Ley 008 Leyton Urban District Council. Annual Health Report for 1906, by A. F. PESKETT. Medical Officer of Health. Walthamstow: GILLETT BROS., LTD., PRINTERS, HOE STREET. Leyton Urban District Council ANNUAL HEALTH REPORT FOR 1906, by A. F. PESKETT, Medical Officer of Health. Gentlemen,— I beg to present to you my Twenty-first, and last, Annual Report, that for the year 1906. For the clearer elucidation of the year's figures some of the usual Tables, especially No. XI., have been altered, while new ones have been introduced. I hope the innovation will meet with general approval. Owing to the prevalence of Scarlet Fever and Diphtheria during its last three months I regret to say I cannot regard the year as a healthy one. Of the 906 cases of illness under these two heads, no less than 452 occurred between October 1st and December 31st. I am at a loss to account for this unusual occurrence, but deem it worth while to point out that September was a very bright and fine month, that in October the weather was exceptionally fine and mild, and that in November, which was unusually mild, there was only one frost, and the dull, damp, sunless days were anything but conducive to the well-being of 4 the public health. A reference to the rainfall for the year, the figures for which are given in full further on, show that as compared with 1905, when 6.09 inches fell between September 1st and the end of the year, last year we had 9.92 inches during the same period. Apart from this period of sickness the year may be regarded as having been a normally healthy one, except for the prevalence of Influenza. RAINFALL. The Death Rate in its relation to the rainfall is worthy of study. Year. Rainfall. Death Rate. 1903 35.0 10.9 1904 17.46 13.1 1905 19.44 11.2 1906 22.47 12.2 The drier the year the higher the Death Rate. Here are the figures month by month for 1906:— Month. Total Depth. Greatest 24 Fall in hours. Number of Days with .01 or more recorded. January Inches. 3.83 Inches. .65 Date. 12 19 February 1.67 .33 17 18 March .75 .27 10 15 April .81 .29 30 9 May 1.16 .50 20 9 June 2.34 1.84 .28 6 July .61 .30 27 6 August 1.38 .64 2 6 September 1.73 76 4 8 October 2.97 .44 29 16 November 3.32 .73 8 17 December 1.90 .30 30 17 22.47 146 5 POPULATION, BIRTHS, AND DEATHS. I estimated the population at 108,000 in the middle of the year. This figure takes into consideration the large number of empty houses and the fact that the number of houses erected and declared fit for human habitation of recent years has steadily decreased. My estimate does not agree with that of the "Registrar-General, but if we take his figure, viz., 118,000, our Death Rate is reduced from 12.2 to the 11.2, which was our figure for 1905. Coming to the figures then, they are as follows :— BIRTHS. Total 3344 (1723 males, 1621 females), of which 79 males and 77 females were illegitimate, 26 of which died under one year of age. The chief causes of death were 10 from diarrhoea and 5 from wasting disease, doubtless aided by improper feeding. This gives an increase over the Births of 1905 of 135 (54 males, 81 females). Births in Union Workhouse included in above, 93 males, 84 females—177. BIRTH RATE. Per 1000 of a population of 108,000 = 30.9 against the 30.5 of 1905. DEATHS. 2355, of which 1327 belong to the District and include those of inhabitants who died in the West Ham Infirmary, Workhouse, or Schools, but not those, unless belonging to Leyton, which occurred in the Bakers' Almshouses or Bethnal Green Schools. Of the 1327 666 were males and 661 females. 6 DEATH RATE. 12.2, against the 11.2 of 1905, a figure which is subject to the estimates of our population above mentioned. MONTHLY SUMMARY. I should like to summarise here the health of the District month by month, together with the state of the weather and its bearing thereon. January:—Wet and trying weather. Rain fell on 14 days. Total, 3.83 inches. Variable temperature. Elderly persons chief sufferers. Diphtheria increased (14 cases) during the wet. Death Rate 14.4. Zymotic Death Rate 1.5. Measles in Capworth Street and Lea Bridge Schools. February:—Wet and sunless weather. Mild temperature. Rain fell on 18 days. Fall 1.67 inches. Severe outbreak Measles and Mumps at Cobbold Road Schools. Both diseases attacked High Road Schools, and present in all Schools more or less. Eleven cases Diphtheria,, 3 deaths. Death Rate 9.9. Zymotic Death Rate .7. March:—Persistent E.N.E. winds. Early days springlike, followed by wintry weather, snow and hail. Rain fell on 15 days. Fall .75 inch. Towards end of month Measles and Mumps subsiding in Council Schools. Diphtheria 11 cases, 3 deaths. Death Rate 14.4. Zymotic Death Rate 1.8. April:—Exceptionally bright sunny weather, occasional cold rain, hail and snow showers. Rain fell on 9 days. Fall .81 inch, one-third of which fell on April 30th. Death Rate 12.3. Zymotic 2.1. May:—Cold weather, E.N.E. winds greater part of month. First half fine, latter half unsettled and dull. Rain fell 7 on 9 days. Fall 1.16 inches. Decrease in Diphtheria 4 cases against 11 in April. Death Rate 9.9. Zymotic 1.6. June:—Fine hot weather. Wind E. Heavy fall of rain, 1.75 inches in nine hours on 28th. Rain on 6 days. Fall 2.34 inches. Increase in Diphtheria 10 cases against 4 in May. Scarlet Fever 42 against 34, and outbreak of Typhoid. Death Rate 10.1. Zymotic .7. July:—Perfect summer weather. Rain on 6 days. Fall .61 inch. Further increase in Diphtheria 18 cases against 10 in June. Death Rate 8.9. Zymotic 1.9. August:—Fine weather. Rain on 6 days. Fall 1.38 inches. Diarrhoea very severe. Decrease in Scarlet Fever and in Diphtheria of 1 case less than in July. Death Rate 17.8. Zymotic 6.8. Great increase in Death Rate. September:—Very bright, fine, cooler weather. Rain on 8 days. Fall 1.73 inches. Large increase in Scarlet Fever and Diphtheria, viz:— Scarlet Fever, 59 in September; 30 in August. Diphtheria, 39 in September; 17 in August. Cooler weather reduced Infantile Diarrhoea. Hospital accommodation utterly inadequate to deal with the calls made upon it. Death Rate 12.2. Zymotic 4.9. October:—Exceptionally fine and mild weather. Rainfall generally at night time, 2.97 inches. Wet days. Further increase in both Scarlet Fever and Diphtheria, viz.:— Scarlet Fever, 114 in October; 59 in September. Diphtheria, 76 in October; 39 in September. Death Rate 11.7. Zymotic 2.3. 