 1 3 2 ... ... ... 6 2 1 3 ... ... ... ... 1 1 ... 2 2 Order 2.—tubercular. Scrofula 2 2 2 8 1 ... 1 ... ... ... ... ... ... 6 16 6 ... 6 3 3 6 2 ... 2 1 1 2 Tabes Mesenterica 13 10 4 5 ... ... ... ... ... ... ... ... ... 27 32 10 2 12 5 ... 6 5 1 6 7 1 8 Phthisis 6 ... 7 13 43 73 66 44 21 2 ... ... ... 22 284 60 18 78 61 15 76 48 14 62 62 6 68 Hydrocephalus and cular Meningitis 26 21 12 1 1 ... ... ... ... ... ... ... ... 59 61 9 2 11 14 6 20 12 ... 12 14 4 18 48 42 25 27 46 79 75 57 38 16 15 ... ... 115 468 99 24 123 98 31 129 78 20 98 101 17 118 III. LOCAL DISEASES. Order 1.—nervous system Cephalitis 1 1 3 3 ... 3 1 ... ... ... ... ... ... 5 12 4 ... 4 1 ... 1 2 ... 2 4 1 5 Apoplexy 2 ... ... ... 1 3 4 13 20 19 7 ... ... 2 69 20 6 26 15 3 18 11 3 14 7 4 11 Paralysis ... ... ... ... ... 2 2 3 9 14 16 5 ... ... 51 9 7 16 4 3 7 7 10 10 6 16 Insanity ... ... ... ... ... ... 1 2 ... ... ... ... ... ... 3 1 ... 1 ... ... ... 1 ... 1 1 ... 1 Chorea ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 Epilepsy ... ... ... ... 1 3 2 1 1 1 ... ... ... ... 9 1 ... 1 2 1 3 1 2 3 2 ... 2 Convulsions 57 15 5 ... ... ... ... ... ... ... ... ... ... 77 77 16 3 19 17 7 24 14 4 18 15 1 16 Brain Disease, &c. 1 6 1 ... 1 1 1 7 8 11 3 1 ... 8 41 5 ... 5 6 2 8 11 1 12 13 3 16 Order 2.—organs of circulation. Pericarditis 2 ... 1 1 ... ... 2 1 ... ... ... ... ... 3 7 ... 1 1 2 ... 2 2 ... 2 1 1 2 Aneurism ... ... ... ... ... 1 2 3 ... ... 1 ... ... ... 7 ... ... ... 2 ... 2 2 ... 2 3 ... 3 Heart Disease, &c. 2 2 ... 2 7 11 17 18 21 33 23 ... ... 4 136 28 12 40 28 4 32 20 2 22 33 9 42 Order 3.—respiratory organs. Laryngitis 6 5 ... 1 ... ... ... ... ... ... ... ... ... 11 12 4 1 5 1 1 1 2 2 ... 2 3 ... Bronchitis 84 23 11 3 2 1 8 15 32 57 27 7 ... 118 270 75 19 94 44 8 52 21 2 23 84 17 101 Pleurisy ... ... ... 1 1 2 1 2 ... ... 1 ... ... ... 8 6 1 7 1 ... 1 ... ... ... ... ... ... Pneumonia 41 28 16 6 3 6 7 10 5 7 2 1 ... 85 132 27 3 30 30 3 33 14 ... 14 45 10 55 Asthma ... ... ... ... ... 1 3 6 3 6 3 ... ... ... 22 3 1 4 5 2 7 ... ... ... 11 ... 11 Lunq Disease, &c 8 ... ... 3 ... 1 5 7 3 8 4 ... ... 8 39 8 3 11 5 2 7 3 1 1 15 2 17 Order 4.—digestive organs. Gastritis ... 1 ... ... ... 1 1 ... ... ... ... ... ... 1 3 1 ... 1 ... 1 1 1 ... 1 ... ... ... Enteritis 7 1 1 2 ... 4 ... 3 ... ... ... ... ... 9 18 3 ... ... 4 ... 4 5 1 6 3 2 5 Peritonitis 4 ... 1 4 3 ... ... 2 ... ... ... ... ... 5 16 1 ... ... 4 1 5 3 1 4 5 1 6 Ascites ... ... ... ... ... ... 1 ... ... 2 ... ... ... ... 3 1 ... 1 1 ... ... ... ... ... ... 1 1 Ulceration of Intestines ... ... ... ... ... ... 3 ... 1 2 1 ... ... ... 7 2 1 3 ... ... ... 1 ... 1 2 1 3 Hernia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ileus ... ... ... ... ... ... ... ... ... 1 1 ... ... ... 2 ... ... ... ... ... ... 2 ... 2 ... ... ... Intussusception ... ... ... 1 1 ... ... ... ... ... ... ... ... ... 2 ... ... ... 1 ... 1 ... 1 1 ... ... ... Stricture of Intestines ... ... ... ... ... 1 ... ... ... 1 ... ... ... 1 3 1 1 2 1 ... 1 ... ... ... ... ... ... Fistula ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Stomach Disease, &c. ... ... ... ... 1 ... 1 ... 1 1 1 ... ... ... 5 1 1 2 ... ... ... 2 ... 2 1 ... 1 Pancreas Disease, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Hepatitis ... ... ... ... ... 1 1 1 ... 