432 (3) St. MARY ABBOTS THE ANNUAL REPORT ON THE HEALTH AND SANITARY CONDITION, ETC., ' OF THE Parish of St. Mary Abbots, KENSINGTON, FOR THE YEAR 1875, and SPECIAL REPORT ALLEGED CHRONIC PREVALENCE OF TYPHOID FEVER IN SOUTH KENSINGTON. by T. ORME DUDFIELD, M.D., (Vice-President of the Society of Medical Officers of Health, etc.,) MEDICAL OFFICER OF HEALTH. KENSINGTON: J. Wakham, Printer, 4, Bedford terrace, church street. 1876. KEN 102 THE ANNUAL REPORT ON THE HEALTH AND SANITARY CONDITION, ETC., OF THE Parish of St. Mary Abbotts, KENSINGTON, FOR THE YEAR 1875, AND SPECIAL REPORT on the ALLEGED CHRONIC PREVALENCE OF TYPHOID FEVER IN SOUTH KENSINGTON. BY T. ORME DUDFIELD, M.D., (Vice-President of the Society of Medical Officers of Health, etc.,) MEDICAL OFFICER OF HEALTH. KENSINGTON: J. Wakeham, Printer, 4, Bedford Terrace, Church Street. 1876. 1 a CONTENTS. page Prefatory General Remarks 5—14 Population, great increase in 5 Death Rate, Metropolitan and Parochial 6 "Kensington" Registration "district" and the Parochial "Sub-districts" 6 Wards, division of Parish into 6 Sub-districts (registration) relative rate of mortality in the 7 Sexes, relative rate of mortality in the 7 Zymotic Diseases, general remarks on the mortality from 7 spread of when not isolated, illustrated by epidemic of measles 7 Small Pox, long immunity from 8 local outbreaks of 9 Scarlet Fever, Diphtheria, &c. 10 unsuspected causes of the spread of 11 "Fever," low rate of mortality from 11 Whooping Cough, a neglected disease 12 Infectious Diseases—the necessity of isolating illustrated 12 compulsory measures adopted for isolation in hospitals 13 Population, number, density, &c. 14 Houses Inhabited, number of, &c. 14 Marriages and Marriage-rate 15 Births and Birth-rate 15 Deaths and Death rates of sexes and at ages 16 Illegitimate Children, high death rate of 17 Death Rate, seasonal 17 Deaths, special causes of 8—22 Public Institutions, large, deaths in the 22 Inquests, particulars of 24 several, great neglect in procuring medical aid for the Sick 24 Deaths "not certified" . 25 „ " no medical attendant" 26 Meteorology 26 Vaccination, satisfactory return of 27 Sanitary Work 27 Ashes, removal of 27 Stable Refuse, removal of 27 1 2a 4 page Legal Proceedings 28 „ „ under slaughter-house bye-laws 28 „ „ for use of unlicensed premises as slaughter-house 29 „ „ 'for nuisance arising from the boiling of offal for food of swine 29 „ „ for keeping swine in unfit places 29 „ „ for keeping cows on unlicensed premises 30 Water, shallow well, unfit for domestic purposes 30 Sewer Ventilation 31 Drainage, new map of, wanted 31 Slaughter Houses 32—39 „ „ report of Sanitary Committee on 32 „ „ action of Vestry in relation to, under the bye-laws (Slaughter Houses Metropolis Act, 1871) 34 „ „ Mr. Stimpson's appeal, unfortunate termination of proceedings in reference to 35 „ „ results of action of Vestry in lation to 36 „ „ proposed additional bye-laws for the regulation of 36 „ „ inconsistencies in dealing with 38 Cowsheds licensed 32—44 „ necessity for regulation of by bye laws 39 „ suggestive code of bye-laws adopted by the Society of Medical Officers of Health necessity for bye-laws, admitted by the Local Government Board 43 Bakehouses—Supervision of 44 Water Supply 44—49 „ dangers from pollution of 47 „ necessity of an alteration of the 14th "regulation" 47 Gas 49 Mortuary and Disinfecting Chamber desiderata 50 Baths and Wash-houses 51 Conclusion 51 APPENDIX. Statistical and other Tables, I.—XII. 53 Special Report on the Alleged Chronic Prevalence of Typhoid Fever in South Kensington. TWENTIETH ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH. Being for the Year 1875. To the Vestry of the Parish of St. Mary Abbotts, Kensington. Gentlemen, In pursuance of my usual practice the vital statistics in the present Annual Report will be laid before your Vestry for the 52 weeks composing the registration year 1875, ended on the 1st January, 1876. The advantage of this arrangement is that it affords the means of comparing parochial and metropolitan statistics. The Vestry year terminates on the 25th March 1876, and the ordinary sanitary statistics will be presented to that date. Some subjects of interest will be dealt with to the date of the report. For many purposes, in fact, the report is for the year ending in July, 1876, as it seems to me a useless refinement to defer speaking of matters worthy of notice until they have lost all immediate interest, because they do not happen to have fallen out within the period nominally embraced by the report, With this brief explanation I pass on to observe that I have again to chronicle a continuation of the altogether remarkable increase of population, which for many years past has distinguished the Parish of Kensington above all others in the Metropolis, a rate of increase which seems likely to persist so long as there is any room for building operations. This, however, at the present rate of growth cannot be for many years, seeing that the increase in the number of new houses brought into occupation has for a considerable period averaged seven hundred annually. The number newly brought into rating last year was 777, and this represents an increase in the population of about 5,500 souls. Some portion of this increase is due to the excess of births over deaths; but, as will be shown later on, the larger part is due to immigration. For reasons stated at length in former reports, the parish has a birthrate considerably below the average in all England and in the Metropolis; nevertheless, the number of children born last year was 4,478; while the deaths registered from all causes were only 2,786, the excess of 90 over the number in 1875 being entirely accounted for by the increase of population. The estimated population at the middle of the year was 143,500; the gross death-rate therefore was 19.4 per 1000 persons living, but after deducting the deaths of non-parishioners that took place in the Hospital for Consumption and Diseases of the Chest at Brompton, and at St. Joseph's House, Notting Hill, the death-rate is lowered to 18.1 per 1000. Allowance, however, should be made for the deaths of parishioners in Hospitals and other places outside the registration districts; a number probably equal to the deaths of 6 non-parishioners in public institutions. Assuming then that the correct death-rate was 19.4 per 1000, it will appear that the state of the public health in Kensington, gauged by that standard, admits of favourable comparison, as it should do, with the Metropolis as a whole, and with the several great districts into which it is divided by the Registrar General, as will be seen in the following table:— Death-rate. 1875. 1874. 1873. Kensington 19.4 19.5 18.3 per 1000. All London 23.7 22.5 22.5 „ West Districts 22.1 20.9 20.5 „ North „ 22.3 21.8 21.2 „ Central „ 26.0 25.6 25.0 East „ 25.5 25.4 25.2 South „ 24.0 21.5 22.0 The rate of mortality last year, as compared with 1874, shows a considerable increase in the Metropolis as a whole, and in the West Districts among others. The death-rate in Kensington, though slightly lower last year than in 1874, was still in excess of 1873. The decennial average death-rate in Kensington is 19.4. For registration purposes the parish is divided into two sub-districts, called respectively "Kensington Town" and "Brompton." These districts are of very unequal size, the former having an area of 1,497 acres, and the latter only 639—total acreage of the parish 2,190. Probably some 300 to 400 acres are still uncovered by buildings, including Brompton and Kensal Green Cemeteries, and Holland Park. " Kensington " registration district, which is commonly supposed to mean Kensington Parish, comprises, in addition, Paddington, Hammersmith, and Fulham. The sub- joined figures show the proportion which Kensington proper bears to the other parts of the Kensington registration district:— Area in statute acres. Inhabited houses, 1871. Population, 1871. Kensington 2,190 15,735 120,299 Paddington 1,251 11,847 96,813 Hammersmith 2,287 6,719 42,691 Fulham 1,716 3,409 23,350 For some parochial purposes the parish is divided into wards. The subjoined figures show the acreage of the several wards and other particulars of interest:— Name of Ward. Area in statute acres. Inhabited houses, 1871. Population, 1871. Rateable annual value of property, 1871. Holy Trinity, Brompton. 439 3,224 22,128 £246.716 St. John, Notting Hill, and St. James, Norland. | 905 7,730 62,475 £365,012 St. Mary Abbotts 846 4,781 35,696 £323,992 2,190 15,735 120 399 £935,720 7 As usual the rate of mortality in the Brompton registration sub-district was much below that in the Town sub-district. It becomes increasingly difficult, however, each succeeding year to fix with precision the amount of difference, owing to the want of definite information on the subject of population, it not being possible to say how much of the increase of population in the entire parish belongs to either district. It is certain, however, that building operations have been conducted on a very large scale during the last few years in Brompton, and that its population has increased largely, so that the estimated death-rate is probably less favourable than it should be to this singularly healthy section of the parish. At the census of 1871 the population of the Brompton sub-district was 28,651, and of the Town sub-district 91,583. If the rate of increase had been equal in the two districts the population of Brompton last year would have been 34,190, and of the Town district 109,310. After making the necessary corrections for deaths in public institutions this would give a death-rate of 17.1 per 1000 in Brompton, and 18.9 in the Town. But I think it is fair to assume that the population of Brompton in July last was at least 35,250, and if so its death-rate for the year would be only 16.6; and that of the Town sub district 19.1 per 1000—the deaths of non-parishioners in the Brompton Hospital being omitted in these calculations. The death-rate in the female sex—whole parish—was only 16.9 per 1,000; that of the male sex 23 per 1,000. As stated in former reports the difference in the relative number of the sexes is very great, the preponderance of females being in ronnd numbers 26,700. Before passing to details, with respect to the special causes of death, it may be well to call attention to some facts with reference to the zymotic diseases—a subject which has always great interest for sanitarians, as their greatest victories have been and will be secured in coping with these. Such another discovery as that of Jenner may scarcely be expected— though I would not limit the possible issue of patient research and accumulated experience—but we may hope by a judicious system of isolation of the sick and disinfection to stamp out infectious maladies. Thus by way of illustration it may be remarked that we have better opportunities of dealing successfully with small-pox, scarlet fever, and typhus fever than with the milder disease, measles; for not only are parents more careful in the home treatment of the graver diseases—striving for the most part to prevent them from spreading—but there are hospitals for the reception of them, to which measles is denied admission. It is true, probably, that if measles was admitted into the hospitals of the Metropolitan Sick Asylum Board few patients would be sent, as most cases prove mild and harmless; and the severer cases generally destroy life by some intercurrent complication, such as pneumonia, and thus when the case becomes dangerous there would not be any great advantage in removing it; but if the power of removal were given and acted 8 on in this disease we should not witness such a wide-spread extension of it nor so great a fatality as has lately been noted in this parish,—for every child removed in an early stage would be one additional source of infection safely disposed of. It would be well if steps were taken to impress on parents and guardians the importance of not making light of measles and whooping cough, as there can be no doubt that very many of the fatal complications are the immediate result of want of care—and of premature or avoidable exposure at a time when the pulmonary organs are peculiarly susceptible and prone to inflammatory action. These observations are well borne out by the prevailing epidemic of measles, which in the first six months of the year destroyed 103 children. The deaths in the 13 weeks, ended 24th June, were 76, and of these only 12 were registered as "measles" simply, of the other deaths 52 being ascribed to chest complications, and the remainder to a variety of secondary affections. It is noteworthy, also, that though the deaths were so numerous the disease was not especially prevalent or concentrated in any particular locality. In four houses only out of 67 where death took place in the second quarter of 1876, did a second death occur, and in only three out of a total of 44 streets where deaths happened were there three deaths in one street; there being two deaths in each of five other streets, and one death in each of 34 streets. In Portobello road, which is a long street, and contains about 400 houses, there were six deaths in as many houses. It must be obvious that a large number of children had the disease, probably 1,500 in the three months. It is a matter of notoriety that epidemics of this kind occur periodically. Thus in 1873-4 this disease was prevalent, and 148 children died of it and its complications in seven months. Afterwards in 19 months there were only 37 deaths; and now a fresh crop of susceptible organisms having come into existence the disease is again epidemic, with the results above stated. It is somewhat interesting to note, as showing the probability of the foregoing remarks, on the danger of exposure to children suffering from measles that the mortality has been high between the ages of 1 and 2 and 2 and 5; and less in extreme infancy. Crawling and walking children, in other words those who are able to get outside the door into the street and into draughts, etc., have suffered more than those whose tender age demanded maternal care and compelled stay within the house. It is worthy of notice that not one fatal case of small-pox was registered during the year. Nor was there a death from this cause in 1874, the last death having occurred in January 1873. In the first half of the current year (1876), however, two deaths have occurred which, with the circumstances attending them, may as well be referred to at once. The first death, after an interval of more than three years, occurred at Notting-hillSquare in February. The deceased was a male, aged 40, and unvaccinated. The illness, which lasted ten days, was not traced to the infection which caused it; probably it was contracted from a 9 patient suffering from modified small-pox, i.e., small-pox occurring in a person who at a previous period of life had been successfully vanccinated a disease often of singular mildness, and then, not compelling the patient's confinement to the house. In April another death from small pox occurred, and the facts that came out in the enquiry to which it gave occasion are so instructive as to bear repetition in this place. The deceased and her only child, a girl of four years, contracted the disease from her husband, the history of whose illness is briefly as follows:— On or about Tuesday, the 14th March, he was taken ill in the street, got home with some difficulty, and for a few days afterwards was confined to the house, though still able to take part in carrying on his business. On Friday, the 17th, an eruption made its appearance on his face, which he suspected to be of the nature of small-pox from having seen cases of the disease during the last epidemic. His suspicions, however, were set at rest by an authoritative assurance that the eruption was of a simple and innocent character. He therefore not only continued to attend to his business, but on Tuesday, the 21st March (fifth day of the eruption), he resumed out-door exercise. No precautions were taken to prevent the spread of the disease, for none appeared necessary, and the unprotected wife and child were thus exposed to the full force of the contagion. The wife fell ill, but not until Sunday, the 2nd April, and again the gravity of the case appears to have been overlooked: the eruption of small-pox appeared on Wednesday, the 5th April, and was recognised on the following day. Arrangements were then made for the patient's removal to the London small-pox hospital at Highgate, which, however, was not effected till Sunday, the 9th, and the poor woman died on the 11th. The child fell ill on Thursday, the 6th April, the eruption made its appearance on the 8th, and she recovered, after a very severe and dangerous attack of confluent small-pox. She had been vaccinated only two days before her illness, viz., on the day that the nature of her mother's illness was recognised, but all too late to do her any good, for the vaccination and the small-pox alike ran their accustomed course side by side without the one in any way influencing the other. Vaccination in infancy had been neglected in deference to the mother's prejudices. The mother herself had been imperfectly vaccinated in childhood. The failure in medical diagnosis in the first of these cases is much to be regretted, for the dates prove that if the disease had been recognised even when the eruption appeared on the husband, his immediate isolation would have saved the wife and child, and they might at that time have been protected by vaccination. Whilst investigating the above cases, another case in the same street came to my knowledge, the circumstances of which are no less remarkable. The patient was a young man, an assistant in a shop. The eruption of small-pox came out on Sunday, the 16th January, but the constitutional disturbance was so slight as not to hinder him, for a day, from following his occupation. On Friday, 10 the 21st, annoyed at his disfigurement, he sought advice, and was assured of the innocency of the eruption. He therefore continued in his employment till Sunday, the 23rd, when the nature of the disease was recognized, and the man was sent home to bed, and made a speedy recovery. I may mention that this man and the other before mentioned, who when seen still bore the traces of their illness on their faces in the form of "pitting," were quite ignorant how or where they contracted the disease. Their cases afford a good practical illustration of the view expressed above, that the first fatal case alluded to may have been contracted from a person suffering from modified small-pox, for it must be obvious that these men were capable of spreading the disease to any extent among susceptible individuals. They both had been efficiently vaccinated in infancy. Could we desire any better evidence of the protective power of vaccination than is afforded by this contrast? Three unvaccinated persons suffer from confluent small-pox, and two of them die; while the two patients who had been vaccinated take the disease so mildly as not to be prevented from attending to their business. At the end of June four other cases of small-pox occurred. The previous cases were all at Notting Hill: these, south of Kensington high road. Two of the patients, domestic servants in place, and the third, a married woman, were removed to the smallpox hospital at Stockwell, through the agency of the relieving officer; the fourth case, a single man, was properly isolated and treated at his own residence. No connecting link between these cases could be traced, though they all occurred within the course of a few days, but at considerable distance apart. There are not wanting signs that small-pox is about to visit this Metropolis again, and it is to be regretted, therefore, that in the absence of a registration of diseases, and of what is still more urgently needed, a legislative enactment for the compulsory disclosure of infectious maladies, we have no certain means of ascertaining the existence of even so dangerous a disease, unless cases occur in dispensary or poor-law practice; and even then we are indebted to the courtesy of the officials for any information we may receive. It was by the merest accident that I heard of the first-mentioned group of cases. Scarlet fever was not prevalent beyond the average, the deaths having been 83, against an uncorrected average in ten years of 73. After making due allowance for increase of population, the deaths in 1876 at the decennial rate would have been 91. The deaths from diphtheria were nine above the average. This disease appears to be on the increase, unless we assume that in former days some cases were returned as scarlet fever, as was the fact prior to 1869 when diphtheria was first separately registered. Diphtheria, Scarlet-fever, and Measles were