MALO 35 THE URBAN DISTRICT of THE MALDENS and COOMBE. Annual Report of the Health and Sanitary Conditions, For the Year 1914. RASHELL DAVISON, M.D., M.R.C.S., Eng., Fellow of Royal Institute of Public Health, Medical Officer of Health. HARRY HUNTER, M.R.S.I., Sanitary Inspector. 3 The Urban Districts of the Maldens and Coombe. PUBLIC HEALTH COMMITTEE, 1914-1915: Chairman : Mr. A. Woollacott. The Chairman of the Council: G. C. Hodgson, J.P. Vice-Chairman of the Council: Mr. H. Baii.ey. R. C. Dodds, A. A. Edwards, H. Mann, G. R. Johnson, W. Patrick, A. H. Smith, G. P. Spicer. OFFICIALS OF THE PUBLIC HEALTH DEPARTMENT: Sanitary Inspector: Harry Hunter, M.R.S.I, and M.S.I.A , Cert. Inspector of Meat and other Foods. Clerk: Oliver Elliott. Veterinary Surgeon : J. E. Lloyd Still, M.R.C.V.S. (Lond.) Medical Officer of Health: Rashell Davison, M.D., M.R.C S. Eng., Fellow of the Royal Institute of Public Health. 4 TABLE OF CONTENTS. PAGE Statistics 6-7 Births and Deaths 8 Infantile Mortality 9 Notification of Births Act 10 Mortuary 10 District Statistic Table 11 Poor Law 12 Infectious Diseases 13-14 Bacteriological Examinations 15 Infectious Diseases (Measles, Scarlet Fever, Diphtheria, Typhoid Fever, Small Pox, Puerperal Fever, Venereal Diseases, Acute Poliomyelitis, Ophthalmia Neonatorum, and Tuberculosis 15-17 Table showing number of cases of Infectious Diseases notified during the last ten years in each District with number of deaths 18 Table showing Streets in which Infectious Diseases notified occurred during the year 1914 19 Tuberculosis Table showing particulars of cases notified during 1914, and action taken. 20-21 Local Government Board Returns:— Table 1. Vital Statistics of the whole District during 1914 and previous years 22 Table 2. Cases of Infectious Disease notified during the year 1914 23 Table 3. Causes of, and ages at, Death during the year 1914 24 Table 4. Infantile Mortality during the year 1914. Deaths from stated causes in weeks and months under one year of age 25 Sanitary Circumstances of the District:— Schools 26-27 Infectious Diseases occurring in Schools 27 Factories, Workshops, Workplaces, and Homework 28-31 Factory and Workshops Acts 31 Dairies, Cowsheds, and Milkshops Order 32 Veterinary Surgeon's Report 32 Housing (Inspection of District) Regulations, 1910 34 Summary of Defects 34 Infants, Feeding and Care of 35-39 Consumptives, Information to 39-41 Food (including Food and Drugs Act) 41-42 Table showing Rainfall in District 43 Sewerage and Scavenging 43 Open Spaces 44 Sewerage Disposal 44-47 5 TABLE OF CONTENTS—continued. PAGE Sanitary Inspector's Report:— Inspection of Dwelling Houses 50-51 Housing of the Working Classes Act, 1890 (Part 2) (as amended by the Housing, Town Planning, etc., Act, 1909) 51-53 Houses inspected under the Housing, Town Planning, etc., Act, 1909 53 House Accommodation 53 Paving of Yards 54 Water Supply 54 Rivers and Streams 55 Railway Stations 55 Street Dust Nuisance 55 Smoke Nuisance 55 Sanitary Accommodation 56 General Work Table 56 Drainage and Sewerage 57 Van Dwellings 59 Mortuary 59 Schools 60 Infectious Diseases 60 Slaughter-houses 60 Offensive Trades 61 Food Supply 61 Factory and Workshops Acts 62-64 Servants' Registries 64 Marine Store Dealers 64 Dairies, Cowsheds, and Milkshops Orders 64 Cleansing Department 65-66 6 The Man District Council of the Maldens and Coombe, 1914. GENERAL STATISTICS. Area—3,220 acres. Situation—Ten miles south from Charing Cross, in the County of Surrey, the greater part of the district lying between the Hogg's Mill Stream and the Beverley Brook. Population Census, 1911—12,140. Estimated Population, 1914—13,910. Estimated Inhabited Houses—3,024. Rates for the year ending March 31st, 1915. Wards. General District Rates. Poor Rate. Total. s. d. s. d. s. d. Coombe 4 3 3 4 7 7 New Maiden 3 9½ 4 0 7 9½ Old Maiden ... 4 11½ 3 8 8 7½ Rateable Value—£116,441 0s. 0d. Assessable, £98,330 6s. 7 Maldens and Coombe Urban District Council. ANNUAL REPORT OF THE Medical Officer of Health, 1914. New Malden, Surrey. January, 1915. Mr. Chairman and Gentlemen, I have the pleasure to lay before you my Eighteenth Annual Report on the Health and Sanitary Conditions of the Urban District of the Maidens and Coombe under your care, for the year ending December 31st, 1914, together with the Report of the Veterinary Surgeon Vital Statistics, 1914. Birth Rate per 1,000 living—21.85. England and Wales—23.8. Death Rate per 1,000 living—9 2. England and Wales—14.0. Infantile Mortality per 1,000 Births—65.78. England and Wales—105.0 Isolation Hospital, Tolworth—Fever and Diphtheria. Small Pox, County Combined Hospital, Clandon. Water Supply from the Thatnes—Metropolitan Water Board. 8 BIRTHS. During the year there were 304 births. Boys 168 Girls 136 Total 304 The birth rate equalled 21.85 per 1,000 inhabitants as compared with 23.8 for England and Wales. Of the total number of births, 7 or 2'3 % were illegitimate. The births were distributed as follows:— Coombe 22 New Maiden 278 Old Maiden 4 Total 304 DEATHS. During the year 135 deaths were registered, being 45 more deaths than during 1913. One hundred and five deaths were registered in the district, and 30 in Public Institutions and other districts. The corrected number of deaths is 128, giving a net death rate of 9.2 per 1,000. That for England and Wales, 14.0. The County Medical Officer of Health, in his Annual Report for 1913, makes this statement: "The lowest death rate was recorded in the Urban District of the Maidens and Coombe, viz., 6.4 per 1,000." The standardized corrected death rate issued by the Registrar-General is 6*5 per 1,000. In 1905 the death rate was the lowest in the county, the London Daily Chronicle referred to it: "Low Death Rate in Surrey." "From a return just issued New Maiden is in the proud position of being able to boast of a death rate (7.1 per 1,000) which is considerably less than half the average death rate for England and Wales (16.2 per 1,000)." 9 The deaths in each Ward and Public Institutions were as follows:— District. Tol worth Isolation Hospital. Workh'se Infirmary Kingston Brookwood Asylum. London Hospitals Other Hospitals Other Districts. Total. Coombe 3 ... 1 ... 1 ... 1 6 New Maiden 98 1 15 2 3 1 4 124 Old Maiden 4 ... 1 ... ... ... ... 5 Total 105 1 17 2 4 ... 5 135 The greatest age registered was a male aged 92. Twelve occurred between 80 and 90, giving an average age per person of 84.1. Among the causes of death were the following diseases :— Measles 2 Diphtheria 2 Phthisis 10 Bronchitis 16 Heart Disease 9 Kidney Disease 16 Cancer 6 Influenza 16 INFANTILE MORTALITY. 1905 15 1906 14 1907 24 1908 18 1909 18 1910 '4 1911 18 1912 16 1913 18 1914 20 Total 175 Average number for the last ten years, 17.5. 10 Figures for the various Wards:— Coombe Nil. New Maiden 19 Old Maiden 1 Total 20 All deaths were certified by the Medical Attendant or H.M. Coroner. Births. Infantile Mortality per 1,000 Births Registered. Corrected Death Rate at all ages. 1910 20.8 53.4 5.9 1911 21.07 65.4 8.5 1912 26.39 46.1 8.5 1913 20.99 62.28 6.4 1914 21.85 6578 9.2 Average for 5 years 22.07 58.43 7.7 NOTIFICATION OF BIRTHS ACT. This Act has not yet been adopted in the district. MORTUARY. INQUESTS. Dr. M. H. Taylor, H.M. Coroner for the Division of Surrey, held inquests on 10 cases. Coombe Nil New Maiden 10 Old Maiden Nil Total 10 11 The verdicts returned were as follows:— District. Disease. Verdict of Juries. Total. New Maiden Shock, exposure to cold. 10 Syncope, Concussion of Brain. Accidental. Coma, Cerebral Haemorrhage. Natural. Syncope, Valvular Disease of the Heart. Natural. Shock, Fracture of Skull, Laceration of Brain, collision between tramcar and van. Accidental. Syncope, improper feeding. Syncope, Angina Pectoris. Natural. Shock, Rupture of Liver and Kidneys, knocked down by a train. Accidental. Shock, Fracture of Skull, Laceration of Brain, knocked down by a motor lorry. Accidental. Syncope, Hypostatic Pneumonia, Fracture of Left Femur. Accidental. Total 10 The inquests are held at the Council Offices. The post-mortems take place in the Mortuary, which is under the entire supervision of the Public Health Department. DISTRICT STATISTIC TABLE. District. Acres. Estimated Population Estimated Houses Occupied. Births. Deaths. Birth Rate. Corrected Death Rate. Coombe 1337 1380 206 22 6 15.9 4.34 New Maiden 1041 11914 2706 278 118 23.3 9.9 Old Maiden 842 616 112 4 4 6.4 6.4 Total 3220 13910 3024 304 128 21.85 9.2 12 POOR LAW. Persons in receipt of Poor Law Relief:— Coombe i New Maiden 44 Old Maiden 4 Total 49 Number of cases in receipt of Out-door Medical Relief only:— Men 63 Women 51 Children 32 Total 146 Number of cases in receipt of In-door Medical Relief, i.e., cases removed to Infirmary:— Men 17 Women 22 Children 3 Total 42 The Kingston Guardians (Poor Law Administration) Buildings at Norbiton Common Farm and the Scattered Homes for Children, Kingston Road, contain inmates and officials as follows:— Inmates. Officials. Workhouse Buildings I92 2 Scattered Homes 289 14 Total 481 l6 13 INFECTIOUS DISEASES. Tolworth Isolation Hospital receives Diphtheria, Scarlet and Typhoid Fever Cases; Smallpox cases are admitted to the Combined Hospital at Clandon. In "Home Cases" circulars are left at every house where infectious disease occurs, advising as to treatment, isolation and disinfection. CASES NOTIFIED UNDER THE INFECTIOUS DISEASES NOTIFICATION ACTS. Two hundred and ninety-one cases have been notified, distributed in the three districts as follows:— Old Maiden. New Maiden. Coombe. Total. Scarlet Fever ... 53 1 54 Diphtheria 1 21 ... 22 Erysipelas ... 8 ... 8 Measles 2 169 ... 186 Typhoid Fever ... 1 ... 1 Puerperal Fever ... ... ... ... Pulmonary Tuberculosis ... 11 ... 11 Tuberculosis, other than Pulmonary Tuberculosis ... 7 ... 7 Ophthalmia Neonatorum ... 2 ... 2 Acute Poliomyelitis ... ... ... ... Total 3 272 16 291 14 Cases Treated at Tolworth Isolation Hospital. Old Maiden. New Maiden. Coombe. Total. Scarlet Fever ... 42 1 43 Diphtheria 1 17 ... 18 Membraneous Croup ... ... ... ... Typhoid Fever ... ... ... ... Total 1 59 1 61 The monthly distribution is as follows:— Measles Erysipelas Diphtheria Scarlet Fever Typhoid Fever Puerperal Fever Tuberculosis (all forms) Ophthalmia Neonatorum Total. January ... ... 3 7 ... ... 2 ... 12 February ... ... 1 3 ... ... ... ... 4 March 40 1 ... 1 ... ... 4 ... 46 April 90 2 3 3 ... ... 3 ... 101 May 21 2 4 ... ... ... 3 ... 30 June 4 ... 2 2 ... ... 3 ... 11 July ... ... 3 3 ... ... ... ... 6 August ... ... ... 1 ... ... ... ... 1 September 2 ... 1 2 ... ... 1 ... 6 October ... 1 2 11 ... ... ... 1 15 November 22 1 1 16 ... ... 1 ... 41 December 7 1 2 5 1 ... 