2 ... ... ... ... 5 ... ... ... 3 1 4 1 ... 1 ... ... ... Jaundice 3 ... ... ... ... ... 1 1 ... 1 2 1 ... 3 9 2 1 3 3 ... 3 1 ... 1 1 ... 1 Liver Disease, &c. 1 ... ... 1 ... 1 5 6 3 9 1 1 ... 1 28 5 2 7 3 3 6 5 2 7 5 4 9 Spleen Disease,&c. ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... 1 1 ... ... ... ... ... ... Order 5.—urinary organs Nephritis 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... 1 ... ... ... ... ... ... ... ... ... Ischuria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Bright's Disease (Nephria) ... ... 1 ... 1 3 ... ... 5 4 3 ... ... 1 30 6 1 7 1 3 5 10 2 12 6 ... 6 Diabetes ... ... ... ... ... ... 2 1 ... ... 1 ... ... ... 4 ... ... ... 1 ... ... 1 ... 1 ... ... ... Calculus (Stone) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cystitis ... ... ... ... ... ... ... 1 1 1 1 ... ... ... 4 ... ... ... ... ... ... 1 ... 1 3 ... 3 Kidney Uisease, &c. ... ... ... ... 1 1 1 1 3 5 3 ... ... ... 15 3 2 5 1 ... 1 2 ... 2 6 1 7 Order 6.—organs op generation. Ovarian Dropsy ... ... ... ... ... ... 1 2 1 ... 2 ... ... ... 6 1 ... 1 ... ... ... 3 ... 3 2 ... 2 Uterus Disease, &e. ... ... ... ... ... ... ... ... 1 1 ... ... ... ... 2 ... ... ... ... 1 1 ... ... ... 1 ... 1 Order 7.—organs op locomotion. Synovitis (Arthritis) ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... 1 ... 1 ... ... ... Joint Disease, &c. ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 Order 8.—integumentary system. Phlegmon 1 1 1 1 1 ... ... ... 3 1 ... ... ... 3 9 3 ... 3 1 ... 1 2 ... 2 1 2 3 Ulcer ... ... ... ... ... ... ... ... 2 ... 1 ... ... ... 3 ... ... 1 ... ... ... 2 ... 2 ... ... ... Skin Disease, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 222 84 41 29 25 47 80 113 123 188 106 16 ... 347 1074 238 67 305 188 48 236 154 25 179 286 66 352 IV. DEVELOPMENTAL DISEASES. Order 1.—diseases or children. Premature Birth 42 ... ... ... ... ... ... ... ... ... ... ... ... 42 42 9 3 12 7 7 14 6 6 10 5 1 6 Cyanosis 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... ... ... 1 ... 1 1 ... ... ... ... ... Spina Bifida 3 ... ... ... ... ... ... ... ... ... ... ... ... 3 3 ... ... ... ... ... ... ... 1 1 1 1 2 Other Malformations 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... ... ... 1 ... 1 ... ... ... ... 1 1 Teething 15 10 3 ... ... ... ... ... ... ... ... ... ... 28 28 5 2 1 7 2 9 4 ... 4 6 2 8 Order 2.—diseases op adults. Paramenia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Childbirth, (see Puerperal fvr) ... ... ... ... 2 6 1 ... ... ... ... ... ... ... 12 3 ... 3 2 1 3 1 ... 1 4 1 5 Order 3.—diseases op old people. Old Age ... ... ... ... ... ... ... ... ... 11 46 17 2 ... 76 16 4 20 13 4 17 16 2 18 18 3 21 Order 4.—diseases op nutrition. Atrophy and Debility 132 4 4 1 ... ... ... ... ... ... ... ... ... 140 141 24 4 31 21 2 23 43 2 45 35 7 42 196 14 7 1 2 6 4 ... ... 11 46 17 2 217 306 60 13 73 52 16 68 70 10 80 69 16 85 V.VIOLENT DEATHS,&c Order 1.—accident or negligence. Fractures and Contusions 1 ... 1 3 1 5 3 3 1 1 1 3 ... 2 23 3 1 4 3 ... 3 6 1 6 10 ... 10 Wounds ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... Burns and Scalds ... ... 2 1 ... ... ... ... ... ... ... ... ... 3 5 ... ... ... 1 ... 1 ... ... ... ... 1 ... Poison ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Drowning ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Suffocation 11 1 ... 