KEN 82 Sr genge THE ANNUAL REPORT on the HEALTH, SANITARY CONDITION, &c., &.c., of the Parish of St. Mary Abbotts, KENSINGTON, FOR THE YEAR 1896, by T ORME DUDFIELD, M.D., Medical Officer of health. Kensington: PRINTED BY J. W. WAKEHAM, 4, BEDFORD TERRACE, AND 116, UXBRIDGE ROAD. W. 1897. TABLE OF CONTENTS. page. Kensington : Registration District and Sub-Districts 1 „ Parliamentary Divisions of the Borough of 2 „ Sanitary Districts, Delimitations of the 2 Population, Quinquennial Enumeration of the 3 „ of the Sub-districts 5 „ of the Wards 7 „ of North Kensington and South Kensington 7 „ Housing of the 7 „ Number of Persons living in tenements of less than five rooms, in 1891 8 „ of the Sanitary Districts 8 „ of the "Notting Dale" Special Area 9 „ Inhabited Houses, Number of, in 1896 11 „ Number of Persons of each Sex in the Parish, and in the Sub-Districts, at different Age-periods, at the Census of 1891 13 „ Inhabited Houses and Rateable Value, Increase of, since 1856, and since 1871 15 „ Estimated to the middle of 1896 16 Marriages and Marriage-Rate in Kensington, and in London. and in England and Wales 17 Births and Birth-Rate, in the Parish and in the Sub-Districts 17 „ „ in the several Sanitary Districts 18 „ of Illegitimate Children 18 „ Annual Number of, Male and Female, and Birth-Rate in the ten years, 1886-95 19 Deaths and Death-Rate in the Parish and in the Sub-Districts 19 „ „ in the Several Sanitary Districts 20 Mortality, District Rates of 20 „ Rate of, in the Notting Dale" District 21 „ Monthly, in London, the Parish, the Sub-Districts, the Parliamentary Divisions, the Sanitary Districts, and "Notting Dale" (Table) 22 Infantile Mortality in the Parish, in North and South Kensington, and in the Sanitary Districts 23 iv. page. Infantile Mortality—continued. „ ,, Causes of Death ot Children under one year 24 „ „ Parentage of Deceased Children 25 „ „ Deaths of Children under five years of age 25 „ ,, Deaths of Illegitimate Children under one year 25 „ „ In London and the several Sanitary Areas 26 Senile Mortality 26 Death-rate at different Age-periods, 1893-1896 (Table) 26 „ „ in England and Wales, and in London, and in other large Towns 27 Mortal Statistics, etc., 1896; Summary of 29 Death, Assigned Causes of 31 Zymotic Diseases Deaths and Death-rate from the " Seven Principal," in Kensington, and in London. 31 ,, ,, Deaths and Death-rate from, in England and Wales, and in the Cities and the Boroughs 32 „ ,, Deaths and Death-rate from, in the Sanitary Districts 32 Small-Pox, in Kensington and in London 33 „ Outbreaks of, in Kensington 33 Measles, in Kensington 35 „ Epidemic of. in 1898 35 „ In London 37 „ Should it be made a Notifiable Disease? 37 Scarlet Fever, in Kensington 37 „ ,, in London 38 „ ,, Tables, Showing Notifications; Admissions to Hospitals; Deaths from, in Kensington and in London, and Cases of in Hospitals. at the end of thirteen consecutive four-weekly periods, in 1896, and 1895 38 ,, ,, Illustrative example of Showing how the Disease may be spread through failure to recognize a first case 39 „ ,, Statistical Returns of Cases of, recorded in Kensington, 1886-1896 (Tables) 40-41 v. Death Assigned Causes of. page. Zymotic Diseases—continued Diphtheria, in Kensington and in London 42 „ Statistical Tables of Cases of, in Kensington, in 1896 43 „ Illustrative examples of; Showing how the Disease may be spread through failure to recognize a first case 45 „ Antitoxin Treatment of: Report by the Medical Superintendents of the Hospitals of the Asylums Board 46 Whooping-Cough, in Kensington and in London 54 Fever, in Kensington and in London 54 Diarrhœa, in Kensington and in London 55 influenza, in Kensington and in London 55 Venebeal Diseases 56 Septic Diseases; Puerperal Fever 56 Parasitic Diseases 57 Dietetic Diseases: Alcoholism 57 Constitutional Diseases Rheumatism 58 „ „ Cancer 58 „ „ Tuberculosis 58 Developmental Diseases 59 Local Diseases 60 ,. „ Nervous System, Diseases of the 60 „ „ Circulatory System „ ,, 60 „ „ Respiratory System „ „ 61 „ „ Digestive System „ „ 61 „ „ Urinary System ,, 62 „ „ Reproductive System „ „ 62 Violence, Deaths from 62 Ill-defined and not-specified Causes of Death 68 Causes of Death in 1896: Summary of Table III. 64 „ „ „ Classified: Local Government Board's Table A 65 Public Institutions. Deaths at 66 „ ., „ Parish Infirmary 66 „ „ „ Brompton Hospital 68 „ „ „ St. Marylebone Infirmary 68 „ „ „ St. Joseph's Home 68 „ „ „ Outlying Hospitals, &c. 68 vi. page. Uncertified Deaths : Report of Select Committee of the House of Commons, and of the County Council, on thesubject of 70 Inquests: Deaths from Violence, Accident, Suicide, Homicide 71 Meteorology 72 Vaccination in Kensington in 1895 73 „ Report of the Royal Commission on 74 „ Conference of Sanitary Authorities with respect to 70 Metropolitan Asylums Board : The Work of the 77 Ambulance Service: Annual Report of the Ambulance „ „ Committee 78 ., „ New Stations 82 „ „ Arrangements for the Removal of Kensington Patients 82 Hospital Accommodation, Provision of 83 „ „ Fever 83 „ „ Small-pox 85 „ ,, at Existing Hospitals for Fever and Small-pox, and provision for Further extension of 85 ,, „ Fever, Deficiency of, in 1890 87 „ „ The Brook Hospital opened 88 Notifications of Infectious Disease, in Kensington and in London 89 „ Local Government Board's Table B 91 „ Corrected Table of, in the several Sanitary Areas of London 92 ,, Four-Weekly Tables of, in Kensington and in London 93 Factory and Workshop Act, 1895 94 Sanitary Supervision of Laundries 95 Duties of the Sanitary Authority with respect to Workshops 96 Lady Inspector; The Work of the 104 vii. page. Sanitary Inspecting Staff: History of the (1891-96) 109 Sanitary Inspectors: The Work of the 114 Statutory Notices, Written Intimations: Number of, issued 115 House Drains: Reconstruction and Trapping of 116 Offensive Businesses 118 „ „ Fat Extractor 118 „ „ Marine Stores 118 „ .. Brickburning 124 Slaughter-house.s, The Licensed 124 Cow-houses„ „ 124 Bakehouses 125 Offensive Street Smells 126 Sewer Ventilation (Defective), in Mews 128 Combined Drainage: Drain or Sewer ? 130 House-to-House Inspection 131 Housing of the Working Classes 133 „ Bye-Laws for Houses Let in Lodgings 133 „ „ Registered Houses in the Sanitary Districts 136 „ „ Streets in which Lodging-Houses should be Registered. 139 „ „ Overcrowding 140 „ „ ,, The Utility of Bye-Laws 141 „ ,, Common Lodging-Houses, List of 142 ,, „ „ „ „ What Constitutes 143 "Notting Dale" Special Area 144 „ Special Committee: Report of the 144 „ ,, „ Recommendations of the 146 „ Sanitary Committee's Report on; (1893) 148 „ Sanitary Inpector's Work in, 1896 151 „ Statistics of, 1896 152 „ Overcrowding of Houses in 153 „ Tenancy of Houses in 165 „ Remedies for the Evils existent in 155 ,, „ The Cost of 157 „ Jubilee Commemoration Schcmc to benefit 158 viii. page. Rabies : The Muzzling Order 159 „ Parishioners Bitten by Dogs affected with 159 „ Report of the Sanitary Committee on 160 Refuse Matters, Prevention of Nuisance from 162 „ „ Offensive; Removal of through Streets 162 House Refuse, Quantity of; Shoots for, &c. 164 „ „ Should be Cremated 164 „ „ Alleged Nuisance from: The Purtieet case 166 stable Refuse: Decrease in Complaints of Nuisance from Storage of 168 ,, „ Difficulty in securing prompt removal of 169 „ „ Nuisance from use of Peat litter 170 Public Mortuary: Bodies admitted into 174 Coroner's Court 175 Disinfection, Enhanced and Increasing Cost of 175 „ Should be carried out by the Sanitary Authority 175 „ Shelter for persons unhoused during the process of, still a Desideratum 177 Baths and Washhousep : Separate Washhouses a Desideratum 180 Sanitary Conveniences, Insufficient Supply of 181 water supply 181 conclusion 182 ix. APPENDIX A. STATISTICAL AND OTHER TABLES. page. Table I. Estimated Population of Kensington, in 1896, and Ten previous years, 1886-93: Number of Inhabited Houses, and number of Marriages, Births. Deaths, &c. 184 „ II. Birth-rate and Death-rate; Death-rates of Children; Deaths in Public Institutions, in 1896; and in 1886-95 185 „ III. Deaths Registered from all Causes in 1896 186-190 (For Summary of Table III., see Page 64) „ IV. Deaths from the Seven Principal Zymotic Diseases; and from Pulmonary Diseases; Tubercular Diseases; Wasting Diseases of Infants, and Convulsive Diseases of Infants; Gross and Proportional numbers 191 „ V. Deaths in 1896, and in 1886-95, from the Seven Prinoipal Diseases of the Zymotic class; in Kensington and in London ; and in England and Wales 192 „ VI. Summary of the Work executed by the Sanitary Inspectors in 1896 193 „ VII. Death-rates, General and Zymotic; in Kensington; and in London; and proportion of Deaths from Zymotic Diseases to Total Deaths, in 1896 and in 1886-95 191 „ VIII. Comparative Analysis of the Mortality, in London and in Kensington, in 1896; Percentages of Deaths under one year to Births registered; and Percentages of Deaths, under one year, and at 60 and upwards, from the Principal Zymotic Diseases; and from Violence; and of Inquest Cases; and of Deaths at Public Institutions, to Total Deaths 195. „ IX. Localities where fatal cases of the more important of the Zymotic Diseases occurred in 1896 196-197 „ IX. Streets, &c.. in .which cases of Infectious Disease were notified, in 1896, under the provisions of Section 55 of the Public Health (London) Act, 1891 198-205 „ X. Vaccination Officer's Annual Return for 1895 206. „ XI. Slaughter-houses, Licensed: and names of Licensees 207 „ XII. Cow-houses „ „ ,, 208. X. APPENDIX B. THE CENSUS OF 1896. page. Table A. Enumeration Districts, and the population thereof, in 1891 and 1896, showing Increase or Decrease 210-223 Table B. Summary of the Returns in the several Enumeration Districts, showing number of Males and Females, and the total of both sexes in the several Districts as compared with the number in 1891 224-5 FORTY-FIRST ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, Being for the Year 1896. To tht Vestry of the Parish of St. Mary Abbotts, Kensington. Gentlemen, The vital and mortal statistics in this report relate to a period of fifty-three weeks, commencing December 29th, 1895, and ending January 2nd, 1897, comprised in the registration year, 1896. Rates have been corrected so as to make the statistics comparable with a year of fifty-two weeks. Registration District and Sub-Districts.—The Registration District of Kensington ("No. 1b" in the RegistrarGeneral's list), comprises an area of 2,190 acres unequally divided into two sub-districts, respectively named Kensington Town,(hereinafter for brevity designated Town) and Brompton. The Town Sub-District comprises an area of 1,497 acres, the area of Brompton being 693 acres. The Town Sub-District comprises that portion of the parish north of Kensington High-street and Kensington-road, together with a portion of the parish south of those roads and north of a line extending, b 2 west to east, along Pembroke-road, Stratford-road, and south of the Workhouse, then through Cornwall-gardens to Queen's-gateplaee, and thence northwards so as to include Queen's-gate, Jays' mews and Kensington-gore. The Brompton Sub-District comprises the remainder of the parish south of the above described line. Parliamentary Divisions. North Kensington and South Kensington are the two divisions of the Parliamentary Borough, separated by High-street, Notting-hill, and Hollandpark-avenue: North Kensington, comprises the North, Northeast and the North-vest sanitary districts; South Kensington comprises the Central, the South-east, and the South-west sanitary districts, as they were constituted during the greater part of the year. Sanitary Districts.—At the commencement of the year the sanitary districts were seven in number. In the month of February they were reduced to six, as described below. At the present writing there are still six sanitary districts, but the boundaries are not the same in respect to the North-east, the North-west and the Central districts, these having been varied in October. This, however, is a matter that will be more conveniently dealt with in the report for 1897. The districts as delimited in February, 1896, and as they were administered for nearly the whole of the year, are as follows:— The North Sanitary District comprises the portion of the parish to the north of the Hammersmith and City Railway, with the exception of a few streets at the south-west corner of that area. The North-west Sanitary District includes the streets above referred to, its north and eastern boundaries extending in a somewhat curved line from, Latimer-road, along Waimer-road and Princes-road to Holland-park-avenue. 3 [The "Netting Dale" Special Area comprises Bangor-street, Crescent-street, St. Katharine's-road, William-street, and part of St. Clement's-road in the North-west district.] The North-east Sanitary District comprises the remainder of the area between the Railway (north), and Holland-park-avenue and High-street, Notting-hill (south). The Central Sanitary District lies between Highstreet, Notting-hill, and Holland-park-avenue (north), and Kensington High-street and Kensington-road (south). The South-east and the South-west Sanitary Districts, south of Kensington High-street aud Kensingtonroad, lie east and west of a line running along Wright's-lane, Marloes-road, Lexham-gardens, Collingham-road, The Boltons and Gilston-road, to Fulham-road. THE QUINQUENNIAL ENUMERATION. The year 1896 will be memorable as that in which, for the first time, a quinquennial enumeration was made of the Metropolitan population. The machinery employed was the same as at the decennial census in 1891, the duty devolving upon the Registrar-General, acting for the London County Council. The enumeration made, on the 29th March, had for its object the ascertainment, for rating purposes, of the gross popidation of the several sanitary districts of the Metropolis: it was made in conformity with the provisions of the Equalization of Rates Act, 1894, the only particulars required of the householder being the sex of each person and his or her relationship to the head of the family. Restricted as the enquiry thus was its results are not without value to the sanitary statistician. Among other things, in this parish, the B 2 4 enumeration served to confirm the suspicion that the census of 1891 did not accurately represent the normal population. The population, as then ascertained, proved to be some 14,000 below the estimate I had made, upon the basis of the number of inhabited houses, excess of births over deaths, &c.; and it was 37,000 below the estimate of the Registrar-General. The decennial increase, between 1881 and 1891, was only 3,157, as compared with increases in the two preceding decennial periods of 50,000 and 43,000 respectively. In the Town subdistrict no increase was shown in 1891, but a decrease of 1,390, since 1881, despite an increase of 812 in the number of inhabited houses which entitled us to expect an increase of about 7,000 in the population. In the Brompton sub-district there was an increase, but of 4,547 only, whereas the increase of 1,101 in the number of inhabited houses entitled us to expect an increase of 7,074. The net result was that in the parish, as a whole, there was, as stated, an increase of 3,157 only, or 11,000 less than the increase in the number of inhabited houses had led me to expect. This result was all the more surprising seeing that during the ten completed years, 1881-90, the births had exceeded the deaths by 13,557 (a number more than four times as large as the enumerated increase in population); so that the l088 during the decennium, by removals, had to be taken at 10,843 as compared with gains, by immigration alone, of 40,588 in the ten years 1861-71, and of 26,076 in the ten years 1871-81. It may be remembered that in the report for 1891, I attributed some portion of the discrepancy between the estimated and the enumerated population to the fact that the census was taken during the Easter Holidays, when many families were out of town. The results of the enumeration made in March, 1896, one week before Easter Day, seem to confirm, to some degree at least, the opinion I expressed in 1891; seeing that during the five years that have since elapsed, the increase in population (4,157) was greater by 1,000 than in the ten years, 1881-91, the 1896 population totalling 170,465, 5 as compared with 166,308 in 1891. These 170,465 persons comprised males 67,002, and females 103,463, the excess of females thus being 36,461. In the Town sub-district the population was 122,164, as compared with 118,751 in 1891: increase 3,413. The males numbered 51,101, the females 71,063 : excess of females 19,962. In the Brompton sub-district the population was 48,301, as compared with 47,557 in 1891: increase 744. The males numbered 15,901, the females 32,400: excess of females 16,499. The Parliamentary division of North Kensington comprised 85,371 persons, viz., males 37,964, and females 47,407: excess of females 9,443. The division of South Kensington comprised a population of 85,094 persons, viz., males 29,038, and females 56,056: excess of females 27,018. It thus appears that there has been a sensible increase in the population since the census of 1891, and more especially in the Town registration sub-district. The increase in this sub-district in the five years 1891-96 was, as we have seen, 3,413, as compared with a decrcane of 1,390 in the ton years 1881-91. In the Brompton sub-district, the increase in the live years was 744, following upon an increase of 4,547 in the ten years 1881-91. During the five years 1891-95 the births in Kensington (18,512) exceeded the deaths (14,235) by 4,277, a number only 120 in excess of the enumerated quinquennial increase in the population, or 24 per annum; whereas in the ten years 1881-90, the births (40,811) exceeded the deaths (27,254) by 13,557, and were 10,400 in excess of the enumerated decennial increase in population, or 1,040 per annum (a number equivalent to 5,200 in five years); so that the results of the census of 1891 6 and the enumeration of 1896 are in this respect widely divergent; the divergence being, to me, at least, inexplicable, excepting upon the assumption that some 5,000 persons must have been absent from their homes in April, 1891 (during the Easter holidays), who were at home on the Sunday before Easter, in 1896. The subjoined table shows the increase of population, and how brought about, in three decennial periods ended with 1891. Increase Decrease by Removals. Total by Births in excess of Deaths. by Immigration. Increase. Population 1861 70,108 — ' — — — ,, 1871 120,299 9,538 40,653 — 50,191 ,, 1881 163,151 16,934 25,918 — 42,852 ,, 1891 166,308 13,557 — 10,400 3,157 It follows from what has been said that, instead of an annual increase in population of 300 since 1891, as estimated in previous reports, there was an actual annual increase to the number of 830. There would have been a larger error in the statistics of the parish during the years 1891-96 than exists, as the result of under-estimate ot population, had I not ventured to assume that, owing to the cause already explained, the census of 1891 showed a total considerably below the normal population. At the time when this census was taken there were about 1,000 non-parishioners in public institutions, and I included all these in the estimate of the number of parishioners living at the middle of 1891; it now appears that this course was amply justified. 7 DISTRIBUTION OF THE POPULATION. Population of the Wards.—I subjoin a statement of the population of the Wards, as follows:— Name of Ward. Enumerated Population.—1896. Golborne Ward Males. 17,690 Females. 19,795 Total. 37,485* Norland Ward 11,726 14,298 26,024 Pembridge Ward 8,548 13,316 21,864 Holland Ward 7,155 12,728 19,883† Earl's Court Ward 5,270 10,690 15,960 Queen's Gate Ward 4,997 9,577 14,574‡ Redcliffe Ward 6,956 13,606 20,562 Brompton Ward 4,660 9,453 14,113§ Total 67,002 103,463 170,465 The first three Wards are in North Kensington, the last live in South Kensington. Of the entire population, as we have seen, rather more than a moiety (85,371) was enumerated in North Kensington, the population of South Kensington being 85,094. In 1891 the census gave 82,633 to North Kensington and 83,675 to South Kensington. The 82,633 persons in North Kensington were in occupation of 9,507 houses and certain public * Including 803 at St. Marylebone Infirmary, 699 of whom were nonparishioners; 248 at St. Joseph's Home, of whom 158 were non-parishioners; and 28 at the Franciscan Convent, Portobello Road. † Including 196 at Kensington Barracks. ‡ Including 933 at Kensington Workhouse, and 695 at Kensington Infirmary. § Including 192 at Brompton Consumption Hospital, of whom 140 were non-parishioners. 8 institutions; whilst the 83,675 persons comprising the population of South Kensington, were in occupation of 12,577 houses and certain public institutions. An error, somewhat widely disseminated, viz., that Kensington is essentially a parish of the rich and well-to-do, may be corrected by a reference to the official report of the census of 1891, from which we learn that 70,718 persons, or 42.5 percent, of the population, were living in 20,052 tenements of less than five rooms. The 166,308 persons comprising the entire population of the parish at that date, were in occupation of 35,953 tenements and certain public institutions. No fewer than 6,398 of these "tenements" consisted of a single room; and these rooms were inhabited by 13,655 persons. The two-roomed tenements were 6.965, and their inhabitants numbered 26,020. The three-roomed tenements were 4,115, and their inhabitants 18,119. The four-roomed tenements were 2,574, and their inhabitants 12,924. Stated in another way, it appears that 8.2 per cent, of the parishioners lived in one-roomed tenements; 15'6 per cent, lived in two-roomed tenements; 10.9 per cent, lived in three-roomed tenements; and 7.8 per cent, lived in four-roomed tenements. In North Kensington there were, approximately, 8.7 persons to a house; in South Kensington less than 6.7. But many houses of eight rooms in North Kensington contained, and contain now, upwards of 20 persons to a house, and some more than 30 persons. Population of the Sanitary Districts.—The subjoined table contains an approximate statement of the population, in 1891, of the respective areas which at the commencement of 1896 were included in the several sanitary districts, after distribution of the inmates of the workhouse and infirmary, and deduction of non-parishioners at certain public institutions. It is interesting as showing the number of separate families, and of tenements of less than five rooms, and the number of inhabited houses in each of the said districts. No similar information will be forthcoming until the middle of 1901. 5 Sanitary Districts. Population. No. of Separate Families. No. of tenements of less than Five Rooms. No. of Inhabited Houses. North 30,705 6,793 5,503 2,866 North East 22,013 4,798 2,514 3,018 North-West (A) 13,087 3,336 1,936 1,984 North-West (B) 15,875 3,669 2,993 1,636 Central 20,179 4,293 2,023 2,997 South-East 32,374 6,354 1,979 5,105 South-West 30,667 6,710 3,104 4,478 Totals 164,900 35,953 20,052 22,084 The "Notting Dale" Special Area.—As something will have to be said later on anent the unsatisfactory statistics, vital and mortal, of this locality, comprising Bangor-street, Crescent-street, William-street, St. Katharine's-road, and part of St. Clement's-road, in the North-west District; it may be well to state here that these streets are located in the enumeration districts numbered 31 and 56, and that Inspector Steward at my request made an enumeration of the population in December, 1895. As I was unable to obtain from the Registrar-General an official statement of the population of these streets in March, 1896, Inspector Steward made for me a further enquiry in June; the two counts, in December, 1895, and in June, 1896, taking in the whole of the streets comprised in the two enumeration districts. The particulars are set out in the subjoined tables. It is remarkable that the population of these two districts should, according to the RegistrarGeneral's return, have increased by so large a number as 603, or 14.5 per cent., since 1891—viz., from 1,880 to 2,241 in 10 enumeration district 31, and from 2,273 to 2,515 in enumeration district 56. Of this increase 490 belongs to the "Notting Dale" district, and 113, to the remaining streets. As no houses have been built in these districts during the five years, it is to me inexplicable how such a large increase should have come about. There can be no reasonable doubt as to the substantial accuracy of the figures, for the returns of the enumerators and of Mr. Steward correspond closely. We have no reason for assuming any increase of overcrowding, and the only explanation I can suggest is, that, in 1891, the information as to population given by the inhabitants to the enumerators, involved considerable under-statements. Be this as it may, the official return in no way invalidates the statistics submitted by me to your Vestry when dealing with the "Notting Dale" Special Area, in the thirteenth report for 1895, and the first and second reports for 1890, which were based on our own enumeration. The official return of 1896 not improbably owes its accuracy to the fact that your Vestry's officer had, not long previously, made an enumeration, a fact which may have influenced the people to make a true return in the official schedules. ENUMERATION DISTRICT No. 31. Description of District. Population. Crescent-street, South side of, from St. Ann's-road to St. Clement's-road 326 St. Clement's-road, from Crescent-street to wall at rear of St. James's-square 111 William-street, South side of, to Princes-road 189 St. Katharine's-road, Nos. 1 to 63 979 St. Katharine's-road, Nos. 64 to 113 338 Population of a portion of the "Notting Dale" - Special Area 1,943 Princes-road, West side, Nos. 105 to 35... 261 Total population of the Enumeration District 2,204 (Registrar-General's Return, 2,241) 11 ENUMERATION DISTRICT No. 56. Description of District. Population. Crescent-street, North side of 383 William-street, North side of 225 Bangor-street 874 St. Clement's-road, West side of, Nos. 33 to 13 130 St. Clement's-road, East side of, from William-street to Police Station at Mary-place 254 . Population of a portion of the "Notting Dale" Special Area 1,866 St. Ann's-road, East side of, from Crescent-street to No. 82 191 Kenilworth-street, South side of, from St. Ann's-road to St. Clement's-road 196 St. Clement's-road, Nos. 45 to 35 48 Mary-place, South side of, including Gorham-place, to Pottery-lane, and hence to north side of William-street 218 Total population of the Enumeration District 2,519 (Registrar-Generals Return, 2,515.) Inhabited Houses.— No information was obtained at the quinquennial enumeration as to the number of inhabited houses. Theoretically, this is to be regretted, seeing that the population of a district is estimated, for statistical purposes, 011 the basis of the rate of increase in the previous inter-censal period, checked by the number of inhabited houses, and by the average number of persons to a house as ascertained at the last census. But in practice I have not found this test to be very reliable in estimating the population of this parish in inter-censal years. In 1861, the enumerated population being 70,108, the number of inhabited houses, as shown in the 12 census returns for that year, was 9,481, equal to 7.39 persons to a house. In 1871, the inhabited houses had increased, by 6,254, to 15,735, and it might have been expected that the population would have been about 116,281. It was, however, returned as 120,299—an excess of 4,018, and an increase of 50,191; the average number of persons to a house being 7.64, and every newly-inhabited house counting for 8.02 persons. In 1881, the inhabited houses had increased, by 4,436, to 20,171, and it might have been expected that the population would have been 154,106. It was, however, returned as 163,151—an excess of 9,045, and an iucrease of 42,852; the average number of persons to a house being 8.08; and every newly-inhabited house counting for 9.66 persons. In 1891, the inhabited houses had again increased, to the number of 1,913, and it might have been expected that the population would have been 178,438. But it was returned as 166,308, an increase of 3,157 only, and some 11,000 fewer than the anticipated increase, calculated on the basis of the number of inhabited houses. The average number of persons to a house was 7.53, but each newlyinhabited house counted for 1.65 persons only. Discrepancies like these cannot well be reconciled. We have seen that the enumerated increase of population during the last five years, since the census of 1891, was 4,157, a total which should account for an increase of some 550 in the number of inhabited houses; but it is difficult to believe that there has been so large an increase, for only 50 houses were in course of building when the census was taken in 1891, since which date building operations in this parish have been almost at a standstill: it appears, moreover, from information supplied by the Vestry Clerk, that the number of empty houses in 1896 (1958) was even larger than in 1891 (1904). The census number of uninhabited houses in 1891 was 1,803, and 103 fewer than the rate-books show. But the Registrar-General regards as "inhabited," many houses which we treat as "empty" houses viz., houses occupied by caretakers only. The approximate number of inhabited houses on the rate-books in April, 1896, 13 was 22,267, or 183 only more than the census number in 1891 (22,084). A return by the rate-collectors, made in May, 1896, shows a total of 22,630 inhabited houses; but in this number there are included 1,131 properties which, being let as Artizans' Dwellings and Flats, would not be counted by the RegistrarGeneral as separate houses. These 1,131 separately rated properties appear to represent 246 houses only, in the official sense of the word "house."* The total number of inhabited houses, therefore, in the census meaning of the term, would be 21,499, plus an unknown number of empty houses occupied only by caretakers, the census number in 1891 having been, as already stated, 22,084. I do not pretend to have solved the intricacies of this question, and, for the present, the conclusion I have arrived at, is, that, under existing circumstances, the simplest course will be to assume the same number of persons to a house as in 1891 (7.53), which would give 22,576 as the number of inhabited houses at the date of the quinquennial enumeration in March, 1896. The Census of 1891.—The following Table shows the relative number of persons of each sex at the census of 1891, grouped according to age, (a) in the entire parish, (b) in the Kensington Town sub-district, and (c) in the Brompton subdistrict, there being no later information available:— "The Registrar-General does not take note of Flats, whether in "Artizans' Dwellings" or "Mansions." For the purposes of the census the front door stands for a house whatever the number of separate occupations there may be. Thus, Campden Houses, in Peel-street, which comprise about 133 separate tenements (supposing none of them to be sub-divided, in which case there would be more than 133), count for only seven houses in the census return for 1891. We, on the other hand, treat as a separate inhabited house, for rating purposes, each Flat, whether in a Mansion or in Artizans' Dwellings. And a house on which no rates are paid, is treated as "empty," even though a caretaker and family may be living therein. 14 (a) ENTIRE PARISH. All Ages. Under Five Years. 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. All Ages. Females 100,591 7466 14191 24216 21147 13520 9420 6774 3367 1278 202 7 100,591 Females. Males 65,717 7394 12963 12947 10759 8695 6337 3822 2046 666 86 2 65,717 Males. Exceps of Females } 34,871 72 1231 11269 10383 4825 3083 1952 1321 612 116 5 34,874 {Excess of Females. Total of both sexes } 166,308 14860 27157 37163 31906 22215 15757 9596 5413 1944 288 9 166,308 {Total of both sexes (b) KENSINGTON TOWN SUB-DISTRICT. All Ages. Under Five Years. 5 to 16. 15 to 25. 25 to 35. 35 to 45. 45 to 55. 65 to 65. 65 to 75. 75 to 85. 85 to 95. 95 and upwards. All Ages, Females 69,381 5976 11192 15483 13330 9172 6592 4060 2450 969 154 6 69,384 Females. Males 49,367 5905 10287 9540 7815 6377 469e 2741 1172 470 63 1 49,367 Males. Excess of Females } 20,017 71 905 5943 5515 2795 189< 1319 978 99 91 5 20,017{Excess of Females. Total of oth sexes } 118,761 11881 21179 25023 21115 15549 1128b 6801 3924 1439 217 7 118,751 {Total of both sexes (c) BROMPTON SUB-DISTRICT. All Ages. Under Five Years. 5 to 15. 15 to 25. 25 to 35. 35 to 45. 45 to 55. 65 to 65. 65 to 75. 75 to 85. 85 to 95. 95 and upwards. All Ages. Females 31,207 1490 3002 8733 7817 4348 2828 1714 917 309 48 1 31,207 Females. Males 16,350 1489 2676 3407 2944 2318 1641 1081 574 196 23 1 16,350 Males. Excess of Females } 14,857 1 326 5326 4873 2030 1187 633 343 113 25 - 14,857 {Excess of Females. Total of th sexes } 47,557 2979 5678 12140 10761 6666 4469 2795 1491 505 71 2 47,557 { Total of both sexes * The death- rate at the different age-periods will be found at page 25, 15 The subjoined figures exhibit the development of the parish, in population and rateable value, 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 44,053 257,103 1853 1861 70,108 444,030 1863 1871 120,299 975,046 1873 1881 163,151 1,711,495 1883 1891 166,308 2,037,221 1893 1896 170,000 £2,095,111 (April) 1897 The following table, brought up to date, exhibits the growth of the parish since the Metropolis Local Management Act came into operation, in 1856:— Number of Inhabited Houses 1856 1896 Increase in 40 years 7,600 22,576 14,976 Population 57,000 170,000 113,000 Rateable Value of Property £308,000 £2,095,111 £1,787,111 The increase in all respects within the last twenty-five years, the period over which my official experience extends, is not inconsiderable, as the subjoined figures show:— 1871 1896 Increase in 25 years Number of Inhabited Houses 15,735 22,576 6,841 Population 121,000 170,000 49,000 Rateable Value £935,720 £2,095,111 £1,159,391 From the foregoing figures we learn that in 1896 the population was nearly 20 times as large as in the first year of the century; and that the rateable value of property was rnore than 27 times as great as in 1823, the first year in respect 16 to which I possess information. Since 1856, the rateable value has increased nearly seven-fold; the mere increase in the last 25 years being more than treble the total in 1856; since which date the population and the number of inhabited houses have increased nearly three-fold. POPULATION IN 1896. For the purposes of the present report the population of the parish at the middle of 1896, and that of the sub-districts, the parliamentary divisions, and the sanitary districts, will be taken to be as follows:— The Parish 170,000 Kensington Town sub-district 121,840 Brompton sub-district 48,160 Parliamentary Divisions:— North Kensington 85,920 South Kensington 84,080 Sanitary Districts:— North 32,550 North-east 32,330 North-west 21,040 ("Notting Dale" Special Area) 3,740 Central 20,090 South-east 32,060 South-west 31,930 17 MARRIAGES AND MARRIAGE RATE. The marriages in the parish in 1896 were 1,706—a considerable increase upon the numbers in recent years, even after correction for the 53rd week—as compared with 1,540, 1,537, and 1,455, in the preceding three years respectively. Of these marriages there were celebrated— By the Church (74.1% of total marriages) 1,264 At Roman Catholic places of worship 127 At other Nonconformist places of worship 65 At the Superintendent-Registrar's Office 250 The marriage rate (i.e., the number of persons married to 1,000 living) was 20.1, as compared with 18.4, 18.4, and 17.4, in the preceding three years respectively. The marriage rate in England and Wales was 15.8 per 1,000, as compared with 14.7, 15.6, and 15.0, in the preceding three years. The rate in London was 18.0 per 1,000, the highest rate recorded in any year since 1883, as compared with 17.2, 17.0, and 17.1, in the preceding three years respectively. BIRTHS AND BIRTH-RATE. Three thousand seven hundred and seventeen births were registered in 1896, or 152 fewer than the corrected decennial average (3,869). Of these births 3,101 were registered in the Town sub-district and 616 in Brompton. They comprised males 1,943 and females 1,774 ; excess of male births 169. The illegitimate births numbered 221. It may be mentioned that the births in 1896, in the 53 weeks, were 324 fewer than the number in 1872 (4041) when the population (127,400) was 42,600 less than in 1896. The Kensington birth-rate, which is considerably below that of London, as a whole (30.2 in 1896), has been declining since 1868, when it was 33.1 per 1,000. In 1896 it was 21.4 per 1000, and 1.4 below the decennial average (22.8). The rate in the sub-districts was: Town, 25.0; Brompton, 12.5 per 1,000. In the Town sub-district the births registered were 757 more in number than the deaths, whilst C 18 iu the Brompton sub-district the excess of births over deaths was to the number of 69 only. Births and Birth-Rate in the Sanitary Districts.— The birth-rate in the Sanitary Districts, irrespective of 133 births which occurred at the Workhouse Infirmary, which is located in the South-west Sanitary District, was as follows:— North Kensington North 1,045 births, or 32•1 per 1,000 persons living. North-east 740 births, or 22•9 per 1,000 persons living. North-west 673 births, or 32•0 per 1,000 persons living. South Kensington Central 312 births, or 15•5 per 1,000 persons living. South-east 367 births, or 11•4 per 1,000 persons living. South-west 447 births, or 14•0 per 1,000 persons living. The births in the "Notting Dale" special area of the North-west district were 118, and equal to 31.6 per 1,000 of the population. In the several sanitary districts the excess of births over deaths was as follows: North, 393; North-east, 194; Northwest, 22; total excess in North Kensington 609. Central, 46; South-east, 46; South-west, 18; total excess in South Kensington, 110. In the "Notting Dale" special area the deaths exceeded the births by 69. The registered births of illegitimate children in the parish, as a whole, were, as stated, 221 (41 more than in 1895), viz., males 116 and females 105. Of these births 198 were registered in the Town sub-district, which includes the parish workhouse, at which institution out of 138 births (males 72, females 66 — including ten of still-born children—males 5, females 5) 105 were illegitimate. In the parish generally, the illegitimate births formed 5.9 per cent. of total births, compared with 4.9, 5.8 and 5.0 in the preceding three years respectively. 19 The subjoined table shows the quarterly number of births, of males and females, in each of the sub-districts:— Kensington Town. Brompton. Males Females Total Males Females Total Parish 1st Quarter 359 372 731 68 66 134 865 2nd ,, 405 374 779 89 70 159 938 3rd ,, 398 349 747 84 81 165 912 4th „ 459 385 844 81 77 158 1002 Totals 1621 1480 3101 322 294 616 3717 The subjoined table shows the population, the number of births, and the birth-rate for each of the ten years 1886-95:— The Year Population Total Births Males Females Birth-rate per 1000 1886 164,820 4,149 2,137 2,012 25•2 1887 165,140 3,941 2,016 1,925 23•9 1888 165,450 3,776 1,914 1,862 22•8 1889 165,760 3,698 1,846 1,852 22•3 1890 166,080 3,864 1,919 1,945 23•3 1891 166,500 3,847 1,935 1,912 23•1 1892 167,200 3,718 1,867 1,851 22•3 1893 167,900 3,661 1,893 1,768 21•9 1894 168,600 3,665 1,883 1,782 21•9 1895 169,300 3,621 1,861 1,760 21•4 Totals 37,940 19,271 18,669 Average:22•8 Excess of male births in the ten years 602 Excess of births over deaths in the ten years 9,889 Estimated increase of population in the ten years 4,800 Estimated loss of population, by migration or removals, in the ten years 5,089 DEATHS AND DEATH-RATE. The deaths registered, inclusive of 353 deaths of parishioners at out-lying public institutions, &c., but exclusive of the deaths of non-parishioners at public institutions, &e., within the parish, were 2,891—males 1,394, and females 1,497. After correction for the 53rd week included in the registration year, the deaths (2,835) were 26 fewer than the corrected decennial C 2 20 average number (2,861). Of the deaths registered 2.344 belong to the Town sub-district and 547 to Brompton. The deathrate (which in the preceding three years had been 17.4, 15.6, and 16 2, per 1,000 respectively) was 16.7 in 1896, being 0.1 below the decennial average, and 19 below the rate in the Metropolis as a whole (18.6); this, moreover, being 1.5 below the decennial average (20.1). The sex-rate was, of males 20.9 per 1,000, of females 145 per 1000, as compared with 19.3 and 14.5 in 1895. The rate in the Town sub-district was 18.9, in Brompton 11.1, against 18.7 and 10.7 respectively in the previous year. The rate in North Kensington was 21.5 per 1000; the rate in South Kensington was 11.7 per 1,000. Deaths and Death rate in the Sanitary Districts.— The death-rate in the sanitary districts, after correction for the 53rd week, was as follows:— North Kensington North 652 deaths, equal to 20.0 per 1,000 persons living North-east 546 deaths, equal to 16.9 per l,000 persons living North-west 651 deaths, equal to 30.9 per 1,000 persons living South Kensington Central 266 deaths, equal to 13.2 per 1,000 persons living South-east 291 deaths, equal to 9.1 per 1,000 persons living South-west 429 deaths, equal to 13.4 per 1,000 persons living The deaths in the "Notting Dale" special area of the North-west district were 187, and equal to 50.0 per 1000 of the population. District Rates of Mortality.—The table at page 22 shows the death-rate in the several districts of the parish, not only for the whole year, but also in each of the 13 four-weekly periods corresponding to my monthly reports. Confining attention to the sanitary inspecting districts, it will be observed that in the three districts (Central, South-east, and South-west) which go to make up the Parliamentary division of South 21 Kensington, the rate was much below the average for the parish as a whole (16.7 per 1,000); the rate in the remaining three districts (North, North-east, and North-west) comprised in the division of North Kensington, being above the average— very slightly in the North-east District (16.9), somewhat considerably in the North District (20.0), and excessively in the North-west District (30.9). The last-named district, containing a population of about 21,040, includes that portion of the parish described as the "Notting Dale" special area. The mortal statistics of the entire district are unsatisfactory: the death-rate in 1896 was more than double the rate in the remainder of the parish (14.7 per 1,000); the zymotic death-rate (5.9 per 1,000) was excessive, being more than two-and-a-half times as large as that of the rest of the parish (2.3 per 1,000); the waste of infant life was also excessive, the deaths under one year (189) being equivalent to 281 per 1,000 births registered, the infantile deaths in the remainder of the parish being in the proportion of 153 per 1,000 births. These figures show to what a large extent the statistics of this district, which contains less than an eighth of the population, spoil those of the parish generally. But if matters were bad in the district, as a whole, they were still worse in the area described as "Notting Dale," the streets included under this description being Crescentstreet, Bangor-street, St. Katharine's-road, William-street, and a part of St. Clement's-road comprising 42 houses numbered 1 to 33, and 2 to 50 inclusively. The death-rate in this area (of which the population was ascertained in 1896 at 3,740) as shown in the last column of the table at page 22 was 50 per 1,000, as against 16.7 in the parish and 26.8 in the North-west District less the area. The zymotic death-rate was equal to 8.0 per 1,000 of the population. The deaths of children under one year were in the proportion of 432 per 1,000 births, the deaths at all ages were 69 in excess of the births. 22 Death-rate in the Metropolis and in Kensington, and in certain Districts of the Parish during the thirteen four-weekly periods ended January 2nd, 1897, and in the registration year, 1896. Four Weeks ended. Metropolis. Parish. Sub-Districts. Parliamentary Divisions. Sanitary Districts. "Notting Dale" Special Area. Kensington Town. Brompton North. South. North. North-East. North-west. Central. South-East. SouthWest January 25 19.0 16.8 19.3 10.5 20.9 12.7 22.8 14.5 27.8 19.4 6.5 14.7 55.6 February 22 19.7 17.6 20.5 10.3 21.5 13.6 22.0 12.9 34.0 21.3 10.5 11.8 66.1 March 21 20.4 17.5 19.5 11.9 22.5 12.4 16.8 20.9 34.0 17.5 6.5 15.1 45.2 April 18 18.9 19.0 21.3 13.2 25.4 12.5 21.6 20.9 38.3 9.1 13.8 13.4 52.1 May 16 18.4 19.8 22.3 13.5 26.5 13.0 26.8 20.5 35.2 13.6 13.4 12.2 55.6 June 13 17.1 15.7 18.5 8.6 20.8 10.5 21.6 15.3 27.8 12.3 8.9 11.0 45.2 July 11 17.9 15.5 17.5 10.3 21.0 9.7 18.0 15.7 34.0 10.4 6.9 12.2 52.1 August 8 23.3 18.5 21.8 10.3 25.9 11.0 27.9 18.5 34.0 13.6 9.3 11.0 55.6 September 5 17.0 13.5 15.2 9.2 17.9 9.0 16.0 17.3 21.6 8.4 6.9 11.4 38.2 October 3 14.8 12.2 13.6 8.9 15.1 9.3 15.2 11.3 21.1 9.7 7.3 11.0 45.2 October 31 17.3 15.4 17.1 11.1 18.9 11.8 14.4 15.3 31.5 10.4 9.7 14.7 52.1 November 28 19.7 18.2 19.1 15.9 20.9 15.5 16.4 16.5 34.6 13.6 10.9 21.2 59.1 Jan. 2, 1897 (5 weeks) 18.0 17.1 19.4 11.3 22.5 11.6 21.2 20.1 28.4 12.9 7.3 15.1 27.8 Death-rate for the Year 1896 18.6 16.7 18.9 11.1 21.5 11.7 20.0 16.9 30.9 13.2 9.1 13.4 50.0 23 INFANTILE MORTALITY. The deaths under one year, which in 1896 were 656 (or 643 after correction for the 53rd week), had been, in the preceding three years, 625, 636, and 624, successively. Of the 656 deaths in 1896, 81 (or 12 3 per cent.) were of illegitimate children ; the ratio of deaths of illegitimate children to births registered as illegitimate (221) being 366 per 1,000. Of the 656 deaths, 159 occurred within one month after birth,including 89 in the first week, 31 in the second week, 20 in the third week, and 19 in the fourth week. In the second month of life there were 63 deaths; in the third month 61 deaths; in the fourth month 50 deaths ; in the fifth month 51 deaths; in the sixth month 46 deaths; in the seventh month 41 deaths; in the eighth month 30 deaths; in the ninth month 49 deaths; in the tenth month 22 deaths; in the eleventh month 46 deaths; and in the twelfth month 38 deaths. It is an opprobrium to Kensington that the rate of infantile mortality, calculated upon the basis of the number of deaths under one year to 1,000 births registered, is always above that of London as a whole. The year to which this report relates was no exception to the rule, for whilst the deaths under one year in London were at the rate of 161 per 1,000 births, the corresponding ratio in Kensington, as a whole, was 176.* But, as we shall see, the rate differed greatly in different parts of the parish, the bad pre-eminence of which, in this respect, is due to the excessive infantile mortality in certain districts in North Kensington. The deaths of infants under one year to births registered in the whole of North Kensington 509 in number, were equal to 207 per 1,000 births, the corresponding ratio in South Kensington being 131 per 1,000, the deaths numbering 147 only. Of the 656 deaths, 78 occurred in the Brompton sub-district, being equal to 127 per 1,000 births, and 578 in the Town sub-district, being equal to 186 * The London rate was 6 above the decennial average. The rate in the 33 great towns of England and Wales was 167 per 1,000. 24 per 1,000 births. In the several sanitary districts the deaths and death-rate of infants under one year, were as follows:— North Kensington. South Kensington North 191 deaths equal to 183 per 1,000 births. North-east 129 deaths equal to 174 per 1,000 births. North-west 189 deaths equal to 281 per 1,000 births. Central 40 deaths equal to 128 per 1,000 births. South-east 40 deaths equal to 109 per 1,000 births. South-west 67 deaths equal to 150 per 1,000 births. In the "Notting Dale" special area the deaths of infants under one year were 51, and equal to 432 per 1,000 registered births. Causes of Infantile Deaths.—The causes of the deaths of infants under one year of age, in 1896, may be summarised as follows:— Causes of Death. Number of Deaths in Sub-Districts. In whole Town. Brompton. Parish. Diseases of the Zymotic Class 121 9 130 „ „ Respiratory System 106 13 119 „ „ Digestive System 59 9 68 „ „ Nervous System 52 10 62 Tubercular Diseases 27 ... 27 Prematurity 65 14 79 Wasting Diseases 74 10 84 Violence 22 ... 22 Other Causes 52 13 65 Total 578 78 656 Parentage of the Deceased Infants.—Few infants comparatively, died in the families of well-to-do persons able to bestow requisite care upon their progeny. On the other hand, the deaths were numerous amongst the children born to persons occupying the lower strata in the social scale. The following statement will probably surprise those who are accustomed to regard Kensington as a city of the rich. 25 Position in life of the male parents of the infants who died under one year of age, as given in the registers of deaths:— Child of Number of Deaths in Sub-Districts. In whole Town. Brompton. Parish. Labourer 154 6 160 Costermonger 12 ... 12 Artizan 117 10 127 Cabman, Carman, Coachman, Horsekeeper, 'Bus Conductor 68 16 84 Male Servant 3 ... 3 Police Officer, Soldier, Postman Sailor 12 ... 12 Railway Servant, Fireman L.C.C. 12 ... 12 Commercial Traveller, Clerk, Collector, Student, Actor 12 8 20 Trade Assistant 54 8 62 Tradesman 46 10 56 Merchant 4 4 8 Professional Person 11 7 18 Person of Independent Means 1 ... 1 Deaths of Illegitimate Children under one year of age 72 9 81 Total 578 78 656 The deaths of children over one year, and under five years of age, were 455 in number; the deaths under five years, therefore, were 1,111, or 1,093 after correction for the 53rd week: (as compared with 965, 1,022, and 951, in the preceding three years respectively), being equal to 299 per 1,000 births, the proportion in London, as a whole, being 262. The deaths of illegitimate children under five years of age, 100, 118, and 129, in the preceding three years respectively, were 104 in 1896 (males 55 and females 49), of which 92 were registered in the Town sub-district. These deaths were equal to 47.1 per cent. on births registered as illegitimate. Of the 104 children only 23 outlived the first year. 26 Infantile Mortality in London.—Having examined the statistics for the several districts in London, I find that the mortality-rate of infants under one year of age was higher than in Kensington (176 deaths per 1,000 of registered births) in nine districts only, viz., in Battersea, 177 per 1,000; in Hammersmith, 179; in Shoreditch, 180; in St. George's, Southwark, 181; in Newington and also in Clerkenwell, 184; in the Strand, 193; in Holborn, 194; and in St. Saviour's, Southwark, 213. In two districts. Limehouse and Poplar, the rate was the same as in Kensington. In seven districts the rate, lower than in Kensington, was higher than in London, as a whole (161 deaths per 1,000 registered births), viz., in Fulham, 175; in Woolwich, 172; in Westminster and also in Bethnal Green, 170; in Chelsea and also in St. Pancras, 168; and in St. Martin-in-the-Fields, 164. In the remaining 24 districts the rate was lower than in London. SENILE MORTALITY. At sixty years of age and upwards there were 778 deaths, or 760 after correction for the 53rd week, as compared with 859, 671, and 784, in the preceding three years respectively. These deaths were equal to 269 per 1,000 on total deaths, the equivalent proportion in London as a whole being 219 per 1,000. The Death-Rate per 1,000 persons living at different age-periods in 1896, and in the preceding three years respectively, was as follows:— Population 1896 Death-rate per 1000. 1896 1895 1894 1893 Under 5 years of age 15,190 72.0 63.5 68.3 64.6 Five and under 15 27,761 3.8 3.9 3.6 5.0 Fifteen „ 25 37,986 2.9 2.3 2.6 2.1 Twenty-five „ 35 32,615 4.7 4.8 4.1 5.3 Thirty-five „ 45 22,709 10.7 10.2 10.5 11.1 Forty-five „ 55 16,107 14.8 18.7 15.2 18.6 Fifty-five „ 65 9,809 32.2 30.2 28.1 33.5 Sixty-five and upwards 7,823 78.8 80.5 67.4 85.8 27 The subjoined table shows the quarterly number of deaths of parishioners, males and females, in each of the sub-districts. Kensington Town. Brompton. Parish. Males. Females. Total. Males. Females. Total. 1st Quarter 294 324 618 63 68 131 749 2nd „ 292 307 599 61 76 137 736 3rd „ 261 271 532 56 61 117 649 4th „ 291 304 595 76 86 162 757 1,138 1,206 2,344 256 291 547 2,891 The Births were, of Males, 1943 The Deaths were, of Males, 1394 Females, 1774 Females, 1497 Total Births, 3717 Total Deaths, 2891 Deduct 2891 Deaths Shows 826 excess of Births over Deaths. Estimated increase of population in the year, 700. DEATH-RATES IN ENGLAND AND WALES ; AND IN LONDON; AND IN OTHER LARGE TOWNS. Before entering upon details with respect to the causes of death in Kensington, I may mention, by way of comparison with our local mortality-rates, that the death-rate in England and Wales, in 1896, was 17.1 per 1,000, and was lower than the rate in any previous year, excepting 1894. As compared with the rate in the ten years 1886-95, the death-rate in 1896 shows a decrease of 1.7 per 1,000. The rate in London, as already stated, was 18.6 per 1,000, and was 1.5 below the decennial average (20.1). The subjoined table shows the annual death-rate per 1,000 persons living, in each of the last eleven years in Kensington, in London, and in England and Wales:— 28  1896. 1895. 1894. 1893. 1892. 1891 1890. 1889. 1888. 1887 1886. Kensington 16.7 16.4 15.7 17.5 17.2 18.4 17.8 14.6 17.1 17.4 16.7 London 18.6 19.8 17.8 21.3 20.6 21.4 21.4 18.4 19.3 20.3 20.6 W. Districts 17.6 18.5 17.1 19.7 20.0 20.8 20.5 18.1 19.3 19.9 19.8 North „ 17.1 18.2 16.3 20.2 19.4 20.0 19.6 16.9 17.7 18.9 18.9 Central ,, 21.2 23.8 20.0 25.7 23.9 26.5 24.8 20.9 22.7 23.5 23.4 East „ 21.3 23.4 20.8 24.9 23.5 24.0 25.1 21.2 22.7 23.3 23.9 South „ 17.5 18.3 16.2 19.5 19.0 19.8 19.6 17.7 18.1 19.4 19.9 England and Wales 17.1 18.7 16.6 19.2 19.0 20.2 19.5 18.2 18.1 19.1 19.5 Greater London.—The death-rate in " Greater London," which is co-extensive with the Metropolitan and City Police Districts, the population, in the middle of the year 1896, numbering 6,178,376 (viz., 4,421,955 in Inner or Registration London, and 1,756,421 in the Outer Ring), was 17.0 per 1,000, as compared with 19.7, 16.4, and 18.3, in the three preceding years respectively. The deaths properly belonging to the Outer Ring, as distinguished from Inner or Registration London, were equivalent to a rate of only 13.1; the rate in the Inner Ring having been 18.6. The death-rate from the principal diseases of the zymotic class in Inner London, was 314 per 1,000; in the Outer Ring 210; the rate in Greater London, as a whole, being 2.87 per 1,000. Other Large Towns.—The death-rate in thirty-two cities and boroughs next in importance to London, and having a population of 6,425,016, was 195 per 1,000, ranging from 14.2 in Croydon, to 22.6 in Manchester and Salford, and 22.7 in Liverpool; without correction for differences between one town and another in regard to the age and sex-distribution of their respective populations. The death-rates in Edinburgh, Glasgow, and Dublin were 16.9, 20.4, and 24.9 per 1,000 respectively. 29 SUMMARY OF MORTAL STATISTICS. We have already seen that the death-rate in 1896 (16.7 per 1,000) was 0.5 per 1,000 above the rate in 1895 (16.2) and 0.1 below the decennial average rate (16.8). There were, as usual, considerable fluctuations in the rate at different periods of the year; the rate ranging between the minimum (12.2) in the tenth four-weekly period ended October 3rd, and the maximum (19-8 per 1,000) in the fifth four-weekly period ended May 16th. On eight occasions the four-weekly rate was above the annual average rate. The minimum and maximum rates in 1895 were 119 in the sixth four-weekly period, and 322 in the third four-weekly period. The deaths from all causes in the first half of 1896 were 1,485, those in the second half of the year 1,406; no material difference. On the other hand, the deaths from the principal diseases of the zymotic class were far more numerous in the first half of the year (290) than in the second half of the year (170). The total deaths from these causes (460) were 138 more than in 1895, and 115 above the decennial average also. The deaths from the diseases of the respiratory organs (504 after correction for the 53rd week) were 70 fewer than in 1895. In the table on page 30 will be found a summary of the principal vital and mortal statistics, arranged in four-weekly periods, the maxima and minima being indicated by special type. 30 SUMMARY OF VITAL AND MORTAL STATISTICS, KENSINGTON, 1896. During the four weeks ended. Births. Deaths. death-rate. deaths at ages. DEATHS FROM ZYMOTIC DISEASES. DISEASES OF RESPIRATORY SYSTEM. Deaths from Phthisis. Deaths from Heart Disease. Deaths under Five from Scrofolous Diseases. Mean Temperature. kensington london. 1896. Decennial Average. 1896. Decennial Average. 0-1 1—5 60 and upwards Totals. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Simple continued Fever. Diarrhœa. Totals. Bronchitis. Pneumonia. January 25 260 220 16.8 22.6 19.0 26.3 33 28 82 21 3 5 5 6 2 ... ... 53 41 9 16 18 1 41.4 February 22 2421 230 17.6 19.0 19.7 22.2 47 37 61 41 17 2 8 13 ... 1 ... 54 35 17 22 16 3 41.0 March 21 285 229 17.5 20.3 20.4 23.4 47 37 59 41 20 5 6 10 ... ... ... 53 29 14 20 16 5 43.3 April 18 369 249 19.0 16.9 1.9 20.2 51 55 55 52 35 1 3 13 ... ... ... 33 21 8 14 18 9 47.1 May 16 284 259 19.8 16.4 18.4 19.1 46 68 58 71 45 2 4 19 1 ... ... 42 24 13 15 15 6 52.6 June 13 282 205 15.7 15.3 17.1 17.7 45 48 43 43 24 ... 5 11 ... ... 2 34 19 11 19 12 4 59.1 July 11 287 202 15.5 14.8 17.9 18.0 50 43 46 45 19 2 5 8 1 ... 10 22 11 7 18 18 2 64.2 August 8 279 242 18.5 15.9 23.3 19.9 106 33 40 62 7 6 9 6 1 ... 33 17 10 6 20 15 4 63.3 September 5 283 176 13.5 13.8 17.0 17.6 40 17 51 22 1 1 5 5 1 ... 9 19 12 4 14 18 4 59.1 October 3 282 160 12.2 13.4 14.8 16.6 31 19 48 16 2 4 6 1 ... ... 3 20 15 2 16 10 3 55.8 October 31 291 201 15.4 15.0 17.3 18.5 44 20 68 12 ... 2 3 1 3 ... 3 36 30 2 16 22 4 45.7 November 28 274 238 18.2 16.6 19.7 19.6 50 27 75 17 ... 4 6 4 3 ... ... 71 59 9 25 14 2 41.0 January 2, 1897 (5 weeks ) 359* 280 17.1 18.5 18.0 21.8 66 23 92 17 ... 4 7 2 3 ... 1 62 44 10 24 22 7 39.6 TOTALS 3717 2891 16.7 16.8 18.6 20.1 656 455 778 460 173 39 72 99 15 1 61 516 350 112 239 214 5 50.1 * Maximum number during the year, and so throughout the table. †Minimum number during the year, and so throughout the table. 31 ASSIGNED CAUSES OF DEATH. Class I.—Specific Febrile or Zymotic Diseases. The Class of diseases called Zymotic comprises, in the Registrar-General's arrangement of the causes of death, six Orders. The first and second Orders, Miasmatic and Diarrhoeal, include the diseases which the Registrar-General describes as the " seven principal diseases of the zymotic class," grouping, as he does, under the generic term "Fever," the three fevers respectively named Typhus, Enteric, and Single Continued. ZYMOTIC DISEASES. The deaths from the "seven principal diseases of the zymotic class," which had been 341, 346, and 322, in the preceding three years, were 460 in 1896, and 115 above the corrected decennial average (345). These deaths, of which 398 belong to the Town sub-district, and 62 to Brompton, were equivalent to 2.7 per 1,000 persons living (33 in the Town subdistrict and 1.3 in Brompton), against 1.9 in 1895. The rate in the Metropolis, as a whole, was 314 per 1,000 (2.6 in 1895); the decennial rate being, for London 2.7, and for Kensington 2.0 per 1,000. The subjoined table shows the number of deaths from the several diseases, in the sub-districts, and at outlying public institutions:— Disease. Sub-districts. In Hospital. Total. Decennial Average. Town. Brompton. Town. Brompton. Uncorrected. Corrected for increase of Population. Smallpox ... ... ... ... ... 1.0 1.0 Measles 150 18 4 1 173 73.9 75.4 Scarlet Fever 6 1 30 2 39 28.7 29.3 Diphtheria 28 10 18 16 72 61.1 62.3 Whooping-Cough 95 4 ... ... 99 69.9 71.3 Typhus Fever ... ... ... ... ... ... ... Enteric Fever 7 2 5 1 15 16.9 17.2 Simple Continued Fever ... 1 ... ... 1 1.1 1.1 Diarrhœa 55 6 ... ... 