1 1 18 Totals 186 8 22 54 1 ... 18 2 291 Note.—Two cases notified as Scarlet Fever and sent to Isolation Hospital, were returned as not Scarlet Fever, one being Measles and the other Nil. One case notified as Diphtheria and sent to Isolation Hospital, was returned as Nil. 15 BACTERIOLOGICAL EXAMINATIONS. Diseases. Examinations. Result. Total. Positive. Negative. Tuberculosis Sputums 21 5 16 21 Diphtheria Swabs 81 14 67 Si Vincents Angina Swabs 1 ... I I Enteric (Typhoid) Fever Blood Serum 2 ... 2 2 105 19 86 105 MEASLES. One hundred and eighty-six cases were notified, two in Old Maiden, fifteen in Coombe, and one hundred and sixty-nine in New Maiden. The death rate of Measles is very low, due to the notification of this disease. Coombe 15 New Maiden 169 Old Maiden 2 Total 186 Under school age 80 At school age 100 Above school age 6 Total 186 One hundred cases occurred in Public Schools, fifty-three occurring in Lime Grove Schools. Sixteen cases occurred, in Private Schools. Eighty were under five years of age and did not attend school. Six were adults. Two deaths were registered SCARLET FEVER. Fifty-four cases were notified during the year, two cases were, however, subsequently found to have been mistaken in diagnosis. 16 Although more numerous than last year, the number, considering the extensive epidemic in London, was small. Treated in Hospital 43 Treated at Home 11 Total 54 Twenty-seven cases occurred in Public Schools. Twelve under five years and ten adults. Five in Private Schools. Forty-three cases were admitted to Hospital, forty-one receiving treatment, and the other two being returned as mistaken diagnosis. DIPHTHERIA. This disease was fairly distributed throughout the year, twentytwo cases were notified; being two less than last year. Tieated in Hospital 18 Treated at Home 4 Total 22 One case sent to Isolation Hospital was subsequently found to have been mistaken in diagnosis. March and August were the only months in the year without a case being notified. A most interesting case occurred in a child, aged five years, who died in Tolworth Isolation Hospital from Post Diphtheritic Para/lysis. The child had a sore throat, three specimens were taken from his throat at short intervals, they were examined by three independent bacteriologists who each reported the organism as pseudo-diphtheritic (Hofmann). Hitherto this bacillus has been only regarded with suspicion, but if the pseudo bacillus is so virulent as to produce Post Diphtheritic Paralysis and death, the only practical and safe treatment for the future will be to treat all pseudo cases as Diphtheritic and at once inject them with Antitoxin. TYPHOID FEVER. One case was notified during the year. 17 SMALL POX. No case was notified during the year. One contact was reported from the Port of London, the case was kept under observation but fortunately no development occurred. PUERPERAL FEVER. No case was notified during the year. VENEREAL DISEASES. As requested by the Local Government Board the statistics as to the local extent of these diseases have been obtained by communicating with each medical practitioner residing in the district, asking for a return of cases coming under their individual notice, with any remarks pertaining to these diseases. The return shows the total number of cases dealt with locally during the past year as follows:— Syphilis 6 Gonorrhœa 3 Total 9 ACUTE POLIOMYELITIS. No case was notified during the year. OPHTHALMIA NEONATORUM. Two cases of this disease were notified during the year. This disease was made compulsorily notifiable in every sanitary district in England and Wales. The Local Government Board have, on advice received, stated that the general notification of this disease is desirable; that a large proportion of the blindness contracted in childhood is due to the neglect of proper precautions against the disease. TUBERCULOSIS. Eighteen cases of this disease were notified, being eight less than last year. The Tuberculosis Medical Officers of the County have been of great assistance in the diagnosis and treatment in this disease, and do their best to gain admission to Sanatoria for as many cases as possible. 18 Cases of Infectious Diseases notified during the last ten years, recording cases in each district, with number of deaths : Year. Number notified in each Year. Number of Deaths. Cases treated at Tolworth Isolation Hospital. Cases treated at Home. Population Year Diphtheria Scarlet Fever Typhoid Fever Measles Erysipelas |Puerperal Fever Tuberculosis (all forms) Ac'te Poliomyelitis Ophthalmia Neonato um Total Diphtheria Scarlet Fever | Typhoid Fever Measles Erysipelas Puerperal Fever Ac'te Poliomyelitis Tuberculosis (all forms) Total Diphtheria Scarlet Fever Typhoid Fever Total Diphtheria Scarlet Fever Typhoid Fever Total 1905 11 29 2 60 9 ... ... ... ... 111 1 ... 1 ... ... ... ... 6 8 8 23 ... 31 3 16 2 21 8642 1905 1906 2 19 2 81 12 ... ... ... ... 116 ... ... ... ... ... ... ... 3 4 2 15 1 18 ... 4 1 5 9927 1906 1907 11 17 ... 60 7 ... ... ... ... 95 1 ... ... ... ... ... ... 7 8 9 14 ... 23 2 3 5 10517 1907 1908 9 21 3 468 9 ... ... ... ... 510 1 ... ... 6 ... ... ... 5 12 7 11 2 20 2 10 I 13 11107 1908 1909 25 83 1 29 12 1 4 ... ... 155 2 ... ... ... 1 1 ... 5 9 19 51 ... 70 6 22 28 11697 1909 1910 7 18 ... 55 10 1 5 ... ... 96 ... ... ... ... ... ... ... 8 9 7 11 ... 18 ... 1 ... 1 12287 1910 1911 12 15 ... 536 12 ... 10 ... ... 585 2 ... ... 6 ... ... ... 8 16 12 13 ... 25 ... 2 ... 2 13044 1911 I912 51 10 3 59 4 1 20 ... ... 148 3 .. 1 1 ... 1 5 11 34 7 3 44 17 3 ... 20 13151 1912 1913 24 36 ... 153 10 1 26 1 ... 251 1 ... ... 1 ... ... 1 8 11 19 35 ... 54 5 2 ... 7 13767 1913 1914 21 52 1 187 8 ... 18 ... 2 289 1 ... ... 2 1 ... ... 6 10 17 41 ... 58 4 11 1 16 13910 1914 Totals 173 300 12 1698 93 4 83 1 2 2356 12 ... 2 16 4 2 1 61 98 134 221 6 361 39 74 5 118 ... ... Average 17.3 30.0 1.2 169.8 9.3 .4 8.3 .1 2 235.6 1.2 ... .2 1.6 .4 2 .1 6.1 9.8 13.4 22.1 .6 36.1 3.9 7.4 .5 11.8 ... ... 19 Table showing- the Streets in which the Infectious Diseases Notified occurred, during the year 1914. The Figures in light type are those for the year 1913, and will be found useful for comparative purposes. Street or District. Cases Notified. Totals. Deaths. Cases Resulting Fatally. Scarlet Fever. Diphtheria. Enteric Fever (Typhoid). Erysipelas. Puerperal Fever. Measles. Tuberculosis (all forms). Acute Poliomyelitis. Ophthalmia Neonatorum. Measles. Diphtheria. Tuberculosis (all forms). Acute Poliomyelitis. New Maiden. Acacia Grove 4 2 ... ... ... 6 2 1 ... ... 13 2 ... ... ... ... ... Albert Road 1 ... ... ... ... 6 ... ... ... 7 ... ... ... ... ... Alric Avenue ... ... ... 1 ... 1 1 ... ... 2 1 ... ... ... ... ... Albany Road 2 2 ... ... ... ... 6 2 ... ... ... 8 4 ... ... ... ... ... Albemarle Gardens 1 1 ... ... ... 6 11 1 ... ... 7 13 ... ... ... ... ... Apsley Road ... 1 ... ... ... 6 ... ... ... 6 1 2 1 ... 1 ... Avenue Road ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... Avenue Terrace ... 1 ... ... ... 5 ... ... ... 6 ... ... ... ... ... Beaconsfield Road 4 3 1 ... ... ... 8 1 ... ... 12 5 ... ... ... ... ... Beverley Road 1 ... ... ... ... 6 ... ... ... 7 1 1 ... ... ... Beech Grove 1 2 1 ... ... ... 2 2 ... ... ... 5 3 ... ... ... ... ... Beresford Road ... 2 ... 1 ... 4 ... ... ... 1 6 1 ... 1 ... ... Blagdon Road 3 2 1 ... ... ... 4 4 2 4 ... ... 10 10 1 1 ... 1 1 ... Burlington Road 1 ... ... 1 ... 1 2 1 ... ... 2 4 1 ... ... 1 ... California Road ... ... ... ... ... 4 ... ... ... 4 ... ... ... ... ... Cambridge Road 1 1 1 ... ... ... 3 1 2 ... 2 6 5 1 ... ... 1 ... Chestnut Grove 1 1 2 ... ... ... 8 1 1 ... ... 12 2 ... ... ... ... ... Cleveland Road ... 2 ... ... ... 1 ... ... ... 2 1 ... ... ... ... ... Coombe Gardens ... ... ... ... ... 1 1 ... ... 2 ... ... ... ... ... Coombe Road ... ... ... ... ... 10 2 ... ... ... 10 2 ... ... ... ... ... Connaught Road ... ... ... ... ... 2 ... ... ... 2 ... ... ... ... ... Dickerage Lane ... ... ... ... ... 4 2 ... ... 2 4 ... ... ... ... ... Dukes Avenue 1 1 ... 2 ... 12 5 ... ... ... 13 8 1 1 ... ... ... Elm Road 2 4 3 ... 1 1 ... 12 3 1 ... ... 19 8 1 ... ... 1 ... George Road 1 ... ... ... ... 3 1 2 ... ... 2 5 ... ... ... 1 ... Grafton Road ... 1 ... 1 ... 3 ... ... ... 3 2 ... ... ... ... ... Grayham Road ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... Gloucester Road ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... Harrow Road ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... Hillbrow' ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... Howard Road 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... Hoppingwood Avenue 1 ... ... ... ... 1 ... ... ... 2 ... ... ... ... ... Kingston Road 5 5 1 2 ... 2 ... 31 2 ... ... 10 38 1 1 ... ... 2 1 ... Kingscote Road 2 1 2 ... ... ... 5 1 1 1 ... ... 9 4 ... ... ... ... ... Kings Avenue 1 ... ... ... ... 1 1 ... ... ... 2 1 ... ... ... ... ... Lime Grove 1 i ... ... ... 3 1 1 ... ... 4 3 1 ... ... 1 ... Maiden Road ... ... ... 1 ... 2 1 ... ... ... 3 1 ... ... ... ... ... Maiden Hill 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... Melrose Gardens 2 ... ... 1 ... 12 2 ... ... ... 15 2 ... ... ... ... ... Montem Road ... 1 ... ... ... 2 ... ... ... 3 ... ... ... ... ... Mount Road 1 1 ... ... ... 3 4 1 ... ... 5 5 ... ... ... ... ... Mount Pleasant Road ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... Nelson Road ... ... ... ... ... 3 ... ... ... 3 ... ... ... ... ... Northcote Road 4 5 3 2 ... ... ... 7 4 2 ... ... 16 11 ... ... ... ... ... Penrith Road 1 1 ... ... ... 1 2 ... ... 3 2 1 ... ... 1 ... Poplar Grove 1 1 ... 1 ... 8 2 1 ... ... 9 5 ... ... ... ... ... Presburg Road ... ... ... ... ... 2 ... ... ... 2 ... ... ... ... ... Queens Road 6 1 ... 1 ... 4 1 1 ... ... 5 9 ... ... ... ... ... Raby Road ... ... ... ... ... 4 ... ... ... 4 ... ... ... ... ... Rodney Road 1 ... ... ... ... 1 ... ... ... 1 1 ... ... ... ... ... Sandal Road 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... Salisbury Road 1 2 ... ... ... 5 1 ... ... 6 3 1 ... ... 1 ... Selwyn Road ... ... 1 ... ... 5 2 ... ... ... 6 2 ... ... ... ... ... South Lane 1 ... ... ... 1 2 1 ... ... ... 3 2 ... ... ... ... ... St. John's Road ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... Sycamore Grove 3 ... ... ... ... ... 1 ... ... 4 ... ... ... ... ... Thetford Road ... ... ... 1 ... 6 1 ... ... 8 ... ... ... ... ... Wellington Crescent 2 1 ... ... ... 20 1 2 ... ... 2 24 ... ... ... ... ... Westbury Road ... ... ... 1 ... 7 ... ... ... 1 7 ... ... ... ... ... Woodside Road ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Coombe. 1 4 1 ... 1 ... 15 4 2 ... ... 16 12 2 ... ... 2 ... Old Maiden. ... 1 1 ... 1 ... 2 1 1 ... 3 4 1 ... ... ... 1 Totals 52 36 21 24 1 8 10 1 187 153 18 26 1 2 289 251 6 11 2 1 1 1 6 8 1 20 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Public Health (Tuberculosis in Hospitals) Regulations, 1911, Public Health (Poor Law) Regulations, 1911. Tabulated Statement showing particulars of Cases notified during 1914, and action taken. No. Sex. Age Residing in District at end of 1914 Did the Patient go to any Public Institution Was Patient able to continue employment Visits undertaken by Sanitary Dept. Other action by Sanitary Dept. Result at end of 1914 I Male 60 Yes Yes, St. Thomas's Convalescent Home. Yes after short period Visited by Sanitary Inspector Subsequent visit Living, an improved condition 2 Female 12 Yes Yes, Out-patient at Royal Waterloo Hospital. No Subsequent visit Living 3 Female 18 Yes No. receiving domiciliary treatment. No None Not known 4 Male 7 Yes Yes, Out-patient at St. Thomas's Hospital. No Subsequent visit Living, an improved condition 5 Female 32 Yes No, receiving domiciliary treatment. Able to follow household duties None Living 6 Female 16 Yes Yes, Barnes Hospital, and now removed to Sanatorium. No None Living, an improved condition 7 Male 9 No Yes, Evalina Hospital, and now at St. Mary's Home, Broadstairs. No None Living 8 Male 4 Mth. Yes Yes, Out-patient at St. Thomas's Hospital. No None Living 2 1 9 Male 55 Yes Yes, St. Thomas's Hospital. No Visited by Sanitary Inspector None Living 10 Male 42 Yes Yes, Barnes Hospital. No None Living 11 Female 30 Yes No, receiving domiciliary treatment. Yes None Living 12 Female 43 Yes No, receiving domiciliary treatment Yes None Living 13 Female 62 Yes No, receiving domiciliary treatment. No None Living 14 Male 39 No Yes, in a London Hospital four years previously and now removed to Sanatorium. No None Living 15 Male 20 No Yes, Royal Naval Hospital, Chatham, and now removed to Sanatorium. No None Living 16 Male 30 Died Admitted to Sanatorium. No Subsequent visit and premises disinfected Dead 17 Female 18 Yes No, receiving domiciliary treatment. No None Living 18 Male 16 No Yes, Eversfield Chest Hospital. No None Living La addition to the above, one Notification was received incorrectly addressed, and transferred to the Medical Officer of Health in its respective district. 22 Table I.—Vital Statistics of Whole District during- 1914 and Previous Years. Year Population estimated to Middle of each Year Births Total Deaths Registered in the District Transferable Deaths Nett Deaths belonging to the District Uncorrected Number Nett of Nonresidents registered in the District of Residents not registered in the District Under 1 Year of Age At all Ages Number Rate Number Rate Number Rate per 1,000 Nett Births Number Rate 1 2 3 4 5 6 7 8 9 10 11 12 13 1909 11,697 269 269 2 2.4 89 7.4 13 22 18 67 105 8.9 1910 12,287 262 262 20.8 83 6.7 4 10 14 53.4 75 6.4 1911 13,044 275 275 21.08 115 8.8 4 19 18 65.4 111 8.5 1912 13,151 347 347 26.39 87 6.6 - 27 16 46.1 112 8.5 1913 13.767 289 289 20.99 69 5.01 1 20 19 62.28 89 6.4 1914 13-910 304 304 21.85 105 7.5 7 30 20 65.78 128 9.2 Area of District in Acres (land and 3,220 Total Population at all Ages 12,140 At Census, inland water) Total families or separate occupiers 2,745 1911 23 Table II.—Cases of Infectious Disease notified during" the year 1914, in the Maidens and Coombe Urban District. Notifiable Disease Number of Cases Notified Total Cases Notified in each Locality {e.g. Parish or Ward) of the District Total Cases Removed to Hospital At all Ages At Ages—Years Under 1 1 to 5 5 to 15 15 to 35 25 to 45 45 to 65 65 and upwards New Maiden Old Maiden Coombe Diphtheria (including Membranous croup) 21 ... 2 16 2 1 ... ... 20 1 ... 18 Erysipelas 8 ... ... ... 1 3 2 2 8 ... ... ... Scarlet Fever 52 ... 8 35 5 4 ... ... 51 ... 1 43 Enteric Fever 1 ... ... ... ... 1 ... ... 1 ... ... Ophth'lmia Neonatorum 2 2 ... ... ... ... ... ... 2 ... ... ... Pulmonary Tuberculosis 11 ... ... ... 5 5 1 ... 11 ... ... ... Other forms of Tuberculosis ... 1 3 ... ... 1 2 ... 7 ... ... ... Measles 187 ... 77 104 5 1 ... ... 170 2 15 ... Totals 289 3 90 155 18 16 5 2 270 3 16 61 The Isolation Hospital is situated at Tolworth, in the Urban District of Surbiton (Tolworth Joint Hospital Board). Total available Beds, 38. Number of Diseases that can be concurrently treated, 3. 24 Table III.—Causes of, and Ages at Death during the Year 1914. Causes of Death All Certified. Nett Deaths at the subjoined ages of "Residents " whether occurring within or without the district All Ages Under 1 year 1 and under 2 years 2 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 45 years 45 and under 65 years 65 and upwards Enteric Fever ... ... ... ... ... ... ... ... ... Measles 2 ... ... 1 1 ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... Whooping Cough 2 1 1 ... ... ... ... ... ... Diphtheria and Croup 2 ... ... 1 1 ... ... ... ... Influenza 4 ... 1 ... ... ... ... 2 1 Phthisis (Pulmonary Tuberculosis) 10 ... 1 ... ... ... 4 5 ... Tuberculous Meningitis 2 ... 2 ... ... ... ... ... ... Cancer, malignant disease 16 ... ... ... ... ... 3 3 10 Rheumatic Fever ... ... ... ... ... ... ... ... ... Meningitis ... ... ... ... ... ... ... ... ... Organic Heart Disease 9 ... ... ... ... ... ... 3 6 Bronchitis 16 1 ... ... ... ... ... 4 11 Pneumonia (all forms) ... ... ... ... ... ... ... ... ... Diarrhoea and Enteritis 1 ... ... ... 1 ... ... ... ... Cirrhosis of Liver 1 ... ... ... ... ... ... ... 1 Nephritis and Bright's Disease ... ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... Congenital Debility and Malformation, including Premature Birth 11 11 ... ... ... ... ... ... ... Violent Deaths, excluding Suicide 8 ... ... ... 2 1 1 1 3 Other Defined Diseases 26 6 ... ... ... ... ... ... 20 Diseases ill-defined or unknown 18 1 ... ... 1 ... 2 7 7 Totals 128 20 5 2 6 1 10 25 59 25 Table IV.—Infantile Mortality during the year 1914. Nett Deaths from stated causes at various Ages under 1 Year of Age. Causes of Death All Certified. Under 1 Week 1-2 Weeks 2-3 Weeks 3-4 Weeks Total under 4 Weeks 4 Weeks and under 3 Months 3-6 Months 6-9 Months 9-12 Months Total Deaths under 1 Year Whooping Cough ... ... ... ... ... ... ... 1 ... 1 Convulsions ... ... 1 ... ... ... ... ... ... 1 Bronchitis ... ... 1 ... ... ... ... ... ... 1 Pneumonia (all forms) ... ... ... ... ... 1 ... ... ... 1 Gastritis ... ... ... ... ... ... ... 1 ... 1 Premature Birth 9 ... ... ... ... ... ... ... ... 9 Atrophy, Debility and Marasmus 1 ... ... ... ... ... ... ... ... 1 Other Causes 1 ... ... ... ... 2 2 ... ... 5 Totals 11 ... 2 ... ... 3 2 2 ... 20 Nett Births in the year—legitimate, 297, illegitimate, 7. Nett Deaths in the year—legitimate infants 19, illegitimate infants. 1. 26 SCHOOLS. The children attending the Public Elementary Schools in the District number:— Boys 1064 Girls 995 Total 2059 The number in each school:— Boys Girls Coombe (Kingston Vale) 22 21 Infants 15 11 Old Malden 78 11 Infants 13 11 New Malden:— Lime Grove, Girls — 176 ,, ,, Infants 84 76 Elm Road, Boys 224 — Burlington Road, Girls — 313 ,, ,, Boys 270 — Infants 171 153 Dickerage Lane, Girls — 125 ,, ,, Boys 80 — ,, ,, Infants 107 98 Total 1064 995 27 The total number of children attending each school is as follows:— Kingston Vale, Coombe 69 Old Maiden 113 New Maiden, Lime Grove 336 ,, ,, Elm Grove 224 ,, ,, Burlington Road East 907 ,, ,, Dickerage Lane West 410 Total 2059 There is an increase of 67 children upon last year's total, as follows:— Kingston Vale, Coombe, same number of children as last year. Burlington Road East, has an increase of 64 Dickerage Lane West ,, ,, 22 Old Maiden has a decrease of 4 New Maiden:— Elm Road has a decrease of 12 Lime Grove ,, ,, 3 Infectious Diseases occurring: in Schools. The number of cases occurring in children attending the Public Schools during the year were:— Schools. Scarlet Fever Measles Diphtheria Typhoid Fever Total Burlington Road 8 14 2 ... 24 Elm Road 2 5 2 ... 9 Lime Grove 13 53 7 ... 73 Old Maiden ... ... ... ... ... Coombe, Kingston Vale ... 11 ... ... 11 Dickerage Lane, New Maiden 4 1 1 ... 6 Schools Outside District ... ... ... ... ... 27 84 12 ... 123 28 The following is a classification, of the total number of cases of disease occurring in the district during the year:— Public Schools Private Schools Not attending Schools Totals Remarks 5 Years and under Adults and others Scarlet Fever 27 5 12 10 54 Diphtheria 12 2 4 4 22 Measles 84 16 80 6 186 Typhoid Fever ... ... ... 1 1 Erysipelas ... ... ... 8 8 Tuberculosis (Pulmonary and other) 1 ... 1 16 18 Puerperal Fever ... ... ... ... ... Ophthalmia Neonatorum ... ... 2 ... 2 Acute Poliomyelitis ... ... ... ... ... Totals 124 23 99 45 291 FACTORIES, WORKSHOPS, WORKPLACES AND HOMEWORK. 1. —Inspection. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisancis. Premises Number of Inspections Written Notices Prosecutions 10 Factories (including Factory Laundries) 18 2 ... 49 Workshops (including Workshop Laundries) 11 1 ... 11 Workplaces (Other than Outworkers' premises included in Part 3 of this Report) 8 ... ... Total 37 3 ... 29 2.—Defects Found. Particulars Number of Defects Number of Prosecutions Found Remedied Referred to h.m. Inspector Nuisances under the Public Health Acts: —* Want of cleanliness 2 2 ... ... Overcrowding ... ... ... ... Want of ventilation ... ... ... ... Want of drainage of floors ... ... ... ... Other Nuisances 7 7 ... ... Sanitary accommodation insufficient ... ... ... ... unsuitable or defective ... ... ... ... not separate for sexes ... ... ... ... Offences under the Factory and Workshop Acts:— Illegal occupation of underground bakehouse (s. 101) ... ... ... ... Breach of special sanitary requirements for bakehouses (ss. 97 to 100) ... ... ... ... Other offences (excluding offenresrelating to outwork which are included in Part 3 of this Report) ... ... ... ... Total 9 9 ... ... *Including those specified in sections 2, 3, 7 and 8 of the Factory and Workshops Act, 1901, as remediable under the Public Health Acts. 30 3.—Homework. Nature of Work Outworkers' Lists, Section 107. Number of Inspections of Outworkers' premises Outwork in Unwholesome Premises, Sec. 108 Lists received from Employers Notices served on Occupiers as to keeping or sending lists Prosecutions Instances Notices served Prosecutions Sending twice in the year Sending once in the year Failing to keep or permit inspection of lists Failing to send lists Lists Outworkers Lists Outworkers Contractors Workmen Contractors Workmen Wearing Apparel— (l) Making, &c 1 4 4 (1) Cleaning and Washing Total 1 4 4 31 4.