8 November:—Unusually mild weather for time of year. Rain on 17 days. Fail 3.32 inches. Scarlet Fever still prevalent. A decrease in Diphtheria from 76 to 44 cases, but disease of a more severe type. December:—Early part of month wet and raw, later period very cold, with heavy snow. Weather extremely trying to young and very old. Rain and snow fell on 17 days. Fall 1.90 inches. Death Rate, 16.0. Zymotic 0.8. Scarlet Fever decreasing, also Diphtheria slightly. For the first time during my tenure, viz., 20 years, of the office of Medical Officer of Health the Deaths in one month exceeded the Births. COUNCIL SCHOOLS. The following are the returns of the number of children on the books attending the various Council Schools. Table I. Cann Hall Ward. Boys. Girls. Junior Mixed. Infants. Total. Cobbold Road Schools mixed 358 Cann Hall Road ,, 529 569 292 236 1626 Trumpington Road ,, 326 389 196 227 1138 Central Ward. Leyton High Road Schools 146 130 - — 276 Newport Road ,, 633 622 — 471 1726 Norlington Road ,, 512 436 — 482 1430 Grove Green Ward. Mayville Road Schools 445 462 217 287 1411 Harrow Green Ward. Goodall Road Schools 526 537 — 447 1510 Harrow Green „ 311 283 132 167 893 Downsell Road „ 473 435 187 283 1378 Leyton Ward. Farmer Road Schools 536 516 266 275 1593 Ruckholt „ 374 401 149 183 1107 9 Table I. (Cont.) Leytonstone Ward. Boys. Girls. Junior Mixed. Infants. Total. Kirkdale Road Schools 374 380 258 106 1118 Davies Lane „ 395 394 201 183 1173 Lea Bridge Ward. Capworth Street Schools 525 532 392 242 1691 Church Road ,, 327 314 199 168 1008 Lea Bridge Road ,, 90 70 — 6o 220 Sybourn Street ,, 99 116 — 94 309 19965 St. Joseph's Roman Catholic School, Vicarage Road 278 20243 Total attending Schools:— In 1899 16133 „ 1900 15246 „ 1901 17674 „ 1902 18175 „ 1903 19184 „ 1904 19748 „ 1905 19515 „ 1906 20243 The year has been rather a quiet one with regard to the Schools, but I must mention the novel course of instruction in cottage gardening that has been introduced during the year, and of which some 70 boys of the Leyton and Leytonstone Schools have taken advantage. There are altogether nearly five acres at the disposal of the authorities for the purpose of educating beys in this useful branch of knowledge. The Board of Education limit the classes to 14, and have given an annual grant of after expending £29 in the purchase of the necessary tools. Our example may, I think, well be followed by other educational "bodies. 10 I am glad to be able to place on record the fact that parents have this year taken more notice than ever before of repeated admonitions on the score of cleanliness, the use of the toothbrush, and so forth. "Without serviceable and healthy teeth you cannot have healthy and serviceable citizens. The public at large has hitherto failed, and lamentably failed, to realise in any adequate manner the amount of preventable evil that dental disease produces, or to realise the value as a national asset that lies in sound and healthy teeth." Mr. Leonard Matheson, L.D.S., made these telling remarks in his presidential address to the members of the British Dental Association, at their general meeting held in the Examination Hall of the Royal Colleges of Physicians and Surgeons last year. That the well-being of the State is largely dependent upon its citizens having good teetlh was, in fact, one of the guiding principles of Mr. Matheson's address, and the fact cannot be too frequently impressed upon young mothers. The President of the L.D.A. said further that:—"In laying' its opinions before educationalists, the association laid stress on three things—the widespread prevalence of and the havoc wrought to general health by bad teeth among children; the importance of instructing both teachers and children in the simple rules of hygiene and preventive treatment; and the absolute necessity of expert supervision and treatment being given to children. The cost of the appointment of dentists to elementary schools would be repaid over and over again in the improved health of the adult population, which should in its adolescent stage pass under the proper supervision of qualified dentists." AGE OF CHILDREN. The following extract from Report of the Organising Inspector was submitted to the Education Committee on 14th December, and is reproduced here :— 11 "In 1904 your Medical Officer of Health strongly recommended that the entrance age should be raised. Medical Officers throughout the country are agreed that the congregation of young children under five years of age is the best means of spreading and developing Measles, Whooping Cough, Scarlet Fever, Diphtheria, &c. The admission of children under this age iscontrary to the World's wisdom. "In Germany, Hungary, Portugal, Prussia, and Switzerland, the admission age is six years. In the Netherlands, Norway, and Sweden, it is seven years. In the United States, two States admit at six; six admit at seven; and 17 at eight. In New South Wales, Queensland, Victoria, and Western Australia, the age is six, and in South Australia and Tasmania it is seven. In North-West Canada, British Columbia, and Nova Scotia., it is seven, and in Ontario, eight. "I can find no country except ours that has adopted such; an early age as five." SWIMMING. The Ley ton Schools' Swimming Association enjoyed a capital year, the increase in attendances and numbers who learned to swim being most encouraging. Attendances:— Boys 40,092 Girls 12,182 Total 52,274 Against 48,098 in 1905. 907 learned to swim, viz 616 boys, 291 girls, 226 secured 1st Class Certificate, viz. 181 „ 45 „ 368 „ 2nd „ „ „ 260 „ 108 207 ,, and ½ mile Medals, viz. 167 ,, 40 ,, 85 „ Elementary Life Saving Certificates, viz. 76 „ 9 „ 94 secured Proficiency Certificates, viz. 85 ,, 9 ,, 12 PHYSICAL DETERIORATION AND ALCOHOLISM. With the view of impressing upon young minds the dangers arising from alcoholism, the Sub-Committee specially appointed for the purpose, and myself in consultation, decided to issue cards to each of the scholars at the Council Schools, on which the following " points " were emphasised Physical Deterioration and Alcoholism. The Report of the Committee appointed to consider the above subject has, by command of His Majesty, presented to Parliament the following among other statements :— 1. The abuse of Alcoholic Stimulants is a most potent and •deadly agent of Physical Deterioration. 2. The excessive use of Alcohol renders persons specially liable to Consumption and all Inflammatory Disorders. 3. The Lunacy Returns show that, as a result of excessive drinking there is a large and increasing number of persons of both sexes admitted to the Asylums. 4. In abstinence and moderation is to be sought the source of muscular vigour and activity. The Abuse of Alcohol. 1. Weakens a man's physical condition and saps his strength, and also acts upon his nervous system, weakening his self-control, exciting his passions, and so leading to crimes, of which numbers are committed under its direct influence. 2. Is a fruitful cause of accidents, in which not unfrequently, through the fault of an individual, the lives of many persons are endangered or destroyed. 3. Is the direct cause of many fatal diseases, and also aggravates acute illnesses, especially those of an infectious nature, which latter are well-known to be especially fatal in alcoholic subjects. 13 4. The children born of drunken parents are frequently feeble from birth and inherit direct tendency to many forms of physical and mental disease. 5. Too frequently the home of the confirmed drunkard may be recognised by its dirt and squalor, his family are neglected his children ill-fed and untaught, whilst his own life, drifting from bad to worse, not seldom ends in a premature grave. 6. Drunkenness is a most terrible enemy to personal health,, to family happiness, and to national prosperity. SCHOOL CHILDREN'S AILMENTS. Ringworm 39 Alopecia Areata 10 Scabies 31 Eczema of Face, Head, &c. 135 Mumps 35 Dirty Head, Verminous state, &c. 40 Inflamed Eyes, Ophthalmia, Corneal Ulcers, &c. 32 Tinea Tarsi 3 Lichen Planus 1 Ulcerated Throats, Tonsilitis, &c. 27 Measles 4 Scarlet Fever 10 Whooping Cough 2 Debility and Anaemia 15 Herpes and Shingles 10 Chicken Pox 9 Imperfect Vision and Weak Eyes 22 Febrile 6 Enlarged Glands 13 Gastritis, &c. 11 Epilepsy 4 Mentally Deficient 9 14 School Children's Ailments. (Contd.) Heart Disease 4 Muscular Rheumatism 2 Injuries to Arms, &c. 6 Bronchitis and Influenza 3 Total 583 The above is a complete list of the chief ailments from which -children of the Schools suffered, who attended at the Town Hall. In every case the sufferer was kept under weekly observation, until 1 could safely certify that they might mix again with the other children at School. MEASLES AND MUMPS. These two ailments legan as usual about the month of February, and were particularly rife throughout the spring. All the Schools were more or less equally affected. Table I. Owing mainly to the very hot summer the Infantile mortality from Diarrhoea was more than twice as much as that of 1905. Deaths of Infants from Diarrhoea under 5 years of age. 1901 35 1902 45 1903 35 1904 180 1905 52 1906 116 15 Table II.—Births for the last 5 years. Males. Females. Total. 1902 1682 1470 3152 1903 1616 1657 3273 1904 1667 1531 3198 1905 1669 1540 3209 1906 1723 1621 3344 8357 7819 16176 The average rate for the past five years is 3,235. Table III.—Deaths for the last 5 years. 1902 2029, of which 1183 belong to the District proper. 1903 1976, „ 1112 ,, ,, ,, 1904 2270, „ 370 „ „ „ 1905 2054, „ 1177 „ „ „ 1906 2355, „ 1327 „ „ „ The excess of Births over Deaths is 989 and the average increase for the past five years is 1,098. Table IV.—Distribution of Deaths. Master Bakers' Almshouses 7 Bethnal Green Schools 2 West Ham Union, Workhouse, Infirmary and Schools 1019 District, including violence, and includes deaths strictly belonging to District which occurred in the above 1327 2355 Estimating the population at 108,000, the Death Rate for the district is 12.2 against 11.2 per 1,000 in 1905; 13.1 in 1904; 10.9 in 1903 ; and 11.8 in 1902. 16 The average Death Rate for the past five years is 11.8. The average Death Rate for the past ten years is 12.1. The London Death Rate is 15.2. The District Zymotic Death Rate is 2.3. The London Zymotic Death Rate is 1.9. The London Birth Rate is 26.7. The District Birth Rate is 30.9. Table V.—Vital Statistics of 76 Largest English Towns during 1906. Birth Rate 27.8 Death Rate 15.9 Zymotic Rate 2.2 Table VI.— Death Rate for each Quarter. First. Second. Third. Fourth. Leyton 12.9 10.7 12.7 13.0 London 16.0 14.2 14.8 16.0 It will be noticed that the Death Rate for this District: compares very favourably in each Quarter with that of London. Table VII.—Deaths Classified with regard to Sex. Males 666 or 50.1 Per cent. of the total Deaths. Females 661 or 49 9 Table VIII.—Ages at which Death Occurred. Under 1 year 382 1 year and under 5 years 167 5 years „ 15 years 65 15 years „ 25 years 44 25 years ,, 65 years 357 65 years and over 312 1327 17 Table IX.—Death Rate per cent. of Total Deaths. Under 1 year 382 28.9 46.3 1 year and under 5 years 167 125 5 years and under 15 years 65 4.9 15 years and under 25 years 44 3.3 537 25 years and under 65 years 357 26.9 65 years and over 312 23.5 The infant mortality, i.e., deaths under 1 year, is 382 or 11.4 per cent. of the total number of births against 9.4 per cent. last year and 13.8 per cent, in 1904. INFANTILE MORTALITY. Per 1,000 births the deaths of infants under 1 year of age in London was 130, in 75 other great towns, 151. The use of cheap brands of condensed milk is still prevalent, and as usual, the inferior quality thereof is all against infant life successfully combating an attack of illness, such as Diarrhoea, This ailment, as mentioned in my Monthly Summary (q.v.), was very severe during a hot August, but abated during the cooler month of September. This year the supply of disinfectants free wherever there was a case of illness of any kind was largely availed of during the hot summer we experienced. To this fact, and to the excellent manner in which our roads are now, as a general rule, watered, I attribute the fact that we went through the very dry and dusty period from June to October without more severe outbreaks than those experienced. 18 Table X.—Chief Causes of Death. Under 1 year. Over 1 and under 5. Over 5 and under 15. Over 15 and under 25. Over 25 and under 65. 