THE SANTRY CHRONICLES OF THE PARISH OF ST. MARYLEBONE; BEING THE ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH, FOR THE YEAR 1894, 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. XIV. LONDON: Printed by George Pulman & Sons, 24 & 25, Thayer Street, and 5, Princes Street, W. THE SANITARY CHRONICLES OK THE PARISH OF ST. MARYLEBONE; BEING THE ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH, FOR THE YEAR 1894, 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. XIV. LONDON: Printed by George Pulman & Sons, 34 & 25, Thayer Street, and 5, Princes Street, W. PREFACE. The present Report deals with the year 1894: a period which taxed to the utmost the resources at the disposal of the Sanitary authority. Since each month a printed Report of matters relating to the health of the district is presented to the Vestry, it was not considered necessary to go into the minute details of the past year, the aim rather being to fulfil statutory requirements and to present a faithful and accurate summary of events. In all essential features the plan of the Report is the same as adopted in previous years. The Court House, February, 1895. CONTENTS. Meteorological Summary 7—9 Births and Deaths 9—10 Smallpox, 1894 11—13 Typhoid Fever, 1894 14—17 Appliances for Disinfection 17 Sanitary Work, 1894 17 Factory and Workshops Acts 19 Prosecutions under Public Health (London) Act 21 Housing of the Working Classes Act 22 Clerical Work of the Sanitary Department 23 Laboratory. Sale of Food and Drugs Acts 24—25 Appendix 28 A REPORT of the METEOROLOGY, MORTALITY, AND SICKNESS of the PARISH OF SAINT MARYLEBONE, FOR THE YEAE 1894. By A. WYNTER BLYTH. METEOROLOGICAL SUMMARY. March Quarter. January of 1894 was a cold wet month ; the first two weeks were of considerable severity, the thermometer sinking to 13o.0; the mean temperature of the month was 39°.0 and the maximum 51°.5. On no less than 20 days rain or snow fell, the total rainfall measuring 3.57 inches. Fogs were occasional. Sunshine was for the most part absent, only a little less than 19 hours being registered during the five weeks. February was also wet, but with many bright sunny days. The minimum temperature was 24°.5; maximum 54°; mean 40o.5. Destructive gales of wind prevailed during the second week. Rain fell on 16 days (1.98 inch). The fourth week was very cold. March was a drier month. Minimum temperature 30o.0; maximum 55o.0; mean 440.7. There was a fair amount of sunshine, varying from 21 to 33 per cent. On 13 days rain fell (l.77 inch). Cold winds prevailed during the fourth week. 8 SANITARY CHRONICLES, 1894. June Quarter. April was a bright sunny month. The minimum temperature was 34o.0; maximum as high as 73°.0; mean 50o.6. On six days rain fell, 1.10 inch. The amount of sunshine was equal to 26.5 per cent. The winds were variable. May was an unsettled month. The minimum temperature was 30o.8; maximum 68°.3 ; mean 50o.7. 2.15 inches of rain fell in 12 days. Cool winds were prevalent. Nearly 30 per cent, of bright sunshine was registered. June was unsettled and wet; 2.46 inches of rain fell in 18 days. The winds were westerly. The minimum temperature was 380.l; maximum 720.5; and mean 57°.2. Only about 23 per cent, of sunshine was received. September Quarter. July was unsettled and wet; 2.79 inches of rain fell in 16 days. The minimum temperature was 36o.0; maximum 84°.5; mean 640.5. There was a fair amount of sunshine, viz., about 365 per cent. August was also an unusually wet month, 2.5 inches of rain falling in 12 days. Temperatures were moderate, the minimum being 45o.0 ; maximum 770.5; mean 61°.2. Sunshine was somewhat deficient, being in amount about 24.5 per cent. September was fairly dry, but dull. On 9 days 0.75 inch of rain fell. The minimum temperature was 41°.0; maximum 740.2; mean 570.3. The winds were variable. Only about 22.5 per cent, of sunshine was received. December Quarter. October was dull and damp; 2.76 inches of rain fell in 18 days. The minimum temperature was 330.4; maximum 60°.5; mean 51o.0. Only 15 per cent, of sunshine was received. November was a month of unusual heavy rain; it rained during some part or other of 20 days, the total rain- BIRTHS AND DEATHS. 9 fall being 5 3 inches. The minimum temperature was 33o-0; maximum 63°.0 ; mean 42°.9. The winds were S.W. Sunshine only 17 per cent. December was a mild, dark month, with a considerable amount of fog. 1.2 inch of rain fell on 10 days. The minimum temperature was 3lo.0; maximum 510.2; mean 410.8. During the whole month there were only about 13 hours of bright sunshine registered. BIRTHS AND DEATHS. The number of births registered during the 52 weeks ending December 22nd, 1894, when all essential corrections have been made, was 3,483. The number of deaths (corrected) of parishioners was 2,724. This gives a birth-rate of 244; a death-rate of 19.1 per thousand. Calculated in the same way, the birth and death-rates for 1894 of the sub-districts were as follows :— All Souls birth-rate 19.8; death-rate 14.9 Rectory „ 26.9; „ 20.6 St. Mary „ 23.4; „ 17.8 Christ Church ,, 27.0; „ 22.6 St. John „ 25.8; „ 20.4 The following table gives the distribution of the deaths of parishioners dying in various extra-parochial institutions, all of which are included in the mortality statistics:— St. Marylebone Infirmary, Notting Hill 441 North-Western Fever Hospital 61 South-Western Fever Hospital 1 Western Fever Hospital 13 Northern Fever Hospital 2 Hospital Ship " Castalia " 5 „ "Atlas" 20 Grove Farm Convaleseent Hospital. 2 South Wharf, Rotherhithe 1 London Fever Hospital 2 Carried forward 548 10 SANITARY CHRONICLES, 189 Brought forward 548 North-western London Hospital 1 University College Hospital 12 King's College Hospital 5 St. Mary's Hospital 78 St. Bartholomew's Hospital 3 St. George's Hospital 2 St. Thomas's Hospital 9 London Hospital 3 Westminster Hospital 2 Charing Cross Hospital 4 Guy's Hospital 1 Royal Free Hospital 2 Cancer Hospital 1 London Temperance Hospital 2 Central London Throat Hospital 2 Brompton Hospital 9 West-London Hospital 1 Children's Hospital, Great Ormond Street 11 Children's Hospital, Bethnal Green 1 Central London Sick Asylum 2 Colney Hatch Asylum 17 Bethlehem Hospital 2 Caterham Asylum 2 Peckham House Asylum 1 Hanwell Asylum 13 llford Asylum 9 Banstead Asylum 4 Cane Hill Asylum 2 Darenth Asylum 5 Leavesden Asylum 25 Grove House, Stamford Hill Grove Hall Asylum Chelsea Infirmary 1 Friedenheim 7 St. Peter's Home, Kennington 5 St. Joseph's Home, Kennington 1 National Hospital for Epilepsy 1 French Hospital 2 German Hospital 1 St. Luke's Hospital 3 Hoxton Hospital 3 North London Consumption Hospital 2 Cleveland Street Asylum 1 Kensington Infirmary 2 City of London Chest Hospital Westminster Workhouse Great Northern Hospital Islington Infirmary 1 St. Pelagia's Creche St. Giles's Workhouse 1 St. Elizabeth's Home 1 Camberwell Workhouse Heart Hospital, Soho 1 H.M. Prison, Holloway 1 Otherwise 5 825 SMALLPOX. 11 SMALLPOX, 1894. In St. Marylebone; during 1890, there were only three cases of smallpox notified; in 1891, but a single case; in 1892, seven cases. In 1893, smallpox began to cause some anxiety, for in January of that year there were ten cases, in February four, in March nineteen, and in May thirty-five. During the remaining months cases occurred, bringing the total for the year up to 127. Smallpox, as a rule, has a distinct seasonal course, increasing up to a maximum in May, and then decreasing, and this course was followed in all the previous outbreaks; so that when, during the whole of the six months ending June 30th, 1894, only five cases of smallpox had been notified, one would, from past experience, have confidently predicted that, so far as St. Marylebone was concerned, the year would be fairly free from smallpox. In July, however, a fatal case occurred in Portland Town, under circumstances which in the first place absolutely precluded removal to hospital, and in the second place, gave unusual facilities for its dissemination. An outbreak of almost unprecedented character occurred in the immediate locality of the case mentioned, the remote effects of which are even now experienced. This outbreak commenced on July 3rd, when four cases were notified, and during the seven days from the 23rd to the 31st, no less than 139 cases from a limited area were removed to hospital. After that date, scattered cases only were reported until August 10th, when there was a smaller but still a serious burst in and around Nightingale Street. The cause of this was satisfactorily traced to infection derived from Portland Town, which had smouldered in Nightingale Street. In other words, cases in Nightingale Street that had not been reported were found to have existed from duly 25th up to August 11th. By the end of August, 71 cases had been reported in connection with this second outbreak. After August, smallpox declined. In September there were 2(5 cases; in October, 10; in November, 11; and in December, 10. 12 SANITARY CHRONICLES, 1894. The general course is plotted out in curve form in the diagram facing page 13. Hence, of the 299 cases reported during the year, the majority of these were derived from the large outbreak in Portland Town and the subsidiary outbreak in Nightingale Street, and they fell for the most part in the months of July and August. The deaths from smallpox amounted to 29, or about 10 per cent, of the attacks. Further details with regard to the outbreak have been already printed and published in the several monthly reports, and it will only be necessary to recall a few particulars. The influence of vaccination and re-vaccination in modifying or preventing attacks, and in diminishing mortality, was strikingly shown. An inspection of the schools also proved that there were a large number of children in the affected areas who had either never been vaccinated or had not been efficiently vaccinated. In the Portland Town outbreak, a local office was temporarily used as a centre to which messages could be sent, and at which the Inspectors and the Medical Officer of Health were in more or less constant attendance. Similarly in the Nightingale Street outbreak, a local administrative centre was established at the Stone Yard. The facilities which this system gave were so great that the experiment, in similar circumstances, will certainly be repeated. It was also found useful to employ special medical aid in visiting from house to house, so as to discover cases which would otherwise be unreported. Dr. Carter, who undertook this duty, did, as a fact, discover a few cases which, had they been neglected, might have formed fresh centres. The great lesson, however, which these outbreaks teach, is the absolute necessity for prompt removal to hospital. The very fact that the outbreaks were due to CHART. SMALL POX AND ENTERIC FEVER CASES, 1894. SMALLPOX. 13 cases kept at home proves the services which the admirable ambulance organisation of the Asylums Board confers on the Metropolis, and shows clearly that if every case of smallpox was early diagnosed and removed, no spread of the disease would be possible. The officers of the sanitary and disinfecting departments worked well and for long hours, and they were thanked by the Vestry for their services. The Guardians also rendered most efficient help in giving facilities for re-vaccination, and in appointing special officers to aid the Public Vaccinator, Dr. Greenwood, whose personal assistance was most valuable, and who for a time may be said to have lived in the affected area. Subsequent events have, however, shown clearly that the outbreak was never stamped out completely. The efforts of the Sanitary Authority, of the Guardians, and of the Asylums Board, were similar in their effects to that of a corps of firemen who, being suddenly called, rapidly allay and extinguish a fire, but unseen sparks are wafted from the scene of the first conflagration and alight in other places, to smoulder there unheeded until, under favourable circumstances, the flame bursts out, and at the present moment these sparks are here and there causing trouble. The writer is, however, in hopes, with approved appliances, that efforts at stamping out may be in the future more successful. A part of this incomplete success he believes to be due to omission to disinfect certain articles of clothing. For instance : a good many of those attacked, and their friends, were very poor and had only one suit of clothing. Friends or relatives of the patient were often in close attendance on the sick for 24 to 48 hours, yet having no change, it was impracticable to disinfect in every case the clothing on their backs for want of a suitable shelter supplied with bath accommodation, and with disinfecting appliances; a scheme has, however, while these sheets are passing through the press, been adopted by the Vestry to meet this want, so that 1895 will inaugurate a new era with regard to our disinfecting appliances. 14 SANITARY CHRONICLES, 1894. TYPHOID FEVER, 1894. Typhoid fever was far more prevalent throughout the Metropolis in 1894 than usual. As regards St. Marylebone, the number of cases of typhoid fever notified in 1890 were 72 ; in 1891, 61 ; in 1892, 70 ; in 1893, 93; and in 1894, 141. 27 of the 141 cases did not however arise in the parish, but were imported from elsewhere ; 17 of the imported cases being derived from other Metropolitan districts; 6 obtained their infection in the provinces; and the remainder from abroad—1 from Paris, 1 from New York, 1 from Yarmouth, and 1 from Buenos Ayres. Hygiene is no longer a matter of local concern. The rapidity with which persons can now travel from one part of the Globe to another, makes all infectious maladies more or less of international importance. A number of the imported cases came into the district to be treated at the several excellent surgical and medical homes which have been established; the treatment of typhoid in a nursing home under skilled supervision constitutes in no way a public danger, and there is no instance on record of the disease spreading in such institutions save to those in actual contact with the patient. The theories current with regard to the causation of typhoid may be briefly referred to : in the first instance, it is supposed to be produced by a minute organism, one of the many microscopic rod-shaped bacteria; this organism in a majority of cases is in some way swallowed, and in the minority of cases breathed. It may be taken as proved that by far the most frequent cause is drinking contaminated water; next in order comes contaminated food; and lastly, it may be produced by the inhalation of bad air containing the specific bacterium. With regard to water, notwithstanding the report of the Royal Commission, one can scarcely deny the possibility for water derived from the Thames to be occasionally inefficiently filtered, and for the specific organism to be distributed with the water supply; if the contaminating matter is small in amount and widely diffused through a large body of water, most persons would escape infection, but some, either from constitutional or temporary causes, might be in such a state of health as to be readily receptive. TYPHOID FEVER. 