—Registered Workshops. Workshops on the Register (s. 131) at the end of the year Number Bakehouses 7 Laundries 2 Plumbers and Glaziers 3 Boot, Shoe and Leather 10 Dressmakers, Milliners, Tailoring and Underclothing 15 Blacksmiths, Wheelwright, etc. 3 Cycle Works, Motors and Carpenters 7 Sundry other workshops 2 Workplaces 11 Total number of workshops on Register 60 5.—Other Matters. Class Number Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 1 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts but not under the Factory and Workshop Act (s. 5) Notified by H.M. Inspector ... Reports (of action taken) sent to H.M. Inspector ... Other ... Underground Bakehouses (s. 101):— Certificates granted during the year ... In use at the end of the year ... THE FACTORY AND WORKSHOP ACTS. Premises on the Register for the year are as follows:— Factories 10 Workshops and Workrooms 49 Workplaces 11 Total 70 32 The factories described as such are mostly laundries, which is an increasing trade, as may be expected in a growing residential district. The workshops and rooms axe occupied by Milliners, Dressmakers, Fancy Work and Laundry Workers. The district is residential, and has no industry of a staple nature. BAKEHOUSES AND EATING HOUSES. These are frequently inspected and the desired standard of cleanliness maintained. DAIRIES, COWSHEDS AND MILKSHOPS ORDER. Under these Orders there are now 67 persons registered, three more than last year. One hundred and six cows and heifers produce milk for sale. Mr. Lloyd Still, your Veterinary Surgeon, has presented a very satisfactory report of the health and condition of the cows located within the district. Cowsheds in occupation in the district 9 Milkshops and Dairies in the district 10 Total 19 VETERINARY SURGEONS REPORT. Three Months ending March 31ST, 1914. Cowsheds visited 9 Milch cows and heifers examined 110 Result of Examinations. Cows and heifers in healthy condition 110 Three Months ended June 30TH, 1914. Cowsheds visited 8 Milch cows and heifers examined 124 33 Result of Examinations. Cows and heifers in healthy condition 124 Three Months ended September, 1914. Cowsheds visited 8 Milch cows and heifers examined 124 Result of Examinations. Cows and heifers in healthy condition 124 Three Months ended December 30TH, 1914. Cowsheds visited 6 Milch cows and heifers examined 106 Result of Examinations. Cows and heifers in healthy condition 106 HOUSING. The district is a residential one, with no industry of a staple character. NEW HOUSES. The number of new houses certified by the Surveyor during the year, as fit for occupation, were:— Coombe 3 New Maiden 40 Old Maiden Nil Total 43 Existing Building's are controlled by the Sanitary Department and any alteration of drainage or reconstruction of drainage works whatever is supervised by the Sanitary Inspector, who is assisted in this respect by the Byelaws relating to the drainage of existing buildings. The following particulars of "Houses inspected" and "Defects found," with other details, have been supplied by the Sanitary Inspector under Article XX. (16) of the General Order of the Local Government Board (13th December, 1910). 34 HOUSING (INSPECTION of DISTRICT REGULATIONS, 1910. The number of dwelling-houses inspected under and for the purposes of Section 17 of the Act of 1909 34 The number of dwelling-houses which on inspection were considered to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil The number of representations made to the Local Authority with a view to the making of closing orders Nil The number of closing orders made Nil The number of dwelling-houses the defects in which were remedied without making of closing orders 32 The number of dwelling-houses which after the making of closing orders were put into a fit state for human habitation Nil The general character of the Defects found to exist in the 34 houses inspected under Section 17 of the Housing, Town Planning, etc., Act, 1909, were as follows:— Houses found with the drains so defective as to require reconstructing 2 Houses requiring proper means of access to the drainage 16 Houses requiring ventilation to the drainage 8 Defective sanitary fittings found in the above houses 43 Houses found with damp walls 12 Houses with defective water supplies Nil Houses found requiring cleansing work 5 Houses requiring repairs 22 Houses with defective eaves and downspouts 4 Houses with water storage cisterns requiring close fitting covers 6 Houses with rainwater pipes connected direct to drainage 2 Houses requiring the yards paved 11 Houses requiring sanitary dust-bins or with defective covers requiring replacing 1 35 HINTS ON THE FEEDING AND CARE OF INFANTS. These hints are for healthy infants. By their use you may save your infant nearly all ill-health. Over 110,000 infants under one year old die in England and Wales every year. Suckle the child yourself if possible. It will then have twice the chance of living. Live healthily while "carrying"; you will then have a healthy child. Live healthily while suckling; you will then keep the child in health. Eat plenty of plain food. It is far better to drink milk than stout, beer, or spirits. Continue taking gruel at least once a day while nursing. The quality as well as the quantity of milk must be kept up. Feeding. Put the infant to the breast every four hours until the milk comes in. For first forty-eight hours give it nothing besides the breast but warm sweetened water. Suckle for ten months if sufficient milk, and wait for cool weather before weaning. Give cows' milk and water as well if breast milk is insufficient. "Infants' foods" are expensive, and seldom are necessary. The first four teeth are Nature's sign that more than milk is required. No potatoes for a year; no meat for eighteen months. Give nothing but mother's milk for seven months. Always feed regularly every two hours at first; never in a hurry; never between times; never, after the first month, between 11 at night and 5 in the morning. Do not rock the baby after feeding; raise its head and shoulders to bring up the wind. 36 A child may be thirsty, and water may stop its crying. Do not give extra milk. Never give sweets or food between meals; they ruin teeth and stomach. Cleanliness, Clothing, and Care. Dummy Teats or Comforters should not be used. Biting a bone ring does no harm. Wash the eyes every day. If they discharge wipe them with clean cotton wool and burn it at once; it may be infectious. If anything is wrong hurry to the doctor; otherwise the child may be blinded for life. Bathe the child once a day before the fire, dry it well, and put on warmed clothes. Wash the mouth out with clean rag in warm water. Change wet napkins as soon as possible, sponge with warm water, dry thoroughly, put on dry warmed napkins. Never wash napkins in soda-water, as they make the baby sore. Clothing should be light and warm, with flannel or wool next the skin, coveiing its body, arms, and legs; never use flannelette; it catches fire. Flannel binders, long-sleeved flannel gowns, and long-sleeved woollen vests will prevent a chill. Never put on a stiff white binder; it prevents the chest expanding. Always let an infant have fresh air to breathe, with windows open day and night, even in cold weather. If fine let the infant sleep in its "pram" out of doors all day in a sheltered corner. Protect its eyes from the sun. Never keep it out after sunset. Always avoid draughts and sudden chills. Infants must sleep ailone, otherwise they are often suffocated; if there is no cot, a box or drawer may be used. Put hot bottle or brick, wrapped in flannel, not too near the feet in cold weather. For "thrush" rub the inside of the mouth with a clean rag dipped in glycerine and borax before and after each meal. Teething powders, soothing syrups, gin and other spirits are poisonous, and must only be given by the doctor's orders. Keep the bowels open every day. Olive-oil is better than castor-oil, as it does not constipate afterwards. The motions should 37 be yellow; if they become green give half-teaspoonful of castor-oil. If not right after a few days consult a doctor. Weigh the baby once a week; if not increasing in weight take it to see a doctor. When the Child Ails. Consult the doctor early, not the chemist; otherwise it may be too late. Take greater care in cleaning everything used for the milk. Read these rules again and find out which is not being kept. Specially keep the child warm and dry. Avoid sudden changes of air. Hand Feeding. When the breast is not enough, give cows' milk and water or barley-water as well. Use only new milk. Much more trouble must be taken to bring a baby up by hand than by the breast. Preparatiofi.—As soon as milk is delivered mix enough of it to last for 24 hours with the right .amount of water; in hot weather bring it to the boil in a clean saucepan; pour into clean scalded jug, cover with clean piece of muslin; stand it in a cool place, not near a sink or drain. Never leave the milk uncovered; nor put your fingers in it; nor put it into any jug, bottle, or saucepan that has not been first scalded. At each feed during the first two months add half a small lump of white sugar; during the later months add the whole of a small lump. Feed by common sense, not by rule. If the baby seems unsatisfied, try the milk stronger. If the baby cannot digest it, try it weaker. Amounts.—The general rules for an average child in good health are as follows:— 38 Age of Child For whole 24 hours For each Meal Time of Meals Milk Boiled Water Milk and Water mixed During 1st fortnight ¼ pint ½ pint 3 tablesp'nfuls Every 2 hours 2nd ,, 1 ¾ ,, 5 ,, ,, 2 ,, 2nd month ½ ,, ¾ ,,. 6 ,, ,, 2 ,, 3rd ,, ¾ ,, ¾ ,, 8 ,, ,, 2½ ,, 4 th „ ¾ „ ¾ ,, 9 ,, ,, 3 ,, 5th ,, 1 ,, ¾ ,, 10 ,, ,, 3 ,, 6th ,, 1¼ pints ¾ ,, 12 ,, ,, 3 ,, 7th ,, 1½ „ ¾ ,, 13 ,, ,, 3 ,, 8th „ 1½ „ ½ ,, 14 ,, ,, 3 ,, 9th „ 2 ,, ½ ,, l6 ,, ,, 3 ,, If cream be obtainable add one teaspoonful to each bottle up to five months old; if not, give a little cod-liver oil, not more than a teaspoonful altogether in the day. At nine months or earlier, if enough teeth axe present, a little broth made from fresh meat, a few crumbs soaked in red gravy, a little bacon fat twice a week, a little milk pudding, bread and milk, or small pieces of bread and butter may be given as well as pure milk. At twelve months a lightly boiled egg may be added. At eighteen months a little minced meat, pounded fish, mashed potatoes with gravy or fresh broth may be given once in the day. Never give cheese, tea, beer, or meat that has not been well minced. Barley-Water.—If barley-water is used it must be made fresh twice a day. To make barley-water take two teaspoonfuls of prepared barley in powder, put it in a, pint of cold water, boil and strain through clean muslin. Pearl barley requires boiling twenty minutes. Bottles.