THE SANITARY CHRONICLES OF THE PARISH of ST. MARYLEBONE; BEING THE ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH, FOR THE YEAR 1893, BY ALEXANDER WYNTER BLYTH, Medical Officer of Health, and Analyst of Food and Drugs, for the Parish of St. Marylebone. Barrister-at-Law of Lincoln's Inn; Fellow of the Institute of Chemistry; &c. &c. VOL. XIII. LONDON: Printed by George Pulman & Sons, Princes Street, THE SANITARY CHRONICLES OF THE PARISH OF ST. MARYLEBONE; BEING THE ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH, FOR THE YEAR 1893, BY ALEXANDER WYNTER BLYTH, Medical Officer of Health, and Analyst of Food and Drugs, for the Parish of St. Marylebone. Barrister-at-Law of Lincoln's Inn; Fellow of the Institute of Chemistry; &c. &c. VOL. XIII. LONDON: Printed by George Pulman & Sons, 24 & 25 Thayer Street and 5, Princes Street, W CONTENTS. page Meteorology 7-8 Population of St. Marylebone 9 Births and Deaths 9 Death-rates 9 Small-pox, 1893 12 Scarlet Fever, 1893, and Hospital Accommodation 13 Prosecutions under the Public Health Act 21 Housing of the Working Classes Act 22 The Laboratory—Sale of Food and Drugs Acts 22 Water and Gas 23 The Mortuary 33 Appendix 25 PREFACE. The present Report of the Sanitary administration of the Parish of St. Marylebone, during 1893, is on the same plan as the Reports of previous years. Its object is to give a summary of all really important matters affecting the Public Health, and to faithfully record the work done by the Sanitary Staff in 1893. Much necessarily consists of tabular matter, uninteresting to the casual reader, but this dry detail is essential, and experience has amply demonstrated its utility. The Court House, April, 1894. A REPORT of the METEOROLOGY, MORTALITY, AND SICKNESS of the PARISH OF SAINT MARYLEBONE FOR THE TEAR 1893. By A. WYNTER BLYTH. METEOROLOGICAL SUMMARY. March Quarter. January was a bitterly cold, gloomy month. Four out of the five weeks were frosty, the temperature falling as low as 14°, and the mean for the whole month being only 32°.8. On 9 days, snow or sleet fell, and there were also 8 days of cold rain, the total rainfall measuring 2.26 inches. February was a month of much rain, but of moderate temperature. Rain fell on 21 out of 28 days, the amount collected measuring 2.39 inches. March was an unusually fine month. Rain fell on only 10 days (1.31 inch). During three out of the four weeks, there was bright sunshine nearly every day. Cold winds were for the most part absent. Mean temperature 46°.5. June Quarter. During the five weeks of April, there was almost uninterrupted sunshine. The rainfall was insignificant (.07 inch). The mean temperature was 46°.5. 8 May was almost as bright and sunny. Rain fell on only six days (0.50 inch). The temperature rose on several days to over 70° and attained a maximum of 76°.0, while the mean temperature of the month was 59°.8. The month of June was dry, bright, and warm. Showers of rain fell on only five days (.23 inch). The temperature rose as high as 85°.8 and the mean was 62°.5. September Quarter. July was a somewhat rainy month, rain falling on 17 days and the rainfall measuring 177 inch. There was a fair amount of sunshine : maximum temperature 81°.8, mean 63°.9. August was warm and bright. On 11 days rain fell, the rainfall measuring 1.77 inch. The mean temperature was 68°.0, and the highest temperature recorded 82.0. September was generally dry and fine. On 9 days only was there any rain, and the total rainfall was under 1 inch (0.77 inch). The mean temperature was 60°.4; the maximum 80°.5. December Quarter. October was a showery month: 2.58 inches of rain fell in 19 days. The mean temperature was 53°.7. There was a fair amount of sunshine, and the maximum temperature was 58°.7. November was almost free from fog. On 12 days rain fell (1.45 inch). There were slight frosts': the minimum temperature was 29o.0; the maximum 49°.5, and the mean 42°.4. December was stormy and cool. On 12 days 275 inches of rain fell. Frosts were frequent, the temperature sinking as low as 20°: the maximum was 50° and the mean 42°.6 S.W. winds prevailed and sunshine was deficient. 9 POPULATION OF ST. MARYLEBONE. According to the Census of 1891, with Age and Sex distribution:— Males. Females. Under 5 6,586 6,704 5—10 5,814 6,066 10—15 5,332 5,790 15—20 6,098 7,744 20—25 6,912 9,992 25—35 11,137 15,951 35—45 8,347 10,805 45—55 5,951 7,737 55—65 3,583 5,070 65—75 1,946 2,936 75 and upwards 666 1,237 62,372 80,032 142,404 BIRTHS AND DEATHS. The number of births registered during the 52 weeks ending December 25th, 1893, when all essential corrections had been made, was 3,552. • The number of deaths of parishioners was 3,156. This gives a birth-rate of 24.9; a death-rate of 22.2 per thousand. Calculated in the same way. the birth and death-rates for 1893 in the sub-districts were as follows:— All Souls birth-rate 20.6; death-rate 18.9 Rectory „ 27.6; „ 23.6 St. Mary ,, 26.2; „ 21.8 Christ Church „ 26.7; „ 25.3 St. John „ 25.7; „ 21.8 All these death-rates require a large correction, and are certainly higher than the truth. There is no more difficult place in the kingdom in which to get a correct 10 death-rate than St. Marylebone: a large majority of the sick poor, all the insane, and most of those suffering from infectious fevers are treated in institutions outside the parochial boundary. In 1893 the extra-parochial deaths were 812 in number, but in some other years they have been 1,000; if therefore only the deaths taking place within the parish, of parishioners, be used for calculating the rate, the result is far too low: thus for 1893 the death-rate would be 16.4; on the other hand, by including the extra-parochial deaths, the rate is higher than the truth, because the corresponding sick population has been left out of the calculation. An estimate of the sick extra-parochial population belonging to St. Marylebone is possible by calculations based on the following data: (1) Census of the hospital population, (2) number of patients treated in 1893, (3) death-rate of the particular hospitals. I have attempted this calculation, and the following is the result:— Probable average number of parishioners under treatment in extra-parochial hospitals, &c., in the middle of 1893. St. Marylebone Infirmary, Notting Hill 813 Asylums 205 General Hospitals 1,726 Fever Hospitals 60 • 2,804 If this 2,800 is added to the census population, then the death-rate becomes 21.7; even now it is probably too high, for at the time of taking the census there were local circumstances at work which tended to make the figures less reliable than usual, and there is little doubt that the population then was somewhat under-enumerated. At all events it is fairly certain that the 1891 population is greater than that of 1891. There are various data on which the increase might be estimated, but calculated populations experience has shown to be so fallacious and so wide of the mark that it is of little use to follow this matter farther. In any case, 1893 was an unusual year, both as to sickness and mortality. 