prevalent diseases for a short time at the end of the year in Brompton, but they did not lay any serious hold on the district. There were six deaths from measles and diphtheria respectively, and two from scarlet+ 11 fever in the last week of the year. Investigation of the cases led to no particular result—to no discovery of any common origin or connecting link between the cases to account for so unusual a mortality—most of the deaths, moreover, taking place in well-to-do families. The excessive mortality proved to be of an exceptional character, for in the first quarter of 1876, no death from diphtheria was registered, only three from scarlet fever, and a very few from measles. About this time, however, a circumstance came to my knowledge which is worth mentioning as an illustration of one of the many unsuspected ways in which infection may be spread. Two cases of scarlet fever had occurred in a house in the Brompton district. Neither the rooms nor their contents had been disinfected, when the head of the family fell into difficulties, and the broker was put in possession. The day and hour appointed for the sale of the infected property had been fixed when I received the first intimation of the state of affairs, for which I was indebted to a member of your Vestry. I lost no time in acquainting the sheriffs officer and the auctioneer with the provisions of the Sanitary Act, 1866, with reference to the sale and removal of infected things without previous disinfection; and the sale was, not without some difficulty, prevented. It would have been a satisfaction to be able to believe that the process of the law had been carried out by the sheriffs officers in ignorance of the facts of the case, but there was little room for such belief. I am assured that the man in possession was duly informed of the nature of the illness at the beginning of his residence in the house, and that the auctioneer's clerk, who took the inventory for the catalogue, and who had ascertained the contents of the sick room by cautiously peering in at the open door, requested permission to smoke, as a protection against infection. I need not comment on this case; but I think it will be considered a not unreasonable inference from the facts that what would have been done in this instance, but for my interference, may have been done in similar cases already, and may be done again, unless some means are taken to call the attention of the proper authorities to the subject. I am told the law of execution is strict, and that the officers are bound to time in fulfilling their duties. It is clear, however, that the sanitary law is strong enough to override any difficulties that may arise, provided the facts become known to the proper officer; and with reference to the case now under consideration, I venture to add, that had the sale gone on, I should have felt it my duty to inform intending purchasers of the risk they were incurring. Subsequently, I may add, and not long afterwards, a child died in the same house of scarlet fever. The deaths from "fever," a term which, in the use made of it by the registrar-general, embraces the three distinct diseases— typhus, enteric, and simple continued "fever," were only 29, the corrected decennial average being 60. The deaths from these diseases were 2, 21, and 6 respectively. Both the cases of typhus were in the Town registration sub-district. Nine of the 21 12 cases of enteric fever occurred in Brompton. A death in Bangor Street, Notting-hill, from this cause, furnished the grounds of an alarming report on a supposed "fever den." On enquiry it turned out that the child had not been in the parish long enough to have contracted the disease; and the almost sudden death—the child having been in apparent good health a few hours before her decease —could not be traced to any definite disease, medical opinion merely asserting a probable in the absence of any demonstrable cause of death. An inquest had been held in consequence of the suddenness of the death, and the jury on viewing the body being annoyed by a bad smell, the coroner directed my attention to the place on the supposition that the smell indicated a sanitary defect which might have been the cause of the child's illness. The house which had recently been cleansed, etc., was on inspection found in general good condition. The deaths from diarrhœa (107) were 29 below the actual average number in the last ten years. Whooping cough was the most prevalent and fatal disease of the zymotic class, the deaths, 107, exceeding the average by 41. There is too much reason for the belief that many of the deaths set down to whooping cough, are due to the want of medical and other attention, the disease being thought too lightly of by the poorer classes which furnish its principal victims, and medical attendance being frequently dispensed with until too late to be of any service. A district medical officer lately told me that he was rarely called to a case of whooping cough until the child was dying, the object of seeking assistance then being, the desire to avoid a fuss about a certificate of the cause of death. The necessary confinement of the little patients to one room is too often neglected, but it must be admitted that the circumstances of the poor oppose practical difficulties in this respect. With reference to the important question of the treatment of the infectious diseases, especially scarlet fever and "fever," I have again to direct attention to the unwillingness of poor persons to avail themselves of the accommodation provided by the Metropolitan District Sick Asylum Board in the Hospital at Stockwell. One of the consequences of the prejudice underlying this objection, is the transference to private and charitable medical practice of many cases that would otherwise be treated by the District Medical Officers. Very few cases come under the notice of the District Medical Officers, but the Dispensary Surgeons have no cause to complain of want of patients. And here I may mention that having knowledge that many of the cases under treatment recently, in connection with the Kensington Dispensary, were without "proper lodging or accommodation," without which they could not be safely treated at home—some of the sick being, in fact, members of large families in occupation of single rooms, I called the attention of the Committee of the Dispensary to the subject, pointing out that the valuable institution over which they preside might easily become an agency for the spread of infectious 13 disease, and I am happy to state that the Committee entering fully into my views, gave such instructions to their Medical Officer as will, I trust, remedy the evil complained of. It will probably be remembered that under the 26th section of the Sanitary Act, 1866, power is given to a justice to order the removal to a hospital within the district, of any person suffering from a dangerous, contagious, or infectious disease, and being without proper lodging or accommodation. The section was rendered abortive by an omission to which your Vestry, at my suggestion, called the attention of the Local Government Board two or three years ago. The omission in question has since been rectified, and now a justice's order is made upon the person legally in charge of the sick person, and disobedience of it entails a pecuniary penalty. So far good. But another difficulty arose owing to the fact already alluded to, that few cases of scarlet fever come under the notice of the District Medical Officers, viz., by application for medical relief being made to the Relieving Officer, through whom alone admission can be obtained into the Hospitals provided by the Metropolitan District Sick Asylum Board. A Justice, however, is empowered to make an order for the admission of a patient, on a medical certificate signed by a legally qualified medical man, into any such hospital within the district, at the cost of the nuisance authority which, in this case, is your Vestry. For the purposes of the Act the entire metropolis is constituted a single district, and the nuisance authority is empowered to arrange with the superintending body of any such hospital for the purpose. No such arrangement, however, had been made, and it appearing to me that the time had come when an arrangement should be made to secure the removal of proper cases to the hospital, even though they should not be in receipt of parochial relief; such cases, namely, as are "without proper lodging or accommodation," and the treatment of which in the crowded habitations of the poor, where they could not be isolated, must always be a source of danger to the public health, I applied to the Local Government Board to learn if the Hospitals of the Metropolitan District Sick Asylum Board were available for the reception of cases removed at the cost of the nuisance authority? The answer was in the negative, and your Vestry thereupon proceeded to make an arrangement with the London Fever Hospital, for the admission therein of the class of cases referred to; and although hitherto no cases have been sent to the hospital, that the arrangement has not been fruitless the following illustration may suffice to prove. A child was taken ill at a small house in a somewhat crowded court. The parents and four other children shared a single and very small room with the sick child. The father's occupation brought him a good deal into contact with private families; he was, nevertheless, strongly opposed to the child's removal to the hospital. The child was not a parish patient, but as he was obviously (in the words of the Sanitary Act, 1866) "without proper lodging or accommodation," I felt it my duty to take steps to obtain a magistrate's order for his removal to the London Fever Hospital. The parents, finding that the child 14 must go to some hospital, determined to accompany him to Stockwell, and they were so well pleased with the hospital, and with the child's treatment therein, as to have spontaneously declared that in the event of their ever having infectious disease in their family again they would seek the assistance afforded by the establishment of the hospital in question. I may be permitted to make two observations on this case—(1st.) That but for the arrangement your Vestry entered into with the authorities of the London Fever Hospital, the child would not have been removed; and (2nd) that but for his prompt removal we might, and most probably would, have had many cases in the house in which he lived, and in the locality, whereas, happily, there has not been a single additional case. The room was disinfected, and the disease was stamped out. In marked contrast to the foregoing case, I may mention another. A child aged four or five years, was taken ill of the same disease, scarlet fever. The parents and three children, of whom the sick boy was the eldest, occupied one very large room. We endeavoured to remove the child to the hospital, but the parents resolutely refused to let him go, and the father took another lodging for himself in order to increase the space available for the sick child. This child recovered, but, unfortunately, after the lapse of several days the second child, aged two years and a-half, took the infection and died, and the infant also fell ill. It is not too much to say that had the first child been promptly removed, and proper measures for disinfection adopted, as in the case first referred to, the second and third children would have escaped, and the parents would have been spared a great trouble, to say nothing of the labour, the anxiety, and the expense entailed by so much sickness. POPULATION. The estimated population at the middle of the year was 143,500, an increase of 5,500 during the year, viz., 1,692 the excess of births over deaths, and 3,808 the gain by immigration. The Town sub-district contained about 108,250, and Brompton 35,250. The males were approximatively 58,400, and the females 85,100; excess of females 26,700. The subjoined table shows the number of persons of each sex arranged in groups of ages at the census, 1871. AGES OF MALES AND FEMALES, 1871. All Ages. Under 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 to 95 95 and upwds. Males, 48977 7005 10198 8948 8317 5963 4339 2464 1270 378 33 2 Females 71322 7147 11527 16585 14203 9080 6241 3768 2000 667 97 7 Trial, 120299 14212 21722 25533 22520 15043 10580 6232 3270 1045 130 9 15 The preponderance of the female sex may be accounted for with more or less probability by the concurrence of a variety of causes, e.g., (1) the large number of female servants always found in a rich neighbourhood; (2) the numerous schools for girls; (3) the residence from choice of an unusually large number of unmarried females; and (4) the superior longevity of women. The density of the population is 76 to an acre, but there are very wide differences in the degree of density in different parts of the parish, the northern parts, for example, being greatly crowded, compared with the central and southern. The number of inhabited houses at the middle of the year was 18,440, and there were about 1,900 empty or in course of construction. The houses newly brought into rating during the year were 777. There are nearly 7.8 persons on an average to each house; the average in the Brompton subdistrict, however, being lower—7 at the census, 1871. The subjoined table shows the growth of the parish in wealth and population during the present century:— The Year. Population. Rateable value of Property. The Year. 1801 8,556 £75,916 1823 1821 14,428 93,397 1833 1841 26,834 142,772 1843 1851 44,058 257,103 1853 1861 70,108 375, 333 1860 1871 120,299 590,711 1865 1876 (July) 149,000 817,326 1870 1,272 409 (April) 1876 MARRIAGES. The number of wedding's celebrated was 1.346. viz.— In Churches 1,131 At Nonconformist places of worship 56 At Roman Catholic „ 69 At the Superintendent-Registrar's office 90 1,346 The marriage rate (persons married to 1,000 population) was 18.7. The rate in England and Wales in 1873, last year of publication was 17.6. The marriages in Kensington in 1874 were 1,311; in 1873, 1,241; in 1872, 1,122; in 1871, 1,131. BIRTHS. The births registered were 4,477 (viz., males 2,275 and females 2,202): 3,636 in the Town sub-district, and 841 in Brompton. The birth rate in the whole parish was 31.2 per 1,000 persons living; 33.6 in the Town sub-distict, and 23.8 in Brompton. The rate in the entire metropolis was 35.7. One hundred and three males were born to every 100 females: the male births forming 50.7 and the females 49.3 per cent. of all the births. The birth rate was rather lower than in 1874, when it was 31.6 per 1000. The rate in the Town district, however, was the same in both years. In Brompton the rate was 24.8 in 1874, just 1 per 1,000 above the 16 estimated rate last year. The low birth rate in the parish generally is due to the disproportion in the relative number of the sexes. The illegitimate births registered were 188 or 4.2 per cent, of all the births. Registration of births was made compulsory by an Act of Parliament, that came into operation on the 1st January, 1875, but it is probable that through ignorance or indifference some few births may still escape registration. The number, however, cannot be large, the risk of omission being naturally greatest in respect of illegitimate births. One hundred and sixty-nine of the illegitimate births were registered in the Town sub-district and 19 in Brompton: the workhouse is included within the former, and in this establishment there took place 115 births, including 4 stillborn (males 66, females 49), of which 93 were returned as illegitimate. The subjoined table shows the quarterly number of births registered in each sub-district:— Kensington Town Brompton Sub-District. Sub-District. Grand Total. Males. Females. Total. Males. Females. Total. 1st Quarter 487 460 947 103 116 219 1,166 2nd „ 466 445 911 93 108 201 1,112 3rd „ 467 421 888 118 104 222 1,110 4th „ 454 436 890 87 112 199 1,089 Total 1,874 1,762 3,636 401 440 841 4,477 DEATHS. Two thousand seven hundred and eighty-six deaths were registered during the year, viz., 2,113 in the Town sub-district, and 673 in Brompton. The deaths in the first-named sub-district include 195 at the workhouse and parish infirmary in Wright's-lane, and 45 that took place at St. Joseph's House, Portobello-road, Nottinghill. The Brompton total includes 143 at the Consumption Hospital. After deducting the deaths of non-parishioners at the last-named institution, and distributing the deaths at the workhouse, the deaths in the Town-district were 2,068, and in Brompton 585. This gives a death-rate for the whole parish of 18.5 per 1,000 persons living, the rate being approximately 19.1 per 1,000 in the Town sub-district, and 16.6 in Brompton. The death rate of the male sex (whole parish) was about 23 per 1,000; of the female sex 16.9. The deaths of males numbered 1,350 in a population of 58,400; the female population, estimated at 85,100, gave a total of 1,436 deaths. The number of males' deaths was the same as last year, the entire increase (90) occurring in the female sex. The deaths under 1 year of age were 686, 76 less than last year, and 24.6 per cent. of total deaths (viz. 2,786—the deaths of nonparishioners being retained as a compensatory allowance for the deaths of parishioners taking place outside the Parish): the rate in all London was 24.4 per cent. These deaths were equal to 17 15.3 per cent. on the registered births, the equivalent rate in the Metropolis, as a whole, being 17.6 per cent. The deaths of children under 5 years of age were 1,119,69 less than last year, and equal to 25 per cent. on the registered births (London 28.5 percent.), and to 40.1 per cent. on the total deaths (London 43.4). Six hundred and forty-two persons died at 60 years of age and upwards, 60 more than last year, and 23 per cent. of all the deaths, the equivalent rate in all London being 20.8. The deaths of illegitimate children under five years of age were 88, equal to 47.6 per cent. on the registered illegitimate births, the rate in legitimates being only 25. In the Brompton sub-district the illegitimate births and deaths were equal in number (19), the explanation being that some of the children were nurslings, and probably born out of the parish. The fact remains, nevertheless, that the death rate in illegitimate children is very high, and it is easily accounted for, by the general absence of maternal care, not to mention any less demonstrable reasons. The subjoined table shows the quarterly number of deaths registered m each subdistrict, the deaths of non-parishioners in the Brompton Hospital (which are dealt with in another section) being excluded:— Kensington Town Sub-District. Brompton Sub-District. Males. Females. Total. Males. Females. Total. Grand Total. 1st Quarter 282 326 608 100 82 182 790 2nd „ 256 285 541 76 80 156 697 3rd „ 205 227 432 64 66 130 562 4th „ 255 277 532 112 93 205 737 Total 998 1,115 2,113 352 321 673 2,786 The subjoined table shows the death rate at 13 periods of four weeks, corresponding to my monthly reports, and the average temperature of the air:— Date of Report. Death Rate per 1,000 living. Mean Temperature of the Air. Five weeks ended Feb. 6, 1875. 20.7 40.4 Four „ March 6 24.0 34.8 „ „ April 3 22.3 42.2 „ „ May 1 24.2 46.5 „ „ „ 29 17.2 55.5 „ „ June 26 18.1 58.3 „ „ July 24 17.1 58.6 „„ Aug. 21 15.2 63.1 „ „ „ „ Sept. 18 14.8 65.2 „ „ Oct. 16 15.2 53.8 „ „ Nov. 14 19.6 46.1 „ „ Dec. 11 21.4 36.5 Three „ Jan. 1,1876. 22.4 42.3 Average 19.4 49.4 18 SPECIAL CAUSES OF DEATH. Zymotic Diseases.—The year was not characterised by any remarkable epidemic: the total deaths from the seven principal diseases of this class being only 372, or 9.6 below the average of ten years, although the population had increased by about 29,000. The deaths occurred in registration sub-districts as follows:— Town. Brompton. Total. Deaths. per 1,000 deaths Small Pox 0 0 0 0 Measles 12 11 23 8.2 Scarlet Fever 58 25 83 29.5 Diphtheria 15 8 23 8.2 Whooping Cough 87 20 107 38.4 Fever 18 11 29 10.4 Diarrhœa 95 12 107 38.4 Total 285 87 372 133.1 It will be seen that the deaths in the Town registration sub-district were 285, and in Brompton 87. This is an increase in the latter district of 31 over 1874, and a decrease in the "Town" of 47. Total decrease 16. The deaths were equivalent to an annual rate of 2.5 per 1,000 persons living, and to 133 per 1,000 deaths, the average of ten years being 2.5 The deaths in all London from these diseases were 178 per 1,000 deaths, and in all England, in 1873 (latest year of publication), 181. There Was not one fatal case of small pox during the year. The most fatal zymotic disease was:— Whooping Cough, the deaths from which (107) were just double, the (uncorrected) average number in ten years; 87 occurred in the Town sub-district, and 20 in Brompton. Measles caused only 23 deaths—less than half the (uncorrected) average, viz., 12 in the "Town" and 11 in Brompton,—19 in the winter quarters, and 4 in the summer quarters. Scarlet fever.