—Never use a bottle with a tube. A boat-shaped bottle marked in tablespoonfuls is best. Always keep two bottles 39 in use. Don't use the same bottle twice running. Do not let baby suck too quickly; ten to twenty minutes should be allowed for each feed. Only warm sufficient of the milk for one feed; never keep what is left over for next feed. Thoroughly wash out and scald the bottle and teat after every meal and keep them covered in a basin of cold water with a little bicarbonate of soda. Always taste the milk to see if it is not too hot. See that the opening in the teat is large enough, but not too large. Prepared Foods.—The use of prepared "Infants' Foods" is expensive. Malted foods are the best; but baked flour, grated rusks, oat flour, or a crust do equally well. For the first of these bake a little wheat flour in the oven until it is well browned, and add this to the milk. The pap must be thin enough to go easily through the bottle; very little to be given at first. Never give "Infants' Foods" until the child is seven months old. Raw meat juice is useful for very delicate or premature babies. Scrape a small piece of fresh raw meat into shreds, tie up in a clean piece of muslin, and give it to baby to suck as a teat until the meat is white. INFORMATION FOR CONSUMPTIVE PEOPLE AND FOR THOSE LIVING WITH THEM. 1.—Consumption is a preventable disease which is caused by minute living germs, called "tubercle bacilli," which usually enter the body with the air breathed. 2.—The matter which consumptive people cough or spit-up contains the germs of the disease in great numbers. If this matter is spat upon the floors, or the walls of any public or private place, or elsewhere, as soon as it becomes dry the germs of the disease which it contains are blown about and float in the air, like any other minute particles of dust, and are inhaled by anybody breathing that air, or they may fall upon milk or other food, and gain access to the body with that food. These are the commonest ways in which the seeds of the disease enter the body of a healthy person. 3.—It is dangerous to sleep with or to live in close relationship with a consumptive, unless the patient is careful that what he coughs up is destroyed. A pocket bottle or a cup containing ,a little water 40 and disinfectant should be used to spit in, so that the matter may not dry, and it should be emptied in the closet (not into the ashpit, or upon the footwalk or the roadway), and carefully washed afterwards with boiling water. If the consumptive prefers to use soft paper, linen or calico cloths or handkerchiefs to spit in, they should be thrown upon the fire and burnt forthwith. He should take care that his hands, face, and clothing do not become soiled with the matter coughed up. He should never swallow the expectoration : it is dangerous. When coughing he should always cover the mouth with the hand and turn the head aside. 4.—A consumptive should sleep alone; the windows should always be wide open, except when dressing or undressing. The bedclothing and personal clothing should be boiled and washed separately from the clothing of other people. 5.—Tubercle bacilli are not only the cause of ordinary consumption of the lungs, but they may also give rise to consumption of the bowels and other parts of the body, and therefore milk and other uncooked food should be carefully protected from the tubercle bacilli. If such food be kept in a place to which a consumptive patient of careless habits has access and who may spit upon the floor, the dry particles of the matter spat up may blow about with dust and find access to milk and other food, and in this way contaminate it. Mothers who are consumptive should not suckle their children. 6.—Cows suffer from consumption, and the milk from consumptive cows is liable to contain the tubercle bacilli. Milk had better be boiled for a few seconds unless the consumer is sure that it comes from a healthy cow, and that it has not been exposed to danger of contamination afterwards. These precautions should be specially observed in the case of children. 7.—Consumption is a disease from which large numbers of patients recover if the rooms they occupy are always kept thoroughly well ventilated, clean, and free from dust. 8.—Sunshine and fresh air destroy tubercle bacilli, and are the principal curative agents; the more sunshine and fresh air the consumptive patient gets, the more likely he is to recover. 41 g.—Sanitary improvements which have been carried out with a view to admit more pure air and sunshine to dwellings, and to lessen overcrowding, have reduced the mortality from consumption to about one-half of what it was 30 years ago, but, to reduce it still further, the people must help themselves by keeping their rooms clean and well ventilated, and by maintaining strictly temperate habits. 10.—Rooms that have been occupied by consumptives should be thoroughly disinfected and cleansed before they are again occupied, and the carpets and bedding should be disinfected; in fact, so far as these precautions are concerned, consumption may be regarded in precisely the same light as any other infectious disease. 11.—The Sanitary Inspector will undertake the necessary disinfection, both of rooms and of clothing, free of charge. By order of the Council, RASHELL DAVISON, M.D., M.R.C.S., Medical Officer of Health. Midwives Act.—The County Council are the Authority who administer the provisions of this Act in the district. There is only one registered Midwife residing in the district. FOOD. There are twelve Butchers' Shops in the district and three Slaughter-houses, two licensed and one registered. Milk.—The milk supply to the district is obtained from cows in the district and milk either sent by rail into the district or supplied to the retailers by one of the large wholesale purveyors carrying on business in the neighbourhood. The milk sold in the district is of good quality, out of 23 samples taken only one was found not up to standard. Milk and Cream Regulations, 1912.—These Regulations are carried out by the County Council. 42 There are in the district four Fish Shops, two Fried Fish Shops, and nineteen shops where Boiled Ham, Tinned Foods, Brawn, German Sausage, and other cooked edibles are sold, the majority of these shops supplying these articles in small quantities are all visited and kept under observation. During the summer months Ice Cream Shops are also visited, and this is a most important work, especially the inspection of the kitchen and back premises where this cool but suspicious sweetmeat is manufactured. Full details as to the Food Supply and Meat condemned, etc., will be iound in the Sanitary Inspector's Report. Sale of Food and Drug's Acts.—These Acts are carried out by the County Council, but the Sanitary Inspector is also appointed an Inspector under the Act, which is a very useful procedure, as this enables independent samples being taken of any article. Return of Samples analysed during the Year ended 31st December, 1914. Urban District of the Maldens and Coombe. Articles Analysed Adulterated or Deteriorated Prosecutions Convictions Formal Informal Total Formal Informal Total Milk 23 23 3 3 1 1 Butter 10 10 Margarine 1 1 1 1 1 1 Lard 1 1 Spirits 1 1 Total 36 36 4 4 2 2 This return was kindly supplied by the County Medical Officer of Health. 43 Table showing Rainfall in the District during the Year 1914, taken at the Sewage Works, Kingston Road, New Malden. January 0.12 inches rain February 2.18 ,, ,, March 3.71 ,, ,, April 0.80 ,, ,, May 1.23 ,, ,, June 2.64 ,, ,, July 2.10 ,, ,, August 1.71 ,, ,, September 0.90 ,, ,, October 1.29 ,, ,, November 2.95 ,, ,, December 6.58 ,, ,, Total for the 12 months 26.30 inches rain. The particulars for this Table were supplied by the courtesy of the Surveyor's Department. DRAINAGE AND SEWERAGE. The water carriage system is the method of removal of sewage in this district. Every opportunity is taken advantage of for the improvement or amendment of drainage of existing buildings, the whole of which is carried out by the Public Health Department, modern sanitary fittings replacing defective or obsolete ones, and thoroughly modern systems replacing the old ones. Details of drainage works and improvements carried out by the Department will be found in the Sanitary Inspector's Report. SCAVENGING AND CLEANSING. Collection and disposal of all refuse is carried out by the Public Health Department, viz., the collection, removal, and destruction of house and trade refuse. The effective disposal of dry refuse, paper, rags, and other more or less combustible material constitutes one of the greatest difficulties which every sanitary 44 authority has to face. Some 3,289 tons are collected yearly. Much of this might be obviated and expense to the ratepayers reduced if individual householders would burn in their own grates such material as paper, rags, potato peelings, cabbage leaves, and similar substances; few do so, with the result that the average dust-bin contains an objectionable amount of readily decomposing material. OPEN SPACES. Maiden Green.—The provision of seats and the improvement of this open space has not yet been accomplished. Beverley Park.