61 86.1 87.8 341 42 57 20 460 338.7 345.4 32 From the above table it appears that the mortality from measles, scarlet fever, diphtheria and whooping-cough was in excess, that from enteric fever slightly, and that from diarrhoea considerably below the average. As usual the deaths were fewer in the Brompton sub-district (62) in proportion to population, than in the Town sub-district (398). The deaths from these diseases were equal to 159 per 1,000 deaths from all causes in Kensington, the proportion in the Metropolis as a whole being 169 per 1,000. The zymotic death-rate was in North Kensington 42 per 1,000 persons living, and in South Kensington 1.2 per 1,000. The rate in the several Sanitary Districts was as follows:— North Kensington. South Kensington North 137 deaths or 4.2 per 1,000 persons living. North-east 96 deaths or 3.0 per 1,000 persons living. North-west 124 deaths or 5.9 per 1,000 persons living. Central 27 deaths or 1.3 per 1,000 persons living. South-east 37 deaths or 1.2 per 1,000 persons living. South-west 39 deaths or 1.2 per 1,000 persons living. The deaths in the "Notting Dale" special area from diseases of the zymotic class, were 30, and equal to 8'0 per 1,000 of the population. The significance of these figures is unmistakeable. The table at page 30 shows the distribution of the deaths in Kensington from these diseases as recorded in the thirteen four-weekly reports. In England and Wales the deaths from these diseases were 127 in each 1,000 deaths, and the rate was 2.18 per 1,000 persons living, the decennial average being about 2.5 per 1,000. In the 32 Cities and Boroughs grouped by the RegistrarGeneral with the Metropolis, the zymotic death-rate averaged 2. 72 per 1,000, ranging from 110 at Halifax, and 1.18 at Huddersfield, to 4.10 at Salford. 33 SMALL-POX. Thirteen cases of small-pox were notified during the year all of them in North Kensington, i.e., north of High-street, Notting-hill, and Holland-park-avenue. All of the cases were removed to hospital. There was no death from this cause, nor had there been any in the preceding two years; the corrected decennial average number is 1. Of the ten deaths in the decennial period nine occurred in 1893. In London, as a whole, nine deaths were registered, the decennial average, corrected for increase of population, being 48. During the preceding ten years the total deaths from this cause in the Metropolis aggregated 444 only, the number in each year successively being 24, 9, 9, 0, 4, 8, 41, 206, 88, and 55. The cases of this disease notifiedwere 225 in number. Small-pox in Kensington.—As already stated, thirteen cases of the disease were notified during the year; four of these cases were recorded in January. The first case was that of a married woman whose illness began three weeks after her confinement,she not having been out of the house since that event. How the infection was conveyed to her remains a mystery. Her baby subsequently fell ill of the disease, having been infected by the mother. The other cases were a mother and an adult son, who fell ill almost simultaneously; the common source of infection was not discovered. In the fourth report a group of five cases was recorded which, as illustrative of a common mode of the spread of this highly infectious disease, is deserving of notice. The first case was that of a tinker named Christopher C-, aged 17, an inmate of a common lodging-house in the Potteries district, Notting-dale, who was removed to hospital, on the 24th March, from the West London Hospital, at which he had applied for medical treatment. He was stated to have been ill since the 19th March, having been tramping about the country with a brother, both before and after that date. During the first week in March he had spent some time at a lodging-house at Littlehampton, the landlady D 34 of which was removed to hospital, whilst he was there, suffering, as alleged, from small-pox. From her it is supposed that he contracted the disease. The men tramped thence to Worthing, putting up for a few nights at a lodging house, whence, it is said, a man was removed to hospital, suffering from small-pox, during their stay. This man had previously been at Little¬hampton. The brothers next moved to Shoreham, where C. C- fell sick. Thence they walked to Brighton, and on the 21st March they came to London by train, going to the common lodging house referred to above. The second case was that of a boy, Walter M-, aged 2 years. He lived at a little house, practically within the curtilage of the common lodging house where he came into contact with C. C-; and in due time he fell ill with small-pox. He was removed to hospital April 7th. This boy's father, at some date not exactly fixed, but after the child fell ill, left town on the tramp. His wife, Jane M-, aged 23, fell ill on the 19th April, and was removed to hospital on the 21st. The fourth case was that of Annie H-, aged 23, wife of the keeper of the common lodging house. She fell ill about the same time, and was also removed on the 21st. The last case was that of Walter M-, aged 31, who having gone, from London after his boy's illness developed, returned home on April 23rd, having fallen ill on the 21st. He was removed to hospital on the 24th. It was stated that this man had stayed at Kingston on the 16th April, at Horsham on the 17th, at Worthing on the 18th, at Shoreham on the 19th, at Brighton on the 20th, at Eastbourne (where he was alleged to have fallen ill) on the 21st, and at Lewes on the 22nd. From the latter town he came home by train, as stated, on the 23rd. I need hardly say that all necessary steps were taken for preventing the spread of the disease, viz., by vaccination, and by closing the common lodging and the other house for disinfection, with the result that no further cases occurred. I communicated the facts of the outbreak to the medical officers of health for Littlehampton and Worthing, and for Eastbourne and Lewes, 35 so that they might be on the look out for cases of the disease at the due dates, but happily there were none. It needs not to dwell on the probable evil consequences of migrant cases of small-pox like those of C. C- and W. M- . The short history above given, indicates the number of places where these men might have sown the seeds of the disease. In each lodging house where they put up, after falling ill, there was the probability that they might have infected other tramps, and so have disseminated disease in many parts of the country. It was fortunate indeed that so little mischief was done where so much might and, probably would have been done, had the constitution of the season been epidemic. MEASLES. Measles was the most fatal of the diseases of the zymotic class; the deaths registered were 173 (154 in the Town subdistrict and 19 in Brompton), and nearly 100 in excess of the corrected decennial average (75.4): of the 173 deaths, 160 were registered during 20 weeks, January 26th—June 14th. These are record figures, considerably exceeding as they do the previous maximum in 1890. when 140 deaths were registered, including 133 in the 20 weeks, April 20th—September 6th. Of the deaths in 1896, 93 were of males and 80 of females : 154 occurred in the Town sub-district and 19 in the Brompton sub-district. The deaths in the several sanitary districts were:— in the North district 58; in the North-east 23; in the Northwest 44; in the Central 21; in the South-east 11; and in the South-west 16:135 of the deaths occurred in North Kensington and 38 in South Kensington : 156 of the deaths took place under five years of age, 32 of them in the first year of life: between 5 and 15 years of age there were 15 deaths. The disease proved fatal to two adults, aged respectively 37 and 41 years. The first of these cases was that of the wife of a collector, measles being complicated with congestion of the lungs and followed by a premature confinement; the second was the daughter of a professional man, the cause of death, as certified, D 2 36 being measles 7 days, exhaustion 3 days. In some of the eases, measles being the primary cause of death, whooping-cough was returned as a secondary cause. In several cases of whoopingcough, returned as the primary cause of death, measles was returned as a secondary cause. In regard to each of these diseases, of course, the death is classified to the primary cause mentioned in the medical certificate of the cause of death. With few exceptions the deceased children belonged to the lower classes in the social scale. Measles indeed is a disease which rarely has a fatal termination among the children of the well-to-do classes. During the epidemic great numbers of children were kept from public elementary schools, either as suffering from the disease, or because of the disease being in the houses where they lived, and, many children no doubt continued to attend school from houses where the disease prevailed; possibly, even in the families of which they were members, and thus, by mediate infection, contributed to spread the disease. Children are not knowingly allowed to attend school from houses where the malady exists. Measles, it may be mentioned, becomes epidemic at about every third year, and few susceptible children escape in the families of persons living in tenemented houses, or houses let in lodgings. It is so infectious a complaint, and from such an early stage—probably from the beginning—that little can be done, by way of isolation, to prevent spread in the homes of the poorer classes. The disease had been epidemic in the Metropolis for a long time, spreading from district, to district, this parish being among the last to be seriously affected. The deaths in the parish from this cause in the ten years 1886-95 were 817, viz.: 111, 56, 108, 124, 14, 140, 29, 109, 18, and 108, in the successive years. The general alternation of a heavy and a light death-rate in successive years is apparent in these figures. In both 1888 and 1889, however, the disease was fatally prevalent; from March to July in the former year, and from October to December in the latter year. 37 The deaths in London from this cause in 1896 were 3,607, and 938 above the corrected decennial average (2,759). These deaths were equal to a rate of 0.82 per 1000 as compared with 0'61, the decennial average. In the preceding two years the deaths had numbered 3,293 and 2,633. Should Measles be Notified ?—The question whether measles should be made a notifiable disease under Section 55 of the Public Health (London) Act, 1891, was again raised during the course of the epidemic, by persons who naturally thought, or hoped, that publication of sickness returns might lead to reduction in the fatality of the disease. I dealt with this subject fully in my report for 1891 (pages 97-106), and, without repeating the arguments then employed, it will suffice here to say, that I have seen no reason to modify the conclusion at which I then arrived, viz., " that it would be of little or no use to have notification of measles unless hospital accommodation were provided on a large scale for the use of the sufferers therefrom," and of this there is no present prospect. SCARLET FEVER. The cases notified as scarlet fever were 1,011, against 957, 390, and 525, in the preceding three years successively; 706 in North Kensington and 305 in South Kensington. The deaths were 39, against 51, 22, and 27, in the preceding three years, and ten above the corrected decennial average. Thirty-six of the deaths belong to the Town sub-district and three to Brompton. Twenty-seven of the deaths were of children under five years of age including one under one year. Ten deaths occurred between the ages of 5 and 15, and two between 15 and 25. Thirty-two of the deaths took place at outlying public institutions, to which 763 cases were removed, and seven at the homes of the sufferers. The case-mortality was 3 9 per cent. (against 5.l in 1895), viz., 2.8 per cent. in home cases, and 4 2 per cent. in hospital cases. 38 The deaths in London, as a whole, were 942 (against 1,596, 962, and 829, in the preceding three years) and were 146 below the corrected decennial average. Of the 94.2 deaths 674, or 71.6 per cent., took place at fever hospitals. These deaths were equal to 0.21 per 1,000 of the population, as compared with 0.24, the average rate in the ten years immediately preceding. The notifications, corrected for duplicate returns, were 25,638, against 19,757 in 1895, 18,440 in 1894, and 36,901 in 1893. The case-mortality was, approximately, 3 7 per cent. on cases notified, as compared with a rate of 4.1 in 1895, 52 in 1894, and 4.3 in 1893. The case-mortality in fever hospitals (admissions 16,627; deaths 674) was 4.05 per cent. The following table shows the degree of prevalence of the disease in the parish, and in London, as a whole, as evidenced by the number of cases notified, and the deaths registered, in thirteen successive four-weekly periods. Scarlet Fever in 1896.* Report for four weeks euded No. of Notifications Kensington London No. of cases admitted to hospitals Kensington London No. of Deaths Kensington London No. of cases in Hospital at the end of the period Jan. 25 79 1761 59 1180 5 101 2916 Feb. 22 90 1527 83 1095 2 74 2937 March 21 57 1350 42 982 5 72 2773 April 18 45 1224 36 837 1 65 2527 May 16 37 1383 25 1003 2 50 2539 June 13 68 1864 52 1272 1 66 2781 July 11 93 2235 70 1309 2 59 3088 Aug. 8 94 2532 65 1367 6 76 3369 Sept. 5 92 2766 73 1611 1 70 3610 Oct. 3 84 2963 58 1689 4 73 4020 Oct. 31 104 2846 65 1611 2 66 4160 Nov. 28 91 2300 70 1477 4 78 4030 Jan. 2, 1897 (5 weeks) 77 2224 65 1484 4 92 3707 1011 26975 763 16917 39 942 *The figures in this and the following table are uncorrected for duplicate notifications. The notifications are taken from the weekly returns of the Asylums Board: the admissions to, and the numbers in, the hospitals, and the deaths in London, from the weekly returns of the Registrar-General. 39 For the sake of comparison, I subjoin the corresponding table for 1895, taken from the report for that year. Scarlet Fever in 1895. Report for four weeks ended No. of Notifications Kensington London No. of cases admitted to hospitals Kensington London No. of Deaths Kensington London No. of cases in Hospital at the end of the period Jan. 26 20 905 14 596 1 42 1662 Feb. 23 22 1006 16 620 1 54 1658 March 23 20 897 15 601 — 32 1587 April 20 23 854 14 583 2 48 1514 May 18 22 946 15 603 4 46 1444 June 15 33 1182 22 779 1 56 1637 July 13 39 1710 31 1223 1 61 2241 August 10 40 2037 30 997 — 76 2511 Sept. 7 24 1717 21 1264 1 89 2600 Oct. 5 63 2346 44 1300 1 78 2802 Nov. 2 91 2695 58 1057 4 90 2841 Nov. 30 62 2418 36 1268 5 77 2799 Dec. 28 66 1941 42 1035 6 80 2798 525 20654 358 11926 27 829 The tables on pages 40-41 shew certain particulars of interest with respect to scarlet fever prevalence, &c., during 1896, and in the decennium, 1886-95. How Disease is Spread.—Among the cases of Scarlet Fever investigated, there was one group which furnishes a good illustration of a common cause of the spread of infectious disease, viz., failure to recognize the nature of a primary case. In this group there were six cases in one family. Attention was drawn to the outbreak by notifications received of the illness of the head of the family and one of his children. Upon visitation of the home, rooms over a stable in a mews, it was ascertained that four other children had recently suffered from an infectious disease, supposed to be, and medically treated as, measles, but which, obviously, was scarlet fever, for the children's skins were desquamating or "peeling." I reported this fact to the medical attendant who took no notice of the communication. The father and four of the children were removed to hospital. Had the first case been recognized and removed, in all probability there would have been no extension of the disease, as an interval of seven days had elapsed before the second child fell ill; and in any case the breadwinner of the family would have escaped, as he did not succumb to the infection till about the sixteenth day after the first attack. 40 Scarlet Fever Cases Recorded in Kensington in 1896, and in Ten Previous Years, in Thirteen Four-Weekly Periods. The Year. Weeks. 1-4 Weeks. 5-8 Weeks. 9-12 Weeks. 13-16 Weeks. 17-20 Weeks. 21-24 Weeks. 25-28 Weeks. 29-32 Weeks. 33-36 Weeks. 37-40 Weeks. 41-44 Weeks. 45-48 Weeks. 49-52 TOTAL 1896 79 90 57 45 37 68 93 94 92 84 104 91 77* 1011 1895 20 22 20 23 22 33 39 40 24 63 91 62 66 525 1894 59 37 27 40 28 21 26 23 30 28 31 15 25 390 1893 45 60 38 34 56 84 84 110 67 113 117 88 61 957 1892 28 23 20 34 51 39 73 74 59 97 85 82 50 715 1891 38 47 18 24 23 23 13 27 17 31 23 22 17 323 1890 10 32 17 23 24 15 12 19 24 42 71 49 38* 375 1889 16 4 6 8 14 17 14 26 19 25 29 41 33 252 1888 46 40 29 19 16 10 15 13 12 7 7 20 18 252 1887 10 8 9 5 16 12 31 14 55 115 92 64 34 465 1886 10 17 7 4 4 7 3 4 8 13 11 9 3 100 Average 1886-95 28.2 29.0 19.1 21.4 25.4 26.1 31.0 35.0 31.5 53.4 55.7 45.2 34.5 435† * Return comprises five weeks. †Without correction for increase in population. Note.—Compulsory Notification has been in operation since October, 1889. 41 Statistics of Scarlet Fever, in Kensington, in 1896, and Ten Previous Years. The Year. No. of Recorded Cases. Total Number of Recorded Cases. Percentage of Removals to total Recorded Cases. Deaths. Total Deaths. Percentage of Deaths. Percentage of Deaths to Recorded Cases. Deaths in London from Scarlet Fever. Treated at Home. Removed to Hospital. At Home. In Hospital At Home. In Hospital 1896 248 763 1011 75 7 32 39 18 82 3.9* 942 1895 167 358 525 68 12 15 27 44 56 5.1 829 1894 131 259 390 66 5 17 22 23 77 5.6 962 1893 389 568 957 59 10 41 51 24 76 5.3 1596 1892 259 456 715 64 9 27 36 25 75 5.0 1174 1891 117 206 323 61 3 13 16 19 81 4.9 589 1890 161 214 375 57 6 20 26 23 77 6.9 875 1889 86 166 252 66 8 20 28 29 71 11.1 778 1888 68 184 252 73 10 16 26 39 61 10.3 1209 1887 149 316 465 68 2.1 23 44 48 52 9.4 1447 1886 37 63 100 63 8 3 11 73 27 11.0 688 * The case-mortality in Kensington patients treated at home in 1895, was 7.2 per cent., and inpatients treated in hospital, 4.2 per cent. 42 DIPHTHERIA. The notified cases of diphtheria (360), and membranous croup (11) which the Registrar-General now classifies as diphtheria, were 371, against 368,268, and 365, in the preceding three years; viz.: 222 in North Kensington and 149 in South Kensington. The deaths registered were 72 (against 83, 75, and 89, in the preceding three years respectively), and 10 above the corrected decennial average: 46 of them belong to the Town sub-district and 26 to Brompton; 44 to North Kensington, and 28 to South Kensington. Thirty-four of the deaths took place at hospitals, to which 231 cases were removed, and 38 at home. The case-mortality was 19.4 per cent., and was much higher in the home-treated cases (27.1 per cent.) than in cases removed to hospital (14.7 per cent.) Of this striking difference, I am unable to suggest any other explanation than the antitoxin treatment, which is practised, doubtless, to a larger extent at the hospitals than in the cases treated at home. In 1895, the first year of antitoxin treatment, the case-mortality in home cases was 34.2 per cent., in hospital cases 20.1 per cent.; whilst in 1894, the case-mortality was practically equal in home and hospital cases, viz., 28.3 and 27.7 per cent. respectively. It must be remembered, moreover, that the percentage mortality in hospital cases is calculated upon true diphtheria, whereas in home cases the calculated mortality is based on notified cases—a very different thing, having regard to the large proportion of cases of mistaken diagnosis ; so that the proportional success of treatment at the hospitals is even greater than represented by the most favourable figures. The deaths in London from diphtheria were 2,683 (797 above the corrected decennial average, 1,886), as compared with 3,265, 2,670, and 2,316, in the years 1893, 1894, and 1895, respectively. Of the 2,683 deaths 956 occurred in the hospitals, to which 4,580 cases of true diphtheria were removed—a mortality of 20.9 per cent. The deaths in 43 London were equal to a rate of 0.60 per 1,000, against rates of 0.76, 0.62, and 0.54 per 1,000 in the three previous years. The rate in Kensington in 1896 was 0.40 per 1,000, against 0.49, 0.46, and 0.53 in the three previous years. The corrected notifications were 13,361 in number, as compared with 10,772 in the preceding year. The following table, based on the thirteen four-weekly reports, sets out some particulars with regard to diphtheria in Kensington, and in London, in 1896, the London notifications being uncorrected (vide footnote, page 38). Diphtheria in 1896. Report for four weeks ended No. of Notifications Kensington London. No. of cases admitted to Hospital Kensington London. No. of Deaths Kensington London. No. of cases in Hospital at the end of the period. Jan. 25 31 988 24 415 5 224 667 Feb. 22 22 1054 13 401 8 217 713 March 21 30 1009 18 386 6 191 706 April 18 14 785 9 355 3 183 671 May 16 25 890 11 401 4 161 710 June 13 25 1060 19 415 5 197 753 July 11 24 1069 14 403 5 167 758 August 8 43 1168 31 363 9 202 708 Sept. 5 29 1082 20 407 5 199 720 Oct. 3 26 1288 16 435 6 227 787 Oct. 31 11 1229 8 444 3 239 793 Nov. 28 27 1160 14 444 6 220 788 Jan. 2, 1897 50 1442 34 609 7 256 844 (5 weeks) 360 14,224 231 5478 72 2683 The table at page 44 gives particulars with respect to diphtheria in North and South Kensington, respectively. 44 PARTICULARS WITH REFERENCE TO DIPHTHERIA IN KENSINGTON, IN 1896. Set out in Report for Four weeks ended. Total Cases Notified. Cases Notified in North Kensington.* Cases Notified in South Kensington.* Cases removed to Hospital from Deaths in North Kensington. South Kensington. North Kensington. South Kensington. January 25 31 19 12 12 12 5 - February 22 22 14 8 8 5 3 5 March 21 30 8 22 6 12 2 4 April 18 14 12 2 7 2 2 1 May 16 25 20 5 9 2 2 2 June 13 25 14 11 10 9 4 1 July 11 24 13 11 5 9 1 4 August 8 43 23 20 18 13 4 5 September 5 29 13 16 10 10 1 4 October 3 26 23 3 15 1 6 — October 31 14 6 8 2 6 2 1 November 28 27 15 12 9 5 5 1 January 2, 1897 (5 weeks) 50 35 15 25 9 7 — 360 215 145 136 95 44 28 *North Kensington and South Kensington are the districts to the North and South of the centre of Notting Hill High-street and Holland-park-avenue, respectively. The population of the two districts is about equal. 45 How Disease is Spread.- - Among the cases of diphtheria recorded, the following groups may be cited as illustrations of how the disease may be spread, owing to failure to recognise a first case. The first group comprised no fewer than eight cases in one household in a South Kensington mews. The outbreak came to my knowledge on receipt of six notifications of "diphtheritic tonsillitis," a disease not named in section .55 of the Public Health (London) Act, 1891. The premises were at once visited for enquiry, when it appeared chat one of the children had fallen ill, with throat disease, eleven days previously. A doctor was called in, but failed, in his single visit, to recognize the illness as diphtheria. Nine days later the doctor was again sent for, to find a second child sick unto death, and five other children more or less ill with a disease, which, in his certificates, received three days later, he described as above mentioned. On two consecutive days two children were removed to a general hospital: both of them required immediate relief by tracheotomy, and one did not long survive the operation. The other four children were removed to hospital, by the Asylums Board, at my request. Subsequently a stable helper living at the same premises was removed to hospital, also suffering from diphtheria, making eight cases in all, with two deaths. Seeking for a cause for the first case—for the other cases were explicable upon the assumption of direct infection from person to person—I ascertained that there had been much cause for complaint of stench arising from a surface sewer ventilator, immediately under the windows of the rooms over the stable in the mews, which has not been taken over by your Vestry. It was stated, moreover, that the child first to be attacked (and not he alone) had been accustomed to dabble in the water which lay in a hollow near to the ventilating opening, and it was presumed that in this way he had inhaled the pestiferous vapours, and so contracted this malignant disease. I lost no time in calling the attention of the Surveyor to the nuisance, and he forthwith had the ventilating opening closed. Susbequently the 46 Sanitary Committee, after view, adopted my recommendation to substitute a pipe-ventilator, the erection of which put an end to an undoubted nuisance. The first case in the second group referred to, appears to have been that of a male infant aged ten months, who, having swellings on the neck, was taken to a doctor who diagnosed "mumps." The same doctor was called in to a second child, also a boy, aged two years, on or about the 25th July, at which time the infant was still ill. This second case was regarded and treated as membranous croup, but it was not notified by the medical attendant as the Act directs. The child, however, was seen on July 30th by another doctor, by whom the case was notified forthwith as one of diphtheria. On the 31st July this child died, the cause of death, as certified by the first practitioner, being " membranous croup," a disease which the Registrar-General classifies as diphtheria. On the 30th July the infant was seen by the second doctor, who notified this case also as diphtheria. The child was removed to hospital the same day, and died of diphtheria on 4th August. The grandmother of the two children lived in the same house with two daughters, aged respectively 18 and 14 years. These girls, who had assisted in the nursing of the two previous cases, were seen by the second doctor on the 31st July, found to be suffering from diphtheria, and were removed to hospital on the following day. The origin of the disease was not traced, but the second, third, and fourth cases, doubtless, contracted the malady from the first and unrecognised case. ANTITOXIN TREATMENT OF DIPHTHERIA. Reference has been made above to the beneficial results attending the antitoxin treatment of diphtheria. In the course of the year the Medical Superintendents of six of the hospitals of the Asylums Board made a joint report, recording their experience of "the use of antitoxin serum in the treatment 47 of diphtheria,," of high interest and on the whole of a decidedly satisfactory character. The experiment, if such it may be called, was conducted on a large scale, no fewer than 2,182 cases having been treated by injection of serum. The results of the treatment are grouped in tables (71 in number), showing the results attained; firstly, at the several hospitals separately, and then at all the hospitals combined. It is not possible to do more than glance at the general conclusions arrived at. It is stated that whilst of 3,042 patients of all ages treated without antitoxin in 1894, 902 died, a mortality of 296 per cent.; of 3,529 cases treated during 1895, only 796 died, a mortality of 22 5 per cent.; the difference in percentage between the two . rates being therefore 7.1, representing a saving of 250 lives during the latter year. There was no change made in the local treatment of the cases; no new factor in the treatment other than the injection of antitoxin. The serum, moreover, was administered to those cases only in which the symptoms on admission were sufficiently pronounced to give rise to anxiety, the mild cases not getting any; so that only 61.8 per cent. of total cases were treated with antitoxin; no less than 46.4 per cent of the antitoxin cases, moreover, being under five years of age. It is shown that the percentage mortality varied widely according to the day of disease on which the patient was admitted and the treatment began. Diphtheria is exceedingly fatal to young children; it is peculiarly satisfactory therefore to note that the reduction in mortality was greatest in early life. The difference in mortalities in 1894 and 1895, in cases under five years of age, was 13.2 per cert, in favour of 1895; the difference at all ages being only 7.1 per cent. The table numbered 24 is interesting as "showing the percentage mortality in relation to day of disease in which cases came under treatment." The percentage mortality of cases admitted on the same day of disease was less in every instance in the year 1895; the difference being most marked in the case of those patients who were admitted on the first and second day of 48 illness, being to the extent of 10.8 and 14.5 per cent. respectively. In this table (24) the comparison of percentage mortality is made between all cases treated in 1894 and in 1895; but if the comparison is made between the cases (only) treated with antitoxin during 1895, and cases treated in 1894, when antitoxin was not in use, striking differences are observed in the figures giving the results of treatment commenced upon the first and second day of illness; for in the antitoxin cases the mortality for the first day is only 4.6 per cent., and for the second day 14.8 per cent., whilst in 1894 the proportional mortality was 22.5 per cent. and 27 per cent. respectively. Specially dangerous cases are those involving the larynx, and which so frequently require the operation of tracheotomy to avert impending death from suffocation. Table 31 gives the combined results in tracheotomy cases. Table 32 gives the combined results in all the laryngeal cases, whether tracheotomised or not, and it is stated that 'the results are most satisfactory." With the object of determining whether any advantage is gained over former methods of treatment by the use of antitoxin in cases of laryngeal diphtheria, the results obtained in all such cases during the year 1895, are placed side by side with those obtained in 1894 before the remedy was employed; and it is seen (in tables 33-39) that the tracheotomy results at each hospital are more favourable in the year 1895 than in 1894; the mortality having ranged in the latter year, at the different hospitals, between 90 per cent. and 59.4 per cent., whereas in 1895 the range was from 56.2 to 40.5 per cent. only. Table 39 shows that the combined tracheotomy mortality for all the hospitals—which in 1894 was 70.4 per cent., had fallen to 49 4 per cent. in 1895; this being a lower death-rate than had ever been recorded in any single hospital of the Board for a year's consecutive tracheotomies. "In other words, rather more than 50 per cent. of children on whom the operation has been performed, have been saved since the employment of antitoxin, In one of the hospitals no less than a fraction 49 under 60 per cent. survived, although the recoveries in that hospital in any former year did not exceed 25 per cent., and in the preceding year—viz., 1894—were as low as 10 per cent." It further appears that "the improved results in the tracheotomy cases of 1895 have also been shared by analogous cases in which the operation was not performed;" for "the percentage mortality of all laryngeal cases fell from 62 in 1894 to 42.3 in 1895"; whilst "the number of laryngeal cases which required tracheotomy fell, in 1895, to 453 per cent.; whereas in 1894 it was 56 per cent." The foregoing results may be summarised by saying that the percentage mortality of laryngeal cases at the hospitals was less by nearly 20 per cent., in the antitoxin year 1895, than in 1894 ; that the percentage mortality in tracheotomy cases was 21'4 per cent. less, and that the percentage of laryngeal cases requiring tracheotomy was 9.2 per cent. less in 1895 than in 1894. Tables 45 to 66, dealing with the number and percentage incidence of complications which arose amongst the cases which form the subject of the report, and the comments of the Medical Superintendents thereon, are highly interesting, but the subject is too technical to be dealt with here. Table 66, however, deserves reference, as showing the "complications probably connected with antitoxin." A rash is the most common sequel, and usually it takes the form of a nettle rash, or an erythema: it is similar to the eruptions of measles and septicœmia, but it may be scarlatiniform. It is often accompanied by secondary fever. The rash was observed in 1,002 cases, or 45.9 per cent. of total cases, 2,182 in number. Joint pains were observed in 103 cases, or 4.7 per cent. of total cases. These pains are seldom severe, they pass off in a few days and apparently leave no ill effects. Fever (secondary), with or without rash or pains, was observed in 647 cases, or 29.6 per cent. of total cases. This secondary fever in some cases persists for several days, and may be unaccompanied by any other obvious symptoms; but it has the effect of some- D 50 what retarding convalescence, and may, in cases of great weakness threatening heart failure, prejudice the patient's prospect of recovery. Abscess at the site of the injection, despite the care exercised, occurred in 52 cases, or 2.3 per cent. of total cases. "Considering the large numbers of injections (5,086) and the septic element which is present in so large a proportion of the severe attacks," it cannot be said that the number of abscesses was excessive, but the percentage of such cases differed widely at the different hospitals. The serum used during the year 1895, was supplied in the first eight months by the British Institute of Preventive Medicine, and in the last four months from the laboratories of the Royal Colleges of Physicians and Surgeons. The dosage of serum is regulated according to the severity of the case rather than by the age or weight of the patient. It is stated that at the three hospitals at which an improvement in the death-rate of more than the mean (7.1 per cent.) was observed, the proportion of cases treated with antitoxin, and the average amount of serum injected, were above the mean at the remaining hospitals. The clinical effects observed to follow the administration of antitoxin, in cases brought under treatment at a reasonably early date, were:—(1) A diminution of the throat swelling and consequent distress. (2) A lessening, if not an entire cessation, of the irritating and offensive discharge from the nose. (3) A limitation of the extention of membrane. (4) An earlier separation of the exudation of membrane. (5) A limitation and earlier separation of membrane in laryngeal cases. (6) An improvement in the general condition and aspect of the patients. (7) A prolongation of life in cases which terminate fatally, to an extent not obtained with former methods of treatment. 51 The improved results in the cases treated during the year 1895, indicated by the statistics and the clinical observations, are thus summarised:—(1) A great reduction in the mortality of cases brought under treatment on the first and second day of illness. (2) The lowering of the combined general mortality to a point below that of any former year. (3) The still more remarkable reduction in the mortality of the laryngeal cases. (4) The uniform improvement in the results of tracheotomy at each separate hospital. (5) The beneficial effect produced on the clinical course of the disease. The conclusion arrived at by the reporters, based on the statistics and the clinical observations, is distinctly in favour of "the value of antitoxin in the treatment of diphtheria," especially in cases brought under the influence of the remedy not later than the second day of disease "From this time onwards, the chance of a successful issue will diminish in proportion to the length of time which has elapsed before the treatment is commenced." Regarding the secondary effects, which not infrequently arise, as a direct result of the injection of antitoxin, and the greater incidence of normal complications following thereupon, the Medical Superintendents of the hospitals have no hesitation in expressing the opinion that "these drawbacks are insignificant, when taken in conjunction with the lessened fatality which has been associated with the use of this remedy." Their final remark is that "in antitoxic serum we possess a remedy of distinctly greater value in the treatment of diphtheria than any other with which we are acquainted." It has been impossible, within the compass of this report, to do more than briefly refer to the tables which summarise the results of the antitoxin treatment for all of the hospitals combined. But valuable lessons are to be learned from the tables which relate to the several hospitals separately. Thus, D 2 52 for instance, it clearly appears that the new treatment was most successful at the hospitals at which the antitoxin serum was injected in the largest closes; at which the largest number of doses were given; and at which the largest proportion of total cases were thus treated. On the other hand, the mortality was greatest at the hospitals at which the smallest and the fewest doses were given, and at which the fewest cases, in proportion to total cases, were thus treated. As stated already, the treatment was successful in proportion as it was adopted at an early stage of the disease. This important point is proved by comparing the death-rate in cases injected on the first day of the disease, viz., 4.6 per cent., with the rate in cases in which treatment was commenced at later periods; viz, 26.1 per cent.; the rate rising to 35.7 per cent. in cases injected on the fifth day and after. An even more striking illustration is furnished by a report (appended to the general report) made by the Medical Superintendent of the Northern (Convalescent Fever) Hospital at Winchmore Hill. At this hospital 119 cases of post-scarlatinal diphtheria occurred in 1895, of which 58, being the severer cases, were treated with antitoxin. Twelve cases were injected on the first day of the disease, and not one of them proved fatal. Of the 119 cases only four proved fatal; a mortality rate of 3.3 per cent., compared with a combined rate of 22 5 per cent. at the Town Hospitals. During the preceding three years, in pre-antitoxin days, exactly the same number of cases (119) had occurred at this Hospital, and these furnished 75 deaths (instead of 4 as in 1895), and a percentage mortality of 63 instead of 3.3 as in 1895. "The cases of 1895," it is stated, "were, in their earliest symptoms, similar to those of previous years," and they included cases "which, both from laryngeal obstruction, and severity of constitutional symptoms, would, in pre-antitoxin days, have been regarded as hopeless;" and as to laryngeal cases, it appears that the mortalities in 1894 and 1895 were in striking contrast; for 53 in 1895 seven out of eight cases recovered, whilst in 1894 of nine cases all died; the only new factor in the treatment of the post-scarlatinal diphtheria being antitoxin. It would thus appear that there is good ground for believing that antitoxin is a real remedy and a powerful remedy against this terrible disease. It may be mentioned that the average reduction in the mortality at all the (town) hospitals combined, is considerably less than has been observed abroad, as a result of the antitoxin treatment. Better results, it may be anticipated, will be shown in the report of the Medical Superintendents for 1896, as it can hardly be doubted that the new treatment will have been had recourse to in a larger proportion than 61.8 per cent. of total cases. As already mentioned "mild" cases were not injected. But who can say that any case, apparently mild at its inception, will continue to be mild throughout its course? And if treatment be delayed until serious symptoms have supervened, there is, as we have seen, a greatly diminished prospect of a successful issue. As a final observation, I would say that in the varying practice at the different hospitals in 1895, an unconscious but valuable experiment was performed, the result of which should be to lead, in the future, to more uniformity of practice in respect of dosage, frequency of injection, and proportion of cases treated. Should this expectation be realized, we may hope to see more uniform and better results at the several hospitals in the next Annual Report of the Medical Superintendents. It is worth repeating that sufferers from this parish participated to the full in the benefits arising from the antitoxin treatment, seeing that in 1895 there was a substantial reduction in the case-mortality as regards hospital patients. In 1894 the percentage mortality was practically the same in home-treated cases (27. per cent.), and in hospital cases (28.3 54 per cent.); whereas in 189.3, the mortality in the cases sent to hospital fell to 20.1 per cent., whilst in home cases it rose 34.2 per cent. I know of no other cause than the antitoxin treatment for the reduction in the mortality of the hospital cases; nor can I suggest any cause for the rise in the percentage mortality of home-cases, unless it be that the disease was more severe in 1895 than in 1894, in which event the reduction in the mortality in the hospital cases becomes all the more striking. In 1896, as already stated, the results were even more satisfactory, the mortality in hospital cases having fallen to 14.7 per cent., the mortality in home cases having been not far short of double, viz.. 271 per cent. WHOOPING-COUGH. Whooping-Cough was the cause of 99 deaths, against 65, 61, and 39, in the preceding three years successively; 95 in the Town sub-district and 4 in Brompton; the corrected decennial average being 71. All but two of the deaths were of children under five years of age, including 39 under one year. The deaths in London from this cause were 2,937, and 256 above the corrected decennial average (2,681); they were in the proportion of 0.65 per 1,000 persons living. The mean rate in the 10 years 1886-95, was 0.60. FEVER. There was no death from Typhus Fever. From Simple Continued Fever there was one death. Enteric Fever was the cause of 15 deaths, as compared with 17, 21, and 15, in the preceding three years respectively, the corrected decennial average being 17. Twelve of the deaths belong to the Town sub-district, and three to Brompton. Six of these deaths occurred in hospitals, to which 46 cases were removed, and 9 at home. Ninety-four cases of the disease were notified, 51 in North Kensington and 43 in South Kensington, as compared with 102, 90, and 48. in the preceding three years successively. The deaths in London from Fever were 609—viz., from Typhus 55 Fever 5, from Simple Continued Fever 13, anil from Enteric Fever 591—and 79 below the corrected decennial average (688). The death-rate was 0.14 per 1,000 persons living, and 015 below the average rate in the ten years immediately preceding. The corrected notifications of these diseases were, Typhus, 6; Simple Continued Fever, 102; and Enteric Fever 3,189. DIARRHŒA. Diarrhœa was the cause of 61 deaths, against 98, 56, and 118, in the preceding three years successively: 55 in the Town sub-district, and 6 in Brompton; the corrected decennial average being 88. All of the deaths, save 4, were of children under five years of age, including 50 under one year. The deaths in London from this cause were 3,223, and 101 above the corrected decennial average (3,121). The death-rate was 0'72 per 1,000 persons living, and slightly in excess of the average in the preceding ten years, which had been 0 70 per 1,000. INFLUENZA. Influenza was not markedly prevalent, only twenty deaths therefrom having been registered in Kensington during the year, against 115 in 1895. Of these deaths 15 occurred in the Town sub-district, and 5 in Brompton. The deaths in London from this cause were 496,* and 543 below the the corrected decennial average. Other Diseases of the Zymotic Class.—Thus far I have dealt with the "seven principal diseases of the zymotic class," which, with Cholera and Influenza, comprise the maladies which in table III. (appendix) go to make up Orders 1 and 2 (Miasmatic and Diarrhoea] Diseases) of Class 1 in the Registrar-General's classification, viz., "Special Febrile or Zymotic Diseases." * This number is considerably smaller than in any year since 1890, the first year of the epidemic in London. The deaths, moreover, did not exceed 26 per cent. of the average annual number in the six years ending with 1895. 56 Still dealing with this important Class, it appears that two deaths, from Ague, were registered in Order 3 (Malarial Diseases), and no death from Zoogenous Diseases comprised in Order 4. Order 5, Venereal Diseases,includes Syphilis, Gonorrhœa, and Stricture of the Urethra. Syphilis was the registered cause of 18 deaths, against 28, 14, and 19, in the preceding three years respectively. Fifteen of these deaths occurred in the Town sub-district, and 11 of them were of children under one year of age. If the truth were known, it would probably appear that this Protean malady was accountable, directly or indirectly, for a number of deaths considerably in excess of the record. There were three deaths from stricture of the urethra. Order 6, Septic Diseases. This Order comprises Erysipelas, Pycemia, Septicœmia, and Puerperal Fever: the total deaths registered were 12, against 32, 11, and 18, in the preceding three years respectively. Erysipelas was the cause of 4 deaths,* all of them in the Town sub-district, against 17, 3, and 9, in the preceding three years respectively. Septicœmia was the cause of one death. Puerperal Fever was the registered cause of 7 deaths, of women between 15 and 45 years of age (against 10, 5, and 3, in the preceding three years respectively), six of them in the Town sub-district. In addition to these 7 deaths, other 13 (11 of them in the Town sub-district) were registered as having occurred in "childbirth," against 10, 8, and 8, in the preceding three years respectively. The deaths registered as having been caused by diseases and accidents associated with parturition (20 in all) were equal to about 54 per 1,000 live * The notified cases of Erysipelas were 277, many of them being of traumatic origin, unimportant in character, and such as the framers of the Act could scarcely have intended to be notified, 57 births, against 4.6, 3.5, and 2.5 per 1,000 in the preceding three years respectively. The notifications of puerperal fever were nine in number. Bearing in mind the disastrous series of cases of this disease on which I reported in 1883, when a verdict of manslaughter was returned by a Coroner's jury against a midwife, under circumstances set out in the fourth and sixth reports for that year, I have ever since felt it to be my duty to warn nurses, and all other women concerned with these painful cases, of the responsibility they incur by attending other parturient women until after a period of three or four weeks, and disinfection of their persons, clothing, &c. This course was adopted in respect of the cases notified in 1896 with satisfactory results, there having been no spread of the disease. Class II.—Parasitic Diseases. The deaths from the diseases in this Order were five, from Thrush, four of them of infants under one year. Class III.—Dietetic Diseases. The deaths from the diseases in this Order were 16; 11 of them in the Town sub-district. To Want of Breast Milk one death was classified, and to Scurvy one. Delirium Tremens was the cause of four deaths, against 3, 2, and 3, in the preceding three years respectively; Chronic Alcoholism of ten deaths, against 18, 8, and 8. Of these 14 deaths 9 occurred in the Town sub-district. It is scarcely necessary, perhaps, to remark that if all the deaths due, directly or indirectly, to the immoderate use of intoxicating liquors, could be ascertained, "Alcoholism" would occupy a more prominent position in the "Bills of Mortality" ; but many deaths due to the misuse of alcohol, get certified, and therefore are classified, to visceral and degenerative diseases caused or aggravated by drink. 58 Class IV.—Constitutional Diseases. This important Class comprises the causes of 548 deaths (equal to 190 per cent. of total deaths), including 70 of children under the age of five years: 423 of the deaths were registered in the Town sub-district, and 125 in Brompton. Rheumatic Fever and Rheumatism of the Heart caused 11 deaths, 6 of them in the Town sub-district; Rheumatism, 3 deaths. Gout was the cause of 7 deaths, 5 of them in the Town sub-district, and Rickets of 6, five of them in the Town sub-district. Cancer, Malignant Disease, was accountable for 173 deaths; 124 in the Town sub-district and 49 in Brompton. Cancer would appear to be on the increase in the country generally: possibly, however, some portion of the apparent increase in the number of deaths classified to this cause, may be due to greater accuracy in diagnosis. The deaths in Kensington in the preceding ten years, were 128, 117, 121, 138, 125, 127, 129, 140, 143, and 136, respectively. Deaths from malignant diseases are usually more numerous, proportionally to population, in the Brompton sub-district than in the relatively poorer Town sub-district, cancer being quite as prevalent, probably even more prevalent, amongst well-todo people, than in the poorer classes. The parts of the body most commonly affected are, the viscera or internal organs; in women, the uterus and the breast; the disease, moreover, being for the most part one of later life. Thus, 147 of the deaths took place at ages above forty-five, and 18 between thirty-five and forty-five years. Purpura (Hemorrhagic Diathesis), was the cause of one death; Anœmia and Leucocythœmia of 7; Glycosuria, Diabetes Mellitus, of 22. Tubercular Diseases were the registered causes of 318 deaths, (as compared with 307, 336, and 350, in the preceding 59 three years respectively); viz., 258 in the Town sub-district, and 60 in Brompton; 62 of the deaths were of children under five years of age. In a few instances Phthisis was returned as the cause of death in infancy, a period of life at which the tubercular diathesis commonly manifests itself in other parts of the body than the lungs, e.g., the brain, bowels, &c. Such deaths have been classified in table III. (appendix), with those ascribed to "Other forms of Tuberculosis, Scrofula," the total being 34 (of which 16 occurred under five years of age), including 30 registered in the Town sub-district. Tales Mesenterica, popularly known as " consumption of the bowels," was the cause of 10 deaths (nine of them in the Town subdistrict); all of them under five years of age, and 8 under one year. Tubercular Meningitis and Hydrocephalus (water on the brain) were the causes of 34 deaths; 7 of them in Brompton, and 28 under five years of age. Phthisis, popularly known as "decline," or "consumption," was the cause of 239 deaths, 8 under five years of age; 4 between five and fifteen years of age, and 217 between fifteen and sixty-five; viz., 26, 58, 73, 39 and 21, in the five decennial periods consecutively; 10 deaths were registered at ages over 65. Of total deaths, 191 belong to the Town sub-district, and 48 to Brompton. The deaths from tubercular diseases were, proportionately, not so numerous in Brompton as in the Town sub-district. Class V.—Developmental Diseases. In this Class the total deaths were 225, viz., 183 in the Town sub-district, and 42 in Brompton. Premature Birth was the assigned cause of 79 deaths, 14 of them only in the Brompton sub-district; Atelectasis of 8, 6 of them in the Town sub-district; and Congenital Malformation of 15, 11 of them in the Town sub-district. Old Age was the registered cause of 123 deaths, all but two of them at ages over sixtyfive: between sixty-five and seventy-five there were 20 deaths so classified; between seventy-five and eighty-five 60; and at eighty-five and upwards 41, 60 Class VI.—Local Diseases. The diseases in this Class, which comprises eleven Orders, named after the systems or organs to which the diseases relate, were accountable for 1,353 deaths (against 1,319 in 1895) or 46.8 per cent. of the deaths from all causes: 1.093 were registered in the Town sub-district, and 260 in Brompton; 394 were of children under five years of age. The deaths from the diseases comprised in the several Orders were as follows: — 1. Nervous System.—Diseases of the nervous system were the registered causes of 273 deaths (against 305, 295, and 248, in the preceding three years respectively), viz., 220 in the Town sub-district, and 53 in Brompton; 74 of the deaths were of children under five years of age, and 151 occurred at ages over forty-five. The fatal Diseases were, Inflammation of the Brain or Membranes, 20 deaths; Apoplexy, Softening of the Brain, Hemiplegia, Brain Paralysis, 124 deaths (98 in the Town sub-district, 26 in Brompton); Insanity, General Paralysis of the Insane, 20 (18 of them in the Town subdistrict): Epilepsy, 12; Convulsions, 53 (all under five, and 47 under one year) ; Laryngismus Stridulus, 6; Disease of the Spinal Cord, Paraplegia, Paralysis Agitans, 6 ; Other Diseases of Nervous System, 32. 2. Diseases of the Organs of Special Sense (e.q., of Ear, Eye, Nose) are comprised in this Order. Three deaths were registered from these causes. 3. Circulatory System.—The deaths due to diseases of the organs of circulation, heart and blood vessels, were 247, against 219, 159, and 196, in the preceding three years respectively: 182 were registered in the Town sub-district, and 65 in Brompton. Heart diseases proper caused 214 deaths. To specified forms of disease, 103 deaths were ascribed, viz., Pericarditis, 1; Acute Endocarditis, 7; Valvular Diseasen 61 of the Heart, 62. Other diseases of the heart caused 144 deaths. Aneurism was the cause of 8 deaths, and Embolism, Thrombosis, of 18. Other Diseases of Blood Vessels caused 7 deaths. 4. Respiratory System.—The deaths from the diseases of the respiratory organs, Phthisis being excluded, were 516 (against 671, 556, and 574, in the preceding three years respectively), and 17.8 per cent. of total deaths. Of these deaths 440 were registered in the Town sub-district, and 76 in Brompton. The deaths under five years of age were 226, or 43.8 per cent. (against 31.3 46.2, and 34.0, per cent. in the preceding three years respectively); and at fifty-five and upwards 199, or 38.6 per cent. of the whole number, against 42.5, 36.0, and 463, per cent. in the preceding three years respectively. The fatal diseases were Laryngitis, 5 deaths; Group, 4* Emphysema, Asthma, 6; Bronchitis, 350; Pneumonia, 112; Pleurisy, 12; and Other Diseases of the Respiratory System, 27. Bronchitis and Pneumonia, therefore, were accountable for 462 deaths (including 211 under five years of age), of which 63 were registered in Brompton. 5. Digestive System.—The diseases of the various organs concerned in digestion were the causes of 209 deaths, 83 of them under five years of age: 164 in the Town subdistrict and 45 in Brompton. Dentition was the cause of 17 deaths under five, 13 of them under one year. Diseases of the Stomach caused 17 deaths; Enteritis (including Gastroenteritis), 69; Obstructive Discases of Intestine, 42; Peritonitis, 16; Ascites, 1. Cirrhosis of Liver caused 27 deaths; Jaundice and Other Diseases of Liver, 17 (including three under one year); and Other Diseases of Digestive System, 3 deaths. * Eleven cases of "membranous croup "were notified. The RegistrarGeneral classifies fatal cases of this disease to diphtheria. 62 6. Diseases of Lymphatic System (e.g., of Lymphatics, and of Spleen). No death was registered. 7. Diseases of Gland-like Organs of Uncurtain Use (eg., Bronchocele, Addison's Disease). No death was registered. 8. Diseases of Urinary Organs.—Of the 76 deaths ascribed to these causes, 60 were registered in the Town subdistrict and 16 in Brompton. The fatal diseases were, Nephritis, 15 deaths; Bright's Disease (Albuminuria), 32; Diseases of Bladder or of Prostate, 16; and Other Diseases of Urinary System, 13 deaths. 9. Diseases of Reproductive System.—(a) Of Organs of Generation—Male Organs, no death; Female Organs, 8 deaths; (b) Of Parturition, 13 deaths, viz., Miscarriage, 1; Puerperal Convulsions, 1; Flooding, 1; Other Accidents of Childbirth, 10. 10. Diseases of Bones and Joints.—Six deaths were registered, viz., Caries, 4; Arthritis, 2. 11. Diseases of Integumentary System.—Two deaths were registered. Class VII.—Deaths from Violence. One hundred and one deaths, including 28 under five years of age, and 22 under one year, are distributed over the four Orders comprised in this Class; 21 of them belong to the Brompton sub-district. 1. Accident ok Negligence.—Total deaths 79, including 15 in Brompton, and 28 under five years of age; viz., from Fractures and Contusions, 45 ; Burn, Scald, 9; Poison, 4; Drowning, 1; Cut, stab, 1; Suffocation, mostly of infants 63 ''overlaid," 19. Eighteen of these "accidents" occurred to children of less than one year old. All of the deaths from suffocation were registered in the Town sub-district. 2. Homicide.—Manslaughter, three deaths. 3. Suicide. — Total deaths, 18, including 6 in Brompton; viz., by Gun-shot Wounds, 2; Cut, Stab, 4; Poison, 5; Drowning, 3; Suffocation, 3; '• Otherwise," 1. 4. Execution.—One death. Class VIII.—Deaths from Ill-Defined and not Specified Causes. This Class includes the causes of 126 deaths, 109 under five years of age, and 94 under one year: 104 and 22 in the Town and Brompton sub-districts respectively. The causes named are: Debility, Atrophy, Inanition?, 96 deaths (all under five years of age, and 87 under one year); Dropsy, 1; Mortification, 5; Tumour, 1; Abac ess, 11; and Hemorrhage, 3. To "Causes not Specified or Ill-defined," 9 deaths were ascribed. The table on page 64, which is a Summary of table III. (appendix) shows the number of deaths from the various diseases in the several Classes and Orders. 64 CLASS I.- SPECIFIC FEBRILE OR ZYMOTIC DISEASES. No. of Deaths Order I. Miasmatic Diseases 419 2. Diarrhœal ,, 63 3. Malarial ,, 2 4. Zoogenous ,, ... 5. Venereal ,, 21 6. Septic „ 12 517 II. PARASITIC DISEASES 5 III. DIETETIC DISEASES 16 IV. CONSTITUTIONAL DISEASES 548 V. DEVELOPMENTAL DISEASES 225 VI, LOCAL DISEASES— 1 Diseases of Nervous System 273 2. Diseases of Organs of Special Sense 3 3. Diseases of Circulatory System 247 4. Diseases of Respiratory System 516 5. Diseases of Digestive System 209 6. Diseases of Lymphatic System ... 7. Diseases of Glandlike Organs of uncertain use ... 8. Diseases of Urinary System 76 9. Diseases of Reproductive System— a. Diseases of Organs of Generation 8 b. Diseases of Parturition 13 10. Diseases of Locomotive System 6 11. Diseases of Integumentary System 2 1,353 VII. VIOLENCE— 1. Accident or Negligence 79 2. Battle ... 3. Homicide 3 4. Suicide 18 5. Execution 1 101 VIII. ILL-DEFINED AND NOT SPECIFIED CAUSES 126 Total 2891 Note.—The form for table "A," on page 65, has been prepared by the Local Government Hoard in order that a "tabular statement of mortality should be made in all districts on a uniform plan," and the table is required to be appended to the Annual Report of the Medical Officer of Health. 65 (a) Table of DEATHS during the Year 1896, in the Parish of Kensington, in the Metropolitan District, classified according to Diseases, Ages, and Localities. (See Note, page 64.) Names of localities adopted for the purpose of these Statistics; Public Institutions being shown as separate localities. (Columns for Population and Births are in Table B., p. 93.) MORTALITY FROM ALL CAUSES, AT SUBJOINED AGES. MORTALITY FROM SUBJOINED CAUSES, DISTINGUISHING DEATHS OF CHILDREN UNDER FIVE YEARS OF AGE. At all ages. Under 1 year. 1 and under 6. 5 and under 15 15 and under 25. 25 and under 65. 66 and upwards 1 2 3 4 6 7 8 9 10 11 13 13 14 15 16 17 18 19 20 Total. Smallpox. Scarlatina. Diphtheria. Membranous Group. Fever. Cholera. Brysipelas. Measles. WboopingOough. Diarrhœa & Dysentery. Rheumatic Fever. Phthisis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease. Injuries. All other Diseases. Enterioicor Typhoid Continued. Relapsing. Puerperal. (a) (b) (c) (d) (e) (f) (g) (h) (i) Kensington Town Sub- District 1066 514 315 49 44 416 328 under 5 ... 2 18 1 ... ... ... ... 2 1 129 85 50 ... 8 166 1 23 343 829 5 upwds. ... 3 8 ... 7 ... ... 6 ... 1 8 1 2 3 103 125 109 27 434 837 Brompton Sub-District 427 73 38 11 19 162 124 Under 5 ... 1 4 2 ... ... ... ... ... ... 13 3 5 ... ... 15 ... 1 67 111 5 upwds. ... ... 4 ... 2 1 ... 1 ... ... 5 1 1 1 30 38 48 16 168 316 Kensington Infirmary 464 59 41 7 21 206 130 Under 5 ... ... 1 ... ... ... ... ... ... ... 12 9 2 ... ... 26 ... 1 19 100 upwds. ... 1 ... ... ... ... ... ... ... 2 1 ... 1 ... 75 82 35 4 163 364 Brompton Hospital 108 .. ... 7 32 69 ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... .. 95 4 7 ... 2 108 St.Marvlebone Infirmary 462 23 40 5 8 219 167 Under 5 ... ... 1 ... ... ... ... ... ... ... 18 4 4 ... ... 14 ... 2 20 63 5 upwds. ... ... 1 ... ... ... ... ... ... 3 3 ... 2 78 109 32 13 158 399 St. Joseph's House 31 ... ... ... ... 3 28 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 9 ... 19 31 Totals 3158 669 434 79 124 1075 777 Under 5 ... 3 24 3 ... ... ... ... 2 1 172 101 61 ... 8 221 1 27 479 1103 5 upwds. ... 4 13 ... 9 1 ... 7 ... 6 17 2 6 4 382 360 240 60 944 2055 The subjoined numbers have also to be taken into account in judging of the above records of mortality. Deaths occurring outside the district among persons belonging thereto 353 16 61 39 29 170 38 Under 5 ... 24 21 ... ... ... ... ... ... ... 2 ... ... ... ... 5 ... 4 21 77 5 upwds. ... 8 13 ... 6 ... ... ... ... ... 3 ... ... ... 23 17 27 32 147 276 Deaths occurring with in the district among persons not belong ing thereto 620 29 40 11 42 300 198 Under 5 ... ... 1 ... ... ... ... ... ... ... 18 4 4 ... ... 