STMARY 70 THE SANITARY CHRONICLES OF THE PARISH OF ST. MARYLEBONE; BEING THE ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH, FOR THE YEAR 1895, 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. XV. LONDON: Printed by George Pulman & Sons, 24 & 25, Thayeb Street, and 5, Princes Street, W. Sek, THE SANITARY CHRONICLES OF THE PARISH OF ST. MARYLEBONE; BEING THE ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH, FOR THE YEAR 1895. BY ALEXANDER WYNTER RLYTH, 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. XV. * LONDON: Printed by George Pulman & Sons, 24 k 25, Thayer Street, and 5, Princes Street, W, PREFACE. The following Report is a brief summary of disease and mortality in the Parish of St. Marylebone, and of the work of the Sanitary Department during 1895. The arrangement is the same as that of previous Annual statements. The Court House, St. Marylebone. February 26th, 1896. . . ■ i? CONTENTS. Meteorological Summary 7—9 Births and Deaths 9—11 Smallpox 11—13 Scarlet Fever 13—15 Diphtheria 15—17 Typhoid Fever 16—17 Sanitary Work, 1895 17—18 Combined Drainage 19 Clerical Work of the Sanitary Department 19—20 Factory and Workshops Acts 20—21 Housing of the Working Classes Acts 21 Laboratory. Sale of Food and Drugs Act 21 Appendix 27 A REPORT of the METEOROLOGY, MORTALITY, AND SICKNESS of the PARISH OF SAINT MARYLEBONE, FOE THE YEAE 1895. By A. Wynter Blyth. METEOROLOGICAL SUMMARY. March Quarter. January of 1895 was a cold dark month; in each week there were frosts. The minimum temperature for the month was 25°.0; the maximum 49°.0; and the mean 37°.5. Ruin or snow fell on 19 days, the rainfall measuring 316 inches. There were several fogs. Sunshine was deficient. February was a month of almost unprecedented frost; the temperature falling even so low as 7°.5. The maximum temperature at the conclusion of the frost was 44°.3; and the mean temperature for the four weeks was only 29°.4. During the whole month but 18.5 hoars of sunshine were received. The weather was generally dry and overcast, but on five days rain or snow fell, equal to 117 inch of rain. March was brighter and milder. The minimum temperature was 24°.0; the maximum 63º.0; the mean 42°.4. On nine days rain or snow fell, equal to 057 inch of rain. The sunshine registered was equal to from 13 to 27 per cent. 8 SANITARY CHRONICLES, 1895. June Quarter. April was a wet month, of moderate temperatures. Rain fell for 18 days, the total rainfall being 2.32 inches. Three out of the five weeks were fairly sunny. The minimum temperature was 33o.0; maximum 65o.0; mean 49°.4. May was exceptionally fine. The sunshine never fell below 19°.5 per cent., and during one week attained 72 per cent. On four days only rain fell (0.34 inch). The minimum temperature was 38°.3; maximum 68°.5; mean 56°.5. June was also bright and warm. On only four days did any rain fall, the total rainfall amounting to 0-39 inch. The sunshine was never less than 41 per cent., and attained a maximum of 72 per cent. September Quarter. July was unsettled and rainy; rain fell on 17 days, to the total amount of 2.57 inches. During three of the five weeks there was bright sunshine, from 2.1 up to 16.1 per cent., but during the other two weeks the sky was mostly overcast. The minimum temperature was 50o.l; maximum 83°.8; mean 63°.7. August was exceptionally wet, no less than 4.19 inches of rain fell in 16 days. Temperatures Avere moderate; the minimum temperature being 48°.3; maximum 79°; mean 63º.2. September was a fine month, with but little rain save a violent thunderstorm on the 7th; no less than 1.43 inch of rain fell in a few hours, so that this one storm contributed almost the whole rainfall of the month, the total being 1.69 inch. The minimum temperature was 43°.5; the maximum 78o.0; the mean 62°.5. December Quarter. A wet but at the same time a bright October followed. The sunshine ranged from 23 to 41 per cent. On 19 days rain fell, to the amount of 4.58 inches. The temperatures were moderate, the minimum being 378.5; the maximum 68°.1; and the mean 53°.7. BIRTHS AND DEATHS, 1895. 9 A somewhat wet November followed, rain falling 16 days, to the aggregrate amount of 2.3 inches. Sunshine was as usual deficient save in one week, when it rose to 30 per cent. There was but little fog. The temperature ranged from 3l°.8 to 63° and had a mean of 47°.6. December was sunless save two consecutive days, on each of which there were eight hours of bright sunshine. The temperatures were moderate, ranging from 30° to 50°, with a mean of 38°.6. On 14 days rain fell, the total rainfall amounting to 376 inches. BIRTHS AND DEATHS. The number of births registered during the 52 weeks ending December 21st, 1895, when all essential corrections have been made, Avas 3,535. The number of deaths (corrected) of parishioners was 2,854. This gives a birth-rate of 28.8; a death-rate of 20.0 per thousand. The birth and death rates for 1895 of the sub-districts were as follows:— All Souls birth-rate 19.2; death-rate 15.7 Rectory „ 26.3; ,, 22.3 St. Mary „ 25.3; ,, 21.4 Christ Church „ 27.2; „ 23.3 St. John „ 27.7; ,, 19.6 The following is a statement of the average death-rates of St. Marylebone and its sub-divisions for five years viz., from 1890 to 1894 inclusive. St. Marylebone birth-rate 24.7; death-rate 21.1 All Souls „ 13.6; „ 12.2 Rectory „ 27.1; „ 21.8 St. Mary „ 23.6; „ 22.0 Christ Church ,, 27.6; „ 24.5 St. John „ 25.4; ,, 20.7 It therefore appears, from a comparison of the rates for five years (1890-1894) with those of 1895, that the latter year was about the average. 10 SANITARY CHRONICLES, 1895. 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 485 North-Western Fever Hospital 18 Western Fever Hospitel. 7 North-Eastern Fever Hospital 1 Fountain Fever Hospital. 1 Hospital Ship "Atlas " 6 South Wharf, Rotherhithe 1 London Fever Hospital. 5 West London Hospital 1 St. Mary's Hospital 63 St. Bartholomew's Hospital 6 King's College Hospital. 2 London Hospital. 1 St. George's Hospital 8 Royal Free Hospital 1 Charing Cross Hospital. 4 North-West London Hospital 1 St. Thomas's Hospital 2 Westminster Hospital 1 University College Hospital 18 Hospital for Women, Soho 1 North London Consumption Hospital 4 British Lyine-in Hospital 1 Children's Hospital, Paddington 6 Children's Hospital, Great Ormond Street. 7 London Temperance Hospital 2 French Hospital. 4 German Hospital 5 St. Pancras Workhouse 2 St. Pancras Infirmary 1 Hackney Infirmary 1 Whitechapel Infirmary. 1 Paddington Infirmary 4 St. Saviour's Infirmary. 1 Lewisham Infirmary 1 Westminster Workhouse. 2 Brompton Hospital 7 Cancer Hospital, Fulliam. 3 Friedenheim 3 St. Camillos Home 1 St. Elizabeth's Home 4 St. Peter's Home 2 St. Joseph's Home 1 Hanwell Asylum 15 Oolney Hatch Asylum. 