—This recreation ground is being more appreciated by the inhabitants every year. Swings, and other open-air amusements have been provided for the children, and the ground for recreation purposes has improved remarkably with the constant attention now given by the groundsman and boy in attendance. SEWAGE DISPOSAL WORKS. A report on the method of treatment of sewage and work carried out at the Sewage Works during the year by your Surveyor is appended. The Maldens and Coombe Urban District Council. Report on Methods of Sewage Disposal. The sewage from all parts of the District gravitates to the Sewage Works, and is discharged through a 6ft. barrel sewer, into a sump or pump well, situated in the pump house. As described in the Annual Report for 1909, alterations have been made to the sump, which has enabled the sewage to be delivered to the tanks in a more uniform character than was formerly the case. The total dry weather flow of sewage treated at the works is approximately 500,000 gallons per day of 24 hours. The sewage passes over a weir before entering the tanks and the volume is recorded on the measuring apparatus. Owing to the practice which has formerly prevailed of allowing roof water from the rear of houses to enter the soil sewers, the 45 volume of sewage received at the works in wet or stormy weather is greatly increased, over 45,000,000 gallons being recorded for the month of December, 1914, or an average of about 1,500,000 gallons per day, and each year the difficulty of proper disposal is intensified, also a very large amount of ground water enters the sewers. Owing to the rapid growth of the population it has been found necessary to considerably increase the means of sewage disposal. In the Annual Report for 1913 a new scheme for extensions and additions to the purification plant was briefly touched upon. This scheme has been completed and brought into use. The method of treatment is as follows:— The sewage after reception in the sump is lifted by means of a 12in. Tangye centrifugal pump, and 8in. centrifugal pump and two three-throw plunger pumps, of 12m. and 10in. diameters respectively, into the delivery chamber situated immediately on the north side of the Engine House, from whence it flows to two Detritus tanks each about 15ft. square by 15ft. deep. The sludge accumulating in these tanks is lifted by the head of sewage in the tanks to such a level as will permit it to flow by gravitation to the sludge beds. The sewage passes over a weir from the Detritus tanks into three concrete sedimentation tanks, two 108ft. by 31ft. by 8ft. deep, and the third 93ft. by 31ft. by 8ft. deep. The sedimentation tanks are so arranged that they may be used either in series or in parallel, on the intermittent principle. They may be sludged by means of channels which empty into a gin. drain leading to an ejector chamber which will be described hereafter. At the outlet end of the tanks is placed a chamber, constructed so as to pass the tank effluent up to three times the dry weather flow on to the filters, the excess over this amount passing to the storm-water area and storm filters. Percolating Filters. These are six in number, each 80ft. in diameter, fitted with revolving distributors, five being new, the one constructed in 1911 still giving excellent results. The filtering material is of clinker suitably graded, the average depth being about 4ft. 9in. The surrounding walls of the filters are of large lump clinker. Each filter rests on a concrete base and has also a false floor composed of stoneware tiles of special design for drainage and aeration. The 46 filters are fed from two reinforced concrete distributing chambers, which enables the sewage to be properly regulated as desired. To allow for growth of population, power has been obtained to construct two additional filters when necessary, these filters will be 88ft. in diameter. The effluent after treatment by the percolating filters flows through open channels through two Humus tanks constructed of reinforced concrete, the capacity being about 43,000 gallons. The construction of these tanks follows closely on the lines of the Detritus tanks, provision being made for the suspended matters, which are intercepted in their passage through the tanks, to be discharged by the head of water ini the tanks to the sludge drain. New Effluent Outfall Channel. After passing through the Humus tanks the effluent, if desired, may be again treated on the existing Contact Beds, Nos. 1 to 4, or sent direct to the Hogg's Mill River by means of a new high-level channel which delivers the effluent above the level of the water in the river; a great improvement on previous conditions. Storm Water Treatment. The excess of sewage above three times the dry weather flow is dealt with on about four acres of land which has been reclaimed and suitably graded and prepared, also through the existing six contact beds. A new open outlet channel to the first four beds has been constructed, which will enable these beds to properly drain and aerate. The effluent will flow along this channel and through two low level Humus tanks of identical size and construction to the high level Humus tanks and thence over the present irrigation land to the Hogg's Mill River. Sludge Beds and Ejectors. These are 19 in number, each 50ft. by 20ft., and are constructed of clinker 12ins. in depth, graded to three different sizes with underdrains which discharge into a drain leading back to the pump well. The beds are fed from a central open channel 12in. wide with suitable inlets to each bed. The sludge from the Detritus tanks is forced by the hydraulic head of water in the tank 47 through a six-inch pipe to the sludge beds. The sludge accumulating in the remainder of the tanks flows by gravitation to an ejector chamber, and is lifted by means of two 25-gallon ejectors to the sludge beds beforementioned. The washout pipes from the filters, feed pipes to distributing chambers, and high and low level Humus tanks also gravitate to the ejector chamber, and the resultant sludge is lifted to the sludge beds. The sludge is allowed to settle, dried, and is then disposed of locally. Analysis of Effluent. Representative samples of crude sewage, tank effluent, etc., are taken daily by the Sewage Works Manager, and the following records kept at the works: Tables showing monthly summaries and treatment, also monthly averages of analysis. Diagrams showing variations in flow, rainfall, and the strength of sewage. The final effluent under normal conditions shows a high percentage of purification and is very satisfactory. R. H. JEFFES, Assoc.M.Inst.C.E., M.I.M. & C.E. Engineer and Surveyor. Mr. Hunter, your Sanitary Inspector, has since September last, been on military duty with his Division, and consequently his valuable services have not therefore been available. Mr. Jeffes, your Surveyor, has been appointed temporary Sanitary Inspector during his absence, by this means the work of the department has been carried on with its usual efficiency. My best thanks are due to Mr. Elliott, the clerk to the department, who has made himself master of the work, who has always rendered me courteous, cheerful, and valuable assistance, under great difficulties, throughout the year, indeed, the department could not be efficiently carried on without his aid. 48 In conclusion, I should like to express my best thanks to all the members of the Council and officers for their courtesy and consideration throughout the year. I am, Mr. Chairman and Gentlemen, Yours faithfully, RASHELL DAVISON, M.D., M.R.C.S. England. 49 SANITARY INSPECTOR'S REPORT. Sanitary Department, Council Offices, New Malden, January, 1915. To the Maldens and Coombe Urban District Council. I herewith present my seventh Annual Report of the work accomplished in the Sanitary Department, and the sanitary circumstances of the district during the past year. A tabulated summary of the various inspections made and nuisances discovered will be found on pages 56 and 57. Systematic inspection of the district has been carried out in accordance with the General Orders of the Local Government Board, Section 92 of the Public Health Act, 1875, and Section 17 of the Housing, Town Planning, etc., Act, 1909, and the Regulations made thereunder. During the year 113 complaints of nuisances were received, a decrease of 16 below the number received during the previous year. All complaints are immediately investigated, and the necessary steps taken to enforce the proper compliance of the Council's Byelaws and Regulations and to secure the abatement of any nuisance found to exist. The majority of nuisances discovered were remedied upon receipt of informal notices only, but in eleven cases the matter had to be again reported to the Committee, and after approval by the Council legal notices served. I am pleased, however, to again be able to say that in no case have legal proceedings been necessary. Two hundred and thirty-one Sanitary Notices were served, one hundred and ninety-seven of which were complied with, sixteen notices being outstanding at the close of the year, though in most of the sixteen cases the works specified in the notices were in course of procedure on December 31st, 1914. 50 INSPECTION OF DWELLING HOUSES. During the year houses in the following roads, have been inspected, and with satisfactory results:— Coombe. Kingston Hill.—"High wood House" and "Hurst House" Stables. Kingston Vale—No. 3, Robin Hood Cottages. New Maiden. Acacia Grove—Nos.. 64 and 67. Albemarle Gardens—Nos. 17 and 58. Albert Road—No. 16. Beech Grove—Nos. 7, 21 and 22. Blagdon Road—Nos. 51, 118, 146 and 188. Burlington Road—Nos. 10, 12, 18, 24, 38, 44, 73, 86 and 104. Cambridge Road—No. 99. Coombe Road—Nos. 22, 42, 46 and 90. Chestnut Grove—Nos. 11 and 88. Eilm Road—Nos. 30, 59 and 193. Grafton Road—No. 19. George Road—Nos. 24 and 50. Howard Road—No. 43. Kingscote Road—Nos. 19, 21 and 23. Kingston Road—Nos. 4, 43, 132, 145, 147, 173, 191, 193, 195 and 287. Maiden Road;—No. 19, "Coombefield" and "Woodfield." Melrose Gardens—Nos. 11 and 35. Montem Road—Nos. 14, 29 and 49. Nelson Road—"Dalrudah." Penrith Road—No. 8. Queen's Road—Nos. 11 and 20. Rodney Road—"Eyton." Salisbury Road—No. 21. Sycamore Grove—Nos. 17, 19, 31 and 32. Thetford Road—"Thetford Lodge." Wellington Crescent—No. 2, 9 and 41. Westbury Road—"The Den." 51 Old Maiden. Idmiston Road—Nos. 2 and 5. Worcester Park—"Elm Lodge." Proper galvanised iron sanitary dust-bins have been provided where required; the yards at the rear for a reasonable distance paved with impervious material, having a fall to a properly trapped gully connected to the drains, so as to take away all rain and other waste waters from the immediate neighbourhood of the back door and windows, the sanitary fittings, drainage, etc., examined and remedied where defective, not to mention many sanitary improvements inside the houses, such as new sinks, sink waste-pipes, new or repaired floors, and the repair, cleansing, etc., of walls, ceilings, and roofs. In no case was admittance to premises for purposes of inspection refused during the year. I have found in the inspection of cottages and the consequent carrying out of work as many as five and six old papers cm the walls, the result of the owners obtaining a little saving in the cost of properly stripping the walls before papering. This can only be described as a very insanitary and dirty way of carrying out this class of work, moreover it is a practice not confined to the smaller properties only, for it can be found in quite better class houses. It is a great pity this practice was not included as one of the nuisances in the amended nuisances clauses of Part 3 of the Public Health Acts Amendment Act, 1907, for it is quite as important as defective drainage. HOUSING OF THE WORKING CLASSES ACT, 1890. Part 2. (As amended by the Housing, Town Planning, etc., Act, 1909.) Housing, Town Planning, etc., Act, 1909. (Sections 14, 15 and 17 and regulations made thereunder.) Houses inspected under Section 15 19 Houses inspected under Section 17 34 Total 53 52 Houses closed voluntarily by the owner Nil "Obstructive Buildings" within the meaning of Section 38 (2) of the Act of 1890 Nil " Schemes for Reconstruction " by the Authority under Section 39 of the Act of 1890 Nil Estimated number of houses in the district within the limit of rent applicable to the district under Section 14 in Closing Orders issued under Section 17, Subsection (2) Nil Houses inspected under the above Act are examined as to the following matters, namely:— 1.