—The deaths from this disease 83, (58 in the "Town" and 25 in the Brompton sub-district), were 10 above the (uncorrected) average in 10 years. Diphtheria caused 23 deaths (3 below the number in 1874); 15 took place in the town, and 8 in the Brompton sub-district. "Fever."— The total deaths from the diseases at present classed under this head were 29 (about 18 below the uncorrected average), viz., Typhus fever 2 (both in the "Town);" Enteric fever 21 (12 in the Town and 9 in Brompton); and Simple continued fever 6, 4 in the Town and 2 in Brompton. Diarrhœa was the cause of death of 107 persons (95 in the Town and 12 in Brompton), the uncorrected average number in ten years being 116. Ninety-eight of the deaths were those of children under 5 years of age (76 under one year), and 5 of persons above the age of 65. The deaths were as usual most 19 rous in the warm summer and autumn weather, 84 having been registered in the second and third quarters, and only 23 in the other quarters. Simple Cholera,-Five deaths were registered under this head, 3 in the Town sub-district and 2 in Brompton. Other Zymotic Diseases.-Croup was the cause of 22 deaths, all under 15 years of age, eleven of them between 1 and 5 : sixteen in the Town sub-district and 6 in Brompton. Quinsy caused two deaths, one in each district, and between the ages of 25 and 45. Erysipelas was the cause of 22 deaths, 17 and 5 in the Town and Brompton sub-districts respectively: eight of the deaths took place under 5 years of age. Puerperal Fever (Metria) was the registered cause of 13 deaths (of which 11 were in the Town district), viz., between 15 and 25 years of age, 4 deaths : between 25 and 35, 5 ; and between 35 and 45, 4. Besides these deaths other 11 (8 of which were in the Town district) were registered from Childbirth (7 between 25 and 35, and 4 between 35 and 45)), i.e., from ordinary diseases incident to the puerperal condition, or from, accidents, such as hemorrhage, etc., and not from disease of a specific or infectious character. The total deaths registered as occasioned by or occurring in childbed were equal to 5 per cent, on the registered births. Rheumatism caused 26 deaths, 18 in the Town and 8 in the Brompton district-only one death occurring under five years of age. The majority of the deaths under this head were immediately due to heart disease occurring in the course of the malady— a much dreaded complication in all severe cases, especially in rheumatic fever. Enthetic Diseases.-Syphilis was returned in 14 cases, two only of which were in Brompton : eleven of the victims were children under five years of age, all but two of them in the first year of life Dietic Diseases.—No death was registered from any disease in this order excepting Alcoholism (euphemistically so called) which caused only five deaths as registered, all from delirium tremens. If the whole truth were known, probably it would appear that the immoderate use of alcoholic stimulants is responsible directly or indirectly for as large an amount of sickness and premature death as of vice and crime. Drink fills our hospitals, our prisons, our workhouses, and —our national exchequer ! Parasitic Diseases.-Ten deaths were caused by Thrush, all in the first year of life : seven in the Town sub-district, and 3 in Brompton. CONSTITUTIONAL DISEASES. The deaths from the diseases in this great class, which includes two orders, were 609, viz., 477 in the Town sub-district, and 132 in Brompton, 20 Order 1. Diathetic.-The deaths from the maladies included in this order were 83, viz., Dropsy, 6; Mortification, 3; and Cancer, 74. Fifty-eight of the deaths from the last-named disease occurred in the Town sub-district, and 16 in Brompton. Ten of the deaths occurred at ages between 35 and 45; 17 in the next decade; 19 between 55 and 65, and 25 at ages above 65. Order 2. Tubercular.-The diseases included in this order are among the most important with which sanitarians have to deal. Generally of an hereditary character they are nevertheless capable of great amelioration, if not of ultimate extirpation like some others, by improved sanitary arrangements. Scrofulous maladies are unknown in Hygeiapolis! Light, dry air, efficient drainage, warm clothing, good food, and sobriety are powerful antidotes to the bane of tubercle, which is fostered by the oppositesby filth and squalor, by cold and nakedness, by vice, by want of the necessaries of life, by over-crowding in ill-constructed houses, and by all conditions inimical to the preservation of a typical condition of health. The cases that occur in the well-to-do classes of society are too often traceable to the direct influence of heredity. Of the several diseases grouped in this order, Scrofula is set down as the cause of 23 deaths, (15 under five years of age,) only 3 in the Brompton sub-district. Tales mesenterica was the cause in 67 cases, (all but one in the first year of life), 15 in Brompton. Hydrocephalus (water on the brain) and Tubercular Meningitis killed 76 persons (16 in Brompton), viz., under 1 year, 29 ; between 1 and 2, 23; between 2 and 5, 18; and between 5 and 15, 6. More than half the deaths in this order, however, were due to Phthisis (consumption) 277, viz.,-213 in the Town sub-district, and 64 in Brompton, irrespective, of course, of the deaths of non-parishioners which occurred at the Hospital for Consumption and Diseases of the Chest. The deaths at ages were : —under 15, 16 ; between 15 and 25, 49; between 25 and 35, 87; between 35 and 45, 52; between 45 and 55, 48; above 55, 25. LOCAL DISEASES Caused 1,217 deaths under the several orders following:- 1. Nervous System, 285 deaths; 227 and 58 in the two subdistricts respectively, viz., Cephalitis (inflammation of the brain), 14 ; Apoplexy, 71 ; Paralysis, 51; Insanity, 1; Epilepsy (fits), 9 ; Convulsions, 81, and "Brain disease," 58. Apoplexy and paralysis are diseases of late life, as convulsions is of infancy. The deaths from apoplexy occurred at ages as follows:-Under 35, 8 ; between 35 and 45, 9; between 45 and 55, 10 ; between 55 and 65, 11 ; between 65 and 75, 17 ; and above 75, 16. From paralysis there was only 1 death under 35; 4 between 35 and 45; 3 between 45 and 55; 12 between 55 and 65; and 31 at ages over 65. Convulsions on the other hand killed 80 children under 5 years of age, of whom 62 were in the first year of life. The mortality from "brain disease" (so described) was pretty equally distributed 21 through the whole period of human life, the deaths being rather more numerous in the earliest and, especially, in the latest years. 2. Organs of Circulation.-Total deaths, 162, viz., 133 in the Town, and 29 in Brompton. Pericarditis (inflammation of the heart-bag), 4; Heart Disease, 162; Aneurism (a disease of the great arteries), 3. The heart diseases occurring in the course of rheumatic fever are included under the head of rheumatism. These are special to no particular period of life: but are most common in youth and early adult life. Twenty-two of the deaths from heart disease occurred under 35 years of age. In the four decades following the deaths were respectively 18, 26, 38, and 34. Above 75 years of age the deaths were 24. Ninety-six of the deaths took place in the two winter quarters, and 66 in the summer quarters. Order 3. Respiratory Organs.—Total deaths from diseases of these important organs, 577 (viz., in the Town district, 480, and in Brompton 97) including Laryngitis, 9; Pleurisy, 8; Asthma, 16 ; and 'Lung disease' 43. The principal causes of death were Bronchitis, 326, and Pneumonia (inflammation of the lungs), 175. Both these diseases are most fatal in the earliest and latest stages of human life, and the number of deaths is always greatest in cold weather—especially when this is associated with winds and fogs. These facts are illustrated by the figures in Table 3 (Appendix) from which we learn that the deaths from Bronchitis and Pneumonia were 79, and 54 respectively in the first year of life, and 153 and 54 at ages above 55. The deaths from Bronchitis at all ages between 1 and 55, were 94, of which 64 occurred between 1 and 5; and from Pneumonia 67, of which 38 likewise occurred between 1 and 5. The deaths from all these diseases in the first and fourth (winter) quarters were 403, and in the second and third (summer) quarters, 174. Order 4. Digestive Organs.—The deaths from the diseases of the organs principally concerned in digestion were 106; viz., 74 in the Town, and 32 in the Brompton sub-district. The number of deaths from the diseases of the several organs may be seen in Table 3 (Appendix). It will suffice here to say that affections of the stomach and intestines killed 52 persons, Liver diseases, 48; Spleen diseases, 3; and Ascites (dropsy), 3. Order 5. Urinary Organs.-57 deaths, viz., Inflammation of the kidneys (Nephritis), 3 ; Kidney Disease, 15; Inflammation of the Bladder (cystitis), 5; Diabetes, 7; Stone (calculus) 1, and Albuminuria (Bright's disease—Nephria), 26. Order 6. Organs of Generation.-12 deaths, viz., Ovarian Dropsy 6, and Uterus disease, &c., 6. Order 7. Organs of Locomotion.—Two deaths from "joint disease 22 Order 8. Integumentary System.-9 deaths, viz., Abscess, 4; Ulcer 3; and " skin disease," 2. Class 4.—DEVELOPMENTAL DISEASES. The deaths in this class were 349, of which only 51 occurred in the Brompton sub-district. Order 1. Diseases of Children.-Premature birth, 42 (33 in the summer quarters, and only nine in the winter quarters), Malformations, 8; Teething, 26. Order 2. Diseases of Adults. Childbirth (already alluded to under the head 'puerperal mortality') 11 deaths. Order 3. Diseases of Old People.-The deaths in this order are grouped under the significant heading " old age," and were 118 in number. Two deaths from this " cause" were registered under 65; 34 between 65 and 75 ; 51 between 75 and 85; 26 between 85 and 95 ; and 5 above 95 years of age. Order 4. Diseases of Nutrition.— Atrophy and Debility, namely. Number of deaths 144, 131 and 13 in the two sub-districts, respectively ; 128 occurred under one year ; 11 in the second year, and 3 between 2 and 5. A death from this cause was registered between 45 and 55, and one between 55 and 65. Many of the deaths due to atrophy and debility might be more properly ascribed to an antecedent cause; to wit, bad or improper food in the case of weaned children, and the children of poor women who go out to work. Scrofula also is in some cases the proximate cause of the wasting. Class 5. Violent Death.—52 deaths; 36 in the Town, and 16 in the Brompton sub-district, viz. Order 1. Accident or Negligence.—Fractures and contusions, 22; burns and scalds, 5 ; poison, 1; drowning, 1; suffocation, 10; "otherwise," 1. Order 3. Homicide, murder, and manslaughter, 0. Order 4. Suicide, wounds, gunshot, cut, stab, 1; poison, 1; drowning, 2 ; hanging, 3 ; " otherwise," 2. Order 5. Execution, 0. Sudden deaths (cause unascertained) 3. Causes not specified or ill-defined, 13. DEATHS IN PUBLIC INSTITUTIONS. The deaths registered in the principal public institutions formed 12.1 per cent, of total deaths, the equivalent rate, in all London being 16.9. At present the principal public institutions enumerated are the Hospital for Consumption and Diseases of the Chest at Brompton, the Workhouse and Parish Infirmary, and St. Joseph's House, both in the Town registration sub-district. There are numerous other minor public institutions, e.g. Kensington Barracks, the Crippled Boys Home, Orphanages, Homes, Convents, &c. A very important addition to the number will shortly be made, the Marylebone Guardians having acquired a large site at Notting Hill for their new separate Infirmary for the treatment of the sick poor. 23 The Hospital for Consumption and Diseases of the Chest. -The deaths at this institution were 143 (males, 88, and females, 55,) an increase of 12 over the number in 1874. The great majority of the dceeased, all, in fact, save 9, were non-parishioners: ninety-six were admitted from London and the suburbs, and 38 from other than metropolitan counties. The registered cause of death was phthisis (consumption) in 132 cases ; aneurism and heart disease in 3 ; pulmonary diseases in, 4; cancer, 2; kidney disease, 1; enteric fever, 1. Eighty-four deaths were registered in the two winter quarters, and 59 in the summer quarters. The deaths under 20 years of age were 26; between 20 and 30, 55; 30 to 40, 40; 40 to 50, 17; and 50 to 60, 5. The "Workhouse and the Parish Infirmary.— The deaths in these institutions, both under the medical charge of Dr. Whitmore, to whose courtesy I am indebted for much interesting information, numbered 197; males 101, and females 96, the quarterly numbers being 60, 56, 41, and 40. Sixteen children died under one year of age, viz., from diarrhoea (2), chicken-pox (1), convulsions (5), atrophy (2), abscess (1), bleeding from the nose (1), malformation (1), premature birth (2), non-expansion of the lungs at birth (1). Eighty-two deaths occurred at 60 years of age and upwards, viz., between 60 and 70, forty deaths; 70 to 80, thirty-seven; 80 to 90, four ; above 90, one; the principal causes of death being diseases of the lungs (23), of the head (2), of the brain (18), and cancer (5). Erysipelas and diarrhoea, each caused two deaths; one death was due to injury (fracture of the femur), and in 23 cases the patients died worn out by old age and debility. Rheumatoid anthritis (1), privation (1), dropsy (2), gangrene (1), and incontinence of urine (1), complete the list. The deaths at ages between 1 and 60 were 99 in number, viz., measles (2), typhus fever (1), enteric fever (1), diarrhoea (4), erysipelas (3), cancer (3), phthisis (36), scrofula (4), brain diseases (16), lung diseases (12), heart diseases (5), kidney diseases (5), dropsy (1), uterine hemorrhage (1), ulcer (1), puerperal mania (1), pyaemia,—childbirth—(1), rheumatoid arthritis (1), marasmus (1). Inquests were held in four cases, the verdicts being—male, 4 days, " Found dead in bed: convulsions." Male, 2£ days, " Sudden death : convulsions." Male, 55 years, " Sudden death : disease of the lungs." Male, 54 years, "Epilepsy;" a post mortem examination having been made in each case. St. Joseph's House.-This Roman Catholic Home for the aged poor, situate in Portobello Road, Notting Hill, contained at the last census, (1871,) 213 persons. The deaths last year numbered 45 (males, 23, and females, 22) and occurred for the most part at very advanced ago (only 2 under 60 years), and principally from affections common to old age, viz., chest diseases, 17 ; heart diseases, 7; brain diseases, 8 ; cancer, 3; kidney disease, 2; diarrhoea, 2; liver disease 1 ; strangulated hernia, 1; and debility of old age, 4. 24 INQUESTS. The cause of death was returned by the Coroner in 164 oases, inquests having been held, viz., 129 in the Town, and 35 in the Brompton sub-district. The cause of death was ascertained by post mortem examination in 116 cases. The reason for holding an inquiry was the suddenness of the death in 88 instances: in 36 cases the deceased had been found dead, in bed or otherwise. Forty deaths were due to violence. The ages of the deceased were as follows: Under 1 year, 48; between 1 and 5, 22; between 5 and 60, 67 ; 60 and upwards, 27. The violent deaths were caused by accidents in 31 cases, viz., by falls under various circumstances (12), by crushing (2), by being run over by a railway train (4), by a horse (1), scalds (2), burns (1) suffocation (8). One death from accidental drowning was recorded. The suicides numbered 9, viz,, by hanging (4), by drowning (1), by poison (1), by cutthroat (1), by falls from a house and window (2). Some of the accidental deaths happened in unusual ways, e.g., one man was killed by a fall of earth on him while grave-digging; another (a servant man) was fotmd dead in an area, a grating having fallen on him apparently as he was descending the steps in the night: a third was killed by the giving way of an arch, which fell on him : another by falling into a grains-pit at a cowshed and being suffocated: another by a fall from a tree. The fatal scaffold accidents were 2- not a large number having regard to the extensive building operations going on. Seven of the victims by "suffocation" were young children. Of the deaths returned as "sudden" all were due to diseases, viz., of the lungs and respiratory organs generally 22, of the heart 31, of the brain 22, diarrhoea 3, measles 1, embolism 2, abscess 1, scrofula 1, indeterminate 5. The causes of death in the cases returned as "found dead " included brain diseases 6, heart diseases 13, lung diseases 6—in several cases the verdicts being " open." I entered So fully in my last annual report into the subject of death after neglected illness, which from the absence of a medical certificate of the cause of death, necessitates the coroner's inquisition, that I do not feel it incumbent on me on this occasion to do more than call attention to the fact that in a very great many of the cases above alluded to, the inquest would have been totally unnecessary had the deceased received proper attention in illness by a medical man being called in. It must be obvious even to those least acquainted with illness, that not a few of the subjects of enquiry in the coroner's court died of diseases of a more or less prolonged and acute character, and such as any medical man would readily detect. Had there been medical attendance in these cases an inquest would have been unnecessary, and it cannot be too often or too strongly insisted on that in a large percentage of such cases the mere fact of an inquest being necessary is proof of neglect against those in charge of the deceased—neglect which, if justice were always done, ' would not unfrequently involve a very serious charge in another 25 court * It may be added that the deaths registered on the information of the coroner were 5.9 per cent, of total deaths in Kensington, and 6.8 in all London. The deaths by violence were 1.9 per cent, in the parish, and 3.5 per cent, of all deaths in London. DEATHS "NOT CERTIFIED." Under this innocent-looking heading the record of deaths from time to time appears in the weekly returns. The meaning of it is that the deceased passed away without medical treatment by any registered practitioner. A duly registered medical man is compelled by law—since January, 1875—to give a certificate of the apparent cause of death of any person whom he may have attended in the last illness. But the production of such certificate is not essentially necessary for the purposes of registration of death, as in many cases it is not forthcoming. And, more, the signing of such a certificate by a person who is not qualified to give it, viz., by an unregistered practitioner, is no offence at law. I was about to observe that such a certificate, signed by an unregistered practitioner, is but waste paper: but, in fact, the evidence it affords of the cause of death is accepted and entered in the register, though the certificate itself is " invalid," and the death is returned as " not certified." At any rate I am not aware that the evidence of the cause of death afforded by unregistered practitioners is ever refused. So far as I know there are only two individuals practising irregularly in this parish to the extent of giving certificates of the cause of death : and they both claim to be doctors of medicine of a foreign university, though whether their degrees were obtained in absentia or after a proper curriculum is more than I can say. Thirty-three deaths were " certified " in this irregular manner during the year—at all ages, from a few days to upwards of seventy years. The causes of death returned include such important diseases as scarlet fever, typhoid fever, diarrhoea, inflammation of the lungs, paralysis, atrophy of children, etc. It is, I need hardly observe, undesirable that such a practice should continue, and I am glad to observe that the attention of the General Council of Medical Education has been directed to it, though they do not as yet appear to have found a remedy. I venture to believe that the course I have in former reports suggested would be attended with good results :—viz., that the giving of" a death certificate by an unregistered practitioner should be made an offence within the meaning of the (40th) penal clause of the Medical Act, and subject the offender to the consequences of "falsely pretending to be registered." Inquests, moreover, should be held on the bodies of persons who die under the treatment of unregistered practitioners, that the * One of the "peculiar people " has just been sentenced to three months imprisonment for neglecting, on mis-called " conscientious*' grounds, to obtain medical aid for his sick child, who died. (September, 1876.) 