65 and over. Total Small Pox - - - - - - 0 Measles 6 22 2 — — — 30 Scar'et Fever 1 9 4 1 — — 15 Whooping Cough 16 20 1 - — — 37 Diphtheria & Membranous Croup 1 19 16 - - - 36 Croup - - - - - - 0 Fevers Typhus - - - - - - 0 Enteric 1 — 1 1 4 — 6 Other continued - - - - - - 0 Epidemic Influenza - — 2 — 4 3 9 Cholera - - - - - - 0 Plague — — — - — — 0 Diarrhoea 95 21 — — 1 — 117 Enteritis 8 2 — 1 — — 11 Puerperal Fever - — — 1 3 — 4 Erysipelas 1 — — 1 4 — 6 Other Septic Phthisis (Pulmonar Tuberculosis) - 1 - 2 2 2 7 Tuberculosis) — — 2 15 66 4 87 Other Tubercular Diseases 11 23 4 4 6 — 48 Cancer (Malignant Diseases) - - 1 1 45 29 76 Bronchitis 27 15 2 2 26 52 124 Pneumonia 9 9 3 2 31 20 74 Pleurisy — — — — 4 1 5 Other Diseases of the Respiratory Organs - 1 1 - 1 - 3 Alcoholism, Cirrhosis of Liver - - - - 13 — 13 19 Table X. (Cont.)—Chief Causes of Death. Under 1 year. Over 1 and under 5. Over 5 and under 15. Over 15 and under 25. Over 25 and under 65. 65 and over. Total. Venereal Diseases 2 — — — 1 — 3 Premature Births 58 - - - - - 58 Diseases and Accidents of Parturition 3 - - - 1 - 4 Heart Disease 4 2 12 4 50 38 110 Accidents 14 3 1 — 9 2 29 Suicide — — — 1 4 — 5 Murder 1 — — 1 — — 2 All other Causes 125 20 13 7 83 160 408 Total 382 167 65 44 358 311 1327 Table XI.—Number of Deaths and Death-Rate per 1,000 of the Population from Certain Causes. Phthisis and Tubercular Diseases. Respiratory Diseases. Heart Disease. Violence. Premature Birth. Diarrhoea. Number of Deaths 135 206 110 36 58 117 Death Rate per 1,000 1.2 1.9 10. .3 .5 1.0 Deaths in 1905 133 224 99 38 42 53 20 Table XII.—INFECTIOUS DISEASES (NOTIFICATION) ACT, 1890. The following Table shows the number of cases of Infectious Diseases per month notified during the year:— Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov Dec. Total. Small Pox 0 0 0 0 0 0 0 0 0 0 0 0. 0 Scarlet Fever 37 35 35 26 34 42 30 23 59 114 96 85 616 Diphtheria 14 11 11 11 4 9 18 17 39 76 44 37 291 Membranous Croup 0 0 0 1 0 1 0 0 0 0 0 1 3 Typhoid Fever 1 1 1 3 1 4 1 8 7 2 3 0 32 Simple Continued Feyer 0 0 0 0 0 0 0 0 0 0 0 0 0 Relapsing Fever 0 0 0 0 0 0 0 0 0 0 0 0 0 Puerperal Fever 1 3 2 0 1 0 2 0 0 0 2 0 11 Erysipelas 4 10 2 4 6 7 3 11 12 11 17 9 96 57 60 51 45 46 63 54 59 117 203 162 132 1049 21 Table XIII—Number of Cases of Infectious Diseases as they Occurred in the Nine Wards of the District, and the Percentages. Leyton. Lea Bridge. Central. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip Total. Small Pox - - - - - - - - - - Scarlet Fever 37 63 153 54 74 69 58 71 37 616 Diphtheria 0 54 98 21 22 22 8 17 16 291 Membranous Croup 10 0 1 0 0 1 0 1 0 3 Typhoid Fever 5 6 3 4 2 4 2 3 3 32 Erysipelas 7 13 12 17 5 16 14 3 9 96 Puerperal Fever 0 1 2 3 0 2 1 1 1 11 Continued Fever 0 0 0 0 0 0 0 0 0 0 Total 82 137 269 99 103 114 83 96 66 1049 Percentage of Cases 708 13.0 25.6 9.4 9.8 10.8 7.9 9.1 6.2 Tables XIV. and XV. are given in full at the end of the book with other Tables of the Local Government Board. 22 Table XVI.—Deaths per Cent, of Deaths notified (exclusive of Public Institutions). Cases. Deaths. Percentage Mortality. 1905. 1906. 1905. 1906. 1905. 1906. *Small Pox 0 0 0 0 0 0 Scarlet Fever 505 616 9 15 17 2.4 Diphtheria and Membranous Croup 126 294 13 36 10.03 12.2 Typhoid 51 32 9 6 17.6 187 Simple Continued Fever 1 0 0 0 0 0 Puerperal Fever 5 11 2 4 40.0 36.3 Erysipelas 111 96 6 6 5.4 6.2 Relapsing Fever 1 0 0 0 0 0 *One case reported, which was removed to the Metropolitan Asylums Board Hospital It was immediately returned as not being a case of Small Pox. The notification was not withdrawn. 23 Table XVII.—Deaths from the Nine Chief Zymotic Diseases for the last Seven Years together with the Zymotic Death Rate and Rate of Mortality from all other Diseases. 1900 1901 1902 1903 1904 1905 1906 Small Pox — — 2 — — — — Measles 13 31 15 37 25 26 30 Scarlet Fever 7 13 7 13 6 9 15 Diphtheria 27 36 36 27 14 10 33 Membranous Croup — — — — — 3 3 Whooping Cough 47 45 59 40 44 28 37 Typhus — — — — — — — Typhoid 14 14 16 10 10 9 6 Diarrhoea 113 125 48 36 186 55 117 Total 221 264 183 163 285 148 241 Deaths from all other Diseases 958 979 1000 949 1085 1029 1086 Death Rate from Seven Chief Zymotic Diseases 2.21 2.64 1.83 1.5 2.7 1.2 2.3 Death Rate from all other Diseases 9.5 97 10.0 9.3 10.4 10.0 9.9 General Death Rate 11.8 12.34 11.8 10.8 13.1 11.2 12.2 24 TYPHOID. Table XVIII.—Probable Causes of Infection. Imported 3 Eating Shell Fish 1 Drinking Water 2 Contact Cases 5 Untraceable 20 Defects in Drains 8 In West Ham Infirmary:— Imported 75 Occurred in Institution 9 West Ham Union Schools 0 SMALL POX. Footnote to Table XVI. explains the single case notified this year—and, as it proved afterwards, wrongly so. VACCINATION. The following figures speak for themselves. They are for the Leyton District:— Births. Vaccinated. Deaths. Ecemption Certificates outained. Insusceptible. 3344 1790 267 76 12 In 1905, out of 3,208 births, 2,344 were vaccinated, and I attribute the smaller number operated upon this year as due to the prevalence of Infantile Diarrhoea, which was, in a very large number of cases, given by the parents as the reason why the infants should not be vaccinated. Moreover, Diarrhoea was so rife as to make the excuse a reasonable one. WHOOPING COUGH. This ailment, from which there were 13 more deaths than in the previous year, was most prevalent during the spring, and again in November and December. VIOLENCE. This year the deaths from violence number 36, of which two were due to murder; five to suicide; and 29 to accidents of various kinds. CONSUMPTION. Taking advantage of what I believe to be a gradual awakening of the public to the serious need for combating this fell disease, I caused the following memorandum to be circulated in the District this year:— LEYTON URBAN DISTRICT COUNCIL PUBLIC HEALTH DEPARTMENT. THE PREVENTION OF CONSUMPTION Memorandum respecting the measures which may be adopted by the public with a view to the Prevention of Consumption. consumption is infectious. Consumption is contracted by taking into the system the germ or microbe which causes the disease, and most, if not all cases, are caused by infection received from some previous case which may have occurred in man or one of the lower animals. spitting or expectorating. The phlegm, spit or