11 Extra-Parochial Deaths. The following is a list of extra-parochial deaths:— St. Marylebone Infirmary, Notting Hill 453 North-Western Fever Hospital 55 Western Fever Hospital 14 South-Western Fever Hospital 1 North-Eastern Fever Hospital 1 Northern Fever Hospital 2 Hospital Ship "Atlas" 3 Hospital Ship "Castalia" 2 London Fever Hospital 1 Children's Hospital, Great Ormond Street 2 St. Mary's Hospital 78 University College Hospital 29 King's College Hospital 7 Westminster Hospital 2 Charing Cross Hospital 8 St. Thomas's Hospital 5 Great Northern Hospital 3 St. George's Hospital 14 Royal Free Hospital 3 Brompton Consumption Hospital 4 Cancer Hospital 3 Royal Hospital, Wandsworth 1 St. Bartholomew's Hospital 4 West London Hospital 2 North-West London Hospital 4 Leavesden Asylum 18 Colney Hatch Asylum 18 Hanwell Asylum 17 Banstead Asylum 4 Grove Hill Asylum 1 Ilford Asylum 3 Darenth Asylum 2 Wandsworth Asylum 1 Bethnal House Asylum 2 Cane Hill Asylum 5 Hoxton House Asylum 4 Camberwell House Asylum 3 Central London Sick Asylum 1 St. Elizabeth's Home, Kennington 3 St. Peter's Home 2 St. Camillo's Home 1 Friedenheim 3 North London Consumption Hospital 2 London Temperance Hospital 2 Islington Infirmary 1 British Lying-in Hospital 1 St. Pancras Workhouse 2 Carried forward 797 12 Brought forward 797 Hospital for Women 2 General Lying-in Hospital 1 German Hospital 2 French Hospital 1 St. Pelagias Creche 1 Paddington Infirmary 4 Paddington Workhouse 1 Butchers' Almshouses 1 Victoria Hospital 1 Homoeopathic Hospital 1 812 SMALLPOX, 1893. Smallpox has a very distinct seasonal prevalence: as a rule it increases up to May and then declines: the cases notified in St. Marylebone in January, February, March, and April, were as follows, 10, 4, 19, 35, all above the average; hence there was some reason to apprehend that it might increase in the month of May to a considerable number. The maximum was attained in May, viz.: 53 cases, but the June number showed a decrease (17) and by October only one case was reported. In nearly every instance the cases were promptly removed to hospital, and in every case efficient and speedy disinfection was performed; in addition to this Mr. Greenwood, the public vaccinator, visited each infected household and re-vaccinated all those who desired to be re-vaccinated. Without a doubt these means in combination materially assisted in controlling and arresting the spread. The total number of cases notified throughout the year was 162; a considerable percentage of these cases occurred in connection with the Salvation-Army and other shelters. 13 SCARLET FEVER, 1893, AND HOSPITAL ACCOMMODATION. Early in May, 1893, it was evident that the admissions of scarlet fever patients into the Asylums Board Hospitals had been, from January of the same year, almost double the number admitted in 1892, as shown by the following return submitted to the Sanitary Committee at their meeting, May 17th:— Table showing the admissions of Scarlet Fever patients into the Board's Hospitals, during the first 19 weeks of each of the years, 1892 and 1893. 1892. 1893. Week ended. Admissions. Week ended. Admissions. January 9 100 January 7 193 „ 16 87 „ 14 229 „ 23 104 „ 21 228 „ 30 91 „ 28 242 February 5 94 February 4 240 „ 13 110 „ 11 242 „ 20 77 „ 18 206 „ 27 75 „ 25 166 March 5 87 March 4 194 „ 12 109 „ 11 180 „ 19 140 „ 18 168 „ 26 122 „ 25 211 April 2 131 April 1 226 „ 9 157 „ 8 182 „ 16 140 „ 15 189 „ 26 208 „ 22 258 „ 30 174 „ 29 248 May 7 189 May 6 264 „ 14 211 „ 13 335 2,406 4,201 With this increase of fever there was at the same time a decrease of accommodation; for, although the Board opened the Tottenham hospital in 1892, the year 1893 began with 1,179 beds less than in 1892, the main cause of the decrease being the use of Gore Farm for smallpox cases, 14 The Sanitary Committee resolved to recommend the Vestry to empower the Committee to take such steps as in case of emergency they might deem necessary. This Report was adopted by the Vestry. At a meeting of the Sanitary Committee, June 2nd, 1893, a letter was read from the Clerk to the Asylums Board to the effect that the available accommodation for scarlet fever cases and for diphtheria was nearly exhausted, and it was resolved:— "That the Committee do take suitable premises and furnish the same for the purpose of isolating cases of scarlet fever and diphtheria in the parish, and that the Chairman, Mr. Stokes, and the Medical Officer of Health be deputed to carry out the undertaking." Subsequently Mr. Hopkins, Dr. O'Brien, and Mr. Soames were added, and the Sub-committee as thus constituted, from that date onwards, under the chairmanship of Mr. Hopkins, managed the affairs of the Hospital. The original small Committee of three interviewed most of the house agents in the N.W. of London and examined and negotiated respecting a considerable number of premises which seemed to be more or less suitable. Ultimately Lord Portman, through Mr. Hunt, placed Nos. 55 & 57, Marylebone Road, free of cost, at the disposal of the Vestry. The letter conveying this intimation is couched in the following terms:— The Portman Estate, 30, York Place, Portman Square, June 16th, 1893. Dear Sir, Referring to our recent correspondence, I am instructed by Lord Portman, in reply to your letter of the 15th, to inform you that, recognising the public necessity of temporary hospital accommodation in the present crisis, he is willing to allow the Vestry to make temporary use of the premises, Nos. 55 and 57, Marylebone Road, for the purpose of fever cases, other than smallpox, from this parish. Lord Portman is of opinion 15 that the tenancy should be one at will, free of rent, but subject to a week's notice in case of necessity; but I need hardly say that Lord Portman will not exercise this right arbitrarily. On hearing from you that this arrangement is satisfactory to the Vestry, you can have the keys. I am, dear Sir, Yours faithfully, FREDK. W. HUNT. Dr. A. W. Blyth, Medical Officer of Health, Court House, Marylebone Lane, W. Your Medical Officer of Health, with the sanction of the Committee, immediately set to work to put the premises in a suitable state of repair and to adapt them for use as a Hospital. The two houses were made into one, by inserting doors in the party walls of every floor, baths were fixed, supplied with hot and cold water, suitable cooking arrangements were provided, the whole of the rooms cleansed thoroughly, whitewashed, and various minor alterations made. A Matron and Nurses were also engaged; bedsteads, bedding, cooking appliances, were purchased, and a portion of the Hospital was actuallv ready by the 24th of June, and on that day 7 patients were received. The accommodation was at first limited to 18 beds and 32 cots, that is, 50 in all. The cases, however, rapidly overtook the accommodation, and on July 3rd your Medical Officer of Health reported that more accommodation was urgently required, especially for the convalescent patients. On the 14th of June, the Hospital was extended by the occupation of 2 more houses, viz., 59 and 61; these were made to communicate with each other and with Nos. 55 and 57 by doors made in the party walls, and the necessary repairs and cleansing rapidly executed; the drainage was also put in order. This raised the accommodation to 100 beds. Ultimately, owing to an outbreak of measles, it became absolutely necessary to still farther enlarge the premises, and No. 63 was, by permission of Mr. Hunt, added. In this house, five beds for cases of measles were provided. 16 No. 63, for obvious reasons, was kept detached, and communication was only effected through the backyards of Nos. 61 and 63. The Hospital, as finally established, consisted therefore of five houses, four of which were by simple structural alterations converted into one, and the fifth was used for the purpose of isolating cases of measles. The five houses are on the south side of the Marylebone Road; they have long forecourts, standing back about 50 feet, and in the rear, parallel to the houses, is Great York Mews; from the back of the houses to Great York Mews is a space 92 feet deep, the five houses themselves occupy a space of 15,300 square feet, and the area of ground, back and front, is no less than 9.000 square feet, in all 24,300 square feet; on both sides, east and west, the premises joined houses that were empty. The houses are three stories high, and have attics in the roof, making practically a fourth story. No. 55 also has an extra story containing a couple of attics. A careful plan has been drawn out by Mr. Kilgallin, and deposited in the office, from which it may be seen how the accommodation was utilised and the way in which the four houses were converted into one. The wards actually occupied by patients were as follows:— On ground floor, 5 wards, cubic capacity 12,727 feet. First floor, 9 wards „ „ 14,610 „ Second floor, 10 wards „ ,, 89,490 „ Third floor, 6 wards „ „ 11,346 „ 128,173 feet. All these wards were well ventilated: the numerous doors of communication, and the facilities afforded by opening windows front and back, always kept them sweet and wholesome. The weather was most of the time also most favourable for allowing plenty of air into the rooms, Scarlet Fever, 1893. Diphtheria, 1893. 17 Had the amount of cubic space been uniformly distributed, each patient would have had about 1,000 cubic feet, which, for a temporary hospital, would have been a fair space, but, owing to the necessity of classification, some of the patients had a great deal more than this, others less. Drainage.—Considerable expense had to be incurred in altering and adapting the drains; the surface water from the front areas, and also the drainage of Nos. 55 and 57, was carried into the sewer in York Place, while the drainage of Nos. 59, 61, and 63, was carried into Great York Mews. A great portion of this had to be entirely reconstructed, and a disconnecting chamber was built. With the exception of a short piece of drain underneath the scullery of No. 55, the whole of the drainage was outside the premises. Officers.—Your Medical Officer of Health was ap pointed Superintendent, and had the general supervision of the staff, undertook the payment of the nurses and tradespeople, and was responsible both for the admission and discharge of the patients. Frank Richardson Blaxall, M.D.(Lond.), L.R.C.P., M.R.C.S., who had occupied the post of Obstetric Assistant and House Physician, University College, and also had been Assistant Medical Superintendent of St. Pancras Infirmary, was appointed Medical Officer, on the condition that he should reside as close as possible to the Hospital and devote his whole time to the duties. Dr. Richard Sisley, M.D.(Lond.), M.R.C.P., of 17, York Street, was appointed Honorary Physician. Miss A. Rees, a Certificated Nurse of great and varied experience, was appointed Matron. Besides these chief officers, there were charge nurses and assistant nurses, and ward maids, a porter, a cook, laundresses, and servants. The numbers of the nurses varied from week to week, according to the number of patients. 18 The Hospital Committee consider themselves fortunate in the officers and staff generally, particularly as the rapidity with which appointments had to be made precluded minute enquiries as to antecedents. As might be expected, there were a few exceptions, e.g., one nurse was dismissed for theft, another for general bad behaviour, and a porter for drunkenness; but with these exceptions the staff worked harmoniously and well. Number of Patients Treated.