15 Again, if the cause of the unusual prevalence was water, some indication would be obtained by comparing the number of attacks per thousand of the population in different districts ; for it is pretty certain, with a contaminated water supply, that districts supplied from different sources would show great inequality of attack. Accordingly the writer has multiplied the number of notifications contained in the Asylums Board returns by a thousand and divided these numbers by the 1891 populations, and thus obtained relative rates as follows :— Rate of incidence of typhoid per thousand of population. Fulham 0.47 Whitechapel 0.54 Camberwell 0.54 Kensington 0.56 Paddington 0.61 Bermondsey 0.64 Lewisham 0.65 Shoreditch 0. 68 Hampstead 0.70 Limehouse 0.80 Marylebone 0.80 Islington 0.84 Newington 0.85 Wandsworth 0.85 Holborn 0.89 St. Giles 0.90 Hackney 0.92 St. Pancras 0. 92 St. George's, Hanover Square 0.93 Clerkenwell 096 Lambeth 0.96 Chelsea 0.99 Battersea 0.99 Greenwich 101 Bethnal Green 1.16 Poplar 1.33 St. George's in the East 1.33 Water Supply. West Middlesex, and Chelsea New River, and East London. Kent, Southwark and Vauxhall. West Middlesex, Grand Junction, and Chelsea. West Middlesex, and Grand Junction. Southwark, and Vauxhall and Lambeth. Kent (in part). East London (in part). New River, and West Middlesex. East London. (Excluding imported cases). West Middlesex mainly, Grand Junction (in part). New River. Lambeth, Southwark and Vauxhall. Lambeth. New River. »» East London. New River. Grand Junction, and Chelsea. New River. Southwark and Vauxhall. West Middlesex, and Chelsea. Southwark, and Vauxhall and Lambeth. Kent. East London. A close examination of the list shows too many anomalies to suggest that even one of the Companies was supplying grossly polluted water. There are now a number of cases on record which would seem to prove that Oysters put down to fatten in the mouths of sewage-polluted rivers cause from time to time 16 SANITARY CHRONICLES, 1894. typhoid. An enquiry and a report is to be made on this matter by the Medical Department of the Local Government Board. Watercress has also been accused of the same thing. Both are probable causes of typhoid; should they really be so, it may be, after all, but a variety of water infection. In 63 of the cases in St. Marylebone, definite answers could be obtained both as to the amount of water drunk unboiled and as to the consumption or otherwise of oysters and watercress within the incubation period. The following are the results:— Drunk lots of unboiled water 13 Never eat either oysters or watercress 25 Never took oysters 3 Eat of both oysters and Avatercress 10 Eat watercress, but no oysters 8 Took oysters alone 4 63 Some of the above cases may, therefore, have been through oysters or watercress, but the numbers consuming one or both are not sufficiently striking to base general conclusions on. In all cases which arose within the parish, an examination of the water-service pipe, of the cisterns, and of the sanitary arrangements were made, and 25 houses showed serious defects of drainage On reference to the spot map a cluster will be found at Grays Buildings. Here alone was there anything approaching to an outbreak. Grays Buildings drained into a sewer which terminated in a dead end, there were no syphons between the houses and the sewer, and on uncovering the drains various defects were found. The houses have now all been re-drained on an improved system, the sewer ventilated, and arrangements made for periodical flushing. In this case certainly there are grounds for believing that sanitary defects, if they did not cause the malady, at all events assisted in its propagation. On the other hand, in the majority of instances the sanitary state of the premises was excellent. SANITARY WORK, 1894. 17 To sum up : Typhoid fever was more prevalent than usual in 1894; the majority of the cases occurred in the autumn ; in a few instances the incidence of the disease was associated with insanitary conditions ; in the others the cause remains obscure. APPLIANCES FOR DISINFECTION. The old hand-cart that had been used formerly for conveying goods to the stoneyard for the purpose of disinfection was finally discarded and replaced by two large vans, built on the model of those in use at St. Pancras. One is used solely for the conveyance of goods to be disinfected ; the other to take goods back to houses after disinfection. The vans are distinguished by their colour. The cubic capacity of each van is something over 200 cubic feet; each will carry a ton of goods. One of the vans can, when occasion requires, be used as an ambulance. The vans are horsed by contract, and so far the contract has been carried out in an efficient manner. A little while after the purchase of the vans, two disinfectors were appointed at a definite weekly wage. Previously, although, as a matter of fact, two men, and sometimes more, were continuously employed, these men were in the Works or Surveyor's Department and not in the Sanitary; they were paid by the hour, and might at any time be called upon to do other work. The present system is better. Messrs. Hodges and Hales, during the whole of a trying year, have carried out their duties efficiently and well. SANITARY WORK, 1894. The efficiency of a Sanitary Authority is not to be judged by any special efforts put forth, or money spent in the arrest of an outbreak, or in activity in meeting sudden emergency. The true judgment should rather be based on the thoroughness with which the ordinary routine duties of inspection and supervision have been performed. In the table at page 36 will be found a fair summary of the details 18 SANITARY CHRONICLES, 1894. of sanitary work as carried out by each of the six inspectors. It will be seen there that no less than 21,166 inspections of premises of various kinds were made during the year, which, if equally divided, gives about 3,500 apiece. During some six weeks the time of the whole staff was taken up with dealing with an outbreak of smallpox; nevertheless, it is satisfactory to find that a large amount of permanent work with regard to drainage was carried out. The drainage of 380 premises was opened and exposed to view by the workmen in the Surveyor's department, and since in each of the 380 cases there was good cause for suspecting defects, it is no matter of surprise that almost without exception the drains thus exposed were found to be defective. Altogether, 85,099 feet of drainage were laid, under the direct supervision of the inspectors. This shows an increase when compared with past years. The number of feet laid in the same manner during 1891 was 41,541; in 1892, 35,612 ; in 1893, 61,753. The drainage thus laid is of a first-class character, viz., suitable glazed pipes, properly jointed, laid on concrete, with a chamber and syphon between the house and the sewer, and with proper ventilating arrangements. In most cases there are indeed at least two chambers, back and front, and in many cases where it was necessary to