26 real cause of death may be ascertained. Provisions of this sort would cut both ways. The unregistered practitioner would be chary of certifying the cause of death for fear of the penalty, and his patients would soon become acquainted with the fact of his disqualification—a fact of which, seeing from what class the patients are drawn, they may fairly be supposed to be ignorant. The unregistered practitioner cannot recover fees for attendance, etc.: but this difficulty is got over by a system of cash payments, which, I doubt not, the registered practitionej would be very pleased to adopt were it practicable. It should be added that something has been done within the last few months by the profession for its own protection and for the public good. An association has been formed for the prosecution of persons practising medicine irregularly, and convictions have been obtained in many cases. Once or twice the offence charged has been that of falsely pretending to be registered under the Medical Act, but more frequently proceedings have been instituted under the Apothecaries' Act, which affords a more simple and easy method of procedure. The principal objection to the working of the latter Act is, as I understand, that the Apothecaries' Company, which will not institute proceedings, takes the penalties, the burden of proving the case and the attendant expenses falling on the Association. The penalties go to the Medical Council, when the proceedings are framed under the Medical Act, but the Council in successful cases invariably make an allowance to the prosecutor sufficient to cover the expenses of the proceedings. It is to be hoped that by an alteration of the law, and by the appointment of a public prosecutor, these matters will be rectified—the public having an infinitely greater interest in them than the profession. The "not certified" deaths in this parish form about 1.2 per cent, of all the deaths. The proportion is far greater in some other parts of the metropolis (especially south of the Thames), and in all England. "NO MEDICAL ATTENDANT." The deaths of persons who had no medical attendance in thenlast illness were nine in number, six infants and three aged people. The cause of death as registered was in the case of the children as follows:-One newly born "premature birth and debility;" two children of one day old, ditto ; a child five weeks old, " diarrhoea;" another of eleven weeks (illegitimate) "thrush, convulsions;" another one year old, " whooping-cough, convulsions." The assigned cause of death in the aged people was as follows:- a female of 64, and another of 73 years, " heart disease;" a male of 82 years, " natural decay." METEOROLOGY. The mean temperature of the air at Greenwich during the year was 49°4 Fahr, the average of 36 years being 49°,3. The averages of the four quarters were 40°.l, 53°.9, 60°.7, and 42°.9. The 27 highest reading by day (85°.4) occurred in the week ended August 21st, the hottest week in the year (mean temperature, 66°.6,): the lowest reading by night (23° 3) was registered in the weeks ended February 27th, and December 11th. The Coldest week was that ended December 4th, (mean temperature 30°9.) The dryness of the atmosphere (i.e. the difference between the dew point temperature and air temperature) was 5°.9 (average of 35 years 5.6). The rain fall was 27.3 inches—the average in 36 years being 24.1. VACCINATION I am again enabled through the courtesy of Mr. Shattock, the indefatigable Vaccination Officer of this parish, to present a complete return of the particulars of Infant Vaccination during the year 1875. ( Vide Table X. Appendix.) The figures speak for themselves, and prove how well the provisions of the law are carried out, the results not being surpassed, I believe, in any other district in the Metropolis. SANITARY WORK. Table 6 (A.ppendix) is a statement of the sanitary work carried out by the inspectors in the year ended 25th March, 1876. Table 6a shows, in respect of many of the details of sanitary work, the proportion executed in thirteen periods of four weeks, summarised for the purposes of my monthly reports. The number of complaints received and entered in the complaint book was 1557, of which a very large proportion resulted from inspections by the sanitary inspectors. DUST REMOVAL. The communications with reference to the removal of dust, etc., which in the previous year reached a total of nearly 6,000, were 4775 last year, viz., 2037 in the north and 2738 in the south district. The actual complaints of non-removal were 223, viz,, 118 in the north and 105 in the south, a great falling off from the number in 1874-5 (1010). The orders issued to the contractors requiring the removal of dust, as a result of inspections principally, were 10,116. Altogether it must he confessed that, though there is much still to be desired, the appointment of a special officer to look after the execution of the dusting contracts has been productive of very considerable advantages. REMOVAL OF MANURE. The Sanitary Act, 1866, gives the sanitary authority power to frame regulations with respect to the removal of manure, etc. from mews, stables, and other like places. Your Vestry have exercised this power, but it cannot be said that the regulations have produced much effect hitherto, complaints arising from collections of manure being numerous. There are nearly 28 one hundred and fifty mews in the parish, irrespective of separate stables; any one of which may become the cause of nuisance from neglect to remove refuse. The regulations require such removal three times a week, viz., on alternate days, and the penalty for neglect, after notice has been served or published directing such periodical removal, is twenty shillings per day. Notice has been duly served on the several premises, and your Vestry have directed further publication of the regulations by posting them in the mews ; but more stringent measures will be necessary before the evil complained of is overcome, viz., by proceedings to enforce the penalties. No doubt, as it is alleged, difficulty is sometimes, and at certain seasons, experienced in getting the refuse removed; generally, however, it is allowed to accumulate for the benefit of the occupiers of stables or their servants. If the farmers who collect the refuse could obtain it without cost when they want it, probably they would collect it regularly, even at some inconvenience at those periods of the year when it is of less value to them, and when they are busily employed in agricultural operations. It must of course be admitted that those who keep horses have the right to make the most they can of their stable refuse (though I suspect they rarely benefit by it personally), but they should comply with the law. It might be well to enquire whether, as your Vestry have the power under sec. 95 of 25 and 26 Vict., cap. 102, to collect and remove stable manure with the consent of the owners thereof, it might not be advisable to undertake the work, inasmuch as the addition of the refuse to ashes, etc., would increase the manurial value of the latter, and thus enable your Vestry to obtain a better price for the material when the day —not distant, probably—arrives when the services of contractors will be dispensed with. The faulty construction of dung-pits is a principal cause of annoyance from collections of manure. I have urgently recommended that so far as practicable the sunken dung pits found in so many mews should be filled up and iron racks substituted. There is not a greater nuisance than a reeking, steaming sunken dung pit. They are rarely dry ; the contents are seldom entirely cleared away, and they are placed under the windows of the rooms in which the coachman and his family live. Only less offensive than these are the ordinary brick and cement receptacles mostly above ground—also difficult to clear and frequently damp from want of drainage. In striking contrast to these are the iron-rack receptacles in which the refuse being fully exposed to the air and kept dry is almost entirely free from ammoniacal or other unpleasant odour, even when kept for long periods of time, as it does not ferment and rot. If the law does not at present enable local sanitary authorities to prescribe arrangements in matters of this sort, the sooner such powers are conferred the better. 29 LEGAL PROCEEDINGS. The cases in which it was found necessary to have recourse to the Police Court to enforce the orders of your Vestry were fifty-eight, but with a few exceptions, not important. Convictions for various offences under the Slaughter-houses Act, viz., for disobedience of the bye-laws, have been obtained in several cases, but the object of legislation (which was to improve the slaughter-houses by stringent bye-laws strictly enforced) has to some extent been defeated by the course adopted by the magistrates, who have reduced a substantial penalty of three pounds to a nominal one of a shilling in every case, excepting one, when 10s. was the amount. I do not presume to question their power to do this, but I may mention that the penalty of five pounds originally proposed by the " local authority," was altered to three pounds on a representation by the Local Government Board of the opinion of the law officers of the Crown, that the penalty, whatever its amount, would not be subject to reduction at the discretion of the magistrates. It would be well to have this point cleared up without delay. In order to deprive the butchers and their employes of any excuse for breach of the byelaws your Vestry have gone to the expense of printing them and mounting them on boards, placing a copy at the disposal of each licensee for suspension in the slaughter-house. A butcher, at Kensal-green, was fined in the mitigated penalty of twenty shillings for slaughtering cattle on his unlicensed premises. NUISANCE FROM BOILING OFFAL FOR THE FOOD OF SWINE. Complaints of nuisance from this cause being rife, proceedings were directed by your Vestry to be taken against Mr. F. N. Squire, of Tobin Street, who carries on the business on a large scale. The magistrate adjourned the case for eight weeks in order to enable Mr. Squire "to adopt the best practicable means for abating the nuisance." Mr. Squire went to a considerable expense in doing this, and I hope he has succeeded. At any rate I do not think there is much risk of annoyance from his business of boiling offal (in addition to the business of a tut melter) provided great care is taken to conduct the boiling with all necessary precautions to avoid the escape of offensive vapours. But what was quite practicable in Mr. Squire's case may not be so easy for the poor persons who carry on the same business in the locality without any means of preventing nuisance. Complaints are still heard, occasionally, even though the boiling is generally done late in the evening or early in the morning. It is surprising at what a distance the offensive effluvia are perceptible. In certain states of the wind they are quite apparent near St. John's Church, Notting Hill, and have been supposed to be due to gases from sewer ventilators or street gullies. The business being to all intents and 30 purposes an "offensive" one, and therefore a suitable one to be regulated by bye-laws under the Act intituled the "Slaughterhouses (Metropolis) Act, 1874," your Vestry have requested the Metropolitan Board of Works, as " local authority" under the said Act, to take the necesssry steps to have the business declared an " offensive business," as required by the third section; but up to the present time no action has been taken, to my knowledge, by the " Board." NUISANCES FROM THE KEEPING OF SWINE IN UNFIT PLACES. Proceedings were taken against two parties for keeping swine in unfit premises, viz., in stables, situated in a private mews, into which the pigs were turned for air, exercise and foraging ; but the magistrate Mr. (now Sir J.) Ingham dismissed the summons, and congratulated the defendants on having discovered bow to keep pigs without creating a nuisance and without cost, the animals, it being alleged, subsisting on the food which fell under the mangers, and which would otherwise have been wasted. This decision, characteristic of the humour which has since been transferred to Bow Street, is to be regretted, and is likely to create discontent in certain quarters. It will also occasion a good deal of trouble should it be drawn into a precedent; and if it is to be understood that stables may be used as styes, and that the private mews, of which there are not a few in- the parish, are a fit exercising ground for swine. Some of these private mews are dirty enough for such use, if filth constitutes fitness, but I rather venture to hope that the magistrate's decision will stimulate your Vestry's efforts to reduce the number of them. In five other cases small fines were inflicted for the offence under consideration, only one being a repeated offence. In the other cases prohibitory orders were made for preventing the keeping of swine on the premises. KEEPING COWS ON UNLICENSED PREMISES. Two convictions were obtained for this offence, and fines of one shilling and two shillings respectively, with two shillings costs in each case, were inflicted on the several defendants. SHALLOW WELLS. It is somewhat remarkable with what tenacity " old inhabitants " cling to the often dangerous water obtained from wells, in spite of repeated warnings, and the evidence of analysts as to its unfitness for any domestic purpose. It may be broadly stated that London does not contain any safe shallow wells. The work of sewering and railway cutting has tapped the springs, and the water of such wells is simply derived from percolation of rain or other less agreeable infusions of surface origin. Nevertheless, such water is often cool, pleasant to the taste, bright, and sparkling, and, so far as the unaided senses can judge, a desirable beverage, particularly if the well is near a grave-yard, the explanation being that the water 31 is then highly charged with saline products of the decomposition of human remains, which give it these physical properties. The public wells in this parish have been closed by your Vestry, and I would urge the owners of private wells to follow so good an example. There is such a well in Edwardes Square, the water of which was lately examined at my request by the public analyst, who pronounced it " very bad," and unfit for any drinking purpose. It contains three times the amount of solid impurities found in Thames water as supplied by the companies, in addition to those dangerous organic impurities derived from sewage and animal decomposition. I have communicated with the Garden Committee of the Square, by which the water is used for garden purposes, with a view to the closure of the well which is under the public roadway, the pump being at the rear of the lodge. So far, however, certain not very effectual steps have been taken to prevent the public from using the water, steps that require a constant and therefore unhoped-for vigilance to be successful. Formerly there were shallow wells in some of the licensed cowsheds, a source of great danger to the public health; but with one exception they have been closed. The exceptional case will, I trust, be successfully dealt with this year, the Sanitary Committee having had demonstrative evidence of the impurity of this water, on the occasion of a recent inspection of the premises. SEWER VENTILATION. Several complaints have been received with respect to offensive gullies, ventilating shafts, &c., and have been dealt with in the most satisfactory manner that could be devised in each case. The whole question of sewer ventilation is a most difficult one, and has recently been dealt with in an interesting historical report, by the Clerk to the Metropolitan Board of Works, which is in the possession of each member of your Vestry, It is hardly too much to say that the labours of many years have only enabled the engineer of the Board to demonstrate the uselessness of most of the remedies recommended for the purpose. Certainly, no plan generally applicable has been discovered. Copious flushing of offensive sewers to get rid of putrescent matters before gases are evolved, promises better results than any of the ventilation schemes hitherto propounded, and I submit as an additional reason for avoiding dribbling waste from countless cisterns, that a vast amount of water might thus be saved aud utilised in cleansing sewers. Several new sewers have Deen constructed during the year, the particulars of which will be found in the Surveyor's report. Many new and re-constructed drains also have been laid under notices from my department. DRAINAGE MAP WANTED. It not unfrequently happens when questions of drainage are under consideration, that the want of a good map of the parish showing the sewers, is much felt, and I submit that it would be a 32 wise and judicious expenditure to set about the preparation of such a map without delay, the wonderful growth of the parish having made the ordnance survey obsolete for a large portion of it. Some of the sewers are old and more or less faulty in construction, material, &c., and will have to be re-constructed. The work of reconstruction is, in fact, going on now, but at the present rate of progress will take a long time to complete, much of the expense, moreover, being charged on the current rates. As it is desirable that defective or inadequate sewers should be replaced by sound and efficient ones as quickly as possible, and the work being of a permanent character, I submit it would be well to hasten it, and to charge the next generation with a share of the expense. It is impossible without a plan and description of the existing sewers showing which are good and sufficient, or bad, i.e. inadequate in size or faulty in construction (levels,) or material, even to guess the probable expense of carrying out this suggestion. I submit it would be desirable - 1. To obtain the thirty sheets of ordnance survey on which wholly or in part the configuration of the parish is delineated, and to insert thereon all streets, mews, &c., which have been formed since the said survey was taken: 2, To show the whole system of sewers (as far as may be laid down from information in possession of the Vestry, or procurable) to present date, with report, indicating- (a.) All sewers in good condition, date of construction, size, and length. (b.) All sewers (or system of drainage) known to be inadequate to the requirements of the respective localities, with description of same. (c.) All sewers which, though possibly of sufficient capacity, may by reason of old age or otherwise, e.g. by defective material, construction, or level, be dangerous to the health of the locality. (d.) All sewers which have blind ends, and which by pipe connection with other sewers, air shaft, or otherwise, might be ventilated. (e.) All sewers difficult of approach from insufficient number of manholes, &c. Engineering experience would probably enlarge the scheme of such an inquiry; but I venture to say that the advantages in a sanitary point of view of such information as the above, followed up by execution of all necessary works, would be simply incalculable, The parish once surveyed to date, it would be easy from time to time to insert new streets, and sewers, and we should thus have ready access at all times to information which is in almost daily requisition in the sanitary department. LICENSED SLAUGHTER HOUSES. The licensed slaughter-houses which at the date of my last report were 48 in number, are now only 32, the license in 16 cases 33 having been either refused or not applied for at the licensing session held in October, 1875. The Works, Sanitary and General Purposes Committee viewed the several slaughter-houses in the month of September, and reported on them in the following terms:— "Your Committee have to report that several of the 'premises' are very small, and the ' slaughter house ' itself cramped for room, especially where a portion of it has been cut off for the purpose of making a pen for the accommodation of the cattle, the pen usually receiving light and air through the slaughter-house. In some of these cases the partition is a mere railing, the living animals being able to see the killing, while the atmosphere of the slaughter-house (in which the carcases are hung to 'cool' and ' set') must be vitiated by their excretions, as they are sometimes kept in the pens for three or four days. "As the bye-laws forbid even a communication between a stable and a slaughter-house, the object being to preserve the latter in as sweet and wholesome a condition as possible, it appears to your Committee that pens should not be allowed to be within the slaughter-house, for it is practically an evasion to say that a railed-off