14 ... 3 25 69 5 upwds. ... ... 1 ... ... ... ... ... ... 3 3 .. 2 ... 174 115 54 19 180 551 * Column 5 (Typhus), from which disease there was no death, has been excluded owing to exigencies of space. 66 DEATHS IN PUBLIC INSTITUTIONS. The only "large public institution" within the parish in which we are directly interested, is the parish infirmary and workhouse, situate in the Town sub-district. There are several minor public, or quasi-public institutions; but, with one exception, they do not furnish occasion for special remark. The excepted institution is St. Joseph's House, Portobelloroad, Notting Hill—a Roman Catholic Home for aged poor persons, of both sexes, brought from various parts, largely from Ireland; but the Registrar-General does not class it as a "public institution." The deaths of non-parishioners at the Marylebone Infirmary, Notting Hill (462), at the Brompton Consumption Hospital (104). and at St. Joseph's House (29), are excluded from our statistics, but will furnish occasion for a few remarks later on. The deaths of parishioners registered at the Parish Infirmary and Workhouse (458), at the Consumption Hospital (4), at St. Joseph's House (2), and at outlying institutions, &c. (353), were 817, or 28'3 per cent. on total deaths; the percentage proportion of deaths in public institutions in the Metropolis, generally, being 27.8. The Registrar-General in his Annual Summary states that ' one in every seven deaths occurred in a workhouse or workhouse infirmary, one in 45 in a Metropolitan Asylum Hospital, one in 10 in some other hospital, and one in 50 in a public lunatic or imbecile asylum." The increase in the number of deaths in public institutions has been great and continuous for years past. The Parish Infirmary and Workhouse.— I am indebted to Dr. H. Percy Potter, the Medical Superintendent, for the statistics of mortality at these important institutions. The deaths were 458, as compared with 423, 440, and 442, in the preceding three years respectively, and were equal to 16 0 per cent on the total deaths. The quarterly numbers were 124, 116, 99, and 119; 243 deaths, therefore, occurred in the first 67 and fourth, or colder quarters, and 215 in the second and third or warmer quarters of the year. The deaths included 232 of males, and 226 of females. The ages at death were: Under one year 66 (as compared with 84,91, and 66, in the preceding three years respectively); between one and sixty, 226 (as compared with 195, 172, and 210, in the preceding three years), and at sixty and upwards, 166 (as compared with 144, 177, and 166, in the preceding three years). SUMMARY OF CAUSES OF DISEASES. DISEASES. 1 Under 1 year Between 1 year and 60 years. At 60 years & upwards. Total. Nervous System. Diseases of 3 21 16 40 Circulatory System. Diseases of ... 21 20 41 Respiratory System, Diseases of 14 46 52 112 Digestive System, Diseases of 5 13 12 30 Urinary System, Diseases of 11 5 16 Tubercular Diseases (including Marasmus) 18 83 6 107 Inanition 2 ... ... 2 Syphilis 4 4 ... 8 Cancer ... 7 17 24 Measles 7 6 ... 13 Scarlet Fever ... 1 ... 1 Erysipelas ... 1 1 2 Diphtheria 1 ... ... 1 Croup ... 1 ... 1 Whooping-Cough 5 4 ... 9 Cellulitis ... ... 1 1 Exposure ... ... ... 1 Delirium Tremens ... ... ... 2 Gangrene ... ... 2 4 Diabetes ... ... 1 3 Premature Birth 7 ... ... 7 Wounds ... ... 3 3 Senile Decay ... ... 30 30 66 226 106 458 58 Eleven inquests were held on the bodies of deceased inmates, of whom four were males and seven were females. One was a child aged three years, the remainder being adults ranging in age from 32 to 75 years. Death in five cases was due to disease; in six cases, including two of suicide, to violence. The Hospital for Consumption and Diseases of the Chest.—In the Kensington portion of this, the "Brompton Hospital" there were 108 deaths, males 60, and females 48, including 4 of Kensington parishioners which are included in table III. (appendix), the remaining deaths, of non-parishioners, being excluded from our statistics. Marylebone Infirmary, Notting Hill.—At this institution, which is under the control of the Guardians of the Poor of the Parish of St Marylebone, 4(52 deaths were registered, all of which are excluded from our statistics. St. Joseph's House, Notting Hill.—The deaths at this quasi-public institution, with the exception of 2 ot parishioners, are excluded from our statistics. They were 31 in number, viz., males 16, and females 15. Some of the deceased persons had previously resided in Ireland, some in London, and the remainder in the provinces and abroad. Out-lying Public Institutions.—The deaths of parishioners at public institutions, &c., without the parish, which in the preceding three years, successively, had numbered 312, 283, and 308, were 353 in 1896. All of these deaths are included in our statistics. The deaths occurred at the several institutions as follows:— 69 St. Mary's Hospital 62 St. George's Hospital 89 Charing Cross Hospital 9 West London Hospital 6 Middlesex Hospital 4 St. Thomas's Hospital 2 Westminster Hospital 2 Guy's Hospital 2 University College Hospital 2 King's College Hospital 2 St. Bartholomew's Hospital 1 London Hospital 1 Royal Free Hospital 1 Brompton Hospital (south wing) 3 Western Hospital 43 North-Western Hospital 13 South-Western Hospital 11 Fountain Hospital 4 Northern Hospital 1 North-Eastern Hospital 1 Gore Farm Hospital 1 Children's Hospital. Paddington 9 Victoria Hospital for Children Cancer Hospital, Fulham Road 7 Queen Charlotte's Hospital 6 German Hospital 3 French Hospital 2 National Hospital 2 London Temperance Hospital 2 Home Hospital, Fitzroy Square 2 Homoeopathic Hospital 1 Throat Hospital, Golden Square 1 Royal Hospital for Incurables 1 Samaritan Free Hospital 1 Lying-in House of St. John the Divine 1 St. Elizabeth's Home 2 St. Peter's Home 2 St. Camillo's Home 1 St. John's Home, Lewisham 1 St. Luke's House 1 Friedenheim House of Peace 4 St. Vincent's Orphanage 1 Southwark Workhouse 1 Mile End Infirmary 1 Paddington Infirmary 1 Hanwell Asylum 11 Banstead Asylum 9 Ilford Asylum 8 Cane Hill Asylum 7 Darenth Asylum 6 Leavesden Asylum 5 Caterham Asylum 4 Colney Hatch Asylum 4 Camberwell House Asylum 2 Hoxton House Asylum 1 Licensed Victuallers' Asylum 1 326 Other twenty-seven deaths occurred without the parish, viz., four by drowning (one male and one female in the Serpentine, one male in Regent's Canal, and one female in the River Thames); six of males in the street; two of males in vehicles; two of males on railway premises; one male in prison; one female in a police station; and seven of males and four of females in private houses. Deaths from diseases of the zymotic class, occurred at public institutions without the parish, as follows:—Western Hospital, 41 {scarlet fever, 21; diphtheria, 13; measles, 5; enteric fever, 2); North-Western Hospital, 13 (diphtheria, 9; scarlet fever, 4); South-Western Hospital, 10 (scarlet fever, 4; diphtheria, 4; enteric fever, 2); Fountain Hospital, 4 (scarlet fever, 2; diphtheria, 2); St. Mary's Hospital 2 (diphtheria); St. George's Hospital 2 (diphtheria); Northern Hospital 1 (scarlet fever); King's College Hospital 1 (diphtheria); Children's Hospital, Paddington, 1 (diphtheria); St. Thomas's Hospital 1 (enteric fever); and West London Hospital 1 (enteric fever.) 70 UNCERTIFIED DEATHS. For the first time within my twenty-six years tenure of office there was not one case of a not-certified death during the year 1896; in other words every death was certified either by a registered medical practitioner or by a coroner after inquisition held. In England and Wales the deaths not certified were 22 per cent of total deaths: the proportion in London was 0 6 per cent. The subject of uncertified deaths was considered, in the Session of 1893, by a Select Committee of the House of Commons, appointed" to inquire into the sufficiency of the existing law as to the disposal of the dead, for securing an accurate record of the causes of death in all cases, and especially for detecting them when death may have been due to poison, violence, or criminal neglect." The recommendations of the Committee were summed up in ten paragraphs' of which it is only necessary to cite the first two, as follows:— (1) "That in no case should a death be registered without production of a certificate of the cause of death, signetd by a registered medical practitioner, or by a Coroner after inquest. (2) "That in each sanitary district a registered medical practitioner should be appointed, as public medical certifier of the cause of death in cases in which a certificate from a medical practitioner in attendance is not forthcoming.'' No action has been taken, hitherto, by the House, to give effect to the recommendations of the Committee. The Public Control Committee of the London County Council have also dealt with the question, and arrived at conclusions, on which they based a variety of recommendations, which were fully set out in my annual report for 1894 (page 70). These recommendations having been approved by the Council, the Public Control Committee were" authorised to attend as a deputation before the Lord Chancellor in support of the 71 amendment of the law relating to coroners' inquests in the County of London, in accordance with the recommendations referred to,"and were directed to" urge the advisableness of paying a juryman a sum sufficient to compensate a workman for actual loss of time incurred in performing that public duty, and of making it compulsory that coroners' juries should be summoned by rota." INQUESTS. Two hundred and thirty-eight inquests were held on parishioners, including 49 at places without the parish, mostly at public institutions to which the deceased persons had been removed for treatment. The cause of death is stated to have been ascertained by post-mortem examination in 139 cases. Thirty-eight inquests were held on the bodies of nonparishioners who had died in Kensington. Of the 227 inquests in the parish, 207 were held at the Coroner's Court at the Town Hall, 17 at the St. Marylebone Infirmary, and three at the Parish Infirmary. It is now some years since an inquest in Kensington was held at a public house. The causes of death in inquest cases may be classified as follows:— Deaths caused by disease 137 Deaths caused by violence (101), viz.:— Accidental 79 Suicidal 18 Homicidal 3 Execution 1 Total 238 Of the 18 suicidal deaths, six belong to the BromptoE subdistrict, and 12 to the Town sub-district. 72 The inquests on Kensington parishioners were in the proportion of 8.2 per cent. on total deaths, the rate in the Metropolis being 9.1. In England and Wales the rate was 6.2 per cent. The relative percentages in 1895 were 8.1, 8.6, and 6.0, respectively. The registered deaths from violence were equal to 3.5 per cent. on total deaths in Kensington, the proportion in the Metropolis being 3.9 per cent.: and in England and Wales 3.5 per cent. These deaths were equal to 0.59 per 1.000 population in Kensington, 0.77 per 1,000 in London, as a whole, and 0.60 per 1,000 in England and Wales. METEOROLOGY. The mean temperature of the air at Greenwich in 1896, was 50o.l Fahrenheit; 1.6 above the average of 125 years, and 0.9 above the average of 55 years. The means in the four quarters respectively were 42.2, 55.6, 60.4, and 42.4. The highest reading by day (91.1) was registered in the week ended July 18, and the lowest reading by night (24.3) in the week ended February 29. The hottest week was that which ended July 11 (mean temperature 68.3), and the coldest week was that which ended December 19 (mean temperature 34.6). July was the hottest month (mean temperature 65.2. December was the coldest month (mean temperature 40.2). June exhibited the greatest range in temperature (46.9); viz., from 86.7 to 39.8; and November the smallest range (viz. 24.4), from 50.9 to 26.5. Rain fell on 161 day9, the total amount registered in the year being 22.42 inches, and 2.56 inches less than the average of 81 years. Most rain fell in September (5.54 inches) and least in May (0.27 inch). The means of the readings of the barometer were 29.847 inches ; the means of January (30.173) and of October (29.557) being the highest and the lowest, respcctively. The relative proportion of wind was, North 99, East 65, South 85, and West 117. Sunshine was registered during 1,018 hours only—the shortest duration in the eleven years 1886-96. June and July were the most 73 sunny months, 187 hours of sunshine having been registered in the four weeks ended June 27, and 171 hours in the four weeks ended July 25. The most sunny week was that ended June 20 (60.3 hours). January and December were the most sunless months, their respective records being, for January 10 hours, for December 8.9 hours. No sunshine was registered in the week ended 4th January. The average annual amount of sunshine registered in the ten years 1886-95 was 1,234 hours, the maximum being 1,454 hours in 1893. VACCINATION. Table X. (appendix) is a return respecting vaccination in Kensington in 1895 (the return for 1896 is not yet published), compiled by Mr. Shattock, the Vaccination Officer, whose able discharge of duties not easy of performance, in these days, deserves recognition. It appears that of 3,634 infants whose births were registered during the year, 2,844 were successfully vaccinated; 25 were returned as "insusceptible of vaccination"; 49 were postponed by medical certificate; 15 were removed to other known districts; and 374 died before attaining the age for vaccination or owing to ill-health were not in a fit condition to be vaccinated; some 327 cases—"from removal of children to places out of the parish unknown, or which cannot be reached, and cases not having been found"— are unaccounted for. These cases are equivalent to a "loss" of 9 0 per cent. compared with the number of births registered, the losses in the preceding nine years having been 5.4, 5.9, 6.0, 6.5, 6.7, 8.0, 8.7, 7.7, and 8.4 per cent. respectively. These tigures clearly indicate that the proportion of unvaccinated persons in this parish is on the increase. But Kensington has not yet fallen to the low level of many other Metropolitan Districts in this respect. Of the 2,844 successful vaccinations 1,609 (58.7 per cent.) were performed at the public stations and the Parish Infirmary, viz., 1,098 at the Notting Hill station, 321 at the South station, and 250 at the infirmary. 74 Calf lymph was employed when parents expressed the wish to have it. The revaccinations at the Stations and the Infirmary were 663 in number, including 602 at the Infirmary. The Report of the Royal Commission.—In the last annual report it was observed that the delay in the production of the report of the Commission," by encouraging Boards of Guardians to disregard their duty of carrying out the law, had produced disastrous results, of which the country will feel the effects for many years to come." I am of the same opinion still, but I have the satisfaction now of recording the fact that the report has now been presented to Parliament and published. The Commission, substantially, was appointed to consider the case in favour of, and the case against vaccination. The report is signed by all but two of the surviving members of the Commission, a note of great length being appended by the two dissentient members; who, though they do not sign the report, yet admit a measure of protective influence against smallpox in vaccination; but, nevertheless, would not have vaccination enforced even to the moderate extent which their colleagues approve and recommend. The opinion which the Commission entertain as to the case for vaccination, may be inferred from the expression of their hope that their report will have the effect of stimulating belief in the protective efficacy of the operation, the dangers of which have been exaggerated by the opponents of vaccination. These dangers, insignificant as they are in the aggregate, would be reduced to an almost imperceptible minimum by the invariable use of calf lymph, as recommended. Given efficient infant vaccination, and revaccination at the age of 12 years, a course which the Commission advocate, but without recommending that it be made compulsory, there is reason for believing that smallpox would at no distant time lose its terrors, even if it did not lapse to the category of extinct diseases. The report recommends the repeal of the law which enables the vaccination authority (the Board of 75 Guardians) to institute repeated prosecutions of the parent who refuses to allow his child to be vaccinated, pecuniary fines and imprisonment being the alternative penalties for disobedience. It may be remembered that in a fifth interim report, published in 1892, the Commission advised that the practice of repeated prosecutions, and the infliction of multiple penalties, should cease. This report had the effect of greatly stimulating the neglect of vaccination in places where the people, brought under the influence of anti-vaccination speech and literature, had already begun to doubt the efficacy of the method as a protection against smallpox. Practically, the final report, if translated into law, would have the effect of abolishing compulsion, seeing that the Commission would permit any parent to deprive his child of the benefits of Tenner's immortal discovery by making a statutory declaration that he had a conscientious objection to vaccination. The making of such a delaration would involve a little trouble, as much, perhaps, as getting the child vaccinated, and it may be that this fact would, in many cases, prevent resort to the police-court, or elsewhere, as an alternative to attendance at the vaccination station. The Commission are of opinion that the mild measures they recommend would prove as effective for securing the general acceptance of vaccination, as the more stringent measures of the present compulsory law; especially if the Scotch system were adopted in England, viz., by the sending of a medical practitioner to the home of the defaulter to vaccinate the child, and subsequently to inspect the vaccination, and if required, to attend the child during any ailment which might arise in what may be termed the vaccination month. The ("ommission would extend the period within which vaccination must be performed, to the age of six months, instead of three months, as at present; and they deprecate the practice, alleged to be common in workhouses, &c., of vaccinating, within a few days of birth, the children born at such institutions. One of the most drastic of the changes they recommend would have the effect of con- 76 stituting every medical practitioner, de facto, a public vaccinator, whose fee would be paid by the vaccination authority. This plan, if carried out, would practically tend to the abolition of the office of the public vaccinator as it now exists. The foregoing observations constitute but the barest outline of some of the principal recommendations of the Commission. It now remains to be seen what course the Government will adopt with a view to giving effect to them. In June, a Conference of Vestries and District Boards, convened by the Vestry of St. Pancras, and at which your Vestry were represented, was held" to consider the question of the administration of the Vaccination Acts." The resolution passed thereat was as follows:— "That in the opinion of this Conference the Vaccination Acts should be administered by the Authorities that administer the Acts and provisions for the prevention of the spread of infectious diseases, by notification, isolation, and disinfection." It was further resolved— "That a deputation be appointed to wait upon the President of the Local Government Board, to urge — 'The desirableness of the administration of the Vaccination Acts being placed in the hands of the Sanitary Authorities.' " I was unable to be present at the Conference; but I had dealt with the subject of it many years ago, and recommended transference of the powers now exercised by the Guardians to a Central Authority, either the Asylums Board or any other body that might be authorised to provide hospital accommodation for the infectious sick. I do not favour the plan of transferring the powers of the Guardians to the local Sanitary Authorities, for reasons into which I need not now enter. It only remains to be added that the Local Government Board did not deem it expedient to receive the proposed deputation, the report of the Royal Commission not having, at the time, been published. 77 THE METROPOLITAN ASYLUMS BOARD. The work of the Asylums Board has of late years assumed increased importance to Sanitary Authorities, by reason of legislation which has conferred power on the Managers to discharge for the Metropolis, as a w hole, the functions which, under the provisions of the repealed Sanitary Act, 1866, formerly devolved upon the 43 Vestries and District Boards in their several districts. The Board are now the central authority for providing hospital accommodation, and an ambulance service, by land and water, for the infectious sick—by warrant of law, as they previously had been in fact; for it is well known that legislation has, these many years, followed in the steps of the Managers' practice in regard to all that concerns the removal of the sick and their admittance to hospital. The ambulance arrangements leave nothing to desire: the accommodation for the sick, moreover, was always sufficient until within the last few years; but the increased and increasing disposition of the public to make use of the hospitals, which dates from the scarlet fever epidemic of 1887, together with the enlarged demands on the resources of the Managers, consequent on compulsory notification of infectious disease, have given rise to difficulties to -which reference has frequently been made in these reports. Happily, the steps taken by the Managers, with the approval of the Local Government Board, encourage the belief that at no distant time, the provision of accommodation will be equal to the demand. The work of the Board is summarised in three reports, issued annually, by the Chairman (Sir E. H. Galsworthy), by the Statistical Committee, and by the Ambulance Committee. The two reports first-named, which have great interest for all who are concerned in the sanitary government of London, and the several sanitary districts thereof, had not been published when this report went to press. I am, therefore, unable to follow my former practice of summarising their contents for the information of your Vestry. I have pleasure in submitting a réumé of the report of the Ambulance Committee. 78 AMBULANCE SERVICE, Annual Report of the Ambulance Committee.—The Committee refer with regret to the increased prevalence of scarlet fever and diphtheria in 1896, as compared with 1895, some 25,647 cases of scarlet fever having been notified against 19,757; and 13,362 cases of diphtheria, against 10,772. This fact, and the fact that "the proportion of notified cases that were admitted into the Managers' hospitals showed a further increase during the year, "caused" the work accomplished by the Land Ambulance Service to be considerably in excess" of any previous year. The accommodation in the hospitals was insufficient, and selection had to be made of the most urgent cases, both early in the year and at a later period. The Gore Farm Hospital at Darenth (erected for the accommodation of small-pox convalescent patients) was used during the whole year for scarlet fever convalescent patients. Extra beds, moreover, were placed in the wards of several of the hospitals. The Brook Ambulance Station, adjacent to the Brook Hospital, at Woolwich, commenced work on August 17th. It is anticipated that the new stations adjacent to the Northwestern Hospital (at Hampstead), and the South Western Hospital (at Stockwell) will be completed and brought into operation in 1897. Land Service.—During 1896 some 22,152 patients were removed to the hospitals, as compared with 16,725 in 1895. The removal of small-pox patients numbered 265, against 1,045 in 1895. The average daily removals of fever patients in the first half of the year was 53, and in the second half 68; as compared with 36 and 56 in 1895. The aggregate removals during the year, including the trausfer of patients from one hospital to another, numbered 44,374; viz., 14,542 by the Eastern Station; 14,634 by the Western (or Fulham) Station; 13,137 by the South-Eastern Station; and 2,091 by 79 the Brook Station. The greatest number removed in a day by the Western Station, in which we are locally interested, was 46, on 17th September: the heaviest week being that ended 19th September, when 351 removals were effected, and 2,386 miles travelled. Small-pox patients were removed from every district in London save four. The largest monthly number (61) was in January; the next largest (48) in June. In 189 cases only, out of 265 removed to the Wharves, was the diagnosis of small-pox confirmed by the Medical Officers: 73 of the non-variolous patients were returned to their homes forthwith. The year began with 3,529 patients in the Fever Hospitals (a greater number by 1,042 than at the beginning of 1895), including 2,844 of scarlet fever, 564 of diphtheria, and 119 of enteric fever. Of these cases, 359 were in the local (Western) hospital, including 258 of scarlet fever, 84 of diphtheria, and 16 of enteric fever. The minimum number under treatment at the hospitals was 3,217 on the 18th April; the maximum, 4,996, was attained on the 2nd November. This number would have been exceeded could all applications have been complied with. Enteric Fever patients to the number of 109 were removed by the Managers to general hospitals by arrangement. The cases admitted, certified to be suffering from diphtheria and "diphtheritic membranous croup," were 5,334, as compared with 4,476 in 1895: 48 per cent. of them in the first half of the year, and 52 per cent. during the second half. To other places than the Managers' Hospitals, 433 cases of infectious disease were removed during the year, under the powers conferred by the Public Health (London) Act, 1891, Section 79 (3). Of these cases, 104 were stated to have scarlet fever, 125 diphtheria, and 97 enteric fever. It is satisfactory to learn that, despite the heavy and anxious work devolving on the staff, "no hitch of any kind was experienced, and that no patient or nurse had cause to complain of injury, or even inconvenience, sustained while under charge of the Service." 80 River Service.—There are four ambulance steamboats "Red Cross," "Maltese Cross," "Albert Victor," and "Geneva Cross" A steam pinnace, "White Cross," added to the fleet in 1896, was built for the sum of £1,888. The distance run collectively by the steamers was 10,333 miles, and they conveyed 2,399 patients and other passengers, besides 76 tons of stores, &c., to and from the Hospital Ships at Long Reach. Provision is being made of a Shelter, with six beds, at the South Wharf, Rotherhithe, for small-pox patients who may arrive at the Wharf too late at night for immediate transfer to the Ships: the Managers will thus be able, on many occasions, to dispense with the use of the ambulance steamboats at night. Cost.—The total payments made during the year were, for the four stations (Eastern, South-Eastern, Western, and Brook) £16,211 10s. 9d., including £4,289 9s. 5d. for the Western Station. The River Service cost £9,942 19s. 10d., including £1,248 13s. 4d. in the Medical Department. The expenditure on Loan Account was £23,064 3s. l0d. The estimated cost of the services of the Nurses, "fairly represented by a fixed charge of 2s. 6d. per journey," was £3,091 10s. The nurses for fever purposes were drawn from the hospitals adjacent to the stations, those for small-pox purposes, partly from the stall of the Ships, and partly from the London hospitals. Elaborate statistical tables complete the report. The foregoing abstract of the report of the Ambulance Committee suffices to show that the important duty of removing the sick to hospital, whether by land or water, is now effected in an unexceptionable manner. In a former report I had to observe that this remark was applicable only in respect of patients in course of transit to or from the Managers' hospitals. It was often quite otherwise in respect of private patients, who were, but too frequently, removed in public vehicles, cabs, &c. The law did not forbid the use of a public vehicle, provided that the 81 vehicle was afterwards disinfected. But the driver of a cab was often unaware of the nature of his fare's illness; the efficacy of any practicable disinfection, moieover, may be reasonably doubted. Consideration of these and other objections to the existing law led me, many years ago, to the conclusion that public vehicles should never be used for this purpose, and that it would be to the public advantage were the Asylums Board made the Ambulance Authority for the removal of the infectious sick of all classes. In 1884, therefore, I addressed a communication to the Managers, proposing that they should place their ambulances at the service of the medical profession, and Medical Officers of Health, with or without payment, for the conveyance of infectious sick persons. The Managers replied that they were "not in a position to undertake the removal of any cases of infectious disease beyond those which are to be received into the hospitals under their own control but in 1888 they came to the conclusion "that the conveyance of infectious cases by public vehicles should be prohibited by lawand having expressed willingness to" use the machinery they possess for the prompt and economical removal of infectious cases,'' the Local Government Board obtained from Parliament the desired powers, in a section of the Poor Law Act, 1889, the provisions of which were subsequently re-enacted in the Public Health (London) Act, 1891. The use of public vehicles for the removal of infectious cases is now illegal; the law on the subject, as set out in section 70 of the Act last named, is explicit, as follows:— Section 70.—"It shall not be lawful for any owner or driver of a public conveyance knowingly to convey, or for any other person knowingly to place in any public conveyance, a person suffering from any dangerous infectious disease, or for a person suffering from any such disease to enter any public conveyance, and if he does so he shall be liable to a fine not exceeding ten pounds; and if any person so suffering is conveyed in any public conveyance, the owner or driver thereof, as soon as it comes to his knowledge, shall give notice to the 82 Sanitary Authority and shall cause such conveyance to be disinfected, and if he fails so to do, he shall be liable to a fine not exceeding five pounds, and the owner or driver of such conveyance shall be entitled to recover in a summary manner from the person so conveyed by him, or from the person causing that person to be so conveyed, a sum sufficient to cover any loss and expense incurred by him in connection with such disinfection. It shall be the duty of the Sanitary Authority, when so requested by the owner or driver of such public conveyance, to provide for the disinfection of the same, and they may do so free of charge." No breach of the law came to my knowledge during the past year. New Ambulance Stations.—Adjoining the Brook Hospital, a complete Ambulance Station has been erected at a cost of £15,000. It provides stabling for 16 horses, coach-houses for 20 ambulances, with all requisite accommodation for a superintendent, 8 nurses, 25 drivers, and other male servants, 5 laundry-maids, and other female servants. It may be mentioned that the Managers have acquired land at Stockwell and at Hampstead on which they propose to erect ambulance stations in connection with the South-Western Hospital and the North-Western Hospital, respectively. Apart from the cost of site, the expenditure involved in the construction of an ambulance station would appear to be about fifteen thousand pounds. Ambulance Arrangements.— Kensington patients are removed by the staff at the Western Station, which adjoins he Western Hospital at Seagrave Road, Fulham. Between a.m. and 8 p.m., on weekdays, cases for removal are reported at the Managers' central offices, Norfolk House, Norfolk Street, Strand, W.C., these being in telephonic communication with the station. During the night, and on Sunday, and on Christmas Day and Good Friday, application for a patient's removal is forwarded direct to the ambulance station. The Managers' telegraphic address is "Asylums Board, London"; their telephone numbers arc 2858 and 2859. 83 HOSPITAL ACCOMMODATION. In the Annual Report for 1893 (pages 117 to 130 inclusive), I dealt with "the needs of the Metropolis in respect of hospital accommodation for the infectious sick," and detailed the steps taken by the Asylums Board to supply the then existing deficiencies, and the difficulties by which their efforts had been confronted and, to a certain extent, foiled. Those difficulties have now been largely overcome; and the needs of the Metropolis, in this regard, which are now fully recognised, will ere long be met to the full extent of and, indeed, beyond the estimate of them made in my tenth monthly report for 1892, which, at the time, was thought to be excessive, viz.: of "at least 5,000 beds for scarlet fever, fever, diphtheria, and isolation." Fever Hospital Accommodation.—It is an accepted axiom that provision for the isolation of infectious disease should be at the rate of not less than one bed for each thousand of the population. The subject, as regards the Metropolis, was considered by the Royal Commission in 1881-82, and the Commissioners stated in their report (1882) that the then provision of hospitals should be extended so as to provide 5,700 beds at the least; viz.: 3,000 nominally for "Fever," and 2,700 for Small-pox. Diphtheria cases were not at that time admissible to the hospitals. The population of London in 1882 was a little under 4,000,000. Consequently, the recommendation of the Commissioners went, to the extent of 1,700 beds, beyond the theoretical requirements of the day. The Commissioners, doubtless, intended to make provision for a lengthened period in advance, and the amount of accommodation they advised to be provided is even now ahead of the standard requirement. But circumstances have since arisen that they could scarcely have anticipated, and which have led to largely increased demands on the Managers resources; not only by the Sanitary Authorities, but also by 84 private medical practitioners and others. Among these circumstances may be mentioned (1) the depauperisation of medical relief in the hospitals; (2) the opening of the several institutions to all classes of the people; (3) the admission of patients on whatever form of application, subject only to the presentation of a medical certificate; (4) gratuitous treatment; (5) the popularity of the hospitals themselves; and last, but not least (6) the increasing recognition by the public of the advantages accruing from the isolation of the infectious sick. The operation of compulsory notification, moreover, has had great effect, for now that Sanitary Authorities become acquainted with, practically, all cases of infectious disease, they are able to secure the admittance to hospital of numbers of cases, such as in pre-notification days they would probably never have so much as heard. In connection with this important question, it may be mentioned that so far back as the end of 1893, the Managers had provided normal accommodation to the extent of about 3,000 beds, for fever and diphtheria patients, by the erection of additional "temporary" hospitals at Tottenham and Lower Tooting. Since that date the "Brook" Hospital for upwards of 500 patients has been erected and opened at Shooter's Hill. Sites, moreover, have been acquired for two additional hospitals for "acute" cases, viz., at Hither Green and at Tooting; the latter site, adjoining the existing (Fountain) Hospital, described as temporary, although from the nature of its construction it is calculated to last for many years. On the Hither Green site the "Park" Hospital, for more than 500 beds, is approaching completion, whilst the "Grove" Hospital at Tooting, of equal capacity, is expected to be completed in 1898. Magnificent progress this! seeing that these three hospitals, for acute cases of fever, scarlet fever, and diphtheria, with isolation wards, &c., will add some 1,650 beds to those previously in the Managers' possession. The Managers have also acquired a site of 135 acres at Carshalton, in Surrey, for a convalescent fever hospital for 700 beds; having, already, north of the 85 Thames, at Winchmore Hill, the Northern Convalescent Hospital, with close on 1,000 beds. In addition to the new hospitals on new sites, previously existing accommodation has been extended and improved by the more or less complete reconstruction, with additions, of most of the older hospitals. Small-pox Hospital Accommodation.—As regards accommodation for small-pox, the Managers have not, as yet, provided anything like the amount recommended by the Royal Commission in 1882, viz., 2,700 beds. The Hospital Ships at Long Reach, on the Thames, furnish 300 beds for acute cases; whilst for mixed cases there is accommodation for about 1,200 patients at the Gore Farm Hospital, which, at the present time, is being utilised for about 750 scarlet fever convalescents. The accommodation on this site could be materially increased, in case of emergency, by the erection of temporary buildings, as also at the Joyce Green estate, a new site, of some three hundred acres, which, (with considerable additions of intervening land connecting the estate with the Hospital Ships) the Managers have acquired, and on which they propose to build a permanent hospital for acute cases of small-pox, which, doubtless, will, in course of time, supersede the Hospital Ships. Summary.—I" ain indebted to Mr. Duncombe Mann, the Clerk to the Metropolitan Asylums Board, for the subjoined tabular statement of the existing, and intended accommodation for various classes of the infectious sick : it cannot fail to be read with interest. "For Fever and Diphtheria Patients the Board's existing accommodation is as follows:— Acute Cases— Beds. Eastern Hospital 410 North-Eastern Hospital 400 North-Western Hospital 456 Western Hospital 390 86 Acute Cases (continued)— Beds. South-Western Hospital 370 Fountain Hospital 426 South-Eastern Hospital 431 Brook Hospital 576 3,459 Convalescent Cases— Northern Hospital 955 Gore Farm (built for Small-Pox Convalescents) 752 - 1,707 5,166 ["N.B. This total includes the 'emergency beds' placed in various hospitals during the recent pressure for accommodation.] " In addition to the above-named Hospitals the Board have in course of erection— The Park Hospital, at Hither Green, for 548 patients The Grove Hospital, at Tooting, for 520 patients 1,068 "The Board have also secured a site for a Convalescent Hospital at Carshalton, on which they propose to provide for 700 convalescent fever and diphtheria patients. "For Small-Pox Patients the existing accommodation is as follows:— Hospital Ships 300 Gore Farm, Upper Hospital 1000 (At present occupied by Scarlet Fever patients) Gore Farm, Lower Hospital (Wooden buildings) 192 1,492 87 "Joyce Green Estate. —On this Estate the Managers proposed to provide beds for 940 patients, but the Local Government Board have refused to sanction provision being made for more than 400 patients." Thus it appears that this Metropolis is endowed, in possession, or in early prospect, with accommodation for nearly 6,200 patients suffering from fever and diphtheria: a number more than double that recommended by the Royal Commission (3,000); irrespective of about 750 beds at Gore Farm, generally available in the abeyance of small-pox. Time alone can determine whether this provision will suffice for the requirements of the Metropolis. For small pox patients the accommodation is, or will be, to the extent of nearly 1,900 beds: a number considerably below the recommendation of the Royal Commission (2,700); but which I am sanguine will suffice, seeing how much more effectually this disease has been controlled since the practice of removing the sick out of London for isolation and treatment, first done upon my advice in May 1881, has been perfected by the Managers, who, since 1884, have practically ceased to use the town hospitals for the isolation of small-pox, now removing direct from their homes to the Ships all patients suffering from this disease—with what beneficent results let the statistics of mortality testify. Deficiency of Fever Hospital Accommodation in 1896.—In the four-weekly report dated July 20th, I had to report that much difficulty had been experienced in obtaining the requisite number of beds for the sick. On some days as many as a dozen patients were detained at home awaiting removal, the majority of them suffering from scarlet fever, others from diphtheria. This state of things, which continued more or less throughout the latter half of the year, was mitigated to a certain extent by the opening of the Brook Hospital. 88 The Brook Hospital. — This magnificent structure, which had been two years in building, was opened in August. It is situated at Shooter's Hill, Woolwich, nine miles from Charing Cross. Containing normal accommodation for 488 patients—scarlet fever 352, enteric fever and diphtheria 112, and isolation 24, it appears to be able on "emergency" to make up 576 beds (vide return page 86.) The buildings were thrown open for inspection on 31st July, and were visited by a large number of persons interested in the treatment of the infectious sick. It would be futile to attempt here any detailed -account of the hospital, but it may be mentioned that the site contains 29 acres, of which 21 acres are used for the purposes of the hospital, leaving eight acres of surplus land available for temporary wards during epidemics. The site, which adjoins the Herbert (Military) Hospital, cost £550 per acre. It stands 200 feet above the level of the sea, and falls rapidly to the south from Shooter's-hill-road, thus enabling the buildings to be arranged in terraces, sheltered from the north and east winds, and with lovely views to the south and west across a large tract of country. The following are the spaces allowed per bed in the several wards of the 12 main pavilions, each pavilion having two storeys, and all the wards being 13 feet high:— Scarlet Fever. Enteric Fever and Diphtheria. Linear wall space 12 feet 15 feet. Floor area 156 feet 195 feet Cubic space 2,028 feet 2,535 feet The main wards for scarlet fever, which each contain 20 beds, are 120 feet long and 26 feet wide. The enteric and diphtheria wards each contain 12 beds and are 90 feet long. There are six isolation pavilions, with 24 beds in 12 wards, for the isolation of concurrent infectious disease, and for the isolation of cases of doubtful diagnosis. There are 23 beds to each acre of utilised site. The staff of the hospital comprises a Medical Superintendent, five assistant medical officers, 89 matron, steward, housekeeper, engineer; 196 nurses, 92 female servants, and 24 male servants, making, with a few others, a total of 325. There are three separate and distinct "Homes;" one for nurses, one for female servants, and one for male servants. In connection with the training of medical students, there is provided a lecture room, together with laboratory, &c. The hospital is lighted throughout by electricity, generated on the premises, and the whole of the buildings are connected up by telephone to a small "central exchange" in the Superintendent-Nurse's office, which is placed, at the centre of the hospital, at the intersection of the two main corridors. The cost of the hospital, exclusive of land and furniture, was £240,000. Obviously expense has not been spared, but, we were told, that "great care had been taken to avoid ornamentation; light, air, and cheerfulness,'' it was said, "had been sought for as the principal features, and there was not a dark corner throughout the hospital." It may be assumed that the other two hospitals in course of erection, at Hither Green ("Park" Hospital) and Lower Tooting ("Grove" Hospital), each to contain upwards of 500 beds, and to be completed in 1897 and 1898 respectively, will not be inferior in suitability for their intended purpose to this splendid institution, the opening of which had been looked forward to with great interest by many of those upon whom rests the burden of the sanitary administration of the Metropolis. COMPULSORY NOTIFICATION OF INFECTIOUS DISEASE. I am indebted to the courtesy of the Clerk to the Metropolitan Asylums Board for the table at page 92, which shows the number of notifications of infectious disease in London in 1896, after correction for duplicate returns. The table at page 93 is designed to show the relative prevalence of the several diseases at different periods of the year, being a summary of the figures set out in my four-weekly reports. In this table it has not been possible to make the afore- 90 mentioned correction; so that the total differs to the number of 2,885 notifications (or about 5.5 per cent. in excess) as compared with the corrected notifications. The Kensington notifications, after correction for duplicate returns (of which there were 121) were 1,782; viz., in the Town sub-district 1,398, and in the Broinpton sub-district 384. The notifications in 1893, 1894, and 1895, were 1,811. 972, and 1,289, respectively. Table IX.A (appendix) shows the streets, &c., where cases of the scheduled diseases occurred. The cases notified in London, as a whole, were 49,099; 8,188 more than in 1895, but 17,780 fewer than in 1893. The notifications of each of the scheduled diseases during the seven years 1890-0, after correction for duplicate certificates, are set out in the subjoined table. Total Notifications in London : Year. Small-pox. Scarlet Fever. Diphtheria. Enteric Fever. Typhus Fever. Other Continued Fevers. Puerperal Fever. Erysipelas. Croup. Cholera. Relapsing Fever. Total. 1890 60 15,830 5,870 2877 35 237 206 1598 550 25 7 29,795 1891 114 11.398 5,907 3372 27 152 221 1764 505 23 39 26,522 1892 423 27.096 7,791 2465 20 147 347 6934 565 54 7 45,849 1893 2813 36,901 13,026 3663 22 205 397 9700 668 86 4 67,485 1894 1192 18.440 10,655 3360 21 162 253 6080 535 21 2 40,925* 1895 978 19,757 10,772 3506 14 105 236 5660 451 29 3 41,511 1896 225 25.638 13,361 3189 6 102 278 6438 446 13 3 49,699 * This total includes 204 cases of diarrhœa. Note.—The form for table "B," on page 91 was prepared by the Local Government Board in order that a "tabular statement of infectious sickness should be made in all districts on a uniform plan:" the table, which is based on the infectious disease register, is required to be appended to the Annual Report of the Medical Officer of Health. 91 (B) Table of POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS coming to the knowledge of the medical officer of health, during the year 1896, in the parish of Kensington, in the Metropolitan District; classified according to Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics: Public Institutions being shown as separate localities. Population at all Ages. Registered Births. Aged under 5 or over 5. New Cases of Sickness in each Locality, coming to the knowledge of the medical officer of health. Number of such Cases Removed from their Homes in the several Localities for treatment in Isolation Hospital. Census 1891. Estimated to middle of 1896. 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11 Small¬pox. Scarlatina. Diphtheria. Membranous Croup. Fever. Cholera. Erysipelas. Small¬pox. Scarlatina. Diphtheria. Membranous Croup. Fever Cholera. Erysipelas. Typhus. Enteric or Continued. Relapsing. Puerperal. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerpueral. (a) (b) (c) (d) (e) Kensington Town SubDistrict 116583 119389 2968 Under 5 4 243 92 9 ... 2 ... ... ... ... 14 4 187 61 ... ... 2 ... ... ... ... 1 5 upwds. 9 545 144 ... ... 64 4 ... 5 ... 153 9 419 87 ... ... 28 3 ... ... ... 3 Brompton Sub¬District 47351 47968 616 Under 5 ... 38 38 2 ... ... 1 ... ... ... ... ... 24 26 ... ... ... 1 ... ... ... ... 5 upwds. ... 82 82 ... ... 26 1 ... 1 ... 27 ... 117 54 ... ... 12 1 ... ... ... 1 Kensington Infirmary and Workhouse 1355 1648 133 Under 5 ... 1 1 ... ... ... ... ... ... ... 2 ... 6 1 ... ... ... ... ... ... ... ... 5 upwds. ... 2 2 ... ... 2 ... ... 3 ... 80 ... 7 1 ... ... 2 ... ... ... ... ... St.Marylebone Infirmary 813 803 ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... 1 1 ... ... ... ... ... ... ... 1 ... 3 1 ... ... ... ... ... ... ... ... Brompton Hospital 206 192 ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total 166308 170000 3,7171 Under 5 4 28 7 131 11 ... 2 1 ... ... ... 16 4 217 88 ... ... 2 1 ... ... ... 1 5 upwds. 9 724 229 ... ... 92 5 ... 9 ... 261 9 546 143 ... ... 42 4 ... ... 4 92 Corrected Notifications of Infectious Disease in 1896. Local Authorities in whose Districts the cases were resident. Small¬pox. Scarlet Fever. Typhus Fever. Typhoid or Enteric Fever. Continued Fever. Membranous Croup. Diphtheria. Erysipelas. Puerperal Fever. Cholera. Totals. Population 1896. Kensington 13 1011 ... 94 6 11 360 277 9 ... 1781 170,465 Battersea 8 1175 ... 109 1 28 391 253 10 ... 1975 165,115 Bermondsey 4 394 ... 65 ... 8 250 131 5 ... 857 85,475 Bethnal Green 2 1257 ... 129 4 35 425 327 12 ... 2191 129,162 Camberwell 13 1222 3 176 ... 23 1407 319 16 1 3179 253,076 Chelsea 2 571 ... 66 2 7 481 120 6 ... 1255 96,646 Clerkenwell 5 461 ... 67 ... 12 234 108 4 ... 891 66,202 Fulham 2 628 ... 54 5 14 342 99 9 2 1155 113,781 Greenwich 14 1163 ... 113 3 17 819 242 17 ... 2388 75,774 Hackney 8 1533 ... 202 7 23 570 311 6 ... 2660 213,044 Hammersmith 3 532 1 51 4 9 209 121 9 ... 939 101,199 Hampstead ... 289 ... 58 2 5 194 54 6 ... 608 75,449 Holborn 1 123 1 30 1 3 69 65 2 ... 295 31,208 Islington 51 2047 ... 236 6 25 1092 394 31 ... 3882 336,764 Lambeth 18 1595 1 165 14 30 662 355 20 6 2866 295,033 Lee 1 168 ... 28 ... ... 75 37 6 ... 315 38,588 Lewisham 1 343 ... 58 ... 4 361 79 9 ... 855 83,213 Limehouse 7 350 ... 27 1 6 264 110 4 ... 769 58,305 Marylebone 4 811 ... 107 ... 7 285 248 3 ... 1465 141,188 Mile End Old Town 2 764 ... 113 2 10 541 197 5 ... 1634 111,060 Paddington 4 795 ... 61 1 8 239 119 10 ... 1237 124,506 Plumstead 4 363 ... 29 3 9 199 43 3 1 654 59,252 Poplar 9 964 ... 184 8 31 670 315 7 1 2189 169,267 Rotherhithe 5 198 ... 45 1 6 117 113 6 1 492 40,379 Shoreditch 1 708 ... 117 9 21 350 297 3 ... 1506 122,348 St. Georgein¬the¬East 2 378 ... 33 1 6 208 89 2 ... 719 47,506 St. George, Hanover Sq. 1 342 ... 54 1 1 123 56 2 ... 580 79,967 St. George, Southwark 3 335 ... 48 ... 12 181 95 3 ... 677 60,278 St. Giles, ... 180 ... 21 ... 4 56 80 1 ... 342 38,237 St. James, Westminster 3 75 ... 6 ... 3 34 20 2 ... 143 23,050 St. Luke, Middlesex 2 264 ... 38 2 4 129 138 2 ... 574 41,527 St. Margaret and St. John, Westminster 2 224 ... 35 2 2 107 79 1 ... 452 53,234 St. Martin¬in¬the¬Fields 1 73 ... 18 2 1 15 12 1 ... 123 13,077 St. Mary, Newington 3 677 ... 88 1 21 386 194 9 ... 1379 120,939 St. Olave, Southwark ... 62 ... 9 ... 1 43 21 ... ... 136 11,731 St. Pancras 6 1079 ... 200 1 13 469 355 21 ... 2144 240,764 St. Saviour, Southwark 4 110 ... 9 ... 1 82 35 ... ... 271 25,365 Stoke Newington 2 226 ... 16 ... 4 76 40 1 ... 365 33,485 Strand ... 132 ... 8 ... 1 36 11 ... ... 189 23,782 Wandsworth 2 1000 ... 102 8 3 296 265 11 1 1688 187,264 Whitechapel 4 638 ... 62 ... 14 337 138 2 ... 1195 77,717 Woolwich 1 146 ... 21 3 2 100 45 1 ... 319 41,314 City of London 2 197 ... 21 1 1 71 34 ... ... 327 30,970 Port of London 5 5 ... 17 ... ... 6 2 ... ... 35 Grand Totals 225 25,638 6 3189 102 446 13361 6438 278 13 49696* * In addition three cases of Realising Fever were notified 93 Table showing the number of Cases of Infectious Disease Notified in Kensington, and in London, in 1896, Arranged in four¬weekly periods. Date of Report. For Four Weeks ended Weeks of the Year. KENSINGTON. LONDON. Weeks of the Year. Date of Report. For Four Weeks ended Small¬pox. Scarlet Fever. Diphtheria. Enteric Fever. Typhus Fever. Other Continued Fevers. Puerperal Fever. Erysipelas. Croup. Cholera. Total Small¬pox. Scarlet Fever. Diphtheria. Enteric Fever. Typhus Fever. Other Continued Fevers. Puerperal Fever. Erysipelas. Croup. Cholera. Total. January 25,1896 1¬4 4 79 31 7 ... ... 1 17 1 ... 140 41 1761 988 277 ... 10 26 497 39 ... 3639 1¬4 January 25, 1896 February 22 „ 5¬8 ... 90 22 2 ... 2 ... 15 2 ... 133 46 1527 1054 250 ... 8 32 453 47 ... 3417 5¬8 February 22 „ March 21 „ 9¬12 ... 57 30 2 ... ... ... 19 1 ... 109 23 1350 1009 144 1 1 29 410 32 ... 2999 9¬12 March 21 „ April 18 „ 13¬16 2 45 14 1 ... ... 2 21 ... ... 85 14 1224 785 144 ... 8 17 368 41 ... 2601 13¬16 April 18 „ May 16 „ 17¬20 6 37 25 5 ... ... ... 16 1 ... 90 22 1383 890 190 ... 5 14 442 43 ... 2989 17¬20 May 16 „ June 13 „ 21¬24 1 68 25 2 ... ... 1 17 ... ... 114 17 1864 1060 162 ... 6 20 478 32 ... 3639 21¬24 June 13 „ July 11 „ 25¬28 ... 93 24 3 ... ... ... 29 ... ... 149 62 2235 1069 155 3 7 17 492 23 ... 4063 25¬28 July 11 „ August 8 „ 29¬32 ... 94 43 10 ... 3 ... 24 1 ... 175 12 2532 1168 276 2 11 20 504 24 8 4557 29¬32 August 8 „ September 5 „ 33¬36 ... 92 29 10 ... ... 3 33 ... ... 167 14 2766 1082 365 ... 9 30 625 22 4 4917 33¬36 September 5 „ October 3 „ 37¬40 ... 84 26 9 ... ... ... 17 ... ... 136 4 2963 1288 434 ... 6 24 639 32 1 5391 37¬40 October 3 „ October 31 „ 41¬44 ... 104 14 12 ... 1 2 22 2 ... 157 2 2846 1229 340 ... 16 21 619 41 ... 5114 41¬44 October 31 „ November 28 „ 45¬48 ... 91 27 14 ... ... ... 17 2 ... 151 ... 2300 1160 331 ... 9 28 633 32 ... 4493 45¬48 November 28 ,, January 2, 1897 (5 weeks) 49¬53 ... 77 50 17 ... ... ... 30 1 ... 175 3 2224 1442 316 ... 7 28 701 44 ... 4765 49¬53 January 2, 1897 (5 weeks) Totals ... 13 1011 360 94 ... 6 9 277 11 ... 1781 260 26975 14224 3384 6 103 306 6861 452 13 52584 Totals. Note —One hundred and twenty¬one duplicate notifications have been eliminated from the total in Kensington 94 FACTORY AND WORKSHOP ACT, 1895. The Factory and Workshop Act, 1895, came into operation on January 1st, 1896. An abstract of the principal provisions of the Act was given in the annual report for 1895, pages 70-74. The duties of the Sanitary Authority thereunder, and, indeed, under the Factory and Workshop Acts generally, are set out in the report of the Sanitary Committee, at page 97. Reference to this report will show that factory legislation has imposed on Sanitary Authorities throughout the Kingdom serious responsibilities. An effort to cope with these responsibilities was made by your Vestry, in October, 1893, by the appointment of two ladies as Inspector of Workshops, Workplaces and Laundries, where women are employed. Both of these ladies, Miss Deane and Miss Squire, have since been appointed, by successive Home Secretaries, to the even more responsible position of Factory Inspectors under the Home Office. Miss Deane's successor, Miss Duncan, ceased to hold office in July, 1895. This lady has now been appointed to the office of Factory Inspector by the Government of New South Wales. The appointment she held in this parish has not been tilled. Miss Squire's successor, Miss de Chaumont, does her best to carry out the work for the entire parish. Her report for a period of 44 weeks in 1896, she having commenced work 1st March, will be found at page 104. With respect to the workshops, &c., where men only are employed, nothing, practically, has been done to give effect to legislation in any way comparable with the work so excellently performed by the female Inspectors of workplaces where women are employed. It is time that these establishments should be taken in hand, but it cannot be done in any effective way with the present limited and reduced staff of Sanitary Inspectors, without letting other and more immediately pressing work fall into arrear. We do not so much as 95 know, at present, the locality of many of the workshops, but probably their whereabouts could be ascertained from Her Majesty's Superintending Inspector of Workshops, &c., were there a possibility of taking up this branch of sanitary work. Sanitary Supervision of Laundries.—The "Abstract, as prescribed by one of Her Majesty's Principal Secret arics of State," required to be constantly affixed in the laundries which are "workshops," i.e., laundries in which no steam, water, or other mechanical power is used, has been duly circulated. Under the head of sanitation, it states that "sanitation, which includes provisions as to cleanliness, overcrowding, ventilation, limewashing, &c., is enforced by the officers of the local Authority"; and, in it, attention is called to other requirements as follows:— "In every room in a laundry there must be at least 250 cubic feet of space for each person employed during ordinary hours, and 400 cubic feet during overtime. A notice is to be affixed in the laundry. showing how many persons may be employed in each room. "Sufficient sanitary convenience, with separate accommodation for each sex, must be provided. "All inside walls of rooms, and all ceilings and tops of rooms, and all passages and staircases to be limewashed every 14 months, or, if painted with oil or varnished within seven years to be washed every 14 months. "If the occupier, or a contractor employed by him. causes or allows wearing apparel to be cleaned or repaired in any house whilst any inmate of such house is suffering from scarlet fever or small-pox, he shall be liable to a fine not exceeding £10." The occupier is required to ascertain the cubic space of the several workrooms in the laundry, so as to determine how many persons may occupy each room, and it is the duty of the occupier to affix the notice, which is in a prescribed form, and is printed on ordinary paper adaptable for pasting on the wall. All of the requirements above set out appear to come within the definition of "sanitation," and, therefore, will have to be enforced by your Vestry. 96 Duties of the Sanitary Authority with respect to Workshops.—The question litis been sometimes asked, whether your Vestry, by appointing special officers to inspect workshops, workplaces, laundries, etc., were not interfering with duties legally attaching to the office of the factory inspectors appointed by the Secretary of State? The answer to this question is distinctly negative. There is nothing conflicting in the duties of factory inspectors and those devolving upon the Inspectors of the Sanitary Authority. The duties of the respective offices are reciprocal. One of the duties devolving upon the Medical Officer of Health under the Public Health (London) Act, 1891 (sec. 27), is to give "written notice to the factory inspector" of "any child, young person, or woman employed in a workshop," and this duty I have discharged, since October, 1893, in a large number of instances, upon information acquired for ine by the women inspectors. I report, moreover, to Her Majesty's Superintending Inspector of workshops, &c., every workshop and workplace newlyopened, or discovered by the inspector; and, reciprocally, that gentleman forwards to me all notices he receives from persons intimating intention to occupy premises as workshops or workplaces. In like manner the Superintending Inspector reports to me all cases of overcrowding discovered by his assistants, and all cases of dirty and insanitary premises, observed by those officers, requiring to be dealt with under the Acts; it being the duty of the Sanitary Authority to take steps to secure the abatement of all such nuisances. The necessary steps have been taken in many instances (since October, 1893) by the Sanitary Committee, to which your Vestry have entrusted the carrying out of the provisions of the Factory and Workshop Acts, 1878 to 1895, and the Public Health (London) Act, 1891; all of which entail responsible duties, in regard to workshops and workplaces, upon your Vestry as the Sanitary Authority. And to facilitate the discharge of these duties the law has conferred on the Sanitary Authority and their officers "all such powers of entry, inspection, taking 97 legal proceedings, or otherwise" as a factory inspector has under the principal Act, i.e., the Act of 1878. The powers of the Sanitary Authority, in regard to the inspection and supervision of workshops, in order to the enforcement of the law, would thus appear to be ample. But lest these powers should be allowed to fall into desuetude, or be wilfully neglected, power is given, by sections 1 and 2 of the Factory and Workshop Act . 