14 Cane Hill Asylum 1 Leavesden Asylum 20 Bethlem Hospital 1 Banstead Asylum 2 Ilford Asylum. 12 Caterham Asylum 2 St. Saviour's Hospital 1 Carried iorward 764 SMALLPOX, 1895. 11 Brought forward 764 Dareuth Asylum 1 Hoxton House Asylum 4 Camberwell House Asylum 2 Peckham House Asylum 1 Aged Pilgrims Asylum 1 Central London Sick Asylum 1 St. Pplagia'a Creche 1 Royal Hospital for Incurables 1 Royal Chest Hospital 1 Italian Hospital ... 1 Steamship " Iona" 1 The " Priory," Putney 1 H. M. Prison, Wormwood Scrubbs ... 1 Salvation Army Shelter, Hackney 1 Hampstead Home Hospital 1 Dock Cottages, Poplar 1 Otherwise 8 792 SMALLPOX, 1895. Smallpox had been dormant for several years, until 1893; thus, taking the five years from 1890 to the end of 1894: in the first of the five years only three cases were notified; in 1891, only a single case occurred; in 1892, but seven cases; in 1893, a local outbreak brought the number up to 170. This outbreak was entirely owing to a case of great severity having been kept and nursed at home, added to which, the scene of the occurrence was in a community in which there had been but little vaccination. In the past year, 1895, a similar but smaller outbreak occurred, the total number of cases being 103. The circumstances connected with this outbreak are detailed at page 4 of the writer's Report, for the month of January, 1895, the cause being that a poor woman in a tenement house suffered from some feverish disorder, which ran so unusual a course as to baffle the skill of a medical man of experience to give it a name. It looked, indeed, like a hybrid of measles and scarlet fever. It was not until the ninth day, when much mischief had been done, that the eruption was sufficiently distinctive for the case to be notified as "smallpox." A few hours after the diagnosis the patient died. The case was only 12 SANITARY CHRONICLES, 1895. effectively isolated after death. Twenty of the subsequent cases were all connected with this first fatal obscure case; all of the twenty had visited the house. In smallpox, there are two kinds of cases which spread the disease; the one class is a very mild form, in which the sufferer feels but slight inconvenience, has, perhaps, one or two pimples, and does not seek any medical advice, but pursues his ordinary avocation. The other class is that in which the dose of the infection has been so large and overpowering as by its very virulence to mask the usual signs. Instances of the latter constantly occur in the course of an epidemic, and when smallpox is actually in the district are generally detected, for if among a series of cases a person suddenly falls ill of some alarming illness, the physician bears in mind the prevailing malady and the sufferer is suspected of having contracted a malignant form of it, but when, as in this instance, a local outbreak begins by malignancy, it is no matter of surprise that, for a time, the highest medical skill may be baffled in diagnosis. Therefore, however unfortunate the result, blame seldom lies on the medical attendant. Diseases are manifold in their manifestations, and the short experience of one life is insufficient to become acquainted with their varying phases. The chart (opposite page), shows a curve, which is the weekly register throughout the year of the number of cases of smallpox notified. Arising in the first week of January, it attained a maximum in the fourth week, and was practically suppressed by the end of February. "Suppressed" is the right word for taking advantage of the facilities for removal by the Asylums Board: 101 out of the 103 cases notified were removed to hospital within, at the most, two hours from notification, some within an hour; added to this the Vaccination Acts were put into force, and disinfection was carried on as completely and as rapidly as the imperfect appliances at the Stoneyard allowed, the Guardians greatly assisting by giving their Vaccination Officer directions suitable to the emergency; and probably St. John's Wood, the chief scene of the outbreak, is, at the present time, as well protected by vaccination from smallpox as any part of London. 1895. CURVES SHOWING, WEEK BT WEEK, THE NUMBER OF NOTIFICATIONS FOR TYPHOID FEVER, SMALLPOX, SCARLET FEVER, AND DIPHTHERIA. SCARLET FEVER, 1895. 13 Vaccination.—In connection with this subject it is as well in this place to state tlie amount of vaccination effected in 1895. The returns given to the writer by Mr. Frith, the Vaccination Officer, are summarised in the following table, and to the return is added the number of births in each of the five sub-districts diminished by the deaths under a year. These numbers are a guide to the efficiency of vaccination, for it is obvious that since vaccination, by law, is to be done within three months of birth, the number of vaccinations in any year should be at least somewhere near the births, less the deaths under one year of age. The table shows that the number of vaccinations have exceeded in every case the births, the reason being that there was, and still no doubt is, a considerable store of unvaccinated material at hand which came forward under fear of infection when the outbreak of 1895 was in progress. Sub-District. Total Vaccinations. Births minus deaths within one year of age. All Souls 716 599 Rectory 607 441 St. Mary 1747 394 Christ Church 984 717 St. John 941 725 4995 2876 SCARLET FEVER, 1895. A reference to the Chart will show the course, week by week, of scarlet fever during 1895. The total number of cases notified was 514, a number rather less than the mean number for the five preceding years, Avhich mean number was 547. The mean is, however, derived from a quinquennial period, which comprised two years which may be justly considered epidemic years, hence the number representing the mean must be taken as an average of two epidemic and three non-epidemic years. Looked at in this light, scarlet fever in St. Marylebone was certainly somewhat prevalent. 