lay the drains under kitchens, the drains are of iron. The regulations made by the Vestry with regard to plans of drainage have been rigidly enforced—that is to say, that all plans of drainage are submitted both to the Medical Officer of Health and the Surveyor; and the drains are not proceeded with until the sanction is obtained. It may be useful to detail the actual steps taken, which are briefly as follows:—A builder who has received an order from the owner to lay a new drain receives on application a form containing the printed regulations of the Vestry, and on the fly-leaf a blank form, divided up into squares, one-eighth of an inch to a foot, on which the plan is to be drawn. This plan is sent to the Court House, and on its receipt the inspector in whose district the premises FACTORY AND WORKSHOPS ACTS. 19 are situated visits the premises in question, plan in hand, and then makes a report to the Medical Officer of Health. The Superintendent also makes a report to the Surveyor as to the depth of the sewer, and the amount of deposit to be paid in order to cover the work done by the Vestry, viz., the connection between the sewer and the premises. If the plan is not approved, it is sent back for alteration. The plan being finally approved by both Surveyor and Medical Officer of Health, the next step is to pay the deposit, and then the connection is made by the Surveyor's department, and from the connection the drain is laid by the builder. During the course of the work it is the Inspector's duty to pay several visits, in order to see that the work is being properly done, and finally, before the pipes are covered, to test the drain by the test known as the ''water test," that is to say, the open end in the chamber nearest to the sewer is plugged up and the drain filled with water, so that any imperfect joint cannot fail to be discovered. The effect of recent legislation having thrown upon the local authority the duty of inspecting the dwellings of outworkers employed in various industries, and also the duty of supervising the workshops with regard to sanitary state, the writer recommended that this should be made the special duty of at least one inspector. Accordingly, Mr. Kilgallin was appointed to this important post. He was also appointed to carry out the statutory provisions with regard to smoke. FACTORY AND WORKSHOPS ACTS. The number of workshops and workplaces in 1894 were as follows :— Wards 1, 2, and 4 697 „ 353 „ 5 and 6 1,199 „ 7 and 8 1,301 3,550 20 SANITARY CHRONICLES, 1894. The bakehouses also belong to the same category, and they number 108. During the year, 22 complaints with regard to workshops were received from the Home Office, and 7 from the London County Council. Twenty-five notices as to the proposed opening of new premises were also received. The clerical labour with regard to the Workshops, as might be expected, was considerable; this, combined with the fact that the Factory Inspector had for several weeks to assist in the general work of the department, and that also his skill as a draughtsman was taken advantage of for the purpose of preparing sketch plans as a guide to the Sanitary Committee in the erection of a combined Shelter and Disinfector, interfered much with the duty of inspection and measurement. Nevertheless the account is not unsatisfactory :— Number of Bakehouses inspected 108 Number of Workrooms measured and particulars as to ventilation and sanitary condition noted 49 Number of Workshops inspected (not measured) 225 Notices to abate Overcrowding 8 Number of Workshop Orders served with regard to limewashing and cleansing 27 Number of Notices served to improve Ventilation and to increase Watercloset accommodation 12 With regard to outworkers who reside in the parish but who work in other districts, they are as follows :— St. George's, Hanover Square 177 St. J ames, Westminster 141 Chelsea 3 Strand 7 Islington 1 329 Prosecutions under the public health act. 21 As to the abatement of smoke, there are but few factory chimneys in the parish, and therefore the number of complaints was not great; in fact, only half-a-dozen during the year. Four of these were considered to be justly grounded, and notices to abate were served. Some three premises at the present time are under observation. PROSECUTIONS UNDER THE PUBLIC HEALTH (LONDON) ACT, 1891. The greatest majority of sanitary notices are at once carried out by the owners or responsible persons on the receipt of a simple written communication, calling attention to the matter. A smaller number are dealt with by letter, followed up by a Vestry notice. A still smaller number have to be enforced by the usual legal proceedings. The following is a list of such cases— The owner of 97, Gloucester Mews „ 34, Balcombe Street „ 10, Thayer Street „ 116, Lisson Grove „ 8 and 98, Balcombe Street „ 29, Frederick Street „ 35, Frederick Street „ 27, St. John's Wood Terrace „ 8, Upper Park Place „ 33, Upper Park Place „ 37, Hereford Street „ 216, Edgware Road ,, 10, St. Anne's Terrace „ Bowman's Buildings were all summoned for non-compliance with regard to notices. The most important of the above cases was that of Bowman's Buildings, a block built according to specifications drawn out by the predecessors of the London County Council, viz., the Metropolitan Board of Works. At the time when this block was building, I drew the attention, 22 SANITARY CHRONICLES, 1894. privately, of one of our own members to certain departures from the specification, and that member actively bestirred himself, and a Committee of the Board of Works visited the block when the work was in progress, and some more close adherence to the specification was enforced. The local sanitary authority at that time did not supervise the carrying out of the drainage. Now, I am glad to say, we have different regulations and a proper system both as to sanction and as to supervision of new drainage, and it is to be hoped that it will be impossible for drains to be laid now such as were found in this block. The block houses some 64 families, each family, save two, having three rooms; the whole drainage was found defective, badly planned, and badly laid ; some of the pipes were even not glazed socket pipes, but made of a porous material, and nearly every joint was open, with a number of minor defects. It is far better to spend money on property than on law, and the owner was unwise to resist the notice of the local authority. HOUSING OF THE WORKING CLASSES ACT. The whole of Ryder's Terrace (Nos. 3 to 9) was reported under the above Act. The owners came forward and suggested a series of improvements which appeared to be likely to remedy the evils complained of, viz., dampness and want of ventilation; and these improvements have since been carried into effect. Hence no further action was taken. A dark insanitary cottage at the back of No. 5, Capland Street, was reported as unfit for human habitation, and action was taken before a magistrate and the house closed. No. 52, Lisson Street, was also reported as unfit foxhabitation, and a "closing order" obtained. The house has since been demolished. No. 40, Park Lane, was also reported under the same Act as unfit for habitation, and a closing order obtained. It has since been unoccupied. 