slice or corner of the chamber used for killing is not a part of the ' slaughter-house ' as defined in the bye-laws, and as distinguished from the remainder of the ' premises.' The lairage should be separate and distinct from the slaughter-house, communicating with it by a doorway only. Your Vestry have already resolved to oppose the renewal of the license where such separate lairage is not provided, and your Committee, after inspection, entirely agree in the propriety of that decision. Your Vestry have also decided to oppose the renewal of the license where there is no approach to the slaughterhouse save over the foot pavement and through a shop or a dwellinghouse ; and your Committee, having inspected all the premises of this description, believe that this course is a proper one, for not only is the approach in these cases very defective, but the doorways also are so narrow that it is difficult to understand how the beasts are got through them. Your Committee found several of the slaughter-houses still used as cart-sheds, notwithstanding the bye-law which forbids the use of a slaughter-house for any other purpose than that for which it is licensed. " A large number of the slaughter-houses having been inspected on the afternoon of Friday, your Committee had the advantage of seeing the business in full operation, and were not favourably impressed by the mode in which it is conducted, for not only were there (as a rule) no ' tubs, boxes, or vessels formed out of proper non-absorbent materials, with tight and close-fitting covers thereto, for the purpose of receiving and conveying away all manure, garbage, offal, filth, and blood,' as required by the bye-laws (which have been in the possession of the butchers for many weeks), but even whore such receptacles were found, they were rarely in use, or only used to receive so much of the blood, etc., as would not run into the drains. To facilitate this disposition of the products of slaughtering, in one case that came under the notice of your Committee, the trap of the drain had been removed, while in another the drain itself was blocked with clotted blood. Your Committee are of opinion that the grating over the gulley should be a fixture, for so long as it is moveable, and while bell traps continue to be used, there is no security that the blood, etc., will be caught and stored for removal. Your Committee desire to call particular attention to this point, which raises the question whether a ' bell-trap,' removable at will, can be fairly desoribed as ' an appropriate trap ' for a slaughter-house, seeing that it offers no obstacle to the improper disposal of blood and excrementitious matters, or even of the entrails of smaller animals, by which, in some cases, they are informed, the drains have been obstructed. "Your Committee have not felt it their duty on the present occasion to enter at any further length on defects in the ' conduct of the business, 34 because the bye-laws, if duly enforced by the sanitary staff, are sufficiently precise and stringent to ensure a satisfactory result in this respect; their remarks, therefore, on the several slaughter-houses will be mainly confined to the enumeration of structural defects, inasmuch as after the 'needful works and repairs to the premises' have been executed, ' no alteration may be made in respect of the paving, drainage, ventilation, or water supply to or in the premises without the consent of the Metropolitan Board of Works.' "And here your Committee would beg to observe that although the ' slaughter-house itself is defined to be but a ' portion of the premises,' that portion, namely, used for killing, there are no bye-laws to ' regulate the structure ' of the lairs or pens, which are often the most defective of all, whether regard be had to their position and construction, to the accommodation they afford, to their lighting and ventilation, or even to the condition in which they are kept. It may be that the framers of the byelaws deemed it unnecessary to make provision for lairage, having directed that cattle should not be kept in the 'premises' for a longer time than ' absolutely necessary ' before slaughtering : but, in fact, cattle are, as before stated, often kept for days either to ' cool,' or to suit the exigencies of trade, and, therefore, proper provision should be made for their accommodation. Such provision, it may be added, will have to be made before the ' local authority ' will give their ' sanction ' to ' establish anew the business of a slaughterer of cattle,' i.e., before a new slaughter-house can be licensed. " Your Committee have only further to add, in explanation of the defects of existing slaughter-houses, that the premises inspected were, with two or three exceptions, never designed for the use to which they are applied. Most of them are nothing more than ordinary stables, and when the premises are very small, it has been customary to use the coach-house indifferently for killing and as a cart-shed, and the stable for the common use of horse and 'cattle, using that word in its broad sense. In larger premises some attempt has been occasionally made to separate the stable from the slaughter-house, generally with ill-success, from want of room, etc. Some of the slaughter-houses are only lean-to sheds, or even washhouses in original construction, and the work of adaptation has not proved easy or successful. The situation of many of the slaughter-houses, moreover, in private and other mews near accumulations of foulsmelling refuse cannot but be regarded as objectionable, and extreme care is necessary in order to keep the locality in a wholesome condition by regular cleansing, and by frequent removal of manure, etc." The Committee then proceeded to specify the slaughter-houses inspected, grouping them as follows:— 1st. Those for which the license will not be applied for again (eleven in number). 2nd. Those to which no opposition need be offered (seven). 3rd. Those that are so objectionable in some respect that the renewal of the license should be opposed (six). 4th. Those the renewal of the license to which should be opposed unless certain specified improvements of the premises are made, of which notice should be given forthwith (twenty-four.) In an appendix the Committee reported the actual condition of each of the slaughter-houses in the third and fourth groups at the time of inspection. The views set forth in the above report were adopted by your Yestry, and successfully carried out at the licensing session, but not without a good deal of opposition, owing to the fact that the Metropolitan Board of Works had adopted a lower standard of the requirements for a slaughter-house. The Board, for instance, 35 did not insist on the provision of lairage or poundage for the cattle, nor on a separate entrance to the slaughter-house independent of the shop or dwelling-house; and with one exception they did not oppose the renewal of the licenses. In twenty-four cases, however, your Vestry had served notice of opposition, with a view to obtain certain alterations and improvements, including the provision of adequate lairage effectually separated from the slaughtering place, and the magistrates refused to renew the licenses until your Vestry's requirements had been complied with. With reference to the six slaughter-houses, the entrances to which were through a shop or house, the Justices were requested to view the premises before coming to a decision, and they did so, the result being that they refused to renew five of the licenses on the ground of the general unfitness of the premises. In the remaining case they renewed the license, being favourably impressed by the clean condition of the premises, and by the statement of the proprietor as to the small use made of his slaughter house. Sheep only are killed, but they have to pass through the shop; up a flight of six steps, along a passage, and down twelve steps into the garden, at the rear of which the slaughter-house is situated.* Mr. Stimpson, of Church Street, appealed against the decision of the magistrates, having unsuccessfully renewed his application for a license at an adjourned sessions held on the 2nd November. The appeal was heard on the 22nd Jauuary, 1876, your Yestry being represented by counsel, in conformity with the resolution adopted at the meeting held on the 5th January. The decision of the Magistrates was reversed, your Vestry's solicitors having, at the last moment, advised a withdrawal from the opposition to the granting of the license (on Mr. Stimpson agreeing to pay the costs incurred), under an apprehension that it would not be successful, Mr. Stimpson having improved the slaughter-house, and two officials from the Metropolitan Board of Works having been subpoenaed to testify to the excellence of the re-constructed premises. This, however, was not the question at issue, and it may be at once conceded that there would be no objection to the slaughter-house if in a suitable locality. Your Vestry's opposition to the renewal of the license, deliberately entered upon after view of the premises and report by the Works and Sanitary Committee, was based on the fact that the only entrance to the slaughter-house is through the shop. The Magistrates, moreover, who also viewed the premises, gave as an additional reason for refusing the license, " in justice to the sanitary interest of the neighbourhood," that the " premises * * * * are surrounded on every side by dwelling houses closely packed."† None of these facts were placed before the Court, which, in granting the license, pointedly alluded * This license will not be applied for again. (August, 1876.) The Magistrates who viewed the premises reported on them in the following terms:—"The entrance to this slaughter-house is through Mr. Stimpson'e shop and dwelling-house. The slaughtering here is carried on to a rery large extent, amounting to some 13 or 14 cattle per week, and occasionally 120 sheep per week. The premises were well kept, but they are most close and confined, and surrounded 36 to the absence of any information as to the grounds on which the magistrates based their refusal of the license, and assumed the accuracy of the altogether erroneous statement made by the learned counsel for the appellant, viz., that your Vestry withdrew from the opposition as the works you required to be done, but which had not been carried out when the license was refused, had since been executed to your satisfaction. This result of the appeal, which has decided nothing, is to be regretted, as much in the appellant's interest as on any other ground, for, setting aside any other objection to this particular slaughter-house, the important question raised by your Vestry still awaits a decision of the superior Court, viz., whether premises are fit and proper to be licensed as a slaughter-house to which the only access is through a butcher's shop or dwelling-house ? This failure excepted, your Vestry have every reason to be satisfied with the results of the not inconsiderable labour and time bestowed on this important question. The gains in a sanitary point of view were thus summed up in my report, dated the 20th October, 1875:- ''Last year we had six slaughter-houses approached through shops or dwelling-houses; now there are but two. Last year a very large proportion of the whole number had lairage in, or not separated from, the slaughter-house; now in every premises their is separate lairage. Great improvements have also been effected in the lighting, ventilation, water supply, and general arrangements of the slaughter-houses, which will be used henceforth exclusively for the purpose for which they are licensed." I do not mean to imply that we should be satisfied to allow matters to rest as they are, for putting aside the preference I have always avowed for the abattoir system—a system that must sooner or later displace the present one—I venture to say that sanitary authorities should not be content till further improvements have been effected, by new bye-laws, in the existing private slaughter-houses. Among the chief of these contemplated improvements I would mention the following, which have been adopted by the Society of Medical Officers of Health, at my instance, in the form of suggestive new bye-laws, some of them being in the number of the conditions" the " Board" require in the case of new slaughter-houses. The Beport of the Society on these suggestions is couched in the following terms:- “ METROPOLITAN SLAUGHTER-HOUSES." "It is the experience of this Society that the construction of existing slaughter-houses in the metropolis, as ordered by the on every side by dwelling houses closely packed. Two tiny stables containing four horses are in close contiguity to the slaughter-house. The place is very close, and smells offensively. Whilst the justices are sorry to interfere with Mr. Stimpson's business, they cannot, in justice to the sanitary interest of the neighbourhood, recommend a renewal of the license." It should be stated that Mr. Stimpson has since abolished the stables, and converted them into lairs for cattle and sheep. 37 Metropolitan Board of Works, is not sufficiently regulated by sanitary considerations. The Health Officers of the Metropolis have opportunity, at the Annual Licensing Sessions, of bringing this consideration under notice of Magistrates, and thus of influencing the sanitary arrangements of slaughter-houses. The Society is of opinion that bye-laws to some such effect as the followingvare proper to be made by the "Local Authority," and that, meanwhile, the principles of the bye-laws here drafted may usefully and successfully be insisted on by Officers of Health, who should invariably appear at the Licensing Sessions of Magistrates. 1.As to independent entrance:— That every slaughter-house should have an entrance apart from and independent of any shop or dwelling-house. 2. As to roof ventilation:— That every slaughter-house shall be open to the roof, and be ventilated by louvre ventilators in the roof in addition to any other ventilation that may already exist. 3. As to exact paving arrangements:— That every slaughter-house should be paved with hard asphalte properly sloped and channelled towards the gulley. But if flag stones or hard small bricks are employed, they should be laid on a bed of concrete six inches in thickness and set in cement-no broken stones or open joints being permitted to remain. 4. As to the position and security of drain inlets:- That the drain inlet should be placed outside the slaughterhouse where practicable, and should be guarded by a locked grating, and provided with a stoneware syphon or other approved trap, not being a bell trap. The drain itself should be ventilated, and blood, garbage, and manure should not be permitted to pass into it. 5. As to water and washing arrangements.— That the water cistern should be made of slate or metal, or of wood lined with metal. It should be properly covered, provided with an overflow or warning pipe, and no waste pipe should be permitted. The requisite taps and hose should be provided, that the walls of the slaughter-house, to the height of six feet at the least, and the floor, may be flushed and cleansed. 6. As to separate and special lairage or poundage:- That every slaughter-house should be provided with an adequate place for the accommodation or poundage of the cattle about to be slaughtered, with an entrance way for the cattle otherwise than through the slaughter-house. The poundage should be effectually separated from the slaughter-house by a brick partition with sliding or other door, and should be well paved, lighted and ventilated, and should be 38 kept clean and in good order. The poundage should have no inhabited rooms over it, and should not be used for any other purpose than for the temporary detention of cattle previous to slaughtering. 7. As to position of dung pits:— That no dung pit or ash pit should be permitted to be near the door or window of a slaughter-house. 8. As to appliances for slaughtering:— That every slaughter-house should be provided with all the necessary and most approved apparatus and tackle for the slaughtering of cattle. 9. As to hanging of meat:— That neither the lairs nor any stable should be used as a hanging place for meat. 10. As to inspectors:— That any interference with an officer in the discharge of his duty, or any molestation, as by the use of abusive language, should be made an offence within the meaning of the bye-laws. I may here mention that the Commissioners of Sewers, as the " local authority" for the City of London, have framed a code of bye-laws much in advance, in a sanitary point of view, of those prepared by the Metropolitan Board of Works for the rest of the metropolis. It remains to be seen, however, whether the said bye-laws will be confirmed by the Local Government Board. I have already mentioned that the "Board" opposed the renewal of one license. The ground of opposition was that the paved flooring of the slaughter-house had to be traversed by a horse in going to and from a stable at the rear. The magistrates viewed the premises and overruled the objection; but in other districts, I am informed, a similar objection had been allowed by the justices. It is the fact also that in other districts, licenses were successfully opposed, because sausages were made in the slaughter-houses. Such use of the premises is undesirable, no doubt, and it is contrary to the bye laws. It is strange, however, that the "Board," which refuses to allow a horse to cross a slaughter-house, or a sausage to be manufactured in it, should permit cattle to pass through houses and butchers' shops through which all the products of slaughtering have to be conveyed; and that they should make no provision for separate lairage—allowing animals to be pounded in the slaughter-houses, where they are to be killed, and where the carcasses will subsequently be hung to cool and set! The slaughter-house licenses in Chelsea, Fulharm, and Hammersmith, had been granted with scarcely an objection before the Kensington cases were called on, many of the premises in those parishes being without lairage, and approached through a house or shop; and the justices were told while adjudicating on Kensington applications that they were reversing their previous decisions. The Court, however, in the 39 absence of information, could not have acted differently. I have only to add that when the Kensington butchers found it necessary to provide separate lairage, they succeeded in every instance in doing so, and not one slaughter-house was closed as a result of your Vestry's opposition on this ground. I had the satisfaction, moreover, of being assured by several of the butchers that they were well pleased with the alterations and improvements in their slaughter-houses, which they had not willingly undertaken in the first instance. In several cases these alterations amounted practically to re-construction, and the improvement was really very great, and necessarily of a permanent character. In leaving this subject, I think it right to explain that the reason for entering into it so fully was, that the past year was a critical one, as the first under the operation of the new Act and the Bye-laws. It seemed only just, moreover, that the prominent, and I may add, exceptional and successful position your Vestry assumed in dealing with an important sanitary question, should be placed on record. It may be reasonably hoped that other sanitary authorities will be encouraged to follow so good an example, and not again surrender one of their most important duties to the " Board " which, at the utmost, has only concurrent powers in the execution of the Act, and is unprovided with a sanitary staff. LICENSED COWSHEDS. The licensed cowsheds, 27 in number, viz., 15 in the north, and 12 in the south sanitary district, were inspected by the Works Sanitary and General Purposes Committee in September, and considerable improvements made in the ventilation of several. The licenses were renewed in every case save that of Mr. Burgar, of Thistle Grove, which was successfully opposed by gentlemen living in the locality, on account of the offensive smells alleged to be due to the manner in which the business had been conducted. Mr. Burgar appealed; but the case did not come into Court, as it appeared that the decision of the magistrates in respect of cowshed licenses is final. The Committee, in a report on the cowsheds which they viewed in July of the current year, expressed an opinion with which I fully agree, on the necessity of legislative powers being given to enable sanitary authorities to frame bye-laws for regulating the conduct of the business of a dairyman, and the structure of the premises (cowshed and dairy) in which the business is carried on.