14 SANITARY CHRONICLES, 1895. Towards the end of September, difficulty began to be experienced in removing cases to hospital. The Asylums Board accommodation was practically exhausted; this was partly, it appears, from a large increase in the cubic space per head allotted to each patient. The Medical Superintendents had found, by careful observation, that in scarlet fever and diphtheria the success of treatment, the rapidity of recovery, and the absence of certain sequelae had a distinct relationship to cubic space: every 100 patients treated in very roomy wards recovering quicker, and so to speak more happily, as compared with 100 patients under not quite such good conditions. Accordingly, what has been described as an excessive amount of air-space was given to each of the patients; this necessarily decreased considerably the accommodation. On the other hand, the writer has urged that, of the two evils, viz. : the keeping of patients in crowded tenement houses, under conditions which admit of no effective isolation, and the decreasing of the cubic space for a short period in hospitals, the latter evil is infinitely the better of the two, and saves more lives and sickness, with its consequent misery and poverty. Besides this restriction of accommodation, the Managers had reason to be apprehensive of outbreaks of smallpox. The St. Marylebone experience of the Portland Town outbreak had taught them the lesson that smallpox might burst suddenly at any period of the year, and assume formidable dimensions, especially in such a vast concourse of persons as comprise the population they have to provide for. Consequently the Gore Farm Hospital was kept unoccupied, ready for the contingency of smallpox. A number of temporary buildings were also being altered to more permanent structures. By statute, the Managers cannot refuse to admit anyone who is a ratepayer in the Metropolitan District. The people of London have no horror of hospitals; the Asylums Board Hospitals have become in a way popular; the consequence is that they are insufficient in number and size to deal effectively with anything but the infectious disease of very ordinary years. It is a question whether even those which are now in course of erection will not be still found insufficient. DIPHTHERIA, 1805. 15 The writer brought early the state of things before the Vestry of St. Marylebone, and suggested that something should be done to provide, directly or indirectly, for cases urgently requiring isolation. The question was discussed in all its bearings; stress was laid on the constant inadequacy of the Asylums Board resources. The expense of assisting the Board seemed to be annual—not temporary, For two successive years the Vestry had established and maintained temporary hospitals, and had thus greatly assisted the Asylums Board by housing and treating a number of sick which would otherwise have been among other applicants for admission into the Asylums Board Hospitals. Without a doubt the advantages gained to the community outweighed the expense of the temporary hospitals; nevertheless, as no other local authority followed the example of St. Marylebone, and it looked as if the same difficulty was going to recur yearly, it is no wonder that the proposal to maintain another hospital met with considerable opposition and was ultimately rejected by a substantial majority. DIPHTHERIA. 226 cases of diphtheria were notified during the year, and this is about the average annual number. The writer suggested to the Vestry that facilities should be given to the medical men of the district for the bacteriological examination of the throats of patients presumed to be suffering from diphtheria, and the Vestry adopted the suggestion. The City of Bristol in this country and the State of New York in America have also a system of methodical examination, and the results are encouraging. As carried out in St. Marylebone the procedure is as follows : Each medical man is supplied with a small box containing two tubes one of which is fitted with a cork carrying a wire, around the end of which is wrapped a little sterile wool. On visiting a case suspected to be diphtheritic, he examines the throat, applies the wool on the end of the wire to the affected part, and replaces it in the tube, or should there be decided membrane, a little of the membrane is detached and put in the empty tube. The tubes thus infected are transmitted to the 16 SANITARY CHRONICLES, 1895. writer, and in about 24 hours after the receipt a Report is obtained from the Institute of Preventive Medicine as to whether the diphtheria bacillus has been identified or not. A great number of the medical men now send the boxes in before notifying, and if the case is not found to be diphtheria, no notification, of course, follows. The expense of enquiry is as follows: The fee charged by the Institute is 2s. 6d , the box costs a penny, the test-tubes, bought by the gross, about one penny and a halfpenny, and the cost of sterilising, supplying the tubes with the wires, and wool, another penny, the postage is three halfpence, which brings the cost up to 2s. lid. per case. There are also, occasionally, some other trifling expenses, so that it will be right to say that this system costs about 3s. per case. On the other hand, since the majority of medical men now do not notify until after such an examination, a good many false cases of diphtheria which would otherwise be notified, and the statutory half-crown paid, are, of course, not notified; besides which, there must be included the great advantage from an economical point of view, in not sending a patient with an ordinary sore throat, however diphtheritic it may look, to hospital, where he is kept for some time at the expense of the rates. It is too early yet to speak decidedly about the success of this measure, but, so far, it looks most promising. Since October, when the Vestry adopted the writer's suggestion, many cases which would otherwise have been kept at home and spread the malady, have been removed to hospital and conversely, many patients which would have been sent to hospital, have been treated at home, because the primary diagnosis has not been confirmed: those cases which have been dealt with at home under the presumption that they were not true diphtheria showed no inclination to spread, and the patients have recovered without showing the rather common sequelfe of paralysis or kidney mischief, which tends to show that the bacteriological diagnosis was the correct one. TYPHOID FEVER. Typhoid fever showed a decided increase. The average number for five years of typhoid cases is 108, but last year SANITARY WORK, 1895. 17 it rose to 133. The writer believes it had some connection with the intense frost in February, 1895. More than a third of all the water-service pipes, and not a few of the water-mains, were, in that memorable season, damaged; those which showed evidence by flooding basements or leaking on to the surface have long since been repaired, but smaller leaks and fine cracks would remain concealed. It is probable that here and there local pollution of the water supply occurred. The fever followed the usual course (see chart opposite page 12)—it rose in June and July, fell in August, and then rose again in September, October, November, and in the first week of December suddenly decreased. SANITARY WORK, 1895. At page 34 will be found a summary of details of Sanitary Work carried out by the six Sanitary Inspectors. First of all, with regard to direct complaints of insanitary condition. These are about the average; 1,633 complaints are recorded in 1895, as compared with 1,556 in 1894. The number of inspections are roughly about 1,500 annually. The notices or orders for abatement issued by the Vestry, and each week placed upon the table and referred to in the agenda show a decrease, viz., 484, as against 774 in 1894; the reason is partly because a less number of houses were found defective, and partly because the great majority of cases do not come now under the direct cognizance of the Vestry. Directly any insanitary condition is found, the Statute has provided that an "intimation" of the defect is to be at once sent to the owner or to the person who is responsible for either causing the nuisance or abating it. The consequence is that, in the majority of cases the matter is at once put right and there is no necessity for a formal Vestry order. 