2 1 ... ... ... 1 ... ... ... ... 12 16 3 ... 3 3 ... 3 4 1 5 6 1 6 Otherwise 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... ... ... ... ... ... 2 ... 2 ... ... ... Order 3.—homicide. Murder and Manslaughter ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 1 1 ... 1 ... ... ... ... ... ... ... ... ... Order 4.—suicide. Wounds: Gunshot,Cut,Stab ... ... ... ... ... ... ... 3 ... ... ... ... ... ... 3 ... ... ... 3 ... 3 ... ... ... ... 1 1 Poison ... ... ... ... ... ... 2 ... 1 ... ... ... ... ... 3 ... ... ... 1 ... 1 2 ... 2 ... ... ... Drowning ... ... ... ... ... ... ... ... 2 ... ... ... ... ... 2 1 ... 1 ... ... ... 1 ... 1 ... ... ... Hanging ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... 2 1 ... 1 ... ... ... 1 ... 1 ... ... ... Otherwise ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Order 6.—execution. Hanging ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Violent Deaths (not classed) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Sudden Deaths (cause unascertained) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Causes not specified or ill defined 14 3 3 6 2 6 5 7 6 2 2 3 20 59 12 1 13 11 ... 11 15 2 17 16 3 18 8 2 1 4 2 4 3 4 3 2 1 ... ... 11 34 7 3 10 7 3 10 3 1 4 9 1 10 CAUSES OF DEATH. Under 1. 1 to 2. 2 to 5. 6 to 15. 15 to 25. 25 to 35. 35 to 45. 45 to 55. 65 to 65. 65 to 75. 76 to 85. 85 to 96. 95 and Total deaths under Five. Grand Total. Kensington Brompton. Total Kensington Brompton. Total 2nd Quarter Kengston Town Brompton. Total Kensington Town Brompton. Total 4th Quarter. AGES. 41 TABLE IV. Showing Mortality from certain classes of Diseases, and proportions to Population, and to 1000 Deaths, 1873, viz.— Total Deaths. Deaths per 1000 of Population. Proportion of Deaths to 1000 Deaths. 1. Seven Principal Zymotic Diseases 290 2.1 119 2. Pulmonary „ (other than Phthisis) 483 3.6 200 3. Tubercular 332 2.4 137 4. Wasting Diseases of Infants 186 1.4 76 5. Convulsive Diseases of Infants 166 1.2 71 NOTES. 1. Includes Small Pox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Fever and Diarrhoea. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. 4. Includes Marasmus, Atropliy, Debility, want of Breast Milk, and Premature Birth. 5. Includes Hydrocephalus, Infantile Meningitis, Convulsions and Teething. TABLE V. Showing the number of Deaths in the 10 years 1863—1872, from the seven principal Zymotic Diseases, and the number in 1873, &c. Disease. 1863. 1864. 1865. 1866. 1867. 1868. 1869. 1870. 1871. 1872. Annual Average 10 years, 1863—1872. Proportion of Deaths to 1000 Deaths in 10 years, 1863—1872. 1873. Proportion of Deaths to 1000 Deaths in 1873. Smallpox 49 5 18 10 29 4 6 8 120 68 31.7 15.5 1 .4 Measles 83 100 52 40 19 84 27 70 64 43 58.2 28.4 38 15.6 Scarlet Fever 89 90 31 28 35 170 106 198 95 29 87.1 42.4 10 4.1 Diphtheria Not separately registered. 9 14 11 14 4.8 2.4 11 4.5 Whooping Cough 22 56 37 28 68 34 71 55 72 77 52.0 25.4 44 18.0 Fever 64 60 77 33 46 52 42 46 48 42 50.0 24.4 41 16.8 Diarrhœa 54 63 104 112 78 113 108 154 129 110 102.5 50.2 145 59.6 Total Kensington 351 374 319 251 275 457 369 545 539 383 386.3 178.7 290 119 London 17,078 16,029 14,272 14,761 11,660 14,925 17,413 16,476 19,455 12,699 15476 208 11,385 149 England & Wales 1861—1870* 70,284 73,220 98,490 96,288 92,030 82,692 72,587 97,352 90,380 100,497 87482 185 103,801 204 1871 * The totals for England and Wales are for the 10 years 1861—1870, compared with the year 1871, the latest year of publication at the present time. TABLE VI. Inspectors' Reports of the Sanitary Work completed in the year ended March 25th, 1874. Sub-Districts. No. of Complaints received during the year. No. of Houses and Premises, &c., inspected. Results of Inspection. House Drains. Privies and W. C.'s. Dust Bins. Water Supply. Miscellaneous. Orders issued for Sanitary Amendments of Houses and Premises. Houses and Premises, &c., Cleansed, Repaired and Whitewashed. Houses Disinfected after Infectious Diseases. Repaired, Cleansed, &c. Trapped or Ventilated. Repaired, Cleansed, &c. Supplied with Water. Now provided. New provided. Repaired, Covered, &c. Cisterns (new) erected. Cisterns Cleansed, Repaired and Covered No. of Lodging; Houses registered under 35th Clause of Sanitary Acts, 1866. No. of Dust Complaints received and attended to. Removal of accumulation of Dung, Stagnant Water, Animal and other Refuse. Removal of Animals improperly kept. Regularly Inspected. Other Proceedings, e. g. Legal Proceedings. Bakehouses. Licensed Cowhouses. Licensed Slaughterhouses. North. 790 4137 773 507 15 211 79 143 49 1 30 15 3 32 ... 911 48 166 69 18 32 48 South. 677 .5270 663 390 12 256 56 174 63 4 13 9 2 17 ... 1286 31 24 48 18 22 13 Total. 1467 9407 1436 897 27 467 135 317 112 6 43 24 5 49 ... 2187 79 180 108 36 54 61 TABLE VII. Showing the estimated Population of Kensington, in each of the 10 years, 1863-72, and in 1873 ; the number of Births and Deaths ; the annual rate of Mortality (and in London), together with the number of Deaths from Zymotic Diseases, &c. The Year. Estimated Population at the middle of the year. Births. Total Deaths. Deaths per 1000 living. Deaths from Zymotic diseases Kensington. Per centage of Deaths from Zymotic diseases to Total Deaths. The Year. Kensington. London. 1863 81,350 2330 1628 18.2 24.4 351 21.3 1863 1864 86,350 2494 1849 19.5 26.5 374 20.4 1864 1865 91,350 2619 1733 17.5 24.5 319 18.5 1865 1866 96,350 3080 1966 19.0 26.4 259 13.3 1866 1867 101,350 3158 1933 18.1 23.0 276 14.2 1867 1868 106,350 3522 2232 19.7 23.6 457 20.8 1868 1869 111,350 3625 2249 18.9 24.6 369 16.4 1869 1870 116,350 3705 2473 20.0 24.1 545 22.2 1870 1871 121,500 3804 2328 18.6 24.7 542 23.3 1871 1872 127,400 4041 2171 17.1 21.4 390 18.1 1872 Average of 10 years 18.6 24.3 376 18.7 1873 133,000 4182 2436 18.3 22.5 290 11.9 1873 44 TABLE VIII. Comparative Analysis of the Mortality in all London and in Kensington in 53 weeks, ended 3rd January, 1874. LOCALITY. Annual Death Rate per 1000 from all causes. Annual Death Rate per 1000. from 7 principal Zymotic Diseases. Percentage of Deaths under 1 year to Births Registered. Per Centage of Deaths to Total Deaths. Under 1 year of age. At 60 years of age and upwards. From 7 Zymotic Diseases. From Violence. Registered upon information of the Coroner (Inquests.) Registered in large Public Institutions. London 22.5 3.3 15.9 25.1 21.9 14.9 3.7 7.3 16.9 Kensington 18.3 2.1 15.9 27.0 24.4 11.9 2.7 7.7 11.6 45 TABLE IX. PARISH OF SAINT MARY ABBOTTS, KENSINGTON. Return respecting the Vaccination of Children whose Births