* So many illustrations have been afforded in late years of the *" Your Committee are satisfied of the necessity of powers being conferred on "Local Sanitary Authorities " to enable them to frame bye-laws for the regulation of the structure of the premises, and the conduct of the business of a cowkeeper or dairyman. Until such powers are conferred, your sanitary staff can only insist that the premises shall be kept clean ; that the manure shall be regularly removed, and that ventilation shall be duly attended to. In default your Vestry may object to the renewal of the license. In the respects specified, and particularly as regards ventilation, the improvements effected by order of your Vestry last year, are not inconsiderable." Report of Works, Sanitary, and General Purposes Committee, July, 1876. 40 dangers arising from the use of contaminated milk, and the facility with which this fluid may become contaminated, that there is now a pretty general consensus of opinion as to the necessity of such regulation. It may be stated generally that disease in man may be caused through the agency of milk; (1) By insanitary conditions in the cowshed and in the dairy, viz., through the absorption by the milk of sewer gas or the products of excremental decomposition; (2.) by the pollution of water; (3.) by the use of improper or unwholesome food for the cows ; (4.) by disease in the cows themselves; and (5.) by disease derived from the employes in the cowshed and dairy. The simple enunciation of the means by which disease may be propagated, furnishes a clue to the proper subjects of byelaws. These are (1) The position, construction, and sanitary condition of the sheds, including questions of cubic and floor space, water supply, lighting, ventilation, drainage, paving, &c.; (2.) everything relating to the health and management of the cows, including quarantine arrangements, the isolation of sick animals, the quality and storage of the food; (3.) the sanitary condition of the dairy and of the vessels used for receiving, storing, and distributing milk; and (4.) the state of health of the persons engaged in the conduct of the business. In a paper read before the Society of Medical Officers of Health last year (1875,) and since published, I submitted a suggestive code of bye-laws based on the above views. The Society by which the importance of the question is well understood, referred the bye-laws to the Council, which reported them to be, “with some slight alterations which have been made, suitable for the purpose.” The Report of the Council having been adopted, the bye-laws, which are subjoined, were published with the imprimatur of the Society, and with the following introductory note:— "This Society has had under consideration the necessity for placing cow-sheds and dairies, and the business of a dairyman, under proper regulations. The subjoined rules embody the sanitary principles which the Society would desire to see enforced. "There is at present no power to make bye-laws on the subject: but, in the expectation of early legislation conferring such power, the principles desirable to be observed are here drawn up in the form of bye-laws. Meanwhile, until the power of framing bye-laws is given, the subjoined regulations will serve to indicate the conditions the Society considers should be taken into account by sanitary authorities, and magistrates who are concerned in the licensing of cow-houses in London and other towns. " The proposed rules are divided into two classes; the one class comprising those regulations which in the Society's opinion are proper to be insisted on in all cases; the other class comprising those regulations which the Society regards as desirable to be 41 enforced in all new cow-sheds and dairies, hut on which it would not be expedient to insist in the case of all cow-sheds and dairies at present established." CLASS I. 1.Every cow-shed shall be properly lighted and ventilated by louvred sky or side-lights. 2. Every person occupying a cow-shed shall cause the inner walla to be covered with hard, smooth, impervious material to the height of five feet, at the least, from the floor, and the doors and other wood work, excepting the divisions between the stalls, to be thoroughly well painted. 3. Every person occupying a cow-shed shall cause it to be well paved with asphalte, iron-stone bricks, or flag-stones, set in cement, on a bed of concrete, and laid with a proper slope and channel towards a gulley, which shall be situated outside the shed; and which shall be properly trapped and connected with the public sewer by an adequate drain of glazed pipes. 4. Every person occupying a cow-shed shall cause it to be provided with a trough manger, constructed of some hard impervious material, and sufficiently sloped to allow it to be readily cleansed by flushing. 5. Every person occupying a cow-shed shall cause it to be provided with an adequate and properly constructed receptacle, made of impervious material, for the supply of water, which shall be closely covered, and provided with an overflow or warning pipe unconnected with any drain: the receptacle to be so placed that the bottom thereof shall not be less than six feet above the floor level. The water to be of good quality, and to be procured from a public water company, where practicabe. (The use of shallow-well water should be strictly prohibited). 6. Every person occupying a cow-shed shall provide a proper place for the storage of fodder, and, if brewer's grains be used as food, a covered receptacle made of impervious material for the storage of the grains shall be provided, such receptacle to be situated outside the cow-shed, to be properly drained, and to be sub-divided into two parts by a partition, so that each part may be thoroughly cleansed in turn, and be kept free from any offensive smell. 7. Every person occupying a cow-shed shall provide a proper covered place or receptacle outside the shed for the reception of dung and other refuse ; the bottom thereof to be constructed of flag-stones or cement laid on concrete, and the sides to be constructed of flagstones, or brick lined with cement. 8. Every person occupying a cow-shed shall cause all needful work to the premises to be forthwith done and executed, and shall not allow any alteration to be made in respect of the paving, drainage, water supply, or ventilation to or in the premises, without the consent of the local sanitary authority. 9. No person occupying a cow-shed shall allow any water-closet, privy, cesspool, or urinal, to be within, or to communicate directly with such cow-shed. 10. No person occupying a cow-shed shall allow any inhabited room, or workshop, to be situ ated over it on any pretext whatever. 11. Every person occupying a cow-shed shall keep in it only such number of cows as shall be specified on his licence; the space for each cow shall not be less than 800 cubic feet; no height of the shed in excess of sixteen feet shall be taken into account in estimating the cubic space. The stalls for single cows shall not be less than four 42 feet in width, and a double stall for two cows shall not be less than seven feet six inches in width. The stall partitions shall not extend in front beyond the front line of the manger, and shall leave a clear open space above the manger. 12. Every person occupying a cow-shed shall cause the inner walls, and every part of the premises, to be kept thoroughly clean and in good order and repair at all times ; and shall cause the inner surface of the roof and of the upper portion of the walls to be thoroughly washed with quicklime at least once in every quarter, viz., in the months of January, April, July, and October, and the woodwork of the stalls at least once in every four weeks. 13. Every person occupying a cow-shed shall cause it to be thoroughly flushed and cleansed twice every day, viz., before nine a.m., and after four p.m. ; and the yard to be cleansed at least once every day. 14. Every person occupying a cow-shed shall cause all dung manure to be removed daily in a properly constructed vehiole, before 8a.m., or where not more than four cows are kept, every other day. 15. No person occupying a cow-shed shall allow it to be used for any pose other than that for which it is licensed, or shall keep or permit to be kept therein any fowl, or any pig, horse, dog, or any other animal, except cattle. 16. Every person occupying a cow-shed shall give notice in writing within twenty-four hours to the local sanitary authority, of the existence of any contagious or infectious disease amongst his cows, and shall cause all diseased cows to be milked on to the ground. 17. E very person occupying a cow-shed shall give twenty four hours' notice to the local sanitary authority of his intention to remove from the shed any cow for the purpose of being slaughtered for the food of man. 18. No person occupying a cow-shed shall allow any person suffering from an infectious disease, or living in a house where such disease exists, to enter the cow-Bhed or dairy, or in any way to assist in the conduct of the business, during the continuance of such disease, or until all danger of the spread of infection shall have ceased, aud every infected room and article shall have been disinfected to the satisfaction of the medical officer of health of the district. The occupier shall give immediate notice in writing to the medical officer of health of the district of the existence of any such infectious disease. 19. Every person occupying a cow-shed or a dairy shall provide for use therein a sufficient number of receptacles made of nonabsorbent materials for the reception, storage, and delivery of milk, and shall cause them to be at all times kept thoroughly cleansed and purified ; and shall cause all milk to be removed without delay from the cow-shed, and shall not add to milk any substance for the purpose of altering its colour. 20. Every person occupying a cow shed shall cause all the cows therein to be curried and cleansed every day, and to bo well fed on sound, sweet, and wholesome food, and to be provided with good water at all necessary times. Distiller's wash shall not be used as food for the cows. 21. Every occupier of a cow-shed or a dairy shall allow any member of the local sanitary authority, in addition to all other persons lawfully entitled to admission, to have free access to every part of the business premises at all reasonable hours. 22. Penalty Clause. (N.B.-The penalty for selling the milk of diseased cows should be heavy, even to the extent of giving magistrates the power of imprisonment.) 43 CLASS II. Regulations for New Cow-sheds and Dairies. 23. Every new cow-shed shall be a detached building, situate in its own yard, and not within twenty feet of any inhabited building, and shall be provided with a paved passage behind the manger at least three feet in width. 24. Every new cow-shed shall be provided with a quarantine shed, effectually separated from the cow-shed, for the reception of cows newly brought on the premises ; and such cows shall be kept in quarantine for a period of twenty-one days before removing them into the cow-shed. 25. Every occupier of a cow-shed shall provide a shed to be called the "Infirmary," which shall be efEeotually separated from the cowshed, for the reception of cows suffering from contagious disease, and such cows shall be placed and kept therein until reoovery, removal, or death takes place. 26. Every dairy shall be well paved With asphalte, iron-stone bricks, or flag-stones, laid on concrete, and set in cement; the inner walls and all woodwork shall be covered with hard, smooth, impervious material to the height of six feet from the ground. The dairy shall have no direct communication with any inhabited dwelling room, and there shall not be within it any drain or other communication with a sewer, nor any water-closet, or privy within or contiguous to it. The dairy shall, at all times, be kept clean, and in good order and repair, and it shall not be used for any other purpose than that for which it is licensed. 27. Every dairy shall be provided with a sufficient number of tables of slate, marble, galvanized iron, or other impervious material, for the reception of the vessels containing milk, all of whioh shall be thoroughly washed and cleansed every morning and evening after the milk shall have been sent out. 28. Any person who shall make application to the local sanitary authority for sanction to establish anew the business of a dairyman, shall furnish with such application a plan of the premises and sections of the building in which it is proposed to carry on such business, drawn to the scale of a ¼ -inch to the foot, and showing the provision made, or proposed to be made, for the drainage, lighting, ventilation, and water supply of the same ; and shall also furnish a key-plan of the locality, showing the buildings and streets within 100 yards of the premises, drawn to the scale of five feet to the mile. 29. Penalty Clause. Definition of Terms—Throughout and for the purposes of these bye-laws, " the premises" shall include all the premises used for the business of a dairyman ; " cow-shed" shall mean that portion of the premises wherein cows are stalled or kept; "dairy" shall mean that portion of the premises which is used for the storage and for the vending or sale of milk; " occupier" shall be construed to mean the person owning, renting, or holding, or rated for, premises where the business of a dairyman is carried on ; and " dairyman" shall mean any and every person whose business is the keeping of cows for the production of milk, or whose sole or chief business is the vending or sale of milk for the food of man. The Society, I may add, directed a copy of the proposed byelaws to be forwarded to the Local Government Board. The President had already promised his best attention to the subject on receipt of a copy of my paper, and the Board renewed that assurance when acknowledging the communication addressed to 44 them by the Secretaries of the Society. There is good reason to hope that in the next session of Parliament the necessary legislative powers for framing bye-laws will be granted. As bearing on this point the subjoined “Parliamentary intelligence” (February 21st, 1875), which I extract from the British Medical Journal, will be read with interest:— "Typhoid Fever at Eagley.-Mr. Charley asked the President of the Local Government Board whether his attention had been called to the recent fatal outbreak of typhoid fever at Eagley, near Bolton, in Lancashire, which was attributed by the Medical Officer of Health to the pollution of milk by water filled with sewage, used for washing the milk cans; and whether, in view of the numerous and fatal outbreaks of a similar kind in Islington, Marylebone, Glasgow, Jarrow, and other places, which had been after due investigation attributed to a similar pollution of the milk supply, he would consider the expediency of introducing a measure for the protection of health by special sanitary supervision of dairy-farms, and of the premises in which milk is stored prior to sale by urban milkvendors ? Mr. Sclater-Booth said that his attention had been called to the question, and he caused immediate enquiry to be made of the sanitary authorities of the locality, who gave a most deplorable account of the ravages of fever in that particular district. Two facts came out, though the enquiry was not quite concluded. In the first place, it would appear that the milk in question, though poor in character was not greatly adulterated with water; and secondly, the cans had been washed with water from highly polluted sources. He could not say that he had it in contemplation to introduce any measure for the protection of health by special sanitary supervision of dairy-farms, but he was aware of the advisability of passing bye-laws, and the subject would receive his consideration." BAKEHOUSES. The bakehouses, 113 in number, viz., 64 in the north, and 49 in the south sanitary district, have been frequently inspected, and the provisions of the Act relating to them carried out as efficiently as possible. WATER SUPPLY. Information respecting the water supply is now derived from two independent sources, viz., from the chemical reports prepared by Professor Prankland, P.R.S., for the Registrar-General, and the Engineering Reports by Mr. Frank Bolton, the water examiner under the Metropolis Water Act, 1871. From Professor Frankland's reports, we learn that the temperature of the Thames water as supplied by the Chelsea, West Middlesex, and Grand Junction Companies, varied from 34°.7 Fahr. in December, to 66°.5 in August, a range of 31°.8, the water being unpleasantly warm in summer, and bordering on the freezing point in winter; while the 45 temperature of the deep well water of the Kent Company, unaffected by the season, had a range of only 5°, viz., from 50°.9 in December, to 55°.9 in May. The solid impurities in the river water—some of which are organic, very largely of animal origin, highly objectionable, and at times eminently noxious, whilst others are entirely or comparatively harmless, which had progressively increased during the years 1871-2-3, and diminished in 1874,—underwent a considerable increase in 1875, the maximum being observed in December, and the minimum in July; whilst in the deep well water of the Kent Company, which is taken as the standard of purity for the sake of comparison, the amount was the same as in 1874, a large amount, but of a harmless character. It is remarked that notwithstanding the application of partial remedies for sewage pollution at Banbury, Eton, and Windsor, and the greater care exercised by most of the companies in the storage and filtration of the water, the organic pollution contained in the Thames water delivered in London does not diminish. The maximum organic pollution occurred in January, February, March, August, and November. Of the three companies supplying this parish, the West Middlesex Company delivered the best water. The following table shows the amount of organic matter in the several supplies, the Kent Company's water being taken as the standard for comparison:— Name of Company. Maximum. Minimum. Average. Kent 1.0 1.0 1.0 West Middlesex 7.6 2.1 4.1 Grand Junction 7.4 2.0 4.2 Chelsea 7.9 2.2 4.4 The water of the Thames is at its source as free from pollution as the chalk well water, but in its downward course becomes largely contaminated by sewage and the washings of cultivated land, particularly during the winter. This water, moreover, is hard, and large quantities of soap and soda are required to soften it before it is used for washing, but the softening could be accomplished for a small fraction of the expense by substituting lime for soap or soda, as practised on similar waters at Aylesbury, Canterbury, Caterham, and Tring. For drinking, however, it would appear, as the result of considerable inquiry into rates of mortality in different districts, that soft and hard (but not excessively hard) waters, if equally free from deleterious orgranic substances, are equally wholesome. The following table exhibits the degree of efficiency of filtration of the water as supplied by the Companies in this parish:— Name of Company. Number of occasions when clear and transparent. Number of occasions when slightly turbid. Number of occasions when turbid. Number of occasions when very turbid. Chelsea 8 4 1 0 West Middlesex 13 0 0 0 Grand Junction 3 6 4 0 46 The natural filtration which the Kent Company's deep well water undergoes through an enormous thickness of chalk, is the cause of its uniform clearness and transparency, which renders it independent of artificial filtration. When examined by the miscroscope, the sediment deposited by turbid water on standing, is almost always found to contain num.bers of living and moving organisms. The annexed table shows the results of such microscopic examinations during the past seven years:— Number of occasions when living organisms were found. Name of Company. 1869. 1870. 1871. 1872. 1873. 1874. 