18 SANITARY CHRONICLES, 1895. As usual there has been great activity with regard to drainage, some 85,500 feet of house drains have been laid according to the Regulations of the Yestry. This is greater than in any recent year, as the following brief statement will show:— Number of feet of drains. Year. 41,541 1891 35,612 1892 61,753 1893 85,099 1894 85,456 1895 The plans of all this drainage are deposited at the Court House, and are open to the inspection of every ratepayer. It is scarcely necessary to add that the supervision of so large a number of individual drains as the 85,500 feet represent, has consumed much time. First of all, before a drain is laid, the Inspector visits the premises, plan in hand, and makes his Report as to whether the plan should be sanctioned. Next, during the progress of the work, in order to ascertain that the Regulations are complied with, the premises must be visited several times, and lastly before the new work is covered in and hid, the whole has to be tested by the water test. It is satisfactory to again note how few prosecutions have been necessary to enforce obedience to demands made for sanitary improvement. In the whole year only 11 summonses have been necessary, as compared with 21 summonses in 1894. There have been during the year, 17 applications for permission to construct combined drainage. A combined drain, in default of the order of the Yestry or evidence that in former years such combination of drains have been made with the sanction of the old Metropolitan Board of Works, or of the present County Council, is in most cases (not all) technically a sewer. It is, therefore, of considerable utility to have a list of the combined drains in recent years, which have been carried out under the order of the Yestry. The following list are those on the minutes, others may be in the archives of the London County Council. 19 CLERICAL WORK OF THE SANITARY DEPARTMENT, 1895. COMBINED DRAINAGE. Date. Year. Vol. Vestry Minutes Page. 189l 26 Feb. 33 & 34, Grove Gardens (San. Min., Vol. 3, pp. 146-149) 1891 160 323 1893 26 Jan. " Flying Horse," 6, Oxford Street 1893 166 387 23 Feb. 104, Carlisle Street, and 25, Richmond Street »» 167 87 2 Mar. 106, &c., Carlisle Street ,, 11 115 13 „ 141-3-5, Carlisle Street ,, ,, 255 13 „ 25a, 26, 27, 28, 29, & 30, Chapel Street ,, ,, ,,,, 19 Oct. 17 & 19 Avenue Road ,, 168 442 1894 22 Feb. Charles Street (L.G.) 1894 170 28-37 1 Mar. 227, 229, 231, Marylebone Road ,, ,, 101 12 July 18 & 18a, Little Queen Street ,, 171 102 27 Sept. 19, Circus Road, and 44, Wellington Road ,, ,, 276 20 Dec. Gray's Buildings (2 to 22) ,, 172 159-176 1895 9 May 15, 17, & 19, Blenheim Terrace 1895 173 229-214 19, Margaret Street, and Fitzroy Temperance Hall ,, ,, 159 30 May 81, Newman Street, and 76, Castle Street East ,, ,, 264-303 13 June 296-298, Oxford Street ,, ,, 334 4 July 35 & 36, Gosfield Street ,, 174 15 26 Sept. 39 & 40 Paddington Street ,, ,, 184 26 „ Site of 9 to 14, Stephen Street ,, ,, ,, 3 Oct. 6, James Street, and 372, Oxford Street ,, ,, 218 31 „ 1 to 7 Beckett's Place ,, ,, 338 7 Nov. Site of 11 & 12, William Street, and 28a & 28b, George Street (L.G.) ,, ,, 398-400 7 „ 22 to 25, Bell Street, and cottages in rear ,, ,, 377 7 „ 1 to 5, Freshwater Place ,, ,, 378 14 „ 156, 158, & 160, Edgware Road ,, ,, 419 21 „ 1 & 2 Weston Place ,, ,, 440 28 „ 9, 10, & 11, Little George Street ,, ,, 448-463 19 Dec. 7 to 14, Hardington Street ,, 175 40-63 Clerical Work of the Sanitary Department. The clerical work is carried out by two clerks, a chief and an assistant clerk. During the year Mr. Woods, the assistant clerk, died, much regretted by all the Court House officials, of a tuberculous affection. The chief clerk's brother, Mr. Curtis, Jun., was a candidate for the office and succeeded in obtaining the appointment. The clerical work of the department has been done conscientiously and well during the past year. 20 sanitary chronicles. 1895. The following is a tabular statement of what this work mainly consists of. In a separate column is placed the corresponding return for 1894, and it will be noted that the clerical work is on the increase. The only figures showing a decrease are those with regard to meetings of committees and subcommittees, the truth being that in 1894, a number of meetings of committees and sub-committees were held which might have been avoided with no loss of efficiency. 1895. 1894. Number of Notifications of infectious diseases entered in Register, copied, and sent to Metropolitan Asylums Board and Schools, receipt acknowledged and filed 1368 1780 Number of Complaints of Nuisance received, entered in Nuisance Register, and filed 1307 1268 Number of Dust requests and Complaints received, entered on Contractors' sheets, copied, and filed 2462 2762 Number of letters despatched from Department 1519 1845 Number of Vestry Notices issued 412 592 Number of Meetings of Sanitary and Sewers Committee prepared for, attended, and Minutes drafted and written 31 23 Number of Reports from Committee to Vestry prepared 26 21 Number of Meetings of Sub-committees prepared for, attended, and Minutes drafted and written 16 20 Number of Reports from Sub-committees to Committee prepared 11 19 FACTORY AND WORKSHOPS ACTS. The great recent development of Factory and Workshop Legislation has placed considerable responsibility and work on the officers of Sanitary Authorities. The workplaces are so numerous in the parish, that it is not practicable for them all to be inspected regularly with the present staff. It may well be a matter of consideration for the Vestry, at some future time, to add the services of a lady inspector; the more especially, as wherever lady inspectors have been appointed in other districts, the testimony of their use and efficiency has been singularly unanimous. There are indeed several places in the parish which can neither conveniently nor decently be supervised by anyone of the male sex. The details of the Acts relating to Factories and Workshops, Bakehouses, and the prevention of smoke, have been allotted to Mr. Richard Phillips, and he has carried out his rather delicate duties creditably and judiciously. 