23 CLERICAL WORK. THE CLERICAL WORK OF THE SANITARY DEPARTMENT. The Clerical Staff consists of a chief clerk (Mr. Curtis) and an assistant clerk (Mr. Woods). These clerks have carried out their duties well and efficiently, although working under considerable difficulties. The difficulties consist in the fact that their office is a room used by the six sanitary inspectors and the dust foremen. It is also the waiting.room for the general public. The consequence is that for about three hours each day there is a number of persons in the office, and much discussion between builders, owners, and inspectors ; these discussions are often carried on in a loud voice, and, since differences of opinion are common, the interviews are—to put it mildly —occasionally of an animated character. It is easier to state a case than to find a remedy: the work of the sanitary department has outgrown its size, and it is only by a reconstruction of the building that extra accommodation can be provided. The clerical work during 1894 may be summarised as follows:— Number of Notifications of infectious diseases entered in Register, copied, and sent to Metropolitan Asylums Board and Schools, receipt acknowledged and filed 1780 Number of Complaints of Nuisance received, entered in Nuisance Register, and filed 1268 Number of Dust requests and Complaints received, entered on Contractors' sheets, copied, and filed 2762 Number of Letters despatched from Department 1845 Number of Vestry Notices issued 592 Number of Meetings of Sanitary and Sewers Committee prepared for, attended, and Minutes drafted and written 23 Number of Eeports from Committee to Vestry prepared 21 Number of Meetings of Sub . committees prepared for, attended, and Minutes drafted and written 20 Number of Reports from Sub.committees to Committee prepared 19 24 SANITARY CHRONICLES, 1894. There was also much extra clerical work in connection with the scarlet fever epidemic of 1803, particularly in the preparation of the accounts relating to the cost of furniture, and to the distribution of the furniture to the various Hospitals of the Metropolitan Asylums Board, besides which, in connection with the smallpox outbreaks in Portland Town and the Lisson Grove district, there were daily written communications to all the schools and hospitals in the district, and constant messages through the telephone, and interviews with the parents and the friends.of patients in Hospital. THE LABORATORY. SALE OF FOOD AND DRUGS ACTS. During 1894, 570 samples of food, drink, and drugs were analysed under the Sale of Food and Drugs Acts, in the Court House Laboratory. Milk.—The system of constantly supervising the milk supply of the parish has been maintained. During 1894 the Inspectors freely used agents in order to meet the objection that they were personally known to the vendors. Samples were also several times purchased on Sundays, and on holidays, yet, notwithstanding, only 15 samples out of 208 were found to be adulterated. Out of the remaining 193 samples some eight or ten were very poor, the rest of fair quality. Butter.—In one case only was Margarine found to be sold as butter. Spirits.—Out of 75 samples of spirits, only 5 were found to be diluted below the strength laid down by statute. From the prosecutions under the Sale of Food and Drugs Acts, on account of the smallness of the fines inflicted, only £19 were recovered by the Vestry. The table at page 34 shows the variety of substances analysed and the general result of the analyses. My own impression is that in comparison with most other districts there is little adulteration in St. Marylebone, but this is a 25 SALE OF FOOD AND DRUGS ACTS. most difficult matter to prove, for the percentage of adulterated samples is no guide to the amount of adulteration in a district. There is nothing easier than to make any particular district show a high or a low percentage of adulteration. If it is required to show a high percentage of adulteration, the inspectors should be directed to confine their operations to those substances experience has shown to be most commonly adulterated, and to more particularly pay attention to the black sheep of the district. If on the other hand it is desired to show a low percentage of adulteration, then let a very large number of samples of tea, of sugar, of flour, of rice, and similar articles be purchased, which experience has shown to be at the present moment but rarely tampered with. In this parish, however, the general method of taking samples has not altered for many years, so that, although the data are insufficient to compare with other districts, the data are fairly applicable for a judgment as to whether adulteration is increasing or decreasing, and it is satisfactory to note that a smaller number of prosecutions for adulteration were instituted in 1894 than in any one of the previous ten years. APPENDIX. 29 TABLE I.—Giving the death.rate per thousand of population, of the five Registration Districts, from certain classes of disease, 1894. The whole District All Souls* Rectory St. Mary Christ Church St. John 1. Zymotic diseases 2.48 1.69 2.09 2.23 3.05 3.86 2. Pulmonary, other than Phthisis 3.78 2.84 4.44 3.85 5.37 5.95 3. Tubercular 2.15 1.54 2.29 2.34 2.49 1.96 With All Souls, Cavendish Square is now included. TABLE II.— Rate of Mortality per cent, of diseases notified in each of the five Registration Districts, 1894. The whole District All Souls Rectory St. Mary Christ Church St. John Smallpox 10.0 ... ... ... 10.6 9.8 Scarlet Fever 9.2 12.7 7.6 10.1 8.6 5.3 Diphtheria 23.1 18.9 17.9 29.1 24.7 27.5 Typhoid Fever 15.6 15.3 13.0 22.7 8.2 18.1 Erysipelas 3.1 ... 5.0 ... 2.5 9.0 30 TABLE III.—District Births and Deaths for the fifty.two weeks ending DECEMBER 22nd, 1894. Population in 1881. Population iu 1891. Births. Deaths. Males. Fmls. Males. Fmls. 41,651 37,713 378 368 280 281 Rectory 24,900 20,024 277 262 196 217 St. Mary 21,122 19,239 241 209 157 185 Christ Church 33,691 33,327 465 453 394 360 St. John 33,640 32,101 404 426 331 323 Total 155,004 142,404 1765 1718 1358 1366 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. TABLE IV.—Vaccinations during 1894. Deaths under one year. Primary Vaccinations. ReVaccinations by Public Vaccinator. Public Vaccinator. Private Practitioners. Total. 618 3084 768 3852 2424 31 TABLE V.—(living the Causes of Deaths during the 52 Weeks ending Deo. 31st, 1894, 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 ... ... ... ... ... Scarlet Fever ... ... ... ... ... Diphteria 13 ... ... ... ... Typhoid mFever ... ... ... ... ... Diarrhoea ... ... ... ... 3 Erysipelas 1 1 ... ... 3 Pneumonia and Pleurisy 23 1 ... ... 31 Pyaemia 8 1 ... ... 1 Syphilis ... 1 ... ... 2 Cancer 88 ... ... ... 23 Phthisis and Tuberculosis 30 ... ... ... 104 Rheumatism 1 ... ... ... 9 Apoplexy 4 ... ... ... 14 Paralysis ••• ... ... ... 31 Bronchitis 10 ... ... 9 85 Asthma ... ... ... 2 1 Peritonitis 10 2 ... ... 2 Disease of Brain 2 ... ... 3 6 ,, Heart 26 ... ... 4 26 ,, Kidney 16 1 ... ... 12 ,, Liver 9 ... ... 2 7 ,,Uterus ... ... 4 ... 1 Ovary 2 ... 1 ... ... Parturition ... 3 ... ... ... Diabetes ... ... ... ... ... Fractures and Injuries 22 ... ... 1 5 Old Age ... ... ... 6 11 Low Vitality, Infants ... 7 ... 6 7 Premature Birth ... 17 ... ... ... Other causes 57 5 4 17 56 Total *328 †39 ‡11 57 440 *Of the 328 deaths in the Middlesex Hospital, 192 were those of non.parishioners, † Of the 39 deaths in Queen Charlotte's Hospital, 34 were those of non.parishioners. ‡Of the 11 deaths in the Samaritan Hospital , 10 were those of non.parishioners. 