1891 which enables the factory inspector to supersede a defaulting Authority in the execution of their duties in respect of workshops or laundries; and to recover from the Authority, in whose district the workshops or laundries are situated, "all such expenses in and about any proceedings as he may incur." With a view to the information of your Vestry, I, with the assistance of Miss Squire, prepared, in December, 1895 for a sub-committee of the Sanitary Committee, a report or "The Duties of the Sanitary Authority with respect to Workshops," a subject, to which, in my sixth report for 1895, attention had been drawn. The report was approved by the subcommittee, adopted by the Sanitary Committee, and accepted by your Vestry as a correct statement of the powers and duties of the Sanitary Authority under the Acts. It read? as follows:— 'The duties of the Sanitary Authority, in London, with respect to Factories, Workshops, Laundries, &c., are set out in the several Factory and Workshop Acts, 1878 to 1895, and in the Public Health (London) Act, 1891. 'For the sake of clearness it may be well to give here the definition of a Workshop as set out in the Factory and Workshop Aot, 1878 (the "principal Act "), section 93 (1) (2), as follows:— "The expression 'workshop' means— (1) Any premises or places named in part two of the fourth schedule to this Act. which is not a factory within the meaning of this Act. Factory and Workshop Act, 1878, sec. 93. 98 (2) Also any premises, room or place, not being a factory within the meaning of this Act, in which premises, room or place, or within the close, or curtilage, or precincts of which premises, any manual labour is exercised by way of trade, or for purposes of gain, in or incidental to the following purposes or any of them, that is to say: (a) In or incidental to the making of any article or of any part of an article; or (b) In or incidental to the altering, repairing, ornamenting, or finishing of any article: or (c) In or incidental to the adapting for sale of any article. and to which or over which premises, room, or place, the employer of the persons working therein has the right of access or control." 'It is further enacted in the same section that "any premises or place shall not be excluded from the definition of a workshop by reason only that such premises or place are, or is, in the open air." 'A shorter definition of a "workshop" is, that it is a workplace in which no "power" is used, a "factory" being a workplace wherein or within the close, or curtilage or precincts of which, steam, water or other mechanical power is used in aid of the manufacturing process carried on there. The Act of 1895 classes a laundry (other than a steam or power laundry) as a "workshop." 'The duty of preventing overcrowding, and of enforcing cleanliness, lime washing, ventilation and freedom from effluvia in workshops, was removed from the Factory Inspector, and laid upon the Sanitary Authority, by the Factory and Workshop Act, 1891, Section 3; and it is the duty of the Sanitary Authority in London, to deal with these matters in workshops, when necessary, as nuisances under the Public Health (London) Act, 1891, sec. 2, sub-sec. (1) (g). 'In the Factory and Workshop Act, 1891, it is enacted (in effect) that where a Sanitary Authority neglect to carry out the duties devolving upon them with regard to preventing overcrowding enforcing cleanliness, limewashing. and freedom from effluvia in any workshops, or class of workshops, or laundries, the Home Secretary may, "by order authorise and direct" a Factory Inspector to take over during such period as may be mentioned in the order, the powers and duties of the Sanitary Authority with respect to workshops, and a Factory Inspector so authorised is entitled to recover from the defaulting Sanitary Authority all the expenses he may incur in so doing. Factory and Workshop Act, 1891, sec. 3. Factory and Workshop Act, 1891, sec. 1 (1) (2 . 99 'The above section refers to any " workshops or class of workshops and laundries," in a district. Section 4 of the "principal Act" refers to any individual workshop. It requires a Factory Inspector to give notice in writing to the Sanitary Authority of any act. neglect or default in relation to any drain, water-closet, ashpit, water supply, nuisance, etc. in a factory or workshop; and it then becomes the duty of the Sanitary Authority to take the necessary action for the purpose of enforcing the law. After the 1st January, 1896. it will be the duty of the Sanitary Authority, within one month after receipt of the said notice, to inform the Factory Inspector of the proceedings taken in consequence thereof. Should the Sanitary Authority not take proceedings in any such case, the Factory Inspector may take the necessary proceedings and recover from the Sanitary Authority the expenses incurred by him in so doing. 'It is, as already stated, the duty of the Sanitary Authority to enforce Section 2 (1) (g) of the Public Health (London) Act, 1891, which includes in the list of " nuisances liable to be dealt with summarily under this Act," the following:— "Any factory, workshop or workplace, which is not a factory subject to the provisions of the Factory and Workshop Act, 1878, relating to cleanliness, ventilation and overcrowding, and (i.) Is not kept in a cleanly state and free from effluvia arising from any drain, water closet, &c., or other nuisance, or (ii.) Is not ventilated in such a manner as to render harmless any gas, vapours, dust or other impurities generated therein that are a nuisance or injurious or dangerous to health, or (iii.) Is so overcrowded while work is carried on as to be injurious or dangerous to the health of those employed therein." 'Overcrowding.—The Factory and Workshop Act, 1895, Section 1, defines overcrowding by specifying the amount of air space required to be given to each of the persons employed in a workroom, viz., not less than 250 cubic feet of space, or during any period of overtime not less than 400 cubic feet of space, to every such person. It will be the duty of the Sanitary Authority on and after January 1st, 1896, to enforce the provisions of this sub-section. 'The Vestry have required the provision of space on the above scale since the Women Inspectors were appointed in 1893, Factory and Workshi p Act, 1878, sec. 4. Factory and W orkshop Act, 1891, sec. 2 (1) (2) , amended by Factory and Workshop Act, 1895, sec. 3. Public Health (London; Act, 1891, sec. 2 (1) (g). Factory and Workshop Act, 1895, sec 1(1) ana (2). 100 'It is provided by the same section that there shall be affixed at the entrance of a factory or workshop, and in such other parts thereof as a Factory Inspector may direct, a notice "in the prescribed form," specifying the number of persons who may be employed in each room of the factory or workshop by virtue of Section 1 (1). This provision will facilitate the discharge of the duty of the Sanitary Authority by enabling the Inspector to see at a glance whether a workroom is overcrowded. 'The Factory Inspector will supply the "form," and it will be the duty of the occupier of the workshop to affix it in the proper place or places, and to keep it so affixed. 'The said notice will have to be affixed in a laundry as if it "was a workshop." 'Contravention of this section involves a penalty not exceeding forty shillings. 'Limewashing.—It is the duty of the Sanitary Authority to serve a notice on the owner or occupier of a workshop if it appears to them, on the certificate of their Medical Officer of Health or Sanitary Inspector, that the limewashing, cleansing, or purifying of the "workshop" is necessary for the health of the persons employed therein. The fine for non-compliance with the notice is a sum not exceeding five pounds, and a continuing fine of ten shillings a day for default after conviction. The Sanitary Authority, moreover, may cause the necessary work to be done at the cost of the defaulting owner or occupier. It will be remembered that by Section 2 of the Public Health (London) Act. 1891, already cited, a workshop not kept in a cleanly state is a nuisance "liable to be dealt with summarily under this Act." 'Bakehouses.—The Sanitary Authority is the "local authority" in respect to bakehouses, which are workshops within the meaning of Sections 34, 35 and 81, of the Factory and Workshop Act, 1878, which it is the duty of the Sanitary Authority to enforce. These sections relate to cleanliness, ventilation, and other sanitary conditions. The general requirements of the law in respect to bakehouses may be summarised as follows:— The walls and ceilings of the bakehouse must be painted in oil or varnished every seven years, and washed with hot water and soap every six months, or be limewashed every six months. Special restrictions are to be enforced with respect to any place on a level with the bakehouse used as a sleeping place. Do. sub-sec, (3) Factory and Workshop Act, 1895, sec- 22 (Iv.) Factory and Workshop Act, 1878, sec. 78. Public Health (London) Act, 1891. sec. 25. Compare Factory and Workshop Act, 1878, sec. 3 (2). Factory and Workshop Act, 1878. sees. 34-35 and 81, amended bv Factory and Workshop Act, 1895, sec. 27. Public Health (London) Act, 1891, sec. 26. 101 No water-closet may be within or communicate directly with a bakehouse, nor may any drain have an opening within the bakehouse. 'After the first day of January, 1896, a place underground may not newly be used as a bakehouse. 'The officers of the Sanitary Authority have the same power of entry to a bakehouse for enforcing the above provisions, as they have into any premises for any purpose in relation to nuisances. 'Laundries which are Workshops.—Laundries have hitherto been subject, as "workplaces," to all the sanitary provisions of the Public Health (London) Act, 1891, respecting overcrowding, cleanliness, limewashing, and freedom from effluvia, which provisions apply equally to "workshops" and "workplaces." Their inclusion under the term "workshop" in the Factory and Workshop Act, 1895, does not therefore, materially affect the position of the Sanitary Authority with regard to them, excepting that, as the law with respect to overcrowding of rooms in a workshop, to which reference has already been made, applies equally to rooms 'in a laundry, it will be the duty of the Sanitary Authority to see that the provisions of Section 1 of the Act of 1895, as to the amount of cubic space required to be given to the workers, are duly observed. 'It is to be assumed, moreover, that it will be the duty of the Sanitary Authority to enforce the provision contained in Section 6 of the Act of 1895, to the effect that if any occupier of a laundry causes or allows wearing apparel to be cleaned in any dwelling-house or building occupied therewith, whilst any inmate of the dwelling-house is (within his knowledge) suffering from scarlet fever or small-pox, he will be liable to a fine not exceeding ten pounds. 'Temperature in Workrooms.—' Adequate measures are to be taken for securing and maintaining a reasonable temperature in each room of a workshop in which any person is employed.' The penalty for default is a fine not exceeding ten pounds. 'This requirement is based on considerations relating to public health, and it will be for the Sanitary Authority to see that this provision of the Act is enforced. 'fit will be remembered that the Vestry decided, when considering the Bill, that a temperature of 55˚ Fahr., may properly be considered "reasonable." And, no reference having been made to the means by which the required heat should be generated, and no restrictive provision having been laid down, the Vestry desired that a sub-clause should be added to the Bill to the effect that "heating by gas burners intended for lighting purposes should be prohibited, and that Factory and Workshop Act, 1883, sec. 15 amended by Factory and Workshop Act, 1895, sec. 27. sub-sec. (3). Public Health (London) Act, 1891, sec. 26 (2). Public Health (London) Act, 1891, sec. 3(1) (g), sec. 35 Factory and Workshop Act, 1895, sec. 22 (iv.) Factory and Workshop Act. 1895. sec. 22, sub-sec 1 (iv.) Factory and Workshop Act, 1895, sec. 6. Factory and Workshop Act, 1895, sec. 32. 102 vision should be made for heating by open grates or stoves, with proper chimney exit, or by hot-air or water pipes, and that in the latter case efficient ventilation should be provided." This suggestion was embodied in an amendment laid before the Committee, but, like many other amendments, it had to be withdrawn in order that the measure might become law before the dissolution of the late Parliament.] ' Sanitary Conveniences.—It is the duty of the Sanitary Authority to enforce the provision of suitable and sufficient accommodation in the way of sanitary conveniences, regard being had to the number of persons employed or in attendance at the factory, workshop, or workplace. Where persons of both sexes are, or are intended to be, employed or in attendance, proper separate accommodation must be provided for persons of each sex. And, "where it appears to a Sanitary Authority that this section is not complied with in the case of any factory, workshop, or workplace, the Sanitary Authority shall serve a notice on the owner or occupier and if the person served with such notice fail to comply therewith, he shall be liable to a fine not exceeding twenty pounds, and to a fine not exceeding forty shillings for every day after conviction, during which the non-com pliance continues." 'Outworkers.-The Order of the Secretary of State with regard to outworkers, requires the occupier of every place from which wearing apparel, or the raw material of certain other trades is given out to be made or manufactured, to keep a list of outworkers Such lists are to be open to the inspection of any officer of the Sanitary Authority, so that the places where the outworkers reside may be visited, in order to see that they are in a proper sanitary condition. The importance of the duty thus devolving upon the Sanitary Authority has been augmented by a provision in the Act of 1895, Sec. 6, whereby it is enacted that the occupier of a factory, workshop or laundry, or any place from which wearing apparel is given out to be made, cleaned or repaired, shall be liable to a fine of ten pounds for knowingly sending such apparel or material to any building or dwelling-house where there is a case of scarlet fever or small-pox. The Vestry recommended that the words, "or any other dangerous infectious disease" should be added after "small-pox," but they were not incorporated in the Act. ['It may be mentioned that after the 1st January, 1896, the lists of outworkers will have to be sent to the Factory Inspector, on March 1st and September 1st, by the occupier of a factory or workshop, or any place from which work is given out. The Vestry desired that duplicates of such lists should be required to be sent to the Sanitary Authority of the district in which the factory or workshop is situated. No provision to this effect is to be found in the Act. Public Health London Act, 1891, sec. 38. Factory and Workshop Act, 1891, sec. 27, amended by the Factory and Workshop Act, 1895, sec. 42. Order of the Secretary of State. Nov , 189a Factory and Workshop Act, 1895, sec. 6. Factory and Workshop Act, 1891, sec. 27. Factory and Worksnop Act, 1895, sec. 42. 103 but it would so obviously facilitate the discharge of their duty by the Sanitary Authority to have such lists sent to them, that the Secretary of State might well be asked to direct the Factory Inspector to supply the Sanitary Authority with duplicate lists of outworkers.] 'Notification of the Employment of "Protected Persons."—The Medical Officer of Health is required to give notice to the Factory Inspector, forthwith, of every woman, young person and child, of whose employment in a workshop he becomes aware. These "expressions" have the following meanings:— "Child" means a person under the age of fourteen years. "Young Person" means a person over fourteen and under eighteen years. "Woman" means a woman over eighteen years of age. 'Notice to the Sanitary Authority by the Factory Inspector.—In order to facilitate the discharge of the duties of the Sanitary Authority with respect to workshops, as above set out, the Factory Inspector is required to send to the said Authority all notices received by him from persons commencing to occupy any place as a workshop. Any place, in this Parish, so notified, is forthwith inspected, and if women are employed therein the workshop is duly entered in the register. The section applies equally to the case of workshops where men only are employed. 'After January 1st, 1896, the occupiers of all existing workshops who have not already notified their occupation of the same to the Factory Inspector, will have to do so before the end of the year, under a penalty of five pounds for default. All notices sent to the Factory Inspector under this section will have to be forwarded forthwith to the Sanitary Authority of the district in which the workshop is situated. 'Power of Entry.—The Sanitary Authority by their officers have power to enter any premises, including a factory, workshop, or workplace, between the hours of six a.m. and nine p.m., and in the case of a nuisance arising in respect of any business, the power of entry may be exercised at any hour when the business is in progress or is usually carried on. 'Penalties for Offences.— In every case above referred to, the exercise of the power of the Sanitary Authority is facilitated by the enactment of fines for disobedience to their orders. 'The Register.—It may be mentioned that there are upon the Register at the present time (i.e. December, 1895) 640 workshops in which women are employed, viz., dressmakers and ladies' tailors 363, laundries 238, and miscellaneous 30. The number of workshops where men only are employed is unknown, save as to bakehouses, of which there are in the Parish some 130.' Factory and Workshop Act, 1891. sec. 3 (3) Publ'c Health (London) Act, 1891, sec. 27. Factory and Workshop Act, 1878, sec, 96. Factory and Workshop Act, 1891, sec. 26. Factory and Workshop Act, 1895, sec- 41. Public Health (London) Act, 189 , secs. 10 and 141. 104 Work of the Lady Inspector of Workshops, etc.— Miss Squire having vacated office at the commencement of the year, on her appointment as Factory Inspector, Miss de Chaumont was selected by your Vestry to fill her place as Inspector of workshops, workplaces and laundries, where women are employed. I have pleasure in submitting her report as follows:— 'I have the honour to present a report of the work done in the Northern and Southern Districts of the Parish during the 44 weeks, March 1st, 1896, to January 2nd, 1897. 'In reviewing the work of the year the following points seem to call for special comment:— 'New Workshops.—In the North district 18 new workshops have been added to the register, and 35 workshops have been removed therefrom. 'In the South district 39 new workshops have been added to the register, and 31 have been removed therefrom. 'The registered workshops, &c., in the whole Parish, which at the date of my taking up office totalled 634, now number 625, of which there are— Dressmakers and Ladies' Tailors. Laundries. Misce laneous Total. In North Kensingtoan 94 210 25 329 In South Kensington 253 24 19 296 347 234 44 625 'The decrease in the number of dressmakers in North Kensington is chiefly amongst those on the outskirts of the parish, who, in many cases, have only moved into the next street, but are thus not subject to my inspection. 105 'Factory and Workshop Act, 1895.—It appears to me that the new Factory Act is having a good effect in respect of overcrowding, and the warming of workrooms. The fact that the amount of cubic space is now legally regulated has convinced the occupiers of workrooms that it is not a "fad" of the Inspector to restrict the number of " hands who may occupy a particular workroom. I have so far, however, found comparatively few rooms overcrowded and none seriously so. 'During the winter I inspected workshops, &c., with a special view to the warming of workrooms, and 1 am pleased to report that the larger number of such rooms in this parish were found to be warmed by good open tires or asbestos gas stoves. In many cases I was enabled to obtain improved means of warming with, as I believe, manifest advantage to employers and employed alike. In the month of November I reported the close and oppressive atmosphere of a bootmaker's workshops, owing to the rooms being warmed by open gas jets hanging low down therein. The matter was brought to the notice of the firm and these rooms are now wanned by asbestos gas stoves fitted with a fiue into the chimney. The difference in the atmosphere is very marked and much appreciated by the employes. The ready acquiescence of the firm in my requirements was entirely due to the recent legislation, Section 32 of the Factor and Workshop Act, 1895. 'Yards, Floors, roofs, &c — A number of yards attached to laundries, reported as damp and uneven, have been well paved with concrete and cement, and others have been repaired. Thirty-nine rooms have had either floors or ceilings or roofs repaired, and in one laundry the washhouse has been more efficiently drained, thus rendering it dryer for the washers. 106 'Cleansing, Whitewashing, &c.—There is an increasing willingness on the part of owners to do necessary work on the written intimation only, and in some laundries the whitewashing of the workrooms is now done regularly where formerly it was left for an indefinite period. It also seems to me that the chance of a visit from the "Sanitary Lady" rouses many occupiers to do their share towards keeping the places clean. 'I could wish that the accumulations of clippings in dressmakers', and particularly in tailors' workshops could be dealt with as a nuisance, for they harbour dust and dirt to a large degree. On complaint of untidiness and dustiness, I am generally told that "the room is swept daily, but that that morning the porter, or servant, responsible for cleasing, had been ill, or had been sent out hurriedly": an explanation which I can seldom accept unreservedly, as the accumulation complained of is rarely the product of a single day's work. 'I append a table setting forth the principal items of work carried out during the year:' 107 Work done during the 44 weeks, from March 1st, 1896, to January 2nd, 1897. NORTH KENSINGTON. SOUTH KENSINGTON. Total for Whole Parish. Dresmakers. Laundries. Miscellaneous. Total. Dressmakers Laundries. Miscel laneous Total. Workshops, &e.. Number on the Register 94 210 25 329 253 24 19 296 625 „ Number of Workrooms therein 127 489 32 648 467 47 22 536 1,184 „ Number of Inspections of 150 437 54 641 407 45 47 499 1,140 „ Number of Re¬inspec tions of 14 144 2 160 42 4 2 48 208 Workrooms, Number of Inspections of 203 1,221 68 1,492 728 95 57 880 2,372 „ found to be Overcrowded 2 4 ... 6 16 ... 2 18 24 „ found to be insufficiently ventilated 2 9 1 12 13 1 2 16 28 „ found to be in a dirty condition 8 89 3 100 36 2 5 43 143 Workshops, &c., newly discovered and registered since March 1st. 1896 8 6 4 18 32 4 3 39 57 „ Workrooms therein measured 10 12 4 26 45 5 3 53 79 „ Removed from Register 17 12 6 35 23 4 4 31 66 Houses visited for enquiry at which no female hands were employed 35 24 10 69 63 11 17 91 160 Statutory Notices, and Written Intimations Served 6 147 2 155 31 4 1 36 191 Nuisances referred to M.O.H. to be dealt with 8 40 2 50 13 1 4 18 68 108 In the final report by Miss Squire (dated January 1896) it was stated, and it is a matter for satisfaction, that there had become manifest, on the part of employers, an increasing wil'ingness to conform to the requirements of the law, with which many of them had been more or less unacquainted, until they were made known by the visits of the lady inspectors, and by the notices issued by the Sanitary Committee. In no respect has greater good been done than by the abatement of overcrowding, and the improvements effected with regard to the warming of workrooms and the ventilation of gas iron heaters, &c. The good work begun by Miss Deane, Miss Squire, and Miss Duncan, has been well carried 011 by Miss de Chaumont, who has performed her duties with tact and discretion to my entire satisfaction, and, what is of more importance, to the satisfaction of the Sanitary Committee, the body to which has been delegated the carrying out of the duties which devolve upon your Vestry as the local authority under the Acts. 109 THE SANITARY INSPECTING STAFF. In view of a contemplated re-arrangement of the sanitary districts, I thought it desirable to place before your Vestry, in the eleventh report (October 8th), an account of the districts, and of the circumstances which led to the appointment of additional inspectors subsequent to the passing of the Public Health (London) Act, and the Factory and Workshop Act, in 1891. The report was to the following effect:— "In 1891. when I reported on the provisions of the Public Health (London) Act, in my tenth report (October 12th, pages 114-133 inclusive) your Vestry's staff comprised four inspectors, a number which had been settled in the year 1877. I was of opinion and reported that the new duties imposed by the Acts referred to could not be executed effectively with so limited a staff; which, as I stated, was inadequate for current duties under then existing laws—for the new Acts were not yet in operation. Your Vestry having requested me to bring up an 'estimate of the probable cost of carrying out the provisions of the Public Health Act in this parish, 'I reported on this subject in my twelfth report (December 15th, p. 152), wherein I recommended the appointment of four additional sanitary inspectors. This report was referred to the Sanitary Committee for consideration, and the Committee. having regard to the importance of the subject, appointed a Sub-Committee of fifteen—five from each of the three then existing wards—to consider, inter alia, my recommendation 'as to the addition required to be made to the sanitary staff to carry out the duties devolving upon the Vestry,' etc. The Sub-Committee reported, March 1st, 1892, recommending the appointment of four additional sanitary inspectors. The Sub-Committee's report was considered by the Sanitary Committee on the 8th March, the Committee, moreover, having before them a Memorandum (dated 5th March) embodying a 'Scheme," which I had prepared, at the request of the Sub-Committee, ' for carrying out the work of the department with the proposed increased staff of sanitary inspectors.' My advice to the Committee was ' to place two inspectors, in addition to Mr. Abbott, in the south district' (i.e., south of Kensington-road) ;. four inspectors in the north district' (i.e., north of Uxbridge-road), and ' one inspector, as at present, in the central district' (i.e., between Kensington-road and Uxbridge road). I further recommended the appointment of Mr. Abbott as Chief Inspector ' to exercise a general superintendence over the (out door) work of the other inspectors.' The Sanitary Committee reported to your Vestry that they were 'unable to concur in the opinion of the Medical Officer of Health' (and of the Sub-Committee) ' that the new duties imposed upon the Vestry required an immediate doubling of the staff of 110 spectors,' but that they ,fully recognized the fact that some augmentation in the staff would have to be made, to allow of the efficient performance of the work imposed upon the Sanitary Authority under the recent legislationand they accordingly recommended the appointment of two additional sanitary inspectors. On 16th March, your Vestry adopted the report of the Committee, and, in due course, two additional inspectors were appointed, raising the staff to six, three of whom were allocated to the northern division of the Parliamentary borough (North Kensington), and three to the southern division (South Kensington). "In January, 1893, an article having appeared in a London morning paper reflecting upon the condition of a portion of the 'NottingDale' district, the subject was referred by your Vestry to the Sanitary Committee, who made a report thereon (March, 1893) stating, in the concluding paragraph, that 'what appears to be most needed ' in the districts inspected by the Committee, ' is frequent house-to house inspection'; and, with a view to this, the Committee recommended the appointment of a seventh inspector. The report was adopted by your Vestry, and, in due course, Mr. Marks, now County Council inspector of common lodging houses, was appointed to take charge of a new district then described as the North-west, division B. The appointment was made in the first instance for one year ; but, before the expiration of that period, and in accordance with a recommendation of the Sanitary Committee, Mr. Marks was re-appointed on the permanent staff. Thus, in 1893, North Kensington had four inspectors as I had recommended in 1892, and the arrangement continued in force until the early part of the present year. On Mr. Marks's retirement (in October, 1894). Mr. Steward was appointed as permanent inspect r to take charge of the North-west district, division B. A vacancy having occurred in the North-east district, by the resignation of Mr. Cave, in March, 1894, Mr. Bridel was appointed to that district for one year, at the expiration of which period he was, on the recommendation of the Sanitary Committee, re-appointed on the permanent staff. "Meantime, and having regard to the various duties imposed upon the Sanitary Authority by the Fsctory and Workshop Acts, your Vestry, upon the recommendation of the Sanitary Committee, decided (in October, 1893) to appoint two ladies for the purpose of inspecting 'workshops, workplaces, and laundries where women are employed,' thus raising the inspecting staff to nine members. One of these ladies (Miss Deane) having been appointed by the Home Secretary to the office of factory inspector, her place was filled (in June, 1894) by Miss Duncan. After an experience of eighteen months, the other lady, Miss Squire, was re-appointed (in April, 1895) during the pleasure of your Vestry, with the status of sanitary inspector. In July, 1895, the Sanitary Committee recommended the re-appointment of Miss Duncan, also with the status of sanitary inspector; but your Vestry, by 111 striking out the paragraph in the Committee's report, allowed the appointment to lapse, and thus the inspecting staff was reduced to eight members. "In November 1895, Mr. Abbott, the senior sanitary inspector, resigned his appointment on the ground of ill-health ; and on the recommendation of the Joint Sanitary and Special Purposes Committees, your Vestry decided (February 26th, 1896) not to All up the vacancy, and thus the sanitary inspecting staff was further reduced to seven members, including Miss de Chaumont, the lady inspector who had been elected, with the status of sanitary inspector, in succession to Miss Squire, whom the Home Secretary had appointed to the office of factory inspector. "The staff of male inspectors having been reduced to six, some re-arrangement of the sanitary districts became necessary, and as the Joint Committees and your Vestry were unanimously of opinion that the North district and the three districts in South Kensington (Central, South-east and South-west) should not be interfered with, the re-arrangement was effected by consolidating the North-east district, and the two divisions ('A' and 'B') of the North west district, so as to make two districts, since known as North-east and North-west. Mr. Steward was allocated to the North west district, which embraced, in addition to his old 'B'division, an area from the 'A' division, to the south thereof, extending to Holland Park Avenue, the eastern boundary being Princes Road, the western limit being the boundary of the parish. Mr. Poole retained the remainder of the 'A' division, pint the whole of the North east district. "In March 1896, your Vestry appointed a Special Committee to enquire into the condition of a portion of the North-west district, referred to above as 'Notting Dale.' Among other recommendations made by the Committee was one indicating the necessity for more sanitary inspection of the area. The report having been adopted by your Vestry, the said recommendation was referred to the Sanitary Committee, who reported recommending— "That the several Sanitary Districts be re-arranged so that, whilst the staff of Inspectors shall be retained at its present number, the district formerly known as North-west (division B), shall be reconstituted, and allotted to one Inspector ; and that the resolution of the Vestry of the 26th February last, above referred to, be revoked to allow of effect being given to this arrangement." "This recommendation was adopted by your Vestry at a meeting held in October." With a view to assist your Vestry in deciding what urther rearrangement of the remainder of the Parish might 112 he most conveniently practicable, I added to the above report a statement showing certain particulars in respect to the six Sanitary Districts as they were constituted in February, 1896, as follows:— NORTH KENSINGTON. Sanitary District Area in Acres Population in 1896. No. of separate Families, in 1891 No of Inhabited Houses in 1891. No. of Tenements of less than five rooms in 1891. Present number of Registered Houses North 255 32,403 6,793 2,866 5,503 271 North¬East 490 36,276 8,184 5,002 4,450 119 North¬West 112 16,875 3,669 1,636 2,993 267 Totals 857 85,554 18,596 9,504 12,946 657 SOUTH KENSINGTON. Sanitary District Area in Acres Population in 1896. No of separate Families in 1¬91. No of Inhabited Houses in 1891 No. of Tenements of less than, five rorms, in 1891. Present number of Registered Houses Central 450 20,035 4,293 2,997 2,023 393 South¬East 470 32,019 6,354 5,105 1,979 100 South¬West 450 31,860 6,710 4,478 3,104 393 Totals 1,370 83,914 17,857 12,580 7,106 886 The report concluded with the observation that the above figures would appear to support the view taken by the Joint Committees, and endorsed by your Vestry, in February 1896, that in any re¬arrangement of the sanitary districts "the three districts south of High¬street, Notting¬hill, and Holland¬park avenue, should not be interfered with." On October 7th, a special meeting of your Vestry was held to receive the report of the Sanitary Committee on the reference of the 15th July, directing them to "arrange for an increase of sanitary inspection in the Notting Dale district, as suggested by the Special Committee." The Committee reported that they had "come to the conclusion that the only alternative to an increase of the 113 existing sanitary staff" (of six inspectors) ''which would allow of increased sanitary supervision in the Notting Dale area, is for the Vestry to revoke their previous resolution" (of February 26th) "and again to re¬arrange the Sanitary Inspectors' districts," which was done with the result that Mr. Steward's district, now known as the North¬West, is exactly the same as it was prior to the enlargement of it made by resolution in February. The Local Government Board took exception to the reduction in the sanitary inspecting staff, pointing out that "the population of four of the six proposed districts" (exceeding 30,000 in each district) " would be in excess of the average population of the districts of sanitary inspectors in the Metropolis" (viz., 22,500), and "urging the Vestry to reconsider their proposal." The County Council, moreover, intervened;* and with regard to the letters from these bodies, the Sanitary Committee, *The Council took up the same attitude as the Local Government Board, on the ground of population. They also expressed their regret that a reduction had been made in the sanitary staff, "especially having regard to the needs of the Notting¬Dale district." The Public Health Commiitee of the Council subsequently intimated that they had instructed one of their Assistant Medical Officers "to report to them as to the sufficiency of the Vestry's staff of Sanitary Inspectors," and asked that facilities might be afforded to him for his enquiry—which did not take place. The Council had previously asked "whether the Vestry could furnish, for the Council's information, any recent report of its Medical Officer on the subject of the adequacy of the Vestry's staff, and if not, whether they would instruct their Medical Officer to report on the question;" and, subsequently, the Public Health Committee stated that "they would be glad to know the views of the Vestry's Medical Officer as to the arrangements now made for the sanitary inspection of the Parish," and requested "that the Medical Officer of Health might be instructed to report upon the subject, and that a copy of the report might be forwarded to the Council." Ultimately, it was decided to inform the Public Health Committee that "the Vestry having fully considered the views placed before them by their Medical Officer of Health, and the advice tendered by him, are of opinion that, in the circumstances, it is unnecessary that that officer should be called upon to report further upon the subject," and with this answer the Public Health Committee were fain to be content. 114 to which they had been referred, thought it well to appoint a sub-committee to "frame the necessary replies." The reply addressed to the Local Government Board had the desired effect, in so far that the Board consented to the reduction of the staff for twelve months on trial; and a firm front having been opposed to the Council's intervention, that body allowed the subject to drop. The matter having been so far settled, as regarded the Central Authorities, it became necessary to make an arrangement for reducing the area comprising the NorthEast district and the North-West district, division A, which at the time was under the charge of Mr. Poole. This was done by taking from its southern part, from east to west, a considerable slice which was tacked on to the Central district, the inspector for which was thenceforth relieved from the duty of superintending disinfection in the parish generally. The Central district, previously, had been restricted to the area lying between Notting-hill High-street and Holland-parkavenue on the north, and Kensington High-street and Kensington-road on the south, a most convenient arrangement, the dissolution of which is, in my humble opinion, a matter for regret. THE WORK OF THE SANITARY INSPECTORS. Table VI. (appendix), contains a summary of the work of the Sanitary Inspectors in 53 weeks ended 2nd January, 1897, the date of termination of the registration year 1896. The duties of the Inspectors are carried out under the Sanitary Committee, your Vestry having conferred on that body, by resolution, power to enforce the provisions of the Public Health (London) Act, 1891; the Housing of the Working Classes Act, 1890, and the Factory and Workshop Acts, 1878 to 1895. At page 2 will be found a description of the Inspectors' districts, as existing, nominally, at the beginning of the year, at which date the South-East district was vacan 115 by the resignation of Mr. Abbott, the senior Inspector. Advantage was subsequently taken of this vacancy to reduce the inspecting staff under the circumstances already set out at page 111. Statutory Notices for the abatement of nuisances to the number of 1,210 were issued during the year, by direction of the Sanitary Committee. Written Intimations of nuisances were served by the Inspectors, under section 3 of the Public Health (London) Act, 1891, to the number of 1,966. As a result of these intimations, many works of sanitary amendment were carried out without delay, thus realizing the intention of the legislature, and obviating the necessity of serving statutory notices. With regard to these intimations, I reported to your Vestry, March 2nd (No. 2 report, p. 25), pointing out the desirability of an alteration in the form in use, so as to enable the Sanitary Inspector to indicate the character of the works necessary for the abatement of the nuisance. It had been a frequent subject of complaint that such works were not specified, and that the person liable to abate a nuisance was left in ignorance of the requirements of the Sanitary Authority. I therefore suggested the desirability of a reference to the Law Committee, as to whether it would be legal (as it was certainly desirable) to use a form of intimation which would enable the Inspector to specify the works which, in the event of the nuisance not being abated, he would report to the Sanitary Committee to be requisite for the purpose The reference was made, and in due course the Committee reported their opinion that the proposed alteration in the form would be lawful. The Committee further prepared a new form of intimation, the use of which has been attended with advantage. On this form, and on the statutory 106 notice, a note is printed,* which gi\es the person liable for the abatement of the nuisance an opportunity of making what, for convenience, may be called an "appeal" to the Committee against the requirements of the Sanitary Inspector and the Sanitary Committee respectively. I confess that I regarded the introduction of these notes with some apprehension, fearing that they might be used for dilatory purposes. My fears, however, have not been realised, for " appeals " are very rare, and, when made, they generally take the form of an application for an extension of time; so that sanitary administration has not been hindered by a procedure which might, perhaps, be not incorrectly described as a little irregular. Reconstruction and Trapping of House Drains.— Reference was made in the annual report for 1885 (pages 83-88), to difficulties, with respect to the issue of notices for the trapping of house drains and the reconstruction of drains found on examination to be defective. The difficulties still continue, and during the past year little work was done by the Inspectors in these directions. As regards trapping, the Sanitary Committee still act upon the view that they have no power to require an existing drain to be dis- * On the new form of written intimation, the note, printed in red, reads as follows:—"I, the above named- Sanitary Inspector, shall, if the above nuisance is not abated, report the existence thereof to the Works and Sanitary Committee at their next meeting, and shall recommend such Committee to require you to execute the works specified over-leaf as necessary for its abatement, and to prevent its recurrence. If you have any objections to urge, and will state them, forthwith, in writing to the Medical Officer of Health, they will be duly considered by the Works and Sanitary Committee." The note on the Statutory Notice is to the following effect;—" If the person liable to abate the nuisance referred to herein has any objections to urge with reference to the requirements of the Vestry, and will state them, forthwith, in writing to the Medical Officer of Health, they will be duly considered by the Works and Sanitary Committee." It may be mentioned that in regard to many of "the requirements" of a Sanitary Authority, as set out in their notices, there is a right of " appeal;" but it is to the London County Council, under the provisions of several of the sections of the Public Health (London) Act, 1891. 117 connected from the sewer unless nuisance is proved to exist, from the want of a trap, or unless infectious disease has occurred in the house ; and notices for the trapping of drains found to be untrapped were issued in such cases only. Your Vestry, on 15th January, adopted a resolution as follows: — " That the practice of requiring the insertion of intercepting traps in drains be continued in all cases where the premises, by the absence of a trap, are in such a state as to be a nuisance, or injurious, or dangerous to health, and that the instruction to the Sanitary Inspectors be varied in accordance with this direction," and on the 12th February the " Instruction " to the Inspectors in regard to this matter was varied to read as follows: — " The drain to be tested with water or smoke, and where the absence of an intercepting trap between the house and the sewer renders the premises a nuisance, or injurious, or dangerous to health, the drain to be trapped from the sewer outside the house, by means of a syphon provided with fresh air inlet." The previously existing instruction read as follows:— "The drain to be tested with water or smoke, and to be trapped from the sewer, outside the house, by msans of a syphon provided with a fresh air inlet; where practicable and necessary, a manhole or access chamber to be provided." If little was done in respect of trapping, still less was done in the way of reconstruction or repair of house drains under sanitary notices, for early in the year a recommendation of the Sanitary Committee was adopted by your Vestry to the effect that no drain was to be opened up for examination without the authority of the Committee,* the result being that the work of reparation of drains, under notice has since been practically in abeyance; for in the ordinary work of house inspection by the Sanitary Inspectors, little *The direction of the Vestry in regard to this matter took the form of a "Note" to the "Instruction" with respect to Drainage, which reads as follows " Before requiring the opening up of the drain of any house, the case shall be reported to the Works and Sanitary Committee, and their authority obtained for such an inspection of the said drain." 118 attention is now given to the underground drain. A certain number of drains suspected to be defective, were tested with smoke,generally with a negative result. The hydraulic test could not be applied without opening up the drain, and this was not done save in rare and exceptional cases. By another resolution, the supervision of the work of trapping and reparation of underground drains was transferred from the Inspectors to the Surveyor.* In the course of the year many drains were, as usual, reconstructed by the owners or occupiers of houses, without sanitary notices having been issued, on the deposit of plans submitted for the approval of your Vestry. Particulars under this head will be found in the report of the Surveyor. OFFENSIVE BUSINESSES. The only business coming under the statutory description " offensive," other than that of a slaughterer of cattle, carried on in this parish, is that of a Fat Extractor, at Tobin Street, in the Potteries, Notting Dale. The conduct of this business gives rise to more or less effluvium nuisance, despite improved arrangements, and care on the part of the proprietor, and supervision by your Vestry's Inspector, as well as by the Inspector of the London County Council. MARINE STORES. The business of a marine store dealer is not scheduled in the Public Health (London) Act, 1891, as an offensive business, but it gives rise often to offensive smells; and it has been held by the Appeal Court to be ejusdem generis with the businesses * The report on the subject by the Sanitary Committee, which was adopted by the Vestry was to the following effect:—" That all works of repair or alteration to the underground drains of any premises be supervised by the Surveyor's Department, provided that this instruction shall not apply to such works of repair or alteration as the fixinsr of gullies or drain inlets apart from other underground work." The Surveyor's staff also supervise the work of ventilation of drains. 119 scheduled, originally, in the now repealed Slaughter Houses (Metropolis) Act, 1874. At my instance your Vestry applied to the late Metropolitan Board of Works, in 1883, to schedule the business under that Act, but without success. And last year, upon receipt of complaints of nuisance arising in the conduct of the business, an application was made to the County Council to schedule the business under the provisions of section 19 of the Public Health (London) Act, 1891. Upon receipt of the Council's communication declining to accede to your Vestry's request, I placed upon record a history of the question, in the thirteenth four-weekly report, dated December 3rd, as follows:— 'An Offensive Trade.—In my eighth report for 1883,1 dealt with the nuisances arising in the conduct of the business of a marinestore dealer, otherwise rag and bone merchant, and cited a glaring illustration of recent occurrence,* Subsequently your Vestry, on the recommendation of the Sanitary Committee, drew the attention of the Metropolitan Board of Works to the subject, and requested them to " consider as to the desirability of the business of a ' marine store dealer' being declared to be an 'offensive business' under the provisions of the Slaughter-houses (Metropolis) Act, 1874, section 3" It was felt that good would result were the business regulated by bye-laws, so as to secure, as in the case of other offensive trades, a proper construction of the premises where it is carried on, the provision of suitable metal receptacles for storage and removal of offensive fat, &c, and frequent if not daily removal of such matters from the premises. The Board did not adopt the recommendation of your Vestry, having in their reply stated that " the businesses to which the Act of 1874 refers, are businesses Which include processes of manufacture of a more or less offensive character," and that it did not appear to them that " the mere collection of a mass of refuse matter into one place was a ' business" *The particulars of the case referred to were set out as follows :— " A most fearful stench caused by a laige accumulation of putrid fat, boneB, rabbit-skins, and the refuse that had been collected from numerous kitchens . . . There were 25 tubs full of fat which was in a putrid state and alive with maggots, and several sacks, baskets, &c., full of offensive fat, bones, &c. The stench was perceptible at a distance of one hundred yards." The Surveyor put the finishing touch to the picture by the statement that " the street was undermined with rat-runs directed to the premises," whgre these vermin, no doubt feasted luxuriously. 120 within the third section of the Act." In a subsequent report (No. 10, 1883), I pointed out that among the offensive businesses scheduled in the Act of 1874 were those of bone-boiler, tallow-melter, and fatextractor, the staple materials of which are obtained largely from rag and bone shops. I further observed that the ' processes of manufacture ' in boiling bones, in melting tallow, and in boiling hog-tub wash, &c., for the purposes of extracting fat, were not very obvious, and that, in any case, the bye-laws for the regulation of those ' businesses' do not allow collections of stinking fat, bones, etc., to be exposed so as to pollute the air in and around the premises. Why then, I asked, should such matters be allowed to pollute the air in the neighbourhood of the stores where they are originally collected, and which are far more numerous than the so-called ' manufactories ' "? The Board considered that the nuisance " should be dealt with under the Nuisances Removal Act, which was intended to apply to such cases," as no doubt it was. But this Act was also intended to apply to the cases of the ' offensive businesses,' regulated, at that time, under the Slaughter-houses Act, subsequently repealed, its provisions having been re-enacted in the Public Health (London) Act, 1891, the County Council, as the successors to the Metropolitan Board of Works, being the ' Local Authority ' in respect of the offensive businesses. In practice, however, it had been found impracticable to deal effectually with nuisances arising in the conduct of these businesses under the Nuisances Removal Act, hence the passing of the special Act in 1874. The Board, presumably, were unaware of the difficulty of dealing, promptly and decisively, with recurring trade nuisances under the Nuisances Removal Act, but no public body knew better the facility of nuisance-prevention, in the case of ' offensive businesses; for under the operation of bye-laws, providing appropriate penalties for offences thereunder, it was manifest, as I observed, that " in properly con. structed premises, in chambers without openings to the external atmosphere, and in covered impermeable receptacles, bones, fat, &c., can be stored without nuisance." Subsequently, and when I supposed that the question of principle had been decided adversely to my views, by the expression of the Board's opinion, with which the Law and Parliamentary Committee expressed their concurrence, it came to my knowledge that the question had already been before, and had been decided in, the High Court, in an appeal case, Passey (Appellant) r. Oxford Local Board (Respondents). The Appellant had been charged with having established anew, within the City of Oxford, the noxious and offensive business of a rag and bone merchant contrary to Section 112 of the Public Health Act, 1875. Upon the hearing, at a Petty Sessions at Oxford, it was found (1) that the Appellant had newly established the said busineo without the consent of the Board ; (2) that the said business was, as a matter of 121 fact, a noxious and offensive one, and (3) as a matter of law, was ejusdem generis with the six* trades specified in Section 112, which corresponds with Section 3 of the Slaughter-houses (Metropolis) Act, 1874, which was an important extension of Section 27 of the Nuisances Removal Act, 1855. The Justices fined the defendant, whose defence was that the business was neither noxious nor offensive within the meaning of the 112th Section of the Statute. Defendant appealed, and it may suffice to cite the terms of the judgment of Lord Chief Justice Cockburn (with which Mr. Justice Lopes concurred) in the Queen's Bench Division, as follows :— " I think that the conviction was right. The Justices find as a fact that the business carried-on, on these premises, was a noxious and offensive one. I agree that that alone is not enough, and that it is necessary that a business, in order that it may be brought within Section 112, should be ejusdem generis with those specified in the Section. Those businesses seem to include animal matter in some form ; and here there was animal matter with the bones stored on the premises, and the mere exposure of bones with animal matter may be very offensive." ' Having regard to the importance of the question, I recommended in my last report for 1883 (No. 15, page 137), a further reference of the question to the Law and Parliamentary Committee, with a view to a further communication being addressed to the Metropolitan Board, requesting reconsideration of their decision in the light of the above judgment. The Committee, in their report, recommended "that proceedings be taken as heretofore under the Nuisances Removal Act, as occasion may arise ; the Committee not being prepared to advise that any further steps be taken at present as to the control of such businesses." The report was adopted by your Vestry and the matter dropped. ' During the present year the subject was re-opened by the Sanitary Committee, consequent on the receipt of complaints of offensive smells emanating from certain marine stores, and your Vestry addressed a communication to the County Council, urging them to issue an order, under Section 19 of the Public Health (London) Act, 1891. declaring the business of a marine store dealer to be an offensive business within the meaning of the said section. On the 19th November, the Council replied that " the facts at present within its knowledge would not justify it in making the order asked for." The Council's letter was accompanied with an extract from a report of the Public Health Committee. in which reference is made to the representations made to the * The trades specified are—blood-boiler, bone-boiler, felhnonger, soap-boiler, tallow-melter, and tripe boiler. 122 Metropolitan Board of Works in 1883, already alluded to. The Committee state, correctly, that Sanitary Authorities can now deal with a part of your Vestry's complaint of 1883, under the Council's bye-laws regulating the conditions under which offensive matter can be removed through the streets ; and as to the " question which remains, whether regulations are required with respect to the deposit and retention of animal matter in the premises of marine store dealers," they refer to the power of the Sanitary Authority to deal with such premises under Section 21 of the Act of 1891, which provides a remedy in cases of offensive effluvia from trade processes." The Committee go on to observe that they " are advised that, as a strict question of law, the Council can, if the Local Government Board confirm its order, declare the business of a marine store dealer (if carefully defined), or of a rag and bone merchant, to be an offensive business within Section 19;" but they "think that the Council would hesitate to make, and the Local Government Board would hesitate to confirm an order .... without considerably more evidence than there seems to be, at present, that an evil exists in London which cannot be effectually dealt with without such an Older, and that such an order is therefore necessary in the interests of the public health." The Committee, therefore, recommended, and the Council directed, that your Vestry be " informed that the Council feels that the facts at present within its knowledge would not justify it in making the order asked for." ' With reference to the 21st Section of the Public Health (London) Act, 1891, I may observe that it is the section under which proceedings were instituted by your vestry (in 1894) against certain brickmakers— proceedings which occupied many months in furnishing the required proof that " the best practicable means " had not been adopted, by the persons complained of, for abating the nuisance, or preventing or counteracting the effluvia arising in the process of brick-burning. And with reference to this business, I may add that, so satisfied were the Council of the difficulty of dealing effectually with the nuisance, under law comparable with Section 21, that before the Act of 1891 was passed they had made strenuous efforts to bring the trade of a brickmaker within the terms of section 23 of the Municipal Corporations Act, 1882, through the operation of section 16 of the Local Government Act, 1888, so as to enable them to regulate the conduct of the business by bye-laws which they framed for the purpose. The Local Government Board, however, refused to confirm the proposed bye-laws, being, at that time, of the opinion that sanitary authorities would be able to take proceedings, with effect, under provisions of an intended law, which now exist in the terms of section 21 of the Public Health (London) Act; a course which was adopted 123 by your Vestry, and carried through, at an enormous expense, in the brickburning case, the proceedings having extended over a period of twelve months. I do not say that equal difficulty or delay would be experienced in proving nuisance on the premises of a marine store dealer; but in each case the nuisance would have to be proved; whereas, if the conduct of the business were regulated by bye-laws, it would only be necessary to prove breach of the bye-laws in order to secure the infliction of a fine, &c.; and thus power to prevent nuisance from a trade which is admittedly a frequent cause of nuisance, would be materially increased. The Council seem to object to a duty " entailing the making of bye-laws, and arranging a system of inspection, affecting the several hundreds of these businesses which there are ... at the present time in London." Put if they would obtain an order and make bye-laws, the several sanitary authorities could do the work of inspection. Such a devolution of powers would be consistent with the recommendations of the Royal Commission on the " amalgamation of the City and County of London," and, I believe, would be agreable to the Council, as among the resolutions of the Conference between representatives of the Council and of the Vestries, &c., convened " to consider and report what powers now possessed by the Council should be transferred to Local Authorities," the following one was adopted :— " Offensive Businesses.—That the powers of the Council under Section 19 of the Public Health (London) Act, 1891, to declare a business to be an offensive business, should be transferred to the local authorities." ' It will probably be the pleasure of your Vestry to let this matter rest for the present, to see what effect, if any, is given to the above resolution. Meantime, I have thought it well to place the above statement on record, and I will only further add that within the last few days a letter has been received from a parishioner making complaint of the " vile odours and most disgusting smells" from which he suffers from the propinquity of a " rag and bone dealer's " place to his residence." The matter was allowed to drop. I have only to add that the several premises where the business is carried on, are regularly inspected by the several Sanitary Inspectors. The particular premise-), in respect of which the complaint arose, which gave occasion to the reports made in 1883, have long since ceased to be used for the conduct of the business; it is a significant fact that the locality is still infested with rats to an extraordinary extent, if the complaints of the inhabitants are to be believed. 