expectoration of a consumptive person is full of the germs of the disease; when in a moist state this expectoration does not infect the air, but if allowed to dry it becomes broken up into dust. Such dust is exceedingly dangerous, for, being carried by the air, it is readily inhaled into the lungs of healthy people, and this is probably the chief means by which the disease is spread from person to person. There is practically no risk of contracting the disease from the breath 26 of a consumptive person, but on the other hand, phlegm infects. everything upon which it falls—handkerchiefs, books, papers, linen, floors, carpets, mats, roads, pavements, railway stations, carriages, omnibuses, or other conveyances. Consequently, the filthy habit of indiscriminate spitting should be unhesitatingly condemned. the fatality of consumption. Consumption (with other forms of Tuberculosis) causes one death in every eight in this country. Of all the deaths in the United Kingdom between the ages of 25-35 nearly one-half are due to Consumption. During 1898 the deaths in England and Wales caused by Consumption alone were 41,335. predisposition to become consumptive. People in good health usually resist infection. But all can be rendered liable to it by getting into a low state of health. Among the chief causes which favour infection are the following—Overcrowding, cramped positions when at work, breathing the stuffy bad air of ill-ventilated rooms and houses, dirty, dark, damp dwellings, bad or insufficient food, intemperance, and other infectious fevers and illnesses. The children of consumptive persons are often predisposed to take the disease, though they are rarely born with the disease. consumption is preventable. Consumption is preventable, for it is contracted only in ways which can be easily prevented, in part by the sufferer, and in part by the care of those who live with him. (1) Destruction of Phlegm. The spit of the consumptive being the chief cause of the spread of consumption, it is essential for the protection of their own families, and to prevent the spread of the disease among the general public, that the following simple precautions be taken by consumptive persons:— 27 The consumptive person must not expectorate about the house, nor on the floor of any railway carriage, omnibus, or other conveyance, nor in any streets or public buildings, &c., but should expectorate into a wide mouthed vessel or pocket spittoon kept for the purpose and containing a little water. The contents of this spittoon should be carefully burned at least once per day, this being the simplest, quickest, and safest way of destroying the germs it contains. The vessel or spittoon should be thoroughly cleansed after by being kept in boiling water for ten minutes. When not provided with such a vessel a piece of rag or paper handkerchief should be used and afterwards burnt. Consumptive patients must not swallow their phlegm, as by so doing the disease may be conveyed to parts of the body not already affected. Neither should he or she kiss or be kissed on the mouth. (2) Milk and Meat. There is great reason to fear that many cases of the disease, especially in young children, are due to taking into the system consumptive germs by food or drink, especially milk. A somewhat serious proportion of the milk of this and other countries is more or less infected with the germ of consumption, therefore uncooked milk should never be given to children. Meat should also be well cooked. Raising infected milk to the boiling point (212 degrees Fahr.) renders it harmless. (3) Fresh Air, Ventilation and Cleanliness. All apartments occupied by consumptive persons should be well lighted and ventilated and free from dampness. Overcrowding should be avoided. Fresh air, light, and sunshine, are important preventatives of consumption. No chimney should ever be blocked up and windows should be kept open as much as possible. 28 Cleanliness and good sanitary surroundings are essential both for the prevention and cure of consumption; rooms, passages, &c., must also be kept free from dust. (4) Directions to Consumptive Persons. Recovery from consumption is not uncommon. Fresh air and plenty of food are two main requisites. Moderate exercise in the open air is beneficial. The above instructions as to spitting and destruction of phlegm should be strictly carried out. A separate sleeping room or bed should be used by the patient, and no food or table utensils should be shared with others. disinfectants. Fresh air and sunlight are excellent disinfectants and each Should be freely admitted to every part of the house. For other purposes of disinfection connected with consumption the following may be used :— Chloride of lime ¼ lb. Water 1 gallon. The same to be well stirred, and may be used with or without sediment. A. F. PESKETT, Medical Officer of Health. Town Hall, Leyton. In addition to this I caused notices to be posted up throughout the District warning people of the dangers of spitting on footpaths, roadways, and other public places. Generally speaking everything has been done that can be done to place before the public the grave danger to the nation at large that lurks in this terrible disease, and I am pleased to think that by the absence 29 of sputa on pavements and in public resorts generally may be read a sign that the public is at last beginning to help itself in this most important matter. I do not know whether others have noticed the above fact, but it has come within my sphere of action, and I consider it worthy of remark at this juncture. SCARLET FEVER. Table XIX.—Notified Cases of Scarlet Fever during the Past Five Years, with the Percentage Mortality. Cases Notified. Deaths. Percentage Mortality. 