2079 Paddington. METROPOLIS LOCAL MANAGEMENT ACT. REPORT OF THE VESTRY FOR THE YEAR ENDING 25TH MARCH, 1873. Paddington. METROPOLIS LOCAL MANAGEMENT ACT. REPORT OF THE VESTRY FOR THE YEAR ENDING 25TH MARCH, 1873. REPORT. The following is a List of the Names and Addresses of the Vestrymen and Auditors of the several Wards, namely:— The Rev. James Moorhouse, 57, Sussex Gardens, Vicar of I'addington. Greatorex, Reuben Courtnell, Esq. 6, Upper Westbourne-Ter. Braid, Charles, Esq 13, Westbourne Park Road. Churchwardens. Flood, Mr. James 28, Burlington Road. Hann, Mr. Robert Barnicot 1, Padding-ton Creen. Overseers. Roche, Charles Mills, Esq. 98, Gloucester Terrace. Representative of the Vestry at the Metropolitan Board of Works. WARD No. 1. FOR ONE YEAR. Brewer, Thomas Gibson, Esq 51, WestbourneParkRoad. Goslett, William, Esq Marlboro'Villa, West- bourne Villas. Rabbeth, Mr. George 13 Cornwall Road. Sawyer, Mr. Samuel 20, Frankfort Terrace. Vickerman, Mr. William John 82, Westbourne Grove. FOR TWO YEARS. Braid, Charles, Esq 13, WestbourneParkRoad. Chew, Thomas, Esq 15, Durham Terrace. Evans, Robert, Esq 48, Westbourne Park. Flood, Mr. James 28, Burlington Road. Moore, Enoch, Esq 21, Aldridge Road Villas. FOR THREE YEARS. Anderson, Mr. James Porter 10, Richmond Road. Dunn, Dr. Joseph Thomas Holt. 69, Hereford Road. Ellerton, John, Esq 3, Aldridge Road Villas. Frazer, Mr. Joseph 76, Westbourne Grove. Lyne, Richard, Esq 44, Leamington.Rd.Villas. Auditor—Brown, Mr. Henry Mark, 84, Westbourne Grove. 4 WARD No. 2. FOR ONE TEAR. BiCKER-CAARTEN,ALFREDGERARD,Esq.2, Warrington Gardens. Buckley, Rev. John Wall 1, St. Mary's Terrace. Ellis, William, Esq 40, Clifton Gardens. Gwyn, Mr. George 28, London Street. Hann, Mr. Robert Barnicot 1, Padding-ton Green. Siiaw, Benjamin, Esq 8, Cambridge Square. Wyatt, Hugh Penfold, Esq 18, Oxford Square. Young, Edward Parker, Esq 10, Delamere Crescent. FOR TWO TEARS. Addison, Lieut.-Col. Henry 9, St. Mary's Square. Collins, Mr. Edward 47, Harrow Road. Collins, Henry Hyman, Esq 5, Randolph Road. Metcalfe, Mr. Richard 11, Paddington Green. Philpot, Mr. Henry 32, Praed Street. Roberts, Edward, Esq 36, Blomfield Road. Seton, Miles Charles, Esq 10, Maida Hill West. Tildesley, Samuel, Esq 2, Iron GateWharf Road. FOR THREE TEARS. BiCKER-CAARTEN,JOHNMARINUS,Esq. 13, Formosa Street. Carter. Mr. Thomas 32, Chippenham Terrace. GREAT0REx,REUBENC0URTNELL,Esq. 6,UpperWestbourne-Ter. Macmullen,RichardHenryBristow, Esq. 9, Frankfort Terrace. Miller, Horatio, Esq 30, Westbourne Terrace. Naylor, William, Esq Manor Place. Richardson, Mr. Samuel 46, Chippenham Road. Urquhart, Mr. William 327, Edgware Road. Auditor—Ayres, Mr. Henry, 4, St. Leonard's Terrace. WARD No. 3. FOR ONE TEAR. Curgenven, John Brendon, Esq. 11, Craven Hill Gardens. Davenport, Edward G., Esq 28, Lancaster Gate. Kemsiiead,Henry Morris, Esq.J.P. Westbourne. Piiillipson, Mr. Michael 4, Craven Terrace. