KIN 049 BOROUGH OF KINGSTON-UPON-THAMES. Annual Report OF THE MEDICAL OFFICER OF HEALTH, PRESENTED TO THE TOWN COUNCIL OF THE SAID BOROUGH, ON TUESDAY, THE 21st DAY OF JANUARY, 1896. KINGSTON-ON-THAMES : Printed by W. Drewett & Sons, Market Place, and East Molesey. BITON NEWS, SATURDAY, FEBRUARY the medical officer's annual report. Councillor Lambert next moved, "That for the future the reports of the medical officer of health be placed in the hands of each member of the corporation at least twenty-one days before they are presented to the council ; and that such reports be considered by each committee before submission to the council." He said he was persuaded to move the motion on account of the glaring impropriety of sending round the last report of the medical officer in the middle of a council meeting, when it was utterly impossible for any member to read it, and then to assume that the council acquiesced in all that it contained. If they were a business council they ought to conduct their affairs in a business-like way. And since he determined to bring forward the motion his action, he thought, had been rendered doubly necessary by what occurred at the last meeting of the council. It seemed to him that the council were placed in a singularly ambiguous position. The council in committee proceeded to negative a certain resolution, which it was not his intention to refer to more definitely just then, and on meeting in open council it agreed to the minutes of a committee which contained the same resolution. It placed the council in a very odd position, which he attributed to the extraordinary action of handing round a report in the middle of a meeting. Councillor Davison seconded, and criticised in severe terms certain remarks contained in the medical officer's last annual report. Dr. Collins said the roads were mostly of gravel and flint, with comparatively little traffic, and during the winter months were in a damp and muddy state owing to the great amount of moisture in the Thames valley. The facts were that there were 20 roads of granite, 113 of flint, nine of granite and flint, nine partially of granite, and three of concrete. As to "comparatively little traffic," returns made some years ago showed that there was a great deal, and he entirely denied that the roads were in a damp and muddy state during the winter. (Laughter.) Dr. Collins next said that the roads were in many places the playground of children, and their condition was a matter of great inconvenience to pedestrians and bicyclists. The council had at much expense provided several excellent playgrounds for the children, and if they played in the street it was not the fault of the council. The place for pedestrians was on the footpath, and he defied Dr. Collins to match any town in Surrey with Kingston so far as paths were concerned. Then Dr. Collins suggested the trial of Professor Spink's plan of combining hot tar—(laughter)—with macadam to secure a cleanly road. If they did that it seemed to him that they would be making a huge skating rink of the whole place. The medical officer further said that "damp roads must greatly increase the amount of moisture in the air, and this moisture is one of the chief drawbacks to a residence in the Thames valley." All the medical officers in the world could not alter the geographical position of Kingston ; accordingly there they must remain. But he denied that the roads added to the moisture of the Thames valley, for the public highways were drier and harder than any other uncovered portion of the valley. Therefore, more roads less moisture. He was told that the medical officer did not intend to refer to the principal thoroughfares of the borough but only to the byeways. Councillor Glover, interrupting: Can I rise to a point of order ? The Mayor : Councillor Davison is quite right, for he is speaking to the motion and giving reasons why it should be passed. Councillor Glover: It is going a long way round then. (Laughter.) Councillor Davison, growing indignant upon the report, said it was too ghastly and absurd to ask anyone of common sense to believe ; it was a silly report, and he was pleased to say that this was the last time such a report would be imposed upon them. Councillor Glover maintained that some of the roads were dirty and that the report was a truthful one. Aid. Allard said a protest should he entered against the last speaker's observations. No one wished to repress a proper report from the medical officer, but they did not wish him to obtrude into every department of the council, when they could get better advice from other officials. Taking a strictly serious view of life, he must say that he also fell foul of the report. In 1892, when the late medical officer submitted his annual report he (the speaker) suggested that its presentation should not be delayed until May, but that it should be sent in as early in the year as possible. Since then the report had been received earlier and this year the council received it on January 21 ; but his satisfaction at receiving the report earlier was a good deal diminished by its contents. Some of the references were very objectionable. Dr. Collins started off by saying that he had neither great epidemics to record nor controversial matters to discuss and criticise ; but he (the speaker) was sorry to say that he took up 26 pages and an extraordinary diagram dealing with matters which he said were uncontroversial. (Laughter.) He suggested that the medical officer should not make his reports so much like a page of the "Leisure Hour" or like a gossiping London letter of a provincial newspaper. He was astonished when he told them that a certain amount of dampness was caused in a small house by the washing of the domestic linen. They were all familiar with the washing of domestic linen, and dampness was not the only evil which it caused, for heat and strife were sometimes generated. (Laughter.) Further on, the medical officer told them that in Edinburgh a room was provided with cells, supplied with hot and cold water, where washerwomen could wash themselves ; but he was glad that Dr. Collins' modesty and delicacy prevented him from penetrating further, and that he said nothing more of the ablutions of Edinburgh lasses. (Laughter.) If an officer belonging to a particular department was to comment in such a report upon everything, the council would be landed into a most extraordinary position. Imagine the surveyor discoursing upon diabetes or dysentery, or the school attendance officer telling Mr. Edgcome about the electric light ! He believed in giving a medical officer every latitude, but if Dr. Collins were less romantic, and confined himself to what strictly belonged to his report, they would be better satisfied. He had every confidence in Dr. Collins, at the same time he felt that Councillor Lambert was perfectly justified in bringing forward his motion. The resolution was then put and carried, and the council rose after sitting two hours and forty minutes. Baths and bathos excited the flow of oratory at the meeting in question, as to which we must refer our readers to the report given in another column. On the question of baths there is much division of opinion, and though we have often protested against uncalled for expenditure, from our point of view, and insisted on greater economy, we go with the promoters of permanent baths, believing them to be a public benefit, if not real necessity. For five or six years the project has been kept simmering in the corporation kitchen, and to try and upset the "pot" when the process of evolution of he "dish" is just upon finished, is both absurd and unwise. The only objection we have to the scheme propounded by Aid. Coppinger, as chairman of the committee, is the making of provision for converting the large swimming bath into a public hall for entertainments. That we submit is totally uncalled for, seeing what public halls the town is already provided with. It is the chief blot of the proposal, and observing that the majority of the Town Council are of the same way of thinking, we urge the committee to drop that part of the plan. * * * From baths to bathos was not a far cry, and after the recommendation of a special committee upon assessments of property in the town had been adopted, consideration was given to the recently issued annual report from Dr. Beale Collins, medical officer to the Corporation. We briefly referred to this last week, arising out of a complaint from Councillor Davison that the medical officer was entirely wrong in what he said about the roads. The question now came up on a motion by Councillor Lambert, to provide for the reports of the medical officer being submitted to each committee concerned therein before being presented to the council. Councillor Davison took up the cudgels in defence of the roads, and Ald. Allard let off quite a broadside discharge at Dr. Collins' report, which he likened to a page in the "Leisure Hour," or "gossiping Loudon letter of a provincial newspaper." Councillor Glover alone stood up for the medical officer, declaring his report about dirty roads to be true ; and being a cyclist he is well qualified to judge as to that. * * * Dr. Collins can no doubt reply with effect to his critics, if he is so inclined ; but he is entitled to sympathy. If he has gone outside his province in this last report, it is not his first act of straying, as reference to former printed documents will show. Hitherto he has been on the safe side ; but now he seems to have erred, though why such severe criticism should have been dealt out to him, it is not easy to say. Possibly there is more in this little episode than meets the eye, and time must be given for its revelation. This one thing is certain : Dr. Beale Collins has striven hard to faithfully discharge the duties of his office, and done much good work, if it is not very conspicuous. An obsequious, timid man is of no use in any public post, and to attempt to fetter or restrict the medical officer of any place when honestly striving to bring about improvements, is neither expedient or wise. * * * Last week in notes upon the meeting of the Town Council, the credit was given to Councillor Lambert of asking for information about the posts in Can bury-passage. It was Councillor Glover who asked the question, following up his letter to the committee thereon ; and the error arose through the substitution of Councillor Lambert's name for his in the report of the proceedings at the council. ??? Grand ??? Fair In aid of the Extension of ST. AGATHA'S CATHOLIC ELEMENTARY SCHOOLS, Will be held in the ALBANY HALL, KINGSTON, IN APRIL NEXT. Persons willing to assist are earnestly requested to communicate with the President, the Rev. Father Lutz, 39, King's-road, Kingston-on-Thames. J. TYLER, Hon. Sec., Florence Villa, Ceres-road, Kingston-on-Thames. TO LET, SELL, BUY, or RENT, LAND, HOUSES, and ESTATES. Apply to J. Garrod Auctioneer. House and Estate Agent, Surveyor and Valuer, HIGH STREET, ESHER, SURREY. Dilapidation Claims prepared and settled. Inventories made and examined. Sales by Auction of Land, House Property, Furniture and Effects. Mortgages arranged. Insurances effected. Surveys made. Plans prepared. Valuations for Probate, Mortgage. Transfer, &c. 55a, HIGH STREET, KINGSTON. MESSRS. FRICKER & SON, Auction- eers, House and Estate Agents, Valuers, and Surveyors, have a Large Selection of furnished and Unfurnished Houses To Let and Properties For Sale. Houses and Properties Registered Free of Charge. Valuations made for Probate, Transfer, &c. Rente Collected and Estates Managed. Sanitary Surveys made at shortest notice. WARMING STOVES IN GREAT VARIETY. Lamps AND WARMING STOVES IN GREAT VARIETY. WE SELL THE VERY FINEST LAMP OILS. GALL STRANGE'S A-1 1s. WATER WHITE 10d. PETRO. or KEROSENE 8d W. G. SMITH, CORNER OF ST. JAMES' ROAD, Built to a now of musical and other entertain ments whilst the swimming bath was closed during the winter months, always yielded a good revenue. Of course there were public halls in the town, and so there were in the places where baths referred to by Mr. Tiltman were erected. There seemed to be an idea that the proposed building would not be high enough for musical and other entertainments, but he thought the hall which would be provided would be a very good one for singing or any other purpose. The distance from the boarded floor over the swimming hath to the wall plate of the roof would be 17ft., to the principal 29ft. Gin., and to the top of the skylight 34ft. Gin. The length of the hall would he 100ft., the width 46ft., and there would be a clear space of 38ft. within the boxes. Roughly speaking the hall would provide accommodation for about 1000 people, 600 on the floor and 400 in the galleries. Referring to the opinion expressed at the recent town's meeting, he said that at the close a councillor who had passed the mayoral chair, and who he thought was not in favour of baths, told him that after such a meeting the corporation were quite justified in spending £6000 on baths, and he should be prepared to vote for £8000 if necessary. The committee had done their best to carry out the resolution of the council, and he had great pleasure in moving the adoption of the minutes. Councillor Huckle seconded the motion. He said he represented a ward which was in need of baths, and referred to the number of members added to the council during late years who had put baths forward as one of the prominent questions to be decided. In bringing forward plans for baths he took it that the council were fulfilling the wishes of the burgesses as expressed at the elections. In serving on the Baths Committee it had been his pleasure to sit under three chairmen, Aid. J. Marsh, Aid. Allard and Aid. Coppinger, and he was pleased to find that the latter had been able to present plans which would satisfy the requirements of the town. Councillor Glover had very great pleasure in supporting the motion. After giving a racy description of the opposition to the baths scheme, showing how the anti-bathites were beaten at the recent town's meeting, he said that not satisfied with defeat the objectors had come on again. It had been asked how they would get any revenue out of the proposed baths, and he thought that was a vital point. (Hear, hear.) There were sources of revenue, however. People heard of Kingston, of its beauties, and its splendid situation, but when they came where could they find houses with baths? There were houses rented at £40, £50 and £60 per annum without baths, which was deplorable. Even the Romans, before they came to England, had their baths, and now, at the end of the nineteenth century, Kingstonians were found opposing their introduction. When he came to the town it was only after great difficulty that he found a house with a bath. The only public accommodation for bathers at the time was an "old tin-pot craft," which he supposed was brought over by the Spanish Armada, and which would probably have sunk if the career of the inglorious expedition had been prolonged another day. With public baths they would find people coming to the town and taking houses although they might be without baths; there would be more visitors in the summer, and the result would be that the rateable value of the borough would increase. Metropolitan swimming clubs had offered to come and compete against similar local institutions, but were unable to do so owing to the absence of suitable accommodation. They were afraid of the old tin, wooden ship sinking with all the people on board. It would be an honour to all who supported the erection of the baths, and it would be a matter of greater pride to support the construction of apparatus to save life than Maxim guns to destroy life. On the ground of morality baths were a necessity, and after remarking upon the practice of youths stripping upon the banks of the Thames and ??? REPORT OF THE MEDICAL OFFICER OF HEALTH, Clattern House, Kingston-upon-Thames, January, 1896. Gentlemen, I have the honour to present to you my third annual report, and trust that with one exception you will find it satisfactory, as I have neither great epidemics to record nor controversial matters to discuss and criticise. It has now been definitely settled that the parish of Kingston is to be three sanitary districts instead of one, and I feel sure that in endeavouring to make it a sanatory district the Medical Officers of the other two districts will unite with me in cordial assistance to one another in all those cases in which our duties come in contact. The most important event of the year was the great frost, and this brought home to all members of the community the disabilities under which we suffer in being without control over our supply of 4 water, one of the elementary necessities of life. For weeks many persons were without water, except what they were able to carry in buckets from long distances. The cause of this stoppage in the supply was due to two causes, the non-continuous supply and the shallow method of laying the mains. In Cambridge Road I measured the depth as 8 inches, and in no place where I saw the ground opened were the pipes at a greater depth than 18 inches. Authorities mention 3 feet as a proper depth for mains, and not less than 2 feet for house connections. That this artificial drought in times of frost is due merely to the supineness and utter disregard for the comfort of those persons compelled to draw their necessity at the will of a monopoly is shewn, and cannot be denied by the Water Company. It is only necessary to enquire how often Continental towns are placed in this pitiable condition. I have lived in places with the thermometer standing at 12º and 15º Fah. and have not experienced any failure in the water supply, simply because the mains and connections were laid at a proper depth below the ground. One death from Typhoid Fever was recorded during this failure of water supply, which, as far as I can ascertain, was due to the foul condition of the house drains owing to insufficient flushing. Considerable progress has been made in improving the drainage of houses of the better class, to which I referred in a former report. Some twenty houses that had long stood empty, owing to the defective drainage and imperfect sanitary arrangements, have been put into good repair, and their sanitation greatly improved and modernized. They are all now occupied, apparently by new comers, as I do not find that other houses in the town have been vacated. 5 During the year about 70 houses have been built, which with the 20 mentioned means the addition of some 500 inhabitants, independent of the increase in the ordinary way. Work has also been done under the Housing of the Working Classes Act. The old houses in Sun Passage have been repaired, the yard paved, and additional closet accommodation provided. Some houses at Norbiton, known as Fuller's Rents, are being dealt with, and it is hoped that they will either be put into a proper state of repair or else pulled down. Other property in the neighbourhood of the Back-lanes has been reported on, and three tumbledown houses have been closed, and will shortly be removed. The working of this Act is a great improvement upon the old procedure, but it still remains very tedious business when it is necessary to deal with an obstructive and litigious owner. However, by constantly pegging away I hope in the course of time to get all this class of property either renovated past recognition, or pulled down to make way for healthier homes. Houses of a somewhat higher rental and let to single tenants, and not in tenements, have also been dealt with under this Act, and also under the Public Health Act, 1875. Drains have been removed from under the houses and laid in concrete outside, with proper disconnecting traps and inspection chambers. Dampness has been remedied in basements by the construction of dry areas and the laying of concrete beneath the floors. A great difficulty in dealing with dampness in houses built from 30 to 50 years 6 ago is found in the absence of a damp course, so that in spite of concrete and dry areas a certain amount of dampness arises from the earth through the porous brickwork. I have to congratulate the Corporation on the purchase of a piece of land on which it will be possible to build an isolation hospital. This hospital is urgently needed by all classes of the community. Cases have arisen during the last year in business premises which entailed great expense on individuals, whose misfortune was probably due to ignorance or carelessness on the part of other member of the community. It must also be remembered that infection in houses of business is always a greater source of danger to the rest of the community, through the enormously increased social intercourse giving numerous facilities for the spread of the infection. Several members of the working classes have also been put to great inconvenience, and even loss of employment, owing to occurrence of infectious disease in their families or that of their lodgers. Persons engaged in businesses dealing with provisions (milk, bread, &c.), stuff goods of all sorts, conveyances, or in offices, are obliged to cease work when infection breaks out in the household, unless there is some means of isolating the sick ; and this means of domestic isolation is entirely absent in three-fourths of the houses in this town. I am aware that great pressure is exerted by ratepayers against increased expenditure, but I think that in this connection the weighty words of Sir Albert Rollit, M P., are well worth recording. Reference to rates demands one word of warning, and, as I venture to think, of wisdom. Too high rates may create re-action, and accumulated public debt may have even worse consequences. Economy is, therefore, the highest prudence; but, in some things, and chiefly in matters of health, parsimony is not economy. The expense of epidemics is not to be counted as against the 7 cost of precaution and prevention, and prevention is probably possible in the case of 25 per cent, of the total mortality, with a direct saving of at least £10,000,000 a year, apart from the loss from mere disablement by illness." I therefore urge upon you the early erection of the Isolation Hospital on the land you have secured. I would also suggest that you should make an arrangement with some of the neighbouring authorities, who are at the present moment endeavouring to make similar arrangements, with regard to the isolation of small pox cases. Distance of transport is of very little moment in treating small pox patients, as thanks to the partial protection afforded by primary vaccination the few cases that occur in our midst are of such a mild character that our only consideration is to get them away from a community where, owing to prejudice and misrepresentation, many persons are foolish enough to neglect vaccination and re-vaccination from fear of purely imaginary dangers, when the operation is properly performed by a competent surgeon, and thus render themselves particularly liable to this loathsome disease. In Germany, where vaccination and re-vaccination are efficiently and universally performed, small pox is practically unknown, except on the frontier ; even in towns like Hamburg, which are in a state of insanitation which would hardly be tolerated in this country. I should like to refer to the condition of the roadways in the Borough. These are mostly gravel and flint roads, with comparatively little traffic, and during the winter months are in a damp and muddy state owing to the great amount of moisture to which we are exposed in the Thames Valley. These roadways are in many places the playground of the children, and their condition is a matter of great inconvenience to pedestrians and bicyclists. It has been suggested by Professor Spinks, of the Yorkshire 8 College, that a cleanly road can be made in the use of macadam combined with hot tar, properly prepared, and finished by the steam roller, and I would suggest that in making up one of the smaller roads this experiment should be tried. Damp roads must greatly increase the amount of moisture in the air, and this moisture is one of the chief drawbacks to a residence in the Thames Valley. The question of Baths and Wash-houses being now before the Coporation it may be desirable to make a few remarks on their bearing upon health. In this town we have a very large population of growing boys and girls, many persons resorting to this town for the benefit of the Tiffins' Schools. These boys and girls require as part of their physical training—without which no mental training can be complete—the opportunity for swimming and bathing. Swimming as an exercise develops many muscles that are rarely used, and therefore undeveloped, in our usual social intercouse, and by developing graceful movements induces those esthetic qualities that have probably a much greater influence on the development of character than is generally supposed. Though the practice of swimming can be acquired by boys by early morning bathing in the river, this opportunity is denied to girls, for whom the acquirement of the art is as needful as for the male sex. In a town whose great attraction is its boating facilities this is particularly needed, merely as insurance against drowning. The question of Wash-houses, or the facilities for enabling the poor to do their laundry work away from their small houses, is also most important. The amount of dampness caused in a small house by the washing of the domestic linen must cause great discomfort and even injury to children and 9 delicate persons, and when it is remembered that many poor people eke out a livelihood by washing for other persons, the importance of providing a suitable place where this work can be carried out under hygienic conditions hardly needs to be insisted on. The recent Factory Act has placed laundries where steam power is employed under its provisions, and places that have in consequence been brought under notice show that much requires to be done to bring such workshops under proper hygienic conditions. Such being the case in the larger establishments, it may be surmised that in smaller workshops there is room for improvement, and for these latter I know, from experience elsewhere, that when there is a Public Laundry in a convenient position washerwomen reside in the neighbourhood, and no washing is done in the houses of the poor people. In connection with Laundry Sanitation I may mention that one disadvantage under which the Sanitary Officials suffer is the want of a right of entry. Under the Public Health Act, 1875, this is only given where there is reason to suspect a nuisance, but if an Inspector were appointed under the Shop Hours Act this right of entry would be given to the official so acting. In connection with Public Laundries the provision of a small playroom, or crèche, for the accommodation of small children, enables mothers who would otherwise be unable to leave home to make use of these places. In Edinburgh a room heated with steam is provided with cells supplied with hot and cold water, where the washerwoman can wash herself without extra charge beyond that for the use of the laundry. The provision of hot baths at a small fee, say id., would be very advantageous to the many poor persons living in Canbury Passage, Canbury Park 10 Road, &c., where very few of the houses are provided with bath rooms. The first class baths would be doubtless a convenience to boating men, and the immediate hot bath on conclusion of violent exercise is found by many to be of great value ; more especially if opportunity is given for gradually cooling by shower or plunge baths, as in the Turkish or old Roman baths. Now that the electric light is being extended throughout the Borough it would seem opportune to suggest that gas should be more extended for warming and cooking purposes. It is only necessary to look down on Kingston from the hill to see that the atmosphere is largely charged with smoke from the numerous fires that continue in great number, even in summer, owing to the great population who live in tenements. The principal objection to this use is the great expense of a gas that has been purified for lighting purposes. If representations were made to the Gas Company, it is possible that they might be disposed to lay mains for an impure gas that would answer for heating and cooking purposes, and enable us to avoid a great deal of dirt in our houses and murkiness in our atmosphere. An application was made for the establishment of a soap boiling and fat melting works in the Borough. Being directed to make enquiries I reported as follows :— London County Council.— The Medical Officer kindly placed the services of an inspector at my disposal, who took me to two works at Bow Common. These works are conducted under the Bye-laws of the Council. They are situated in a very poor neighbourhood, and are surrounded by other works of a similar description. As far as the actual bone-boiling and tallow-melting are concerned, 11 there does not appear to be any very appreciable nuisance, but the Inspector pointed out to me that any disregard of the rules by a workman might make a great difference in this respect. For instance, some of the exhaust draught fans might not be in working order ; the furnace for cremating the fumes might be allowed to get low ; or there might be broken windows, open doors, &c., allowing the stench to come out of the closed rooms into the open air. I found, however, that the cartage and storage of the bones and fat caused considerable nuisance, and this I was informed was practically insuperable in conducting the business. The Medical Officer pointed out to me that the trade of tallow melter was removed from the control of the London County Council by the Public Health (London) Act, 1891, so that new works of this character have been considered by Parliament unsuitable for establishment in London. He agrees with the principle of the Act and advises me to put the case against the works as strongly as possible to my authority. He also writes, "We were troubled in my own house with offensive smell—bone boiling. I took a cab and traced the smell to some tallow-melting premises 11/3 of a mile in N.N.E. direction across London." This shows that the odour will travel a considerable distance ; in this case arising from infringement of regulations by workmen. Croydon Rural District Council.—Several fat and bone-boiling works in district. I have not visited them, but the Medical Officer writes :— "We have secured the adoption, in most cases now, of apparatus for destroying the offensive vapours by fire, but I cannot say that the results have been highly successful." 12 Portsmouth.—The Medical Officer writes :— "If possible I should advise you should prevent any such business being established, except in a very sparsely populated district." I visited the works at Portsmouth. The fumes are here washed in a spray, which seems to be very successful. Great nuisance arises from the cartage and storage of fat, which in this case is of a superior character, mostly coming from the Government slaughter-houses at Gosport, and from the ships and barracks. The General Hospital is adjacent to the works, and the patients have suffered great inconvenience from the smell of the rancid fat. In certain cases vomiting has been induced, leading to an unsuccessful termination of the attempt to save life. West Ham.—The Medical Officer writes :— "The only practical nuisance arising from these works is the smell during certain parts of the manufacturing process." I did not visit any works. Brentford.—The Medical Officer writes:— "If precautions are taken against the effluvium being allowed to escape into the outer air, except at a sufficient height, and the works conducted in a proper manner, they ought not to be a source of nuisance to the neighbourhood." I have not visited these works, but I went over to Brentford and walked about the neighbourhood of the works, when I found considerable effluvium. The neighbourhood is of a very poor class, and I was informed by a resident that sometimes the smell was " very strong." Observations.— It seems that by diligent inspection and stringent regulation it is possible to avoid nuisance from the actual bone-boiling and tallow-melting, but that the carting and storage of the fat invariably gives rise to nuisance. The proposed site is contiguous to that for the proposed Isolation 13 Hospital, and the experience of Portsmouth is adverse to such propinquity. Other authorities are endeavouring to get rid of similar works, and should you sanction the establishment of one, you would doubtless have further applications. This would entail the appointment of a special Inspector to look after the different works. Wherever these works have been established the immediate neighbourhood has greatly deteriorated. It should not be forgotten that neighbouring Authorities are empowered under the Public Health Act, 1875, to proceed against such works for nuisance even when outside their own districts. All the Medical Officers of Health who have expressed an opinion on this question recommend me to oppose the application. I do not see any objection to soap-boiling and candle-making, if carried out under proper regulations. The works at Hampton and Staines are very well arranged, but 110 tallow-melting was going on at the time of either of my visits. Before coming to a conclusion, I think it very desirable that you should visit some of these works and judge for yourselves. The application was refused. I have to congratulate you on the greatly improved Building Bye Laws, and also on the progress that is being made in revising other Bye Laws, and in framing new ones for the regulation of houses let in lodgings, which are greatly needed to prevent overcrowding and to establish cleanliness and healthy surroundings. A superheated, or other steam disinfection apparatus is greatly needed, and I think it would not only repay the cost of erection by saving the heavy expenses at present entailed by sending goods away, 14 but it would be available for the use of the surrounding districts and might in that way prove a source of revenue. The appended form has been introduced to safeguard the books in the Free Library from infection. The Inspector gives the names and addresses of all persons notified for infectious disease to the Librarian, and he gives a receipt to the occupier in exchange for any books that may be in the infected house. When the patient recovers notice is given to the Librarian, and the books returned after disinfection, or destroyed, as may be directed by the Medical Officer of Health. Names of persons and houses with dates of notification to the Librarian of infection and disinfection. Notification to the Librarian of freedom from infection of persons previously notified. With notice of destruction of book by the order of Medical Officer of Health when requisite. Receipt of the Sanitary Inspector for Library card or book given up to him by persons on the outbreak of infectious disease in their houses. Information to the Librarian of Infectious Diseases. ( CONFIDENTIAL.) Date on List. Name and Address. (Red Ink). Date off List. Date. Name and Address. No. of cards or books. Remarks. Date. Name and Address. No. of cards or books. Remarks. Date. Name and Address. No. of cards or books. Remarks. 16 Births I estimate the population of the Borough for the middle of the year 1896 to be 30,050. During the year 1895 there have been 954 births registered, giving a birth rate of 317 per 1000. Of these births 493 were males and 461 females. Deaths. The deaths were 490, 256 males and 234 females. This gives a death rate of 16,3. This increase over last year is almost entirely due to the increase in the number of deaths under 5 years of age, being 196 instead of 161. The deaths of persons over 65 years of age amounted to 117, almost one-fourth of the mortality. 155 children died before reaching the age of one year, of whom 22 appear to have been illegitimate, and 41 died under 5 years of age, giving an infantile mortality of 22.8, or more than one child in five does not reach the age of 5 years. The death rate of infants under one year of age is 162.4 per 1000 of births, which compares very nearly with the last quarterly return for St Giles', City of London, Whitechapel and Poplar, instead of such rates as 114, 105, 123, given for districts more like our own, viz., Lewisham, Woolwich, and Plumstead. It will be useful to enumerate the roads in which these deaths occurred. I only cite the roads where the figures were high for the numbers living in the road. 17 Canbury Group. Hogg's Mill Group. Norbiton Group. Town Group. These four groups show the chief incidence of the mortality. The Canbury group follows the course of the old Latchmere brook. The Town group seems to point to the influence of overcrowding of space with buildings. The Hogg's Mill group may be accounted for by the general dampness of that neighbourhood, which will continue as long as the mills remain. This seems to me to be the most unsatisfactory portion of my report, but its remedy lies in a great measure in the hands of those who are responsible for the moral and religious teaching of the people, for I fear the greater number of these deaths are due to carelessness combined with ignorance. Canbury Park Road 12 Canbury Passage 6 Cowleaze Road 6 Hudson Road 8 Acre Road 8 Elm Road 7 King's Road 8 Shortlands Road 8 Cross Road 3 Mill Street and Place 9 Fairfield Place 2 Portland Road District 7 Cambridge Road 5 Cambridge Grove Road 3 Asylum Road 5 Vincent Road 4 Fairfield 5 Young's Buildings 4 Church Street 4 London Street 4 Bridge Street 2 Apple Market 1 18 In this report I am enabled by the kindness of Dr. Seaton, M.O. to the County Council, to include the deaths of persons belonging to the Borough who died in Institutions outside. The zymotic death rate amounts to 1.3 per 1000. This compares with 2.02 per 1000 for 1894 and 3.29 per rooo for 1893. This is very favourable. Comparing Kingston in 1895 with England and Wales 1886-90. Kingston. England & Wales. 1895. 1886-90. Scarlet Fever Nil .3 Diphtheria .09 .25 Enteric Fever .03 .27 Whooping Cough Nil .55 Diarrhœa .6 .76 Phthisis 1.7 2.7 Measles .19 .56 There were no deaths from any other zymotic disease except Influenza, for which there are no comparative figures. Small Pox. Only one case is recorded, which recovered. The disease was of a semi-confluent character and ran. a mild course; the patient, a tramp, made a good recovery. He had been vaccinated in infancy and had four small marks. He was strictly isolated in the Workhouse Isolation Ward, and all persons who had been in contact with him in the building were re-vaccinated. Unfortunately he had slept in the Casual Ward one night before the eruption was fully out, or observed, and many of those who had been with him were dispersed over the country. To show the danger run by the community from this class 19 of person I may mention that the man had come from Coventry, not having slept in a bed for three weeks. He had doubtless been in various public houses, cottages, barns, shops. &c., begging and obtaining food, and must have brushed up against many people in the course of his peregrinations. The Medical Officers of Health for the various districts through which he had passed were communicated with and as far as could be learnt the disease had not been communicated to others. Diphtheria. Twenty-one cases have been reported, with 3 deaths. The cases were generally of a mild type. One of the fatal cases was the child of a bootmaker aged 4. On Saturday, October 12th, a female tramp purchased a pair of boots and left her old boots behind her in the shop. They were put out in the yard and remained there till Monday, when they were taken away by the dustman. On the 15th the child was ailing, and was notified to me on the 19th as suffering from Diphtheria. On 19th, Saturday evening, the husband of the tramp came into the shop and told the proprietor his wife had Diphtheria. Unfortuately his name and address were not taken, and although enquiry was made in all the common lodging houses, and the police and poor law authorities notified, no trace of the woman could be obtained. It was ascertained that the child was in the yard on the Sunday morning, and it is quite possible she may have played with the boots and derived the infection from them. In one case notified the patient had come home ill from a house in Surbiton where she had been in service. The M.O. H for Surbiton inspected the house, but he was unable to find anything to account for the origin of the disease. When she left 20 Surbiton the disease had not been diagnosed, but greater care might have been taken to find out what was wrong before removing the patient. Two children attending a school in Middlesex were attacked on the same day. It was found that they sat next to each other in class, but nothing appears to have been discovered to account for the origin of the disease at the school ; but the house in which the scholar living in Kingston resided was not in a satisfactory condition. Both children made good recoveries. One child attacked was found to have played in the street with another child who was notified two days previously, the second child suffering from Diphtheritic Paralysis, although she had shown no signs of illness when another member of her family had been attacked with Diphtheria six weeks previously. This shows that this disease may be so mild as to be readily overlooked, though likely to be followed by paralysis and capable of transmitting infection to susceptible persons. Croup and Laryngitis. The ages of death of the children were 11 months, 14 months, 3 years, and 4 years. The first was returned as Membranous Croup, and I should imagine that the other cases would have been more correctly returned under the head of Diphtheria. No P.M. examination appears to have been made to substantiate the diagnosis. Membranous Croup has now been added to the list of notifiable diseases. Whooping Cough. Five deaths occurred under one year of age, 2 under five years, and 1 over five years. These 21 cases were all complicated with Pneumonia or Bronchitis, and occurred in the poorest streets. This disease seems rarely fatal after the first year of life, when due care is taken in the treatment. Scarlet Fever. 104 cases have been notified, but not a single death. The origin of the disease has been approximately traced in a few cases, but the great majority appeared to spring up spontaneously. A.W. travelled with his mother from Norbiton to Kingston in a carriage with a lady and child who appeared to have come some distance. This lady advised the mother who had entered the carriage with A.W. to travel elsewhere, as her child was ill, but the train started before there was time to change. Three days later A.W. developed Scarlet Fever. B. sickened three days after wearing some new underclothing purchased at a linen draper's. No other cases seem to have been infected from this source, but the particular garment may have been the only article in the package sent to Kingston that had been in an infected place. Other purchasers may have washed the clothing before using it, and this course is to be recommended to all persons purchasing ready-made underclothing. C. was notified as suffering from this disease four days after the return of his brother from the Scarlet Fever Convalescent Home. The brother had been a patient in the Richmond Hospital, where he contracted the disease three weeks after leaving home. This child had been four weeks in the Convalescent Hospital and there was no possibility of infection by clothing, it having been destroyed and new supplied. The child had been 22 under treatment in the Richmond Hospital for strumous disease of the knee joint, and some discharge continued. It seems possible that the infection was conveyed by means of this discharge. D., a young woman of 19, was attacked not having been out of the house for weeks, being under treatment for debility. It was found that all her younger brothers and sisters suffered from enlarged tonsils, but there were no signs of desquamation or history of a rash. There were some signs in October of the commencement of an epidemic of Scarlet Fever, isolated cases breaking out in different parts of the Borough, mostly in children attending two schools. At the same time the disease was rife in Richmond, Wimbledon, and Surbiton, so that there were numerous sources of infection near at hand. I communicated with the School Managers, and arranged to visit and inspect the schools, should the number of attacks increase. Happily, however, the numbers fell off, and this I attribute to the discover) of two families of children who were partly absent from school, and some of whom were found to be desquamating, whilst others showed suspicious symptoms. They were all notified and isolated. The parents pleaded ignorance of the nature of the disease, and as it appeared that the children had not shown any symptoms of illness beyond the desquamation no proceedings were taken. These cases were discovered through the School Attendance Officer, and it is very desirable that arrangements should be made so that all children absent from school for more than three days should be visited promptly. Such cases as those mentioned above would then be readily notified and isolated. I would suggest that a clerk should go round to the schools daily and make out a 23 list of absentees with their names and addresses, to be given to the Medical Officer of Health every day. The expense of such a clerk would in my opinion be amply repaid by the decrease of infectious disease. This would be almost complete if private schools could be induced to give similar facilities to the health officials. Typhoid or Enteric Fever. The only fatal case was that of a boy, occurring in a house without water on account of the frost. Two cases occurred in houses with well water. The wells had both been recently affected by pumping operations in the neighbourhood. The water was examined ; in one case it was chemically impure, in the other the results were negative. The wells were both ordered to be closed. One case was attributed to eating oysters, but there were numerous sanitary defects in the house, and it was not shewn that the oysters had caused illness in other persons. In 3 cases the disease arose in old houses, none of them with any obvious sanitary deficiencies, but with the general structure and arrangement very far from the requirements of modern sanitation. One case occurred in a medical student, who may have been exposed to infection in various ways. Phthisis. Fifty-two deaths were registered from this disease, or a rate of 1.7 per jooo. This compares with 1.5 in 1893 and 1.2 in 1894. 24 Diarrhœa. Twenty deaths occurred; 16 were under six months of age and 4 under one year. There were 3 cases in July, 8 in August, and 4 in September, and the localities chiefly affected were in the course of the old Latchmere Brook and the Hogg's Mill stream. Measles. Fifty cases occurred in one school, which was closed for 14 days in May and June. Six deaths were recorded, all under five years of age, and nearly all from complications. It will be observed that this disease is much more fatal than Scarlet Fever. Influenza. Eleven deaths were recorded, 10 of them being in the early spring, but nearly all were complicated with other diseases. WARDS and DISEASES IN EACH. Primary Cases. Secondary Cases. Totals. 1st Qr. 2nd Qr. 3rd Qr. 4th Qr. 1st Qr. 2nd Qr. 3rd Qr. 4th Qr. Town— Scarlet Fever 1 3 1 3 2 10 Diphtheria 2 2 4 Enteric Fever 1 1 2 — 16 NORBITON— Scarlet Fever 2 2 i 7 3 1 7 23 Diphtheria 1 1 1 3 Enteric Fever — 26 CANBURY— * Scarlet Fever 6 4 6 6 1 23 Diphtheria 2 2 2 1 1 8 Enteric Fever 1 1 2 2 6 - 37 HILL— Scarlet Fever 2 1 10 4 17 Diphtheria 1 1 2 1 1 6 Enteric Fever 1 1 Small Fox 15 1 19 16 34 2 4 1 13 1 — 25 Scarlet Fever 9 11 9 26 2 3 1 12 73 Diphtheria 4 6 4 5 1 1 21 Enteric Fever 2 1 3 3 9 Small Pox 1 1 *Barracks: Scarlet Fever: 11. Grand Total 104 26 Dairies. Attention has been called to the cowkeepers who had allowed more cattle to be kept in the sheds than is permitted by the Dairies and Milkshops Order. The numbers will be reduced or extra accommodation will be built. Bakehouses. All have been inspected twice during the year. A few bakehouses are underground, and the following letter was sent to the proprietors of these establishments : Clattern House, December 5, 1895. Sir, 1 think it most desirable that the bakehouses should be in thoroughly good order, more especially those that are underground either entirely or partially. With a view to remedying the disadvantages of position I would desire to call your attention to the following recommendations: 1. That every underground bakehouse should have an area 4ft. wide constructed outside, if practical on two sides, reaching from the level of the floor upwards to the level of the adjacent land. 2. Windows should be constructed to open from the area into the bakehouses with openings on the flap principle, opening either outwards or inwards, so as to allow of free ventilation. These windows should be as large as possible. 