124 BRICKBURNING. Neither in 1895, nor in 1896—the second year completed since the successful proceedings taken by your Vestry to abate the nuisance from effluvia caused by brickburning—was any complaint made by parishioners of nuisance arising in the conduct of the business, nor have I any reason for thinking that any cause for complaint existed. It is satisfactory to know that it has been found practicable to burn bricks without nuisance, as no one connected with your Vestry ever had any desire to interfere needlessly with the conduct of a lawful business. LICENSED SLAUGHTER-HOUSES. Thirteen premises were licensed to be used as slaughterhouses at the Licensing Sessions of the County Council held in October. Of these seven are situated in North Kensington and six in South Kensington. The several premises were, as usual, regularly visited by the Sanitary Inspectors. The names of the licensees, and the localities of the premises, are set out in Table XI. (appendix). The premises were inspected in July by the Sanitary Committee, who reported favourably with respect to them. In 1874 there were some 1,500 slaughter-houses in the Metropolis; in 1896 only 469, and 15 fewer than in 1895. In Kensington, 48 were licensed in 1873, the year before the passing of the Slaughter-houses (Metropolis) Act; in 1874 only 31. Now, as above stated, there are only 13. The business of a slaughterer of cattle has not been established anew in this parish since 1874. LICENSED COW-HOUSES. Four premises were licensed to be used as cow-houses: three of them are situated in North Kensington and one in South Kensington. The several premises were, as usual, regularly inspected by the Sanitary Inspectors. The names of the licensees, and the localities of the premises, are set out 125 in Table XII. (appendix). The premises were inspected in July by the Sanitary Committee, and found to be in a generally satisfactory condition. There were only 14 cows, in three of the sheds, the fourth shed being empty. Not many years ago there were 28 sheds, containing about 500 cows. There has been a corsiderable reduction in the number of cow-houses in the Metropolis, viz., from 1,044 in 1880, to 394 in 1896, or 22 fewer than in 1895. In Kensington, the reduction has been from 23 in 1880, to 4 in 1896. BAKEHOUSES. The bakehouses, to the number of 138, viz., 74 in North Kensington, and 64 in South Kensington, were, as usual, regularly inspected, and such action was taken, in individual cases, as was found to be necessary for ensuring compliance with the sanitary provisions of the Factory and Workshop Acts, 1878 to 1895, and the Public Health (London) Act, 1891, relating to bakehouses. In my annual report for 1894 (pp. 152 to 166 inclusive), when dealing with the "regulation of bakehouses," I summarised the steps which had then been recently taken by the County Council with the object of securing such an amendment of the law as would enable the Sanitary Authority to exercise an efficient control over bakehouses. The Council thought that the Factory and Workshops Bill, which was to be brought in by the Government in 1895, would "afford an opportunity for amending the law relating to bakehouses," and the Public Health Committee of that body subsequently waited upon the President of the Local Government Board to press their views with reference to the matter. The President stated that it was improbable that any clause would be inserted in the proposed Bill dealing with London bakehouses, as the Bill would have reference to the whole country and not particularly to London, and he suggested that the Council itself should introduce a Bill. In accordance with the Committee's recommendation, the Parliamentary Com- 126 miittee was, in January, 1895, instructed to prepare a Bill amending the law relating to bakehouses in London, in accordance with the Council's views; but no action appears to have been taken. One provision with reference to bakehouses is contained in the Factory and Workshop Act, 1895, in section 27 (3), to the effect that " a place underground shall not be used as a bakehouse unless it is so used at the commencement of this Act," i.e., at the beginning of the year, 1896. The value of this provision has been reduced almost to the vanishing point by magisterial rulings, that the disuse of an underground bakehouse subsequent to the 1st January, 1896, as by the premises becoming empty, does not prevent the use of them for the purposes of a bakehouse, however unsuitable in character they may be, upon the premises being re-occupied. A drafting amendment of the terms of the section is necessary to give effect to what may be assumed to have been the intention of the legislature, viz., that underground bakehouses vacant on, or vacated at any time after, January 1st, 1896, should not be again used for the purposes of the business. OFFENSIVE STREET SMELLS. I had occasion in 1895 to refer to the frequency of complaints, during the hot weather, of offensive smells arising from street gullies, sewer ventilating gratings, wood-paved roads, etc. I regret to have had to refer again to the subject in 1896. In the former year the Sanitary Committee recommended, with reference to these complaints— " That looking to the long-continued drought, and to the complaints" (which have been received relative to the offensive smells from gullies and wood-paved roads) " the Wharves and Plant Committee be requested to instruct the Surveyor to take all necessary steps for a more frequent cleansing of the gullies and wood-paved roads in this parish." 127 This recommendation was adopted by your Vestry, and a similar direction was given last year. It would be well, however, to authorise the Surveyor to do whatever may be necessary in regard to these matters, at all times, so as to avoid the delay involved in a -reference to the Committee. The annoyance caused by untrapped gullies, and sewer ventilating openings also, should not be suffered. Nor would it be if Sanitary Authorities gave effect to the provisions of section 7, of the Metropolis Management Act, 1855, which reads as follows:— 44 Every District Board and Vestry shall, by providing proper traps or other coverings, or by ventilation, or by such other ways and means as shall ha practicable for that purposa, prevent the effluvia of sewers from exhaling through gully-holes, gratings, and other opeuings of sewers in any of the streets or other places within their district *or parish." Such exhalations or effluvia constitute an undoubted nuisance, and they are not merely dangerous to health but injurious also. It is surprising that individuals affected by the disgusting smells do not seek the available remedy, by making complaint of the nuisance to a justice, under the provisions of section 12 of the Public Health (London) Act, 1891, which reads as follows— " Complaint of the existence of a nuisance liable to be dealt wit h summarily under this Act, on any premises* within the district of any sanitary authority, may be made by any person, and thereupon the like proceedings shall be had with the like incidents and consequences as to the making of orders, fines for the disobedience of orders, appeal, and otherwise, as in the case of a like complaint of the sanitary authority." Naturally, the complaints are commonly addressed to me, but all I can do is to inform the complainants that I have referred their grievances to the Surveyor. For remedy of the * ' The expression " premises " includes .... lands .... of any tenure, whether open or enclosed, whether built on or not, and whether public or private, and whether maintained or not under statutory authority.' Public Health (London) Act, 1891, section 141. (" Interpretation.") 128 nuisance what is necessary is, daily sweeping, washing, and disinfecting of wood-paved roads ; frequent emptying of gullies, followed by disinfection ; and copious Hushing of sewers with free use of sulphate of iron in solution as a disinfectant. But gullies should be trapped, especially in narrow mews; and the sewer ventilating gratings should be abolished and ventilating pipes be carried up to a sufficient height, and so placed as not to injuriously affect adjacent buildings. The carrying out of these measures would of course entail considerable expense, but money could not be better laid out; it is only right, moreover, that the inhabitants, whether rich or poor, should be protected from the nuisance, and the danger to health, resulting from the stenches from sewers, &c. DEFECTIVE SEWER VENTILATION IN MEWS. Reference was made in the eleventh report (October 8th) to outbreaks of infectious disease in mews, due, probably, to the escape of sewer gas at the level of the roadway, either through ventilating gratings or untrapped gullies. Consideration of instances of this kind induced me to have the several mews of the parish, to the number of 176, inspected with a view to ascertain the character and amount of the provision made for ventilating the sewers therein. Particulars are subjoined which show the number of instances in which there would appear to be no means of ventilation, unless by untrapped gullies, or by rain-water pipes connected with the drains, or by soil pipes of water closets. In other instances, there is surface ventilation, but, as a rule, to an inadequate amount, by means of gratings in the roadway, in addition to any ventilation that may be effected by gullies, rain-water pipes or soil-pipes, whilst in a few cases ventilation has been provided, more or less effectually, by means of a pipe or pipes carried up adjacent buildings. The subjoined table summarises the facts ascertained :— 129 NORTH KENSINGTON. Sanitary District. Number of Mews in which there is no visible apparatus for sewer ventilation. Number of Mews ill which the sewer is ventilated by one or more surface gratings only. Number of Mewt in which the sewer is ventilated by one or more speecial pipes only. Number of Mews in which the sewer is ventilated by one or more surface gratings and one or more special pipes. Total number of Mews. North 13 2 ... ... 15 North-east 37 2 6 1 46 North-west 12 1 1 ... 14 SOUTH KENSINGTON Central 8 ... 2 ... 10 South-east 38 9 11 3 61 South-west 18 6 5 1 30 Totals 126 20 25 5 176 In these mews there is an aggregate of about 751 drain inlets, of which some 131 appear to be properly trapped by stoneware street gullies. The subject of sewer ventilation in mews is of considerable importance, having regard to the narrowness of the roadway, which is usually the playground of the children who inhabit the rooms over the stables. In one mews in South Kensington, where a number of cases of scarlet fever and diphtheria, t.wo of which were fatal, occurred three years ago, I saw children playing cricket, the stumps being wedged between the bars of a stinking sewer grating. Your Vestry on my recommendation had the sewer in this mews ventilated by means of shafts, the surface gratings being abolished, and (whether propter hoc or post hoc) no child in this mews has since suffered from either of the diseases named. The recommendations I made in relation to this matter were (1) that grvllies in mews be effectually trapped ; (2) that surface sewer gratings be abolished ; (3) that ventilating shafts be erected in suitable positions; and (4) that, where practicable, sewers with dead ends be connected with adjacent sewers so as to allow of free currents of air. I also 130 pointed out that in the case of private mews your Vestry can provide, by notice, for the abatement of any nuisance dangerous to health arising from the lack of sewer ventilation, and that steps would be taken with this object. In regard to public mews it is obvious that conditions which involve danger to health should not be allowed to continue. The report was referred to the Sanitary Committee and it was resolved (November 10th): "That each case be treated on its merits, and that the Medical Officer of Health be requested to report from time to time on those mews where, in his opinion, the sewers should be ventilated by means of shafts." COMBINED DRAINAGE. Various Sanitary Authorities made representations to the County Council in 1894, asking that body to promote legislation " with a view to an alteration in the definition of the word drain and the word sewer" in the Metropolis Management Act, 1855 (sec. 250); and ultimately a deputation representing a large majority of the Vestries aud District Boards, waited upon the Main Drainage Committee with reference to the subject. This Committee subsequently (7th July, 1894), came to the conclusion that " a grievance exists, and that a heavy responsibility is thrown upon the local authorities to repair combined drains which were laid down for the benefit of the owners of the houses, and with the intention that the owners should be held responsible for their maintenance. Having carefully considered the matter," the Committee came "to the conclusion that the Council should, as the central authority, promote legislation in accordance with the views of the local authorities and upon their recommendation it was resolved : " That the Council do apply to Parliament for an amendment of the definition of the words sewer and drain in the Metropolis Local Management Act, in the way desired by the local authorities, and that it be referred to the Parliamentary Committee to prepare a public Bill, and take such other steps 131 as may be necessary for that purpose." Such a Bill ("Metropolitan Sewers and Drains ") was brought in on behalf of the Council last session, but it did not become law; and so far it does not appear to have been introduced during the current session. Legislation is certainly necessary, seeing that Sanitary Authorities are unwilling to carry out the provisions of the law, by repairing, as " sewers," conduits which they consider to be " combined drains" properly repairable at the expense of the owners of the houses drained, in common, thereby. Cases are not unknown in which a Sanitary Authority have neglected to abate nuisances, after the refusal of the owners of houses to comply with notices requiring them to execute work which, in the present state of the law, has been held by the highest legal authorities to be the duty of the Sanitary Authority. HOUSE TO HOUSE INSPECTION. When time permitted, house-to-house inspection was carried on during the year, as required by section 1 of the Public Health (London) Act, 1891 ; streets being dealt with as a whole in conformity with the instructions of your Vestry. This work had been in practical abeyancefor some time owing to more pressing engagements of the Sanitary Inspectors in regard to matters requiring attention day by day. But when these officers were relieved of the duty of supervising works of repair of underground drainage, it was felt that some of their time should be devoted to this important duty. I was of opinion, moreover, that their attention should be given, in the first instance, to some of the so-called better class streets, the houses in which are, in some cases, not so well sanitated, structually, as the houses in many of the poorer streets, which have properly received attention to the largest extent hitherto. I was led to suspect that this might prove to be so by observing in the Inspectors' diaries, that when they had had to inspect " good " houses, on complaint, or by reason of the occurrence of infectious disease thereat, the sanitary 132 appliances were but too commonly found to be defective in construction or in condition. In illustration of this statement, I subjoin the substance of the Inspectors' reports of a few of the houses inspected, as follows :— 1. Rainwater pipe connected direct into drain, and head thereof close to room window ; inefficient bell trap in yard ; waste pipe of sink direct into drain and head of tame close to room window; both w.c.'s badly supplied with water and foul and offensive ; soil pipe defective and unventilated ; waste pipe of bath insufficiently trapped. 2. Waste pipe of sink in direct communication with drain; rainwater pipe combined with soil pipe, and head of same close to room window ; inefficient bell trap in yard; ashpit defective and insufficiently covered ; both W.C.'s insufficiently supplied with water and foul and offensive ; slop sink insufficiently trapped. 3. Rainwater pipes (3) in direct communication with drain, and heads of same in too close proximity to living-room windows; inefficient bell trap in yard ; lower w.c. insufficiently supplied with water, and supply pipe (apparently) connected with drinking water cistern : no ashpit; soil pipe defective and unventilated; top w.c. foul and offensive and insufficiently supplied wioh water. 4. Offensive pan closet on third floor ; lavatory waste connected to soil pipe; w,c. in basement without water supply; rainwater pipe connected to soil pipe, and back addition rainwater pipe connected to drain ; drain not properly trapped from sewer or ventilated. 5. No water supply to basement w.c.; rainwater pipe connected to soil pipe; back addition rainwater pipe connected to drain; offensive pan closet on first floor landing in connection with drinking water cistern; lavatory waste pipe connected to soil pipe; interiors of both drinking water cisterns dirty ; drains not properly trapped from sewer or ventilated. The two streets in which these houses lie are of a superior class, oue of them however, being of much older date than the other. It is manifest that nothing but good for the occupiers can come of such inspections, followed as they are by notices for the abatement of the nuisances implied in the existence of sanitary defects so obvious and dangerous as those above set out. 133 THE HOUSING OF THE WORKING CLASSES. Bye-Laws for Houses Let in Lodgings or occupied by Members of more than one Family. Under the provisions of the Sanitary Acts of 1866 and 1874, regulations were made by your Vestry, in 1885, and some 1,500 houses have been registered thereunder. The said Acts having been repealed, and modified provisions in respect of bye-laws enacted in the Public Health (London) Act, 1891, the Local Government Board addressed a circular letter on the subject to the Sanitary Authorities in 1892, and again in 1894. In the latter communication the Board point out that the powers conferred by the new Act (section 94) " differ in some respects from those exerciseable under section 35 of the Sanitary Act, 1866, and section 47 of the Sanitary Law Amendment Act, 1874, in pursuance of which the regulations now in force in (this) district were made ; " inasmuch as section 94 of the new Act " no longer provides that such matters as the enforcement of privy accommodation, the paving of premises, the notices to be given in cases of infectious or contagious disease, the cleansing of cisterns, or the keeping of water-closets in good order, &c., shall be dealt with by regulations applicable to houses let in lodgings. These matters," it is added, " can be otherwise dealt with, in some cases by bye-laws made by the Sanitary Authority and applicable generally to all houses in the district, whether let in lodgings or not, and in others by bye-laws made by the London County Council." The Board's letter was accompanied by copies of " a model series of bye-laws, which they had caused to be prepared for the use of Sanitary Authorities under section 94 of the Act;" and it was stated that " these model forms were drawn up after very careful consideration by the Board of the regulations which might be properly enforced in the case of the class of houses to which the enactment applies." The Board's model clauses deal with none of the subjects referred to, and it was suggested 134 that your Vestry's existing regulations should be modified on the basis of the model clauses. Accordingly, the matter was referred to the Sanitary Committee to consider and report what modifications were necessary to bring the said regulations into conformity with the provisions of the Public Health (London) Act, 1891. This subject being new to a considerable proportion of the members of your Vestry, I thought it desirable, when preparing my annual report for 1894, to give an outline of former proceedings with regard to it. To what I said in that report (pp 191-199) I have little to add now, inasmuch as the matter stands practically where it did two years ago, when the Sanitary Committee approved the modified bye-laws I had drafted for their consideration, and decided to recommend the adoption of them by your Vestry. Meantime, however, they thought it well to forward the proposed bye-laws to the Local Government Board tentatively, to ascertain if they were such as the Board would be prepared to sanction. After waiting a long time, and no reply being forthcoming, the proposed bye-laws were submitted to your Vestry, and, after discussion, were referred to the Law Committee and the Sanitary Committee, jointly, for further consideration and report. With a view to lightening the labours of the joint Committees, I prepared a statement showing "generally, in what respects the proposed new byelaws differ from the existing bye-laws, and from the model series framed for the guidance of the Sanitary Authorities by the Local Government Board." (Vide No. 4 monthly report, April 25, 1895, pp. 50-60 inclusive). To this report I subjoined a list of streets, showing the number of houses in each which had been registered since 1885, and a further list of some of the principal streets the houses in which, so far as they are let in lodgings or occupied by members of more than one family, appeared to be proper to be registered under the provisions of the Act. (Vide page 139.) The joint Committees submitted their report on July 31,1895, and the bye-laws in the 135 shape recommended by them were on that day adopted by your Vestry, and ordered to be sent, and they were sent forthwith, to the Local Government Board for their sanction. On the same day a communication had been received from the Board intimating their willingness to approve, with a few, mostly verbal, amendments, the bye-laws which the Sanitary Committee had tentatively forwarded for their consideration five months previously ; these bye-laws, I may add, differing in some material respects from the bye-laws adopted by your Vestry, and forwarded to the Board. After a further long interval of time the Board returned the bye-laws, with suggested amendments. To some of the Board's suggestions your Vestry demurred, and a further communication was made to the Board, urging, inter alia, the desirability of a proposed bye-law requiring the landlord of a registered house to give notice to the Sanitary Authority when intending to carry out the annual cleansing, so as to enable the Sanitary Inspector to supervise the execution of the work. The Board had expressed doubt as to the competency of the Sanitary Authority to make such a bye-law.* Regarding the desirability of such a power being given, there can be no question. The matter is still unsettled. Nothing has been done towards the registration of houses since the Public Health (London) Act, 1891 came into operation; the Sanitary Committee considering it desirable that new registrations should be made subject to bye-laws conforming to the provisions of that Act, as recommended by the Local Government Board in 1892. * The Board's suggestion was that a definite period should be fixed for the execution of the works of cleansing, &c., meaning one month, so that the Sanitary Authority, knowing about when the work would be in progress should have a chance of being able to exercise supervision, The period limited by the proposed bye-laws, March 1st to August 1st inclusive, is so prolonged that it is practically impossible to supervise, as the Inspectors rarely know when the work is likely to be in progress. 136 I have only to add that registration, whilst facilitating the work of the department, has given rise to none of the evils feared by the owners and occupiers of houses proposed to be registered; that the existing bye-iaws, made in 1885, have worked smoothly, and without objection by any of the parties affected by them; and that the extension of the operation of the bye-laws to all tenemented and other houses occupied in lodgings by the poorer classes, would, with an adequate inspecting staff, be an unmixed benefit from the public health point of view, by enabling the Sanitary Authority to maintain the conditions necessary to secure healthy homes for the people who, in regard to such matters, have little power to help themselves. Registered Houses.—At the request of the Sanitary Committee a return was prepared last year, showing the streets in which houses have been registered, the number of the houses registered in each street, and the number of houses not registered in the several streets. I subjoin a copy of the return, which was made for each of the sanitary districts, as follows:— • NORTH SANITARY DISTRICT. Name of Street. No. of Houses in Strret. No. of Houses Registered No. of Houses not Registered Absalom Road 22 16 6 Adair Road 33 26 7 Appleford Road 46 43 3 Bransord Street 13 31 3 Edenham Street 33 31 2 Gol borne Gardens 2S 21 7 Southam Street 128 124 4 Totals 303 271 32 137 NORTH-EAST SANITARY DISTRICT. Name of Street. No. of Houses in Street No. of Houses Registered. No. of Houses not Registered. Bolton Road 33 27 6 Convent Gardens 29 22 7 Portland Road 121 70 51 Totals 183 119 64 NORTH-WEST SANITARY DISTRICT. Name of Street. No. of Houses in Street No of Houses Registered. No. of Houses not Registered Rangor Street 39 31 8 Barandou Street 19 10 9 Oalverley Street 17 11 6 Crescent Street 39 17 22 Martin Street 15 5 10 St. Clement's Road (including Edin- 5O burgh Terrace) 120 70 St. Katharine's Road 112 97 15 William Street, Netting Dale 21 2 25 Totals 412 207 145 CENTRAL SANITARY DISTRICT. Name of Street. No. of Houses in Street. No of Houses Registered. No. of Houses not Registered. Campden Street 71 59 12 Church Court 3 2 1 Cousins Terrace 7 5 2 Dartmoor Street 61 57 4 Duke's Lane 10 10 — Edge Street 37 19 18 Ernest Street 20 20 — Farmer Street 26 20 6 Jameson Street 31 29 2 Johnson Street 29 16 13 Kensington Place 47 36 11 Lome Gardens 32 23 9 Newcombe Street 22 16 6 Peel Street 71 44 27 Uxbridge Street 52 29 30 William Street. Notting Hill Gate 18 15 3 Totals 53 7 393 144 138 SOUTH-EAST SANITARY DISTRICT. Name of Street. No. of Houses in Street. No of Houses Registered. No. of Houses not Registered. Clifton Place 8 8 Merton Road 34 32 2 South End 22 2 20 South-End Row 6 4 2 St. Alban's Road 18 10 8 Trafalgar Place 5 3 2 Yeoman's Row 48 41 7 Totals 141 100 41 SOUTH-WEST SANITARY DISTRICT. Name of Street. No. of Houses in Street No of Houses Registered. No of Houses not Registered. Ashley Cottages 27 15 12 Blithfield Street 17 17 — Childs Place 19 16 3 Childs Street 26 11 15 Itield Road 152 136 16 North Row 22 15 7 North Street, St. Mark's 15 15 Pembroke Road 63 12 51 Prince Teck Buildings 14 6 8 Radnor Terrace 5 4 1 Seymour Place 57 85 22 Shaftesbury Road 26 16 10 South Street, St. Mark's 19 16 3 St. Mark's Road 22 16 6 Stamford Cottages 10 7 3 Wallgrave Road 31 23 8 Walljjrave Terrace 13 13 - Warwick Road (late Lily Terrace) 6 5 1 Warwick Road (late Warwick Terrace) 25 15 10 Totals 569 393 176 The information contained in the above return may be summarised as follows :— District. Number oi Streets dealt with. Number of Houses in Streets Number of Houses Registered. Number of Houses not Registered North Sanitary District 7 303 271 32 North East Sanitary District 3 183 119 64 North-West Sanitary District 8 412 267 145 Central Sanitary District 16 537 393 144 South East Sanitary District 7 141 100 41 South West Sanitary District 19 569 393 176 Totals 60 2,145 1,543 602 139 Many of the houses in the last column of the return were not let in lodgings or occupied by members of more than one family when the other houses in the same streets were registered, between the years 1885-89. Inspections made in 1895 showed that many of the non-registered houses were at that time so occupied, and a report to that effect was made to the Sanitary Committee. The Committee, however, decided not to register any more houses pending the confirmation by the Local Government Board of the proposed new bye-laws; and, as already stated, no houses have been registered since the passing of the Public Health (London) Act, 1891. In the fourth monthly report for 1895, this subject was fully dealt with (pp. 50—63 inclusive), and I submitted " a list of some of the principal streets, the houses in which, so far as they are let in lodgings or occupied by members of more than one family, would appear to be proper to be registered," as follows :— (1) North District.—Branstone Street,Rackham Street, Raymede Street, Swinbrook Road, Tottenham Street, Treverton Street, and Wheatstone Road. (2) North-east District.—All Saints' Road, Bucking- ham Terrace, Dulford Street, Lonsdale Road, St. George's Road, Talbot Grove, and Western Terrace. (3) North-west District.—Blechynden Street (north of Bramley Road), Hurstway Street, Manchester Street, Royal Crescent Mews, St. James's Place, Testerton Street, Tobin Street, and Walmer Road (south of Lancaster Road). (4) South-east District.—Chapel Place, Garden Row, Lloyd's Place, Middle Street, New Street, and Rutland Street. (5) South-west District.—Barker Street, Emma Place, Holmes Place, Kensington Buildings, Park Terrace, and Providence Terrace. No action was taken upon the report. 140 OVERCROWDING. I have had on many occasions to refer in the monthly reports to the offence of overcrowding, and last year I drew attention to a case which had attracted attention in the press, as an illustration of a common mode of bringing about this dangerous nuisance. A married couple obtained a " furnished" room (having a capacity of 1,300 cubic feet) in a registered house in St. Clement's-road (in the "Notting-dale" district) for themselves and three young children. Soon after they took possession two older children were introduced, the family thus comprising seven persons, equivalent to five adults, requiring an air space of 2,000 cubic feet. The "keeper " of the house did not report the nuisance to us, but he called in the Inspector for the National Society for the Prevention of Cruelty to Children, and ultimately proceedings were taken against the father and mother, who were sent to prison for six weeks and one month respectively. It is a common practice with people having large families to conceal the number of their children until after entering into possession of their lodging—usually a single room ; and then, should it be desired to get rid of them, all the tedious processes, by notices, police-court proceedings, &c., have to be gone through, these occupying many (at least six) weeks,during which time the unfortunate landlord may not receive any rent on peril of failure to obtain an ejectment orderIn the above case, had it been reported to me, proceedings could have been taken under the second bye-law for houses let in lodgings or occupied by members of more than one family, but these would have occupied two or three weeks at the least. The people were in occupation of the room for nine weeks, the nominal taking, however, being by the day or night; but no rent, it is stated, was paid during the last five weeks. The "keeper" of a registered house is equally liable with the ''lodger" for the offence of overcrowding, and as I pointed out in the ninth report (August 13th, page 111), it would be well if a bye-law were made requiring him, under penalty, to 141 report any case of overcrowding to the Sanitary Authority: it would have been to the keeper's interest to do so in the above case and it is difficult to understand why he failed in so obvious a duty. On consideration of the report, your Vestry decided (23rd September), to apply to the Local Government Board for sanction to a bye-law requiring the keeper of a registered house to report overcrowding, as follows "If any lodger in a registered house cause or suffer any room under his control to be occupied by a greater number of persons than is allowed by this bye-law. it shall be the duty of the keeper of the registered house, upon his becoming aware of the fact, to notify such fact to the Medical Officer." The Local Government Board's views on the subject of this proposed bye-law have not yet been received. The Utility of Bye-laws.—In connection with the question of overcrowding reference may be made to a case which serves as an illustration of the utility of bye-laws. The keeper of a registered house, who had had a notice served upon him to abate overcrowding, applied to the Magistrate at the West London Police Court for advice. He stated that he had been required to abate the nuisance within three days, but could not comply because the tenants (six persons living and sleeping in one room) would not go out. He desired, therefore, to have an ejectment order. The Magistrate, presumably unacquainted with the provisions of your Vestry's bye-laws, observed that the applicant would have to serve the tenant with the proper notice, the first step in a process for ejectment which usually requires about six weeks for its completion. But the applicant (as "keeper" of the registered house) was equally liable with the, "lodger" to the penalties prescribed by the bye-law for the offence of overcrowding, and, somehow, he succeeded, without much loss of time beyond that allowed him by your Vestry, (for he was not entitled to notice) in getting rid of his objectionable tenants, and thus abating the nuisance. 142 COMMON LODGING-HOUSES. The County Council have taken over from the police the supervision of Common Lodging Houses, under the circumstances set out in my Annual Report for 1893 (p. 207). I am indebted to the Council's Medical Officer of Health for the subjoined Return of the common lodging-houses in this parish, which are 32 in number, and contain accommodation for 943 persons. Sanitary District. Name of Keeper. Address of Common Lodging House. No. of Single Lodgers for which registered in 1806. N'o. of Double Beds Authorized. Male. Female Total. N. Marsh, Hy. Chas. 88, Wornington Road 35 -35 - N.W. Moore, John 21, Bangor Street 23 — 23 - „ Do. do. 23, do. — 9 9 10 „Do. do. 25, do. 33 — 33 — „ Do. do. 29. do. — 21 21 5 „ Slater, William 10, do 24 — 24 - „ Phipps, William 18, do. 32 - 32 - „Do. do. 20, do. 54 — 54 — „ Reynolds, Charles 35, do. 35 — 35 - „ Phillips, E. S. 5, do. 25 — 25 — „ Do. do. 7, do. 29 — 29 - „ Do. do. 9, do. 24 — 24 - „ Hanking, George 10, Crescent Street 23 7 30 1 „ Do. do. 28, do. 2 14 16 7 „ Do. do. 30, do. 30 — 30 — „ Do. do. 40, do. 14 14 5 „ Phipps, William 25, do. 35 — 35 3 „ Do. do. 27, do. 9 17 26 - „ Do. do. 31, do. 34 — 34 — „ Do. do. 33, do. 20 — 20 6 „ Hallett, Thomas 4, Hesketh Place — 9 9 5 „ Do. do. 6, do. — 6 6 3 „ Do. do. 8, do. - 14 14 3 „ Simpson, James 1, Mary Place 16 — 16 — „ Do. do. 2, do. 21 — 21 — „ Davis, Mark 66, St. Ann's Road 43 7 50 12 „ Phipps, William 28, St. Clement's Road 13 — 13 6 „ Do. do. 30, do. 35 - 35 — „ Bailey, Henry 29, do. 30 - 30 — „ Do. do. 31, do. 25 - 25 — C. Redman, John 24, Peel Street 20 - 20 - ,, Do. do. 22, do. 23 — 23 — Twenty-three of the Common Lodging-Houses, with accommodation for 703 persons, are located in the "Notting Dale" special area. 143 In connection with the inquiry by the Special Committee, dealt with in the next paragraph, as to the causes of the high rate of mortality in the "Notting Dale" Special Area, an application was made to the County Council to define the meaning of the term "Common Lodging-house," to which a reply was received, in October, from the Council to the following effect:— "The Council is advised that in order to bring a house within the operation of the Common Lodging-Houses Acts, 1851 and 1853, it is essential that the following facts should exist: — 1. The house must be kept by somebody for the purpose of gain. 2. It must be open for the reception of all comers as lodgers. 3. The persons resorting to the house must be of such a class as, if left to themselves, would either be unwilling or unable to secure cleanliness and prevent overcrowding. 4. Some one room or rooms in the house must be used in common by all the lodgers. "A large variety of circumstances might arise in any particular case which might come before the Council, but it is safe to say that if in any case one of the four facts above mentioned were absent, it would be a doubtful question whether the house could be regarded as a common lodging house within the meaning and intention of the statutes, and such a case would need special and particular consideration. ''This opinion has been come to after a careful study of the decisions in the following cases:— Booth v. Ferrett.—Decision by Lord Chief Justice Coleridge and Mr. Justice Mathew. Langdon v. Broadbent.—Decision by Mr. Justice Grove and Mr. Justice Lindley." It is manifest that the houses in the "Notting Dale" special area cannot, under the provisions of the existing law, be dealt with as Common Lodging Houses, excepting in so far as they may be registered as such by the Council upon the application of the owners—a fact which the Special Committee fully recognize in their report. 144 "NOTTING DALE" SPECIAL AREA. This report would be incomplete without some reference to that portion of the North-west Sanitary District which, in 1893, was irreverently described as "A West-end Avernus," but which is of late more decorously known, locally, as the "Notting Dale" Special Area. In the last monthly report for 1895) published in January, 1896, and in the first two reports for 1896, attention was directed to the deplorable statistics, vital and mortal, of this limited area, which comprises St. Katharine's-road, William-street, Bangor-street, Crescent-street, and part of St. Clement's-road. Your Vestry manifested no little concern in regard to these statistics, which dealt with the general death-rate, the infantile death-rate, and the zymotic death-rate; and in the hope of being able to do something to ameliorate the sad condition of the inhabitants, by ascertaining the causes of such abnormal rates, a Special Committee was appointed.* This Committee, over which the present Chairman of the Vestry presided, and of which the late Chairman of the Vestry (now Bishop of Peterborough) was an active member, held several meetings, visited the locality twice, and took evidence, both oral and written. In July the Committee presented their report, in which, to put the matter briefly, they attributed the bad condition of the houses, and the evil state in which the inhabitants were found, or represented, to be, to the vicious proclivities and evil habits of the people themselves. They stated that they did not find the area in question to be "an insanitary or unhealthy area;" they regarded "the situation as a healthy one;" the high death-rate being "due to the habits and conditions of the people themselves"—the "filth and dirt * The Committee was appointed, pursuant to a resolution (11th March, 1896) to the effect:—"That the several reports which the Medical Officer of Health has submitted to the Vestry relating to Division B of the North-West Sanitary District, be referred to a Special Committee for consideration and report as to whether any steps can be taken by the Vestry, either singly or in conjunction with some other Authority, to effect an improvement in the conditions at present prevailing in the district in question." 145 of many of the people "being" at once the cause and effect of the filth and dirt of their abodes"—though "the houses as structures are not bad." The specially evil conditions affecting the people had been represented to the Committee as "overcrowding, drunkenness, prostitution, and inherited disease," the people themselves being "largely made up of loafers, cabrunners, beggars, tramps, thieves, and prostitutes"; a "deplorable state of things "existing, "the ordinary laws of decency being disregarded or set at defiance." The locality was said to be "not a very poor one," the population on the whole being a stationary one. "No doubt some work-people and their families find homes here, but this does not leaven the mass." "Great numbers of rooms in the district are let out as furnished apartments," in houses which "should be brought under control and registered as common lodging-houses," of which there are many in the district, the condition of these being "superior to those which are not and cannot be registered" as such. The Committee reported that "the evils described are spreading, and the character of several neighbouring streets is rapidly deteriorating." Reference is made to the insanitary condition of the yards at the rear of the houses; and to the streets as "the playgrounds of a large number of children who do not resort to Avondale Park," into which "additional entrances should be made." The Committee took note of the "unsatisfactory attendance of the children at school," a matter of great concern, as, "though it may be impossible to do much for the adult portion of the population, it is plainly our duty to see that everything is done that can be done for the children, who, living under the conditions indicated, lose all abhorence of the evils which unhappily surround them." The Committee were of opinion that the necessity of sanitary inspection "can hardly beover-stated," but they qualify their opinion by adding that "this does not necessarily mean an increase to our permanent staff of sanitary inspectors," which, in fact, had been reduced a few days prior to the appointment of the Committee. "A sufficient staff of sanitary inspectors" is stated to be "absolutely necessary," 146 between April and August, when, "under No. 7 of our bye-laws there is to be a thorough cleansing" of houses let in lodgings oroccupied by members of more than one family, and registered— as "the evidence clearly shows that this cleansing is often done in the most perfunctory and unsatisfactory manner, even if it be done at all." It was "satisfactory to note that, in the judgment of several witnesses, an immense amount of good could be done if the (said) bye-laws were stringently and rigidly enforced," which, I may add, is not possible in present circumstances. The water supply was described as "satisfactory and constant"; that is to say, it is on the "constant" system; but in nearly all cases the water is delivered into cisterns of which not much cau be said that is satisfactory. Reference was made to the inadequacy of water-closet accommodation, a matter which, as the Committee noted with satisfaction, was being dealt with by the Sanitary Committee. The Committee say it is "clear the time has come for the application of stringent and even exceptional remedial measures," which they sum up in "Recommendations for adoption by the Vestry" (and which were adopted) "as summarizing the several suggestions embodied" in their report. These recommendations are shortly as follows:— (a) That the Sanitary Committee should require the owners to asphalte or pave with impervious material the yards in the rear of the houses; which has not yet been done. (b) That "one or two of the streets" should be asphalted; and three of the streets and a part of a fourth street are being done. (c) That additional entrances should be made to Avondale Park; and negotiations are in progress for the acquisition of land for one such new entrance. (d) That the Sanitary Committee should "arrange for the suggested increase of sanitary inspection in the district" (without increase to the permanent staff of Inspectors), "with a view to the more strict enforcement of the existing bye-laws . . . relating to houses let in lodgings"; but nothing has yet been done to give effect to this recommendation, nor 147 can increase of sanitary inspection be had without increase to the stall' of Inspectors, unless by employing the services of the Inspectors of the other sanitary districts. (e) That the Sanitary Committee should "see that particular attention is given to those cases where the bedding and other contents of the room are in such a state as to cause the premises to be a nuisance, or injurious or dangerous to health, in order that the provisions of the Public Health (London) Act, 1891, may be applied to secure the cleansing or destruction of the said articles so that the nuisance may be abated." Practically little or nothing has been done to give effect to this recommendation; the Sanitary Committee not seeing their way to cleanse bedding, etc., or to replace it, when destroyed, at the public cost. (f) That street gullies should be efficiently trapped. This is now being done in connection with the asphalting of certain streets. A further recommendation, made by myself, to abolish the surface sewer ventilating openings, and to substitute ventilating shafts carried up against houses, was approved by the Sanitary Committee and your Vestry, and has been carried out. (g) "That representations be made to the Local Government Board for an amendment of the law, so as to extend the machinery of the Common Lodging Houses Acts to those houses the rooms of which are let out at practically nightly rents." This has not yet been done. (h) "That a communication be addressed to the School Board for London, pointing out the absolute necessity for action on the part of the Board to enforce the attendance of the children at the schools in the locality." Such a communication was made to, and not very graciously received by, the Board, who appeared to regard the suggestion as a somewhat unnecessary interference, and adopted the tu quoque line in their reply. (i) That "particular attention" should be given "to the periodic and frequent removal of refuse from the houses;" and the refuse is now removed twice in each week where practicable. (j)That the County Council be requested to alter the names of some of the streets in the district; a request which has been complied with, new names having been substituted for Williamstreet and St. Clement's-road. 148 The Committee conclude their report with thanks "to all those who have assisted them by supplying information, or by reporting to them as to the condition of the district." Apart from the oral evidence given by three clergymen, a district medical officer, a relieving officer, and a member of the Vestry, all of which was summarised by the minuting clerk, the Committee had the benefit of written reports by three of their own members, and by three School Board attendance officers. The Vestry Clerk also submitted an interesting memorandum setting out the building history of the district and other particulars relating thereto. My share in the work of the enquiry was limited to the preparation of a draft report, setting out in detail the results of the observations made by the Committee on their view of the locality. These several documents throw light upon the subject of the Committee's enquiry, and would not have detracted from the interest of the report, had it been thought desirable to publish them as an appendix thereto. The report was brought up 1st July, but the consideration of it was adjourned until 15th July, when it was unanimously adopted without discussion. It was then moved:— "That the Vestry having received and adopted the report of the Special Committee with reference to that part of the Parish called Notting-dale, recommend that a public meeting of the inhabitants of Kensington be called to consider the report, and that the several Vicars and other Clergymen having charge of Parishes and Districts within the Deanery of Kensington be specially invited to be present." After debate the motion was, by leave of the Vestry, withdrawn. But it will be seen (vide page 158), that the course recommended by the mover, was, in effect, subsequently recommended by the Diamond Jubilee Committee, approved by your Vestry, and carried into effect. It will be remembered that in March, 1893, the Sanitary Committee submitted to your Vestry a report upon the district, which, together with the substance of my own reports on the 149 subject, may be seen in the annual report for 1892-93 (pages 152163 inclusive). The report of the Committee was by no means of a wholly unfavourable character, and a few extracts therefrom may not be out of place here. Dealing with the bye-law which provides for an annual cleansing of the registered lodging houses, and the majority of the houses are registered,* the Sanitary Committee observed that "a prime obstacle to carrying out work of this kind satisfactorily arises from the difficulty of emptying the rooms of their inhabitants whilst the work is in progress; and it would be well," they said, "if temporary shelters for a few families could be provided, so as to give the workmen vacant possession of the rooms successively. But," they significantly added, "there are no empty houses in the district." The Committee went on to say, that, "on all sides," they observed, "the fruits of their labours during the last few years, in well-ventilated drains, disconnected wastepipes, flushing tanks for water-closets, &c. Not all of the houses," they added, "have been provided with these modern sanitary arrangements, but the work of improvement will be continued to completion." A good deal of additional work of a like kind, I may observe, has since been carried out, but in one respect, perhaps the most important of all, the work came to an end when the Committee discontinued the issue of notices for the reconstruction and trapping of drains, a matter already referred to. The Committee further stated that it had "been suggested that steps should be taken by the Vestry to get the several streets condemned as insanitary (or unhealthy) areas," but that they "saw no occasion for any such drastic and costly procedure," under Part I. of the Housing of the Working Classes Act, 1890. "There may be," they added, "a few houses which it would be desirable to close temporarily," under Part II. of the last named Act, or under the Public Health (London) Act, 1891, "as being, at present, 'unfit for human habitation'; but there are * See list at page 137, the streets being, as before stated, St. Katharine'sroad, William-street, Bangor-street, Crescent-street, and part of St. Clement'sroad. 150 none, probably, that cannot bo repaired and made good at more or less expense." Effect was subsequently given to this suggestion, sixteen houses on the north side of William-street having been closed by the magistrate, upon my certificate, and put into thorough order by their owners under the supervision of your Vestry's Surveyor. The Committee, extending their observations to the adjacent "Potteries" district, observed that "some of the streets have been asphalte-paved with manifest advantage in respect of cleanliness, and (they) would gladly see this system of paving extended both in the Potteries, and in the so-called 'Avernus' district." Nothing came of this suggestion at the time, but it is now bearing fruit, the Special Committee of 1896 having endorsed the recommendation to which effect is being given at the present time (March, 1897). Referring to the particular sanitary defects observed, the Committee said "it is almost needless, perhaps, to point out that such sanitary defects . . . are of constant recurrence in houses occupied by the lowest classes, and are largely brought about by the dirty and careless or mischevious habits of the people themselves." The report concludes with a pregnant expression of opinion, viz., that "what appears to be most needed in these districts is frequent house-to-house inspection; and with a view to secure this," the Committee recommended the appointment of a temporary Sanitary Inspector. Your Vestry adopted the Committee's report, and an additional Inspector was appointed, for one year, to take charge of what was, until February, 1896, described as Division B of the North-west district. Subsequently, your Vestry decided to make the appointment a permanent one, thus raising the Inspecting Staff to seven; but in February, 1896, about a fortnight before the appointment of the Special Committee, it was resolved to dispense with the seventh Inspector. Moreover, the district assigned to the Inspector for the North-west district (Division B), which includes the "Notting Dale" special area, was enlarged; but in October the district was reduced to its original dimensions, as 151 already explained, and was re-named "North-west," alterations at the same time being made whereby large additions were made to the districts now described as North-east, and Central. As to the North-west district, as delimited in October, particulars as to acreage, population, number of separate families, and number of inhabited houses, and of tenements of less than five rooms, may be seen in the table at page 112. It has already been mentioned that it is, at present, impracticable to give effect to the recommendation of "frequent house-to-house inspection" which the Sanitary Committee in 1893, and the Special Committee in 1890, alike regarded as of prime necessity. The work done in the five streets in 1896 was as follows:— Name of Street. Number of Houses in Street. Number of Houses Inspected. Number of Inspections. Number of Re-inspections. Bangor-street 39 39 59 184 Crescent-street 38 38 81 219 St. Clement's-road (part of) 38 38 70 176 St. Katharine's-road 110 91 118 538 William-street 50 49 70 40 275 255 398 1157 152 the difficulty in getting the work carried out with the proper expedition. The Inspector, I may add, gave as much attention to the "Special Area" as he could, having regard to the claims upon his time of the district generally, his work in which, so far as it can be tabulated, is set out in Table VI. (Appendix.) "Notting Dale" Statistics in 1896.—The inquiry by the Special Committee, above referred to, was the outcome of the statement of the vital and mortal statistics of the special area, in 1895, as set out in the last monthly report for that year and the first two reports for 1896. I regret that I have nothing more favourable to report in respect of the latter year; for, as we have already seen, the death-rate was excessive (50 per 1000), and the death-rate from diseases of the zymotic class was abnormal, being 8.0 per 1000, as compared with a rate of 2.7 for the parish as a whole. The deaths of infants under one year, moreover, were in the proportion of 432 to 1000 registered births. The deaths from all causes (187) exceeded the births (118) by 69. The deaths and the death-rate in the several streets were as follows:- St. Katharine's Road, 64 deaths, death-rate 48.6 per 1,000; Bangor Street, 46 deaths, death-rate 52.6 per 1,000; Crescent Street, 29 deaths, deathrate 40.9 per 1,000; St. Clement's Road (part of), 28 deaths, death-rate 56.5 per 1,000; William Street, 20 deaths, deathrate 48.3 per 1,000. Of the 187 deaths, 77 took place in the locality—"at home;" 98 at the Parish Infirmary; 5 at the Western Fever Hospital; 2 at lunatic asylums; 2 at hospitals 1 at a "Home;" 1 at a police station, and one in a garden. The ages at death were as follows:—In 51 cases under one year; in 31 cases between one and five years; in 6 cases between 5 and 20 years; in 70 cases between 20 and 60 years; and in 29 cases at 60 years and upwards. The causes of death include 44 from tubercular diseases and wasting diseases (i.e., atrophy, debility and inanition); 49 from diseases of the heart and lungs; 30 from diseases of the zymotic class; 17 from diseases of the nervous system, including convulsions; 7 from cancer; 6 from syphilis; 4 from old age; and 30 from various other 153 causes, including seven deaths from violence, viz., two of women from injuries (verdicts of manslaughter having been returned), two of infants suffocated, one in bed with the parents and one otherwise, but how is unknown; one of a child at 3, from injuries due to an accidental fall, one of a man from injuries, also due to an accidental fall, and one of a woman from internal hemorrhage from violence—how caused is unknown. These deaths from violence were in the proportion of 3.7 per cent. on total deaths; the relative proportion for the parish, as a whole, being 3.5 per cent. Fifteen inquests were held, viz., in the seven cases of violence and in eight cases of death from "natural causes." The proportion of deaths in respect of which inquests were held to total deaths, was 8.0 per cent., the relative proportion of such cases in the parish, as a whole, being 8.2 per cent. The recommendations of the Special Committee designed to effect an amelioration of the conditions of life in the district, to which in their report the excessive mortality is attributed, have already been set out, in brief (at page 146). In the second report for 1896 I dealt, in a measure, with those conditions, and suggested remedies. For what it is worth, I reproduce here what I had to say on the subject a year ago. And firstly, with regard to the question of— Overcrowding, the figures I submitted went to show that, on an average, there was not much appearance of overcrowding, the average number of persons to a room, being, in round numbers, two. The houses, apart from the 23 common lodging houses, number about 253; they contain about 1,606 rooms, which were inhabited by 1,187 families, comprising 3,231 persons. At the same time it can hardly be doubted that individual cases of overcrowding are by no means rare. The table at page 154, showing the occupation of the houses, needs no comment, excepting that ten persons in any one of the houses in the district would not constitute overcrowding, provided that the lodgers were evenly distributed in the several rooms, 154 "NOTTING DALE" SPECIAL AREA: OCCUPATION OF HOUSES. Number of Persons to a House in 1896. Bangor Street. Crescent Street. St. Katharine's Road. William Street. St. Clement's Road, South of Board School. Total Houses. Nos. 1 to 63. No. 64 and upwards. 10 roomed houses. 8 roomed houses. 7 or 8 roomed houses. 5 roomed houses. 5 or 6 roomed houses. 7, 8 or 9 roomed houses. Under 10 persons to a house 2 4 6 41 28 15 96 Between 10 and 15 persons to a house 1 9 16 8 21 4 59 ,, 15 ,, 20 „ ,, 4 12 22 ... ... 9 47 ,, 20 „ 25 ,, ,, 10 2 16 ... ... 2 30 ,, 25 ,, 30 ,, ,, 8 4 1 ... ... 5 18 30 persons and upwards „ 3 ... ... ... ... ... 3 Totals 28 31 61 49 49 35 253 The above statement takes no cognizance of common lodging houses, which, to the number of 23. are registered and are under the control of the County Council, viz:-11 houses in Bangor Street, with accommodation for 339 persons (31 to a house), in which it was stated that there were 252 persons at the date of inquiry: Crescent Street, eight houses for 249 persons (31 to a house), in which it was stated that there were 238 persons; and in St. Clement's Road four houses for 115 persons (29 to a house), in which it was stated that there were 88 persons. 155 On the subject of Tenancy, I stated that— In the houses let in lodgings (for there are some houses occupied by single families) the rooms are very seldom let by the week, a rent book being supplied. In a considerable proportion of the weekly tenancies the rooms are let "unfurnished." In almost every instance the "furnished" rooms are let by the night; sometimes, however, a room is let for seven nights on the prepayment of the rent for six nights. Generally, the nightly rent is paid in advance. No doubt bad debts are sometimes made, especially in the case of weekly tenants with rent books; but on the whole there is good reason for believing that the "house-farmers," of whom there are not a few, manage to make a good living by their business. The Sanitary Committee requested the Law and Parliamentary Committee to advise them "as to whether a large number of the houses . . . could not be registered as common lodging-houses?"; and it would be well if this could be done. But it is impracticable, as, according to the Law Officers of the Crown, who were consulted many years ago. the term "common lodging house" appears "to have reference to that class of lodging-houses in which persons of the poorer class are received for short periods, and. though strangers to one another, are allowed to inhabit one common room:" the "obvious intention" of the law being "to distinguish lodgers promiscuously brought together from members of one family or household." The period of letting is unimportant in determining whether a lodging-house comes under the Common Lodging-Houses Act. It signifies little that, "if the inmates of a lodging-house allege that they are members of the same family, the burden of proving such allegation lies on the persons making it," for there is no one interested in the question; disproof, moreover, would be in many cases impossible. In the case of a common lodginghouse there is a common sitting room or kitchen in which the lodgers rest and cook their food. The bedrooms are furnished with bedsteads, necessary bedding, and chamber utensils, and, so far as my observation goes, with nothing else. Such houses are. in this parish, regularly cleansed, ventilated, &c.. and generally kept in good sanitary condition. It is, as a rule, far otherwise in regard to the houses let in lodgings even when these are "registered," as most of the houses in the district are, the necessary supervision being impracticable. Remedies.