—There were treated in the Hospital, from first to last, 280 cases of scarlet fever, and 9 cases of diphtheria. The number of cases actually in the Hospital, at successive dates, was as follows:— July 3 26 „ 16 39 „ 24 74 „ 27 84 „ 31 94 Aug. 9 96 „ 15 92 „ 23 80 „ 30 76 Sept. 6 75 „ 13 88 „ 20 89 Sept, 27 100 Oct. 4 104 „ 11 109 „ 18 125 „ 25 105 Nov. 1 108 „ 8 86 „ 15 67 „ 22 40 Dec. 6 12 „ 20 0 Mortality.—Two deaths from diphtheria and 23 from either scarlet fever or from measles after scarlet fever occurred. The crude mortality of a Scarlet Fever Hospital affords but little information, unless the mortality is worked out for each sex and for various age periods. The mortality of male babies under one year of age from scarlet fever, is, for example, about 27 per cent. of those attacked; the mortality of female babies under one year of age is 36 per cent. of those attacked. The mortality from scarlet fever of adults from 20 to 25 is about 3 per cent. of those attacked. It is therefore obvious that if it were possible to imagine two hospitals under similar conditions, the one taking only very young children attacked with scarlet fever and the other only taking adults, in the one Hospital the mortality would be 19 30 per cent., in the other only 3 per cent.; and yet the mortality of 3 for the one and 30 for the other would be normal, and would show neither exceptional severity nor exceptional mildness of the disease, nor could it be maintained that the 30 per cent. mortality showed bad administration. By the aid of the standard rates of mortality, deduced from no less than 55,000 cases treated at the Asylum Board Hospitals, it is practicable to correct the deaths from scarlet fever in the St. Marylebone Temporary Hospital for the disturbing influence of age and sex, and to ascertain how many would have died had the Asylum Board mortality been exactly followed in the St. Marylebone Temporary Hospital. I have done this in the annexed table, from which it appears that if the mortality had been precisely that of the Asylum Board, the number of deaths would have been 22.4, and they were as before stated 23. It is therefore clear that, notwithstanding the unfortunate outbreak of measles, the number of deaths was precisely what might have been on a priori grounds from experience expected, neither more nor less. Scarlet Fever Admitted. Standard Mortality as Board Hospitals. (55,204 cases 1871—1892). Theoretical number of Deaths. Actual Deaths. M. F. M. F. M. F. M. F. Under 1 2 2 26.6 36.1 0.5 0.7 1 1—2 4 3 28.0 28.8 1.1 0.9 3 1 2—3 9 8 22.4 22.9 2.0 1.8 5 1 3—4 13 8 17.9 15.4 2.3 1.2 1 4—5 15 11 11.6 10.9 1.7 1.2 1 5—10 52 49 6.4 5.7 3.3 2.7 1 6 10—15 32 29 2.9 2.8 0.9 0.8 2 15—20 19 9 3.6 2.4 0.7 0.2 20—25 4 3 2.7 3.0 0.1 0.1 1 25—30 3 4 4.9 3.2 0.1 0.1 30—35 1 4.8 5.5 153 17 12.7 9.7 12 11 280 22.4 23 20 Illness of Members of the Staff.—Charge-nurse Firth, Assistant-nurse Barker, and Ward-maid Emery, all suffered at different dates from scarlet fever, probably contracted in the exercise of their duties. Charge-nurse Wilson also contracted diphtheria and was removed to one of the Asylum Board Hospitals. Dr. Blaxall was incapacitated for duty from an illness for about 10 days, and the Medical Officer of Health during that time undertook both the duties of Superintendent and resident Medical Officer. With these exceptions the health of the staff was uniformly good. Religious Services in the Hospital.—The chairman (Mr. Hopkins) thought that as there were so many patients there should be opportunities afforded to any of them, should they so desire it, of the religious services of ministers of the denomination they belonged to. Accordingly an enquiry was made of the patients as to the place of worship they or their parents usually attended; the majority were found to belong to the Church of England, a few were Roman Catholics, and a few Nonconformists. Canon Leigh volunteered to attend regularly at the Hospital and did so for a short time, but the Committee of an Institution to which Canon Leigh was at that time chaplain, strongly objected, on the ground that infection might be conveyed to that establishment, and therefore Canon Leigh resigned. The Rev. Carter took Canon Leigh's place, and altogether some six Sunday services were held there. Attacks on the Hospital Administration.—In October, an anonymous letter appeared in the Mercury, attacking the administration of the Hospital, and this was soon followed by a number of wild charges in the local press, and also in one of the evening papers. Some of the parents who had been unfortunate enough to lose one or more children in the Hospital, and others, joined in the outcry. Added, therefore, to the onerous duties of the ordinary work of administration, the Management Committee and the chief Officers had their attention distracted from their official duties by having to frame long statements of facts 21 and to controvert the false or exaggerated assertions made by various persons. The more these matters were minutely investigated the more abundant the proofs accumulated, that there was really nothing in the charges: that the patients had been treated with every consideration; that they had all had skilled medical attention, suitable diet, and during convalescence, abundance of the best of food; and that from first to last, considering the difficulties of the undertaking, the Officers deserved praise and not blame, and that the management generally would compare most favourably with that of the best-appointed permanent hospitals. Analysis of Expenditure at Temporary Hospital, 1893-4. £ s. d. A lterations and Repairs to Premises, &c. 413 16 5 Settlement of Compensation Claim 40 0 0 Furniture, Fittings, Bedding, &c. 425 19 6 Provisions, Groceries, Drugs, &c., Conveyance of Patients, and Petty Expenses 761 0 8 Salaries to Medical Attendant and Matron, and Wages to Staff 575 4 8 £2,216 1 3 Credit. £ s. d. £ s. d. Received from Sisters' Hospital, St. Albans, for sundry Furniture, Towels, &c. 3 10 0 To be received from Metropolitan Asylums' Board for Furniture and Effects 200 0 0 