21 sale of food and drugs acts. The following is a tabular statement of certain matters which can be numerically expressed. Much of the work done does not admit of tabulation — 1895. Visits to Outworkers 251 Ascertaining by Measurement the cubic space of Workrooms 172 Investigating in detail the ventilation of Workrooms 40 Inspection of new places of Business, and reporting on the same 26 Inspection of the 126 Bakehouses in the Parish 254 Attending to complaints of Smoke, the complaints in number being 23 THE HOUSING OF THE WORKING CLASSES ACTS. But little work has been done under these Acts during the year, the fact being, that owing to the extensive alterations and the demolition of houses necessitated by the construction of the Manchester and Sheffield Railway, and owing to a number of leases on the large estates falling in, no small portion of the parish is under reconstruction. However dilapidated a house may be, if the lease under which it is held comes to an end within two years, it is certainly wiser for a local authority to await events than to use the cumbrous and expensive machinery of an Act which, if opposed, can certainly not be brought to bear effectively within that space of time. THE LABORATORY. Sale of Food and Drugs Acts. During the year an important change took place. Mr. Colwell, who had been for several years in the Court House Laboratory, resigned his office owing to his being successful in obtaining more than one public appointment as analyst; and Mr. W. A. Rogers, a gentleman of special 22 SANITARY CHRONICLES, 1895. analytical skill, was selected from a number of applicants as his successor. About the same large number of samples have been analysed under the Sale of Food and Drugs Act as in former years; the number being 568 as compared with 570 for the year 1894. MILK. There is really very little adulteration of milk in the parish which can be dealt with by law. The majority of 219 samples which were analysed had certainly in no way been tampered with; a few had probably been mixed with separated milk and, as such, showed a poorness in milk fat, and 12 samples had been wilfully adulterated. It may be thought that this result is because the Inspectors are personally known and supplied with different milk from that which is sold to the public, but this is not so; for agents have been freely used: samples have been collected in the street, on Sundays and holidays, and very early in the morning. Inspectors, on complaint, have attended at private houses and taken milk on delivery, but still with the same result; the true explanation being as I have often reiterated, that the system of steady and methodical supervision has had its effect. As a rule the grossest adulterators of milk are not residents and tradesmen belonging to this district at all, but come from bordering parishes and sell milk from the barrow in the poorer parts. One, for example, was rather smartly caught by an Inspector in the last month of the year, selling "separated" milk for "new." This man refused his address, but he was ultimately found to live in Paddington. The Magistrate fined him £10, and as he could not pay he was sent to prison for six weeks. This itinerant vendor, should he continue fraudulent practices, will probably transfer his energies to some other Metropolitan district in which analyses are few. This is only an instance of what has gone on for at least ten years: an itinerant vendor suspected of selling adulterated milk is ultimately detected, fined or imprisoned, and afterwards fights shy of St. Marylebone. The writer could also give instances of persons settling in the parish, setting up a fraudulent business as milk sellers, and in a few months having to close their doors, owing to their practices being detected. Stress is laid upon this matter, for the system of 23 BUTTER—SPIRITS. strict supervision of milk is of immense importance, and the Vestry of St. Marylebone, by putting no vexatious obstacles to the taking of large numbers of samples, has done quite as much if not more in this respect than any district in London, and has never had any special credit for it. The per centage of Adulteration of Milk, and the results of the prosecutions are as follows:— Milk, 4 per cent. added water, and 9 per cent. of fat abstracted. Fined XI and costs. Milk, 9 per cent. added water. Pined 10s. and costs. Milk, 10 per cent. added water, and 23 per cent. of fat abstracted. Fined £2 and costs. Milk, 22 per cent, added water. Fined £1 and costs. Milk, 23 per cent. added water. Fined £3 and costs. Milk, 24 per cent. added water. Fined 5s. and costs. Milk, 20 per cent. fat abstracted. Fined £1 10s. and costs. Milk sold as New, but really separated, and therefore destitute of Milk Fat. 6 weeks imprisonment in default of paying a fine of £10. BUTTER. As a rule Butter is sold genuine; out of 93 cases only one was found adulterated. This sample was a mixture of 25 per cent. of margarine, mixed with good butter. The case was adjourned several times; the defence being that the butter came direct from Australia, and had deteriorated during the voyage; proof of this failed, and a penalty of £2 and costs was inflicted. SPIRITS. The legal limit of the strength of Spirits, for brandy, whisky, and rum, is 25 degrees under proof, that for gin is 35 degrees under proof. Any person accustomed to take spirits would consider that he was aggrieved if he bought by the bottle spirits diluted down to exactly the legal limit. It is indeed a low standard, and all spirits should at least be of the strength mentioned. In a good many cases, in order to evade the Act, the licensed victualler places up in the bar (sometimes in a not too conspicuous position) a notice to the effect that all spirits sold in that establishment 24 Sanitary chronicles, 1895. are diluted with water. It is a fair inference that in such establishments some of the spirits sold are diluted below the legal limit. In those cases in which there is no such notice, dilution is not frequent; 69 samples of Spirits were all genuine and of proper alcoholic strength, save two: two samples of brandy were found three or four degrees below the 25 degrees limit; one of the vendors was fined 5s. and costs, the other £2 and costs. The other samples do not require special comment. APPENDIX. 27 TABLE I.—Giving the death-rate per thousand of population, of the five Registration Districts, from certain classes of disease, 1894 and 1895. The whole District All Souls* Rectory St. Mary Christ Church St. John 1. Zymotic diseases 1894 2.48 1.69 2.09 2.23 3.05 3.86 ,, 1895 2.27 2.01 2.04 2.91 2.19 2.65 Pulmonary, other than than Phthisis 1894 3.78 2.84 4.44 3.85 5.37 5.95 ,, 1895 5.09 4.35 5.94 5.40 6.09 4.20 3. Tubercular 1894 2.15 1.54 2.29 2.34 2.49 1.96 ,, 1895 2.32 1.62 2.59 2.65 2.88 1.99 * With All Souls, Cavendish Square is now included. TABLE II.