were Registered during the year 1873. DATE. Registration Sub-Districts comprised in Vaccination Officer's District. Number of Births returned in Birth List Sheets. Number of these Births duly entered in Columns 10, 11, and 13 of the Vaccination Register (Birth List Sheets) viz. : •Number of these Birtbs which are not entered in the Vaccination Register, on account (as shown by Report Book) of Column 11. Postponement by Medical Certificate. Removal to Districts, the Vaccination Officer of which has been duly apprized. Removal to places unknown, or which cannot be reached, and cases not having been found. Cases still under proceedings by summons and otherwise. Column 10. Successfully vaccinated. Insusceptible of Successful Vaccination Had Small-pox. Column 13. Dead. Un-vaccinated. 1 2 3 4 5 6 8 9 10 1st January to 30th June. Kensington Town 1609 1347 10 147 13 5 87 Brompton 421 365 4 27 3 22 1st July to 31st Decern. Kensington Town 1664 1349 6 154 19 6 122 8 Brompton 417 344 2 37 5 1 27 1 Total 4111 3405 22 365 37 15 258 9 TABLE X. Showing the Principal Localities in which Fatal Cases of Zymotic Diseases occurred in 1873. Name of Street or Place. Measles. Scarlet Fever. Diphtheria. Whooping Cough. FEVER. Diarrhoea. Total. Name of Street or Place. Measles. Scarlet Fever. Diphtheria. Whooping Cough. FEVER. Diarrhoea. Total. Typhus. Enteric. Simple | Contind. j Typhus. Enteric. Simple contind. Absalom Road ... ... ... ... ... ... ... 2 2 Ladbroke Grove ... ... ... ... ... 1 ... ... 1 Appleford Road 1 ... ... ... ... 1 ... 3 5 Lancaster Road ... ... ... 1 ... 2 ... 2 5 Abingdon Road ... ... ... ... ... ... ... *1 1 Ledbury Road ... ... ... ... ... 1 ... ... 1 Abingdon Villas ... ... ... ... ... 1 ... ... 1 Lonsdale Road 1 ... ... ... ... 1 ••• 2 4 Addison Road North ... 1 ... ... ... ... ... ... 1 Archer Street ... ... 1 ... ... ... ... ... 1 Norburn Street ... ... ... ... ... ... 1 ... 1 Ashley Cottages ... ... ... ... ... ... ... 2 2 Norfolk Terrace ... ... ... 2 ... ... ... 1 3 Norland Place ... ... ... ... ... ... ... ... 1 Barandon Street ... ... l ... ... ... ... ... 1 North Row ... ... ... ... ... ... ... 2 2 Blagrove Road ... 1 ... 1 ... ... ... ... 2 Blochynden Mews † ... ... ... ... ... ... ... 2 2 Onslow Gardens ... ... 1 ... ... ... ... ... 1 Blecheim Crescent ... ... ... ... ... ... ... 3 3 Blenheim Crescent ... ... ... 1 ... ... ... 2 4 Peel Street ... ... ... 2 ... ... ... ... 2 Bosworth Road ... ... ... ... ... ... ... 2 2 Pembroke Road ... ... ... ... ... ... ... ... 1 Bramley Road 1 ... ... 2 ... 1 ... 1 5 Pembroke Square ... 1 ... ... ... ... ... ... 2 Brompton Road ... ... ... ... ... 1 ... 1 2 Portland Road 3 ... ... 1 ... ... ... 5 9 Bute Street ... ... l ... ... ... ... ... 1 Portobello Road ... ... ... 1 ... ... 1 4 7 Princes Road ... ... ... ... ... ... ... 4 4 Calverley Street ... 1 ... ... ... ... ... 1 2 Carlton Road ... 1 ... ... ... ... ... ... 1 Queen Street 2 ... ... ... ... ... ... ... 2 Cathcart Road ... 1 ... ... ... ... ... ... 1 Chepstow Villas ... ... 1 ... ... ... ... ... 1 Russell Mews ... ... ... ... ... ... 1 ... 1 Child Street ... ... ... ... ... ... ... 2 2 Church Court ... ... ... ... 1 ... ... ... 1 St. Ann's Road 1 ... ... l ... ... ... 1 3 Convent Gardens 1 1 ... ... ... ... ... ... 2 St. Clement's Road ... ... ... ... 1 ... 1 ... 2 Cornwall Gardens ... ... ... ... ... 1 1 ... 2 St. Ervan's Road 1 ... 1 1 ... ... ... 1 4 Crescent Street ... ... ... ... ... 1 ... 1 2 St. James' Terrace ... ... ... ... ... ... ... ... 1 St. Katherine's Road 2 ... ... ... ... ... ... 3 5 Dartmoor Street ... ... ... 2 1 ... ... 1 4 Scarsdale Terrace ... ... ... ... ... 1 ... ... 1 Denbigh Terrace ... ... ... ... ... ... ... 2 2 Silchester Road ... ... ... ... ... ... ... 1 2 Silver Street ... ... ... ... ... ... ... *1 1 Edenham Street ... ... ... 3 1 ... ... ... 4 Southam Street ... ... ... 2 ... ... ... **4 7 Elgin Crescent ... ... ... ... 1 ... ... ... 1 Southend ... 1 ... ... ... ... ... ... 1 Elvaston Place ... ... ... ... ... ... 1 ... 1 Swinbroke Road 2 ... ... ... ... ... ... 2 4 Fenelon Road l ... ... 1 ... ... ... 1 3 Testcrton Street ... ... ... ... ... ... 1 1 2 Finborough Road ... ... ... ... ... ... ... 2 2 The Grove, Boltons ... ... ... ... ... ... ... ... ... 2 Thomas Street,Potteries ... ... ... ... ... ... ... 1 2 Gloucester Grove 2 ... ... ... ... 1 ... ... 3 Treverton Street ... 1 ... 1 ... ... ... ... 2 Golbrone Gardens ... ... ... ... ... 1 ... 1 2 Golborne Road 1 ... ... 1 ... ... ... 2 5 Uxbridge Street ... ... ... ... ... ... ... 2 2 Grove Place ... ... l ... ... ... ... ... 1 Upper Uxbridge Street ... ... ... ... ... ... ... ... 1 Holland Street ... ... ... ... ... 1 ... 1 2 Walmer Road ... ... ... l ... ... ... 6 7 Harcourt Terrace ... ... ... ... ... ... ... 1 2 Warwick Gardens ... ... ... ... ... ... ... ... 1 Hurstway Street ... ... ... ... ... ... ... 3 3 Warwick Road ... ... ... ... ... ... ... **2 2 Western Terrace 1 ... ... ... ... ... ... 2 3 Ifield Road ... ... ... 2 ... ... ... 1 3 William Street ... ... ... ... ... ... ... 2 2 Workhouse (The) ... ... ... 1 ... ... ... 5 6 James' Street Potteries ... ... ... ... ... ... ... 2 2 Johnson Street 1 ... ... 1 ... ... ... ... 2 Yeoman's Row l ... ... ... ... 2 ... ... 3 Kensington Square ... ... ... ... ... 1 ... 1 2 † Blechynden Mews. The only fatal case of Small-Pox occurred in this Mews. * Choleraic Diarrhoea. ** Ditto ditto in one case. 47 TABLE XI. LICENSED SLAUGHTER HOUSES. SOUTH SANITARY DISTRICT, (21.) LOCALITY. LICENSEE. Glo'ster Grove East Mrs. Nutkins 11, Church Street, Kensington Mr. Stimpson 11, Peel Place, Silver Street „ Andrews The Mall, Silver Street „ Wright 57, Fulham Road „ Turner 356, Ditto „ Smith 37, Brompton Road „ Shackell 121, Ditto „ Cox 183, Ditto „ French 12, New Street, Brompton ,, Lidstone 7, Montpelier Street, Brompton „ Hall 60, Kensington High Street „ English Phillimore Mews „ Clayton 1, Newland Place „ Sandford 15, High Street, Notting Hill ,, Short 133, Ditto ditto „ Candy 6, Hope Terrace, Notting Hill „ Miller 1, Earl's Court Road „ Cannon 35, Ditto ditto ,, Matson Ditto ditto „ Collins Warwick Road „ Fazan NORTH SANITARY DISTRICT, (28.) 13, Archer Mews Mr. H. Rush Ditto ,, Ward 20, Lolton Mews Messrs. Smith and Son 48 TABLE XI— Continued. LICENSED SLAUGHTER HOUSES. NORTH SANITARY DISTRICT. LOCALITY. LICENSEE. 