—Under this heading I observed that it would naturally be asked, 'Is there no remedy for the state of affairs found to prevail in the district? and, Can nothing be done to improve the general health, to lessen the excessive mortality? The answer to these questions, I said, is that everything should be done that can be done to enforce the provisions of the Public Health (London) Act, 1891, and the bye laws framed thereunder. But to secure this, the most essential 156 condition is that "frequent house-to-house inspection" recommended by the Sanitary Committee in their report made in the early part of 1893. This, unhappily, cannot be done, seeing that, even before the recent enlargement of the Inspector's district (which has had added to it upwards of 700 houses with a population of more than 4,000), there were some 1,600 houses under his charge, containing a population of 16,000 persons, comprised in about 3,700 families, very many of which were in occupation of a part of a house—often a single room—the number of tenements in the district of less than five rooms each, being close upon 3,000.* It is impossible to make a single thorough inspection of each of these tenements in the course of a year, much less "frequent house-to-house inspection." Still, what can be done, should be done, and I do not know anything more important than to insist on compliance with your Vestry's Bye-law (No. 7), which requir's that— "The owner of a registered house shall cause the walls and ceilings of every room, and of the common passages, staircase, waterclosets, and out-houses thereof, to be thoroughly stopped, cleansed, and, where not painted or papered, well and sufficiently whitewashed or coloured, at least once a year, between the months of April and August both inclusive, and at any other time when necessary." 'In many of the houses the water-closet accommodationis deficient, but means are being taken to enforce the County Council's Bye-law, which, corresponding with your Vestry's Bye-law, requires that— "The owner of a registered house shall provide and maintain accommodation in the proportion of one properly constructed water-closet for every twelve persons lawfully occupying the house." 'The house-refuse should be removed at least once in every week, and it would be well if the present ash-pits were abolished, galvanized iron receptacles being substituted. 'The district has a constant water-supply, and it would be a great advantage, therefore, if, in the lodging houses especially, provision were made enabling the occupants to obtain water for drinking from a tap on the rising main. 'Probably no greater service could be done than to cause the yards (there are very few rear spaces that can be reasonably described as gardens) to be properly paved and drained, so as to secure the greatest * As explained elsewhere, the district was enlarged, as described, in February, but reduced to its original limits in October, 1896. 157 possible dryness, and to obviate the evils resulting from the practice of throwing filth in the yard, and even on the surface of the roadways, which might with advantage be asphalted as, in effect, the Sanitary Committee recommended in 1893. (This is now being done in three streets and part of a fourth street.) 'Obviously the drainage should be made as perfect as possible, and I should be glad to see all the untrapped drains properly intercepted from the sewer. Many of the houses have already been provided with this safeguard against the incursion of sewer gas, in the event of the drain being otherwise defective. 'Lastly, every practicable effort should be made to prevent over crowding, and to enforce the prescribed penalty whenever this most dangerous of nuisances is found to exist. The Cost.—Dealing with this important point, I observed that necessarily the permanent improvements suggested would involve a considerable outlay, but this, I said, might, by arrangement, when necessary, be spread over a number of years, especially if the work could be carried out by the Sanitary Authority. 'But it may be suggested that the class of property, regarded as a source of income, is so "bad" that it could not bear the burden. This is too commonly taken for granted, and I am confident that, if enquiry were made, it would be found that these houses "pay," not only those who take them with a view of making a livelihood by letting lodgings, but also the present owners who get what, in these days, may be considered a good return for their investments, which, for the most part, have been made on advantageous terms. One case may serve as an illustration. It is that of an eightroomed house in the "bad" part of St. Katharine's Road, for which the "tenant," who is non-resident, pays fifteen shillings and sixpence per week = £40 (is. per annum. The several rooms are let "furnished," after a fashion, and when occupied, as is usually the case, they are let nightly, to the same persons as a rule, and bring in thirty-five shillings a week, or at the rate of £91 per annum. Now, making all deductions for bad debts (if any), wear and tear of "furniture," &c., I think it is reasonable to assume that out of the £51 difference between the owner's rent and the tenant's bikings, the tenant clears at least ten shillings a week, or £26 per annum. I may mention, in passing, that the "keeper" of this house rents other houses in the district (some persons are reported to hive as many as ten houses), and lets them on similar terms. Now, as to the owner. It appears that he acquired the house ten years ago for £185, the ground rent being £5. The estimated rates and taxes amount to £7, the repairs to (say) £10. These charges, and the ground rent, absorb £22, leaving a profit of £18 6s., or nearly ten per cent. per annum; not a bad return, in these days.' 158 It does not belong to the history of the year, but it may be mentioned, in passing, that your Vestry having, on 24th February, 1897, appointed a Special Committee "to consider and report what action should be taken to commemorate, in the parish of Kensington, the Diamond Jubilee of Her Most Gracious Majesty the Queen," the said Committee thought it desirable that an effort should be made to elicit the views of "representative residents" of the parish on the subject. In accordance with this suggestion, after approval by your Vestry, a meeting was held at the Town Hall on 15th March, at which it was unanimously resolved, on the motion of Mr. T. W. Wheeler, Q.C., the Chairman alike of the Vestry, the Special Committee and the meeting, to give effect to the loyal feelings of the parishioners by "the promotion of a scheme, having for its object the amelioration of the condition of the inhabitants of that limited district in the parish, to which public attention has for some time past been prominently drawn "—in other words the so-called "Notting Dale "Special Area; a course which had been suggested, but was not approved, on July 15th, 1896, when the report of the Special Committee was submitted. By all well-wishers of the poor a fervent "God speed" will ascend for the success of the well-meant endeavour to remove an opprobrium to the Royal Parish of Kensington; and, probably, by no one would the success of the endeavour be more heartily appreciated than by the Gracious Lady, in honour of whose long and glorious reign the scheme has been initiated. 159 RABIES: THE MUZZLING ORDER. On 2nd February, 1896 regulations of the County Council, familiarly known as the "Muzzling Order," came into force, and they continued in force until 2nd February, 1897, when the Public Control Committee were enabled to report that the regulations had been "so far beneficial in their effects as to warrant them in advising an immediate relaxation of their conditions," to which the Council agreed. During the period between 17th February, 1896, and 2nd February, 1897 (when the regulations were amended, so as to exempt dogs under control and wearing collars with the names and addresses of their owners*), the number of unmuzzled dogs seized was 44,743, of which 11,190 were claimed by their owners. The remainder, with the exception of a small number of valuable animals which were sold, were painlessly dealt with in the lethal chamber. The subject of rabies was brought vividly to my attention in the month of January, upon receipt of information that a poor man had been bitten by a dog, undoubtedly rabid, as proved by the symptoms during life, and by post-mortem examination,† I sent the man to the Pasteur Institute on the third day, the cost incurred in his three * Within the month of February, however, the Board of Agriculture issued a fresh Order, imposing the use of wire cage muzzles, much to the discontent of the owner of dogs. † The dog was bitten by another dog, at Anerley, at the end of November, 1895. On 17th January, 1896, the dog began to show symptoms of being "queer." On the 18th she was disobedient, and began to eat pieces of coal, rags, &e. On the 20th, a peculiar bark was noticed. On the 21st, the animal seemed not to understand what was said to her. She was taken to a Veterinary Surgeon, who diagnosed rabies. An employe put the dog into a kennel, in doing which he got bitten on the face. The dog having broken her chain, the same man, in trying to fasten her up, got bitten again on the face, five wounds in all being inflicted. 160 weeks' stay in Paris being defrayed by a voluntary subscription contributed mainly by the members of your Vestry. Not long previously another man who also had been bitten in the face, by another dog undoubtedly rabid, was sent to the Institute by the owner of the dog. Both of these men returned home apparently well, and they are still well after the interval of more than a year. The question of rabies received attention as a matter of ''urgency" at the meeting of your Vestry held on 29th January, in order to consider a special report of the Sanitary Committee, as follows:— 'Your Committee have to report that their attention has been called to the prevalence of rabies in dogs in many parts of the Administrative County of London, and to the lamentable fact that two men in this Parish have recently been bitten by rabid dogs. These men have been, sent to the Pasteur Institute at Paris, and it may be hoped that by the preventive treatment carried on there, they will be preserved from hydrophobia, although the cases cannot be regarded without anxiety, seeing that in both the bites were inflicted upon the face. Under these circumstances, your Committee beg to recommend that the County Council and the Commissioners of Sewers, as the Local Authorities for London under the provisions of the Diseases of Animals Act, 1804, be urged to make a Regulation under Article 10 of the Rabies Order of 1895, of the Board of Agriculture. "For providing for the muzzling of dogs while in or on any public places . . . . and for providing for the seizure, detention and disposal, including slaughter, of dogs not muzzled." Such regulation should be made to apply to the whole of the Administrative County of London. 'It may be mentioned that Article 2 of the above-named Order enables a Local Authority to "cause all stray dogs found within their district to be seized,'' and prescribes the mode in which such dogs so seized shall be dealt with. This power also the Local Authorities should be urged to exercise forthwith. How necessary it is, may be * Having regard to the severity of the injuries, and to the fact that the bites were on the face, the man was injected with the anti-rabid solution four times a day for the first three days, and twice daily in the next five days. The injection was then given once daily for thirteen days, 35 injections in all being administered in three weeks. The wounds healed in the course of this time, leaving, of course, scars. 161 inferred from the Annual Report, for 1894. of the Chief Veterinary Officer to the Board of Agriculture, who states that with a view to the prevention of Rabies "the slaughter of all ownerless dogs is of primary importance. It is" (he adds) "the common street dog which has always perpetuated rabies, not the dog which is cared for by its proprietor, though such also suffer by being bitten by the stray street dog." In the same report the importance of the application of the muzzle to dogs is insisted on, as well as the necessity of measures for preventing there-introduction of the disease from abroad and from Ireland, where the disease is very rife. 'It may be mentioned that the Commissioner of Police has powers for seizing ownerless and stray dogs, which he is now exercising energetically, under section 18 of the Metropolitan Streets Act, 1867; great numbers of suoh animals have recently been captured by the police in the streets, and have been conveyed to the Dogs' Home at Battersea, and there dealt with as the Act directs. 'Your Committee cannot conclude their report without an expression of regret that there does not appear to be possessed by any public authority the power to defray the expenses incurred by sending poor persons to the Pasteur Institute, there being no similar institution in this country where those bitten by rabid dogs can undergo the preventive treatment which, according to all accounts, has been the means of saving many valuable lives. 'They recommend, therefore, that the attention of the Local Government Board and of the Local Authorities for the County of London be called to this matter, with a view to such power being conferred on the 'Local Authority' or the Sanitary Authority, or the Poor Law Authority.' The report was adopted, and by a further resolution a copy of the report was ordered to be forwarded to the Local Government Board, the Board of Agriculture, the London County Council, the Commissioners of Sewers, and the several Vestries and District Boards of the Metropolis. Shortly afterwards, however, as above stated, the muzzling regulations were put in operation by the Council, to whom a communication had been addressed, and the intended communication was therefore not forwarded to the other public bodies named; and even now there is no means, other than private benevolence, whereby persons bitten by rabid dogs, and in danger of death in one of its most ghastly forms, can be sent abroad for preventive treatment; for it need hardly be said that in this country there is no place comparable with I'institut Pasteur at Paris. 162 REFUSE MATTER. The prevention of nuisance in connection with the storage, the collection, and the conveyance through streets of offensive substances coming under the general description "Refuse," which was formerly a matter of no little difficulty, has been made more easy by the County Council's bye-laws made in 1893, under the provisions of section 16 of the Public Health (London) Act, 1891. But in order to prevent nuisance in the conveyance of offensive matter through the streets constant supervision is necessary, and as the police are always on duty, and have therefore opportunities of observing offences against the bye-laws, it appeared to the Public Health Committee of the Council that it would be of material assistance if the police were instructed to take note of any such offences, and to give notice thereof to the Sanitary Authority of the district concerned. The Committee communicated their views to the Commissioner, who thereupon issued an instruction to the police to note and report to the Sanitary Authorities any breaches of the bye-laws made under the Act. REMOVAL OF OFFENSIVE REFUSE MATTERS THROUGH STREETS. In connection with this important subject, at the meeting of the Sanitary Committee held 29th October, 1895, I reported the receipt of a letter from a fish and game dealer carrying on business at South Kensington, who stated that his contractor for the removal of offensive trade refuse had intimated to him that " he was forbidden to collect any more (of the said refuse) on a Saturday night, the consequence being that the refuse would have to remain on the premises from Saturday morning till Monday morning, permeating and poisoning the adjoining houses." The writer of the letter reasonably added that "this is a very serious matter and requires immediate attention, as during the game season the offal is very objectionable." 163 After full consideration of the subject, the Sanitary Committee made a recommendation, which was adopted by your Vestry on the 6th November, to the following effect:— "That a communication be addressed to the County Council, pointing out the desirability of their Bye law being revised so as to allow of the removal of fish offal, &c., at other times than those specified in Bye-law No. 1,* provided such offal is removed from the premises in suitable and closely-covered receptacles, which will effectually prevent any noxious effluvia escaping therefrom." I had previously submitted a report on the subject to your Vestry,† setting out the action taken, over a long period of time, with a view to securing an amendment of the law so as to allow of offal being removed in the evening after business hours, under conditions not only as to collection and transit, but of previous storage also, which would effectually prevent nuisance. The main proposal was that the offal of fishmongers, poulterers, &c., should be stored in galvanised iron receptacles with tight-fitting covers, and that the offal should be removed in the vessels, a subsidiary advantage of the plan being that the storage vessels could be effectually cleansed before being returned to the shopkeeper. I recommended that the attention of the Sanitary Authorities generally should be called to the subject, in the belief that many, if not all of them, would be willing to support your Vestry's action in applying to the Council to makp a more reasonable bye-law. This course was adopted, and a considerable number of the Sanitary Authorities not only expressed agreement with the views set out in the report, but also communicated with the Council in support of the action taken by your Vestry. The Council, however, took no action in the matter. * The hours for removal prescribed by the Bye-law are, between 4 and 10 a.m. from March to October, and between 6 a.m. and noon from November to February inclusive. † Vide Annual Report for 1895, pp. 100-104. 164 HOUSE REFUSE. The collection of ashes and miscellaneous refuse from some 23,000 inhabited houses, in a district having an area of 2,200 acres, and to the extent of 39,869 loads in 1896-97, is no light task. The work has been systematised by division of the parish into districts, and provision has been made for inspection of dust-bins and oversight of the dusting-gangs, the arrangements being under the supervision of the Surveyor. A call is, or should be, made at every house once a week, and, subject to removal once a week only, further improvement is scarcely possible until the objectionable practice of refuse-harbourage shall have given place to the more rational system of daily, or at any rate, frequent collection from moveable receptacles. It need hardly be said that nuisance from house refuse does not arise from the proper contents of the receptacle, viz. ashes, but from the addition of matters of organic origin. With the object of preventing, as far as practicable, nuisance from this cause, a printed notice was ordered (in January) by your Vestry to be served at every house by the dust inspectors, calling the attention of householders to the danger, on sanitary grounds, of vegetable and other objectionable refuse being placed in the dust-bin, and asking that directions might be given for all such refuse to be burned. An increasing difficulty is experienced in finding accessible shoots for house refuse, to the deposit of which within their boundaries the Sanitary Authorities of other districts naturally object. In previous reports I have intimated that a solution of the difficulty of the sanitary disposal of the refuse would be found in cremation, which could, under proper conditions, be carried out successfully and innocuously. This view is supported by the Medical Officer of Health and the Engineer to the County Council, who, having made a thorough inquiry into the subject of dust destructors, in accordance with an 165 instruction of the Public Health Committee, came to the conclusion that the cremation of house refuse may be effected, in a properly constructed apparatus, without nuisance. The report of these officers having been forwarded by the Council to your Vestry, and referred to the Wharves and Plant Committee, I reported thereon, at the request of the Committee, dealing with the subject, of course, from the sanitary point of view. I stated that I agreed with the conclusion arrived at by the Medical Officer of Health and the Engineer, and that " the process (of cremation) would appear to offer, in existing circumstances, the most effectual and economical, and the only sanitary method of dealing with the refuse of the parish, inasmuch as, at the minimum of cost, the offensive constituents of the domestic receptacle called a dust-bin, can be reduced in bulk by some three-fourths, the residuum, morever, being not only innocuous, but, where the demand for such material prevails, also of some value." I concluded by commending the report to the favourable consideration of the Committee, "believing that the erection and utilisation of dust destructors in this parish would be a distinct advantage from the public health point of view." No steps have been taken hitherto to give effect to these recommendations. Indeed this solution of the difficulty seems to be further off than ever, seeing that the Wharves and Plant Committee, on the reference by your Vestry "as to the possibility of securing, on advantageous terms, a suitable site for the erection of a cremator for the disposal of the refuse of the Northern portion of the Parish," reported (in October), "that, looking to the possible development of electric traction at an early date, it is not advisable to take further action in the matter at present." The Surveyor had reported on available sites for a cremator, and submitted estimates of the cost of cremating the refuse. It appeared to the Committee, from his figures, that little saving was likely to accrue from the adoption of a cremation scheme at either of the two sites. But surely the question should be viewed from another than the pecuniary side. 166 The Purfleet Case.—In former reports I have referred to the depot at Purfleet, as a place for the deposit of the refuse of the Parish when no other more economical shoot was available. A good deal of the refuse was consigned to Purfleet last year, but the use of the depot was brought to an untimely close by proceedings instituted against your Vestry by the Orsett Rural District Council, in respect of an alleged effluvium nuisance caused by the deposited refuse. The summons was heard before a Bench of County Magistrates sitting in Petty Sessions at Grays, on the 29th May and 9th June, when the case was adjourned, upon the application of your Vestry's counsel, until the 10th July, to allow of the three Medical Officers of Health, (viz., for the District Council, the County of Essex, and the Port of London Sanitary Authority), who had given evidence on behalf of the complainants, meeting your Vestry's Medical Officer, and considering what steps could be taken with the object of preventing nuisance from the deposit of house refuse at the said depot. On the 10th July the subjoined memorandum, which had been drafted by your Vestry's Medical Officer, and signed by the four Medical Officers of Health, was handed to the court, and, by consent, the summons was further adjourned until the 6th November, it being understood that the work should be carried on under the conditions laid down in the memorandum, and that if the work were discontinued, or could be carried on without nuisance to the inhabitants, the Orsett Rural District Council would consent to withdraw the summons subject to the payment of their reasonable costs by the Vestry. The memorandum was as follows:— "ORSETT RURAL DISTRICT COUNCIL v. THE VESTRY OF KENSINGTON. alleged nuisance at the vestry's depot at purfleet. "We, the undersigned, having met this day* at the Vestry's Depot at Purfleet, and taken into consideration the steps which appear to us to be necessary with the object of preventing nuisance from (he deposit of house refuse at the said Depot, recommend as follows:— (1.) That no refuse be deposited within fifty (50) yards of the railway cottages or mills. *June 25th, 1896. 167 (2.) That refuse when deposited at either end of the land, be first deposited in the form of a bank, the said banks to extend from the railway at (approximately) a right angle to the river; the spaces between the proposed banks and the existing deposit to be subsequently filled up. (3.) That the outer slope and top of the said banks be continuously covered, as completed, to the depth of three inches, with earth, or sifted ashes from the older portions of the deposit, and planted with some quick-growing vegetable matter; the refuse deposited in the intervening spaces and elsewhere to be treated in like manner. (4.) That the spaces between the spurs of the existing deposit be filled up first, and that the proposed banks be made, and the intervening spaces be filled up, as far as practicable, during the colder months of the year. (5.) That all reasonably practicable steps be taken to accelerate the unloading of the refuse from t he barges. "We feel it but right that we should express our approval of the work carried out by the Vestry at the Depot since the 9th of June, 1896. The recent deposit has been almost entirely covered with sifted ashes from the older portions of the deposit, and planted with rapeseed. This work is still in progress, and when completed, in a few days, we are of opinion that the condition of the deposit will be unobjectionable to the senses of sight and smell. (Signed) W. COLLINGRIDGE, Medical Officer of Health, Port of London. JOHN C. THRESH, Medical Officer of Health, Essex County Council. REA CORBET. Medical Officer of Health, Orsett Rural District. T. ORME DUDFIELD. Medical Officer of Health, Kensington." The above particulars are taken from the report of the Law and Parliamentary Committee (15th July), the final paragraph of which reads as follows:— "Your Committee think it but right to record their appreciation of the services which Dr. Dudfield has rendered in connection with the proceedings, he having been at great pains to bring the several Medical Officers of Health to an unanimous agreement, and they fully endorse the views expressed by the Vestry's Solicitors that no better arrangement in the interests of the Vestry was practicable for the settlement of the matter." 168 It may be mentioned that the Purfleet depot has not since been used by your Vestry, the house refuse having been more economically transferred, under contract, to another place. The Purfleet land, moreover, has been let to a contractor, on terms set out in a report by the Wharves and Plant Committee, which was adopted by your Vestry on the 2nd December. STABLE REFUSE. In former reports I had to note the frequency of com plaints of effluvium nuisance arising in the storage, and, much more, in the removal of stable refuse from pits underground. Thanks to the operation of the County Council's bye-law, which has been carried out effectually in this parish, complaints are now few in number; and as the cause of complaint, the sunken dung-pit, is now almost a thing of the past, we may reasonably hope to be free from annoyance on this score in the future. This subject was fully dealt with in my annual report for 1894 (pp. 184-189), to which I would refer anyone desirous of knowing what a serious difficulty the question involved, until we were able to abolish, to a large extent, the brick receptacle, whether above or below ground, and to substitute therefor the iron cage now so familiar an object in the mews in this parishnot far short of two hundred in number. The following statement shows the progress made to the end of 1896 in giving effect to the bye-law:— North District. South District. . Iron cages erected 564 999 1,563 Brick receptacles abolished 171 554 725 Prick receptacles constructed or re-constructed 281 45 326 Sunken pits, improved, allowed to remain 36 38 74 Sunken pits abolished 132 434 566 169 This work was carried out under the supervision of the street inspectors whose duties include the inspection of mews. Difficulty in Securing Removal of Stable Refuse. The repealed Sanitary Act of 1866 enabled the "Nuisance Authority" to contract with the occupiers of stables and cowhouses for the collection and removal of manure or other refuse matter; but the said Authority could remove it only "with the sanction of the owner." The Public Health (London) Act, 1891, has not made any material difference in the position, for section 36 does no more than authorise the Sanitary Authority to collect and remove the refuse from stables, &c.," the occupiers of which signify their consent in writing to such removal," which would have to be effected at the cost of the said authority. The necessary consent would be forthcoming, in most cases, if it became known that the requirements of the law would be enforced in case of neglect by the owner to comply with the regulations. In many cases money is paid by the owuers for the removal of the refuse, and there is no reason why they should not pay the Sanitary Authority a suitable fee for the service. Many persons would be glad to do so, and thus relieve themselves of a burdensome obligation. At the same time, it is not improbable that the large amount of refuse produced in our numerous mews, would have a value sufficient to defray the cost of an organised system of collection and removal to the country. Section 35 authorises a sanitary inspector to serve a notice on the owner of any accumulation of manure or other obnoxious matter, requiring him to remove it, and if the notice is not complied with within forty-eight (the Bill read 24) hours from the service thereof, the "matter" becomes the property of the Sanitary Authority, and may be removed and disposed of by them at the cost of the former owner. This provision does not, in practice, supersede enforcement of the regulations by proceedings for the recovery of penalties ; but it is occasionally useful. 170 Nuisance from Stable Refuse.—Several complaints of offensive smells from stable refuse were made in the summer months by parishioners residing in the vicinity of Chepstowvillas, Chepstow-place, Walmer-road, &c., the said smells being due to the use of peat litter, and mainly arising in the course of the removal of the refuse from the premises. I have had occasion several times to call the attention of the Sanitary Committee to this subject, and the Committee have caused communications to be addressed to the proprietors of stables (mostly large public companies, cab proprietors, &c.) on whose premises the nuisance arose. The use of peat litter is now general at such establishments. The material remains in the stable for some considerable time, and becomes more or less charged with the products of the decomposition of animal secretions. It smells badly enough when removed from the stable for temporary deposit in the receptacle, where, in the heap, the process of putrefaction goes on with accelerated speed, the result being that when the refuse is turned over, in the course of transfer to the vehicle in which it is to be removed from the premises, offensive gases of a nauseous and penetrating character are given off, to the annoyance of people in the vicinity of the premises, and of all who come near the vehicle in its transit through the streets. I am of opinion that steps should be taken to abate the nuisance, on complaint, and to prohibit the recurrence thereof The County Council's byelaw dealing with the "cleansing of receptacles for dung," requires the owner of any such receptacle, once at least in every week, to cause every such receptacle to be emptied and thoroughly cleansed. But section 36 (2) of the Public Health (London) Act, 1891, provides that— "Notice may be given by a Sanitary Authority (by public announcement in the district or otherwise) requiring the periodical removal of manure or other refuse matter from stables, cow-houses, or other premises; and where any such notice has been given, if any person to whom the manure or other refuse matter belongs, fails to comply with the notice, he shall be liable, without further notice, to a fine not exceeding twenty shillings for each day during which such non-compliance continues." 171 Your Vestry have given the said notice, and require the removal of manure from stables three times every week, namely, on Monday, Wednesday and Friday, or on Tuesday, Thursday and Saturday. According to my information, the requirements of the notice would appear to be generally complied with by the occupiers of the premises where the nuisance arises to which reference is herein made. In some instances the Sanitary Committee have, upon my advice, authorised the service of a notice, in individual cases, requiring a daily removal of the refuse deposited in the storage receptacle. But even if this notice were complied with, I am of opinion that, under existing arrangements, it would not be effectual to prevent the occurrence of the nuisance, which arises, as before stated, in the disturbance of the offensive matter in the course of transfer from the receptacle to the removing vehicle, and in its transit through the streets. It need hardly be said that the Sanitary Authority have power, not merely to serve a notice requiring abatement of a nuisance, and to call upon the person "by whose act, default, or sufferance the nuisance arises or continues . . . . to do such things as may be necessary for that purpose;" but they "may also, by the same or another notice served" on such person, "require him to do what is necessary for preventing the recurrence of the nuisance." They may also, "if they think it desirable, specify any works to be executed for that purpose, and may serve that notice notwithstanding that the nuisance may for the time have been abated, if the Sanitary Authority consider that it is likely to recur on the same premises." Now, acting upon my advice, the Sanitary Committee have, on more than one occasion, called the attention of persons by whose act, default, or sufferance, this nuisance arises, to a method of dealing with the refuse which would, I think, materially mitigate the nuisance, if it did not wholly remove cause for complaint; viz., by placing the refuse, at once, on removal from the stable, in the vehicle in which it is to be taken away from the premises. By so doing, the immediate cause 172 of the principal nuisance, viz., disturbance of the matter in transfer from the receptacle to the vehicle, would be avoided; I, therefore, advised that the several persons in occupation of premises in respect of which complaint had been made, or where complaint was likely to arise, should be served with a prohibition notice, to be followed, in case of disobedience, by proceedings in the petty sessional court, under section 4 of the Public Health (London) Act, 1891, so as to obtain a "nuisance order," which should be both an "abatement order" and "prohibition order." In this connection it may be well to cite sub-section (9) of section 5, which enacts that— "If a person fails to comply with the provisions of a nuisance order with respect to the abatement of a nuisance, be shall, unless he satisfies the court that he has used due diligence to carry out such order, be liable to a fine not exceeding twenty shillings a day during his default; and if a person knowingly and wilfully acts contrary to a prohibition order he shall be liable to a fine not exceeding forty shillings a day during such contrary action; moreover, the Sanitary Authority may enter the premises to which a nuisance order relates, and abate or remove the nuisanee and do whatever may be necessary in execution of such order." Apart from the power conferred on the court by the above cited section, the court have further powers under section 4 which enacts, in sub-section (4), that— "When a notice has been served on a person under this section, and either— (а) The nuisance arose from the wilful act or default of the said person ; or (b) Such person makes default in complying with any of the requisitions of the notice within the time specified, he shall be liable to a fine not exceeding ten pounds for each offence, whether any such nuisance order, as in this Act mentioned, is or is not made upon him." The powers of your Vestry, and of the petty sessional court, are ample to secure the abatement and prevent the recurrence of the nuisance; and as the nuisance is a serious one, causing great offence to many parishioners, I was of opinion 173 and I recommended that the necessary steps be taken to enforce the provisions of the law, as above set out. I will only further observe that, if due care were exercised in giving effect to the recommendation with reference to the removing vehicle, which might be a covered cart or wagon, similar in construction to a properly covered dust-cart, there would be no occasion to remove the refuse matter oftener than on alternate days as the existing regulation requires, and that any expense to which the owner of such refuse might be put, in providing a suitable vehicle, would probably be less in amount than the fines to which he would render himself liable, should he disobey the requirements of the notice of the Sanitary Authority, or the order of the petty sessional court. The Sanitary Committee reported on this subject in June, stating, with reference to the complaints received from parishioners" of offensive smells from manure at those stables where a large number of horses are kept, particularly during the disturbance of the manure in the process of its removal," that" it is necessary, in order to abate the nuisance, that vans or portable receptacles should be used for the storage of the manure, in which vans or receptacles the manure could be removed without the emission of a considerable amount of effiuvium." They therefore gave "directions for a communication to be addressed to the owners of all stables of the class referred to requiring them to adopt this course." But I am not aware of any instance in which this course was adopted. In July a further recommendation of the Sanitary Committee was adopted by your Vestry, authorising the Medical Officer of Health "to give notice for the daily removal of manure in those cases in which he may deem it necessary for the abatement of the nuisance" (which had been complained of as existing at stables where a large number of horses are kept), "that the manure should be removed more frequently than once in every forty-eight hours," 174 THE PUBLIC MORTUARY. During the year 289 bodies were deposited at the Public Mortuary, upon application, as follows:— 1. At the request of relatives of the deceased 11 2. At the request of undertakers 60 3. At the request of the Coroner (inquest cases) Cases of sudden death 135 Cases of violent death 48 — 183 4. Brought in by the Police Found dead 18 Accident cases 3 — 21 5. On account of death due to infectious disease 14 289 In 126 of the above cases post-mortem examinations were made by authority, principally under the Coroner's warrant. The mortuary comprises two chambers, for infectious and non-infectious bodies respectively, separated by" a place provided for post-mortem examinations." This "place" is designed "for the reception of dead bodies during the time required to conduct a post-mortem examination ordered by the Coroner" who "may order the removal of a dead body to and from such place, for carrying out such examination, and the cost of such removal shall be deemed to be part of the expenses incurred in and about the holding of an inquest."* Too little use is made of the mortuary, and especially as a place of deposit for the bodies of those who have died from infectious disease. Medical men can effect the removal of the body, in such cases, by Justice's Order (Public Health (London) Act, 1891, sec. 89) if persons live or sleep in the room where the body is retained, or if the body is in such a state, from decomposition, as to enda nge the health of the inhabitants of the same house or room. * Coroners' Act, 1887, sec. 24. 175 INQUESTS AND CORONER'S COURT. During the past five years no inquest in this parish has been held at a public house; and now all of the inquests are held at the Town Hall, in a room placed at the service of the Coroner by your Vestry, but which is unsuitable for the purpose. Parliamentary powers for the purchase of two houses at the rear of the Hall have been obtained by the County Council, at the request of your Vestry, and it is intended to purchase the property from the Council—when it shall have been acquired by that body—and to provide thereon a Court for the Coroner, for the use of which the Council will pay a rent—an arrangement authorised by section 92 of the Public Health (London) Act, 1891. DISINFECTION. The Public Health (London) Act, 1891, imposes additional duties on the Sanitary Authority in the matter of disinfection, the practical effect of the legislation of late years having been to throw upon the rates the entire cost of disinfecting houses, and cleansing and disinfecting bedding, clothing, &c. The cost of this work has greatly increased since the Act came into operation at the beginning of 1892 : the amount expended in 1896 was £1361 5s. 5d., as compared with £381 in 1891. In the latter year the weight of the articles disinfected was under twenty tons, and their number about 9,400 only, whereas in 1896, 29,206 articles were dealt with, the aggregate weight being 72 tons 3 cwt. In the same year some 1,319 rooms, in 1,187 houses, were disinfected by your Vestry's staff, as compared with 364 in 1891. In my report for 1893 (pp. 215-217), under the heading "Duties of the Sanitary Authority with respect to Disinfection,' I explained the state of the law, and described your Vestry's practice in regard to this matter. I need only observe now that the expenditure on disinfection, including cleansing of clothing, bedding, &c., will necessarily vary from year to year, in proportion to the relative prevalence of infectious disease; but under existing arrangements it is likely to increase as the 176 public become better acquainted with the provisions of the Act. I append a statement of the monthly cost of this work in 1896, amounting, as before stated, to £1,361 5s. 5d., irrespective of the salaries of the disinfectors, as compared with £950 9s. 1d. in 1895, and £381 in 1891:— £ s. d. January 127 10 8 February 117 2 6 March 96 19 3 April 89 9 2 May 82 15 6 June113 18 11 July 119 4 5 August 129 13 11 September 102 0 2 October 126 6 10 November 130 7 7 December 125 16 6 The expenditure under this head is too great, and, as I have reported on several occasions, might be reduced by some hundreds of pounds per annum were your Vestry to undertake the work without the intervention of a contractor, as recommended by the London Count}* Council and by the Metropolitan Asylums Board. The question "as to the desirability of the Vestry erecting a disinfecting station, and also providing shelters for persons displaced from their homes during the progress of disinfecting work," was referred for consideration to the Sanitary Committer who reported thereon in July. A Sub-Committee had been appointed to view stations and shelters. One of the places visited was Islington, where, as the Sub-Committee reported, "the Vestry have provided a most complete station, comprising two Nottingham disinfectors and ample laundry accommodation for washing and cleansing articles when necessary. A shelterhouse to accommodate four families is also provided, and a small house has been erected for the use of the engineer and his wife, who are in charge of the station, The total cost of this station," 177 it was added, "without charge for land, amounted to about £4500, made up as follows:—Disinfectors, Laundry, Chimney Shaft, Paving and Drainage, £3,500; Shelter and Caretaker's House £1,000; and the annual expenditure amounts to £350 per annum." The report further stated that the cost of disinfection and cleansing of infected articles in Kensington in the three years 1893-95, had been £2,988, or on an average about £1,000 a year (irrespective of the salaries of disinfecting officers); a sum which was largely exceeded, as we have seen, in 1896. Information which I laid before the Committee went to show that a station and a shelter could probably be erected for a less amount than had been expended at Islington, and that many hundreds of pounds per annum might be saved on the present cost of disinfection; no provision having hitherto been made for a shelter. But "as a result of the Committee's consideration of the matter," they came to the conclusion that "it is not desirable that the Vestry should provide their own disinfecting station in the Parish, but that the disinfecting and cleansing of clothing, bedding, &c., should continue to be entrusted to the present contractors.'' The Committee accordingly recommended "that no variation be made in the arrangements at present in force for the execution of this work," and their report was adopted by your Vestry. TEMPORARY SHELTER OR HOUSE ACCOMMODATION. In June, 1895, the Strand District Board of Works addressed a circular letter to the Sanitary Authorities, inquiring whether they were in favour of the repeal of sub-section (4) of section 60 of the Public Health (London) Act, 1891, relating to Temporary Shelters for persons turned out of their homes during the time necessary for disinfection after infectious disease, it being the experience of that Board that such 178 Shelters are not appreciated by the persons for whose use they are intended. The sub-section referred to is to the following effect— "The Sanitary Authority shall provide, free of charge, temporary shelter or house accommodation, with any necessary attendants, for the members of any family in which any dangerous infectious di tease has appeared, and who have been compelled to leave their dwellings for the purpose of enabling such dwellings to be disinfected by the Sanitary Authority." In my sixth report (1895) I reported with reference to the subject as follows— "The sub-section (4) is a re enactment of the provisions contained in section 15 of the Infectious Disease (Prevention) Act, 1890, now repealed as far as London is concerncd, to which I directed your Vestry's attention in my tenth monthly report for that year, and on subsequent occasions. Nothing, however, has been done in this parish to give effect to the requirements of the sub-section, which are of an obligatory character. In December, 1894, the Medical Officer of Health to the London County Council prepared a return, showing what had been done, in the way of providing the required accommodation, by the Sanitary Authorities, to the number of 20 (out of 43) of these bodies; such accommodation varying widely in extent and suitability in the different districts. The Medical Officer stated that 'somewhat different views had been taken by the several Sanitary Authorities who have provided a shelter, as to the character of the accommodation which is required. In some instances this accommodation is provided for use by night, but in others only day accommodation has been considered necessary. The time occupied in the removal of infected articles to the disinfecting station, in their disinfection, and in their return, extends to several hours. The time occupied in the purification of the room, often the only room of the family, extends to many hours. It is obvious, therefore,' as the Medical Officer pointed out, 'that the use of the shelter by night must be contemplated in any arrangements made; provision, however, which would meet the necessities of the use of the dwelling-room by night, has not, in a number of instances, been made.' The Medical Officer further stated 'that the opinion was frequently expressed during the inquiry that poor persons were unwilling to use the accommodation which had been provided;' but that 'in connection with this difficulty it deserves to be pointed out, that these people need the experience which time only can give,' and 'will eventually find this 170 accommodation meet their convenience,' so that' the use of shelters will grow from year to year.' The final observation is' that the expectation that the poor will avail themselves of these temporary homes must depend very largely upon the shelter being made reasonably attractive, as in the case of hospitals and mortuaries.' I need hardly say that I concur in the views of the Council's Medical Officer on this important question; and to emphasize the necessity for a shelter in this parish, it will suffice to say that (as I pointed out in the same, sixth, report) during the year 1894, when infectious disease was by no means excessively prevalent in our midst, some 64 cases occurred in families occupying single rooms; that in every such case the room was disinfected, and was generally, but not without exceptions, closed for a period of 24 hours, and, therefore, during one whole night, necessarily to the great inconvenience of numerous poor persons, many of whom, it is to be supposed, would have been glad to make use of a shelter had such accommodation been available." It may be mentioned that, in 1896, 305 cases of infectious disease occurred in families occupying three rooms; 384 in families occupying two rooms, and 144 in families occupying each a single room. Of the sufferers in families in occupation of single rooms, 88 had scarlet fever, 43 had diphtheria, 8 had enteric fever, and 5 had small-pox. It need hardly be said that it is pre-eminently for the use of families in occupation of single rooms that shelter accommodation is required. This subject was referred to the Sanitary Committee for consideration, whose report was to the effect— "That it be referred to the Medical Officer of Health to report to the Works and Sanitary Committees as to. any premises which the Vestry might obtain for the purpose referred to." I have not been able to find any suitable premises, and in my humble opinion the only satisfactory plan would be to erect a shelter and provide it with a proper equipment. In the absence of provision for the purpose, the Sanitary Inspectors have been authorised to pay for lodgings for people dispossessed of their rooms during the process of disinfection. These officers, however, find it difficult to obtain accommodation for the people, many of whom, being respectable, object to go to 180 a common lodging house, where, indeed, they would be neither welcome, nor, in their infective condition, desirable guests. The difficulty is got over sometimes by giving the people permission to open the door of their room late at night, the result being that the infected walls and furniture are exposed to the disinfecting gas for only a few hours instead of the 24 hours usually deemed requisite. The Inspector who, until recently, had charge of the disinfecting arrangements, reported that in many cases the doors had been burst open when he left the premises, with the result that practically no disinfection was effected. It is, I admit, a difficult question; but the best solution would doubtless be found in compliance with the provisions of the law in the interests of public health and humanity alike. PUBLIC BATHS AND WASHHOUSES. The Baths and Washhouses at the junction of Lancasterroad and Silchester-road, Notting-hill, opened in April, 1888, were well supported during the year: the washers in the twelvemonths ended 25th March, 1897, were 59,960, an increase of 4,410 over the preceding official year; the bathers 108,895, a decrease of 1,196. But it must be admitted that for the great majority of parishioners the site is not sufficiently central for baths, and obviously it is too remote for use for washing purposes. The same objection would apply, more or less, to any single site in the parish. Much good might be effected by the provision of several buildings on a modest scale in convenient localities, to which the poor could resort for the purpose of washing clothing, &c. The statistics contained in the successive annual reports of the Commissioners for the Baths and Washhouses show a constantly increasing use to be made of the washhouses, and are of a nature to encourage the hope that it may be found practicable to provide, at no distant date, for the wants of the poor in the Central and Southern districts of the parish. 181 PUBLIC SANITARY CONVENIENCES. There are only 19 public urinals in the parish—a very inadequate provision, which, however, is supplemented by about 170 urinals at public-houses to which the general public have access: accommodation not of a satisfactory sort, as a rule, but better than none at all, and improved as the result of proceedings taken by your Vestry in 1888 and subsequently. There are three sets of public water-closets, for the male sex only, situated, respectively, at the rear of the Central Public Library, at the west end of Westbourne-grove, Notting-hill, and in the Old Brompton-road, opposite the Bell and Horns tavern. Sanitary Authorities now have ample power to make provision of this sort; section 88 of the Metropolis Management Act, 1855, enabling them to " provide and maintain urinals, water-closets, and like conveniences, for both sexes, in situations where they deem such accommodation to be required." Suitable sites exist, none better, perhaps, or where provision of the kind is more needed, than in Kensington High-street, where, opDosite the Parish Church, an underground retiring place for both sexesmight be constructed without giving rise to nuisance in any sense of the word. Increased powers were conferred by the Public Health (London) Act, 1891, which, to facilitate the construction of underground conveniences, vests the sub-soil of roadways in the Sanitary Authority, who, moreover, have power to compensate persons injured by the erection of these conveniences near their houses, &c. WATER SUPPLY. In former reports I have dealt at length with matters affecting the water supply of the Metropolis generally, and of this parish in particular. There is little to be added to what has been said in those reports. The County Council are still minded to promote legislation to confer on themselves power to acquire the interests of the several companies, but their 182 posals will be opposed, the Government, it being understood, favouring the appointment of a Royal Commission of Inquiry. The question is of importance, affecting alike the public health and the material interests of the people of the Metropolis, and of the surrounding districts included in the water areas served by the several companies. As regards this parish, nearly the whole of it is now in the enjoyment of a constant service. That the public are not dissatisfied with existing arrangements may be inferred from the fact that during the past year no complaint was made to this department, either with regard to the quality of the water or as to insufficiency of supply ; and, for my part, I consider that the water is of a satisfactory character. I do not say it cannot be improved, for I have in these reports, during many years, advocated the adoption of Clark's softening process which I believe would have a distinctly beneficial effect upon the quality of the water, which has undergone considerable improvement of late years, and is, as I believe, capable of being made everything that can be desired so as to satisfy the requirements of all but the super-fastidious. Conclusion.—In conclusion, I gladly acknowledge the valuable help received from Mr. E. R. Hill, first Assistant Clerk, in the collation of statistics, and in passing this report through the press. I desire also to bear testimony to the good work of the officers of the department generally, and not least to that of the Sanitary Inspectors, which has been carried out faithfully under circumstances of no little difficulty, not to say discouragement. I am, Gentlemen, Your obedient Servant, T. ORME DUDFIELD, Medical Officer of Health. Public Health Department, Town Hall, Kensington, W. March, 1897. APPENDIX A. Note.—The Forms for Tables I. to VI. inclusive, were arranged by the Society of Medical Officers of Health, with the object of securing uniformity in Statistical Returns. [Table: 1. 184 TABLE 1. Showing Population, Inhabited Houses, Marriages, Births, and Deaths, in 1896, and in the preceding ten years : gross numbers. The Year. Estimated Population.* No. of Inhabited Houses.† Marriages. Registered Births. Deaths. Total, all Ages ‡ Under One Year. Under Five Years. In Public Institutions. 1896 170,000 22,576 ** 1,706 ** 3,717 * * 2,891 656 1,111 817 1895 169,300 22,483 1,455 3,621 2,748 624 951 762 1894 168,600 22,390 1,537 3,665 2,623 636 1,022 749 1893 167,900 22,297 1,540 3,661 2,916 625 965 740 1892 167,200 22,204 1,584 3,718 2,882 587 972 687 1891 166,500 22,084 1,569 3,847 3,066 633 968 773 1890 166,080 21,800 ** 1,511 ** 3,864 ** 2,951 651 1,095 612 1889 165,760 21,700 1,491 3,698 2,412 489 789 570 1888 165,450 21,600 1,497 3,776 2,825 604 1,077 590 1887 165,140 21,566 1,561 3,941 2,872 680 1,129 608 1886 164,820 21,500 1,605 4,149 2,756 636 1,029 604 Average 10 years 1886-95. 166,675 — 1,535 3,794 2,805 616 1,000 670 Census Population 1861, 70,108 ; 1871, 120.299 ; 1881, 163.151 ; 1891, 166,308 ; 1896, 170,465. Average Number of Persons to each house at Census : in 1861, 7.4 ; in 1871, 7.6 : in 1881, 8.1; in 1891, 7.53. Area of Parish, 2,190 acres. Number of persons to an acre (1896). 77.6. * For statistical purposes, the population is estimated to the middle of the year on the basis of the rate of increase in the preceding inter-censal period, checked by the number of inhabited houses, and by the average number of persons per house. as ascertained at the last Census. † The data are somewhat unreliable. The Census number, which includes house. occupied only by caretakers, is given for 1891. The number in the years 1892-96 has been calculated upon the assumption of an average number of 7.53 persons to each house as ascertained at the census in 1891. * Inclusive of the deaths of parishioners at public institutions without the Parish, but exclusive of the deaths of non-parishioners at public institutions within the Parish. $ Viz.: At the Parish Infirmary. Ac., and outlying public institutions, including the Asylums Board Hospitals, * In 53 weeks. 185 TABLE II. Showing the Annual Birth-rate and Death-rate; Death-rates of Children; and Proportion of Deaths in Public Institutions to 1,000 Deaths, for the year 1896, and the preceding ten years. The Year. Birth-rate per 1,000 of the Population. Death-rate per 1,000 of the Population. Deaths of Children under one year; per l,000 of Registered Births. Deaths of Children under one year; per 1,000 of Total Deaths. Deaths of Children under five years; per 1.000 of Total Deaths. Deaths in Public Institutions per 1,000 of Total Deaths.* 1896 21.4 16.7 176 227 384 283 1895 21.4 16.2 172 227 346 277 1894 21.7 15.6 174 242 389 285 1893 21.8 17.4 170 214 331 254 1892 22.2 17.2 158 204 337 238 1891 23.1 18.1 164 206 315 252 1890 23.3 17.8 168 221 371 207 1889 22.3 14.6 132 203 327 236 1888 22.8 17.1 160 214 381 208 1887 23.9 17.4 172 237 393 212 1886 25.2 16.7 154 230 373 219 Average of 10 years. 1886-95. 22.8 16.8 162 220 356 239 * Includes Deaths of Parishioners at outlying Public Institutions, but excludes Deaths of Non-Parishioners at Brompton Consumption Hospital. St. Marylebone Infirmary. Notting Hill. etc. 186 187 TABLE III. Deaths registered from all causes in the year 1896. (Exclusive of the Deaths of Non-Parishioners at Public Institutions within the Parish, but inclusive of the Deaths of Parishioners at Public Institutions, etc., without the Parish.) For a Summary of this Table see Page 64. CAUSES OF DEATH. AGES. Total under Five Years of Age. Grand Total All Ages. Sub-district. 0 to 1. 1 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 and upwards Kensington Town. Brompton. CLASSES. 1. SPECIFIC FEBRILE or ZYMOTIC DISEASES 142 261 52 9 8 13 10 10 8 3 1 403 517 446 71 II. PARASTIC DISEASES 4 ... ... ... ... ... ... ... ... 1 ... 4 5 4 1 III. DIETETIC DISEASES 1 ... ... ... 3 8 3 1 ... ... ... 1 16 11 5 IV. CONSTITUTIONAL DISEASES 36 34 19 46 68 98 85 81 56 25 ... 70 548 423 125 V. DEVELOPMENTAL DISEASES 102 ... ... ... ... ... ... 2 20 60 41 102 225 183 42 VI.LOCAL DISEASES 255 139 29 48 62 118 124 197 211 142 28 394 1,353 1,093 260 VII. DEATHS FROM VIOLENCE 22 6 6 7 12 6 15 12 8 5 2 28 101 80 21 VIII. DEATHS FROM ILL-DEFINED AND NOT SPECIFIED CAUSES 94 15 1 1 2 2 2 3 3 3 ... 109 126 104 22 656 455 107 111 155 245 239 306 306 239 72 1,111 2,891 2,344 547 I. SPECIFIC FEBRILE or ZYMOTIC DISEASES. Order 1.—Miasmatic Diseases. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 32 121 15 ... ... 2 ... ... ... ... ... 156 173 154 19 Scarlet Fever 1 26 10 2 ... ... ... ... ... ... ... 27 39 36 3 Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping-Cough 39 58 2 ... ... ... ... ... ... ... ... 97 99 95 4 Diphtheria 5 42 22 1 1 ... ... 1 ... ... ... 47 72 46 26 Simple Continued or Ill-defined Fever ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 1 Enteric or Typhoid Fever ... ... 1 2 3 4 3 2 ... ... ... ... 15 12 3 Other Miasmatic Diseases—Influenza 1 2 ... 1 ... 3 4 2 4 2 1 3 20 15 5 2.—Diarrheal Diseases. Simple Cholera 2 ... ... ... ... ... ... ... ... ... ... 2 2 2 ... Diarrhoea, Dysentery 50 7 ... ... ... ... ... ... 3 1 ... 57 61 55 6 3.—Malarial Diseases. Remittent Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ague ... ... 1 ... ... ... ... ... 1 ... ... ... 2 2 ... 4.—Zoogenous Diseases. Cow-pox. and effects of Vaccination ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases (e.g., Hydrophobia, Glanders, Splenic Fever) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5.—Venereal Diseases. Syphilis 11 2 1 1 ... 1 2 ... ... ... ... 13 18 15 3 Gonorrhæa. Stricture of the Urethra ... ... ... ... ... ... 1 2 ... ... ... ... 3 3 ... 6.—Septic Diseases. Erysipelas l ... ... ... ... 2 ... 1 ... ... ... 1 4 4 ... Pyæmia, Septicaemia ... ... ... ... ... ... 1 ... ... ... ... 1 1 ... Puerperal Fever ... ... ... 2 4 1 ... ... ... ... ... ... 7 6 1 142 261 52 9 8 13 10 10 8 3 1 403 517 446 71 II.—PARASITIC DISEASES. Thrush, and other Vegetable Parasitic Diseases 4 ... ... ... ... ... ... ... ... 1 ... 4 5 4 1 Worms, Hydatids, and other Animal Parasitic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 ... ... ... ... ... ... ... ... 1 ... 4 5 4 1 III DIETETIC DISEASES. Want of Breast Milk—Starvation 1 ... ... ... ... ... ... ... ... ... ... 1 1 1 ... Scurvy ... ... ... ... 1 ... ... ... ... ... ... ... 1 1 ... Chronic Acoholism ... ... ... ... 1 5 3 1 ... ... ... ... 10 5 5 Delirium Tremens ... ... ... ... 1 3 ... ... ... ... ... ... 4 4 ... 1 ... ... ... 3 8 3 1 ... ... ... 1 16 11 5 IV.—CONSTITUTIONAL DISEASES. Rheumatic Fever. Rheumatism of the Heart ... ... 1 3 2 1 3 ... 1 ... ... ... 11 6 5 Rheumatism ... ... ... 1 ... ... ... ... 2 ... ... ... 3 3 ... Gout ... ... ... ... ... 1 ... 2 2 2 ... ... 7 5 2 Rickets 4 2 ... ... ... ... ... ... ... ... ... 6 6 5 1 Cancer, Malignant Disease 1 ... 1 4 2 18 41 49 39 18 ... 1 173 124 49 Tabes Mesenterica 8 2 ... ... ... ... ... ... ... ... ... 10 10 9 1 Tubercular Meningitis, Hydrocephalus 8 20 5 2 ... ... ... ... ... ... ... 28 35 28 7 Phthisis 3 5 4 26 58 73 39 21 9 1 ... 8 239 191 48 Other forms of Tuberculosis. Scrofula 11 5 8 5 3 2 ... ... ... ... ... 16 34 30 4 Purpura, Hæmorrhagic Diathesis 1 ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 Anæmia. Chlorosis, Leucocythæmia ... ... ... 2 ... 1 ... 3 1 ... ... ... 7 5 2 Glycosuria, Diabetes Mellitus ... ... ... 3 3 2 2 6 2 4 ... ... 22 17 5 Other Constitutional Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 36 34 19 46 68 98 85 81 56 25 ... 70 548 423 125 188 189 TABLE III. (continued). CAUSES OF DEATH. AGES. Total under Five Years of Age. Grand Total All Ages. SUB-DISTRICT. 0 to 1. 1 to 5. 5 to 15 1 to 25. 25 to 35. 35 to 45. 45 to 55. 55 to 65. 65 to 75 75 to 85. 85 and upwards. Kensington Town. Bromton. V.—DEVELOPMENTAL DISEASES. Premature Birth 79 ... ... ... ... ... ... ... ... ... ... 79 79 65 14 Atelectasis 8 ... ... ... ... ... ... ... ... ... ... 8 8 6 2 Congenital Malformation 15 ... ... ... ... ... ... ... ... ... ... 15 15 11 4 Old Age ... ... ... ... ... ... ... 2 20 60 41 ... 123 101 22 102 ... ... ... ... ... ... 2 20 60 41 102 225 183 42 VI.—LOCAL DISEASES. 1.—Diseases of Nervous System. Inflammation of Brain or Membranes 9 5 2 2 ... ... 1 1 ... ... ... 14 20 16 4 Apoplexy, Softening of Brain, Hemiplegia, Brain Paralysis ... ... ... 1 2 17 14 30 31 24 5 ... 124 98 26 Insanity, General Paralysis of the Insane ... ... ... ... 2 7 6 1 4 ... ... ... 20 18 2 Epilepsy ... ... 1 2 ... 4 3 ... 2 ... ... ... 12 12 ... Convulsions 47 6 ... ... ... ... ... ... ... ... ... 53 53 45 8 Laryngismus Stridulus (Spasm of Glottis) 5 1 ... ... ... ... ... ... ... ... ... 6 6 5 1 Diseases of Spinal Cord, Paraplegia, Paralysis Agitans ... ... ... ... ... ... ... 3 2 1 ... ... 6 3 3 Other Diseases of Nervous System 1 ... 1 1 3 3 8 3 7 5 ... 1 32 23 9 2.—Diseases of Organs of Special Sense. (e.g., of Eye, Ear, Nose.) ... 1 1 1 ... ... ... ... ... ... ... 1 3 3 ... 3.—Diseases of Circulatory System. Pericarditis ... ... ... ... 1 ... ... ... ... ... ... ... 1 1 ... Acute Endocarditis ... ... ... 1 2 ... 2 2 ... ... ... ... 7 6 1 Valvular Diseases of Heart ... ... 2 5 7 5 5 12 15 11 ... ... 62 43 19 Other Diseases of Heart 1 ... 6 5 6 11 16 40 43 14 2 1 144 108 36 Aneurism ... ... ... ... 1 2 1 3 1 ... ... ... 8 7 1 Embolism, Thrombosis ... ... ... 1 1 3 1 3 5 3 1 ... 18 13 5 Other Diseases of Blood Vessels ... ... ... ... ... ... 3 2 2 ... ... ... 7 4 3 4.—Diseases of Respiratory Organs. Laryngitis 1 1 ... ... ... 1 ... ... 2 ... ... 2 5 3 2 Croup ... 2 2 ... ... ... ... ... ... ... ... 2 4 4 ... Emphysema, Asthma ... ... ... ... ... 2 ... 1 3 ... ... ... 6 6 ... Bronchitis 93 77 1 1 2 12 17 39 51 44 13 170 350 306 44 Pneumonia 19 22 4 12 7 13 5 9 10 10 1 41 112 93 19 Pleurisy 1 ... 1 ... 2 1 4 1 1 1 ... 1 12 8 4 Other Diseases of Respiratory System 5 5 ... ... 1 2 1 4 5 3 1 10 27 20 7 5.-Diseases of Digestive System Dentition 13 4 ... ... ... ... ... ... ... ... ... 17 17 14 3 Sore Throat, Quinsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diseases of Stomach 1 ... ... 3 3 2 3 3 2 ... ... 1 17 15 2 Enteritis 46 10 2 ... 2 4 ... 1 3 1 ... 56 69 61 8 Obstructive Diseases of Intestine 4 1 1 1 1 2 6 8 5 9 4 5 42 30 12 Peritonitis 1 ... 3 ... 2 5 1 3 ... 1 ... 1 16 11 5 Ascites ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... 1 Cirrhosis of Liver ... ... ... ... 2 5 10 8 2 ... ... ... 27 20 7 Jaundice, and other Diseases of the Liver 3 ... 1 ... 2 2 2 4 2 1 ... 3 17 10 7 Other Diseases of Digestive System ... ... ... ... ... ... ... 1 1 1 ... ... 3 3 ... 6. Diseases of Lymphatic System. (e.g., of Lymphatics and of Spleen.) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7 —Diseases of Glandlike Organs op Uncertain Use. (e.g., Bronchocele, Addison's Disease ) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8.-Diseases of Urinary System. 2 2 1 1 1 1 2 2 2 1 ... 4 15 13 2 Nephritis ... 1 ... 2 4 3 7 7 3 5 ... 1 32 28 4 Bright's Disease, Albuminuria ... ... ... ... ... 1 1 4 4 6 ... ... 16 9 7 Disease of Bladder or of Prostate ... ... ... 1 2 2 3 1 3 ... 1 ... 13 10 3 Other Diseases of the Urinary System 9,-Diseases of Reproductive System. A. Of Organs of Generation. Male Organs ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Female Organs ... 1 ... 1 1 2 2 1 ... ... ... 1 8 6 2 B. Of Parturition. Abortion, Miscarriage ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 ... Puerperal Convulsions ... ... ... ... 1 ... ... ... ... ... ... ... 1 1 ... Placenta Prævia, Flooding ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 ... Other Accidents of Childbirth ... ... ... 4 4 2 ... ... ... ... ... ... 10 8 2 10.—Diseases of Bones and Joints. Curies, Necrosis ... ... ... 3 ... 1 ... ... ... ... ... ... 4 4 ... Arthritis, Ostitis, Periostitis 1 ... ... ... ... 1 ... ... ... ... ... 1 2 1 1 Other Diseases of Bones and Joints ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 11.-Diseases of Integumentary System. Carbuncle, Phlegmon ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Integumentary System 2 ... ......... ... ... ... ... ... ... ... ... 2 2 2 ... 255 139 29 48 62 118 124 197 211 142 28 394 1353 1093 260 190 Table III. (continued). causes of death. aoes. Total under Five Years of Ages. Grand Total All Ages. Sub-district 0 to 1. 1 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 and upwards Kensington Town. Brompton. VII.—DEATHS FROJI VIOLENCE. 1.—Accident or Negligence. Fractures and Contusions. 3 3 5 4 4 4 7 5 5 3 2 6 45 35 10 Gun-shot Wounds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cut. Stab ... ... ... ... ... ... ... ......... ... ... ... ... 1 1 ... Burn, Scald 1 3 ... ... 1 ... ... 1 1 2 ... 4 9 7 2 Poison ... ... 1 ... 2 ... 1 ... ... ... ... ... 4 1 3 Drowning ... ... ... ... ... ... 1 ... ... ... ... ... 1 1 ... Suffocation 18 ... ... ... ... ... 1 ... ... ... ... 18 19 19 ... Otherwise ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2.—Homicide. Manslaughter ... ... ... 1 1 1 ... ... ... ... ... ... 3 3 ... Murder ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3.—suicide. Gun Shot Wounds ... ... ... ... ... ... 1 1 ... ... ... ... 2 2 ... Cut, Stab ... ... ... ... ... ... ... 2 2 ... ... ... 4 2 2 Poison ... ... ... ... 1 1 2 1 ... ... ... ... 5 3 2 Drowning ... ... ... 1 1 ... ... 1 ... ... ... ... 3 2 1 Suffocation ... ... ... ... ... 2 1 ... ... ... ... 3 2 1 Otherwise ... ... ... ... 1 ... ... ... ... ... ... ... 1 1 ... 4.-Execution. Hanging ... ... ... ... 1 ... ... ... ... 1 1 ... 22 6 6 7 12 6 15 12 ...8 r» 2 28 101 80 21 VIII.—DEATHS FROM ILL-DEFINED AND NOT SPECIFIED CAUSES. Dropsy ... ... ... ... ... ... ... ... ... l ... ... 1 ... 1 Debility. Atrophy, Inanition 87 9 ... ... ... ... ... ... ... ... 96 96 82 14 Mortification ... ... ... ... ... ... 1 2 1 l ... ... 5 4 1 Tumour ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... 1 Abscess 1 ... 1 1 2 2 1 1 1 l ... 1 11 8 3 Hemorrhage 3 ... ... ... ... ... ... ... ... ... ... 3 3 3 ... Sudden Death (Cause not ascertained) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Causes not specified or ill defined 3 6 ... ... ... ... ... ... ... ... ... 9 9 7 2 94 15 1 1 2 2 2 3 3 3 ... 109 126 126 22 191 TABLE IV. Showing the number of Deaths at all ages in 1896, from certain groups of Diseases; and proportions to 1000 of Population, and to 1000 Deaths from all causes: also the number of Deaths of Infants under one year of age, from other groups of Diseases; and proportions to 1000 Births, and to 1000 Deaths from all causes under one year. Division I. (Adults.) Total Deaths. Deaths per 1,000 of Population, at all .ages Deaths per 1,000 of Total Deaths at all ages. 1. Principal Zymotic Diseases 460 2.7 159 2. Pulmonary Diseases 511 3.0 178 3. Principal Tubercular Diseases ... 289 1.7 100 Division II (Infants under one year.) Total Deaths. Deaths per 1,000 of Births. Deaths per 1,000 of Total Deaths under one year. 4. Wasting Diseases 167 44.9 255 5. Convulsive Diseases 95 25.6 145 NOTES. 1. Includes Small-pox, Measles, Scarlet Fever, Diphtheria, Whoopingcough. Typhus Fever, Enteric (or Typhoid) Fever, Simple Continued Fever, and Diarrhoea. Seventy-seven of the deaths occurred in Hospitals without the Parish. 3. Includes Phthisis, Scrofula, Tuberculosis, Rickets, and Tabes. 4. Includes Debility, A-trophy, Inanition, Want of Breast-milk, and Prema- ture Birth. 5. Includes Hydrocephalus. Infantile Meningitis. Convulsions, and Teething. (In Table III., Hydrocephalus and Infantile Meningitis are classified with tubercular diseases, Convulsions with diseases of the nervous system, and Teething with diseases of the digestive system) 192 TABLE V. Showing the Number of Deaths from the Principal Diseases of the Zymotic Class in the ten years 1886-95 and in the year 1896. Diseases. 1886. 1887. 1888. 1889. 1890. 1891. 1892. 1893. 1894. 1895. Annual Average of ten years, 1886-95. Proportion of Deaths to 1000 Deaths from all causes in ten years 1886-96. Deaths in 1896. Proportion of Deaths to 1000 Deaths from all causes in 1896. Small-pox 0 1 0 0 0 0 0 9 0 0 1.0 0.4 0 0 Measles 56 108 124 14 140 29 109 18 105 33 73.9 22 .8 173 59.8 Scarlet Fever 11 44 26 28 26 16 36 51 22 27 28.7 10 .2 39 13.5 Diphtheria 30 40 89 111 35 28 31 83 75 89 61.1 21.8 72 24.9 Whooping-cough 82 86 100 26 93 84 63 65 61 39 69.9 24.9 99 34.3 Enteric Fever 11 11 21 19 15 24 15 17 21 15 16.9 6.0 15 5.2 Sim.Continued Fever 0 0 2 0 0 1 2 0 3 1 1.1 3.9 1 0.3 Diarrhæa 90 124 58 71 78 91 77 98 56 118 86.1 30.7 61 21.1 Kensington. 280 416 420 269 387 273 333 341 346 322 338.7 120.7 460 159.1 TOTALS. London. 11121 12684 10803 9709 12279 9675 11983 13223 11544 11544 11456 135.8 14100 168.8 England & Wales 62859 64676 50684 61027 59698 53221 56032 73499 52771 64901 59936 110.0 66936 126.8 193 TABLE VI. Summary of the Work of the Sanitary Inspectors during the year 1896. Sanitary Districts.* No. of Complaints made by Inhabitants, &c. No. of Houses, Premises, ice., inspected. No. of Re-inspections of Houses, Premises. &c. Results of Inspection. House Drains. Water Closets. Dust Receptacles. Water Supply. Miscellaneous. Written Intimations of Nuisances Served. Notices served by order of the Works and Sanitary Committee. Final Notices signed by Medical Officer served. Houses, Premises, &c., Cleansed, Repaired, Whitewashed, Ac. Houses Disinfected after illness of an Infectious character.† Repaired, Cleansed, &c. Ventilated, Trapped. &c. Repaired, &c. Supplied with Water. Soil-pipes Ventilated. New provided. Repaired, Covered, &c. Cisterns erected. Cisterns Cleansed, Repaired, Covered, &c. Waste-pipes connected with drains, kc., abolished. No. of Lodging Houses newly Registered under 94th Section of the Public Health (London) Act, 1891. Yards and Area3 paved and drained. Animals removed, being improperly kept. Regularly Inspected. Legal Proceedings, i.e., Summonses. Bakehouses. Licensed Cowsheds. Licensed Slaughter-Houses. North 255 1,032 3,527 386 278 25 45 301 89 79 152 76 64 31 47 3 42 6 • •• 118 1 21 • •• 1 14 N.E. 190 881 2,978 378 200 23 59 144 138 92 46 124 74 20 52 3 64 18 • •• 90 • •• 27 1 3 6 N.W. 152 1,310 3,927 336 364 50 177 307 170 73 200 151 46 49 65 1 27 7 ... 85 13 2 2 2 Central 180 759 948 190 123 10 119 129 59 58 47 18 40 16 7 2 31 1 • •• 76 26 1 6 3 S.E. 176 933 2,642 309 110 8 24 176 20 36 90 43 99 10 21 8 28 2 • •• 82 • •• 28 • •• • •• 3 S. W. 209 1,350 3,288 367 135 5 145 130 109 48 222 142 72 42 25 27 92 • •• • •• 189 2 23 • •• 1 2 1,162 6,265 17,310 1,966 1,210 121 569 1,187 585 386 757 554 395 168 217 44 284 34 • •• 640 6 138 4 13 30 * For a description of the Sanitary Districts, see page 2. † Done under the supervision of the Inspector for the Central District until October 21st, when a Special Officer was appointed. ‡ The to all number of houses on the Register in December, 1896, in round figures, was 1,500. ( Vide page 136.) 194 TABLE VII. Showing the Death-rate per 1,000 persons living; the Annual Rate per 1,000 from the principal Diseases of the Zymotic Class; and the proportion of Deaths from these Diseases to total Deaths, in Kensington and in all London, in 1896, and in the preceding ten years, 1886-95. The Year. Deaths per 1,000 living. Total Deaths from seven principal Zymotic Diseases, Kensington. Annual rate of mortality per 1,000 living, from seven principal Zymotic Diseases. Proportion of Deaths to 1.000 Deaths, from seven principal Zymotic Diseases. The Year. Kensington. London. Kensington. London. Kensington. London. 1886 16.7 20.6 280 1.7 2.8 101 135 1886 1887 17.4 20. 3 416 2.5 3.1 144 154 1887 1888 17.1 19. 3 420 2.6 2.7 148 137 1888 1889 14.6 18.4 269 1.6 2.3 111 128 1889 1890 17. 8 21.4 387 2.3 2.8 131 134 1890 1891 18.4 21.4 273 1.6 2.3 89 107 1891 1892 17.2 20.6 333 2.0 2.8 115 136 1892 1893 17.5 21.3 341 2.0 3.1 117 136 1893 1894 15.7 17.8 346 2.1 2.7 132 150 1894 1895 16. 4 19.8 322 1.9 2.6 117 133 1895 AVERAGE OF TEN YEARS 1886-95. 16.8 20.1 339 2.0 2.7 121 135 AVERAGE OF TEN YEARS, 1886-95. 1896 16.7 18.6 460 2.7 3.1 159 169 1896 195 TABLE VIII. Comparative Analysis of the Mortality in all London, and in Kensington, in 1896. Annual Death-rate per 1000 living, from all causes. Annual Death-rate per 1000 living, from seven principal Zymotic diseases. Percentage of Deaths under 1 year to Births Registered PERCENTAGE OF DEATHS TO TOTAL DEATHS. Under 1 year of age. At 60 years of age and upwards. From seven principal Zymotic diseases. From Violence. Registered upon information of Coroners. (Inquests.) Registered at Public Institutions * Uncertified. London 18.6 3.1 16.1 26.2 21.9 16.9 3.9 9.1 27.8 0.6 Kensington 16.7 2.7 17.6 22.7 26.9 15.9 3.5 8.2 28.3 0.00 * Viz.—Parish Infirmary and Workhouse, Brompton Consumption Hospital, so far as relates to Deaths of Parishioners therein, and Outlying Public Institutions, i.e., General and Special Hospitals, etc. 196 197 TABLE IX. Showing the Localities in which Fatal Cases of the Principal Diseases of the Zymotic Class occurred in 1896. KENSINGTON TOWN REGISTRATION SUB-DISTRICT. Locality. Small-pox. Measles. Scarlet Fever. Diphtheria. WhoopingCough. Enteric Fever. Diarrhoea. Total. Locality. Small-pox. Measles. Scarlet Fever. Diphtheria. WhoopingCough. Enteric Fever. Diarrhæa. Total. Absalom Road ... 3 ... ... ... ... 1 4 Lancaster Road ... 3 2 2 2 ... 1 10 Acklam Road ... ... ... 1 1 1 ... 3 Linden Gardens ... ... ... 1 ... ... ... 1 Adair Road ... 2 ... ... 1 ... ... 3 Lionel Mews ... 3 ... 1 ... ... ... 4 All Saints' Road ... 1 ... 1 5 ... ... 7 Lockton Street ... ... ... 1 1 ... ... 2 Appleford Road ... 3 ... ... 2 ... ... 5 Lonsdale Road ... 3 ... ... 2 ... ... 5 Bangor Street ... 1 ... ... 4 ... 2 7 Manchester Road ... 1 1 ... ... ... ... 2 Barandon Street ... 1 ... 1 ... ... ... 2 Manchester Street ... 2 2 ... 2 ... ... 6 Bevington Road ... 2 ... ... ... ... ... 2 Maxilla Gardens ... ... ... 1 ... ... ... 1 Blechynden Street ... 6 1 ... ... ... 1 8 Murchison Road ... ... ... ... ... 1 ... 1 Blenheim Crescent ... ... ... 1 ... ... ... 1 Newcombe Street ... ... ... 1 ... ... ... 1 Bolton Road ... 1 ... ... 1 ... ... 2 Peel Street ... 2 ... ... ... ... 1 3 Bonchurch Road ... 1 1 ... ... ... ... 2 Portland Road ... 1 2 ... ... ... 2 5 Bosworth Road ... ... ... ... 2 ... 1 3 Portobello Road ... 2 ... 3 4 ... 1 10 Bramley Road ... 1 l 3 2 ... ... 7 Princes Road ... 3 1 ... ... ... ... 4 Bramley Street ... 1 ... ... 1 ... ... 2 Rickham Street ... 3 ... ... ... ... 1 5 Branstone Street ... 1 ... 2 1 ... ... 4 St. Clement's Road ... ... 1 1 1 l 2 6 Campden Houses ... 2 ... ... 1 ... ... 3 St. Ervan's Road ... ... ... 1 ... l 1 2 Campden Street ... 1 l ... ... ... ... 2 St. George's Road ... 2 ... 1 ... ... 1 4 Clarendon Road ... ... ... 1 ... ... 1 2 St. James's Place ... 3 ... ... ... ... 1 4 Colville Gardens ... ... ... ... ... 1 ... 1 St Katharine's Road ... 2 ... ... 1 ... 1 5 Colville Terrace ... 1 ... ... ... ... 1 2 St. Luke's Mews ... ... ... ... ... l ... 1 Cornwall Road ... ... ... 1 1 1 2 5 St. Mark's Road ... ... 1 ... 3 ... ... 4 Crescent Street ... ... 1 1 1 ... 2 5 St. Mary's Road ... 2 ... 1 ... ... ... 2 Drayson Mews ... ... ... ... ... 1 ... 1 St. Quintin's Road ... ... ... 1 ... ... ... 1 Edenham Street ... 8 ... ... 2 ... ... 10 Shaftesbury Mews ... ... 1 ... ... ... ... 1 Edinburgh Road ... 3 ... ... 1 ... ... 4 Silchester Road ... 1 ... ... 2 ... 2 5 Elsham Road ... ... ... ... ... 1 ... 1 Silchester Terrace ... 4 ... ... ... ... ... 4 Ernest Street ... 1 ... ... ... ... 1 2 Southam Street ... 4 l ... 5 l 4 15 Faraday Road ... 1 1 1 ... ... ... 3 Stoneleigh Street ... ... 2 1 ... ... ... 3 Fowell Street ... ... ... l 1 ... ... 2 Swinbrook Road ... 2 1 ... 1 ... ... 4 Gadsden Mews ... 2 ... ... ... ... ... 2 Talbot Grove ... 2 1 1 3 ... ... 7 Golborne Gardens ... 1 1 1 ... ... 1 4 Tavistock Crescent ... 1 ... ... 2 ... 1 4 Hazlewood Crescent ... 2 l ... 1 ... ... 4 Tavistock Road ... ... ... ... ... ... 3 3 Heathfield Street ... ... ... 1 ... ... ... 1 Testerton Street ... 1 ... ... 3 ... 2 6 Hesketh Place ... ... 1 ... ... ... ... 1 Tobin Street ... 1 ... ... 1 ... ... 2 High Street. Notting Hill ... 1 ... 1 ... ... ... 2 Treverton Street ... 1 2 l 1 ... 1 6 Holland Park Avenue ... ... ... ... ... l ... 1 Walmer Road ... 4 ... 2 3 ... ... 9 Hurstway Street ... 1 ... ... 1 ... ... 2 Wellington Mews ... 1 ... ... 1 ... ... 2 Jameson Street ... ... 1 ... ... ... ... 1 Westbourne Grove ... ... ... 2 ... ... ... 2 Kensington Infirmary ... 13 1 1 8 ... 3 26 Wheatstone Road ... 3 ... ... 1 ... 1 5 Kensington Park Road ... ... l ... 2 ... ... 3 William Street. Notting Dale ... ... 2 ... ... ... ... 2 Kensington Place ... 1 ... ... 1 ... ... 2 William Street, Notting Hill ... 1 ... ... 1 ... ... 2 Kensington Square ... ... ... l ... ... ... 1 Wornington Road ... 8 3 5 2 ... 3 21 Ladbroke Grove ... 3 ... 1 ... 1 ... 5 BROMPTON SUB-DISTRICT. Bolton Mews ... ... 1 ... ... ... ... 1 Onslow Gardens ... ... ... 1 ... 1 ... 2 Chapel Place ... 2 ... ... ... ... ... 2 Pelham Street ... ... ... 1 ... ... 1 2 Chelsea Grove ... 1 ... l ... ... ... 2 Queen's Gate ... ... ... 1 ... ... ... 1 Courtfield Mews ... ... ... 2 ... ... ... St. Mark's Road ... ... ... 1 ... ... ... 1 Drayton Gardens ... 1 ... 1 ... ... ... 2 Seymour Place ... ... ... 1 ... ... ... 1 Drayton Villas ... ... ... 1 ... ... ... 1 Sloane Place ... ... ... 3 ... ... ... 3 Fenelon Road ... ... ... 1 ... ... ... 1 South Street, St. Mark s Road ... ... ... 1 ... ... ... 1 Finborough Road ... 2 ... ... ... ... ... 2 Stanhope Mews West ... ... ... 1 ... ... ... 1 Fulham Road ... ... 1 3 ... ... ... 4 TrebovirRoad ... ... ... ... ... 1 ... 1 Hollywood Mews ... ... ... 1 ... ... ... 1 Wallgrave Road ... ... ... 2 ... ... ... 2 Ifield Road ... 3 ... 2 ... ... ... 5 Warwick Road ... ... ... 1 ... ... ... 1 Lexham Gardens ... ... l ... ... 1 ... 2 Yeoman's Row ... 1 ... 1 ... ... ... 2 198 TABLE IXa. Showing Streets, etc., in the Registration sub-districts and in the Sanitary Inspecting districts, from which the 1,781 cases of Infectious Disease were notified, under the provisions of the Public Health (London) Act, 1891, during the year 1896. The Registration SubDistricts are Kensington Town (K T), and Brompton (B). For list of Sanitary Districts see page 2. Street or Place. ##]Street or Place. Registration Sub-District. Sanitary district. Small pox. Scarlet Fever. Diphtheria. Enteric Fever. Puerperal Fever. | Erysipelas. Croup. Total. Abbey Road KT N W ... 1 ... ... ... 1 ... 2 Abingdon Road 11 S W ... ... ... ... ... 2 ... 2 Abingdon Villas 11 11 ... ... ... ... ... 1 ... 1 Absalom Road 11 N ... 2 2 ... ... 1 ... 5 Acklam Road 11 11 ... 3 2 2 ... 3 ... 10 Adair Road 11 11 ... 6 ... 1 ... ... ... 7 Adam and Eve Mews 11 S W ... 2 ... ... ... ... ... 2 Addison Road 11 C ... 2 1 ... ... 1 ... 4 Addison Road North 11 11 ... 1 1 ... ... ... ... 2 Admiral Place 11 N ... ... 1 ... ... ... ... 1 Adrian Terrace B S W ... 1 3 ... ... 3 ... 7 Albion Place K T N E ... 1 ... ... ... ... ... 1 Alexander Square B S E ... 1 ... ... ... ... ... 1 Alfred Place (Thurloe Place) 11 11 ... I ... ... ... ... ... 1 Alfred Place West 11 11 ... ... ... ... ... 1 ... 1 All Saints Road K T N E ... 3 2 1 ... 1 ... 7 Alveston Mews B S E ... ... 1 1 ... ... ... 2 Appleford Road K T N ... 2 3 ... ... ... ... 5 Archer Street 11 N E ... ... 1 ... ... ... ... 1 Argyll Road 11 C ... ... 1 1 ... ... ... 2 Arundel Gardens 11 N E ... ... 1 ... ... ... ... 1 Ashley Cottages B S W ... ... ... ... ... ... 1 1 Astwood Mews 11 S E ... ... ... ... ... 1 ... 1 Ball Street K T S E ... 3 ... ... ... ... ... 3 Bangor Street 11 N W ... 2 ... ... ... 2 ... 4 Barandon Street 11 11 ... 1 1 ... ... ... ... 2 Barker Street B S W ... 2 ... ... ... ... ... 2 Barkston Gardens 11 11 ... 1 1 ... 1 ... ... 3 Basing Road K T N E ... 1 l ... ... ... ... 2 Bassett Road 11 N ... 6 ... ... ... ... ... 6 Beauchamp Place B S E ... ... 1 ... ... ... ... 1 Bedford Terrace K T C ... 1 ... ... ... ... ... 1 Bevington Road 11 N ... 5 ... ... ... 2 ... 7 Blagrove Road 11 11 ... 3 ... ... ... ... ... 3 Blechynden Mews 11 N W ... ... 1 ... 1 ... ... 1 Blechynden Street 11 11 ... 20 8 ... 2 ... 31 Blenheim Crescent 11 N E ... 1 1 ... ... 1 ... 3 Bolton Gardens B S W ... ... 1 ... ... ... ... 1 Bolton Mews 11 S E ... 1 4 ... ... ... ... 5 Bolton Mews (Notting Hill) K T N E ... ... ... ... ... ... ... I Bomore Road 11 NW ... 4 2 ... ... ... ... 6 Bonchurch Road 11 N ... 1 1 ... ... ... ... 2 Bosworth Road 11 11 ... 7 ... ... ... 1 ... 8 Bramley Road 11 NW ... 23 9 l ... 4 1 38 Bramley Street 11 11 ... 1 ... ... ... 1 .. 2 199 TABLE IXa.—conontinued. Street or Place. Registration Sub-District. Sanitary District. Small pox. Scarlet Fever. Diphtheria. Enteric Fever. Puerperal Fever. Erysipelas. Croup. Total. Bransford Street K T N ... ... ... ... ... 1 ... 1 Branstone Street 11 11 ... 1 3 ... ... 1 ... 5 Brechin Place B SE ... 2 1 ... ... ... ... 3 Brompton Crescent 11 11 ... 1 ... ... ... ... ... 1 Brompton Road 11 11 ... 4 3 2 ... 1 ... 10 Brompton Square 11 ,, ... 6 ... 1 ... ... ... 7 Buckingham Mews K T N E ... 1 ... ... ... ... ... 1 Buckingham Terrace 11 11 ... 1 ... ... 1 ... ... 2 Bulmer Place 11 C ... ... 1 ... ... 1 ... 2 Bute Street B S E ... 6 ... ... ... ... ... 6 Calverley Street K T N W ... 1 ... ... ... ... ... 1 Cambridge Gardens 11 N ... l 1 1 ... ... ... 3 Campden Grove 11 C ... ... ... ... ... 1 ... 1 Campden Hill 11 11 ... 1 ... ... ... ... ... 1 Campden Hill Road 11.. 11 ... 1 ... ... ... ... ... 1 Campden Hill Square 11 11 ... 1 ... ... ... ... ... 1 Campden Houses 11 11 ... 5 ... ... ... ... ... 5 Campden Street 11 11.. ... 5 1 ... ... 2 ... 8 Cathcart Road B s w ... 1 ... ... ... ... ... 1 Chapel Place 11 S E ... 5 ... ... ... ... ... 5 Chapel Road KT NE ... ... ... 1 ... ... ... 1 Charles Street, Norlands 11 C ... ... 1 ... ... 1 ... 2 Chelsea Grove B S E ... 2 2 ... ... 1 ... 5 Cheniston Gardens K T s w ... ... 1 ... ... ... ... 1 Chepstow Place 11 C ... I ... 1 ... ... ... 2 Chesterton Road 11 N ... 10 1 ... ... ... ... 11 Church Court 11 c ... l ... ... ... ... ... 1 Church Street 11 11 ... ... ... ... ... 1 ... 1 Church Walk 11 11 ... ... ... ... ... 1 ... 1 Cianricarde Gardens 11 11 ... 1 ... ... ... ... ... 1 Clarence Place 11 11 ... ... ... 1 ... ... ... 1 Clarendon Place 11 11 ... 1 ... ... ... ... ... 1 Clarendon Road 11 N E ... 4 2 ... ... 2 ... 8 Clareville Grove B S E ... 3 ... ... ... 1 ... 4 Clifton Place 11 11 ... ... 2 ... ... ... ... 2 Clydesdale Mews K T N E ... ... ... l ... 1 ... 2 Collinghum Gardens B S W ... 1 ... ... ... ... ... 1 Colville Gardens K T N E ... ... ... 1 ... ... ... 1 Colville Square 11 11 ... 1 ... ... ... ... ... 1 Colville Square Mews 11 11 ... 2 ... ... ... ... ... 2 Colville Square Terrace 11 11 ... 1 ... ... ... ... ... 1 Colville Terrace 11 11 ... 1 ... ... ... ... ... 3 Convent Gardens 11 11 ... 1 1 1 ... ... ... 3 Cornwall Gardens KT & B SE ... 1 ... ... ... l ... 2 Cornwall Road K T N E ... 7 4 3 ... 1 ... 15 Cottage Place B S E ... 2 ... ... ... ... ... 2 Courtfield Gardens 11 S W ... 1 ... ... ... ... ... 1 Courtfield Mews 11 S E ... 1 8 ... ... ... ... 8 Courtfield Road 11 11 ... 1 ... ... ... ... ... 1 Cranley Gardens 11 11 ... 1 1 l ... I ... 4 200 TABLE IXa.—continued. Street or Place. Registration Sub-District. Sanitary District. Small-pox. Scarlet Fever. Diphtheria. Enteric Fever. Puerperal Fever. Erysipelas. Croup. Total. Cranley Place B S E ... 2 ... ... ... ... ... 2 Crescent Place 11 11 ... 2 ... ... ... ... ... 2 Crescent Street K T M W ... 8 3 ... ... 3 ... 14 Cromwell Crescent '... B s w ... ] ... 1 ... ... ... 2 Cromwell Houses 11 S E ... 1 ... 1 ... ... ... 2 Cromwell Mews 11 11 ... 1 ... ... ... ... ... 1 Cromwell Place 11 11 ... ... ... 1 ... ... ... 1 Cromwell Road 11 S E & S W ... 2 1 ... ... 1 ... 4 Dartmoor Street K T C ... 3 ... ... ... 6 ... 9 Dawson Place 11 11 ... ... 1 ... ... ... ... 1 Denbigh Mews 11 n e ... ... l ... ... ... ... 1 Denbigh Terrace 11 11 ... 2 ... ... ... 2 ... 4 De Vere Mews 11 SE ... 1 ... ... ... ... ... 1 Drayson Mews 11 c ... ... ... 1 ... ... ... 1 Drayton Gardens B se ... 5 3 ... ... ... ... 8 Drayton Villas 11 11 ... ... 1 ... ... ... ... 1 Dove Mews 11 11 ... ... 1 ... ... ... ... 1 Duke's Lane Chambers K T c ... ... 1 ... ... 1 ... 2 Dulford Street 11 n e ... 1 ... ... ... 1 ... 2 Eardley Crescent B S W ... 1 1 ... ... ... ... 2 Earl's Court Road KT & B 11 ... 5 1 ... ... ... ... 6 Earl's Court Square B 11 ... 1 ... ... ... 2 ... 3 Earl's Terrace K T 11 ... 1 ... ... ... ... ... 1 East Cottages, Norlands 11 C ... 1 ... ... ... 1 ... 2 East Mews Road 11 N W ... 2 ... ... ... ... ... 2 Edenham Street 11 n ... 1 2 ... ... ... ... 3 Edge Street 11 C ... 1 ... ... ... ... ... 1 Edinburgh Terrace 11 N W ... 2 2 ... ... ... ... 4 Egerton Gardens B S E ... ... ... 1 ... ... ... 1 Elsrin Crescent K T N E ... 1 1 ... ... 3 ... 5 Elgin Mews 11 11 ... 2 ... ... ... ... ... 2 Elsham Road 11 C ... 1 ... 2 ... ... ... 3 Elvaston Place 11 s e ... 1 ... ... ... ... ... 1 Emperor's Gate B 11 ... 1 1 ... ... ... ... 2 Evelyn Gardens 11 11 ... ... 1 1 ... ... ... 2 Faraday Road K T N ... 10 4 1 ... 1 1 17 Farmer Street 11 C ... ... 1 ... ... ... ... 1 Farnell Mews B S W ... 1 ... ... ... ... ... 1 Fawcett Street 11 11 ... ... ... ... ... 1 ... 1 Fenelon Road 11 11 ... 1 1 ... ... ... ... 2 Finborough Road 11 11 ... 5 1 2 ... 2 ... 10 Fowell Street k T N W ... 1 1 ... ... ... ... 2 Fulham Road B S E & S W ... 15 8 1 ... ... ... 24 Gadsden Mews k t n ... ... 2 ... ... ... 1 3 Gledhow Gardens B S E ... 3 1 1 ... ... ... 5 Golborne Gardens K T N ... 4 5 ... ... ... ... 9 Golborne Mews 11 11 ... 1 ... ... ... ... ... 1 Golborne Road 11 11 ... 6 2 1 ... 2 ... 11 Golborne Terrace 11 11 ... 1 1 ... ... 2 ... 4 Golden Mew» 11 N E ... 1 ... ... ... ... ... 1 201 TABLE IXa.—continued. Street or Place. Registration Sub District. Sanitary District. Sin all-pox. Scarlet Fever. Diphtheria. Enteric Fever. Puerperal Fever. Erysipelas. Croup. Total. Hansard Mews K T C ... 3 ... ... ... ... ... 3 Hans Road B SE ... ... 1 ... ... ... ... 1 Harrington Gardens ,, ,, ... 5 ... ... ... ... ... 5 Harrow Road K T N ... ... ... ... ... ... ... 1 Hayden Place ,, N E ... 1 ... ... ... ... ... l Hazlewood Crescent ,, N ... 8 ... ... 1 4 ... 13 Heathfield Street ,, N W ... 4 1 ... ... ... ... 5 Hesketh Place ,, ,,, 3 1 ... ... ... ... ... 4 Hesper Mews B S W ... 1 ... ... ... ... ... 1 Highlever Road K T N ... 1 ... ... ... ... ... 1 High Row ,, C ... 2 ... ... ... ... ... 2 High Street. Notting Hill ,, ,, ... ... 1 ... ... 1 ... 2 Hippodrome Stables ,, N E ... 1 ... ... ... ... ... 1 Hogarth Road B S W ... ... ... ... ... 1 ... 1 Holland Mews K T C ... 1 ... ... ... ... ... 1 Holland Park ,, ,, ... 1 1 ... ... ... ... 2 Holland Park Avenue ,, ,, ... 4 2 1 ... ... ... 7 Holland Park Garaens ,, ,, ... ... ... ... ... 1 ... 1 Holland Park Mews ,, ,, ... 3 ... ... ... ... ... 3 Holland Place ,, ,, ... ... ... ... ... 1 ... 1 Holland Road ,, ,, ... 1 ... 1 ... ... ... 2 Holland Villas Road ,, ,, ... ... ... ... ... 1 ... 1 Holly Mews B S E ... 6 ... 1 ... ... ... 7 Hollywood Mews ,, S W ... ... 1 ... ... ... ... 1 Hooper's Court ,, S E ... 2 ... ... ... ... ... 2 Horbury Crescent K T C ... ... ... ... ... 1 ... 1 Hurstway Street ,, N W ... 8 1 ... ... ... ... 9 Ifield Road B S W ... 9 5 ... ... ... ... 14 Jameson Street K T C ... 2 1 ... ... ... ... 3 Jolliffe's Yard ,, N W ... ... ... ... ... l ... 1 Kempsford Gardens B S W ... 2 ... ... ... ... ... 2 Kendrick Mews ,, S E ... 3 ... ... ... ... ... 3 Kenilworth Street K T N W ... 1 ... ... ... ... ... 1 Kensal Road ,, N ... 2 2 ... ... 2 ... 6 Kensington Court ,, S E ... ... ... 1 ... ... ... 1 Kensington High Street ,, C & S W ... 3 ... ... ... ... 1 4 Kensington Infirmary ,, S W ... 14 3 2 3 82 ... 104 Kensington Mansions B ,, ... ... ... ... ... 1 ... 1 Kensington Park Road K T C&N E ... 1 ... l ... 1 ... 3 Kensington Place ,, C ... 3 ... ... ... ... 1 4 Kensington Square ,, S E ... 1 2 2 ... ... ... 5 King Street ,, ,, ... 2 1 ... ... ... ... 3 Ladbroke Crescent K T N E ... 1 1 ... ... ... ... 2 Ladbroke Dwellings ,, N ... 1 ... ... ... ... ... 1 Ladbroke Grove ,, N, N E & C ... 18 8 1 ... 1 2 30 Ladbroke Road ,, C ... 3 1 ... ... ... ... 4 Ladbroke Square ,, ,, 2 1 ... ... ... ... ... 3 Ladbroke Terrace Mews ,, ,, ... 2 ... ... ... ... ... 2 Lancaster Mews ,, N E 3 1 ... ... ... ... 4 202 TABLE IXa.—continued. Street or Place. Registration Sub-District. Sanitary District. Small pox. Scarlet Fever. Diphtheria. Enteric Fever. Puerperal Fever. Erysipelas. Croup. Total Lancaster Road K T N E & N \V ... 27 9 1 ... 5 ... 42 Lansdowne Crescent ,, N E ... ... 2 ... ... ... ... 2 Lansdowne Road ,, N E & C ... 4 5 ... ... 1 ... 10 Latimer Road ,, N W ... 1 ... ... ... ... ... 1 Laverton Mews B S W ... 1 ... 2 ... ... ... 3 Ledbury Road K T N E ... 2 1 ... ... ... ... 3 Lexham Gardens B S W ... 6 ... 2 ... ... ... 8 Linden Gardens K T C ... 1 2 ... ... ... ... 8 Linden Mews ,, ,, ... ... 1 ... ... ... ... 1 Lionel Mews ,, N ... ... 1 ... ... ... ... 1 Lockton Street ,, N W ... 2 2 ... ... ... ... 4 Longridge Road B S W ... 1 ... ... ... ... ... 1 Lonsdale Road K T N E ... 3 ... 1 ... 1 ... 5 Lome Gardens ,, C ... 4 ... ... ... ... ... 4 Manchester Road K T N W ... 2 6 ... ... ... ... 8 Manchester Street ,, ,, ... 20 3 ... ... 2 ... 25 Manson Mews B S E ... 3 ... ... ... ... ... 3 Marloes Road KT&B S W ... 1 ... 1 ... ... ... 2 Martin Street K T N W ... 2 ... ... ... ... ... 2 Mary Place ,, ,, ... 2 ... ... ... 1 ... 3 Maxilla Gardens ,,,, N ... ... 1 ... ... ... ... 1 McLeod's Mews B S E ... 1 ... ... ... ... ... 1 Mentone Mansions ,, S W ... 1 ... ... ... ... ... 1 Milborne Grove ,, S E ... ... 1 ... ... ... ... 1 Millwood Street K T N ... 5 ... ... ... ... ... 5 Montpelier Row B S E ... 1 ... ... ... ... ... 1 Montpelier Street ,, ,, ... ... 2 ... ... ... ... 2 Moreton Gardens ,, ,, ... 1 ... ... ... ... ... 1 Mount Carmel Chambers K T C ... ... ... ... ... 1 ... 1 Monro Mews ,, N ... ... ... 1 ... ... ... 1 Murchison Road ,, ,, ... ... 1 1 ... ... ... 2 Neville Terrace B S E ... ... 1 ... ... ... ... 1 Newcombe Street K T C ... ... l ... ... 1 ... 2 New Street B S E ... 1 l ... ... ... ... 2 Norland Road K T C ... 1 ... ... ... ... ... 1 Norland Square ,, ,, ... 1 ... ... ... ... ... 1 North Row B S W ... 2 ... ... ... ... ... 2 North Street ,, ,, ... 5 2 ... ... ... ... 7 Old Manor Yard B S W ... 2 ... ... ... ... ... 2 Onslow Gardens ,, S E ... ... 4 1 ... ... ... 5 Onslow Houses ,, ,, ... 3 1 ... ... ... ... 4 Onslow Mews ,, ,, ... ... ... ... ... 1 ... 1 Onslow Mews West ,, ,, ... 1 ... ... ... ... ... 1 Onslow Square ,, ,, ... ... 1 ... ... ... ... 1 Ovington Square ,, ,, ... ... l ... ... ... ... 1 Oxford Gardens K T N ... 3 l ... ... 1 ... 5 Palace Gardens Mansions K T C ... ... l ... ... ... ... 1 Palace Gardens Terrace ,, ,, ... ... ... 2 ... ... ... 2 Pamber Street ,, N W ... 4 1 ... ... ... ... 5 203 TABLE IXa. —continued. Street or Place. Registration Sub-District Sanitary District. Small-pox. Scarlct Fever. Diphtheria. Enteric Fever. Puerperal Fever. Erysipelas. Croup. Total Peel Street K T C ... 1 1 1 ... ... ... 3 Pelham Street B SE ... ... 2 ... ... ... ... 2 Pembridge Crescent K T C ... ... 1 ... ... ... ... 1 Pembridge Road 11 11 ... 2 1 ... ... 1 ... 4 Pembroke Gardens 11 s w ... ... 1 ... ... 1 ... 2 Pembroke Square 11 ... ... ... ... ... ... ... 1 Penywern Road B 11 ... 1 ... ... ... 2 ... 3 Petersham Mews K T S E ... ... 3 ... ... ... ... 3 Philbeach Gardens B S W ... 3 ... ... ... ... ... 3 Phillimore Mews K T C ... 1 ... ... ... ... ... 1 Portland Road 11 N E & C ... 28 2 ... ... 6 ... 36 Portobello Road 11 N&NE ... 24 7 1 ... 3 ... 35 Powis Gardens 11 N E ... 2 ... ... ... ... ... 2 Powis Square 11 11 ... ... 1 ... ... 1 ... 2 Prince's Gate B S E ... ... ... ... ... 1 ... 1 Prince's Mews 11 11 ... 6 1 ... ... ... ... 7 Prince's Place K T C ... 6 ... ... ... I ... 7 Prince's Road 11 11 ... 8 2 ... ... 1 ... 11 Prince Teck Buildings 0B s w ... ... 1 ... ... ... ... 1 Queensberry Mews East B S E ... 2 ... ... ... 1 ... 3 Queensberry Mews West 11 11 ... 2 1 ... ... ... ... 3 Queen's Gate K T & B 11 ... 2 1 ... ... ... ... 3 Queen's Gaie Gardens KT&B 11 ... 3 ... 3 ... ... ... 6 Queen's Gate Mews K T 11 ... 2 2 ... ... ... ... 4 Queen's Gate Place Mews B 11 ... 1 ... ... ... ... ... 1 Queen's Gate Terrace K T 11 ... 1 ... ... ... ... ... 1 Queen's Place 11 C ... 1 ... ... ... ... ... 1 Queen's Road 11 11 ... 3 1 1 ... ... ... 5 Queen's Terrace Mews 11 S E ... ... 1 ... ... ... ... 1 Rackham Street K T N 2 7 3 ... ... 3 ... 15 Raddington Road 11 11 ... 3 ... ... ... 1 ... 4 Radley Mews B S W ... ... 2 ... ... ... ... 2 Radnor Terrace K T 11 ... 4 ... ... ... 1 1 5 Raymede Street 11 N ... 1 ... ... ... ... ... 1 Redcliffe Gardens B S W ... ... 1 ... ... ... ... 1 Redclitfe Mews 11 11 ... ... 1 ... ... ... ... 1 Redcliffe Road 11 11 ... 1 ... ... ... 2 ... 3 Redcliffe Square 11 11 ... 7 1 ... ... ... ... 8 Redfield Lane 11 11 ... 1 ... ... ... ... ... 1 Relton Mews 11 S E ... 4 ... ... ... ... ... 4 Rendle Street K T N ... 6 ... ... ... ... ... 6 Richmond Road B S W ... 1 1 ... ... ... ... 2 Rillington Place K T N E ... 5 ... ... ... ... ... 5 Roland Gardens B S E ... 1 ... ... ... ... ... 1 Rosary Gardens 11 11 ... ... ... ... ... ... ... 1 Royal Crescent Mews K T C ... ... 1 ... ... ... ... 2 Rutland Mews (West) B S E ... 1 ... ... ... ... ... 1 Rutland Mews (South) 11 11 ... 1 ... ... ... ... ... 1 Rutland Street 11 11 ... 2 ... ... ... ... ... 3 Rustor. Mews K T N E ... 1 1 ... ... ... ... 2 204 TABLE IXa.—continued. Street or Place. Registration Sub District. Sanitary District. Small pox Scarlet Fever. Diphtheria. Enteric Fever. Puerperal Fever. Erysipelas. Croup. Total. St. Alban's Road K T S E ... 2 ... ... ... 1 ... 3 St. Anil's Road 11 C& N W ... 6 2 ... ... 1 ... 9 St. Charles's Square 11 N ... l 1 ... ... ... ... 2 St. Clement's Road 11 X W ... 12 3 2 ... 3 ... 20 St. Ervan's Road 11 N ... 14 2 1 ... 2 ... 19 St. George's Road 11 N E ... 8 1 ... ... 2 ... 6 St. Helen's Gardens 11 X ... 3 ... ... ... ... ... 3 St. James's Place 11 C ... 5 ... ... ... 2 ... 7 St. James's Square 11 11 ... ... 1 ... ... ... ... 1 St. James's Terrace 11 11 ... 2 ... ... ... ... ... 2 St. John s Place 11 11 ... 2 1 ... ... ... ... 3 St. Katharine's Road 11 N W ... 9 1 ... ... 1 ... 12 St. Lawrence Road 11 N ... ... ... ... ... 1 ... 1 St. Lukes Mews 11 N E ... 4 ... 1 ... ... ... 5 St. Mirk's Road, Notting Hill 11 N &N E ... 10 ... 1 ... ... ... 11 St. Mark's Road. Fulham Road B s w ... ... 6 ... ... ... ... 6 St. Mary Abbott's Terrace K T c ... 1 ... ... ... ... ... 1 St. Marylebone Infirmary 11 X ... 3 1 ... ... 1 ... 5 St. Mary s Road 11 N E ... 1 1 ... ... ... ... 2 S>t. Michael's Gardens »11 N ... ... ... ... ... 1 ... 1 St. Quintin Avenue 11 11 ... 1 1 ... ... ... ... 2 Scampston Mews 11 11 ... 4 1 ... ... ... ... 5 Scarsdale Terrace 11 S W ... ... ... ... ... 2 ... 3 Scarsdale Villas 11 11 ... 2 ... ... ... ... ... 2 Seymour Place B 11 ... ... 5 ... ... ... ... 5 Shaftesbury Mews K T 11 ... 1 ... ... ... 1 ... 2 Silchester Road 11 N W ... 11 ... ... ... ... ... 11 Silchester Street 11 11 ... 2 ... ... ... ... ... 2 Silchester Terrace 11 11 ... 9 1 ... ... ... ... 10 Sloane Place B S E ... 1 4 ... ... ... ... 5 Southern Street K T N ... 28 2 ... ... 10 ... 44 South End Row 11 S E ... 1 ... ... ... ... ... 1 South Street, St. Mark's Road B S W ... ... 4 ... ... ... ... 4 South Street. Thurloe Square 11 S E ... 1 ... ... ... ... ... 1 Stafford Terrace K T C ... ... ... ... ... 1 ... 1 Stamford Cottages B S W ... ... 3 ... ... ... ... 3 Stanford Road K T S E ... 1 ... ... ... 1 ... 2 Stantope Gardens B 11 ... 2 ... ... ... ... ... 2 Stanhope Mews (East) 11 11 ... 1 ... ... ... ... ... 1 Stanhope Mews (West) • J 11 ... ... 1 ... ... ... ... 1 Stanley Crescent K T N B ... 2 ... ... ... ... ... 2 Stoneleigh Street 11 N W ... 15 4 ... ... 3 ... 23 Stratford Road B S W ... 1 ... ... ... ... ... 1 Sussex Place B S E ... 1 ... ... ... ... ... 1 Sussex Villas K T 11 ... 1 ... ... ... ... ... 1 Swinbrook Road K T N ... 8 3 1 ... 2 ... 14 205 TABLE IXa.,— continued. Street or Place. Registration Sub-District Sauitary District. Small-pox. Scarlet Fever Diphtheria. Enteric Fever. Puerperal Fever. Erysipelas. Croup. Total. Tabernacle Terrace K T C ... 1 1 ... ... ... ... 2 Talbot Grove 11 N E ... 2 2 ... ... ... ... 6 Talbot Mews 11 11 ... 1 ... ... ... ... ... 1 Tavistock Crescent 11 11 ... 2 ... ... ... 1 ... 3 Tavistock Road 11 ,, 2 10 ... ... ... ... ... 12 Telford Road 11 N ... 10 ... ... ... ... ... 11 Testerton Street 11 N W ... 6 2 1 ... 2 ... 11 The Triangle N ... 2 ... ... ... ... ... 2 Thistle Grove Lane B S E ... ... 1 ... ... ... ... 1 Thomas Place K T N W 3 2 ... ... ... ... ... 6 Thurloe Mews B S E ... 6 ... ... ... ... ... 6 Thurloe Square ,11 11 ... ... ... ... ... 1 ... 1 Tobin Street K T N \V ... 4 l ... ... 3 ... 8 Tottenham Street 11 N ... ... l ... ... ... ... 1 Treadgold Street 11 N W ... 1 l ... ... ... ... 2 Trebovir Road B S W ... 2 ... 1 ... ... ... 3 Tregunter Road 11 M ... 2 1 ... ... ... ... 3 Treverton Street k' T N ... 12 2 ... ... 1 ... 15 Upper Addison Gardens 11 C ... 2 ... ... ... ... ... 2 Upper Phillimore Gardens 11 11 ... 1 ... ... ... ... ... 1 Uxbridge Street 11 11 ... 1 1 ... ... ... ... 2 Vicarage Gardens 11 11 ... 1 ... ... ... ... ... 1 Vicarage Gate 11 11 ... ... l ... ... ... ... 1 Victoria Dwellings 11 N ... 2 2 ... ... ... ... 4 Wallgrave Road B S W ... 5 4 ... ... ... ... 9 Wala er Road K T N W ... 38 7 4 ... 3 ... 52 Warwick Gardens B S W ... ... 1 ... ... ... ... 1 Warwick Road 11 11 1 ... 4 ... ... ... ... 5 Warwick Street K T 11 ... ... 1 ... ... ... ... 1 Westbourne Grove 1111 N E ... ... 2 ... ... 1 1 4 West Cromwell Road B S W ... ... 1 ... ... ... ... 1 Western Dwellings K T N ... 3 ... ... ... ... ... 3 Western Terrace 11 N E ... 1 1 ... ... ... ... 2 West Mall 11 C ... ... ... ... ... 1 ... 1 West Pembroke Place 11 s w ... 1 ... ... ... ... ... 1 Wetherby Gardens B S E ... ... 1 ... ... ... ... 1 Wetherby Terrace 11 s w ... ... ... ... ... 1 ... 1 Wheatstone Road K T N 5 1 1 ... ... ... 7 Williams Place 11 s w ... ... 1 ... ... ... ... 1 William Street, Notting Dale 11 N W ... 11 4 ... ... 1 ... 16 William Street, Notting Hill 11 c ... ... ... ... ... l ... 1 Wornington Road 111 N ... 22 9 5 ... 7 1 44 Wynnstay Gardens 11 S W ... ... ... 1 ... 1 ... 2 Yeoman's Row B S E ... 3 2 ... ... 1 l 7 York Mews K T N W ... 2 ... ... ... ... ... 2 In addition, 6 cases of "continued fever were notified, viz.,one each from St. Ann's Road (N.W.), Silchester Terrace (N.W.), and Telford Road (N), in the Kensington Town Sub-District; and Milborne Grove (S.E.), North Row (S.W.), and Queen's Gate (S.E) in the Brompton Sub-District. 206 TABLE X. Vaccination Officer's Return respecting the Vaccination of Children whose Births were Registered in 1895.* (Vide page 73). 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, Unvaccinated. Postponement by Medical Certificate. Removal to District the Vaccination Officer of which has been duly apprised. 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 Vaccination. "Had Smallpox." 1895. 1 2 3 4 5 6 9 10 11 1st January to Kensington Town 3,064 2,382 20 ... 329 40 15 278 ... 31st Dec. Brompton 570 462 5 ... 45 9 ... 49 ... Total 3,631 2,844 25 ... 374 49 15 327 ... * The complete Return for 1896 will not be due until February, 1898. 207 TABLE XI. LICENSED SLAUGHTER-HOUSES. SOUTH OF HOLLAND PARK AVENUE, (SOUTH KENSINGTON.) LOCALITY OF PREMISES. NAME OF LICENSEE. 60, Kensington High Street Mr. Evans 35, Earl's Court Road Mrs. Matson 21, Peel Place, Silver Street Mr. Osborne 25, Silver Street ,, Wright 133, High Street, Notting Hill ,, Candy 113, Holland Park Avenue ,, Holloway NORTH OF HOLLAND PARK AVENUE, (NORTH KENSINGTON.) Lonsdale Mews Mr. Grove 13, Archer Mews ,, Bawcombe 10, Edenham Mews ,, Goddard 61, Silchester Road ,, Shattock 195, Clarendon Road „ Simmons 235, Walmer Road Mrs. Van 4, Royal Crescent Mews Mr. Brooker 208 TABLE XII. LICENSED COW-HOUSES. SOUTH OF HOLLAND PARK AVENUE, (south kensington.) LOCALITY OF PREMISES. NAME OF LICENSEE. Campden Street (Yard in) Mr. Lunn NORTH OF HOLLAND PARK AVENUE, (north kensington.) 187, Walmer Road Mr. Arnsby 5, Ledbury Mews „ Liddiard 23, Bramley Road „ Tame 209 APPENDIX B. QUINQUENNIAL ENUMERATION OF THE POPULATION, IN 1896. Table A.—Enumeration Districts, and the population thereof, in 1891 and 1896, shewing Increase or Decrease. Table B.—Summary of the Returns in the several Enumeration Districts, showing number of Males and Females, and the total of both Sexes in the several Districts, compared with the number in 1891. 210 APPENDIX. TABLE A. Enumeration Districts.—Being a list of the Streets and Places contained in each of the several Districts, as mapped out by the Registrar, and the Population of the Districts, in 1891 and 1896, together with the Increase or Decrease in the same, at the latter date. KENSINGTON TOWN SUB-DISTRICT. No. 1.—From 27 to 46, Queen's Gate; from 15 to 1, Queen's Gate Place; from 23 to 11, Queen's Gate Gardens; from 12 to 1, Petersham Terrace; Elvaston Place; 35 to 15, Gloucester Road; Gore Street; 1 to 43, Queen's Gate Terrace; Queen's Gate Mews ; Petersham Mrws; Elvaston Mews. Population, 1891, 1,356; 1896, 1445. Increase 89. No. 2.—From Boundary Stone at 17, Kensington Gore to Queen's Gate; Jay's Mews, Park Lane, to rear of South Kensington School of Music (omit the latter building): Queen's Gate, on the east side, from Kensington Gore to No. 167; Imperial Institute Road; the whole of Hyde Park Gate and Mews, from Queen's Gate to Palace Gate; Palace Gate; 1 to 26, Queen's Gate; 2 to 58, Queen's Gate Terrace, and Queen's Gate Terrace Mews; 1 to 13, Gloucester Road; Kensington Gate; the whole of De Vere Gardens, from High Road to Canning Place and Mews; North side of Canning Place; Palace Gate Mews; Laconia Mews, and Edinburgh Terrace. Population, 1891, 2,363; 1896, 2,671. Increase 308. No. 3.—From 1 to 13, Canning Place; 2 to 34, Gloucester Road; St. George's Terrace and Place, and Victoria Grove Mews; Cornwall Mews East; 1 to 50, Cornwall Gardens; Cornwall Gardens Mansions and Stabling; Cornwall Mews West; Sussex Villas; Victoria Grove; Albert Mews and the east side of Victoria Road, from No. 1 to wall in rear of Cornwall Gardens (omit Edinburgh Terrace.) Population, 1891, 1,201; 1896, 1,247. Increase 46. No. 4.—From 53, on the West side Victoria Road, to wall in rear of Cornwall Gardens; Cambridge Place; Albert Place; Douro Place; St. Alban's Road to Stanford Road; Cottesmore Gardens; Eldon Road; Stanford Road; Kingsley Villas and Mews; Merton Road, Kelso Place and Studios to fence wall, Kensington Court Gardens. Population, 1891, 1,303; 1896, 1,285. Decrease 18. No. 5.—Charles Street (omit Kensington Court Gardens); Little Charles Street; both sides of St. Alban's Road from Stanford Road to South-end; the Flats; South end and Gardens; Trafalgar Place and Cottages; James' Street and Place; Kensington Court Place; Kensington Square; King Street: Burden Mews; Ball Street; Young Street; Mews in latter; 97, High Street to Victoria Road; Prince of Wales' Terrace; Kensington Court, and Mansions, and Mews. Population, 1891, 2,746 ; 1896, 2,442. Decrease 304. 211 No. 6—From 99 to 127a, High Street; Scarsdale House, Terrace and Place; Cottages on West side of Wright's Lane; Cheniston Gardens and Studios; 1 to 43, and 2 to 44, Abingdon Villas; 2 to 36. North side of Scarsdale Villas; 1 and 2, Shaftesbury Villas; Board Schools; Phillimore Terrace; Somerset Yard; Adam and Eve Yard, Stables and Mews; Long's Terrace; 129 to 195b, Kensington High Street. Population 1891,1,216; 1896,1,258. Increase 42. No. 7.—From 65 to 1, East side of Farl's Court Road; Kensington Buildings; 217 to 253, Kensington High Street; Residents at Pro Cathedral; Baxter's Cottages; 197 to 215, Kensington High Street; Wynnstay Gardens; Britannia Brewery; 3 to 6, Shaftesbury Villas; Nos. 45 to 85 and 46 to 84, Abingdon Villas; Scarsdale Villas, North side, from 38 to 72; 1 to 87, and 2 to 70, Abingdon Road; Lyon Mews; Warw ick Street (now Sutton Street); Warwick and Abingdon Mansions; Park Terrace; Emma Place. Population 1891, 1,862; 1896, 2,001. Increase 139. No. 8.—From 1 to 16, Leonard Place; la to 66, Earl's Court Road (West side); Pembroke Place and Pembroke Place West; William's Place; Pembroke Square; Pembroke Cottages North (omit Pembroke Cottages South); Pembroke Mews; 73 to 67, Earl's Court Road (East side): 57 to 1, South side of Scarsdale Villas; 72 to 82, and 89 to 101, Abingdon Road; 7 to 10, Alma Terrace; 7 to 12, Inkerman Terrace; Marloes Road, from Scarsdale Villas to Stratford Road; 1,3 and 5, Stratford Road; Blithfield Street, and in the rear of Marloes Road, above described; Shaftesbury Mews. Population 1891, 1,673 ; 1896, 1,569/ Decrease 104. No. 9.—Kensington Crescent; 6 to 12, Radnor Terrace; Cottages and Stabling to Wharf: 235 to 261, Warwick Road; Stabling on East side ot Warwick Road from High Road to School House Passage; Nos. 2 to 46 and 1 to 41, Warwick Gardens; Pembroke Gardens; John's Lodge Studios and Pembroke Lodge Studios, in High Road; Edwardes' Cottages: Stabling, &c., in rear of 1, 2 and 3, Warwick Gardens; Edwardes' Terrace and Place; Edwardes' Square, West side; Mews and Lodges ; Earl's Terrace and Lodges. Population 1891,1.184; 1896, 1,342. Increase 158. The preceding 9 Enumeration Districts are in the South Division of the Parliamentary Borough of Kensington. No. 10.— From Boundary of Parish, 40, High Street, to Church Street: Brown's Buildings; Cousin's Terrace; Clarence Place and Mews; Nos. 2 to 64, Church Street; Melon Place; Vicarage Gardens, Gate and Mansions; 2 to 90, and 1 to 53, Palace Gardens Terrace; Sheffield Gardens; 1 to 7, Berkeley Gardens; Inverness Gardens; Brunswick Gardens. Population 1891, 1,405; 1896, 1,490. Increase 85. No. 11.—From 92, Palacc Gardens Terrace to High Road; Palace Gardens Mansions and Mews to Boundary Stone; 26 to 22, Palace Gardens; Lucerne Mews; Mall Cottages; 73 to 55, Palace Gardens Terrace; Strathmore Gardens; Courtland and Brunswick Terrace; 8 to 11, Berkeley Gardens; Bedford Terrace and High Row, to the Mall; 14 to 30 and 1 to 13, Silver Street; 11 to 39, High Street, Notting Hill; West side of The Mall to Silver Street; Mall Chambers; West Mall and Mews: Rabbit Row; No. 1, Kensington Place and -Residences on the South side of Kensington Place; 1 and 2, Vine Place; 2 to 46, Edge Street; Residences at Water Works. Population 1891, 1,293; 1896, 1,254. Decrease 39. 212 No. 12.—Nos. ] to 25, Edge Street, on the South side, taking Cousins Cottages in rear; 1 to 16, Peel Place; Peel Street; Campden Houses; West House and 4 houses Campden Hill West, between Peel Street and Campden Street; Campden Street and Mews; 2a to 76, Bedford Gardens. Population, 1891, 2,023; 1896, 2,048. Increase 25. No. 13.—Holland Park and Mews; Osborne House; 1 to 29. Holland Park Avenue; Aubrey P.oad (omit Aubrey House); South side of High Street, Notting Hill, to No. 147; 90 to 100. Campden Hill Road; Campden Hill Gardens; Notting Hill Grove and Mews, North side to Tower Cressy; New Road; Campden Hill Square. Population, 1891, 1,547; 1896,1,486. Decrease 61. No. 14.—Newcombe Street (omit Board School); Jameson Street: Farmer Street; East side of Johnson Street; Kensington Place; 5 to 25, Dartmoor Street, from Jameson Street to Johnson Street; Uxbridge Street, from Newcombe Street to Johnson Street; 101 to 41. South side of High Street. Notting Hill. Population, 1891, 1,637; 1896,1.547. Decrease 90. No. 15.—From 1 to 71. South side of Bedford Gardens; Campden Hill Terrace; 1 and 2, Norwood Place; Sheffield Terrace; Wilton Villa; Hypatia Villa; Percy Lodge; Percy Villas; Fern Lodge; York Villas; South Villas; Tor Villas; Observatory Gardens; Campden House Road and Mews; Observatory Avenue; Campden and Little Campden Houses and Stables; Gardener's Lodge; Lancaster Lodge; Gloucester Walk; 81 to 25, Church Street: Campden Grove. 2 to 38, and 1 to 31; Gordon Place; Pitt Street; Hornton Villa; Duke's Lane; Mount Carmel Chambers; Gordon Cottages; Annis Place; Bullingliarn Place; Vine Terrace; Holland Place Chambers; 2 to 50, North side of Holland Street. Population, 1891, 2,047; 1896,2,000. Decrease 47. No. 16-—From 1 to 39. South side. Holland Street; Gregory Place; Gordon Place, from Holland Street to wall of Churchyard; Church Walk; 23 to 1. Church Street. West side; Police Station; Church Court; 80 to 114. North side of High Street; Hornton Place; Hornton Street; Drayson Mews; Hornton Cottage; Middry Lodge; 10 to 21, Lower Phillimore Place; Mews in rear, between Hornton Street and Campden Hill Road; The Abbey and The Grey House, Campden Hill; Bute House; Bute House Garden Lodge; Thornwood Lodge; Argyll Lodge; Holly Lodge; Moray Lodge on North side of Avenue; Airlic Gardens; Thorp Lodge; South side of Notting Hill Grove, to, and including Aubrey House. Population, 1891,1,618 ; 1896.1,609. Decrease 9. No. 17.—22, Lower, to 32. Upper Phillimore Place; 1a to 23, Campden Hill Road; Argyll Road; Phillimore and Upper Phillimore Gardens; Stafford Terrace; Essex Villas; Durham Villas; Phillimore Mews, from West side of Campden Hill Road to Holland Walk; Holland House and Lodge. Population, 1891,1,645; 1896,1.801. Increase 156. No. 18.—Melbury Road, both sides, from High Road to Addison Road; Lee Cottage in grounds; Laura Place; Alfred Place; Catherine Terrace; Holland Park Road, from Melbury Road to Addison Road; Addison Road on the East side, from Kensington Road to Holland Park Avenue; 31 to 73. Holland Park Avenue; Holland Park Mansions; 1 to 49. St. Mary Abbot's Terrace; Russell Road to Russell Gardens; South side of Russell Gardens to Holland 213 Road; Holland Road on the West side from Russell Gardens to Kensington Road; Holland Road on the East side from Napier Road; Holland Mews, in rear of Holland Road; Napier Road, on the South side, from Holland Road to Addison Road; Addison Road on West side, from No. 49, to High Road. Population 1891, 2,140; 1896, 2,119, Decrease 21. No. 19.—North side of Napier Road, from Addison Road to Holland Road; East side of Holland Road, from Napier Road to No, 166; South side of Addison Gardens, from Holland Road to Holland Villas Road; West side of Holland Villas Road from Addison Gardens to Holland Road; the whole of Addison Crescent; East side of Holland Villas Road; West side of Addison Road, from Napier Road to Holland Park Avenue. Population 1891,1,091; 1896, 1,094. Increase 3. No. 20.—Russell Gardens, North side, from Railway to Holland Road; Russell Gardens Mews; Elsham Road; Hansard Mews; West side of Holland Road, from Russell Gardens to Boundary Stone at No. 163; East side of Holland Road, from 168 to Holland Park Avenue; North side of Addison Gardens, from Holland Road to Holland Villas Road; West side of Holland Villas Rood, from Addison Gardens to Upper Addison Gardens; the whole of Upper Addison Gardens; 75 to 127. Holland Park Avenue; Cottages and Stabling; Lome Gardens. Population 1891, 1,726; 1896, 1,690. Decrease 36. No. 21. —From Boundary Stone at 8, Wellington Terrace, to 90, High Street Notting Hill. North side; Clanricarde Gardens; Linden Gardens and Mews, and Garden Mews; Pembridge Gardens; Nos. 2 to 48, Pembridge Road; 55 to 1, Pembridge Villas; Stables between 27 and 29. Pembridge Square to Boundary Stone at 17a; Stables at rear of 16, Pembridge Square; Nos. 1 to 29, and 2a to 32, Dawson Place; Pembridge Place; Chepstow Place Mews; Chepstow Tavern Mews and Yard; Westbourne Grove, South side; from Chepstow Place to Boundary Stone at 121; also Stables at rear of 121, Westbourne Grove (Leinster Yard). Population 1891, 2,663; 1896, 2,759. Increase 96. No. 22.—From Boundary Stone at 106, Westbourne Grove (North side) to Richmond Road; two Houses and Mews on the East side of Richmond Road; Stable on the West side of Richmond Road; 14 to 176, Westbourne Grove; Norfolk Road Villas; Mews on East and West sides of Norfolk Road (omit Norfolk Road); 48 to 62, Ledbury Road; St. John's Mews; 178 to 232, Westbourne Grove; 133 to 247, Westbourne Grove; 4 to 46, Ledbury Road; and 1 to 61a, Ledbury Road; Pembridge Mews; also Mews on each side of Ledbury Road; Norfolk Yard; Brunswick Mews; Lambton Mews; 1 to 14, Pembridge Crescent; Stables adjoining 14, Wellington Mews; 2 to 56, Pembridge Villas; la to 13, East side of Denbigh Road; 2 to 40, and 1 to 23, Chepstow Villas. Population 1891,1,860; 1896, 2,051. Increase 191. No. 23.—From 15 to 30, Pembridge Crescent; 2 to 24, Denbigh Road (West side); 58 to 66, Pembridge Villas; Denbigh Terrace; Denbigh Mews; 42 to 52. and 25 to 33, Chepstow Villas; 1 to 16, Archer Street (South side); Archer Mows; 2 to 112 East side of Portobello Road; Portobello Mews; Pelham Mews; Lonsdale Yard, on the West side of Portobello Road; the West side ot Portobello Road to Chepstow Villas. Population 1891, 1,343 ; 1896, 1,267. Decrease 76. 214 No. 24.—From 13, Pembridge Road (West side) to Lonsdale Yard (omit the latter); 1 to 13, Portobello Road; 65 to 111, West side of Portobello Road; 54 to 64, and 35 to 41, Chepstow Villas; 2 to 120, Kensington Park Road; East side Stanley Gardens Mews; South side of Archer Street, from Kensington Park Road to (No. 17) corner of Portobello Road; South side of Ladbroke Gardens to Stanley Crescent; East side of Stanley Crescent; the whole of Stanley Gardens; Nos. 25 to 47, Kensington Park Gardens. Population 1891, 1,142 ; 1896, 1,134. Decrease 8. No. 25.—From 92 to 180, High Street, Notting Hill (North side); 2 to 38, Holland Park Avenue; 2 to 32, Ladbroke Grove; Ladbroke Square; West side of Kensington Park Road, from Ladbroke Square to Horbury Chapel; Horbury Crescent; Horbury Mews; Victoria Gardens and Stabling; Ladbroke Road, on both sides, from Horbury Chapel to Ladbroke Terrace; Prince Albert Mews; Ladbroke Terrace (both sides); Ladbroke Terrace Mews; Welby Mews; Ladbroke Road, both sides, between Ladbroke Terrace and Ladbroke Grove; Lorton Terrace; 1 to 11, Pembridge Road; Bulmer Place and Terrace; Uxbridge Terrace. Population 1891, 1,755; 1896, 1,788. Increase 33. No. 26—From 40 to 74, Holland Park Avenue; Mews in rear of 66 to 74, Holland Park Avenue; East side of Lansdowne Road, from la to 108; Ladbroke Grove on the West side, from Lansdowne Road to 40, Holland Park Avenue; Lansdowne Crescent; St. John's Gardens; 1 to 14, Hanover Terrace; 71 to 91, and 38 to 46, Ladbroke Road; 34 to 68, Ladbroke Grove (on the East side); 34 and 35, Ladbroke Gardens; 23 to 1, Stanley Crescent; 24 to 1, Kensington Park Gardens, and Gardener's Lodge. Population 1891, 1,505; 1896, 1,515. Increase 10. No. 27.—From 76 to 98, Holland Park Avenue; Lansdowne Mews in rear of 80 to 98, Holland Park Avenue; 2 to 78, East side of Clarendon Road; South side of Elgin Crescent to Chichester Road; two houses in Chichester Road; Nos. 77 to 1 on the West side of Lansdowne Road; 48 to 54, and 93 to 109, Ladbroke Road; 1 to 71, Clarendon Road (on the West side); 16 to 19, Hanover Terrace. Population 1891, 997 ; 1896, 876. Decrease 121. No. 28.—From 100 to 116a, Holland Park Avenue; 1 to 100, on the East side, Portland Road; South side of Clarendon Place: Woburn Cottage; 111, Ladbroke Road; Alfred Mews; West side of Portland Road, from 43 to 179; Heathfield Street; Omnibus Yard; East side of Pottery Lane, from Dispensary to School House; 247, Walmer Road; Portland Place and St. John's Place, between Pottery Lane and Portland Road. Population 1891, 1,324; 1896, 1,419. Increase 95. No. 29-—From 1 to 33, West side Prince's Road; Norland Stables and Prince's Yard; 124 to 150, Holland Park Avenue; East and West sides of Norland Square; 152 to 178, Holland Park Avenue; 1 to 12, and 33 to 35, Addison Road North; Percy Mews, adjoining Norland Arms; Royal Crescent; Darnley Road; 180 to 204a, Holland Park Avenue; East side of Norland Road to Queen's Road; Royal Crescent Mews and Cottages; Phoenix Place and Mews; Queen's Place; Royal Crescent Mews, East; South side of Queen's Road from Norland Road to Prince's Road. Population 1891, 1,894; 1896, 1,799. Decrease 95. 215 No. 30.—North side of Queen's Road from Prince's Road to Salvation Army Barracks, including the Northern end of Norland Square; Charles Street; St. Ann's Villas; St. Ann's Road on the West side to Boundary Stone at 65; Boundary Road; 13 to 32, Addison Road North; Nos. 2, 4, 6 and 8, Latimer Road; St. Ann's Road on the East side to Crescent Street. Population 1891, 1,148; 1896, 1,092. Decrease 56. No. 31.—South side of Crescent Street, from St. Ann's Road to St. Clement's Road; St. Clement's Road, from Crescent Street to wall in rear of St. James's Square; South side of William Street to Princes Road; 105 to 35, West side of Prince's Road; St. Katharine's Road. Population 1891, 1,880; 1896,2,241. Increase 361. No. 32.—St. Ann's Road, on the East side, From No. 84 to No. 38, Bramley Road; North side of Kenilworth Street; Abbey Road (or Street); Stoneleigh Street; St. Clement's Road, from No. 47, to Lancaster Road; Edinburgh Terrace; Treadgold Street; 259 to 195, Lancaster Road; 1 to 47, South side of Bomore Road; from 195, Lancaster Road, to School House at corner of Walmer Road; West side of Walmer Road, from Bomore Road to No. 230; North side of Mary Place, taking Hesketh Place; Tobin Street; Pottery Residences between Walmer Road and St. Clement's Road. Population 1891, 3,233 ; 1896, 3,361. Increase 128. No. 33.