—Rate of Mortality percent. of diseases notified in each of the five Registration Districts, 1894 and 1895. The whole District All Souls Rectory St. Mary Christ Church St. John Smallpox 1894 10.0 ... ... ... 10.6 9.8 ,, 1895 9.7 ... ... 9.5 11.2 ... Scarlet Fever 1894 9.2 12.7 7.6 10.1 8.6 5.3 ,, 1895 4.4 5.2 6.6 1.5 2.5 7.0 Diphtheria 1894 23.1 18.9 17.9 29.1 24.7 27.5 ,, 1895 15.4 3.7 31.5 14.2 13.5 25.4 Typhoid Fever 1894 15.6 15.3 13.0 22.7 8.2 18.1 ,, 1895 13.5 8.3 44.4 8.0 18.8 9.0 Erysipelas 1894 3.1 ... 5.0 ... 2.5 9.0 ,, 1895 1.6 ... ... ... ... 10.5 28 TABLE III.—District Births and Deaths for the fifty-two weeks ending december 21st, 1895. Population in 1881. Population in 1891. Births. Deaths. Males. Finis. Males. Fmls. All Souls 41,651 37,713 365 360 308 283 Rectory 24,900 20,024 272 254 203 243 St. Mary 21,122 19,239 255 231 216 195 Christ Church 33,691 33,327 468 440 410 367 St. John 33,640 32,101 454 436 296 333 Total 155,004 142,404 1814 172l 1433 1421 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. 20 TABLE IV.—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 1895; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ church St. John Totals Population at all ages. (6) Census 1891 37,701 20,019 19,238 33,323 32,100 142,581 (c) Registered Births 725 526 486 908 890 3535 (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 bach Locality coming to the knowledge of the medical Officer of Health. 1 Smallpox 1 5 1 2 4 17 9 53 1 10 16 87 2. Scarlatina 43 88 24 67 17 45 61 98 27 44 172 312 8. Diphtheria 15 39 4 15 8 13 31 50 16 35 74 152 4. Membranous Croup .. .. 1 .. .. .. .. .. .. 1 1 1 Fryers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid 1 57 .. 12 2 7 1 31 1 21 5 123 7. Continued .. 1 .. .. .. .. .. 1 .. 1 .. 3 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. 4 .. .. .. 2 .. 1 .. .. .. 7 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas 2 37 .. 65 •• 27 2 65 4 34 8 228 Number of such Casks Removed from their Homes in the several localities for Treatment in Isolation Hospital. 1. Smallpox .. 5 1 2 4 17 9 52 1 10 15 86 2. Scarlatina 40 68 15 59 9 23 47 82 24 29 135 261 3. Diphtheria 9 16 2 6 4 7 18 29 11 15 44 73 4. Membranous Croup .. .. 1 .. .. .. .. .. .. .. 1 .. Fevers. 5 Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid 1 29 .. 7 1 4 1 20 1 8 4 68 7. Continued .. .. .. .. .. .. .. .. .. 1 .. 1 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas 1 7 •• 35 .. 13 .. 22 2 9 3 86 30 TABLE V.—Giving the Causes of Deaths during the 52 Weeks ending December 21st, 1895, 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 .. .. .. .. .. Diphtheria 5 .. .. .. .. Typhoid Fever 8 .. .. .. 2 Diarrhoea 1 18 .. .. 6 Erysipelas 2 .. .. .. 7 Pneumonia and Pleurisy 16 2 .. 4 27 Pyaemia 5 .. .. 1 2 Syphilis .. .. .. .. 3 Cancer 112 1 .. .. 33 Phthisis and Tuberculosis 33 1 .. 4 110 Rheumatism 1 .. .. .. 6 Apoplexy 6 .. .. 8 9 Paralysis 1 .. .. .. 38 Bronchitis 18 .. 28 131 Asthma .. .. .. 4 1 Peritonitis 13 .. .. .. 3 Disease of Brain 8 .. .. 2 2 „ Heart 28 .. .. 3 29 „ Kidney 13 1 l .. 7 „ Liver 1 .. .. 1 9 „ Uterus 1 .. 8 .. .. „ Ovary 2 .. 5 .. .. Parturition .. .. .. .. .. Diabetes .. .. .. .. .. Fractures and Injuries 21 .. .. 2 8 Old Age .. .. .. 5 9 Low Vitality, Infants .. 4 .. 14 .. Premature Birth .. 17 .. 1 ... Other causes 54 12 3 11 43 Total *349 †56 ‡21 88 485 *Of the 349 deaths in the Middlesex Hospital, 274 were those of non-parishioners. †Of the 56 deaths in Queen Charlotte's Hospital, 53 were those of non-parishioners. ‡The 21 deaths in the Samaritan Hospital were those of non-parishioners. 31 TABLE VI.—TABLE OF DEATHS in the Sanitary District of ST. MARYLEBONE during the 52 weeks ending December 21 st, 1895, classified according to Diseases, Ages, and Localities. All Souls Rectory St. Mary Christ Church St. Jons 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. (6) At all ages 591 446 411 777 629 2854 767 411 (c) Under 1 year 126 84 92 191 166 659 41 53 (d) 1 and under 5 37 28 46 77 53 241 53 22 (e) 6 and under 15 19 15 13 28 22 97 19 15 (f) 15 and under 25 30 19 6 30 25 110 40 20 (g) 25 and under 65 248 167 139 270 196 1020 370 256 (A) 65 and upwards 131 133 115 181 167 727 244 45 (i) Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 6 upwards Under 5 5 upwards Under 5 5 upwards Mortality from subjoined causes,distinguishing Deaths of Children under Five Years of Age. 1. Small Pox .. .. .. .. 2 .. 4 3 .. .. 6 3 7 .. .. .. 2. Scarlatina 4 3 4 2 1 .. 4 .. 3 2 16 7 8 6 1 .. 3. Diphtheria .. 2 1 5 3 .. 9 2 10 3 23 12 13 2 2 .. 4. Membranous Croup 1 .. .. .. .. .. 1 .. .. .. 2 .. .. .. 1 .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 5 .. 1 .. 4 1 5 .. 2 1 17 .. 6 .. 8 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. 4 .. 1 .. 1 .. .. .. 1 .. 7 .. 1 .. 2 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. .. .. .. .. .. 1 3 1 3 3 1 .. 1 12. Measles 5 2 1 .. 2 .. 2 .. 4 .. 14 2 2 .. 1 1 13. Whooping Cough 6 2 3 .. 6 .. 7 .. 11 33 2 .. .. .. .. 14. Diarrhœa and Dysentery 14 6 8 2 17 1 21 2 19 4 79 15 12 1 19 .. 15. Rheumatic Fever .. .. 1 1 .. 1 .. 2 .. 1 1 5 .. 3 .. 4 16. Ague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 17. Phthisis 11 45 6 48 11 44 9 87 6 53 42 277 9 135 1 26 18. Bronchitis, Pneumonia & Pleurisy 34 130 29 90 33 68 64 149 51 94 211 531 14 163 12 23 19. Heart Disease 1 42 2 31 1 27 .. 40 3 46 7 186 .. 42 .. 26 20. Injuries 5 18 4 8 4 7 17 14 16 15 40 02 6 22 4 16 21. All other Diseases 82 169 53 145 59 120 129 205 95 186 418 825 20 291 34 229 Total 163 428 112 334 138 273 268 509 219 410 900 1954 94 673 75 336 32 TABLE VII.—Sale of Food and Drugs Act.—Samples analysed during the Tear 1895. Genuine. Adulterated. Total. Dairy Produce: Milk 207 12 219 Butter 92 1 93 Condensed Milk 5 — 5 Margarine 2 — 2 Cream 3 — 3 Condiments: Mustard 12 - 12 Vinegar 15 — 15 Pepper 16 — 16 Beverages: Cocoa 11 - 11 Coffee 14 — 14 Tea 15 — 15 Sprits: Brandy 21 2 23 Gin 13 — 13 Rum 7 — 7 Whisky 26 — 26 Sweetmeats : Jam 15 - 15 Sweets 5 — 5 Marmalade 1 — 1 Drugs: Quinine 4 — 4 Laudanum 1 — 1 Farinaceous Food: Oatmeal 2 — 2 Miscellaneous: Lard, Sugar, Ground Ginger, Carraway Seeds, Sauce, Sherbet, Salad Oil, etc. 66 — 66 Total 553 15 568 33 REPORT OF MORTUARY KEEPER FOR THE YEAR 1895. Number of bodies received from January 1st, 1895, to December 31st, 1895. Males Females Males Females Brought forward 156 162 January 20 29 July 18 20 February 42 44 August 21 21 March 41 39 September 23 14 April 18 23 October 15 21 May 21 11 November.. .. 