195, Clarendon Road Mr. J. W. Rush 142, Ditto ditto „ Rutland 10, Edenham Mews „ Gibson Tavistock Mews, Portobello Road „ Hughes 8, Vernon Mews, Portobello Road „ Young 196, Portobello Road ,, Scoles Ledbury Mews „ French Lonsdale Mews „ Olney 50, Prince's Road, Notting Hill ,, Parratt 98, Ditto ditto ,, Roser 10, Prince's Mews, Notting Hill „ Cole 10, Prince's Road Mews, ditto ,, Coles Portland Road ditto „ Colley 41, Prince's Place, ditto „ Pickworth 23, Norfolk Terrace „ Matthews 61, Silchester Road „ Matthews 5, James Street, Potteries „ Van Mary Place, Potteries „ Nind 7, Thomas Street, Potteries „ Squire 27, Ditto ditto „ Squire Royal Crescent Mews „ Blackburn Ditto ditto „ Macpherson Ditto ditto „ Down 140, Walmer Road „ Seaton 144, Ditto ,, Baker 49 TABLE XII. LICENSED COW SHEDS. SOUTH SANITARY DISTRICT, (16.) LOCALITY. LICENSEE. 5, Glo'ster Grove East Mrs. Reeves 7, Silver Street Mr. Mackenzie 7, The Mall, Notting Hill „ Edwards Ditto ditto „Draper Fulham Road (St. Mark's Place) „ Starr Holland Park Farm Messrs. Tunks and Tisdall N ewland Terrace ... Mr. Harman Gore Lane „ Thompson Earl's Court Road (Pembroke Place) „ Harman Ditto ditto „ Jones Ditto ditto „ Clark Warwick Road „ Pool South End, Kensington ,, Woolhouse Ditto ditto „ Lunn Stratford Road „ Clark Addison Cottage, Lome Gardens „ Lyons Thistle Grove ,, Burgar NORTH SANITARY DISTRICT, (17.) 191, Portobello Road Mr. D. Hughes 207, Ditto Aylesbury Dairy Company Ditto (Angola Mews) Mr. Johnson Wornington Mews „ Jones Ledbury Mews „ Boon Ditto „ Liddiard Notting Barn Farm „ Liddiard James' Street, Potteries „ Arnsby 5, Ditto ditto „ Van 21, Thomas Street, Potteries... „ Bidgood 12, Blechynden Mews „ White 14, Ditto „ Copperwheat 15, Ditto „ Cockman 9, East Road Mews „ Stephen Keen 165, Walmer Road „ Fredk. Keen 10, Talbot Mews „ Hornsby 3 & 4, Archer Mews Skingle The subjoined Notice was issued to householders during the year 1873. PARISH OF SAINT MARY ABBOTTS, KENSINGTON. SANITARY NOTICE. Parishioners are earnestly requested not to deposit animal or vegetable refuse in their dust-bins, the decay of such matters, especially in hot weather, when few ashes are made, causing offensive smells injurious to health. All such refuse being, after slight drying behind the fire, combustible in ordinary grates, may, and should be burned, small quantities being placed on the fire at a time. Parishioners are further requested to have their water-cisterns cleansed frequently, and particularly during the summer months. The waste-pipe, if connected with a drain or soil-pipe, should be effectually trapped, otherwise, the water will become polluted by foul air to the great danger of health and life. In all cases when practicable, however, the waste-pipe should be abolished, and an overflow or warning pipe substituted. Cisterns should be carefully covered to exclude dirt. Water closets should have an independent water supply. A ventilating pipe, at least 1½ inch in diameter, should be arranged so as to carry off into the open air the gas generated in the soil-pipe of the W.C., and the waste-pipe of the sink. The main drain of the house should also be ventilated and trapped, so as to prevent the entrance into any part of the house of sewer gas. Impure air and polluted water being fertile sources of disease, especially of diarrhœa, which is so fatal in summer, and of communicable diseases, such as Typhoid Fever, &c., the important the above recommendations must be obvious. By Order of the Vestry, T. ORME DUDFIELD, M.D., Vestry Hall, Kensington, Medical Officer of Health. May, 1873. P