1902 393 3 .76 1903 397 13 3.27 1904 445 6 1.3 1905 505 9 1.7 1906 616 15 2.4 The course of the disease was fairly normal until the autumn, when there was a marked increase in the number of attacks, the four months September—December producing 354 cases of the year's total 616. Altogether 111 more cases than last year were reported, and of these there were 6 more fatal cases than in 1905. Of the 616 cases— 37 or 6.0 per cent, occurred in the Leyton Ward 63 „ 10.2 „ „ Lea Bridge „ 153 „ 24.8 „ „ Central ,, 54 „ 8.9 „ „ Forest „ 74 „ 12.0 „ „ Leytonstone „ 69 „ 11.2 „ „ Grove Green „ 58 „ 9.4 „ „ Harrow Green „ 71 „ 11.5 „ Cann Hall „ 37 „ 6.0 „ „ Wanstead Slip ,, 30 DIPHTHERIA The number of cases notified was 291, or 73 more than in 1905. I have for several years noticed bad throats are common after rain following much dry weather as was the case in 1906. Diphtheria on this occasion closely followed the bad example of Scarlet Fever, as the severest time was, as with that ailment, from September—December. During that period we had 196 of the whole year's record of 291 cases. The percentage mortality was 12.2 against the 10.03 of the previous year. TEMPORARY ISOLATION HOSPITAL. SCARLET FEVER. Under Treatment at beginning of 1906 50 Admitted 322 Discharged 305 Died 8 Under Treatment on Dec. 31st, 1906 52 DIPHTHERIA. Under Treatment at beginning of year 2 Admitted 9i Discharged 69 Died 10 (Under Treatment on Dec. 31st, 1906 11 31 TABLE XIXa.—DIPHTHERIA AND MEMBRANOUS CROUP. The number of notifications received since the adoption of The Infectious Diseases (Notification) Act, 1890, and Deaths and Percentages. Year. Population. N umber Deaths Percentage Mortality 1890 64,000 210 47 22.3 1891 (Census) 63,000 301 65 21.5 1892 63,000 252 36 14.2 1893 64,000 277 49 17.6 1894* 70,000 310 34 16.7 1895* 75,OOO 410 72 17.5 1896 77,000 195 25 12.9 1897 85,000 156 20 12.8 1898 90,000 162 28 17.2 1899 93,000 216 31 14.3 1900 100,000 224 28 12.5 1901 (Census) 100,000 261 36 13.7 1902 100,000 245 36 14.6 1903 102,000 187 27 14.4 1904 104,000 154 15 9.7 1905 105,000 126 12 9.5 1906 108,000 294 36 12.2 House-to-House Inspection started on the 18th June, 1895. 32 SCARLET FEVER. Table XX. Number of cases notified. Number of cases treated in Hospital. Percentage of cases treated in Hospital. Number of beds available. Mortality per cent, of cases notified. Mortality per cent, of cases treated in Hospital. 1900 243 142 58.4 40 2.8 2.1 1901 396 158 39.8 40 3.2 1.9 1902 393 176 44.7 40 .76 1.7 1903 397 206 51.8 40 3.27 4.8 1904 445 220 49.4 40 1.3 .45 1905 505 281 55.6 40 1.7 1.7 1906 616 322 52.2 40 2.4 2.4 DIPHTHERIA AND MEMBRANOUS CROUP. 1900 201 63 31.3 10 11.9 15.8 1901 255 101 25.1 10 14.1 18.8 1902 236 71 30.0 10 14.8 28.1 1903 185 48 25.9 10 14.6 16.1 1904 150 50 33.3 10 9.3 8.0 1905 118 48 24.4 10 8.4 12.5 1906 294 91 31.2 10 12.7 10.9 33 SCARLET FEVER. Table XXI. Deaths Admissions to Hospital. Year. Notified. In District. In Hospital. 1897 510 17 3 177 1898 350 5 1 139 1899 315 4 3 133 1900 243 7 3 142 1901 396 13 7 158 1902 393 7 3 176 1903 397 13 10 206 1904 445 6 1 220 1905 505 9 5 281 1906 616 7 8 322 4170 88 44 1954 The District Death Rate over this period is 2.1 per cent. The Hospital Death Rate over this period is 2.2 „ DIPHTHERIA. Table XXII. Deaths Admissions to Hospital. Year. Notified. In District. In Hospital. 1897 156 20 2 30 1898 162 28 5 40 1899 200 31 15 62 1900 201 27 10 63 1901 255 36 19 101 1902 236 36 20 71 1903 185 27 8 48 1904 150 27 4 50 1905 118 10 6 48 1906 291 36 10 91 1954 278 99 604 The District Death Rate over this period for Diphtheria is 13.6 per cent. The Hospital Death Rate over this period for Diphtheria is 16.3 „ 34 Table XXIII.—Cases of Infectious Diseases Removed to Hospital During the Year 1906. Notifiable Disease. At Ages—(Years). At all Ages. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Scarlet Fever 322 0 71 219 26 6 0 Diphtheria Membranous Croup 91 o 34 45 8 2 2 Totals 413 0 105 264 34 8 2 35 I wish to record here my very warmest appreciation of the manner in which the Matron and the Nursing Staff of the Hospital invariably carried out their duties during the latter half of the year when the cases were of a very acute nature demanding very close attention. The greatest success attended their efforts. PERMANENT ISOLATION HOSPITAL. During the past few years, as I have from time to time pointed out, we have been quite unable to cope with the demand for admissions, and I would urgently beg the Council not to delay in providing adequate accommodation. 36 PUBLIC INSTITUTIONS. WEST HAM UNION WORKHOUSE, INFIRMARY, AND SCHOOLS, INCLUDING FOREST HOUSE. Births :—There were 177 births, 93 males and 84 females, a total of 2 more than in 1,905. Deaths:—There were 1,019 deaths, viz., males 571 and females 448. This year I give the Causes of Death more fully divided up as regards age. This is really the recognised form, and is as follows:— Under 1 Year. Over 1 and under 5 Over 5 C and under 15 )ver 15 and under 25 Over 25 and under 65 65 and Over. Total. Measles 0 16 2 0 0 0 18 Whooping Cough 2 5 0 0 0 0 7 Diphtheria 0 1 0 0 0 0 1 Enteric Fever 0 0 2 2 5 0 9 Influenza 0 0 0 0 2 0 2 Diarrhœa 10 5 0 0 0 0 15 Enteritis 5 0 0 0 0 0 5 Puerperal Fever 0 0 0 1 2 0 3 Erysipelas 0 0 0 0 1 2 3 Other Septic Diseas 0 0 0 0 2 2 4 Phthisis 0 1 4 18 123 4 Other Tubercular Diseases 2 10 9 4 4 0 29 Cancer 0 0 0 2 56 26 84 Bronchitis 2 7 1 1 39 34 84 Pneumonia 3 0 2 1 28 5 39 Pleurisy 0 0 0 0 0 1 1 Respiratory Diseases 1 1 0 0 0 0 2 Alcoholism 0 0 0 0 8 0 8 Venereal Diseases 1 0 0 0 0 0 1 37  Under 1 Year. Over 1 and under 5 Over 5 and under 15 Over 15 and under 25 Over 25 and under 65 65 and over Total. Premature Births 8 0 0 0 0 0 8 Diseases and Accident (Part) 0 0 0 0 1 0 1 Heart Disease 0 1 3 7 56 32 99 Accidents 0 0 0 1 8 11 20 Suicide 0 0 0 0 1 1 2 All other Causes 74 36 4 6 95 209 424 Total 108 83 27 43 431 327 1019 Cases of Infectious Diseases occurring in the Union. Scarlet Fever 15 cases, of which 4 were imported Diphtheria 4 2 Typhoid 84 75 Erysipelas 57 44 Puerperal Fever 11 11 THE INFIRMARY, WHIPPS CROSS ROAD. During the year there were:— 5677 Admissions. 4705 Discharges. 925 Deaths. 4 Births. BETHNAL GREEN SCHOOLS. There were 29 cases of Whooping Cough, while 5 cases of Diphtheria, and 3 of Scarlet Fever, were removed to Homerton during the year. There were two deaths, both from other Tubercular Diseases. 