Estimated to be realized for remainder of Furniture, Bedding, Ironmongery, &c., say 30 0 0 233 10 0 £1,982 11 3 Note—If the amount for Salaries, Provisions, &c., be considered "maintenance," then the cost per head averages about £4 12s. 5d. PROSECUTIONS UNDER THE PUBLIC HEALTH ACT, 1891. When the number of notices and letters requesting work to be done is taken into account, the cases necessitating an appeal to the magistrate are very few indeed; they were as follows:— 22 The owner of 3, Hanover Place was prosecuted with regard to failure to carry out a Vestry notice as to defective drainage. The magistrate inflicted a fine of 20s. and costs, and ordered the premises to be closed until the works were executed. The work had not been done at the time of writing this Report, and the premises remain closed. The owner of 25 and 26, Little North Street having failed to carry out a Vestry notice, the magistrate granted an order for the work to be done within 14 days, and this was duly attended to. The owner of 49, Salisbury Street was summoned for neglect to carry out the notice of the Vestry to properly drain the premises, and a magistrate's order was obtained for the work to be done within 14 days. The owner of a bakehouse, 58, George Street, Portman Square, was prosecuted under the Public Health and Factory and Workshops Acts for various sanitary defects, and a magistrate's order was obtained for the work to be done within six weeks. A tradesman, carrying on business at 288, Edgware Road, was prosecuted for exposing unsound fruit for sale, and the magistrate inflicted a small fine (10s.) THE HOUSING OF THE WORKING CLASSES ACT, 1890. Six wretched houses in Jeffs Place were condemned under the Housing of the Working Classes Act, and a magistrate's order obtained to close the houses. These houses still remain closed. THE LABORATORY. SALE OF FOOD AND DRUGS ACTS. During 1893, 595 samples of food, drink, and drugs were analysed under the sale of Food and Drugs Act, in the Court House Laboratory. 23 For many years more samples have been taken in St. Marylebone than in any district in the Metropolis, with the happy result that, at all events, gross adulteration of milk has received a considerable check. It is capable of proof that several itinerant vendors known to carry on a distinctly dishonest trade avoid the parish; others who resided in the district, after frequent fining, have removed elsewhere. No amount of supervision can, however, prevent skilful watering down and skimming to the low limit of the food analyst, and generally speaking London milk, in comparison to the milk sold retail in counties such as Devonshire, is second class. During 1893, 205 samples of milk were submitted to analysis, and in 24 cases certified to be adulterated. These samples were taken at all times of the day, some indeed were taken from the Railway Station as the milk was delivered, in the small hours of the morning; many samples were taken on Sunday, and to meet the objection that the Inspectors were personally known to the vendors, there was a free use of agents. The fines received from the prosecution of adulterators of milk amounted to £26. There appears to be little butter in the parish sold in contravention to the Act. Out of 101 samples collected from different places, many from coffee houses, only 4 were certified to be mixtures, or to be margarine. The vendors of the 4 samples were prosecuted and fined, the fines received amounting to 30s. There were also a few prosecutions for diluted spirits. The total amount of fines received for offences against the Sale of Food and Drugs Act amounted to £28 10s. WATER AND GAS. The water as well as the gas supplied to the parish has been systematically examined, and the results published month by month. APPENDIX. 27 TABLE I.—Giving the death-rate per thousand of population, of the five Registration Districts, from certain classes of disease, 1893. The whole District All Souls* Rectory St. Mary Christ Church St. John 1. Zymotic diseases(as enumerated in table) 2.69 .94 1.75 2.86 3.5 3.21 2. Pulmonary, other than Phthisis 4.60 4.06 5.75 3.85 5.55 4.08 3. Tubercular 2.39 2.12 2.35 2.86 2.88 1.96 * With All Souls, Cavendish Square is now included. Rate of Mortality per cent, of diseases notified in each of the five Registration Districts, 1393. The whole District All Souls Rectory St. Mary Christ Church St. John Smallpox 3.1 6.9 2.6 6.2 ... ••• Scarlet Fever 8.5 7.2 8.8 14.0 8.8 7.2 Diphtheria 19.3 19.0 19.7 11.9 16.7 26.8 Typhoid Fever 23.6 15.7 18.7 30.0 39.1 14.3 Erysipelas 4.6 9.6 2.5 4.4 3.2 6.8 28 TABLE II.—Giving the Causes of Deaths during the 52 Weeks ending Dec. 25th, 1893, at the Middlesex Hospital, Queen Charlotte's Lying-in-Hospital, Samaritan Hospital, the Workhouse, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital. Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill Infirmary. Influenza ... ... ... 1 ... Scarlet Fever • • • ... ... ... ... Diphtheria 21 ... ... ... 3 Typhoid Fever 3 ••• ... ... 2 Diarrhœa ... ... ... 7 3 Erysipelas 3 ... ... ... 2 Pneumonia and Pleurisy 39 2 ••• 8 38 Pyaemia 4 ... 1 ... 1 Syphilis 1 1 ... 2 4 Cancer 100 ... ... ... 31 Phthisis and Tuberculosis 19 1 ... 2 128 Rheumatism 5 ... ... ... 3 Apoplexy 3 1 ... 5 4 Paralysis ••• ••• ••• 3 22 Bronchitis 12 ... ... 22 96 Asthma ... ••• ... 3 ... Peritonitis 7 ... ... 1 1 Disease of Brain 1 ••• ... 5 7 „ Heart 17 1 2 5 23 „ Kidney 16 1 1 1 16 ,, Liver 3 ... ... 3 6 „ Uterus 1 1 2 ... ... „ Ovary 2 ... 9 ... 1 Parturition ... 1 ... ... ... Diabetes ... • • • ... ... ... Fractures and Injuries 15 ••• ••• 2 13 Old Age 1 • • • ••• 9 7 Low Vitality, Infants ... 2 1 8 ... Premature Birth ... 8 ... 4 ... Other causes 31 5 2 5 42 Total *304 †24 ‡18 96 453 * Of the 304 deaths in the Middlesex Hospital, 257 were those of strangers to the Parish † Of the 24 deaths in Queen Charlotte's Hospital, 22 were those of non-parishioners. ‡ The 18 deaths in the Samaritan Hospital were those of non-parishioners. In the Middlesex Hospital there were, in 1893, 2,513 in-patients; the mortality was therefore 12.1 per cent. In the Samaritan Hospital there were 573 in-patients; the mortality was therefore 31 per cent. In the Notting Hill Infirmary there were 3,211 patients; the mortality was therefore 141 per cent. 29 TABLE III.—TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, in the Sanitary District of ST. MARYLEBONE, during the twelve months ending December 31st, 1893; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals Population at all Ages. (b) Census 1891 37,713 20,024 19,239 33,327 32,101 144,404 (c) Registered Births 778 553 505 890 826 3552 (d) Aged under 5 or over 5 Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards New Cases of Sickness in each Locality. coming to the knowledge op the medical Officer of Health. 1. Smallpox 5 24 1 37 3 13 8 52 3 16 20 142 2. Scarlatina 37 130 24 67 23 63 57 202 77 199 218 661 3. Diphtheria 27 52 8 33 12 30 35 79 26 56 108 250 4. Membranous Croup 1 4 1 .. 1 2 4 1 1 2 8 9 Fevers. 5. Typhus .. •• .. •• •• .. .. 1 .. .. .. 1 6. Enteric or Typhoid 4 15 .. 16 1 9 .. 23 .. 21 5 84 7. Continued .. .. 1 2 .. •• .. 1 .. • • 1 3 8. Relapsing .. .. .. .. .. •• .. •• .. •• .. •• 9. Puerperal .. 3 .. 4 .. •• .. .. .. 2 .. 9 10. Cholera .. 1 .. .. .. .. .. .. .. .. .. 1 11. Erysipelas .. 52 3 76 7 38 5 125 3 56 18 347 Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospital. 1. Smallpox 4 20 1 37 1 13 6 51 3 14 15 135 2. Scarlatina 20 96 9 47 12 46 39 147 45 150 125 386 3. Diphtheria 19 28 5 22 8 14 21 46 20 19 73 129 4. Membranous Croup .. .. .. 1 .. .. 1 .. .. 1 1 2 Fevers. 5. Typhus .. .. .. .. •• .. .. 1 .. .. •• 1 6. Enteric or Typhoid .. 14 .. 8 1 6 .. 15 .. 13 1 56 7. Continued .. .. .. 1 .. •• .. .. .. .. .. 1 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. •• .. .. .. .. .. .. 11. Erysipelas .. 9 1 35 1 8 .. 25 .. 6 2 83 30 TABLE IV.—TABLE OF DEATHS in the Sanitary District of ST. MARYLEBONE during the 52 weeks ending December 2oth, 1893, classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals The subjoined numbers have been taken into account in judging of the records of mortality. Deaths occurring outside the district among persons belonging thereto. Deaths occurring within the district among persons not belonging thereto. Mortality from all causes at subjoined ages. (b) At all ages 715 473 420 846 702 3156 791 331 (c) Under 1 year 156 78 91 204 175 704 42 31 (d) 1 and under 5 60 30 41 101 88 320 75 24 (e) 5 and under 15 25 26 16 51 24 142 44 23 (f) 15 and under 25 41 17 21 39 29 147 55 27 (g) 25 and under 65 300 194 168 309 227 1198 399 190 (A) 65 and upwards 133 128 83 142 159 615 176 36 (i) Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Mortality from subjoined causes, distinguishing Deaths of Children under Five Years of Age. 1. Smallpox 2 .. .. 1 .. 2 .. .. .. .. 2 3 2 2 .. .. 2. Scarlatina 9 3 5 3 7 5 12 11 14 6 47 28 22 10 6 5 3. Diphtheria 10 5 3 5 3 2 9 10 15 7 40 29 24 10 5 1 4. Membranous Croup 3 2 .. .. 2 1 3 .. 2 .. 10 3 3 .. .. .. Fever. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 3 .. 3 .. 3 1 8 .. 3 1 20 1 10 .. 3 7. Continued 1 .. .. .. .. .. .. .. .. .. 1 .. .. •• .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. .. •• .. •• 9. Puerperal .. 1 .. .. .. .. .. 1 .. .. .. 2 .. •• •• •• 10. Cholera .. .. .. .. .. .. .. .. 1 .. 1 .. .. •• •• 1 11. Erysipelas 1 4 2 •• 1 1 2 2 4 .. 10 7 . . 3 •• 2 12. Measles 2 2 .. • • 3 .. 11 3 6 .. 22 5 1 •• 1 .. 13. Whooping Cough 9 .. 2 12 .. 16 4 25 1 64 5 .. .. .. .. 14. Diarrhœa and Dysentry 14 2 9 2 12 1 22 2 16 3 73 10 4 4 4 .. 15. Rheumatic Fever 1 2 .. 3 .. 2 .. 4 1 3 2 14 • • 3 .. 3 16. Ague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 17. Phthisis 9 71 4 43 6 49 11 85 6 57 36 305 2 154 1 10 18. Bronchitis, Pneumonia, & Pleurisy 47 106 27 86 21 53 57 128 38 93 190 466 10 140 11 31 19. Heart Disease .. 48 2 23 2 29 1 39 .. 31 5 170 .. 41 2 21 20. Injuries 9 12 1 2 3 5 16 12 7 7 36 38 4 19 3 13 \21. All other Diseases 99 238 53 91 60 135 144 232 128 228 484 1027 44 275 22 187 Total 216 499 108 366 132 288 305 541 263 139 1024 2132 117 674 55 276 31 TABLE V.—District Births and Deaths for the 52 weeks ending december 25th, 1893. Population in 1881. Population in 1891. Births. Deaths. Males. Fmls. Males. Fmls. All Souls 41,651 37,713 383 395 375 310 Rectory 24,900 20,024 294 259 232 241 St. Mary 21,122 19,239 201 244 189 231 Christ Church 33,091 33,327 502 388 455 391 St. John 33,040 32,101 394 432 342 360 Total 155,004 142,404 1834 1718 1593 1563 Note.—In the above the births and deaths have all been properly corrected, strangers have been eliminated, and extra-parochial deaths and others have been allotted to their proper sub-district. The population has also been corrected for presumed increase. TABLE VI.—Vaccinations during 1893. Deaths under one year. Primary Vaccinations. ReVaccinations by Public Vaccinator. Public Vaccinator. Private Practitioners. Total. 704 1556 1227 2783 369 TABLE VII.—SALE OF FOOD AND DRUGS ACT, 1875-1879. Samples Analysed during the year 1893. Genuine. Adulterated. Total. Dairy Produce: Butter 101 4 105 Margarine 1 — 1 Milk 181 24 205 Condensed Milk 11 — 11 Evaporated Cream 1 — 1 Cheese 1 — 1 Condiments: Mustard 21 — 21 Currie powder 2 — 2 23 Pepper 23 — Ketchup 2 — 2 Sauce 2 — 2 Chutney 1 — 1 Beverages: Cocoa 6 — 6 Chocolate 2 — 2 Coffee 29 — 29 Coffee and Chicory 1 — 1 Tea 17 — 17 Sweetmeats: 47 Sweets 47 — Ice Cream 2 — 2 Jam 8 — 8 Jelly 2 — 2 Marmalade 2 — 2 Honey 2 — 2 Canned Goods: Ham and Tongue Paste 1 — 1 Bloater Paste 4 1 5 Tinned Fruit 1 1 2 Spirits: Brandy 10 — 10 Gin 24 — 24 Rum 7 2 9 Whisky 17 1 18 Drugs: Sulphate of Quinine 6 — 6 Citrate of Magnesia 1 — 1 Seidlitz Powder 1 — 1 Magnesia 1 — 1 Miscellaneous: Vinegar 7 — 7 Soda Water 3 — 3 Lard 8 — 8 Linseed Meal 4 — 4 Flour 1 — 1 Pea Flour 1 — 1 Total 562 33 595 33 REPORT OF MORTUARY KEEPER FOR THE YEAR 1893. Number of bodies received from January 1st, 1893, to December 31st, 1893. Total Total. Carried forward 240 January Males 23 Females 17 40 July Males 18 Females 24 42 February ,, 22 ,, 20 42 August ,. 