14 18 June 14 10 December 21 21 156 162 Total 268 277 545 Number of Inquests from January 1st, 1895, to December 31st, 1895. Brought forward 165 January 25 September 18 February 36 October 16 March 18 November 10 April 18 December 16 May 20 Bodies received for inquest, Dec. 1894 and the inquests held Jan. 1895 were 2 June 12 July 16 Total 227 August 20 Number of bodies to await burial only 318 Number of bodies for inquest 227 Total 545 Infectious cases received. Smallpox 2 Scarlet Fever 3 Diphtheria 5 Typhoid Fever 2 Total 12 34 REGISTER OF SANITARY WORK, 1895. SANITARY DEPARTMENT. Number of Complaints received 1,633 Inspections Of Dwelling Houses 2,738 14,828 „ Kitchens (separately occupied) 608 „ Schools 136 ,, Houses registered under Public Health (London) Act, 1891 1,760 „ Dairies and Cow-houses 150 „ Bakehouses 411 „ Slaughterhouses 115 „ Miscellaneous Inspections 8,910 Notices issued for Abatement of Nuisances 484 Letters written relating to Abatement of Nuisances 1,254 Proceedings taken before Magistrates under Sanitary Acts 11 Reports made to Medical Officer of Health 2,648 Infectious Patients removed to Hospital 759 Rooms Disinfected after Infectious Disease 1,276 New Pipe Drains (feet) 85,456 Houses where defects in Drainage have been detected and remedied 707 Unwholesome Food—Number of Seizures made 7 Food Adulteration Samples collected for Analysis .. 569 Proceedings taken before Magistrates 12 Removal of Bodies to Mortuary 27 35 INDEX TO MONTHLY REPORTS, 1895. PAGE A Abbey Gardens (No. 25), Prosecution of owner of 28 All Souls, Births and Deaths . January Table IV. 8 February „ IV. 21 March . ,, VI. 34 March quarter „ VIII. 35 April „ IX. 47 May „ IV. 62 June ,, VI. 80 June quarter ,, VIII. 81 July ,, IV. .97 August ,, VIII. 115 September „ X. 116 September quarter ,, XII. 117 October ,, IV. 131 November ,, IV. 142 December ,, VI. 157 December quarter ,, IX. 159 All Souls, Causes of Death in January Table XI. 9 February ,, VI. 22 March X. 36 March quarter XI. 37 April ,, VI. 48 May „ VI. 63 June quarter ,, X. . 82 July „ VI. 98 September quarter ,, V. 112 October ,, VI. 132 November ,, VI. 143 December ,, VIII. 158 December quarter ,, IX. 159 All Souls, Notification of Infectious Disease. January Table II. 6 February II. 19 March ,, II. 30 March quarter ,, III. 31 April ,, II. 45 May ,, II. 60 June II. 76 June quarter ,, III. 77 July ,, II. 95 August ,, II. 110 September ,, III. 111 October ,, II. 129 November ,, II. 140 December „ II. 153 December quarter 154 Ammonia in Wood Pavement 72 Andrews, D. J. Sanitary Work done during January 11 February 34 March 39 March quarter 40 April 50 May 65 June 84 June quarter 85 July 100 August 119 September 120 September quarter 131 October 134 PAGE Andrews, D. J. Sanitary Work done during November 144 December 161 December quarter 162 B Balcombe Street, No 33, Prosecution of owner 18 No 31 „ 18 Births and Deaths January 2 February 14 March quarter 26 April 42 May 52 June quarter 69 July 88 August 104 September 104 September quarter 105 October 124 November 136 December 148 December quarter 149 Boston Place, Nos. 93, 95, Prosecution of owners of 5 C Carraway Seeds, Adulteration of 74 Chapman, June, Prosecution of for Milk Adulteration 75 Christ Church, Births and Deaths. January Table IV. 8 February „ IV. 21 March ,, VI. 34 March quarter ,, VIII. 35 April ,, IX. 47 May „ IV. 62 June ,, VI. 80 June quarter ., VIII. 81 July IV. 97 August ,, VIII. 115 September „ X. 116 September quarter ,, XII. 117 October ,, IV. 131 November ,, IV. 142 December ,, VI. 157 December quarter ,, IX. 159 Christ Church, causes of Death in January Table XI. 9 February ,, VI. 22 March ,, X. 36 March quarter ,. XI. 37 April „ VI. 48 May „ VI. 63 June quarter ,, X 82 July „ VI. 98 September quarter ,, V. 12 October „ VI. 132 November ,, VI. 143 December ,,VIII. 158 December quarter ,, IX. 159 36 INDEX TO THE MONTHLY REPORTS— continued. PAGE Chris'. Church, Notification of Infectious Disease in January ,, II. 6 February ,, II. 19 March ,, II. 30 March quarter III. 31 April ,, II. 45 May ,. II. 60 June ,, II. 76 June quarter ,, III. 77 July II. 95 August II. 110 September ,, III. 111 October ,.11. 129 November ,, II. 140 December II. 153 December quarter 154 Cold, Effects of in February 16 Colwell, resignation of 18 Cubic space in Hospitals 93 D Diphtheria. Bacteriological diagnosis of 126, 137, 150 ,, Outfit" 126 Diseases said to be produced by Wood Pavement 73 Disinfecting Chamber and Shelter 151 Dust emanating from different Pavements . 73 Drinking Troughs in connection with Glanders and Farcy 55 G Gas, Analysis of January Table VIII. 10 February ,, VIII. 23 March quarter ,. XIII. 38 April ,, VIII. 49 May (wanting) June quarter „ XII 83 July „ VIII. 99 September quarter ,, XV. 118 October „ VIII. 133 November ,, VIII. 145 December quarter ,, XI. 160 Glanders and Farcy, Report on 54 Gorniot. Sanitary work done by, during January 11 February 21 March 39 March quarter 40 April 50 May 65 June 84 June quarter 85 July 160 August 119 September 120 September quarter 121 October 134 November 144 December 161 December quarter 162 Great James Street—No. 10, Prosecution of owner of 94 H Harewood Place—No. 3, Prosecution of owner of 18 Heather, Great Titclifield Street, Prosecution of, for diluting Brandy 152 Hospialt Accommodation for Scarlet Fever 90, 93 PAGE Hodges. Sanitary work done by, during January 11 February 34 March 39 March quarter 40 April 50 May 65 June 84 June quarter 85 July 160 August 119 September 120 September quarter 121 October 134 November 144 December 161 December quarter 162 Hospital, temporary, suggested . 108 I Influenza 16,17,28 K Keen, Emma, Prosecution of, for Adulteration of Milk 75 Kilgallin. Register of Sanitary Work during January. 11 February 34 March 39 March quarter 40 King's Scholars Pond Sewer, inadequacy of 106 L Lorne Gardens (No. 9). Prosecution of owner 5 M Mallein as a re-agent for Glanders 55 Mandeville Place, flooding of basements 106 Meteorology of January 1 February 13 March 25 April 42 May 51 June 67 July 87 Augus t 103 September 104 October 123 November 135 December 147 Middlesex Hospital—causes of Death in January Table III. 7 February ,, III.20 March quarter ,, IV. 32 April III. 46 May ,, III. 61 June quarter ,. IV. 78 July „ III. 96 September quarter ,, VII. 114 October ,, HI. 130 November ,, III. 141 December quarter .. V. 156 Milan. W., Prosecuted for selling "Separated " for New Milk 151 37 INDEX TO THE MONTHLY REPORTS—continued. PAGE P Park Street (No. 9), Prosecution of owner of 18 Park Street (No 49) 94 Perrv, Arthur. Sanitary work done by, during January 11 February 24 March 39 March quarter 40 April .50 May 65 June 84 June quarter 85 July 160 August 119 September 120 September quarter 121 October 134 November 144 December 161 December quarter 162 Phillips, Richard. Sanitary work done by during January 11 February 24 March 39 March quarter 40 April 50 May 65 June 84 June quarter 85 July 160 August 119 September 120 September quarter 121 October 134 November 144 December 161 December quarter 162 Prosecutions under the Public Heath Act 5, 10, 18. 