38 SANITARY WORK. Under the most capable supervision of Captain Miller and his energetic staff the following sanitary work has been properly carried out:— Houses inspected 3168 Connections of drains tested 3120 Notices served 1834 Complaints received 380 Defective drains remedied 370 W.C.'s in defective state, new traps and straight backed pans provided where necessary 409 Sink, bath and lavatory wastes, and rain pipes made to discharge in open air over trapped gullies 177 Defective gullies replaced, and defective connections of gullies remedied 441 New sink and bath waste pipes provided and repaired 126 New salt-glazed stoneware sinks provided 53 Bath, waste and lavatory sink pipes trapped immediately under arrangement 82 Ventilating shafts repaired, also provided to soil pipes and drains 106 Defective soil pipes remedied, &c. 9 Flush cisterns supplied to w.c.'s with efficient flush pipes 43 Flush cisterns and flush pipes repaired 259 Yards paved around back additions of houses and forecourts paved or repaired 175 Yards cleansed 21 New manhole covers provided and sealed 35 Manholes rendered and repaired 10 Ventilation provided under flooring 14 Floors of sculleries paved and repaired, and cellars and floors drained and concreted 76 House roofs and guttering repaired and renewed 191 Houses in a general insanitary, dilapidated, or filthy condition, repaired and cleansed 583 Walls of back additions properly rendered 22 39 Plots of land in an insanitary condition 3 Nuisances abated arising from stagnant water in basements of houses 12 Air inlets provided to drains and repaired 59 Stables paved and drained 3 Mews in filthy condition paved, drained, and cleansed 12 Manure receptacles provided 9 Houses entirely redrained with intercepting syphons and manholes provided between the house drains and sewer, and with efficient air inlets and outlets 65 Houses without water supplied by the Metropolitan Water Board and water supplies to houses restored and improved, water fittings repaired 63 Covers to domestic water cisterns provided 418 Domestic water cisterns removed from improper positions, or cleansed or repaired 91 Nuisances by overcrowding 14 Nuisances caused by fish, offal, manure, and other refuse deposits 73 Animals kept in an insanitary state 21 Houses disinfected, walls stripped, limewashed, &c. 782 Books disinfected 90 Receptacles for fish offal 2 Smoke nuisances abated 17 Pig nuisances abated 1 Plots of land fenced in 1 Squatters removed 1 Houses closed 2 Wells closed 3 COWSHEDS AND DAIRIES ACT. During the year the Cowsheds and Dairies throughout the District have been visited, and any nuisances found to exist have been rectified, and the register has been kept up-to-date. 40 Seventeen new dealers were registered during the past year, and in two cases, where infectious diseases occurred, immediate steps were taken to remove the patients, and to carry out the requisite disinfection, as well as to have the milk found on the premises destroyed. BAKEHOUSES. The Bakehouses of the District have been periodically inspected, and special attention has been paid to the sanitary condition of same. It was found necessary to serve 31 notices re cleansing and limewhiting, &c. SLAUGHTER HOUSES. There are 18 Slaughter Houses in the District. Three licenses have been transferred during the year, and one house has been closed. UNSOUND FOOD. A quantity of fruit and fish found, on inspection, to be unfit for human consumption, was destroyed. SEWER VENTILATORS. Return of Sewer Ventilators erected during the period January, 1906, to December, 1906:— Forest Ward 8 Leytonstone Ward 3 Lea Bridge Ward 6 Central Ward 13 Cann Hall Ward 1 Leyton Ward 0 Grove Green Ward 0 Harrow Green Ward 0 Wanstead Slip Ward 0 31 41 ERECTION OF HOUSES. Return of Houses erected during the period January to December, 1906:— Forest Ward 110 Leytonstone Ward 35 Lea Bridge Ward 81 Leyton Ward 1 Central Ward 103 Grove Green Ward 3 Cann Hall Ward 1 Harrow Green Ward 0 Wanstead Slip Ward 0 334 DRAINAGE WORK. The following are the complete details of the work executed by the Surveyor's Department during the year. Relaying Drainage of:— January. Nos. 20, 22, 24, and 26, Ramsay Road. January. Nos. 404, 406, 408, 410, 412, 414, 416, 418, 420, 422, 424, 426, 428, and 430, High Road., Leyton. February. Nos. 61, 63, 65, 67, 69, 71, 73, and 75, Downsell Road. March. Nos. 399, 401, 403, and 405, High Road, Leyton. April. Nos. 16,18, 20, 22, 24, 26, 28, 30, 32, 34, 36, and 38, Stewart Road. May. Nos. 16, 18, 20, 22, 24, 26, 28, 30, 32, 34, 36, 38, 40, and 42, Manby Road. July. Nos. 9, 11, 13, 15, 17, and 19, Steele Road. July. Nos. 21, 23, 25, 27, 29, and 31, Mornington Road. July. Nos. 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, and 12, West Street, Leytonstone. July. Nos. 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, and 32, Brierley Road. Oct. Nos. 58, 60, 62, 64, 66, and 68, Bulwer Road. Nov. Nos. 85, and 87, Mornington Road. Nov. Nos. 79 and 81, Burchell Road. 42 BEAUMONT ROAD WATERING. In accordance with the recommendation of the Public Health Committee, the Surveyor obtained 160 gallons of by-product of gas tar from the Lea Bridge District Gas Company, at a cost of £1 6s. 8d. This was used for watering Beaumont Road, in the proportion of 20 gallons of tar to 400 gallons of water. The first application was made on 18th July, and the last on 22nd September. This experiment was done with a view to minimising the danger arising from dust contamination of milk which is generally believed to be a fruitful source of infantile diarrhoea. The experiment was completely successful on the score of expense as Beaumont Road only required watering once every two or three days instead of several times a day as before. I have asked the opinion of some medical men who agree with me that the experiment was sufficiently successful to justify its continuance during the summer months. FACTORY AND WORKSHOP ACT. Twelve new workshops have been registered during the year. All these premises, as well as the dwellings of 135 out-workers, have been subjected to the necessary periodical and thorough inspection. Wherever anything of the kind was found, overcrowding and any existing nuisances were abated. In this respect it was found necessary to serve 30 notices. PETROLEUM LICENSES. Twelve licenses were granted during the year. DUST COLLECTION. 