3.—The walls of the bakehouse should be lined with glazed bricks, or tiled, and the water supply should, where there is a constant system, be taken from the rising main. No drain should on any account open into the bakehouse. 27 4—The bakehouse should be at least 8ft. in height, and 500 cubic feet should be allowed for every person working therein. 5.—Wherever artificial light is required it is highly desirable to take advantage of the electrical supply. Gas and lamps consume oxygen and give off carbonic acid and other deleterious gases detrimental to the workpeople. Electric light is absolutely clean and avoids the dirt, dust and heat that arises from the use of gas. Trusting that you will take these recommendations into your consideration and that you will be able to modify the existing arrangements at an early date. Yours faithfully, H. Beale Collins. Common Lodging Houses. Two houses have been closed altogether and one has been put into good repair. Two others have been reported upon as unsuitable for the purpose and will be dealt with shortly. The Bye-laws are under revision and it is to be hoped that by stringent administration the number of these houses may be permanently reduced in the town. The large number existing in the Back Lanes has merely made Kingston the dumping ground for all the disreputable characters in the neighbourhood, and as these people confer no benefit on the community it is desirable to reduce the opportunity for their aggregation to the greatest extent possible. Remarks. 246 visits of Inspection were made. 8 „ to School. 81 „ to Absentee Scholars. 28 78 visits to Bakehouses. 7 „ to Dairies. 8 notices were served, and several others held over. 103 letters were written. 19 visits were paid in making enquiries outside the Borough. 5 notices of overcrowding. 11 enquiries and consultations' were attended. 9 samples of water were analysed. 1 wells were orded to be closed. 28 inquests were held. 2 cases of uncertified deaths were returned. The Health of the Borough has been on the whole satisfactory, and with the exception of the increase in the infant mortality shows improvement over former years. H. BEALE COLLINS, Medical Officer of Health. HEALTH DEPARTMENT. Showing the work done by the Sanitary Inspector. Abstract of Notices for the Year 1895. Choked and defective drains 125 Defective closets and syphons 23 Defective soil pipes and ventilators 14 Defective yard, sink and bath waste traps 27 Defective water apparatus to closets 61 To provide separate cisterns for flushing closets 17 Foul drinking water cisterns 39 To lay on water supply to houses 6 To cleanse and limewash houses 83 To cleanse and disinfect houses and cellars 39 29 To cleanse and limewash closets and yards 10 To cleanse urinals adjoining public thoroughfares 9 To screen urinals adjoining public thoroughfares 3 Dilapidated house roofs, floors and yards 15 Dilapidated and damp bedroom walls 10 Dilapidated manure and dust places 15 Accumulations of manure, offal, &c. 41 Pig keeping (a nuisance) 3 Fowl keeping (a nuisance) 17 Undrained slables and yards 9 Overcrowding of houses 5 Canal Boats Acts, &c. Canal Boats and Barges inspected 30 Offences in Contravention of Canal Boats Acts Nil Notification of Infectious Diseases Acts. Notices served to Householders 104 Notices served to Attendance Officer 104 Notices served to Schools 124 Disinfecting houses after Infectious Diseases 97 The Slaughter Houses, Cowsheds, Dairies and Milkshops have been visited at various times and found in a fairly satisfactory condition. FRED. J. PEARCE, Assoc. San. Inst., Sanitary and Buildings Inspector. January, 1896. 30 REPORT OF THE LODGING HOUSES, MARKETS, AND PETROLEUM INSPECTOR FOR THE YEAR, 1894. Lodging Houses. Registered Lodging Houses, to the number of 9, have been kept clean and satisfactory. The total number of Lodgers for the year using these houses amounted to 87,383, being a decrease of 13.296 upon the previous year. Petroleum Act. Premises and tanks licensed under this Act have been kept in a satisfactory condition, and have afforded no cause for any complaint. Markets. All stalls occupied by perishable goods have been kept under close observation, and I have had no cause to make any complaint. FRED. J. PEARCE, Inspector (pro tern.) January, 1896. BIRTHS. DEATHS. AGES OF THE DYING. CAUSES OF DEATHS. 1895. Month. Males. Females. Total. Males. Females. Total. Legitimate, under 1 year. Illegitimate, under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. Over 65. Small Pox. Scarlet Fever. Diphtheria. Croup and Laryngitis. Enteric Fever. Typhus Fever. Puerperal Fever. Erysipelas. Measles. Whooping Cough. Diarrhœa. Influenza. Rheumatic Fever. Phthisis. Bronchitis, Pleurisy and Pneumonia. Heart Disease. Tuberculosis. Cancer. Injuries. All other Diseases. JANUARY 42 34 76 24 29 53 15 2 5 1 16 14 Under 5 1 1 1 2 7 3 7 1 7 6 5 2 2 8 FEBRUARY 31 35 66 30 29 59 13 3 8 2 2 10 21 Under 5 1 9 3 11 1 2 16 4 2 10 MARCH 60 52 112 28 36 64 16 1 7 1 6 15 18 Under 5 1 1 1 9 4 3 8 4 5 20 1 1 6 APRIL 39 36 75 21 21 42 9 3 5 4 11 10 Under 5 1 1 1 3 4 7 1 1 2 2 4 2 2 11 MAY 41 37 78 14 13 27 5 3 1 1 10 7 Under 5 3 2 3 1 3 2 1 1 11 JUNE 41 37 78 16 11 27 8 2 2 2 10 3 Under 5 2 2 1 7 2 3 2 2 2 4 JULY 41 32 73 16 9 25 9 1 2 3 7 3 Under 5 3 3 4 7 1 2 1 1 1 2 AUGUST 36 42 78 17 23 40 16 3 1 13 7 Under 5 1 8 1 2 3 4 4 5 3 1 8 SEPTEMBER 28 49 77 19 20 39 15 2 2 2 1 13 4 Under 5 1 4 2 6 6 3 1 4 3 1 8 OCTOBER 42 36 78 22 11 33 12 2 1 1 1 9 7 Under 5 1 1 3 3 7 5 4 1 1 1 6 NOVEMBER 45 33 78 16 13 29 5 1 1 1 1 9 11 Under 5 1 1 1 4 1 4 2 3 2 1 9 DECEMBER 47 38 85 26 16 42 10 3 6 11 12 Under 5 1 2 6 1 9 5 9 2 2 5 Deaths in Brookwood Asylum 7 3 10 1 5 4 1 1 8 TOTALS 493 461 954 256 234 490 133 22 41 15 19 139 121 Under 5 3 4 6 7 20 1 2 48 28 77 1 1 11 50 64 35 7 19 10 96 Rate per 1000, 1895 164 15 2 31 7 8.5 77 16 3 44 7 1 3 4 6 45 4.0 .09 .13 .03 .19 .2 .6 .3 1.7 3.7 1.1 1.1 .6 .3 5.7 Rate per 1000, 1893 15.3 13.9 29.2 9.15 8.78 17.9 3.5 .03 2.2 .77 •8 6.18 3 .71 035 .24 .8 .21 .07 .03 .21 .28 •99 •42 .105 1.5 3.4 1.5 .8 .3 .3 6.4 Rate per 1000, 1894 15.5 14.5 30.1 7.7 6.4 14.2 3.1 •3 1.9 .4 .6 3.7 3.7 •24 •24 •06 .03 .06 •6 •27 •3 •3 •03 1.2 2.2 1.1 .7 •4 •5 5.3