28 Q Queen Charlotte's Hospital—causes of Death in January Table III. 7 February , III. 20 March quarter ,, IV. 32 April ., III. 46 May „ III. 61 June quarter ,, IV. 78 July „ III. 96 September quarter ,, VII. 114 October III. 130 November ., III. 141 December quarter V. 156 Quinine as a Prophylactic for Influenza 28 R Raven, Mrs., Prosecution of, for Milk Adulteration 29 Rectory, Births and Deaths January Table IV. 8 February „ IV. 21 March „ VI. 34 March quarter ,, VIII. 35 April ,. IX. 47 May „ IV. 62 June VI. 80 June quarter ,, VIII. 81 July „ IV. 97 August ,, VIII. 115 September ,, X. 116 September quarter ,, XII. 117 PAGE Rectory, Births and Deaths October „ IV 131 November ,, IV. 142 December „ VI. 157 December quarter ,, IX. 159 Rectory, Causes of Death in January ,, XI. 9 February VI. 22 March X. 36 March quarter ,, XI. 37 April ,, VI. 48 May „ VI. 63 June quarter ,. X. 82 July „ VI. 98 September quarter ,, V. 112 October ,, VI. 132 November ,, VI. 143 December ,, VIII. 158 December quarter ., IX. 159 Rectory, Notification of Infectious Diseases. January Table II. 19 February „ II. 19 March ,, II. 30 March quarter ,, III. 31 April ,, II. 45 May „ II. 60 June ,, II. 76 June quarter ,. III. 77 July „ II. 95 August II. 110 September „ III. 111 October ,, II. 129 November II. 140 December ,, II. 153 December quarter ,, III. 154 S St, John, Births and Deaths. January Table IV. 8 February „ IV. 21 March ,. VI. 84 March quarter „ VIII. 35 April „ IX. 47 May „ IV. 62 June ,, VI. 80 June quarter ,, VIII. 81 July ,. IV. 97 August ,, VIII. 115 September „ X. 116 September quarter ,, XII. 117 October ,, IV. 131 November ,, IV. 142 December ,, VI. 157 December quarter ,, IX. 159 St. John, Causes of Death in January Table XI. 9 February „ VI. 22 March ,. X. 36 March quarter „ XI. 37 April ,, VI. 48 May ,, VI. 63 June quarter „ X. 82 July „ VI. 98 September quarter ,, V. 112 October ,, VI. 132 November ,, VI. 143 December ,, VIII. 158 December quarter IX. 159 St. John. Notification of Infectious Diseases. January Table II. 19 February „ II. 19 March ,, II. 30 March quarter ,, III. 31 April „ II. 45 May „ II. 60 June ,, II. 76 38 INDEX TO THE MONTHLY REPORTS—continued. PAGE St. John, Notification of Infectious Diseases. June quarter ,, III. 77 July ,, II. 95 August ,, II. 110 September III. 111 October ,, II. 129 November ,, II. 140 December ,, II. l53 December quarter ,, III. 154 St. Mary, Births and Deaths. January Table IV. 8 February „ IV. 21 March „ VI. 34 March quarter ,, VII. 35 April „ IX. 47 May „ IV. 62 June ., VI. 80 June quarter ,, VIII. 81 July „ IV. 97 August ,,VIII. 115 September ,, X. 116 September quarter ,, XII. 117 October ,, IV. 131 November „ IV. 157 December ,, VI. 142 December quarter ,, IX. 159 St. Mary, Causes of Death in January Table XI. 9 February ,, VI. 22 March ,, X. 36 March quarter „ XI. 37 April „ VI. 48 May „ VI. 63 June quarter ,, X. 82 July ,, VI. 93 September quarter ,, V. 112 October ,, VI. 132 November ,, VI. 143 December ,. VIII. 158 December quarter IX. 159 St. Mary, Notification of Infectious Diseases. January ,, II. 19 February ,, II. 19 March „ II. 30 March quarter ,, III. 31 April „ II. 45 May „ II. 60 June „ II. 76 June quarter ,, III. 77 July ,, II. 95 August ,, II. 110 September ,, III. 111 October ,, II. 129 November ,, II. 140 December ,, II. 153 December quarter III. 154 St. Marylebone, Births and Deaths. January ,, IV. 8 February ' ,, IV. 20 March ,, VI. 34 March quarter ,, VIII. 35 April ,, IX. 47 May „ IV. 62 June ., VI, 80 June quarter ,, VIII. 81 July „ IV. 97 August ,, VIII. 115 September „ X. 116 September quarter ,. XII. 117 October ,, IV. 131 November ,, IV. 142 December ,, VI. 157 December quarter ., IX. 159 St. Marylebone, Causes of Death in January „ XI. 9 February „ VI. 22 March ,, X. 36 March quarter ,, XI. 37 April , VI. 48 May „ VI. 63 June quarter „ X. 82 PAGE St. Marylebone, Causes of Death in July „ VI. 98 September quarter ,, V. 112 October ,, VI. 132 November „ VI. 143 December „ VIII. 158 December quarter ,, IX. 159 St. Marylebone, Notification of Infectious Diseases. January „ II. 19 February ,, II. 19 March „ II. 30 March quarter ,, III. 31 April ,, II. 45 May „ II. 60 June ,, II. 76 June quarter ,, III . 77 July ,, II. 95 August ,, II. 110 September ,, III. 111 October „ II. 129 November „ II. 140 December „ II. 153 December quarter ,, III 154 St. Marylebone Infirmary, Notting Hill, Causes of Death in January „ III. 7 February ,, III. 20 March quarter ,, IV. 32 April ,, III. 46 May „ III. 61 June quarter ,, IV. 78 July „ III, . 96 September quarter „ VII. 114 October ,, III. . 130 November „ III. 141 December quarter ,, V. 156 Sale of Food and Drugs Act, work done under during March quarter 29 June quarter Table V. 74,79 September quarter ,, VI. 103,113 December „ IV. 151, 155 Samaritan Hospital, Causes of Death in January ,, III. 7 February ,, III . 20 March quarter ,, IV. 32 April ,, III. 46 May ,, III. 61 June quarter ,, IV. 78 July „ III. 96 September quarter VII. 114 October „ III. 130 November ,, III. 141 December quarter ,. V. 156 Scarlet Fever, Report on the deficiency of Hospital Accommodation for 90. 93. 106-8, 126, 138, 150 Schools, Closets in 139 Shelters, Report on 127 Smallpox 4, 5, 17 Smith. Ellen, Prosecution for Adulteration of Brandy 152 T Trough Closets in Schools . 139 V Vaccinations in January Table V. 8 February ,, V. 21 March ,, VII. 34 March quarter ,, IX. 35 April „ V. 47 39 INDEX TO THE MONTHLY REPORTS—continued. PAGE Vaccination in May V. 62 June „ VII. 80 June quarter „ IX. 81 July V. 97 August ,, IX. 115 September ,, XI. 116 September quarter ,, XIII. 117 October „ V. 131 November ,, V. 142 December quarter 157 W Water, Analysis of January ,, VII. 10 February ,, VII. 23 March quarter ,, XII. 38 April ,, VII. 49 May „ VII. 64 June quarter „ XI. 83 July „ VII. 99 September quarter ,, XIV. 118 October „ VII. 133 November ,, VII. 145 December quarter X. 160 Wigmore Street, Flooding of Basements in . 106 Wood Pavement, Report on 70 Workhouse, Causes of Death in January Table m. 7 February ,, III. 20 PAGE Workhouse, Causes of Death in March quarter ,, IV. 32 April ., III. 46 May „ III. 46 June quarter ,, IV. 78 July ,, III. 96 September quarter ,, VII. 114 October ,, III. 130 November ,, III. 141 December quarter „ V. 156 Y Yeo. Register of Sanitary Work. January 11 February.24 March 39 March quarter 40 April 50 May 65 June 84 June quarter 85 July 160 August 119 September 120 September quarter 121 October 134 November 144 December 161 December quarter 162