1875. Chelsea 3 2 2 3 2 5 4 West Middlesex 0 0 0 0 0 0 0 Grand Junction 4 1 1 2 3 5 7 The subjoined table exhibits the averages, for 1875, of solid impurity ;and other particulars, the numbers relating to 100,000 parts of each water:— Name of Company Temperature in Centigrade Degrees. Total Solid Impurity. Organic Carbon. Organic Nitrogen. Ammonia. Nitrogen as Nitrates and Nitrites. Total Combined Nitrogen. Previous Sewage or Animal Contamination. (Estimated.) Chlorine. Total Hardness. Proportionate Amount of organic Elements, that in the Kent Company's Water being taken as 1. Chelsea 11.8 26.46 .211 .039 .001 •155 •196 1250 1.87 19.3 3.7 West Middlesex 12.6 26.62 •176 •028 •001 •124 153 930 1.83 19.4 3.0 Grand Junction 11.4 27.00 •186 .033 001 .129 •161 990 1.83 20.0 3.3 Kent 124 40.36 •067 •012 •000 •371 •383 340 2.48 28.1 1.0 From Mr. Frank Bolton's reports we learn that the West Middlesex Company are giving constant supply to a number of houses on the application of the owners, and are fully prepared to extend the system as required: as a matter of fact, however, the number of houses having constant supply is small. The construction of a new filter bed at Barnes, of two acres area, is progressing. The Company having large reservoir capacity for subsidence avoid taking in water during floods. The construction by the Grand Junction Company of further impounding reservoirs for subsidence at the intake at Hampton (so as to avoid the flood waters) is in contemplation, as this Company will require such reservoirs before they can deliver effectually filtered water during the period when floods prevail. The Chelsea Company's new works, which I referred to in my last annual report, are progressing rapidly; the pumping main has been laid, and the water is now taken in at West Molesey instead of at Seething Wells. The impounding reservoirs are also progressing upon the land (comprising an area of about 50 acres necessary for their construction) near Molesey. The erection of the necessary engine power is in progress; meanwhile, temporary engines have been fixed to afford supply from the new intake, and the Company are urging on the completion of 47 their new works with all possible despatch. We may hope, therefore, that this Company will soon be in a position to supply water as good as that of any other Company, and that the Companies generally will be able to supply all parts of the parish with clear and transparent water. The question of constant supply, however, makes very slow progress, though there is no doubt of the power of the " Metropolitan authority" (Metropolitan Board of Works) to demand it, or of the power of the Companies to give it. In the East of London the East London Waterworks Company are giving constant supply to very large areas, and the same may be said of the district supplied by the Kent Company. Constant supply for domestic purposes, however, without the abolition of cisterns, would be a doubtful gain, the principal cause of pollution of water being the dirty neglected state of the receptacles which are often left uncovered and rarely cleaned out-the latter defect being in many cases attributable to the difficulty of getting at them. As a rule the water is delivered clear and transparent, filtration being effectual, especially by those Companies that have provided large reservoirs in which the water is allowed to stand for some days to allow of the subsidence of suspended impurities. But it is of little use getting clear water if it is put into dirty tubs or similar receptacles. Domestic filters, moreover, are often a delusion, being left undisturbed for long periods, as though they were capable of selfcleansing. It is not uncommon to receive complaints of bad water even when the water has been filtered on the premises, the cause being a dirty cistern or a dirty filter. Moving organisms have in such cases been perceptible to the naked eye—and the entire subject of complaint has been removed by a little attention to cleanliness* It would be well, however, if local sanitary authorities were clothed with greater powers in dealing with questions of water supply, which are now governed by regulations framed by the Companies and sanctioned by the Board of Trade, whose powers have since been transferred to the Local Government Board. As these "water regulations" were settled after an exhaustive enquiry by a Government commission, at which the Companies and the Metropolitan authority were represented, there can be no doubt that sanitary purposes were contemplated, as well as the prevention of waste: but practically the regulations are carried out (when acted on at all) as if the prevention of waste were the sole object of them. As an illustration I may more particularly allude to the 14th regulation, which runs thus : " No *The subjoined extract from one of my monthly reports will bear repetition: A fatal case of diphtheria in a house in Elsham-road led to the premises being inspected with the following results: "The cause of the illness would appear to have been the unsanitary condition of the house. There are two water-closets in the centre of the house and ventilating into it. The large water cistern in the roof sjas found uncovered and in a filthy condition, while the cistern in the basement contained the wing cases of hundreds of cockroaches, whose bodies had been slowly macerated and consumed by the household. The larger cistern, moreover, was in direct communication with the soil-pipe by means of the waste-pipe. In all probability these cisterns had not been cleansed for years.'' 48 overflow or waste pipe, other than a warning pipe' shall be attached to any cistern supplied with water by the Company : and every such overflow or waste pipe existing at the time when these regulations come into operation shall be removed, or at the option of the consumer shall be converted into an efficient "warning pipe" within two calendar mouths next after the Company shall have given to the occupier of, or left at the premises in which such cistern is situate, a notice in writing requiring such alteration to be made." This regulation is practically a dead letter.* Nearly all cisterns still have ordinary waste-pipes, and in very many cases these are in untrapped communication with a drain or with the soil-pipe of a water-closet. If there is no "waste" the Companies have no motive for interfering. But the danger in a sanitary point of view is greatest when there is no "waste," as the trapping of the waste-pipe is usually effected by a S bend : so that when, as generally is the case, the mouth of the waste-pipe is above the water level, the pipe is constantly empty and dry, and no obstacle is offered to the passage of sewer gas into the cistern. This constitutes an undoubted nuisance, and in individual cases it may be abated by legal proceedings:— such, at least, is the experience of some Medical Officers of Health, though Police Court decisions are not uniform. But what is wanted is a general plan of enforcing the regulation, and abolishing the waste pipe wherever it is connected with a drain or a soil-pipe of a water-closet, or so situated as to endanger the pollution of the water. The Companies alone can enforce the regulation. The West Middlesex Company, however, do not enforce it excepting in special cases which come under their notice, and for the prevention of waste : this Company, taking the view that the 14th regulation must be read with the 33rd, which enacts that " all existing fittings which shall be sound and efficient, and are not required to be removed or altered under these regulations shall be deemed to be prescribed fittings under the " Metropolis Water Act, 1871." But surely the waste-pipe is a fitting that is "required to be removed or altered," under these regulations, viz., by the 14th! The Grand Junction Company have not adopted the regulations, and having a very abundant supply of water, are not under any anxiety respecting the amount of waste. These Companies, moreover, have no regular staff of inspectors whose sole duty it is to see that the regulations in respect of fittings are carried out. The Chelsea Company, on the other hand, employ three inspectors for this purpose, and there can be no doubt that much advantage has accrued to the district supplied by this Company from the systematic manner in which the fittings have been overhauled, and when nccessary "removed or altered." I have it on the authority of the Secretary of the Company, that the waste pipe has been removed in * Mr. Frank Bolton in his report for August, remarks that the 14th regulation should be " strictly enforced," and he gives some very cogent reasons for this opinion; but, as I have shown in the text, it is more easy to prove the necessity of such observation of the bye-law than to enforce it. 49 some thousands of houses in this Company's district, and that in course of time the whole of the cisterns will be provided with warning pipes as prescribed by the 14th regulation. The inspector assures me, moreover, that no practical difficulty is experienced in effecting the alteration, the inhabitants generally, on explanation, recognising the value of it. It is almost superfluous to say that what has been done by one Company may be done by the others; and if the Companies are unwilling to do the work, local sanitary authorities should have co-ordinate jurisdiction with them, and be empowered to serve the necessary notices for the abolition of the waste-pipe in all proper cases. It is curious that the law should be so stringent with respect to offences nnder the Act, viz., for fouling the water in bulk-every precaution being taken to secure the water being brought in a state of purity to the cistern— and then so absolutely indifferent as to what becomes of it afterwards. We must not pollute the water in bulk, and so poison our neighbours, but we may commit constructive suicide by allowing emanations from sewers and water-closets to enter our water cisterns. The regulations, it may be added, may be altered, and the mode of procedure, to obtain such alteration, is specified in the Act, viz., by an application to a water company by the " Metropolitan authority," or by any ten consumers of water supplied by the Company, to repeal or alter any of the regulations, or to make new regulations instead of any of them : aud if the Water Company refuses to comply, the Local Government Board may, if they think fit, appoint a competent and impartial person of engineering knowledge and experience, to report to them, ... as to the expediency of altering or repealing regulations, or of making new regulations in conformity with such request as aforesaid, and on the report of such person, the Board may make such repeal or alterations as they think fit. I would, therefore, beg to recommend that the Metropolitan authority (Metropolitan Board of Works) be asked to make request as aforesaid, so as to enable local sanitary authorities to enforce such of the regulations as have a sanitary bearing. GAS. During the year there has not been any complaint made to me on the subject of gas supply in this parish. The subjoined tables are taken from the quarterly reports of the chief gas examiner. 1. Maximum, minimum, and average lighting power of the gas in standard sperm candles at the testing place Ladbroke Grove, Notting Hill:— Maximum. Minimum. Average. Quarter ended Mar. 31st, 1875 18.0 16.1 16.92 Quarter ended June 30th, 1875 18.1 16.0 16.97 Quarter ended Sept. 30th, 1875 18.0 16.3 16.88 Quarter ended Dec. 31st, 1875 18.2 15.9 16.93 Averages, whole year 18.07 16.07 16.92 50 The gas would therefore appear to have been always (with one exception, viz., 15.9 on the 1st November) up to the standard lighting power of 16 oandles. 2. Grains of sulphur per 100 cubic feet of gas— Maximum. Minimum. Average. 1st Quarter 31.9 8.7 19.40 2nd „ 16.6 6.5 10-40 3rd ,, 19.1 7.4 11.77 4th „ 20.7 6.8 12.99 Averages 22.07 7.3 13.64 The prescribed quantity of sulphur impurity (viz, 25 grains in 100 cubic feet of gas) was exceeded on four occasions in the first quarter, viz., on January 9th (29 grains), 11th (31.9 grains), and 12th (29 grains), and February 25 (25.4 grains) : but on no occasion in the other three quarters, the purity of the gas in this respect being generally considerably above the requirements of the gas referees. Sulphuretted hydrogen, which is absolutely disallowed, was not found on any occasion, and the quantity of ammonia was very much below the prescribed amount, viz., 2½ grains in 100 cubic feet. The most interesting fact in connection with gas supply during the year is that your Vestry, following the example of other parishes, have resolved to adopt the "average meter" system, so as to pay only for the amount of gas actually consumed. MORTUARY AND DISINFECTING CHAMBER, &c. Numerous articles have been disinfected, free of cost for poor persons, after infectious diseases, and a still larger number have been disinfected at the cost of the owners who were able to bear the expense. All, or nearly all disinfection is done at Notting Hill by a firm who have the requisite conveniences; but it is eminently desirable to provide a parochial disinfecting chamber. This and a mortuary are among our chief sanitary desiderata at the present time. With reference to the mortuary, I am still of opinion that whenever it is provided, there should be attached to it a court room for holding inquests, and all the conveniences necessary for post-mortem, examinations, in order to avoid the necessity of resorting to public houses, and making them in the dwellings of the poor; it being no uncommon experience that such examinations are made in the single room used for all purposes, and at all times by an entire family. If such a mortuary, with a striking semiecclesiastical elevation, and in a good position, were provided, it would be of great service; but a mean looking building, hidden away in a corner, would be less likely to prove a success. If one mortuary only were provided for this extensive parish, it should be centrally situated though it is most wanted in the northern section of the parish. It would be well, however, to provide two, one in 51 the north, and one on the site that has always appeared to me very suitable for such a building, namely, in the disused burial ground of the parish church. A mortuary in this place (and surely none more fitting for the temporary reception of our dead!) could be superintended by the keeper of the Vestry Hall: the bodies of the poor on which inquests have to be held could be removed to it, and doubtless arrangements could be made to enable the coroner to hold his court at the Vestry Hall, old or new. The average yearly number of inquests is about 160-say three a week-and it is the custom when practicable, to hold two or more inquests on the same day, so that no great inconvenience would arise if such an arrangement were carried out; and I have reason to believe that it would be acceptable to the coroner, whom I consulted on the subject some years ago. It may, perhaps, be alleged that jurymen would be put to unnecessary trouble in coming long distances from north and south to the centre of the parish, but in answer to this it is only neccssary to observe that by a discreet exercise of his powers in selecting jurors (who are usually drawn from the locality of the deaths) the coroner's officer could reduce the probable inconvenience to an insignificant minimum. BATHS AND WASH-HOUSES. The question of baths and wash-houses was not mooted last year; I venture to hope, however, that as soon as the new Vestry Hall question haa been settled this will be taken in hand. The St. Pan eras Vestry are erecting a second establishment for the convenience of their numerous constituents. The East of London is moving in the matter. St. George's, Hanover Square; St. Margaret's, Westminster; and St. James', have public baths; Hammersmith has provided baths through the agency of a limited liability company, and Chelsea is doing the same. Kensington will be last in the race, and would be badly off indeed but for the propinquity of the superb establishment provided by the Paddington Vestry in the Queen's Road, Bayswater. Let us hope, however, that if we are " last" we shall be the reverse of " least;" and that when we do build baths and wash-houses they will be on a scale commensurate with the size and grandeur of the parish, and replete with all the improvements suggested by experience. In concluding my report, I have again the satisfaction of acknowledging the courteous readiness of the parochial officers generally to assist me in the performance of my duties, by information of infectious diseases, etc. The Guardians and the Dispensary Committee have always exhibited a desire to co-operate with your Vestry in measures for improving the public health. The sub-district registrars of deaths, etc. (Messrs. Barnes and Hume) spare no trouble to supply me with 52 ation on all matters connected with their department. My efforts are well seconded by the sanitary inspectors, who perform their onerous and important duties with care and fidelity. Lastly, I have to express my obligations to your Vestry for the confidence placed in me, through which the work of my department is greatly facilitated. I am, Gentlemen, Your obedient Servant, T. ORME DUDPIELD, M.D , Medical Officer of Health. Vestry Hall Kensington, August, 1876. APPENDIX. Note.The forms for Tables I.—VI. have been settled by the Society of Medical Officers of Health to ensure uniformity of Statistical returns. TABLE I. Estimated population 1875, 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. 1875. 143,500 18,444 4,478 2,786 1,346 1874 138,000 17,667 4,356 2,696 1,311 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 2,473 892† 1869 111,350 14,654 3,625 2,249 891† 1868 106,350 14,029 3,522 2,232 984† 1867 101,350 13,404 3,158 1,933 974† 1866 96,350 12,779 3,080 1,966 984† 1865 91,350 12,154 2,619 1,733 920† Average of 10 years, 18651874 114,300 14,848 3,609 2,221 " Notes.—Population at Census, 1871, 130,234. 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 known 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. † The returns of marriages for the years 1865-70, inclusive, do not include those that took place at the Superintendent Registrar's Office, concerning which I have no information. TABLE II. Showing Birth & Death Rate: Deaths of Children, & Deaths in Public Institutions 1875, & 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 1875. 31.2 194 25 15.6 40.3 338* 1874 31.7 19.5 28.5 17.5 45.4 352 1873 31.4 183 27.0 15.9 400 272 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. 16.4 42.9 330 1869 32.5 20.2 t t t 313 1868 33.1 21.0 t t t 303 1867 31.2 19.0 t t 40.6 221 1866 32.0 20.4 t t 41.6 248 1865 28.7 19.0 t t t 250 Average of 10 Years, 1865.1874 31.6 19.4 t t 42.3 280 *Viz. The Workhouse (195), and the Hospital for Chest Diseases at Brompton (143). † No information. Note.—The calculations in this Table are made on the gross number of deaths registered without deduction of those of non.parishioners at public institutions. TABLE III. Deaths Registered from all causes during the year 1875. (The Deaths in Public Institutions of non-residents being excluded.) CAUSES OP DEATH. AGES. Total deaths umder Fove Grand Total. SUB-DISTRICT Under1 1 to2 2 to5 5 to15 15 to25 25 to 35. 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 85 to 95. 95 and upwards. Kensington Brompton. (classes) I. ZYMOTIC DISEASES 159 81 98 57 17 27 12 9 13 10 8 ... ... 341 494 376 118 II. CONSTITUTIONAL 86 42 31 20 51 91 64 65 35 32 8 1 ... 159 526 411 115 III. LOCAL 239 91 59 34 21 54 99 116 173 179 132 21 ... 389 1218 982 236 IV. DEVELOPMENTAL 191 22 4 1 ... 7 4 1 3 34 51 26 5 217 349 298 236 V. VIOLENT DEATHS 12 2 4 1 4 2 14 5 3 2 3 ... ... 18 52 36 51 (Not specified) 2 1 1 2 1 ... 2 ... ... 2 2 ... ... 4 13 10 3 I. ZYMOTIC DISEASES. Order 1.-Miasmatic 689 242 197 115 94 181 195 196 227 259 204 48 5 1128 2652 2113 539 Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 6 8 9 ... ... ... ... ... ... ... ... ... 23 23 ... Scarlet Fever (Scarlatina') ' j, 35 23 83 12 11 Diphtheria 1 2 7 10 1 1 1 ... ... ... ... ... ... 10 23 15 8 Quinsy ... ... ... ...in... ... 1 1 ... ... ... ... ... ... ... 2 1 1 Croup 2 7 9 4 ... ... ... ... ... ... ... ... ... 18 22 16 6 Whooping-cough 40 31 28 7 1 ... ... ... ... ... ... ... ... 99 107 87 6 Typhus ... ... ... ... 1 1 ... ... ... ... ... ... ... ... 2 2 ... Enteric or Typhoid Fever ... ... 1 5 2 6 1 1 3 1 1 ... ... 1 21 12 9 Simple continued Fever ... ... 3 ... 1 ... ... 1 ... ... 1 ... ... 3 6 4 2 Erysipelas 6 2 ... ... ... 1 1 1 6 3 2 ... ... 8 22 17 5 Puerperal Fever (Metria) ... ... ... ... 4 5 4 ... ... ... ... ... ... ... 13 11 2 Carbuncle ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Dysentery ... ... 1 ... ... ... ... ... 1 ... ... ... ... 1 2 1 1 Diarrhœa 76 18 4 ... ... 3 ... ... 1 4 1 ... ... 98 107 95 12 Simple Cholera 4 ... ... 1 ... ... ... ... ... ... ... ... ... 4 5 3 2 Ague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Remittent Fever 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 ... Rheumatism ... ... 1 5 5 3 ... 5 2 2 3 ... ... 1 26 18 8 Other Zymotic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Order 2—enthetic. Syphilis 9 2 ... ... ... 2 1 ... ... ... ... ... ... 11 14 12 2 Stricture of Urethra ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Glanders ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Order 3.—dietic. Privation ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Want of Breast-milk ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Purpura and Scurvy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... a Del. Tremens ... ... ... ... ... 1 3 1 ... ... ... ... ... ... 