—The arrangements for preventing the contamination of the water supply. 2. —C loset accommodation. 3.—Drainage. 4.—The condition of the dwelling-house in regard to light, the free circulation of air, dampness and cleanliness. 5.—The paving, drainage, and the sanitary conditions of any yard or outhouse, belonging to, or occupied with the dwellinghouse. 6.—The arrangements for the deposit of refuse and ashes. 7.—The existence of any room which would in pursuance of Subsection (7), Section 17, of the Act of 1909. be a dwellinghouse so dangerous or injurious to health as to be unfit for human habitation. 8.—Any defects in other matters which may tend to render the dwelling-house dangerous or injurious to the health of an inhabitant. The implied warranty that houses within the definition of Sections 14 and 15 are reasonably fit for human habitation, only affects houses which have been let to tenants since the passing of the Act, which is certainly not justifiable, as I have inspected cottages which have been occupied by the same tenant for over twenty years, with rooms in them which have never been redecorated and have had the same paper on the walls for over 15 years, but in such cases the property does not come within the definition of Sections 14 and 15. 53 The Act, therefore, seems to put a penalty on the careful and thrifty tenant who occupies the same property for a number of years, and assists the tenant who is always moving into another house. CLOSING ORDER. No Closing Order was served during the year. HOUSES INSPECTED UNDER THE HOUSING, TOWN-PLANNING, etc., ACT, 1909, AND THE REGULATIONS MADE THEREUNDER. Coombe. Coombe Lane—Nos. 1 and 2, Coombe Cottages. Kingston Vale—Nos. 1, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14 and 15, Beverley Cottages. New Maiden. Avenue Terrace—Nos. 1, 2, 3, 4, 5, 6, 7, 8 and 9. Beaconsfield Road—Nos. 30, 32, 34, 36 and 38. Blagdon Road—Nos. 53, 55, 57 and 59. California Road—Nos. 18, 20, 22 and 24. Cambridge Road—Nos. 83, 85, 87 and 89 Grafton Road—Nos. 47, 49, 51 and 53. Kingston Road—Nos. 249, 251 and 253. Lime Grove—"Nursery Cottage" and "Farm Cottage." South Lane—No. 2. Sycamore Grove—No. 2. HOUSE ACCOMMODATION. During the year the following buildings were completed and Certificates of Occupation granted by the Surveyor:— New Maiden— 40 Houses. 4 Additions. — 44 Old Maiden- Nil — Coombe— 3 Houses. — 3 Total 47 54 THE PAVING OF YARDS. During the year 42 yards have been paved in connection with dwelling-houses, in 28 cases the yards being paved in accordance with notices served, the remaining 14 being reinstatements where existing paving was not satisfactory. In most cases the yards were paved from the rear wall of the main building around the back addition to the water-closet or party fence; generally carried out in six inches of Portland Cement Concrete, worked up to a good impervious surface with an efficient fall in every way to a properly trapped gully connected to the drainage system. The use of Portland Cement Concrete is always recommended in preference to the use of tar-paving, as the latter class of work is cheap and unsatisfactory, necessitating constant repairs and renewal, whilst the former makes a sound permanent paving. YARDS PAVED DURING THE YEAR. New Maiden. Acacia Grove—No. 64. Albert Road—No. 16. Avenue Terrace—No. 9. Blagdon Road—No. 133. Burlington Road—No. 38. Cambridge Road—Nos. 85, 87 and 89. Chestnut Grove—No. 11. Cleveland Road—Nos. 56, 58, 60. 62, 70 and 72. Grafton Road—Nos. 19, 37, 39, 43, 51 and 53. Kingston Road—Nos. 251 and 293. Lime Grove—"Farm Cottage." Northcote Road—Nos. 23, 70 and 72. Old Maiden. Idmiston Road—No. 8. WATER SUPPLY. The district is provided with a plentiful supply of excellent water from the mains of the "Southern District" Metropolitan Water Board. 55 During the year thirteen notices of withdrawal of water supply to premises were received from the Metropolitan Water Board, two being for non-payment of rates, seven being in respect of premises "unoccupied," and four for defective service pipe. In nineteen cases houses were found without any cover whatsoever to the water storage cisterns, and notice was served in each case to provide proper close-fitting dust-proof covers. Section 35, Subsection (1), of the Public Health Acts Amendment Act, 1907, now in force in the district, gives power to remedy improperly kept, placed, or constructed water cisterns used for the supply of water for domestic purposes. RIVERS AND STREAMS. Beverley Brook.—No complaint has been received during the year from the Port of London Authority respecting this stream. Hogg's Mill Stream.—No case of pollution or compiaint has been received during the year. Railway Stations.—The Sanitary conveniences at the two railway stations in the district have been periodically inspected during the year. The Street Dust Nuisance.—This troublesome and costly nuisance was again dealt with by the Council, and under the direction of the Surveyor (Mr. R. H. Jeffes), the main roads and a great many of the secondary roads were treated with tar to minimise the dust nuisance as much as possible. The Smoke Nuisance.—(Public Health Act, 1875, Section 91, Subsection (7)).—Very little cause for complaint has arisen during the year, only one chimney being the subject of complaint. In the one factory chimney complained of (laundry vertical boiler) the cause of complaint was due to neglect in stoking; the fireman going away from the boiler on other little jobs and neglecting his fire, which, with vertical boilers, is disastrous, for this type of boiler requires constant attention, and from a smoke prevention point of view is most difficult to obtain a fairly steady head of steam, consequently this means constant clinkering and firing, therefore the risk of causing black smoke is greater. 56 The only practicable material for combustion with verticil boilers is coke and anthracite coal. Sanitary Accommodation.— The cleansing of the urinals at certain of the licensed premises (an arrangement commenced in 1910) is a great advantage to the district. The systematic cleansing of these urinals twice in each week obviates much trouble and nuisance, and at a very small cost, is a great convenience to the public. The following is a tabulated summary of the inspections made and nuisances discovered during the year ending December 31st, 1914. nature of cases dealt with. NO. Notifications of Infectious Disease 290 Visits to Houses where Zymotic Diseases have occurred 325 Houses Disinfected 147 Lots of Clothing and Bedding Disinfected 21 Inspections of Houses 145 „ ,, Houses let in Lodgings — ,, ,, Factories 15 ,, Workshops and Workrooms 11 ,, „ Outworkers' Premises 1 ,, Bakehouses 11 ,, ,, Cowsheds 32 ., „ Dairies and Milkshops 33 ,, „ Slaughterhouses 80 ,, „ Butchers and Fishmongers 312 ,, „ Other Shops 27 ,, ,, Schools 35 ,, ,, Yards and Stables 192 „ „ Urinals 82 Sundry Inspections 1022 Re-inspections of Work in progress 1583 Complaints Received and Investigated 113 Smoke Observations 6 Lots of Food Condemned ana Destroyed 7 Drains Tested 309 Drains Re-laid 143 Drains Repaired 27 Tons of Refuse removed (approx.) 3289 57 NUISANCES DISCOVERED. NO. Premises requiring Repair 63 ,, ,, Cleansing and Whitewashing 33 ,, Overcrowded — Drains found Defective 168 ,, ,, Stopped 106 Defective Sanitary Fittings 288 ,, Yard Surfaces 45 ,, Eaves and Downspouts 45 ,, Manure Receptacles 2 ,, Urinals 3 ,, Ashbins 31 ,, Waterfittings 32 Smoke Nuisances 1 Animals improperly kept — Offensive Accumulations 33 Sundry other Nuisances 87 Total Number of Nuisances 937 Informal Notices Served 231 Informal Notices Complied with 197 In Abeyance 16 Referred to Committee 11 DRAINAGE AND SEWERAGE. Combined Drains. Combined drains have been dealt with on the following properties:— New Maiden. Cleveland Road, Nos. 70 and 72, premises entirely redrained, contribution by the Council. Grafton Road, Nos. 35 to 53 (partly relaid) a contribution made by the Council. Drainage. During the year 309 drains were tested, 168 were found defective, 143 drains were relaid, and 27 drains were repaired. In two cases it was necessary to provide new connections to the Council's soil sewer. 58 Complete Re-drainage Work was carried out, necessitating entirely new drainage systems, on the following properties:— New Maiden. Burlington Road—No. 38. Cambridge Road—No. 89. Coombe Road—No. 46. Cleveland Road—Nos. 60, 62, 70 and 72. Grafton Road—Nos. 51 and 53. Northcote Road—Nos. 4, 10 and 23. Partial Re-drainage Works were carried out on the following properties:— New Maiden. Acacia Grove—Nos. 64 and 67. Elm Road—No. 30. Kingston Road—No. 132. Montem Road—No. 14. Rodney Road—"Eyton." Old Maiden. Maiden Road—"Woodfield." Repairs to Drainage Systems were carried out on the following properties:— Albemarle Gardens—No. 17. Beech Grove—Nos. 7 and 21. Beaconsfield Road—Nos. 30, 32, 34, 36 and 38. Blagdon Road—Nos. 118 and 146. Burlington Road—Nos. 12 and 86. Cleveland Road—Nos. 58 and 64. Elm Road—Nos. 59 and 193. George Road—No. 24. Grafton Road—No. 49. Howard Road—No. 43. Kingston Road—No. 147. Kingscote Road—Nos. 19, 20 and 23 Montem Road—No. 29. Northcote Road—Nos. 70 and 72. Queen's Road—No. 20. Salisbury Road—No. 21. Wellington Crescent—No. 2 59 SECTION 41 PUBLIC HEALTH ACT, 1875. In ten cases notices were served under this section of intention to open the ground and examine the drains. In house to house inspections, upon complaint, or in cases of illness in the house and the drainage is suspected, the smoke test is applied smoke machine under pressure. All drains, however, upon being reliaid or in any way repaired, are required to be laid upon a bed of good Portland cement concrete at least four inches in thickness, with an efficient fall, the joints made watertight with Portland cement, wiped out inside carefully to remove any excess of cement, the drain packed up with concrete to half the vertical height of the pipes, and tested with the hydraulic or water test with a head of at least two feet of water. A general sanitary survey of all fittings, etc., including the testing of drains, is carried out in all cases of diphtheria, scarlet fever, or typhoid fever occurring in the district, and the proper notices served to remedy any defects found. Owing to the clay formation of the ground, especially in the New Maiden district, it would be much wiser on the part of owners if upon reconstruction the use of iron pipes and caulked lead joints was more general in practice in place of stoneware pipes. The difference in cost is not great, and the assurance against further trouble would more than justify the small extra initial outlay. Drainage Byelaws.