32 TABLE VI.—TABLE OF POPULATION, BIETHS, AND OF NEW CASES 01 INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer o Health, in the Sanitary District of ST. MARYLEBONE, during the 5S weeks ending December 314(, 1894; classified according to Diseases, Ages, ani Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals Population at all Ages. (b) Census 1891 .. 37,713 20,('24 19,239 33,327 32,101 142,404 (c) Registered Births 746 539 450 918 830 8483 (d) Aged under 5 or over 5 Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards j Under 5 ^ 5 upwards Under 5 5 upwards Under 5 5 upwards New Casks op Sickness in each Locality. coming to the knowledge op the medical Offices of Health. 1. Smallpox 1 7 .. 5 .. 5 5 42 18 216 24 275 2. Scarlatina 45 96 20 32 18 51 43 142 22 74 148 395 3. Diphtheria 23 56 8 31 7 17 22 39 19 50 79 193 4. Membranous Croup 1 .. 2 .. 1 1 1 1 3 1 8 3 Fbvbbs. 5. Typhus .. .. .. .. .. 1 .. .. .. .. .. 1 6. Enteric or Typhoid .. 39 .. 23 1 21 .. 24 3 30 4 137 7. Continued .. 1 .. .. .. 1 .... .. .. 1 .. 3 8. Relapsing .. .. .... .. .. .. .. .. .. .. .. .. \9. Puerperal .. 3 .. 1 .. 2 .. 2 .. 1 .. 9 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas 1 37 2 58 2 38 4 78 3 29 12 240 Numbbb of such Cases Removed from theib Homes in the sbvebal Localities fob Tbeat. mbnt in Isolation Hospital. 1. smallpox 1 6 .. 3 .. 5 5 42 18 215 24 271 2. Scarlatina 32 80 18 29 12 40 34 124 15 56 111 329 3. Diphtheria 14 36 3 15 6 9 21 28 14 25 58 113 4.. Membranous .. .. 1 .. 1 1 .. .. .. .. 2 1 Fevers. 15. Typhu .. .. .. .. .. 1 .. .. .. .. .. 1 6. Enteric or Typhoid .. 24 .. 19 1 10 .. 15 2 13 3 81 7. Continued .. .. .. .. .. 1 .. .. .. 1 .. 2 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .... .. .. .. .. 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. U. Erysipelas .. 9 •• 25 .. 8 1 11 2 5 3 58 33 TABLE VII.—TABLE OF DEATHS in the Sanitary District of ST. MABYLEBONT during the 52 weeks ending December 22nd, 1894, classified according U 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 nmong persons not belonging thereto. Mortality from all causes at subjoined ages. (b) At all ages 561 413 342 754 654 2724 837 358 (c) Under 1 year 116 80 72 196 154 618 32 27 (d) 1 and under 5 55 45 34 102 103 339 101 23 (e) 5 and under 15 .. .. 27 12 13 36 25 113 48 16 (/) 15 and under 25 25 13 9 25 27 99 48 18 (g) 25 and under 65 258 142 132 268 210 1010 400 233 (h) 65 and upwards 80 121 82 127 135 545 208 41 (i) | Under 5 5 upwards Under 5 5 upwards Under 5 | 5 upwards | Under 5 5 upward j Under 5 5 upwards | Under 5 | | 5 upwards j Under 5 5 upwards Under 5 J 5 upwards | Mortality from subjoined causes, distinguishing Deaths of Children under Five Years of Age. 1. Small Pox .. .. .. .. .. 1 2 3 9 14 11 18 11 16 .. .. 2. Scarlatina — 11 7 4 .. 6 1 12 4 5 .. 38 12 30 7 2 1 3. Diphtheria .. 9 6 5 2 6 1 8 7 12 7 40 23 19 13 2 .. 4. Membranous Croup 2 .. .. .. .. .. .. 1 1 .. 3 1 .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. |6. Enteric or Typhoid .. 6 .. 3 .. 5 .. .. 1 5 1 21 .. 10 .. 4 7. Continued .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. 1 .. .. .. 1 .. 3 .. 1 .. 6 .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 11.Erysipeals .. .. 1 2 .. .. .. 2 2 1 3 5 .. 2 .. .. 12. Measles 11 1 14 .. 3 .. 23 5 22 1 73 7 5 1 .. .. 13. Whooping Cough 4 .. 7 .. 6 .. 8 .. 6 .. 31 .. .. .. .. .. 14. Diarrhoea and Dysentery 3 .. 3 1 6 4 15 .. 9 1 36 6 2 2 2 .. 15. Rheumatic Fever .. 3 .. 1 .. 3 .. 8 .. 2 .. 17 .. 7 1 2 16. Ague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 17. Phthisis 4 54 7 39 7 38 17 67 11 52 46 250 8 132 3 22 18. Bronchitis, Pneumonia & Pleurisy 35 72 26 63 28 46 78 101 63 57 230 339 11 116 9 25 19. Heart Disease .. 39 3 34 .. 20 .. 43 2 41 5 177 .. 45 1 21 20. Injuries 10 12 4 12 .. 3 19 20 7 16 40 63 3 28 3 20 21. All other Diseases 82 189 51 131 44 113 116 189 107 199 400 821 44 325 27 210 Total 171 390 126 288 106 236 298 456 257 397 57 1767 133 704 50 338 34 TABLE VIII.—Sale of Food and Drugs Act.—Samples analysed during the Year 1894. Genuine. Adulterated. Total. Dairy Produce: Milk 193 15 208 Butter 99 1 100 Condensed Milk 4 — 4 Condiments: Mustard 22 — 22 Vinegar 11 — 11 Pepper 19 — 19 Beverages: Cocoa 1 — 1 Coffee & Chicory 2 — 2 Coffee 27 — 27 Tea 15 — 15 Spirits: Brandy 12 1 13 Gin 23 1 24 Rum 8 2 10 Whisky 27 1 28 Port Wine 1 — 1 Sherry . 1 — 1 Sweetmeats: Jam 11 — 11 Sweets 14 — 14 Marmalade 3 — 3 Drugs : Magnesium Citrate 1 — 1 Liquorice Powder 1 — 1 Quinine. 4 — 4 Sulphur Tablets 1 — 1 Canned Goods. 11 — 11 Farinaceous Poods : Corn Flour 2 — 2 Oatmeal 3 — 3 Miscellaneous, viz.: . Currie, Capers, Pea Flour, Lucca Oil, Sauce, Lard, Pickles,Baking Powder, Limejuice, Herrings, and others 33 — 33 Total 549 21 570 35 REPORT OF MORTUARY KEEPER FOR THE YEAR 1894. Number of bodies received from January 1st, 1894, to December 31st, 1894. Total. . Total. Carried forward 238 January Males 17 Females 23 40 Julv Males 24 Females 18 42 February „ 21 „ 18 39 August 15 „ 21 36 March „ 30 ,, 23 53 September „ 17 ,, 16 33 April „ 19 ,, 13 32 October „ 18 ,, 16 34 May „ 18 ,,18 36 November „ 9 ,, 16 25 June „ 24 ,, 14 38 Decembeer „ 19 ,, 22 41 Total 449 Number of Inquests from January 1st, 1894, to December 31st, 1894. Carried forward 118 January 26 July 19 February 17 August 16 March 16 September 7 April 28 October 19 May 16 November 10 J une December 23 Total 212 Number of bodies to await burial only 237 Number of bodies for inquest 212 Total 449 Number of Infectious cases received from January 1st, 1894, to December 31st, 1894. Diphtheria 14 Typhoid Fever 4 Scarlet Fever 1 Total 19 36 REGISTER OF SANITARY WORK , 1 8 9 4. SANITARY DEPARTMENT. Mr W. Yeo, No. 1 District. Mr. A. Perry, No. 2 District. Mr. T. Gorniot, No. 3 District. Mr. D. J. Andrews, No. 4 District Mr. R. Phillips, No. 5 District. Mr. C. J. Kilgallin, Special Duties. Total. Number of Complaints received 318 211 345 332 174 186 1,556 Inspections Of Dwelling Houses 313 1,751 465 573 647 93 3,842 21,166 „ Kitchens (separately occupied) 80 34 96 319 106 10 645 „ Schools 70 20 8 8 28 3 137 „ Houses registered under Public Health (London) Act, 1891 . 2,560 36 235 645 553 — 4,029 „ Dairies and Cow.houses 121 26 8 15 30 3 203 „ Bakehouses 153 33 84 23 5 90 388 „ Slaughterhouses 62 30 — 8 28 — 128 „ Miscellaneous Inspections 2,349 3,102 2,410 2,035 1,544 354 11,794 Notices issuer! for Abatement of Nuisances 283 204 93 96 46 52 774 Letters written relating to Abatement of Nuisances 355 165 380 332 232 77 1,541 Proceedings taken before Magistrates under Sanitary Acts 1 5 9 4 1 1 21 Reports made to Medical Officer of Health 814 521 373 301 661 143 2,843 Infectious Patients removed to Hospital 260 150 178 179 267 68 1,102 Rooms Disinfected after Infectious Disease 398 337 335 228 412 142 1,852 New Pipe Drains (feet) 21.055 16,372 10,610 9,134 22,439 5,489 85,099 Houses where defects in Drainage have been detected and remedied 295 116 200 158 177 43 989 Unwholesome Food—Number of Seizures made 1 — 6 2 2 — 11 Food Adulteration. Samples collected for Analysis 120 96 118 120 108 12 574 Proceedings taken before Magistrates 8 1 10 1 — — 20 Removal of Bodies to Mortuary 9 5 — 7 14 — 35 37 List of Sewers Underpinned with New Bottoms during 1894. ft. Charles Street (South of Henry Street) 685.0 Henstridge Place 495.0 Circus Road 360.0 St. Ann's Terrace 170.0 Cochrane Street 215.0 Wellington Place (East of Wellington Road) 300.0 Crawford Street (New Sewer, 225 feet) 885.0 Total 3,110.0 38 INDEX TO ANNUAL REPORT. A page Adulteration in St. Marylebone . 