5 4 1 Alcoholism b Intemperance ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Order 4.—parasitic. Thrush 10 ... ... ... ... ... ... ... ... ... ... ... ... 10 10 7 3 Worms, &c ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... II. CONSTITUTIONAL DISEASES. Order 1.—diathetic. 159 84 98 57 17 27 12 9 13 10 8 ... ... 341 494 376 118 Gout ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Dropsy 1 ... ... 1 ... ... ... ... 1 2 1 ... ... 1 6 6 ... Cancer ... ... ... ... ... 3 10 17 19 18 6 1 ... ... 74 58 16 Cancrum Oris (Noma) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Mortification ... ... ... ... ... ... ... ... ... 2 l ... ... ... 3 2 1 Order 2.—tubeeculae. Scrofula 4 4 7 3 2 1 2 ... ... ... ... ... ... 15 23 20 3 Tabes Mesenterica 52 12 2 1 ... ... ... ... ... ... ... ... ... 66 67 52 15 Phthisis ... 3 4 9 49 87 52 48 15 10 ... ... ... 7 277 213 64 Hydrocephalus and Tubercular Meningitis 29 23 18 6 ... ... ... ... ... ... ... ... ... 70 76 60 16 III. LOCAL DISEASES. Order 1.—nebvous system. 86 42 31 20 51 91 64 65 35 32 8 1 ... 159 526 411 115 Cephalitis 1 ... ... 1 5 3 3 ... 1 ... ... ... ... 1 14 9 5 Apoplexy 1 1 ... 1 ... 5 9 10 11 17 14 2 ... 2 71 55 16 Paralysis ... ... ... ... 1 ... 4 3 12 21 10 ... ... ... 51 35 16 Insanity ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 1 ... Chorea. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epilepsy ... 1 ... 2 ... 2 1 3 ... ... ... ... ... 1 9 8 1 Convulsions 62 l2 6 1 ... ... ... ... ... ... ... ... ... 80 81 71 10 Brain Disease, &c 4 2 4 3 1 3 5 5 10 12 8 1 ... 10 58 48 10 Order 2.— organs op circulation. Pericarditis ... 2 1 ... ... ... ... 1 ... ... ... ... ... 3 4 4 ... Aneurism ... ... ... ... ... 2 1 ... ... ... ... ... ... 3 3 ... Heart Disease, &c 1 ... 1 8 5 7 18 26 38 34 23 1 ... 2 162 133 29 Order 3.—eespibatoet organs. Laryngitis 5 1 1 ... ... ... 1 ... 1 ... ... ... ... 7 9 7 2 Bronchitis 79 43 21 2 1 5 4 18 38 53 49 13 ... 143 326 273 53 Pleurisy 1 ... ... 2 ... ... ... ... 1 2 2 ... ... 1 8 4 4 Pneumonia 54 20 18 8 1 10 16 15 13 8 10 3 ... 92 176 148 28 Asthma ... ... ... ... ... 1 5 5 2 2 1 ... ... 16 14 2 Lung Disease, &c. 18 5 3 2 ... 1 ... 5 3 4 ... ... 26 43 34 9 Order 4.—digestive oegans. Gastritis 2 ... ... ... 1 2 ... ... 1 1 ... ... ... 2 7 5 2 Enteritis 3 1 ... ... 1 1 ... ... 1 ... 2 ... ... 4 9 7 2 Peritonitis 1 ... ... ... ... 3 1 3 3 1 ... ... ... 1 12 9 3 Ascites ... ... ... ... ... 1 ... 1 1 ... ... ... ... ... 3 3 ... Ulceration of Intestines ... 1 ... ... ... ... 3 1 1 ... ... ... ... 1 6 6 ... Hernia ... ... ... ... ... ... ... ... 1 1 1 ... ... ... 3 3 ... Ileus 1 ... ... 1 1 ... 1 ... ... 2 1 ... ... 1 7 5 2 Intussusception ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... 1 Stricture of Intestines ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 2 1 1 Fistula ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Stomach Disease, &c. 1 ... ... ... ... ... 1 2 ... 1 ... ... ... 1 5 3 2 Pancreas Disease, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Hepatitis ... ... ... ... ... 2 1 ... 1 2 ... ... ... ... 6 4 2 Jaundice 2 ... ... ... ... ... 1 ... 1 ... 1 ... ... 2 5 4 1 Liver Disease, &c. ... ... ... 1 ... 3 10 8 10 5 ... ... ... ... 37 4 1 Spleen Disease, &c ... ... ... ... ... 1 ... 2 ... ... ... ... ... ... 3 1 2 Order 5.—urinary organs. Nephritis ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... 3 2 1 Ischuria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Bright's Disease (Nephria) ... ... 1 ... ... 1 6 4 7 6 1 ... ... 1 26 15 11 Diabetes ... ... ... ... ... ... 1 1 4 ... 1 ... ... ... 7 6 1 Calculus (Stone) ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 1 Cystitis ... ... ... ... ... ... ... ... 1 2 2 ... ... ... 5 5 ... Kidney Disease, &c. ... 1 ... 1 2 2 2 1 3 3 ... ... ... 1 15 12 3 Order 6.—oegans of generation. Ovarian Dropsy ... ... ... ... ... 1 ... 2 2 ... 1 ... ... ... 6 6 ... Uterus Disease, &c. ... ... ... ... 1 ... 2 2 ... 1 ... ... ... ... 6 5 1 Order 7.—organs of locomotion. Synovitis (Arthritis) . ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Joint Disease, &c. ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... 2 2 ... Order 8.—integumentary system. Phlegmon 2 ... 2 ... ... ... ... ... ... ... ... ... ... 4 4 4 ... Ulcer 1 ... ... ... ... ... 2 ... ... ... ... ... ... 1 3 3 ... Skin Disease, &c ... 1 1 ... ... ... ... ... ... ... ... ... ... 2 2 1 1 239 91 59 34 21 54 99 116 173 179 132 21 ... 389 1218 982 236 IV. DEVELOPMENTAL DISEASES. (Order 1.—diseases of children. Premature Birth 42 ... ... ... ... ... ... ... ... ... ... ... ... 42 42 34 8 Cyanosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Spina Bifida 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 2 2 ... Other Malformations 5 ... ... 1 ... ... ... ... ... ... ... ... ... 5 6 5 1 Teething 14 11 1 ... ... ... ... ... ... ... ... ... ... 26 26 19 7 Order 2.—diseases of adults. Paramenia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Childbirth (see Puerperal fever) ... ... ... ... ... 7 4 ... ... ... ... ... ... ... 11 8 3 Order 3.—diseases of old people. Old Age ... ... ... ... ... ... ... ... 2 34 51 26 5 ... 118 99 19 Order 4.—diseases of nutrition. Atrophy and Debility 128 11 3 ... ... ... ... 1 1 ... ... ... ... 142 144 131 13 191 22 4 1 ... 7 4 1 3 34 51 26 5 217 349 298 51 V. VIOLENT DEATHS, &c. Order 1.—accident of negligence. Fractures and Contusions ... 1 2 3 1 7 3 1 1 3 ... ... 3 22 11 8 Wounds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Burns and Scalds l 1 1 1 ... ... 1 ... ... ... ... ... ... 3 5 5 ... Poison ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... 1 Drowning 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 ... Suffocation 8 ... ... ... ... ... 2 ... ... ... ... ... ... 8 10 8 2 Otherwise ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 ... Order 3.—homicide. Murder and Manslaughter ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Order 4.—suicide. Wounds: Gunshot, Cut, Stab ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 Poison ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 1 ... Drowning ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 2 2 ... Hanging ... ... ... ... l ... 1 ... ... 1 ... ... ... ... 3 1 2 Otherwise ... ... ... ... ... '1 1 ... ... ... ... ... ... ... 2 ... 2 Order 5.—execution. Hanging ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Violent Deaths (not classed) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Sudden deaths (cause unascertained 2 ... 1 ... ... ... ... ... ... ... ... ... 3 3 3 ... Causes not specified or ill defined 12 2 4 1 4 2 14 5 3 2 3 ... ... 18 52 36 16 2 1 1 2 1 ... 2 ... ... 2 2 ... ... 4 13 10 3 CAUSES OP DEATH. Under 1. 1 to2. 2 to 5. 5 to 15 15 to 25 25 to 35. 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 85 to 95. 95 and upwards, Total deaths under Five. Grand Total ton Town. Brompton AGES. sub-district TABLE IV. Showing Mortality from certain classes of Diseases, and proportions to Population, and to 1,000 Deaths, 1875, viz.— Diseases. Total Deaths. Deaths per 1000 of Population. Proportion of Deaths to 1000 Deaths. 1. Seven Principal Zymotic Diseases 372 2.5 133 2. Pulmonary (other than Phthisis) 577 4.0 208 3. Tubercular 367 2.5 133 4. Wasting Diseases of Infants (under 5) 184 1.2 66 5. Convulsive Diseases of Infants (under 5) 176 1.2 63 NOTES. 1. Includes Small Pox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Fever and Diarrhœa. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. 4. Includes Marasmus, Atrophy, 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, 1865-74, from the seven principal Zymotic Diseases, and the number in 1875, &c. Disease. 1865 1866 1867 1868 1869 1870 1871 1872 1873 1874 Annual Average 10 years, 1865—74. Proportion of Deaths to 1000 Deaths in 10 years, 1865—74. 1875 Proportion of Deaths to 1000 Deaths in 1875. Smallpox 18 10 29 4 6 8 120 68 1 0 26.4 11.9 0 0 Measles 52 40 19 84 27 70 64 43 38 121 55.8 25.0 23 8.2 Scarlet Fever 31 28 35 170 106 198 95 29 10 32 73.4 33.2 83 29.5 Diphtheria Not separately registered. 9 14 11 14 11 26 8.5 3.8 23 8.2 Whooping Cough 37 28 68 34 71 55 72 77 44 45 53.1 24.3 107 38.4 "Fever" 77 33 46 52 42 46 48 42 41 52 47.9 21.7 29 10.4 Diarrhœa 101 112 78 113 108 154 129 110 145 112 116.5 52.6 107 38.4 Total, Kensington 319 251 275 457 369 545 539 383 290 388 381.6 172.5 372 133 Total, London 14,272 14,761 11,660 14,925 17,413 16,476 19,455 12,699 11,385 11,230 14,427 178 13,411 164 Total, England & Wales 1863-72* 1863 1864 1865 1866 1867 1868 1869 1870 1871 1872 1863—72 1863—72. 1873 1873 98,490 96,279 92,030 82,692 72,587 97,352 90,380 100,497 103,801 91,743 92,584 188 89,286 181 * The Totals for England and Wales are for the ten years 1863—72, compared with 1873, the last year of publication at the present time. TABLE VI. Inspector's Report of the Sanitary Work completed in the year ended March 25th, 1876. 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, Premises, &c., Cleansed, Repaired and Whitewashed. Houses Disinfected after Infectious Diseases. Repaired, Cleansed, &c. Trapped or Ventilated. Repaired, Covered, &c. Supplied with Water. New 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 accumulations of Dung, Stagnant Water, Animal and other Refuse. Removal of Animals, &c., improperly kept. Regularly Inspected. Other Proceedings, e.g. Legal Proccedings. Bakehouses. Licensed Cowhouses. Licensed Slaughterhouses. North. 764 2492 748 642 32 189 84 156 76 3 12 42 11 42 ... 2037 79 112 64 15 21 53 South. 793 2364 761 465 20 196 62 172 48 1 7 27 5 28 ... 2738 68 16 49 12 12 5 Total. 1557 4856 1509 1107 52 385 146 328 124 4 19 69 16 70 ... 4775 147 128 113 27 33 58 * The Act has not been put into operation. TABLE VIa. Summary of Monthly Returns of Sanitary Work done by the Inspectors. Date of Report. Houses Inspected. Mews Inspected. Slaughter Houses Inspected. Cowsheds Inspected. Bakehouses Inspected. Offensive Trades Inspected. Sanitary Orders Issued. Letters &c. Received re Dust Removal. Complaints of nonremoval of Dust. Orders Issued for the removal of Dust. Date of Report. North South North South North South North South North South North South North South North South North South North South May 5, 1875 184 164 18 17 9 7 8 8 11 10 7 0 60 68 687 310 51 18 1162 559 May 5, 1875 June 2 „ 212 229 19 18 8 8 10 7 9 10 8 0 44 39 245 209 50 21 566 429 June 2 „ June 30 „ 186 198 18 16 10 8 8 9 12 12 7 0 60 74 90 269 2 17 296 661 June 30 „ July 28 „ 192 186 34 29 14 6 7 10 12 14 4 0 65 52 63 127 1 6 181 300 July 28 „ Aug. 25 „ 168 173 36 39 34 29 9 7 12 11 6 0 41 64 62 142 1 6 219 280 Aug. 25 „ Sept. 22 „ 184 122 22 24 32 20 8 7 12 9 4 0 62 15 41 111 1 2 112 213 Sept. 22 „ Oct. 20 „ 98 85 19 21 36 23 24 19 7 11 3 0 47 78 51 103 — 2 112 203 Oct. 20 „ Nov. 17 „ 84 98 21 26 22 18 16 17 12 9 6 0 52 61 45 152 — 4 108 324 Nov. 17 „ Dec. 15 „ 126 147 18 14 6 5 9 8 12 11 4 0 54 60 74 266 — 5 199 475 Dec. 15 „ Jan. 12, 1876 112 129 19 16 9 5 7 10 10 8 2 0 53 32 207 303 3 6 381 618 Jan. 12, 1876 Feb. 9 „ 127 118 24 18 8 7 7 6 10 12 3 0 74 81 244 197 8 3 638 411 Feb. 9 „ March 8 „ 112 121 22 19 9 6 11 8 9 10 5 0 64 67 129 270 1 8 341 504 March 8 „ April 5 „ 164 182 24 22 12 6 8 10 13 11 2 0 72 70 99 279 — 7 263 561 April 5 „ Totals. 1949 1952 294 279 209 148 132 126 141 138 61 — 748 761 2037 2738 118 105 4578 5538 Totals. TABLE VII. Showing the Death rate per 1,000 living; the annual rate of Mortality per 1,000 living from seven Zymotic Diseases; and the proportion of Deaths from these Diseases to the total Deaths in Kensington and in all London in 1875, and in the ten years, 1865-74 The Year. Deaths per 1000 living. Total Deaths from seven Zymotic diseases, Kensington. Annual rate of Mortality per 1,000 living from seven Zymotic Diseases. Proportion of Deaths to 1000 Deaths from seven Zymotic diseases. ear. Kensington. London. Kensington. London. Kensington. London. 1865 19.0 24.5 319 3.5 4.7 185 196 1865 1866 20.4 26.4 259 2.6 4.8 133 185 1866 1867 19.0 23.0 276 2.7 3.7 142 166 1867 1868 21.0 23.6 457 4.2 4.7 208 200 1868 1869 20.2 24.6 369 3.3 5.5 164 227 1869 1870 21.2 24.1 545 4.6 5.1 222 213 1870 1871 19.1 24.7 542 4.4 6.0 233 242 1871 1872 17.0 21.4 390 3.0 3.8 181 179 1872 1873 18.3 22.5 290 2.1 3.3 119 149 1873 1874 19.5 22.5 388 2.8 3.3 144 147 1874 average of ten years. 19.4 23.7 383 3.3 4.4 173 190 average of ten years. 1875 19.4 23.7 372 2.5 3.9 133 164 1875 TABLE VIII. Comparative Analysis of the Mortality in all London and in Kensington, in 52 weeks, ended 1st January, 1876. LOCALITY. Annual Death Rate per 1000 living from all causes. Annual Death Rate per 1000 living from principal Zymotic diseases. Per centage 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 23.7 3.9 17.6 24.4 20.8 16.4 3.5 6.8 16.9 Kensington 19.4 2.5 15.3 24.6 23 13.3 1.9 5.9 12.1 TABLE IX. Showing the Principal Localities in which fatal cases of the chief Zymotic Diseases occurred in 1875. Brompton Registration Sub-District. Kensington Town Registration Sub-District. Locality. Measles. Scarlet Fever. Diphtheria. Whooping Cough. FEVER. Diarrhœa. Total. Locality. Measles. Scarlet Fever. Diphtheria. Whooping Cough. FEVER. Diarrhœa. Total. Locality. Measles. Scarlet Fever. Diphtheria. Whooping Cough. FEVER. Diarrhœa. Total. Typhus. Enteric. Simple Continued. Typhus. Enteric. Simple Continued. Typhus. Enteric. Simple Continued. Brompton Road 1 ... ... ... ... ... ... 1 2 Absolom Road ... ... ... ... ... ... ... 2 2 Manchester Road ... 1 ... ... ... ... ... 1 2 Bute Street ... 1 ... ... ... ... ... ... 1 Abingdon Road ... 1 ... 3 ... ... ... ... 4 „ Street ... 1 ... ... ... ... ... 2* 3 Cathcart Road ... 1 ... ... ... ... ... ... 1 Adair Road ... ... ... 2 ... ... ... ... 2 Norfolk Terrace ... ... ... 2 ... ... ... 1 3 Chapel Place 2 ... ... ... ... ... ... ... 2 Admiral Place 1 ... ... ... ... ... ... 2 3 Oxford Gardens ... ... 1 ... ... ... ... ... 1 Childs Place and Street ... ... 1 1 ... ... ... ... 2 Aldermaston Street 1 ... ... ... ... 1 ... ... 2 Pembridge Square ... ... 1 ... ... ... ... ... 1 Coleherne Terrace ... 1 ... ... ... ... ... 1* 2 Barandon Street ... ... ... 1 ... ... ... 1 2 Phillimore Mews 1 ... 1 ... ... ... ... 2 Collingham Place ... ... 1 ... ... ... ... ... 1 Basing Road ... ... ... 2 ... ... ... ... 2 Portland Road 1 1 ... ... ... ... ... 4 6 „ Road ... ... 1 ... ... ... ... ... 1 Bevington Road ... ... ... 1 ... ... 1 ... 2 Portobello Road ... 1 1 3 ... 2 1 2 10 Eardley Crescent ... 1 ... ... ... ... ... ... 1 Blechynden Street ... 3 1 2 ... ... ... 3 9 Princes Place ... 2 ... ... ... ... ... ... 2 Earl's Court Road ... 1 ... 3 ... ... ... ... 4 Blenheim Crescent ... 2 ... ... ... 1 1 ... 4 „ Road 1 2 ... ... ... ... ... ... 3 Finboro' Road ... 2 ... ... ... ... ... ... 2 Bolton Road ... ... ... ... ... ... ... 2 2 Queen's Gate Mews ... ... ... 2 ... 1 ... ... 3 Fulham Road ... 1 ... 1 ... 1 ... 1 4 Bosworth Road ... ... ... 3 ... ... ... 1 4 „ „ Terrace ... ... 1 ... ... ... ... ... 1 Hollywood Mews ... ... ... 2 ... ... ... ... 2 Bramley Road ... 2 ... 1 ... ... ... 1 4 Queen's Road ... 1 ... ... ... ... ... ... 1 Hooper's Court 1 1 ... 1 ... ... ... ... 3 Buckingham Terrace ... ... ... 2 ... ... ... 1 3 St. Ann's Road ... ... ... 1 ... 1 ... 1† 3 Ifield Road ... 3 1 2 ... 1 1 ... 8 Campden Street ... ... ... 1 ... ... ... 2 3 St. George's Road 1 ... ... 1 ... 1 ... ... 3 Kempsford Gardens ... ... 1 ... ... ... ... ... 1 Charlotte Terrace ... ... ... 1 ... ... ... 1 2 St. James' Place ... 2 ... ... ... ... ... ... 2 Kramer Mews ... 1 ... ... ... ... ... ... 1 Chepstow Mews ... ... ... 2 ... ... ... ... 2 St. Joseph's House ... ... ... ... ... ... ... 2 2 Montpelier Row 2 ... ... ... ... ... ... 1 3 „ Place ... 1 ... ... ... ... ... ... 1 St. Katherine's Road ... ... ... ... ... 1 ... 7‡ 8 Neville Terrace ... ... ... ... ... ... 1 ... 1 Clarendon Road ... 1 ... ... ... ... ... 2 3 Silchester Terrace ... ... ... 1 ... .. ... 1 2 Old Brompton Road ... 2 ... 3 ... 1 1 1 8 Convent Gardens ... ... ... 2 ... ... ... ... 2 Silver Street ... 1 ... 1 ... ... ... 1 3 Onslow Mews ... 1 ... ... ... ... ... ... 1 Cornwall Road ... 2 ... ... ... 1 ... ... 3 Southam Street ... 2 ... 3 ... ... ... 4 9 Princes Mews ... 1 ... ... ... ... ... ... 1 Crescent Street ... 1 ... 1 ... ... ... 1 3 Swinbroke Road ... 1 ... ... ... ... ... 3 4 Priory Grove ... ... 1 ... ... ... ... ... 1 Dartmoor Street ... 2 ... 4 ... ... ... 1 V Sylvester Mews ... 1 ... ... ... ... ... 1 2 Redcliffe Road ... ... ... ... ... 1 ... 1 2 Edenham Street ... 1 ... 5 ... ... ... ... 6 Talbot Grove ... 1 ... ... ... ... ... 1 2 Redcliffe Gardens ... ... 1 ... ... ... ... ... 1 Elsham Road ... ... 1 ... ... ... ... ... 1 Tavistock Crescent ... 1 ... ... ... ... ... ... 1 Relton Mews ... 2 ... ... ... ... ... ... 2 Fowell Street ... 5 ... 2 ... ... ... ... 7 Testerton Street ... 1 ... ... ... ... ... 2 3 Rutland Street ... 1 ... ... ... ... ... ... 1 Golborne Gardens ... ... ... 2 ... ... ... 1 3 The Mall ... ... 1 ... ... ... ... 1 2 Seymour Place 1 ... ... ... ... 1 ... ... 2 „ Road ... 6 ... ... ... ... ... 1 7 Thorpe Mews ... ... ... 3 ... ... ... 1 4 Southwell Gardens ... 1 ... ... ... ... ... ... 1 „ Terrace ... ... ... ... ... 1 ... 1 2 Tobin Street ... ... ... ... ... ... ... 2 2 Thistle Grove ... ... ... ... ... 1 ... ... 1 Hazlewood Crescent ... ... ... ... ... ... ... ... 2 2 Treverton Street ... 1 ... ... ... ... ... ... 1 Thurloe Place ... ... ... ... ... 1 ... ... 1 Holland Road ... ... 1 ... ... ... ... ... 1 Uxbridge Street ... ... 1 2 ... ... ... 1 4 Walgrave Road ... 2 ... ... ... ... ... ... 2 Johnson Street ... 1 ... ... ... ... ... ... 1 Walmer Road ... 2 1 1 ... ... ... ... 4 Warwick Road 1 1 1 4 ... ... ... ... 7 Kensington High Street ... 1 ... ... ... ... ... ... 1 Western Terrace ... ... ... 1 ... ... ... 1 2 Yeoman's Row 1 1 ... ... ... 1 ... 1† 4 „ Place ... ... ... 2 ... ... 1 ... 3 William Street ... ... ... 4 ... ... ... 1 5 Ladbroke Grove Road ... 2 ... ... ... ... ... ... 2 Workhouse (The) ... ... ... 2 1 1 ... 6 10 „ Road ... ... ... ... ... 1 ... ... 1 Wornington Mews ... 1 ... ... ... ... ... ... 1 Lorne Gardens ... 2 ... ... ... ... ... ... 2 „ Road ... 1 ... 2 ... 1 ... ... 4 (*) Infantile Cholera. (*) Choleraic Diarrhœa. (†) Choleraic Diarrhœa. (†) Infantile Cholera. (‡) Choleraio Diarrhœa. TABLE X. PARISH OF ST. MARY ABBOTTS, KENSINGTON. Return respecting the Vaccination of Children whose Births were Registered during the year 1875. 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 Births which are not entered in the Vaccination Register, on account (as shown by Report Book) of Column 10 Successfully vaccinated. Column 11. Column 13. Dead. Un-vaccinated. 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. Insusceptible of Successful Vaccination. Had Small-pox. 1 2 3 4 5 6 8 9 10 1st January to 30th June Kensington Town 1854 1499 8 190 15 6 136 Brompton 415 344 3 38 4 1 25 1st July to 31 st Decern. Kensington Town 1795 1444 10 180 32 7 118 4 Brompton 425 366 1 33 12 2 11 Total 4489 3653 22 441 63 16 290 4 TABLE XI. LICENSED SLAUGHTER HOUSES. SOUTH SANITARY DISTRICT, (12). LOCALITY. LICENSEE. 11, Church Street, Kensington Mr. Stimpson 11, Peel Place, Silver Street „ Andrews The Mall, Silver Street „ Wright 121, Brompton Road* „ Cox 183, Ditto „ French 12, New Street, Brompton* „ Lidstone 60, Kensington High Street „ English Phillimore Mews „ Clayton 15, High Street, Notting Hill „ Short 133, Ditto ditto „ Candy 6, Hope Terrace, Notting Hill „ Beall 35, Earl's Court Road „ Matson NORTH SANITARY DISTRICT, (21). 13, Archer Mews Mr. H. Rush 20, Bolton Mews Messrs. Smith and Son 195, Clarendon Road Mr. J. W. Rush 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, Princes Road, Notting Hill „ Parratt 98, Ditto ditto „ Roser 10, Princes Mews, Notting Hill „ Cole 10, Princes Road Mews ditto „ Coles Portland Road ditto „ Colley 41, Princes Place ditto „ Pickworth 23, Norfolk Terrace „ Matthews 61, Silchester Road „ Matthews 5, James Street, Potteries „ Van Mary Place, Potteries „ Nind Royal Crescent Mews „ Macpherson Ditto ditto „ Down * These licenses will not be applied for again. TABLE XII. LICENSED COW SHEDS. SOUTH SANITARY DISTRICT. (12.) LOCALITY. LICENSEE. 5, Glos'ter Grove East Mrs. Reeves 7, Silver Street Mr. Mackenzie 7, The Mall, Notting Hill „ Edwards Ditto Ditto „ Draper Fulham Road (St.Mark'sPlace) „ Starr Holland Park Farm Messrs. Tunks & Tisdall Newland Terrace Mr. Harman Gore Lane „ Thompson Earl's Court Road „ Jones Warwick Road „ Pool Stratford Road „ Clark Addison Cottage, Lorne dens „ Lyons NORTH SANITARY DISTRICT. (15.) Portobello Road, 191 Mr. D. Hughes ditto 207 Aylesbury Dairy Company Ditto (Angola Mews) Mr. Johnson Wornington Mews „ Jones Ledbury Mews „ Boon 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 10, Talbot Mews „ Hornsby 3 & 4, Archer Mews „ Skingle 23, Bramley Road „ Crew R 12/69