19,649 tons 12 cwts. of house refuse were removed in 1906 to the Destructor. LADY SANITARY INSPECTOR. I have pleasure to report for your consideration that Miss M. Miller, who has been attached to the Public Health 43 ment for upwards of five years, has obtained the Certificate of the Sanitary Institute, and has also been elected an Associate of that body. I would strongly recommend that she be authorised to carry out the duties of a Lady Sanitary Inspector,, or Health Visitor. If this is done good results will, I am sure, accrue, particularly in visiting the numerous workrooms of the District, which are more generally occupied by females. She is also qualified to advise as to Domestic Hygiene in the poorer parts of the District, having, in addition to the above qualifications, obtained the Certificates granted by the Board of Education for examinations in Hygiene. As Lady Sanitary Inspector, Miss M. Miller's services in the investigation of all cases of deaths of children under five years, as well as into the sanitary arrangements of homes where inspection by men is regarded in the light of an intrusion, would be of the utmost value to the District, and would, I feel sure, be cordially welcomed by all concerned. farewell note. In concluding my last Annual Report as Medical Officer ot Health of Leyton, I should like in bidding goodbye to the scenes of my labours for the past 20 years to give a few facts and figures relating to the District for 1886 as compared with those of my last year in office. As an instance of the growth of the District since my first year I may point out that the Annual Report for 1886, my first year, occupied only two sides of a foolscap sheet of paper. 1886. 1906. Estimated Population 38,000 108,000 Death Rate 16.4 12.2 Birth Rate 41.0 30.9 44 The Annual Report did not assume book form until the year 1892, by which time the population of the District had increased to 63,000 exclusive of Public Institutions. The rapid strides made by the Population just about that time is noteworthy. In 1881 the total was 27,068, so that in just over ten years there was the enormous increase of over 36,000 souls. Between 1892-1906 the increase is of some 40,000, so that the number of our population has increased at a very steady and regular rate ever since I took up the appointment. It is interesting to note that in 1891 the number of houses in the District was, roughly, 11,650. Finally, I wish to acknowledge my indebtedness to the hearty co-operation of all who have worked with me in whatever capacity, and to tender to all my thanks as I feel that to their ready assistance any meed of success which may have attended my efforts is largely due. I am, Gentlemen, Your obedient servant, A. F. PESKETT, Medical Officer of Health. 45 Table XIV.—Cases of Infectious Disease Notified During the Year 1906. Including Cases OCCURRED in West Ham Union Infirmary, &c., but NOT those Imported. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Locality—Wards. No. of Cases Removed to Various Hospitals from each Locality—Wards. At all Ages. At Ages—Years. 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9 Under 1. 1 to 5. 5 to 15 15 to 25. 25 to 65. 65 and upwards. Leyton—Isolation Hospital in this Ward. Lea Bridge. Central. Forest—West Ham Infirmary in this Ward Leytonstone—Bethnal Green Schools in this Ward. Grove Green—Home of Good Shepherd in this Ward. Harrow Green—West Ham Workhouse in this Ward. Cann Hall. Wanstead Slip. Leyton. Lea Bridge. Central. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wansttad Slip- Small-pox Cholera — — — — — — — — — — — — — — -- — — — — — — — — — — Diphtheria 293 6 122 126 17 21 1 33 54 98 21 22 22 10 17 16 7 25 30 9 9 7 2 7 5 Membranous Croup 5 — 5 — — — — — — 1 2 — 1 — 1 — — — — 2 — 1 — — — Erysipelas 110 3 7 15 12 6l 12 7 13 12 20 5 l6 25 3 9 1 — — 6 — 1 13 — — Scarlet Fever 625 11 214 341 42 17 — 37 63 153 61 74 69 60 71 37 24 47 99 31 25 39 32 25 18 Typhus Fever — — — — — — — — — — — — — — — — — — — — — — — — — Enteric Fever 39 — 2 12 10 15 — 5 6 4 9 2 4 3 3 3 4 4 2 7 — 3 2 3 2 Relapsing Fever — — — — — — — — — — — — — — — — — — — — — — — — — Continued Fever — — — — — — — — — — — — — — — — — — — — — — — — — Puerperal Fever 10 — — — 3 7 — — 1 2 1 — 2 2 1 1 — 1 — 1 — 2 — — — Plague — — — — — — — — — — — — — — — — — — — — — — — — — Totals 1082 20 350 494 84 121 13 82 137 270 114 103 114 100 96 66 36 77 131 56 34 53 49 35 25 46 Table XV.—Infantile Mortality During the Year 1906. Deaths from Stated Causes in Weeks and Months Under One Year of Age. CAUSE OF DEATH. Under i Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months. 2-3 Months. 3-4 Months 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under 1 Year. All Causes 76 17 17 22 132 36 25 33 23 17 24 13 27 15 20 16 382 Common Infectious Diseases— Small-pox — — — — — — — — — — — — — — — — — Chicken-pox — — — — — — — — — — — — — — — — — Measles — — — — — — — — — 2 — 1 — 1 1 1 6 Scarlet Fever — — — — — — — — — — — — — — — 1 1 Diphtheria: Croup — — — — — — — — — — — — — — — 1 1 Whooping Cough — 1 — 1 2 — 1 2 1 — — 2 2 — 3 3 16 Diarrhœal Diseases— Diarrhoea, all forms — — 1 3 4 2 8 14 9 6 10 3 6 3 9 6 80 Enteritis (not Tuberculous) — — — 1 1 3 1 3 4 2 3 1 2 2 1 — 23 Gastritis, Gastro-intestinal Catarrh — — — 1 1 — 2 — 1 — 1 — 1 — 1 — 7 47 Wasting Diseases— Premature Birth 42 2 3 5 52 2 2 1 — — — — — — — — 57 Congenital Defects 4 — — — 4 1 1 1 1 — — 1 — — — — 9 Injury at Birth 6 — — — 6 — — — — — — — — — — — 6 Want of Breast-milk — — — — — — — — — — — — — — — — — Atrophy, Debility, Marasmus 14 7 4 3 28 14 6 2 3 2 3 — 4 1 1 — 64 Tuberculous Diseases— Tuberculous Meningitis — — — — — — 1 — 1 — — 1 1 2 1 1 8 Tuberculous Peritonitis: Tabes Mesenterica — — — — — — — — — — — — — — — — — Other Tuberculous Diseases — — — — — — — 1 1 2 1 — 1 — — — 6 Erysipelas — — — 1 1 — — — — — — — — — — — 1 Syphilis — — 1 2 3 1 — — — — — — — — — — 4 Rickets — — — — — — — — — — 1 1 1 — — — 3 Meningitis (not Tuberculous) — — — — — — — — — — — — — — — 1 1 Convulsions 4 3 2 1 10 3 1 2 — 1 1 1 2 1 — 1 23 Bronchitis — 1 1 4 6 4 1 4 — 1 2 1 4 1 1 — 25 Laryngitis — — — — — — — — — — — — — — — — — Pneumonia — — — — — 2 — — — 1 1 1 2 3 1 — 11 Suffocation, overlaying 2 1 — — 3 3 1 1 — — 1 — — — — 1 10 Other Causes 3 2 5 — 10 1 — 2 2 — — — 1 1 1 1 19 Murder 1 — — — 1 — — — — — — — — — — — 1 Total 76 17 *7 22 132 36 25 33 23 17 24 !3 27 15 20 16 382 Population Estimated to Middle of 1906 108,000 Births in the Year Legitimate 3188 Illegitimate 156 3344 Deaths in the Year Legitimate infants 356 Illegitimate infants 26 Deaths from all causes at all ages 1327