24 Andrews, D. J., Sanitary Work.36 All Souls, Births and Death Table III 30 Birth and Death rate 9 Causes of Death ,, VII. 33 Death rate from pulmonary, tubercular, and zymotic diseases ,, I. 29 Notified Cases of Sickness ,, VI. 32 Notified Cases, Death rate of ,, II. 29 B Bakehouses. Inspection of 20 Births ami Deaths 9, Table III. 30 Bowman's Buildings21 Butter, Analysis of24 C Capland Street, No.5 22 Carter, Dr., Services of, during Smallpox outbreak12 Christ Church, Birth and Death rate . 9 Births and Deaths Table III 30 Causes of Death „ VII. 33 Death rate from pulmonary, tubercular, and zymotic diseases „ I. 29 Notified Cases of Sickness ,, VI. 32 Notified Cases, Death rate of ,, II. 29 Clerical Work of the Sanitary Department . 23 Curtis, work of, during 1894 23 D Deaths, extra.parochial 9 Diphtheria, rate of mortality from Table II. . 29 Disinfecting appliances17 Drainage regulations18 Drains examined in 1894 . 18 E Erysipelas, rate of mortality from Table II. . 29 Extra.parochial deaths 9 F Factory and Workshop Acts 19 G Gorniot, T., work of, during 1894 36 Gray's Buildings and Typhoid Fever 16 Greenwood, Dr., services in relation to Smallpox13 H page Housing of the Working Classes Acts 22 I Infectious Sickness notified Table VI. 32 K Kilgallin's work under Factory and Workshops Act19 Kilgallin's work during 1894 36 L Laboratory, work in, during 1894 24 Lisson Street, No. 5222 M Meteorology for the year 1894 1.2 Middlesex Hospital, causes of death in Table V 31 Milk, Analysis of24 Mortuary Keeper, Report of 35 N Nightingale Street, Smallpox in . 11 Notifications of Infectious Disease, 1894 Table VI. 32 O Out.workers under the Factory and Workshops Acts20 Oysters and Typhoid Fever 16 P Perry. A., Sanitary Work of 1894 36 Phillips, K., Sanitary Work of 1894 36 Prosecutions under the Public Health Act 21 Pulmonary Diseases, Death rate from Table 1. 29 Q Queen Charlotte's Hospital, causes of death in V.31 39 INDEX TO ANNUAL REPORT—continued. R PAGE Rectory, Birth and Death rate in 9 Births and Deaths Table III.30 Causes of Death „ VII.33 Death rate from pulmonary, tubercular, and zymotic diseases ,, I. . 29 Notified Cases of Sickness ,, VI.. 32 Notified Cases of Death rate ,, II. . 29 Kyder's Terrace22 S Sale of Food and Drugs Act, 24, Table VIII.. 34 Samaritan Hospital, causes of death in ,, V. . 31 Sanitary work, 1894 17 St. John, Birth and Death rate in . .9 Births and Deaths Table III. 30 Causes of Death ,, VII. 33 Death rate from pulmonary, tubercular, and zymotic diseases ,, I. . 29 Notified Cases of Sickness ., VI. . 32 Notified Cases of Death rate ,, II. . 29 St. Mary, Births and Death rate in 9 Births and Deaths Table III. . 30 Causes of Death in ,, VII. . 33 Death rate from pulmonary, tubercular, and zymotic diseases „ I. . 29 Notified Cases of Sickness in ,, VI. . 32 Notified Cases of Death rate ,, I. . 29 page St. Marylebone Infirmary, causes of Death in Table V. . 31 Sewers constructed or repaired, 1894 37 Scarlet Fever, rate of mortality Table II. . 29 Smallpox, 1894 11.13 Smallpox, mortality from Table II29 Smoke, nuisance from21 Spirits, analysis of24 T Tubercular Diseases, death rate from Table I. . 29 Typhoid Fever, rate of mortality „ I. 29 Typhoid Fever, 1894 14.10 V Vaccinations, 1894 Table IV. 30 Vaccinations in reference to the Smallpox outbreak12 Vans for the purpose of conveying goods for disinfection 17 W Water and Typhoid Fever , 14.15 Woods, clerical work of . .23 Workhouse, causes of death in Table V. 31 40 INDEX TO MONTHLY KEPOliTS, 1894. pagb A All Souls, Births and Deaths . January 2 February 12 March quarter 22 April 36 May 52 June quarter63 J uly82 September quarter 100 October122 November134 December quarter147 All Souls, Causes of Death. January Table III.. 6 February ,, III. 15 March ,, X. 31 March quarter XI.82 April VI. 45 May „ VI. 58 June ,, X. . 76 June quarter ,, XI. 77 July „ VI. .94 September quarter ,, XI. 116 October ,, VI. 130 November ,, VI. 141 December quarter ,, X. 156 All Souls. Notified Cases of Infectious Sickness. January Table II. 5 February ,, II.14 March ,, II. 25 March quarter „ III. 26 April ,, V. 44 May ,, II. 55 June ,, II. 70 June quarter , III. 71 July „ II. 91 September quarter ,, II. .111 October ,, II. 127 November ,, II. 138 December II. 150 December quarter ,, III. 151 Asylums Board Hospitals admission of scarlet fever patients in proportion to the population of various districts 38 B Balcombe Street, No 98, Prosecution of Owner of, under Public Health Act . 42 Beadle, G. Prosecution of, for Adulterated Milk 149 Bell Street School. Proportion of unvac. cinated children in105 Bentinck Street, No. 22. Prosecution of Owner under Public Health Act 136 Births and Deaths January Table V. . 2, 8 February „ V. 12,17 March ,, VI. 21, 29 March quarter ,, VIII.21, 30 April ,t VII. 36,46 May „ IV. 52,57 June „ VI. 61,74 1 page Births and Deaths. June quarter Table VIII. . 62, 75 July „ IV. . 82, 93 August „ V. . 98. 114 September ., VII. . 98, 114 September quarter ,, IX. . . 115 October ,, IV. . 122, 140 November ,, IV. . 134,140 December ,, VI. . 146, 154 December quarter ,, VIII. . 146, 154 Bowman's buildings, Mortality of . . 65, 66 Brighton J. .prosecution for Adulterated Milk 68 Brown, W., ,, ,. 24 Bye.laws of L.C.C. with regard to Closets . 64 C Capland Street, No. 5, closing of, under Magistrate's order53 Capland St. School, proportion of Children unvaccinated in . 105 Carter, Dr. . 88 Christ Church, Births and Deaths. January2 February 22 April 36 May52 June quarter 63 July82 September quarter 100 October 122 November 134 December quarter 147 Christ Church, Causes of Death. January Table III. 6 February ., III. 15 March ,, X. 31 March quarter XI. 32 April ,, VI. 45 May „ VI. 58 June X. 76 June quarter ., XI. 77 July „ VI. . 94 September quarter ,, XI. . . 116 October ,, VI. 130 November ., VI. 141 December quarter „ X. 156 Christ Church, Notified Cases of Infectious Sickness. January Table II. 5 February „ II. 14 March ,, II. 25 March quarter „ III.26 April ,, V. 44 May ,, n. 55 June „ II. 70 June quarter ,, HI. 71 July II. 91 September quarter „ II.111 October ,, II.. 127 November ,, II. 138 December ,, II.150 December quarter „ III. w . 151 41 INDEX TO THE MONTHLY REPORTS—continued. page D Deaths, extra.parochial. January2 February12 March.21 April31 May52 June 62 J uly82 August and September .98 October322 November134 December146 Delaney, Father109 Diphtheria23 Dirty Walls and Ceilings as Nuisances 124 Disinfecting Vans13 Disinfection inadequate, appliances for . 135 Disinfectors, appointment of 67 E Edgware Road, No. 216, Prosecution of owner of, under the Public Health Act 90 Evans, J., Prosecution of, for Adulterated Milk110 F Factory and Workshops Acts 4 Farquhar, W. M., Rev109 Farrar110 Finucane, Prosecution of, for Adulterated Milk24 Frederick Street, Nos. 29, 35, Prosecution of owner of, under the Public Health Act 42 Gas Lighting, power of January Table VIII 10 February „ VIII.19 March „ XII. 34 April ,, X. . .47 May „ VIII. 59 June ,, XIII. 78 July ,, VIII. 95 Augustand September,, XIII. . 