24 ,, 19 43 March „ 30 ,, 23 53 September „ 16 ,, 22 38 April „ 11 ,, 24 35 October „ 20 ,, 20 40 May „ 14 ,, 20 34 November „ 29 „ 19 48 June „ 22 ,, 14 36 December „ 23 ,, 36 59 510 Number of Inquests from January 1st, 1893, to December 31st, 1893. Carried forward 102 January 19 July 11 February 9 August 13 March 32 September 14 April 16 October 14 May 16 November 18 June 10 December 28 200 To await burial 304 For inquest 200 504 Note. 6 Bodies were received for Inquest in December, 1893, but the Inquests were not held until Jan., 1894. 6 Total 510 Number of Infectious cases received from Janurry 1st, 1893, to December 31st, 1893. Diphtheria 9 Scarlet Fever 26 Typhoid Fever 1 Total 36 REGISTER OF SANITARY WORK, 189 3. SANITARY DEPARTMENT. Arthur Perry, Nos. 1, 2,and 4 Wards. W. Yeo, No. 3 Ward. D. J. Andrews, Nos. 5 and 6 Wards. Richard Phillips, Nos. 7 and 8 Wards. T. Gorniot, Special Duty. Bakehouses, and Sale of Food and Drugs Act. C. J. Kilgallin, Special Duty. Factories and Workshops, etc. Totals. Number of Complaints received 425 430 342 304 ... 13 (Factory Inspections.) 1514 Inspections Of Dwelling-houses 2549 659 574 888 ... 40 4710 „ Kitchens (separately occupied) 53 71 326 215 ... ... 665 „ Schools 13 57 9 24 ... 4 107 „ Houses registered under Public Health (London) Act, 1891. 419 1326 714 634 194 201 3488 „ Dairies and Cow-houses 22 83 8 31 12 10 166 „ Bakehouses 34 94 27 53 108 108 424 „ Slaughterhouses 22 43 2 29 20 ... 116 ,, Miscellaneous Inspections 5738 2739 2724 2030 1199 197 14627 Notices issued for Abatement of Nuisances 243 301 115 101 3 98 861 Letters written relating to Abatement of Nuisances 233 484 393 366 185 72 1733 Proceedings taken before Magistrates under Public Health (London) Act, 1891 1 4 1 ... 2 8 Reports made to Medical Officer of Health 326 961 299 625 50 32 2293 Infectious Patients removed to Hospital 222 398 183 245 ... ... 1048 Rooms Disinfected after Infectious Disease 529 457 284 420 ... 128 2013 New Pipe Drains (feet) 20565 16910 5186 18835 195 87 61753 Drains Repaired 178 221 91 94 170 ... 584 Number of houses in which defects of Drainage have been detected and remedied 286 226 135 139 3 3 792 Unwholesome Food—Number of Seizures made 2 8 2 2 2 ... 16 Food Adulteration Samples collected for Analysis 123 134 110 111 124 14 616 Proceedings taken before Magistrates ... 8 1 1 ... ... 30 Removal of Bodies to Mortuary 6 15 8 10 1 ... 40 Infected Articles removed and stoved, 19726. Statistical Returns to Government and other Departments, 564. Cautionary Notices to Schools re Infectious Sickness, 349 36 INDEX TO ANNUAL BEPORT. page: A. All Souls, Birth and Death-rate 9 „ Births and Deaths 31 Andrews, D. J., Sanitary Work 35 B. Births and Deaths 9 Blaxall, Dr., appointment of, as Resident- Medical Man to Hospital 17 Butter, Adulteration of 23 c. Christ Church, Birth and Death-rate of 9 ,, Births and Deaths in 31 D. Deaths, causes of 30 ,, Extra-parochial 11 Diphtheria, Death-rate from 27 E. Erysipelas, Death-rate from 27 F. Fruit, Prosecution for selling unsound 22 G. George St. (No. 58), Prosecution of Owner of 22 Gorniot, T., Sanitary Work done by 35 H. Housing of the Working Classes Act, 1890 22 Hanover PI. (No. 3), Prosecution of Owner of 22 Hospital, cubic space in temporary 16 ,, drainage of 17 ,, expenditure of 21 ,, illness of Staff in 20 ,, mortality of patients 18 ,, number of patients 18 ,, religious services in 21 Hunt, F. W., letter from 35 K. Kilgallin, C. J., Sanitary Work done by 35 L. Little North St. (Nos. 25 and 26), Prosecution of Owner of 22 M. Meteorology, 1893— March Quarter 7 June ,, 7 September,, 8 December ,, 8 Middlesex Hospital, causes of death in 28 Milk, Analysis of 23 Mortuary Keeper, Report of 33 page. N. Notified Diseases 29 Notting Hill Infirmary, Causes of Death in 28 P. Perry, A., Sanitary Work done by 34 Phillips, R. „ ,, 35 Prosecutions under the Public Health Act 21 ,, Sale of Food and Drugs Acts 23 Population of St. Marylebone 9 Q. Queen Charlotte's Hospital, Causes of Death in 28 R. Rectory, Birth and Death-rate 9 ,, Births and Deaths 31 Rees, Miss A., Appointment of as Matron 17 s. St. John, Birth and Death-rate of 9 ,, Births and Deaths in 31 St. Mary, Birth and Death-rate of 9 ,, Births and Deaths in 31 Sale of Food and Drugs Act 32 Salisbury St. (No. 49), Prosecution of Owner 22 Samaritan Hospital, Causes of Death in 28 Sanitary Work, Register of 34-115 Scarlet Fever and Hospital Accommodation 13 ,, Death-rate from 27 Sisley, Dr., Appointment of to Hospital 17 Smallpox, 1893 12 ,, Death-rate from 27 T. Typhoid Fever, Death-rate from 27 V. Vaccination, 1893 31 Y. Water and Gas, Analysis of 23 Workhouse, Causes of Death in 28 w. Yeo, W., Sanitary Work done by 34 z. Zymotic Diseases, Death-rate from 27 37 INDEX TO MONTHLY REPORTS, 1893. PAGE A- All Souls', Birth and Death-rate of during ,, January 2 February 14 „ March 25 ,, April 40 ,, May 50 ,, June 61 July 78 ,, August 91 „ September 91 ,, October 110 ,, November 122 ,, December 122 All Soula', Births and Deaths. ,, January 8 „ February 19 ., March 31 ,, March quarter 32 ,, April 45 ,. May 55 ,, June 71 ,, June quarter 72 ,, July 84 ,, August 101 ,, September 102 ,, September quarter 103 ,, October 116 ,, November 128 ., December 129 December quarter 130 All Souls', notification of Infectious Disease in ,, January 4 „ February 16 ,, March 26 ,, April 42 ., May 52 ,, June 63 ,, July 82 ., August 93 ,, September 93 ,, October 112 ,, November 124 December 124 Aughlie, Prosecution of, for Milk Adulteration 125 Allen, G., Prosecution of, for Milk Adulteration 29 B Bakehouses 64 Birth and Death Rates 2,14,25,40,61,78,91,110,121 Britton,Sam'l., prosecution of,for adulteration 98 C Cavendish Square, Birth and Death Rates, during „ January 2 ,, February 14 ,, March 25 April 40 ,, May 50 ,, June 6l July 78 page Cavendish Square, Births and Deaths, during January 8 ,, February 19 ,, March 31 ,, March quarter 32 .. April 45 „ May 55 „ June 71 June quarter 72 July 84 Cavendish Square combined with All Souls (footnote) 91 Cavendish Square,Notifications of Infectious Disease in, ,, January 4 „ February 16 ,, March 26 ,, March quarter 27 „ April 42 ,, May 52 ,, June 62 ,, June 63 July 82 ,, August 93 „ September 93 ,, October 112 ,, November 124 ,, December 124 Christ Church, Birth and Death Rates, during „ January 2 ,, February 14 ,, March 25 ,, April 40 May 50 „ June 61 » July 78 ,, August 91 ,, September 91 ,, October 110 ,, November 122 ,, December 122 Christ Church, Births and Deaths. ,, January 8 ,, February 19 ,, March 31 ,, March quarter 32 ,, April 45 ,, May 55 ,, June 71 ,, June quarter 72 ,, July 84 ,, Augus 101 ,, September 102 ,, September quarter 103 ,, October 116 ,. November 128 ,, December 129 December quarter 130 Christ Church, Notifications of Infectious Disease in, during ,, January 4 ,, February 16 „ March 26 ,, March quarter 27 ,, April 42 ,, May 52 ,, June 62 ,, June quarter 63 ,, July 82 38 INDEX TO THE MONTHLY REPORTS—Continued. . page Christ Church Notification of Infectious Disease in, during ,, August 93 ,, September 93 „ October 112 „ November 124 ,, December 124 D Dan vers, T., Prosecution of, for Adulteration 66 Davis, J., „ „ 66 Diphtheria 13 ,, at Trinity Schools 113 Disinfection by Sulphur Dioxide 17 Downs, H , Prosecution of, for Adulteration 125 F. Female Inspectors 43 G Gas Testing for ,, January 11 „ February 22 ,, March 38 ,, April 48 May 58 ,, June 75 July 87 ,, August 108 ,, September 108 ,, October 119 ,, November 135 ,, December 135 H. Hilton, L., Prosecution of, for Adulteration 98 Hospital Accommodation 53 Housing of the Working Classes Act 65 Hovell, H., Prosecution of, for Adulteration 29 Howlett, J., ,, „ 125 J. Jackson, Rd., Prosecution of, under the Public Health Act 123 Janes, Elizabeth, Prosecution of,, under the Public Health Act 123 Jeff's Place, Reported under Housing of the Working Classes Act 65 K. Kerr, Norman, Dr., Letter from 29 L. Laboratory Work during „ March quarter 29 „ June 66 ,, September 98 „ December 125 page M. Mackay, A.. Prosecution of, for Adulteration 98 McKay, „ „ 125 Meteorology for January 1 ,, February 13 ,, March 23 „ April 40 „ May 50 ,, June 60 July 77 ,, August 89 ,, September 90 ,, October 109 ,, November 120 ,, December 121 Middlesex Hospital, causes of Death in „ January 7 ,, February 18 ,, March quarter 30 ,, April 44 ,, May 54 ,, June quarter 68 July 83 ,, September quarter 100 ,, October 115 ,, December quarter 127 P. Price, R., Prosecution of, for Adulteration 66 Q1 Queen Charlotte's Hospital, causes of death in during January 7 ,, February 18 ,, March quarter 30 „ April 44 ,, May 54 ,, June quarter 68 July 83 ,, September quarter 100 ,, October 115 ,, December quarter 127 R. Rectory, Birth and Death-rates. ,, January 2 ,, February 14 ,, March 25 ,, April 40 ,, May 50 ,, June 61 July 78 ,, August 91 ,, September 91 ,, October 110 ,, November 122 ,, December 122 Rectory, Births and Deaths. „ January 8 ,, February 19 ,, March 31 March quarter 32 April 45 May 55 ,, June 71 ,, June quarter 72 „ July 84 „ August 101 ,, September 102 ,, September quarter 103 „ October 116 „ November 128 ,, December 129 ,, December quarter 130 39 INDEX TO THE MONTHLY REPORTS— Continued. page Rectory, Notification of Infectious Disease in ,, January 4 February 16 March 26 ,, April 42 „ May 52 ,, June 63 July 82 August 93 ,, September 93 ,, October 112 November 124 ,, December 124 S. Sage, A., Prosecution of, for Adulteration 66 St. John, Birth and Death-rates of during ,, January 2 ,, February 14 ,, March 25 April 40 May 50 June 61 July 78 ,, August 91 ., September 91 ,, October 110 ,, November 122 „ December 122 St. John's, Births and Deaths. ,, January 8 February 19 ,, March 31 ,, March quarter 32 „ April 45 May 55 June 71 ,, June quarter 72 ., July 84 August 101 September 102 ,, September quarter 103 ,, October 116 ,, November 128 December 129 ,. December quarter 130 St, John, Notification of Infectious Disease. January 4 ,, February 16 ,, March 26 „ April 42 May 52 June 63 July 82 ,, August 93 ,, September 93 ., October 112 November 124 ., December 124 St, Mary, Birth and Death-rates. January 2 ,, February 14 ,, March 25 ,, April 40 ,, May 50 „ June 61 July 78 ,, August 91 ., September 91 ,, October 110 ,, November 122 ,, December 122 St, Marv, Births and Deaths. „ January 8 ,, February 19 ,, March 31 ,, March quarter 32 , April 45 page St, Mary, Birtbs and Deaths, ,, May 55 ,, June 71 ,, June quarter 72 ,, July 84 ,, August 101 ,, September 102 September quarter 103 October 116 ,, November 128 ,, December 129 ,, December quarter 130 St. Mary, Notification of Infectious Disease in ,, January 4 „ February 16 ,, March 26 April 42 ., May 52 ,, June 63 , July 82 ,, August 93 September 93 ., October 112 ,, November 124 ,, December 124 St. Marvlebone Infirmary, Notting Hill Causes of death, January 7 ,, February 18 ,, March quarter 30 ,, April 44 ,, May 54 ,, June quarter 68 ,, July 83 ,, August ,, September quarter 100 ., October 115 ,, December quarter 127 Sale of Food and Drugs Act, work done under ,. March quarter 29, 33 ,, June quarter 66,67 ,. September quarter 98, 99 ,, December quarter 125,126 Samaritan Hospital, causes of death in ,, January 7 ,, February 18 March quarter 30 „ April 44 ,. May 54 ,, June quarter 68 July 83 „ September quarter 100 ,, October 115 „ December quarter 127 Sanitary Inspectors, appointment of additional 43 Sanitary work—January 9 ,, February 20 ,, March 34 ,. April 46 May 56 ,, June 70 ,. July 85 ,, August 104 ,, September 105 ,, October 117 ,, November 131 ,, December 132 Scarlet Fever 65, 80, 95, 97, 113 Shanley, M., Prosecution of, for Adulteration 98 Shelters, Shaftesbury 5 Smallpox 5, 17,28, 43 Smith, J., Prosecution for Adulteration 125 State, E., ,, „ 125 T. Temporary Hospital 53, 80, 96, 123 Tenements, one-roomed, in proportion to the population 95 40 INDEX TO THE MONTHLY REPORTS— Continued page V. Vaccination returns for ,, January 8 ,, February 19 ,, March 31 April 45 May 55 ,, June 72 ,, July 84 September quarter 103 ,, October 116 W. Walker, Prosecution of, for Adulteration 29, 66 Water Analysis for January 11 ,, February 22 ,, March 38 ,, April 48 ,, May 58 June 75 July 87 ,, August 108 September 108 ,, October 119 page Water Analysis for November 135 ,, December 135 Workhouse, Causes of Death in ,, January 7 ,, February 18 ,. March quarter 30 „ April 46 May 54 ,, June quarter 68 July 83 ,, September quarter 100 October 115 ,, December quarter 127 Z. Zymotic death-rate ,, January 3 ,, February 15 ,, March 25 ,, April 41 May 51 ,, June 61 ,, July 79 September quarter 92 ,, October 111 ,, December quarter 123