—From 121 to 247. East side Walmer Road; both sides of Dulford Street; from 120 to 184 011 West side of Walmer Road; North side of Bomore Road; Fowell Street: 153 to 193, Lancaster Road; 2 to 24 (Railway Archway) Silchester Road; Baths (to Railway Archway) opposite side; Lancaster Road from Baths, corner of Silchester Road to No. 320, Blechynden Mews; Blechynden Street to Railway Archway; Hurstway Street; Barandon Street; Testerton Street; 40, Bramley Road to Railway Station; and opposite side from 15 to Railway Archway. Population 1891, 3,485 ; 1896, 3,320. Decrease 165. No. 34 -From Bramley Road, Railway Archway, West side, to Silchester Road; Martin Street; Brainley Road Mews; York Mews; from South side Bramley Road, to No. 75, Silchester Road. Boundary Stone, taking Silchester Terrace; Lockton Street; Blechynden Street, from Bramley Road to Boundary Stone at School House; Mission Hall; Manchester Road. Street, and Mews; the South side of Silchester Road; East Mews Road; Latimer Mews. Population, 1891.2.667; 1896.2,779. Increase 112. No. 35.—North side of Silchester Road, from Bramley Road to Latimer Arms; Bramley Road, West side from Silchester Road to St. Helen's Gardens; Silchester Mews; that portion of Manchester Road between Silchester Road and Walmer Road; Silchester Street; Bramley Street; Calverley Street; Carnarvon Mews; Walmer Road, both sides, from Bramley Road to Latimer Arms; Pamber Street; Aldermaston Street; Cottage in the rear of Latimer Arms; St. Helen's Gardens; Kelfield Gardens; St. Quintin's Avenue; Upper St. Helen's Gardens; Highlever and Upper Highlever Roads; The Triangle (omit the Vicarage.) Population, 1891,2,602; 1896,2,821. Increase 219. No. 36.—North side of Chesterton Road to St. Mark's Road; East side of St. Mark's Road, from Chesterton Road to Fields; imaginary boundary across Fields to St. Mary's Terrace; From St. Mary's Terrace, taking South side of Harrow Road to. and including Cemetery; from Canal Bridge, taking West 216 side of Ladbroke grove, to North side of Chesterton Road; Edinburgh Road; Admiral Terrace, Mews and Place; Treverton Street; Bransford Street; Branstone Street; Hewer Street; Raymede Street; Exmoor Street; Rackham Street; St. Charles's Square and Place; Norburn Street; Millwood Street; from Cemetery to the Plough Inn, No. 599, Harrow Road, thence direct South, over Canal and Railway, to Ladbroke Grove; Barges, if any (omit St. Marylebone Infirmary). Population, 1891, 4,957 ; 1896, 5,266. Increase 309 No. 37.—From 128, Ladbroke Grove to No. 320: the West side of Portobello Road from its Northern junction with Ladbroke Grove to Railway Archway; both Bides of Oxford and Cambridge Gardens, between Ladbroke Grove and Portobello Road; Thorpe Mews; St. Michael's Gardens; Chesterton Road, both Bides, between Ladbroke Grove and Portobello Road; St. Lawrence Road; Bonchurch Road; Faraday Road; Telford Road; Lionel Mews; Golborne Mews (omit St. Elizabeth's Home). Population 1891, 3,238; 1896, 3,317. Increase 79. No. 38.—From 181, Portland Road, West side, to Brewery; 102, on the East side, to Clarendon Road; West side of Clarendon Road, from Walmer Road to North side of Clarendon Place (omitting Dulford Street) taking North side of Clarendon Place to Portland Road; 81 to 123, Lansdowne Road; 63 to 115, and 50 to 124, Elgin Crescent; both sides of Blenheim Crescent, from Ladbroke Grove to Clarendon Road; Cornwall Road, on the South side, from Ladbroke (irove to Clarendon Road; that portion of St. Mark's Road between Blenheim Crescent and Cornwall Road; Nos. 80 to 120, Clarendon Road; Chapel Road, both sides; 83 to 119, Ladbroke Grove. Population 1891, 2,871 ; 1896, 3,034. Increase 163. No. 39,—From 121, Ladbroke Grove to 137; North side of Cornwall Road, from Ladbroke Grove to Clarendon Road; St. George's Road; St. Mark's Road, from Cornwall Road to Lancaster Road; Ladbroke Crescent; Talbot Grove and Mews; Clarendon Road, from the North side of Cornwall Road to Lancaster Road; and South side, only from Clarendon Road to Ladbroke Grove (the bank corner). Population, 1891, 2122; 1896, 2,270. Increase 148- No. 40. —Lancaster Road, North side, from Ladbroke Grove to the Wesleyan Chapel at corner of Walmer Road; St. Marks Road on the East side to Chesterton Road; St. Mark's Road on the West side throughout from Lancaster Road to fields; Rillington Place; Maxilla Gardens; Ruston Mews; Oxford and Cambridge Gardens, both sides, to Ladbroke Grove; Bassett Road, ditto; Scampston Mews; South side of Chesterton Road, from St. Mark's Road to Ladbroke Grove; Oxford Mews; West side of Ladbroke Grove, from Chesterton Road to Lancaster Road; Railway Mews. Population 1891, 3,110; 1896,3,033. Decrease 77. No. 41.—From 63 to 75, Ledbury Road, West side (see Boundary Stone); Lonsdale Road, Mews, and Yard; Colville Mews; North side of Archer Street, from Colville Road to Portobello Road; East side of Portobello Road, from 112 to 154, taking Bolton Road and Mews; Western Terrace; Buckingham Terrace and Mews; the whole of Colville Terrace, and that portion of Colville Road between Archer Street and Colville Tereace. Population 1891, 2,701; 1896, 2,758, Increase 57. 217 No. 42.—From 156, East side of Portobello Road to Cornwall Road, taking Dunworth Mews, between Nos. 204 and 206; South side of Cornwall Road to Boundary Mews; West side of Boundary Mews to Talbot Road; Talbot Road on the North side, from Boundary Mews to Portobello Road, and on the South side from Portobello Road to No. 103; Colville Square Terrace; Colville Square, Mews, and Gardens; Colville Mansions and Houses; Powis Square, Mansions, Gardens and Houses; Clydesdale Road, Mews and Mansions; Aston Road. Population, 1891, 2,052; 1896, 2,132, Increase 80. No. 43.—North side of Cornwall Road from Portobello Road to St. Luke's Road; West side of St. Luke's Road and Mews; 216 to 238, Portobello Road; Roseland Place; Albion Place; Lancaster Road, on the South side, from Portobello Road to St. Luke's Road; Basing Road, North of Cornwall Road to Lancaster Road; Lancaster Mews; that portion of All Saint's Road between Cornwall Road and Lancaster Road. Population, 1891, 1,370; 1896, 1.320. Decrease 50. No. 44.-Lancaster Road, North side, from Portobello Road to St. Luke's Road; the whole of Tavistock Road; Tavistock Crescent on South side, from Portobello Road to St. Luke's Road; and on the North side, from Portobello Road to Tavistock Hotel foot bridge; No. 240. Portobello Road to Railway Archway; St. Mary's Road; All Saints' Road, between Lancaster Road and Tavistock Crescent; Basing Road, ditto; Golden Mews, between 242 to 244, Portobello Road; Sylvester Mews. Population, 1891, 2.370; 1896.2,524. Increase 154. No. 45.—From 264, East side, Portobello Road to Golborne Road; South side of Golborne Road; to Swinbrook Road (No. 79); the West side of Swinbrook Road to Acklam Road; Acklam Road, North side, from Swinbrook Road to Portobello Road (omit St. Joseph's Home.) Population, 1891 ; 1,335; 1896, 1.387. Increase 52. No. 48.—North side of Archer Street, from Portobello Road to Kensington Park Road; North side of Ladbroke Gardens to Ladbroke Grove; East side of Ladbroke Grove, from Ladbroke Gardens to South side of Elgin Crescent; South side of Elgin Crescent, from Kensington Park Road to Ladbroke Grove, and from Kensington Park Road to Portobello Road; Vernon Mews, between Nos. 117 and 119, Portobello Road; Portobello Road. West side, from Elgin Crescent to Archer Street, taking Kensington Park Road, from Archer Street to Elgin Crescent; the whole of Arundel Gardens. Population, 1891.1.004; 1896, 1,064. Increase 60. No. 47.—North side of Elgin Crescent, from Portobello Road to Ladbroke Grove; East side of Ladbroke Grove to Railway Archway; Kensington Park Road, between Elgin Crescent and Cornwall Road; Kensington Park Mews; Convent Gardens; Cornwall Road, both sides, from Portobello Road to Ladbroke Grove; Elgin Mews; Blenheim Crescent, between Ladbroke Grove and Portobello Road; Codrington Mews; Lancaster Road, both sides, between Ladbroke Grove and Portobello Road; West side of Portobello Road, from Railway Archway to North side of Elgin Crescent, taking Tavistock Mews; Hayden's Place; Grove Place. Population, 1891, 2,710; 1896, 2,776. Increase 66. 218 No. 48.—From 77. South side of Golborne Road to Railway Bridge; East side of Swinbrook Road to Acklam Road; North side of Acklam Road, from Swinbrook Road to St. Ervan's Road; Wornington Road, both sides, from Golborne Road to Acklam Road; the whole of St. Ervan's Road; North side of Golborne Road. Population, 1891, 3,670; 1896. 3.712. Increase 42. No. 49.—Wornington Road, from Golborne Road, both sides, to Ladbroke Grove, including Victoria and Western Dwellings (i.e.. 1 to 175. and 2 to 162. and 214 to 234), taking Faraday Road on the East side of Portobello Road; Telford Road, ditto; Rendle Street; Murchison Road and Mews; Queen Anne's Terrace; Wheatstone Road; Munro Mews; Wornington Mews; the East side of Portobello Road, from Golborne Road to Railway Bridge. Population 1891, 4,559; 1896. 4,788. Increase 229. No. 50.—South-east side of Golborne Road, from Railway Bridge to Kensal Road; Edenham Street and Mews; Tottenham Street; Nos. 16 to 72. and 27 to 99. Southam Street; 61 to 67, and 85 to 115. Kensal Road: 2 to 8, Northwest side of Golborne Road; 2 to 68, North side of Hazlewood Crescent; Holy Souls' R.C. Church. Population 1891, 2,817; 1896, 2,885. Increase 68. No. 51.—North-west side of Golborne Road, from 22 to Railway Bridge, and No. 36; 42. Bosworth Road to Boundary Stone at Southam Street; from No. 23, Bosworth Road to end; Southam Street, both sides from Golborne Road to Bosworth Road, and Golborne Terrace; Adair Road; between Appleford Road and Southam Street; Absolom Road; South side of Appleford Road. Population 1891, 2.458; 1896. 2,715. Increase 257. No. 52.—West-side of Johnson Street, from Uxbridge Street to Kensington Place; both sides of Uxbridge Street, from Johnson Street to Durham Place; Street, from Johnson Street to William Street; Ernest Street; William Street; 91 to 99, Campden Hill Road; Warehouses; South side of High Street, Notting Hill, rear of 145 to 103 (to corner of Johnson Street); 24 to 47. Kensington Place. Population 1891,1,502; 1896, 1,551. Increase 49. No. 53.—West side of Portland Road, 1 to 41a; West side of Pottery Lane to "Zetland Arms;" East side, 2 to 116, Prince's Road ("Zetland Arms"); 118 to 122, Holland Park Avenue; Tabernacle Terrace; St. John's Place; St. James's Place; Prince's Place; Charlotte Terrace; Virginia Place; St. James's Square; St. James's Terrace. Population 1891, 1,662; 1896, 1,766. Increase 104. No. 54.—Bramley Road, East side, from Railway Arch to Silchester Road; both sides from Railway Arch to Bramley Road; both sides of Walmer Road; from Railway Arch to Bramley Road; East side of Bramley Road, from Silchester Road to Walmer Road. Population 1891, 806; 1896, 836. Increase 30. No.55.—South side of Acklam Road to Footbridge over Railway; Bevington Road; Angola Mews ; Blagrove Road; Raddington Road. Population 1891, 1,928; 1896, 1,941. Increase 13. 219 No. 56.—North side of Crescent Street and William Street; East side of St Ann's Road, from Crescent Street to 82, Bangor Street; South side of Kenilworth Street, from St. Ann's Road to St. Clement's Road; Nos. 45 to 13, West side of St. Clement's Road; East side of St. Clement's Road, from William Street to Police Station at Mary Place; the South side of Mary Place, including Gorham Place, to Pottery Lane; and hence to North side of William Street. Population 1891, 2,273; 1896, 2,515. Increase 242. No. 57.—Nos. 10 to 20, North-west side of Golborne Road, from Golborne Road to Bosworth Road: Roman Catholic Church; 1 to 21, and 12 to 40, Bosworth Road; Adair Road, both sides, from Hazlewood Crescent to Appleford Road: North side of Appleford Road; South side of Hazlewood Crescent; Stockton Mews; Gadsden Mews: Golborne Gardens; St. Andrew's Church; Lodging House. No. 30, Absolom Road. Population 1891, 1,925; 1896, 2,031. Increase 106. St. Joseph's Home for the Aged Poor, Portobello Road. Population 1891, 243; 1896, 248. Increase 5. Francisan Convent, Convent School, and St. Elizabeth's Home, Portobello Road. Population 1891, 146; 1896, 28. Decrease 118. St. Marylebone Infirmary. Population 1891, 813; 1896, 803. Decrease 10. Kensington Workhouse and Infirmary. Population 1891, 1,355; 1896,1,648. Increase 293. Kensington Barracks. Population 1891, 180; 1896, 196. Increase 16. BROMPTON REGISTRATION SUB-DISTRICT. No. 1.—From 1 to 4 Sloane Street; Brompton Road, 1 to 31; Blackman's Yard; Hooper's Court, 1 to 26; Garden Row, 1 to 8; Brompton Road, 33 to 85; New Street, 18 to 28, and the "Sloane's Head"; Sloane Place. 1 to 9, and Alma House, and the Mission Chapel; New Street, 1 to 14; Brompton Road, 87 to 109; Queen's Gardens, 13, 14, and 31, and School Board Schools; Brompton Road, 111 to 135. Population 1891, 944; 1896, 770. Decrease 174. No. 2.—From 1 to 39, and 2 to 42. Hans Road; Brompton Road. 137 to 161; Lloyd's Place, 1 to 12, also Bennett's Livery Yard, and Ward's Livery Yard; Brompton Road, 163 to 195; Beaufort Gardens, 1 to 48; Beauchamp Place, 1 to 62; Ovington Mews, 1 to 22; Ovington Gardens. 2 to 10, and 11 to 24; Ovington Square, 1 to 35, and 2 to 34, with two Stables in rear. Population 1891, 1,559; 1896, 1,328. Decrease 231. No. 3.—From 197 to 251, Brompton Road, and the White Horse Livery Yard; Yeoman's Row, 1 to 69; Michael's Grove, 1 to 41, and 6 to 24; Egerton Mews (12 Stables); Egerton Gardens, 1 to 75, and 18 to 48, including Mortimer House; Crescent Place, 1 to 13; Fulham Road, 35 to 75; Egerton Mansions, 1 to 8, including Egerton House; Brompton Crescent, 26 to 59. Population 1891,1,811; 1896, 1,621. Decrease 190. 220 No. 4.—From 38 to 190. Brompton Road; Tullett Place. 1 to 6; Montpelier Street, 1 to 11, and 2 to 18, also Brompton School Hall; Relton Mews, 1 to 11, and the Metropolitan Fire Brigade Station; Chapel Place, 1 to 59, and 4 to 56; Rutland Street. 1 to 31. and 2 to 28, and the Montpelier Arms"; Middle Street. 1 to 11; Montpelier Row, 25 to 37; Cheval Place, 1 to 5, and Barnes's Coach Yard. Population 1891, 1,293; 1896, 1,194. Decrease 99. No. 5—Brompton Square. 1 to 61; Brompton Road. 192 to 204; Cottage Place, la and 1 to 6; Holy Trinity Church; The Oratory; South Kensington Museum; Royal Engineers Barracks; Art Training Schools; The Residences, 1 to 4; Prince's Gate, 64 to 72; Prince's Mews, 1 to 71, and 81 to 85; Rutland Mews, South, 1 to 20; Ennismore Gardens, 36 and 37; The Natural History Museum; The National Art Gallery, and the buildings of the Imperial Institute. Population 1891, 852; 1896, 950. Increase 98. No. 6.—Fulham Road, 2 to 42 ; North Terrace, 1 to 11, and Western Grammar School; Alexander Square, 1 to 24; Alfred Place, 1 to 20, and the Turkish Baths; Thurloe Mews, 1 to 10; South Street, I to 33. and 2 to 22; Thurloe Square, 6 to 33, and 45; the Studios to end. including Thurloe House; Pelhain Street; Cromwell Gardens Mews, 1 to 4; Onslow Villas, 3 and 4 ; South Kensington Railway Station; Onslow Houses, 1 to 6; Station Buildings, 1 to 12a. Population 1891, 796; 1896, 893. Increase 97. No. 7.—Fulham Road. 44 to 78; Pelham Crescent. 1 to 27 ; Pelham Place, 1 to 29, and 2 to 18; Sydney Place, 1 to 12 ; Onslow Square, 1 to 75, and 2 to 42 ; Onslow Crescent, 1 to 16; Sumner Place, 13 to 23; Onslow Square Mews, 67 to 75; Sumner Terrace, 1 to 10; The Avenue. 1 to 12; Sydney Mews, 1 to 30a. Population 1891, 930; 1896, 1,019. Increase 89. No. 8.—Onslow Square, 44 to 54. and 77 to 109; Onslow Mews East, 1 to 4; Sumner Place, 1 to 12; Cranley Place, 1 to 19; Onslow Mews West, 1 to 18; Onslow Gardens, 1 to 17a; Foulis Terrace, 1 to 14; Fulham Road, 80 to 132; Neville Street, 1 to 26, and Onslow Hall; Neville Terrace, 1 to 14, and Onslow Chapel; Onslow Gardens, 17 to 48; Selwood Terrace, la to 21; Selwood Place. 1 to 18; Little Elm Place, 1 to 5; Selwood Cottage; Elm Place, 1 to 14; Alpha Cottage; Glenmore House. Population 1891, 1,343; 1896, 1,382. ncrease 39. No. 9.—Thistle Grove Lane, 1 to 9; Holly Mews, 1 to 6; Holly Terrace, 1 to 4; Drayton Gardens, 2 to 88, and 1 to 89; Drayton Terrace, 1 to 9; Moreton Terrace; Drayton Villas, 1 to 4; Vine Cottage; Priory Grove, 1 to 12; Gilston Road (East side); Tregunter Lodge; The Limes, Gilston Lodge, and 24 to 21a, Milborne Grove; Harley Gardens, 1 to 14; Chelsea Grove; St. Mary's National Schools ; Clifton Place, 1 to 8 ; Fulham Road, 134 to 178. Population 1891, 1,161; 1896, 1,117. Decrease 44. No. 10.—Gilston Road (West side); Bolton Mews; St. Mary's Church; The Boltons, I to 28; Sidmouth Lodge; Moreton Tower Lodge; Moreton Gardens, 1 to 11; Cresswell Gardens, 1 to 13; Bolton Gardens Mews, 1 to 12; Bolton Gardens, South; Ratlimore Lodge; Osborne House; Bladen Lodge; Hereford House; The Grove, Boltons, 1 to 35, and 2 to 36; Ruthven; Tregunter Road, 2 to 26, and 1 to 37; Cathcart Road, 2 to 18, and 1 to 25; Fulham Road, 180 to 200; Holmes Place, 1 to 3; Moreton Mews. Population 1891, 1,162; 1896,1.125. Decrease 37. 221 No. 11.—Fulham Road. 202 to 238a; Redcliffe Road, 1 to 66 (including Bolton Studios), and la and 2a. and Catheart House; Seymour Place, 2 to 58, and 1 to 43, and Wilton Lodge; Hollywood Road, 1 to 55. and 2 to 14; Hollywood Lodge; Hollywood Arms; Grove House; Hollywood Mews, 1 to 10; Harcourt Terrace, 57 to 89, and 16 to 46; Redcliffe Mews, 1 to 23, and 2 to 26; Redcliffe Square, 1 to 51. and 2 to 84; St. Luke's Church. Population, 1891, 1,884; 1896, 1,977. Increase 93. No. 12. —Tregunter Road. 28 to 56. and 37 to 65; Cathcart Rood, 20 to 54. and 27 to 61, and Adrian House; Fawcett Street. 1 to 25, and 2 to 28; Fawcett Mews, 1 to 5; Oakfield Street. 1 to 6; Fulham Road. 240 to 296; Barker Street. 1 to 15, and 2 to 16; Redcliffe Gardens. 1 to 79, and 2 to 82; Clyde Street, 1 to 13. and 2 to 12; Redcliffe Street, 1 to 25. and 2 to 26; Westgate Terrace. 2 to 28, and 1 to 25. Population, 1891, 1,826; 1896, 1,830. Increase 4. No. 13. —Redcliffe Gardens. 84 to 102; Coleherne Court; Colelierne Terrace. 1 to 11; Colelierne Road. 1 to 35, and 2 to 34; Claro Terrace; Finborough Road; Wharfedale Street; Coleherne Mews; Queen's Jubilee Hospital; Lodge at Cemetery; West Brompton Railway Station and District Railway Station. Population, 1891, 1,664; 1896, 1,722. Increase 58. No. 14.—Fulham Road. 298 to 366; Mentone Mansions; I field Road. 1 to 129, and 2 to 180; Adrian Mews, 1 to 7; Brompton Cemetery, South Lodge; St. Mark's Grove, 1 to 7; St. Mark's Road. 1 to 22; North Street, 1 to 15; Stamford Cottages, 1 to 10; South Street, 1 to 19. Population, 1891, 2.595; 1896, 2.617. Increase 22. No. 15.—Thurloe Place. 1 to 40; Thurloe Place Mews; Thurloe Square. 34 to 52; Alfred Place West; Exhibition Road, 1 to 11. and 2 to 6; Cromwell Gardens, X to 7; Cromwell Road, 1 to 41; Queensberry Place, la and 1 to 27, and 2 to 20; Queensberry Mews East. 2 to 32. and 1 to 29; Cromwell Place, 1 to 23; Onslow Place, 1 to 15; Cromwell Mews, 1 to 32, and 8a to 14a. Population, 1891, 1.248; 1896, 1,176 Decrease 72. No. 16.—Harrington Road, 1 to 47, and 12a to 50; Norfolk Hotel; Glendower Place, 1 to 17, and 2 to 8; Bute Street, 1 to 31, and 2 to 22; Harrington Mansions, 1 to 5; Reece Mews. 1 to 14; Kendrick Mews, 1 to 14; Sussex Place, 1 to 47; Queen's Gate, 108 to 134; St. Augustine's Church; Queensberry Mews West, 1 to 17, and 2 to 22; Cromwell Road. 43 to 57; Manson Place, 1 to 18. Population, 1891, 1,629; 1896, 1,548. Decrease 81. No. 17.—Onslow Gardens. 49 to 93; Ensor Mews, 1 to 23; Cranley Gardens, 2 to 50, and 1 to 37; St. Peter's Church; Evelyn Gardens, 1 to 29, and 2 to 44; Roland House; Cranley Mews; Roland Gardens, 1 to 41, and 2 to 46; Alveston Mews, 1 to 31, and 2 to 40; Roland Houses, 1 to 6; Roland Cottage. Population, 1891, 1,476; 1896, 1,555. Increase 79. No. 18.—Queen's Gate. 88 to 107; Manson Mews, 1 to 31; Gloucester Grove East, 1 to 15; Clareville Grove, 1 to 25, and 2 to 60; Hereford Square. 1 to 35; Wetherby Place; Gloucester Road, 119 to 161; Stanhope Mews South, 1 to 11; Gloucester Terrace, 1 to 15; Dove Mews, 1 to 10; Bina Gardens, 1 222 to 11, anil 2 to 30; Brechin Place, 2 to 34. and 1 to 31 (including Cranley Mansions); Roland Mansions ; Rosary Gardens, 1 to 43, and 2 to 36a; Gledliow Terrace. 1 to 15; Gledhow Gardens, 1 to 29; Harrington Gardens (including Gloucester Mansions), 1 to 25, and 2 to 26; Wetherby Gardens, 1 to 25; Ashburn Place, 8 to 40; Colbeck Mews; Clareville Grove Mews. Population, 1891, 2,474 ; 1896, 2,526. Increase 52. No. 19.—Queen's Gate from 68 to 87; Stanhope Mews East. 1 to 20, and 86 to 68; Stanhope Gardens, 1 to 62; Cromwell Road, 59 to 85; Stanhope Mews West, I to 16; Gloucester Road, S3 to 117, and 80 to 94; Lenthal Mews; Gloucester Road Railway Station; Grenville Mews; Ashburn Mews; Bailey's Hotel; Courtfield Road. 1 to 47, and 2 to 12; Cromwell Road, 85 to 95; Ashburn Place. 2 to 6, and 1 to 29. Population, 1891, 1.527; 1896, 1,572. Increase 45. No. 20.—Cromwell Road, 97 to 159; Caspar Mews; Astwood Road, 1 to 14; Astwood Mews. 1 to 29; Courtfield Gardens, 1 to 74; Courtfield Mews; Collingham Road, 2 to 14, and 1 to 35; Laverton Mews, 1 to 6; Collinghain Place, 2 to 30, and 1 to 41; Collingham Gardens, 1 to 30; Bramham Gardens and Mansions; Knaresborough Place, 2 to 10. and 1 to 7; Karl's Court Gardens, 1 to 36; Courtfield Hotel; Earl's Court Road, 183 to 199; Barkston Gardens, 2 to 46, and 1 to 23; Barkston Mansions (Flats), 1 to 25 and 2 to 26; York Mansions, 1 to 20; Hesper Mews; Harrington Gardens, 27 to 75, and 26 to 50; The Mansions. 1 to 4. Population, 1891, 3,356; 1896. 3,612. Increase 256. No. 21.—Bolton Gardens, 1 to 23; Wetherby Road. 1 to 4; Strathallan House; Jasper House; Park House; Park Lodge; Wetherby Mews, 1 to 9; Wetherby Terrace. 1 to 10; Bolton Gardens West. 1 to 15; Merrington House; Radnor House; Coleherne Mansions, 1 to 15; Rich Terrace; 2 to 8, Warwick Road; St. Matthias Church; Earl's Court Square, 1 to 69, and 2 to 52; Farnell Mews; Warwick Road, 2 to 38; Penywern Koad. 2 to 58, and 1 to 49; Old Manor Yard, 2 to 12; Earl's Court Station; Karl's Court Road, 144 to 222; Trebovir Road. 1 to 33, and 2 to 66; Kensington Mansions (Flats), 1 to 41, and 2 to 42. Population, 1891, 2,510; 1896, 2,930. Increase 420. No. 22.—Warwick Road, 1 to 33, and 46 to 78; Philbeach Gardens, 1 to 110; Eardley Crescent, 1 to 75, and 2 to 58; Kempsford Gardens. 1 to 47 and 2 to 34; Kramer Mews, 1 to 23; Richmond Road, 58 to 114; Nevern Mansions, 13 to 22. Population, 1891, 2,234; 1896, 2,252. Increase 18. No. 23.—Hogarth Place; Hogarth Road, 1 to 39, and 2 to 62; Cromwell Road, 161 to 255; Earl's Court Road, 109a to 179; Child's Street, 1 to 20; Child's Passage, 1 to 4; Child's Place ; Prince Teck Buildings, 1 to 13; Providence Terrace, 1 to 19; Kenway Koad, 1 to 13; North Row, 1 to 22; Wallgrave Road, 1 to 25; Wallgrave Terrace, 1 to 13; Redfield Lane; Farrow's Livery Yard ; St. John's Mission Hall; Redfield Lane Mews. Population, 1891, 2,295; 1896, 2,422. Increase 127. No. 24.—Fopstone Road, 2 to 34, and 1 to 35; Templeton Place, 1 to 13. and 2 to 8; Longridge Road, 1 to 75, and 2 to 76; Nevern Road, 2 to 18, and 1 to 17; Earl's Court Road, 98 to 142 ; Spear Mews; West Cromwell Road, 1 to 77, and 2 to 86; Cromwell Crescent, 1 to 23; Logan Mews ; Nevern Square, 1 to 63, and Flats; Cluny Mews ; Fenelon Road (South side), 1 to 37. Population, 1891, 2,471; 1896, 2,485. Increase 14. 223 No. 25.—Fenelon Road. 2 to 32; Shaftesbury Road. 1 to 22 ; Ashley Cottages. 1 to 27; 82 to 108, Warwick Road; 112 to 160, Warwick Road; Pembroke Road; Pembroke Villas; 135 to 179, Warwick Road; Erard's Pianoforte Works; Kensington Vestry Stables. &c., Coal Wharves, &c., between 235 and . 179, Warwick Road; Warwick Gardens, 43 to 73, and 48 to 102. Population. 1891, 1,646; 1896, 1,601. Decrease 45. No. 26.-Queen's Gate, 67 to 46; Queen's Gate Place Mews, 1 to 45. and 2 to 38; Queen's Gate Place. 16 to 21; Queen's Gate Gardens. 24 to 53, and 1 to 10; Atherstone Mews, 1 to 23; Cromwell Road, 52 to 88a; Atherstone Terrace, 1 to 10; Cornwall Gardens. 83 to 98; Southwell Gardens. 1 to 20; Cromwell Road, 90 to 114a; St. Stephen's Church ; Presbyterian Chapel. Population. 1891, 1,355; 1896, 1,418. Increase 63. No. 27.-Grenville Place. 1 to 16; Emperor's Gate, 1 to 47 (including St. Stephen's Vicarage); Osten Mews, 1 to 20; McLeod's Mews; Cornwall Mews South; Cornwall Gardens. 51 to 81; Cromwell Road, 116 to 178; Pennant Mews; Lexham Gardens, 1 to 55. and 2 to 88; Lexham Gardens Mews; Marloes Road. 2 to 26; Marloes Houses. Population. 1891, 1,806; 1896, 1.948. Increase 142. No. 28.—Marloes Road. 1 to 35; Stratford Road, both sides (except 1, 3, and 5), including Stratford Avenue; Radley Mews, 1 to 23; Sunningdale Gardens, 1 to 8; St. Philip's Terrace; Abingdon Road, 84 to 96, and 103 to 113; Inkerman Terrace. 1 to 6; Alma Terrace. 1 to 6; Earl's Court Road, 64 to 96, and 75 to 109; Lexham Mews. 1 to 5. and 6 to 20; Lexham Gardens. 90 to 116. and 57 to 105; Cromwell Road, 180 to 220, and Tower House; St. Philip's Church. Population, 1891, 1,504, 1896, 1,519. Increase 15. Brompton Hospital for Consumption, Fulham Road. Population, 1891, 206; 1896, 192. Decrease 14. [Table. 224 TAB SUMMARY OF CENSUS RETURNS, Showing the Number of Persons; of Males and of Females. Also number of Persons KENSINGTON TOWN No. of Enumeration District. Persons, 1896. Population 1891. Increase 1896. Decrease 1896. Males. Females. Total. 1 508 937 1445 1356 89 ... 2 832 1839 2671 2363 308 ... 3 358 889 1247 1201 46 ... 4 393 892 1285 1303 ... 18 5 980 1462 2442 2746 ... 304 6 434 824 1258 1216 42 ... 7 701 1300 2001 1862 139 ... 8 615 954 1569 1673 ... 104 9 429 913 1342 1184 158 ... 10 376 1114 1490 1405 85 ... 11 518 736 1254 1293 ... 39 12 963 1085 2048 2023 25 ... 13 433 1053 1486 1647 ... 61 14 761 786 1547 1637 ... 30 15 601 1399 2000 2047 ... 47 16 654 955 1609 1618 ... 9 17 441 1360 1801 1645 156 ... 18 597 1522 2119 2140 ... 21 19 290 804 1094 1091 3 ... 20 568 1122 1690 1726 ... 36 21 780 1979 2759 2663 96 ... 22 775 1276 2051 1860 191 ... 23 600 667 1267 1343 ... 76 24 373 761 1134 1142 ... 8 25 700 1088 1788 1755 33 ... 26 344 1171 1515 1505 10 ... 27 254 622 876 997 ... 121 28 613 806 1419 1324 95 ... 29 727 1072 1799 1894 ... 95 30 447 645 1092 1148 ... 56 31 1075 1166 2241 1880 361 ... 32 1722 1639 3361 8233 128 ... 33 1613 1707 3320 3485 ... 165 34 1344 1435 2779 2667 112 ... 85 1291 1530 2821 2602 219 ... 36 2511 2755 5266 4957 309 ... 37 1427 1890 3317 3238 79 ... 38 1285 1749 3034 2871 163 ... BROMPTON 1 360 410 770 944 ... 174 2 391 937 1328 1559 ... 231 3 568 1058 1621 1811 ... 190 4 543 651 1194 1293 ... 99 5 347 603 950 852 98 ... 6 965 628 893 796 97 ... 7 254 765 1019 980 89 .... 8 318 1064 1382 1343 39 ... 9 401 716 1117 1161 ... 44 10 304 821 1125 1162 ... 37 11 696 1281 1977 1884 93 ... 12 589 1241 1830 1826 4 ... 13 591 1131 1722 1664 58 ... 14 1197 1420 2617 2595 22 ... 15 377 799 1176 1248 ... 72 16 522 1026 1548 1629 ... 81 17 404 1151 1555 1476 79 ... 18 719 1807 2526 2474 52 ... 19 526 1046 1572 1527 45 ... 20 986 2626 3612 3356 256 ... 225 IE B. 1896, AS SET OUT IN TABLE A. in 1891; together with Increase or Decrease in each Enumeration District in 1896. SUB-DISTRICT. No of Enumeration District. Persons, 1896. Males. Females. Total. Population 1891. Increase 1896. Decrease l896. 39 1047 1223 2270 2122 148 ... 40 1145 1908 3033 3110 ... 77 41 1266 1492 2758 2701 57 ... 42 731 1401 2132 2052 80 ... 43 638 782 1320 1370 ... 50 44 1113 1411 2524 2370 164 ... 45 711 676 1387 1335 52 ... 46 338 726 1064 1004 60 ... 47 1266 1510 2776 2710 66 ... 48 1860 1852 3712 3670 42 ... 49 2376 2412 4788 4559 229 ... 50 1474 1411 2885 2817 68 ... 51 1342 1373 2715 2458 257 ... 52 776 775 1551 1502 49 ... 53 779 987 1766 1662 104 ... 54 392 444 836 806 30 ... 55 931 1010 1941 1928 13 ... 56 1385 1130 2515 2273 242 ... 57 971 1060 2031 1925 106 ... Totals 49754 69487 119241 116014 4604 1377 Public Institutions: Net Increase (1896) 3227 Kensington Infirmary 281 414 695 659 36 ... Kensington Workhouse 451 502 953 696 257 ... Kensington barracks 177 19 196 180 16 ... St. Joseph's Home 83 165 248 243 5 ... Franciscan Convent and St. Elizabeth's Home ... 28 28 146 ... 118 St. Marylebone Infirmary 355 448 803 813 ... 10 Total Kensington Town Sub-district 51101 71063 122164 118751 4918 1505 Net Increase (1896) 3413 SUB-DISTRICT. 21 830 2100 2930 2510 420 ... 22 701 1551 2252 2234 18 ... 23 1045 1377 2422 2295 127 ... 24 700 1785 2485 2471 14 ... 25 658 943 1601 1646 ... 45 26 443 975 1418 1355 63 ... 27 580 1368 1948 1806 142 ... 28 512 1007 1519 1504 15 ... Totals 15827 32282 48109 47351 1731 973 Public Institution: Increase 758 Brompton Consumption Hospital 74 118 192 206 ... 14 Total Brompton SubDistrict 15901 32400 48301 47557 1731 987 Net Increase (1896) 744 No. IV., 1897. REPORT on the Health, Sanitary Condition, &c. of KENSINGTON. For the Four Weeks, Starch 28th to April 24th, being the 13th 14th, 15th and 16th Weeks of the Registration Year, 1897. by T. ORME DUDFIELD, M.D., MEDICAL OFFICER OF HEALTH. Public Health Department, Town Hall, Kensington, W., April 28th, 1897. Gentlemen, 1.—I have to report that 248 births (males 119, females 129), and 187 deaths (males 102, females 85), were registered in the four weeks ended 24th April. After making due allowance for increase of population, the births were 56, and the deaths 38, below the numbers registered in the corresponding weeks in the previous ten years. The births were equivalent to an annual rate of 18.9 per 1,000 persons living, or 4.3 per 1,000 below the decennial average (23.2). The deaths were equivalent to an annual rate of 14.2 per 1,000, or 2.9 per 1.000 below the decennial average (17.1). The rate in the successive weeks was 18.0, 15.2, 13.7 and 10.1. The death-rate in the Metropolis was 17.3 per 1,000; 3.1 above the rate in Kensington, and 2.7 below the decennial average (20.0). Fifty-four of the deaths of Kensington parishioners were of children under 5 years of age, including 36 under one year. Sixty-two persons died at 60 and upwards. Thirty-eight deaths were caused by the diseases of the respiratory organs, including bronchitis 22, and pneumonia 12. The deaths from phthisis were 13, from diseases of the heart 11, and from tubercular or scrofulous diseases of children under 5 years of age, 10. 40 Localised Death-Rates.—In conformity with the request of your Yestry for information as to the relative death-rates in localised portions of the parish, I submit the following statement, showing the death-rate in the several Districts of the parish:— Locality. Estimated Population. Deaths in the four weeks. Death-Rate. In the four weeks. In the precedingtwelve weeks. in 1896. (Whole Year.) The Parish 170,700 187 14.2 15.8 16.7 Sub-Districts:— Kensington Town 122,400 149 15.8 17.6 18.9 Brompton 48,300 38 10.2 11.2 11.1 Parliamentary Divisions:— North Kensington 86,440 115 17.3 19.6 21.5 South Kensington 84,260 72 11.1 12.0 11.7 Sanitary Districts:— North 32,850 40 15.8 18.2 20.0 North-East 30,140 24 10.4 14.4 16.9 North-West 16,450 37 29.2 29.7 30.9 " Special Area " 3,700 14 49.2 50.0 50.0 Central 27,140 29 13.9 15.3 13.2 South-East 32,140 21 8.5 10.1 9.1 South-West 31,980 36 14.6 12.4 13.4 Abnormal Death Rates.—In conformity with the request of your Vestry that I should "furnish in the case of any district showing an abnormally high death-rate, an explanatory note setting forth such facts as are within my knowledge relating to the deaths, and, in the case of any such district containing common lodginghouses, the number of deaths occurring in such houses,'' I now report that the only abnormally high death-rate during the four weeks was that in the North-West district, viz., 29.2 per 1,000, or 23.5 after deduction of the deaths in the "Notting Dale" Special area, the death-rate in this area being 49.2 per 1,000. The death-rate in the parish less the North-West district was 12.6 per 1000. Particulars of the deaths allocated to the Special Area are set out at page 41. Four of them (Nos. 6, 7, 10 & 11) took place at the Parish Infirmary, to which the deceased persons had been admitted since 14th March last. The death numbered I took place at the Western Fever Hospital; the deaths numbered 3 and 12 took place at the West London Hospital; the death numbered 13 took place at the Leavesden Asylum, to which the deceased person had been removed in December, 1896. The death numbered was of a person who had been removed to the Infirmary on the 7th instant from No. 28, St. Clement's Road, a common lodging-house at which he had been resident for some months. 41 Deaths Registered and Allocated to the "Notting Dale" Special Area, during the Four Weeks ended April 24th, 1897. Description of Deceased. Sex. Age. Date of Death. name of Street. Cause of Death. 1 Son of a Labourer M. 6 Mar. 27th 17, William Street Scarlatina 2 Wife of a Hawker F. 47 Mar. 30th 46, St. Katharine's Road Influenza and Bronchitis 3 Widow of a Labourer F. 52 Mar. 31st 41, St. Katharine's Road Burns 4 Son of a General Labourer M. 14 days Mar. 31st 107, St. Katharine's Road Bronchitis 5 Wife of a Master Grocer F. 59 Mar. 31st 38, Bangor Street Cancer of Breast 6 Daughter of a Labourer F. 12 months April 2nd 31, St. Katharine's Road Tuberculosis 7 Laundress F. 25 April 3rd 40, St. Katharine's road Pneumonia 8 Son of a Journeyman Bricklayer M. 21 days April 4th 41, Crescent Street Convulsions 9 Son of a General Labourer M. 8 months April 5tb 54, St. Katharine's Road Meningitis 10 Illegitimate daughter of a Laundress F. 1 day April 7th 25, St. Katharine's Road Inanition 11 Scaffolder M. 63 April 7th 28, St. Clement's Road Chronic Pneumonia 12 Daughter of a Labourer F. 1 month April 9th 63, St. Katharine's Road Spina Bifida 13 Needlewoman F. 71 April 11th 4, St. Katharine's Road Cancer of Breast 14 Journeyman Bricklayer M. 30 April 14th 90, St. Katharine's Road Phthisis 42 2.—Zymotic Diseases.—The deaths from the principal diseases of the zymotic class were 8, and 15 below the corrected decennial average number. In the Metropolis, as a whole, the deaths from these diseases were 521, and 337 below the corrected average. Measles.—There was no death from measles, nor had there been any death from this cause in the four preceding four-weekly periods respectively. In the Metropolis, as a whole, the deaths from this cause were 74, and 217 below the corrected average. Whooping-Cough.—There was one death from whooping-cough, as compared with 2, 4, and 1, in the three preceding four-weekly periods respectively. In the Metropolis, as a whole, the deaths from this cause were 197, and 87 below the corrected average. Diarrhæa.—There were 2 deaths from diarrhoea, as compared with 2, 1, and 1, in the three preceding four-weekly periods respectively. In the Metropolis, as a whole, the deaths from this cause were 49, and 5 below the corrected average. Enteric Fever.—Five cases of enteric fever were recorded (1 in North Kensington and 4 in South Kensington), of which 3 (1 from North Kensington and 2 from South Kensington) were removed to hospital. There was 1 death from this cause (in South Kensington), as compared with 2, 1, and 2, in the three preceding four-weekly periods. In the Metropolis, as a whole, the deaths from this cause were 28, and 3 below the corrected average. There were 67 cases in the Asylums Board Hospitals on the 24th inst., as compared with 110, 94, and 82, on January 30th, February 27th, and March 27th; and 42 cases were admitted in the four weeks, as compared with 56, 67, and 57, in the three preceding four-weekly periods. The notifications of cases were 133, as compared with 203, 198, and 166, in the three preceding fourweekly periods. Scarlet Fever.—Twenty-eight cases of scarlet fever were recorded (18 in North Kensington and 10 in South Kensington), of which 20 (15 from North Kensington and 5 from South Kensington) were removed to hospital. There were 3 deaths from this cause, as compared with 1, 2, and 0, in the three preceding four-weekly periods. All of these deaths occurred in hospital, and were of North Kensington persons. In the Metropolis, as a whole, the deaths from this cause were 39 (and 30 below the corrected average), as compared with 63, 52, and 41, in the three preceding four-weekly periods. There were 2,442 cases in the Asylums Board and London Fever Hospitals on the 24th April, as compared with 3,311, 2,817, and 2,585, on January 30th, February 27th, and March 27th; and 928 cases were admitted to the Asylums Board Hospitals in the four weeks, as compared with 1,001, 935, and 859 in the three preceding four-weekly periods. The notifications of cases were 1,206, as compared with 1,439, 1,289, and 1,174, in the three preceding four-weekly periods: 43 Diphtheria.—Twenty-one cases of diphtheria were recorded (16 in North Kensington, and 5 in South Kensington), of which 18 (14 from North Kensington and 4 from South Kensington), were removed to hospital. There was 1 death from this cause of a North Kensington person, as compared with 4, 3, and 7, in the three preceding four-weekly periods. In the Metropolis, as a whole, the deaths from this cause were 134 (and 7 above the corrected average), as compared with 239, 185, and 176, in the three preceding four-weekly periods. There were 774 cases in the Asylums Board Hospitals on the 24th April, as compared with 902, 855, and 808, on January 30th, February 27th, and March 27th; and 375 cases were admitted in the four weeks, as compared with 421, 405, and 413, in the three preceding four-weekly periods. The notifications of cases were 730, as compared with 915, 916, and 902, in the three preceding four-weekly periods. Small-pox.—Nine cases of this disease were notified in London during the four weeks, as compared with 8, 48, and 5, in the three preceding four-weekly periods. There was no death from this cause; and there were 9 cases in hospital on the 24th April. 3.—Deaths in Public Institutions.—Thirty-seven deaths of parishioners were registered at the Parish Infirmary, and 18 at public institutions, etc., without the parish. 4.—Deaths of Non-Parishioners.—There were 48 deaths in the Parish of persons who were not parishioners, viz , 7 at the Brompton Consumption Hospital, 38 at the St. Marylebone Infirmary, Notting-hill; 1 at the Jubilee Hospital; 1 at an hotel; and 1 of an infant whose body was found in a railway carriage at Addison Road Station. These cases are excluded from our statistics. 5.—Notifications of Infectious Disease in the Metropolis. I append (page 52) a summary of the cases of infectious disease notified to the several Metropolitan Medical Officers of Health (and by them reported to the Metropolitan Asylums Board as the Act directs), 2,493 in number, including small-pox 9, scarlet fever 1,206, diphtheria 730, and enteric fever 133. The cases notified in the three preceding four-weekly periods were 3,097, 2,977, and 2,706, respectively. 6.—Inquests.—The cause of death in 20 cases, including 9 from violence, was returned by Coroners. The cause of death in 9 of these cases is stated to have been ascertained by post-mortem examination. Inquests were held on the bodies of 4 nonparishioners. Twenty of the 21 inquests in the parish were held at the Coroner's Court at the Town Hall, and 1 at the Parish Infirmary. 44 7.—Hospital Accommodation.—It may have been observed that during the last few weeks there has been a considerable decline in the prevalence of infectious disease, as indicated by the reduction in the number of notified cases, the result being that the Asylums Board have been able to take in all applicants for admission to their hospitals. Attention may be called to the disproportionate provision of accommodation for scarlet fever and diphtheria, upwards of 3,800 beds being set apart for the first-named disease and only about 700 for the latter. And yet diphtheria is by far the more serious of the two diseases, seeing that the case-mortality in hospitals in 1896, (about 21 per cent.) was five times as great as that of scarlet fever (4.05 per cent.). It would be wise to provide accommodation for diphtheria to the full extent necessary, even by the exclusion of a considerable number of scarlet fever patients. It would indeed be an imperative duty to do so if it were possible to select the more severe cases of scarlet fever for admittance, when it is not possible to admit all applicants; but in practice the rule is "first come, first served." Several reasons could be adduced in support of the course recommended, the most important one having been already indicated; viz., the relatively greater danger of diphtheria, whose victims should therefore be placed in the circumstances most favourable for recovery; that is, in hospital, where the per-centage of recoveries is greater than in the cases treated at home; whilst, on the other hand, the case-mortality in the home treated cases of scarlet fever is considerably lower than in the hospital cases. A very large proportion of the cases of scarlet fever a re of the mildest description; but for complete recovery many weeks' stay in hospital is necessary. I would gladly see all such cases isolated, if there were room; but assuredly I would not admit them to the exclusion of diphtheria, however mild the cases of the latter disease might seem to be. I note with satisfaction that this question is receiving the attention of the Managers, who have instructed the Ambulance Committee to "report to the General Purposes Committee (i.e., the Board sitting in Committee) from time to time, whenever, in the opinion of the Ambulance Committee, the incidence of infectious disease in the Metropolis may necessitate the re-allocation and re-appropriation of beds in the several fever hospitals of the Board." The General Purposes Committee, moreover, have been empowered, until further orders, to take such action in the matter as they may deem necessary under the circumstances. The action taken will, no doubt, lead to a large increase in the number of beds appropriated to the treatment of diphtheria, a course from which the most happy results may be anticipated. I am able, by the courtesy of the Clerk to the Asylums Board, to lay before your Vestry the subjoined interesting statement showing the existing and the prospective accommodation in the hospitals for fever, &c., and small-pox respectively. 45 "For Fever and Diphtheria patients the Board's existing accommodation is as follows :— Acute Cases— Beds. Eastern Hospital 410 North-eastern Hospital 400 North-western Hospital 456 Western Hospital 390 South-western Hospital 370 Fountain Hospital 426 South-eastern Hospital 431 Brook Hospital 576 3,459 Convalescent Cases— Northern Hospital 955 Gore Farm Hospital 752 (Built for Small-pox convalescents) - 1,707 5,166* * "N.B.—These figures include the 'emergency beds' placed in various hospitals during the recent pressure for accommodation.' In addition to the above-named Hospitals, the Board have in course of erection :— The Park Hospital, at Hither Green, for 548 patients. The Grove Hospital, at Tooting, for 520 " 1,068 " "The Board have also secured a site for a Convalescent Hospital at Carshalton, on which they propose to provide for 700 convalescent fever and diphtheria patients. "It is anticipated that the Park Hospital will be opened about next July, and the Grove Hospital sometime in 1898. "For Small-pox patients, the existing accommodation is as follows:— Hospital Ships 300 Gore Farm, Upper Hospital (At present occupied by Scarlet Fever patients). 1,000 Gore Farm, Lower Hospital (Wooden buildings). 192 1,492 46 "Joyce Green Estate. On this estate the Managers proposed to provide beds for 940 patients, but the Local Government Board have refused to sanction provision being made for more than 400 patients." The net result is, that there will soon be 6,182 beds for fever and diphtheria; viz., 4,527 for acute cases, and 1,655 for convalescent cases; and 1,892 beds for small-pox, viz., 700 for acute cases, and 1,192 for convalescent cases. The Royal Commission, in 1892, recommended the provision of 3,000 beds for fever, and 2,700 beds for small-pox. Times have changed since 1892, when my estimate of the needs of the Metropolis, viz., "at least 5,000 beds for scarlet ever, diphtheria and isolation "was deemed to be excessive. As to small-pox accommodation, I am not disposed to quarrel with the action of the Local Government Board in limiting the immediate provision at the Joyce Green Estate to 400 beds, having regard to the remarkable diminution in the prevalence of this disease as a result of its extra-mural isolation first practised, upon my recommendation, in May, 1881. In a sense it is now a matter of ancient history, but the facts, forgotten doubtless, are worth recalling in explanation of the comparative freedom from this loathsome disease which London has long enjoyed. The Asylums Board were first called upon to provide for the accommodation of small-pox patients at the end of 1870. During the ten years, 1871-80, they dealt with upwards of 33,000 cases, all of which were treated in the Town Hospitals. The deaths in London in the ten years were 15,539, including 7,912 in 1871. In May, 1881, the "Camp Hospital" was opened at Darenth, and the system of removing cases of small-pox to the country thus initiated was gradually perfected, so that for many years all of the sufferers coming under the Managers' care have been treated at extra-mural hospitals. During the ten years, 1887-96, the number of cases admitted to the hospitals was 5,232. The deaths in London were429 only, and of these 206 were registered in 1893, in which year 2,376 cases of small-pox were admitted to the Managers' Hospitals. Had the mortality during the ten years, 1887-96, been at the same rate as in the ten years, 1871-80, regard being had to increase of population, the deaths would have been, not 429, but 18,752. The net gain in life saved during the ten years, therefore' was represented by 18,323 lives. In other words, had the average death-rate from small-pox in the ten years, 1871-80, continued throughout the ten years, 1887-96, 18,323 lives would have been sacrificed in addition to the 429 which were actually lost by death *Monthly Report No. 10 1892, page 126. 47 from this cause. This satisfactory result is admittedly due in a large measure, if not entirely, to the removal of nearly all cases of small-pox out of London, and this was the outcome of the deputation of the Sanitary Authorities, and other public bodies, to the President of the Local Government Board on April 23rd, 1881, the primary object of the deputation being to present the resolutions adopted at the Conference of Sanitary Authorities, held at the Town Hall, 23rd March, to consider the question of the Compulsory Notification of Infectious Diseases, a measure for which London had to wait a further period of eight years. The proceedings at the deputation were reported very fully in the British Medical Journal for May 7th, 1881, page 744. And in my Annual Report for 1880-81, page 57, may be seen not only the history of the movement, originated by your Vestry, to secure Compulsory Notification, but also the story of the circumstances which led up to my recommendation of the removal of small-pox cases out of London for isolation and treatment; a recommendation which was acted upon by the Local Government Board and the Asylums Board with such promptitude, that within two or three weeks, hundreds of patients were comfortably housed at the Darenth "Camp," and the "difficulty" of hospital accommodation for sufferers from this disease was solved once and for ever with the happy result above indicated. 8.—"Notting Dale" and the Jubilee.—In the previous report certain suggestions were made, in the hope that they might be found useful to the Committee which had been appointed "to give effect to the loyal feelings of the parishioners, by the promotion of a scheme having for its object the amelioration of the condition of the inhabitants of that limited district in the parish to which public attention has for some time been prominently drawn"—in other words, the "Notting Dale" special area. The main suggestion had for its object the "amelioration of the condition of the inhabitants" by the provision of healthy and decent homes for them. The report was forwarded to the several members of the Committee who appear not to have entertained the suggestion. They appear, rather, to favour the proposal that, in the first instance, their scheme should embrace the provision of a Creche for children; the provision of club-rooms for men and women; and the erection of a People's Hall for entertainments, music, gymnastics, and classes. Very excellent things in their way, as supplementary to the provision of healthy and decent homes for the persons proposed to be benefited. In view of the possibility that the Representative Committee might not adopt the suggestion to provide such homes, I briefly referred to the power of the London County Council 48 to deal with the matter under the provisions of Part III. of the Housing of the Working Classes Act, 1890. In the present position of affairs it would seem to be desirable to enter somewhat more fully into the matter, if only to show that the power referred to exists, and could, without any great ultimate expense, be forthwith employed, so as to ameliorate the condition of the inhabitants. PART III of the Act in question consolidates, with certain amendments, the repealed Lodging Houses Acts, 1851 to 1885, commonly known as Shaftesbury's Acts, its object being precisely what is now desiderated, the provision of suitable homes for the working classes. Section 53 defines the expression "lodging-houses for the working classes," as including "separate houses or cottages for the working classes, whether containing one or several tenements;" and "the purposes of this part of the Act" includes "the provision of such houses and cottages." Were this part of the Act to be adopted by the local authority, i.e., the London County Council (section 54), they would have power to carry it into action; and for that purpose they could exercise the same powers, whether of contract or otherwise, as in the execution of their duties under the Metropolis Management Act, 1855, and the Acts amending the same; and these powers appear to be ample for the purpose (section 56). The Council, for instance, have power (under section 57) to acquire laud, for the purposes of this Part, in like manner as if those purposes were purposes of the Public Health Act, 1875, sections 175 to 178 inclusive. The same (57th) section enables the Council to contract for the purchase or lease of any lodging-houses for the working classes already or hereafter to be built, and to appropriate them for the purposes of this part of the Act. Section 59 provides for the erection of lodging-houses. It reads as follows :— "The Local Authority may, on any land acquired or appropriated by them, erect any buildings suitable for lodging-houses for the working classes, and may alter, enlarge, repair, and improve the same respectively, and fit up, furnish, and supply the same respectively, with all requisite furniture, fittings, and conveniences." Section 61 vests in the Local Authority the general management, regulation, and control of the lodging-houses established or acquired, and enables them to "make such reasonable charges for the tenancy or occupation" of them "as they may determine by regulations," which (by section 62), they are empowered to make "for the management, use, and regulation of the lodging-houses." The section makes it obligatory on the local authority, "except in the case of a lodging-house which is occupied as a separate dwelling," 49 by the bye-laws, "to make sufficient provision for the following purposes, set out in the Sixth Schedule, to wit:— "For securing that the lodging-houses shall be under the management and control of the officers, servants, or others appointed or employed in that behalf by the local authority. "For securing the due separation at night of men and boys above eight years old from women and girls. "For preventing damage, disturbance interruption, and indecent and offensive language and behaviour and nuisances. "For determining the duties of the officers, servants, and others appointed by the local authority." It may be added that, by section 63, tenants of lodging houses become disqualified for continuing to be such lenauts by the receipt of parochial relief, "other than relief granted on account only of accident or temporary illness ; " and that, by section 64, it is provided that any lodging-houses, established for seven years or upwards, aud "determined by the local authority to be unnecessary or too expensive to be kept up,'' may be sold. It would thus appear that the Council have power to provide separate tenement dwellings for the families of the working classes, and lodging-houses that would be available for the nomadic poor, tramps, wayfarers, travellers, etc; and should the Jubilee Committee be indisposed to adopt the proposals set out in the last monthly report (page 32), it is to be hoped that the Council may be induced to take pity on the poor in "Notting Dale" by exercising such power. But failing Council and Committee, I should like to point out that there is a third course open; for the Public Works Loan Commissioners are authorised, by Section 67, to lend money to any "company, society, or association established for the purpose of constructing or improving, or of facilitating or encouraging the construction or improvement, of dwellings for the working classes"; and any such body is for the aforesaid purposes, authorized to acquire land; and " for the purpose of holding such land," if not already a body corporate, shall nevertheless be " deemed a body corporate with perpetual succession." Without exhausting the powers of this Part of the Act I have said enough, perhaps, to show, prima facie, that it would appear to enable a public body like the County Council, or a body like the Jubilee Committee, or any body of philanthropic or business persons, to provide a remedy for an evil which all deplore and al 50 desire to remedy. But, it may be said, What about the cost ? To my own mind one of the most satisfactory features of the proposed plan is, that it mightbe made nearly if not quite self-supporting. Nay! in good business hands it should produce a profit which might be applied to the extension to neighbouring parts of the parish, almost as much in need, the benefits it is calculated to confer on the inhabitants of "Notting Dale." It is needless to elaborate this point, however, as necessarily enquiry would precede action. I may, nevertheless, refer to a concrete case, to which I called attention in the second report for 1896, when, after dealing with the evil under the head "Remedies," I, at page 24, dealt also with the question of "Cost"; showing that the "keeper" of a registered "lodging-house" in the special area, made a good thing of his tenancy; the house, moreover, paying the owner a clear nine or ten per cent. But, it may be urged, that if such is the case, the houses would be costly to buy. I do not think so. There is reason for thinking that some of the owners would be rather glad than otherwise to be quit of their disreputable property; and should it be necessary, in the last resort, to have recourse to arbitration, the Act lays down principles, the application of which would tend to keep down prices to the fair market value, at which the properties would "pay" the Authority or the Association which might acquire them. "Rental value " would, no doubt, have to be taken into consideration, but evidence would be receivable by the arbitrator to prove— "(1st) that the rental of the dwelling house was enhanced by reason of the same being used for illegal purposes, or being so overcrowded as to be dangerous or injurious to the health of the inmates ; or (2ndly) that the dwelling house is in a state of defective sanitation, or is not in reasonably good repair; or (3rdly) that the dwelling house is unfit, and not reasonably capable of being made fit, for human habitation; and if the arbitrator is satisfied by such evidence, then the compensation - (a) Shall in the first case, so far as it is based on rental, be based on the rental which would have been obtainable if the house was occupied lor legal purposes, and only by the number of persons whom the dwelling house was, under all the circumstances of the case, fitted to accommodate, without such overcrowding as is dangerous or injurious to the health of the inmates and 51 (b) Shall in the second place, be the amount estimated as the value of the dwelling house if it had been put into a sanitary condition, or into reasonably good repair, after deducting the estimated expense of putting it into such condition of repair ; and (c) Shall in the third place, be the value of the laud, and of the materials of the buildings thereon." The above quotation is from section 41, "Settlement of Compensation," in Part II. of the Act dealing with "Scheme for Reconstruction," (section 39), in relation to "Obstructive Buildings" (section 38): but the principles laid down would be applicable in respect to the purchase, under Part III,, of houses " in a state of defective sanitation," or "not in reasonably good repair," or the rental value of which was enhanced "by reason of the same being used for illegal purposes, or being so overcrowded as to be dangerous or injurious to the health of the inmates." Under one or other of these categories many, if not most of the houses would probably come. Be this as it may, however, I am confident that, properly gone about, by a properly constituted Authority or Association, with the powers of this Act behind them, no insuperable difficulty should be experienced in obtaining the houses at their fair market value. To the County Council, then, as local authority under Part III.; to your Vestry, as local authority under Part II.; and to the Jubilee Committee, which might become a Society or Association for the purposes of the Act (under section 67), I make appeal that the suggestions contained in this report may receive fair consideration, and that, if found to be practicable, effect may be given to them, so that a grave opprobrium may be taken away from this royal parish as a memorial of this year of Royal Jubilee. I am, Gentlemen, Your obedient Servant, T. ORME DUDFIELD, Medical Officer of Health. To the Vestry of Kensington. 52 Cases of Infections Disease notified in the several Sanitary Districts in the Four Weeks ended Saturday, 24th April, 1897. Name of District. Small-pox. Scarlet Fever. Diphtheria. Enteric Fever. Typhus Fever. Continued Fever. Puerperal Fever. Erysipelas. Croup. Cholera. Totals. Population in 1896. Kensington ... 28 21 6 ... ... 4 22 ... ... 81 170,465 Battersea 1 68 39 4 ... ... 2 18 ... ... 132 165,115 Bermondsey ... 35 21 1 ... ... ... 1 ... ... 58 85,475 Bethnal Green ... 44 35 8 ... ... ... 19 4 ... 110 129,162 Camberwell 1 76 70 8 ... ... 1 21 ... ... 177 253,076 Chelsea ... 33 22 3 ... ... ... 6 1 ... 65 96,646 Clerkenwell ... 15 13 3 ... ... ... 7 ... ... 38 66,202 Fulham ... 34 14 5 ... ... ... 9 ... ... 62 113,781 Greenwich ... 69 49 9 ... ... 1 20 1 ... 149 75,774 Hackney 1 61 57 10 ... ... ... 17 4 ... 150 213,044 Hammersmith ... 18 7 6 ... ... 1 4 5 ... 42 104,199 Hampstead ... 15 6 3 ... ... ... 3 1 ... 28 75,449 Holborn ... 10 4 2 ... ... ... 5 1 ... 22 31,208 Islington ... 84 47 7 ... 1 3 22 1 ... 165 336,764 Lambeth ... 68 46 11 ... 2 1 21 1 ... 150 295,033 Lee ... 6 10 2 ... ... ... 2 ... ... 20 38,588 Lewisham ... 17 8 1 ... ... ... 3 ... ... 29 83,213 Limehouse ... 19 14 2 ... ... ... 12 ... ... 47 58,305 Mile End ... 36 19 2 ... ... 1 11 ... ... 69 111,060 Newington ... 31 16 3 ... ... ... 15 1 ... 66 120,939 Paddington Plumstead ... 22 16 3 ... ... ... 11 1 ... 53 124,506 ... 12 6 1 ... ... ... 8 ... ... 22 59,252 Poplar 2 55 39 8 ... ... 2 18 1 ... 125 169,267 Rotherhithe ... 13 2 2 ... ... ... 3 ... ... 20 40,379 Shoreditch ... 43 24 4 ... ... ... 11 2 ... 84 122,348 St. George-in-the-East 1 19 4 ... ... ... ... 4 ... ... 28 47,506 St. George, Hanover Sq ... 19 3 4 ... ... ... 2 ... ... 29 79,967 St. George-the-Martyr ... 16 6 ... ... ... ... ... ... ... 22 60,278 St. Giles, Bloomsbury ... 11 3 ... ... ... 1 3 ... ... 18 38,237 St. James, Westminster ... 9 5 1 ... ... ... 2 ... ... 17 23,050 St. Luke, Middlesex ... 8 6 ... ... ... ... 7 1 ... 22 41,527 St. Martin-in-the-Fields ... 1 ... ... ... ... ... ... ... ... 1 13,077 St. Marylebone ... 19 2 1 ... ... ... 13 ... ... 35 141,188 St. Olave, Southwark ... 7 3 1 ... ... ... 1 ... ... 12 11,731 St. Pancras ... 51 19 5 ... ... 1 19 ... ... 95 240,764 St. Saviour, Southwark ... 8 3 ... ... ... ... 1 ... ... 12 25,365 Stoke Newington ... 11 3 2 ... ... ... ... ... ... 16 33,485 Strand 2 8 3 ... ... ... ... ... ... ... 13 23,782 Wandsworth ... 54 23 1 ... ... ... 17 ... ... 95 187,264 Westminster ... 10 3 2 ... ... 1 2 ... ... 18 53,234 Whitechapel ... 32 23 2 ... ... ... 5 ... ... 62 77,717 Woolwich ... 3 9 ... ... ... 1 4 ... ... 17 41,314 City of London ... 7 7 ... ... ... 1 ... ... ... 15 30,970 Port of London 1 1 ... ... ... ... ... ... ... ... 2 Totals 9 1,206 730 133 ... 4 21 364 25 1 2,493