120 October „ VIII. .132 November ,, VIII. 143 December ., XII. 159 G Gentry, W., Prosecution of, for Diluted Whisky149 Gloucester Mews, No. 97, Prosecution of owner of4 Gorniot Apportionment of District to 5 ,, Work of, in connection with Smallpox89, 110 Greenwood, Dr88, 104 Gregory, W., Prosecution of, for Adulterated Milk24 H Hereford Street, No. 37, Prosecution of owner of, under the Public Health Act 89 Housing of the Working Classes Act. 63,125,136 I Infants, Deaths of, from wasting or convulsive diseases January3 February13 pa.gb Infants, Deaths of, from wasting or convulsive diseases. March quarter23 April37 May53 June quarter63 July 83 September quarter .100 October123 November137 December quarter147 J Jones, Rev109 K Kilgallin, Duties of, in relation to the Factory and Workshops Acts 4 L Lewin, Prosecution of, for Adulterated Milk 24 Lisson Grove, No. 116, Prosecution of owner of, under the Public Health Act 42 Lisson Street, No. 52, Closing Order under the Housing of the Working Classes Act 53 M Manley, Richard, Prosecution of, for selling margarine instead of butter 67 Measles. Epidemic of54 Meteorology. January1, 2 February11 March20, 21 April35 May51 June61 J uly83 August97 September98 October21, 122 November133, 134 December145 Milk, reference to Somerset House. 68 N Nightingale Street, Smallpox outbreak. 101.110 P Park Lane, No. 40, Reports against, under Housing of the Working Classes Act. 125,136 Perry, Re.arrangement of District of 4 ,, Work of, in relation to Smallpox 110 Phillips, Richard, work of, in relation to Smallpox 89. 110 Price, F., Prosecution of, for Adulterated Milk24 Portland Town outbreak of Smallpox 84, 89 Povah, Rev109 Prosecutions nnder the Public Health Acts .... 4,13.42,65,89,136 Pulmonary Diseases, Deaths from January3 February .13 March quarter23 April May 53 June quarter .63 42 INDEX TO THE MONTHLY REPORTS—continued. page Pulmonary Diseases, Deaths from July83 September quarter100 October123 November137 December quarter147 R Rectory, Births and Deaths in January2 February12 March quarter22 April3(5 May 52 June quarter63 July82 September quarter100 October122 November134 December quarter147 Rectory, Causes of Death in January Table III.6 February „ III. .15 March X. 31 March quarter „ XI. 32 April VI. 45 May ,, VI. 94 June .. X. . .76 June quarter ,, XI. 116 July „ VI. 94 September quarter ,, XI. . . 116 October ,, VI. , 130 November ,, VI. 141 December quarter ,, X.15 Rectory. Notified Cases of Infectious Sickness in January Table II. 5 February ,, II. 14 March ,, II. 25 March quarter ,, III. 26 April ,, V.44 May „ II. 55 June „ II. 70 June.'quarter III. 71 July ,, II. 91 September quarter ,, II 3 October ,, II 127 November ,, II. 138 December ,, II. 138 December quarter ,, III.151 Redrup, R., prosecution of, for adulterated milk 24 Richardson, E., prosecution of, for adulterated milk24 Roman Catholic Schools, percentage of un. vaccinated children in 105 Ryder's Terrace, report relative to, under the Housing of the Working Classes Act 53 S St. Ann's Terrace, No. 10, prosecution of owner of, under Public Health Act 90 St. Cyprian's School, percentage of unvacci. nated children in St. James' Terrace 105 St. James' Terrace, No. 13, prosecution of owner of, under Public Health Act 136 St. John's, Births and Deaths. January2 February12 March quarter22 April36 May 52 June quarter63 July82 September quarter100 October122 November134 December quarter147 pa.gk St. John, Causes of Death. January Table III. 6 February „ III. 15 March ,, X. 31 March quarter „ XI. 32 April ,, VI.45 May „ VI. 58 June ,, X. 76 June quarter ,, XI. 77 July „ VI. 94 September quarter „ XI. . . 116 October ,, VI. 130 November „ VI. .141 December quarter ,, X. 156 St, John, Notified cases of Infectious Sickness. January Table II5 February „ II. . .14 March ,. II. . . 25 March quarter ,, III. . .26 April VI. Table V44 May „ II. 55 June ,, II.70 June quarter ,, III. 71 July ,, II. •91 September quarter ,, II. Ill October ,, II127 November ,, II 138 December ,, II. . . 150 December quarter ,, III. 151 St. John's Wood Terrace, No. 27, prosecution of owner under Public Health Act 42 St. Mary, Births and Deaths. January2 February 12 March quarter22 April 36 M!ay52 June quarter63 J uly 82 September quarter100 October122 November134 December quarter147 St. Mary, Causes of Death. January Table III. 6 February „ III. 15 March ,, X. 31 March quarter ,, XI. 32 April VI. 45 May ,, VI. 58 June ,, X. 76 June quarter ,. XI. 77 July „ VI. 94 September quarter ,, XI. . .116 October „ VI. 130 November ,, VI. 141 December quarter ,. X.156 St. Mary, Notified Cases of Infectious Sickness January Table II. 5 February ,, II. 14 March ,, II. 25 March quarter ,, III. 26 April „ V. 44 May ,, II. .35 June „ II. 70 June quarter ,, III. 71 July ,, 91 September quarter „ II. Ill October „ II. 127 November II. 138 December ,, II. 150 December quarter ,, III. 151 St. Marvlebone, Births and Deaths. January2 February .12 March quarter 22 April 36 May52 June quarter July 43 INDEX TO THE MONTHLY REPORTS—continued. page St. Marylebone, Births and Deaths. September quarter100 October122 November134 December quarter147 St. Marylebone, Causes of Death. January Table III6 February ,, III15 March „ X. 31 March quarter ,, XI32 April „ VI. 45 May „ VI. 58 June „ X. 76 June quarter ,, XI. 116 July „ VI. .94 September quarter ,, XI. 116 October VI. 130 November ,, VI. 141 December quarter X. 156 St. Marylebone, Notified Cases of Infectious Sickness. January Table II. 5 February „ II. 14 March „ II.25 March quarter ,, III. 26 April „ V. . 44 May ,, II. 55 June „ II. 70 June quarter ,, III. 71 July „ II. 91 September quarter ,, II. 3 October ,, II. 127 November ,, II. 138 December quarter ,, III. 151 St. Paul's School, percentage of unvaccinated children in 105 St. Stephens' School, percentage of unvaccinated children in105 Sale of Food and Drugs Act. March quarter Table IV. 27 June quarter „ IV.72 September quarter ,, III. 112 December quarter ,, IV. 152 Sanitary Works, Register of January9 February18 March33 April48 May 58 June 80 July 96 August117 September.118 October131 November142 December158 Sanitary Works, delay in the execution of . 125 Scarlet Fever, removal to hospital under magistrate's order of patient42 Seasonal Mortality4 Smallpox148 Deaths from106 ,, Effect of early removal . 87 ,, Effect on tra ,, Nightingale Street outbreak 101 ,, Portland Town ,, 84, 89 ,, Relief Fund 108, 109 T Thayer Street, No. 10, Prosecution of owner under the Public Health Act . 13 Tubercular Diseases, deaths from, and rate per thousand of the population January 3 page Tubercular Disease, deaths from, and rate per thousand of the population February13 March quarter 23 April37 May . 53 June quarter63 July 83 September quarter100 October323 November 147 December quarter117 Typhoid Fever, undue prevalence of 135, 148 U Upper Park Place, Prosecution of owner of Nos..8and3389 V Vaccination and the Schools 103.4 ,, snd Smallpox 85, 107 ,, Neglect of in St. Marylebone .105 Vaccinations, Table of January8 February17 March29, 30 April16 June74, 75 July93 October129 November140 December154, 155 W Water Analysis, Table of January10 February19 March34 April47 May59 June78 July95 August and September 120 October132 November 143 December156 Y Yeo, Re.arrangement of District of 4 ,, Work of, during smallpox outbreak 89, 100 Z Zymotic diseases, Deaths from, and rate per thousand of the population January3 February13 March quarter23 April37 May53 June quarter63 July33 September quarter100 October123 November137 December quarter 147 .