—I am pleased to say that the bytlaws with respect to the drainage of existing buildings and with respect to the water-closets, earth-closets, privies, ashpits, and cesspools in connec tion with existing buildings have again been of great assistance during the year, especially with regard to the "giving of notice" previous to work being commenced. Van Dwellings.—The one caravan reported last year as stationed in Messrs. Thomas's Yard, Dunbar Road, New Maiden, has now removed from the district. Wlortuary.—(Public Health Act, 1875, Sections 141, 142 and 143).—During the year ten bodies were admitted to the mortuary and in each case post-mortem examinations were carried out. 60 SCHOOLS. The sanitary accommodation at all the schools in the district is periodically inspected to ensure an efficient state of cleanliness at all times. There are six Public Elementary Schools and six Private Schools (including Maiden College) in the district. INFECTIOUS DISEASES. During the year 291 cases of infectious disease were notified, necessitating 325 visits to the houses (apart from subsequent inspections of premises). One hundred rand forty premises were disinfected and also one hundred and forty-seven lots of clothing, bedding, etc. Disinfection. Diphtheria 23 Scarlet Fever 56 Measles 40 Consumption 7 Verminous conditions 10 Cancer 1 Pneumonia 1 Deaths 2 Total 140 SLAUGHTER-HOUSES. There are three slaughter-houses in the district, one registered and two licensed, viz.:— (1) Rear of 1, Park Terrace, Worcester Park. (2) Rear of Maiden Road, New Maiden. (3) At Norbiton Common Farm, Kingston Road, New Maiden. During the year 81 inspections of meat in slaughter-houses were made. The tables given under Food Supply give the details of these very necessary inspections, with particulars of meat condemned as unfit for food of man. 61 The lime-washing of these slaughter-houses has on all occasions been carried out as required, but the structure and the position of the premises are certainly not ideal, although the occupiers endeavour to make the best of matters and conduct the premises in as sanitary a manner as possible. No. 2 slaughter-house has been used very little indeed. All animals slaughtered at the Norbiton Common Farm slaughter-house have again been inspected, the Superintendent continuing to give notice of slaughter. OFFENSIVE TRADES. Section 112 Public Health Act, 1875 (35 and 39 Vict., cap. 55). The following "Offensive Trades" are registered in the district:— Trade. Situation of Premises. Name of Proprietor. Fat Melter Thomas's Yard, Dunbar Road, New Maiden. Messrs. Baker & Co. Dealer in Rags and Bones 227, Kingston Road, New Maiden. Messrs. A. Hazell & Son Fish Frier 4, Grafton Road, New Maiden. Mr. G. Hay. Fish Frier 41, Northcote Road, New Maiden. Mr. R. Osmond. Fish Frier 87, Burlington Road, New Maiden. Mr. R. P. Cheek. Horse Slaughterer.— One person is registered as a slaughterer of horses, but there is no registered knacker's yard or business of a knacker in the district. FOOD SUPPLY. During the year frequent inspections have been made of the various shops and premises in the district where articles of food, meat, fish, etc., are sold, or prepared for sale, or deposited temporarily, but intended to be sold. 62 The following is a table of the premises and inspections made:— Nature of Premises. No. of Inspections. Slaughter-houses 86 Butcher's Shops 261 Fishmongers 50 Bakehouses 17 Cowkeepers 32 Dairies and Milkshops 33 Hawkers of Food 33 Total 512 The following is a statement of food destroyed as unfit for the food of man:— Public Health Act, 1875, and Public Health Acts Amendment Act, 1890. Description. Weights in lbs. Beef Mutton — Pork 46¼ Oflal 6¾ Fish 68 Other Articles 96½ Total 217½ FACTORY AND WORKSHOPS ACTS. Factories.—with the exception of that part of the law dealing with sanitary accommodation and conveniences, the legislation regarding factories is administered by the Home Office. There are 10 F actories on the register. One notice was served during the year. Workshops.—There are now 49 workshops and 11 workplaces on the register. 63 One notice was served for matters requiring attention in connection with a workplace. The following is a table of the various workshops and the trades carried on therein:— Workshops on Register and Trades carried on therein. Trade. No. of Workshops. Bakehouses 7 Laundries 2 Plumbers and Glaizers 3 Boot, Shoe, and Leather 10 Dressmakers, Milliners, Tailoring, and Underclothing 15 Blacksmiths, Wheelwrights, etc. 3 Cycle Works, Motors, and Carpenters 7 Sundry other Workshops 2 Workplaces 11 Total 60 The following is a tabulated summary of all the various matters requiring attention and notices served:— Matters requiring Attention. Factories. Work, shops. Workplaces. Homeworkers Bakehouses. Laundries. Total. Infectious Disease occurring — — — - - — — Premises requiring Ventilation - - - - - - - Cleansing and Limewashing 1 1 1 — — — 3 Insufficient Sanitary Accommodation - - - - - - — Defective Drainage - - - - - - - Paving of Yards or Floors - - - - - - - Sundry Nuisances 2 — — — 1 — 3 Total 3 1 1 — 1 — 6 All defects found were remedied during the year. One case of failure to affix Abstract of the Factory and Workshop Acts (Section 133), 1901, was notified to H.M. Inspector of Factories. 64 Bakehouses.— Six bakehouses are now on the register, all of which have been inspected at intervals during the year. There is no underground bakehouse in the district. A circular letter was sent in each case, twice in the year (during March and August), to remind the occupiers of bakehouses of their obligations respecting the cleansing and limewashing of such premises. There has been no necessity to serve a sanitary notice to carry out such work. HOME WORK. Four home-workers were notified during the year in this district. Seven home-workers residing in the district were notified to this Council by other Local Authorities. SERVANTS' REGISTRIES. (Public Health Acts Amendment Act, 1907, Section 85.) Eight persons are registered under the above Act as carrying on the business of keeper of a female domestic servants' registry. MARINE STORE AND DEALERS IN OLD METAL. (Public Health Acts Amendment Act, 1907, Section 86.) Three persons are registered under the Act as carrying on the business of a dealer in old metal or as a marine store dealer. DAIRIES, COWSHEDS, AND MILKSHOPS ORDERS. There are now 67 names on the register; only 40 of the persons registered are, however, now carrying on business in the district, viz.:— Cowkeepers 10 Dairymen 6 Milkshops 2 Purveyors of Milk (residing in the district) 3 Purveyors of milk (residing outside the district, but carrying on trade in the district) 19 Total 40 65 The number of milch cows, in the district at the close of the year was 113, a decrease of 30 upon the number of last year. Two persons have been registered during the year, both as purveyors of milk in this district. The improved condition of the dairy cows reported at the close of 1913 has been maintained during the past year. During the year bills were posted in various parts of the district calling the attention of persons interested, to the requisition of the above Orders with regard to registration, and the penalty if found carrying on these trades without registration. The power provided under the Public Health Acts Amendment Act, 1907, requiring dairymen to furnish lists of the sources of their supply was not enforced during the year. The following works have been requested to be carried out with respect to premises used by registered persons:— Dairies. Milkshops. Cowsheds. Totals. Paving of Yards and Premises 2 — — 2 Cleansing and Limewashing 1 - 1 2 Alteration to Premises — - - — Defective Drainage - — — — Sundry other Nuisances — — — — Total 4 CLEANSING DEPARTMENT. The Collection and Disposal of Refuse. During the year approximately 3,289 tons of refuse was collected. During the year 30 galvainised-iron sanitary dust-bins have been provided in place of defective ones. It is the general practice for the dustmen to report any premises without a proper receptacle for refuse, when the matter is investigated and the proper notice served. Disinfectant powder is carried on all the dust carts for use if necessary after the refuse receptacles have been emptied of their 66 contents. Neglected dust-bins very soon become most offensive and a nuisance, generally close to the back doors of premises. If only occupiers of premises would take a little interest in such matters and have the dust-bins thoroughly washed out and put to dry occasionally, a great deal of the cause of complaint would be removed. Trade refuse (with the exception of offal or obnoxious refuse from fishmongers, poulterers, butchers, etc.) is now collected at a small charge, as is also garden, builders', etc., refuse, and I have found this provision very useful in obtaining the removal of accumulations. The amount of refuse collected has greatly increased much more so than the number of additional houses or increased population can account for. In concluding this report, I have to acknowledge, with very many thanks, the very great help rendered me by Mr. 0. Elliott, the assistant in the department. Owing to the present great war, when mobilisation occurred, I had to rely upon Mr. Elliott in a far greater measure than ever I anticipated might be the case, and since the middle of September, 1914, when my military duties prevented me rendering but little assistance to the work entailed in the department, Mr. Elliott has put his every endeavour in rendering constant and devoted attention to his work, and I am happy to say he has done so with great credit to both the Council and himself. I would like to express my sincere thanks to the Council, the Public Health Committee, and in particular the Chairman of the Committee, A. Woollacott, Esq., and all my brother officials of the Council for their devoted support during the past year, and especially so in the trying time since mobilisation occurred, and trust that this great war may have a speedy and satisfactory termination, and that I may be spared to resume my duties so happily discharged during the seven years I have been in your service. I have the honour to be, Gentlemen, Vour obedient Servant, HARRY HUNTER, Captain.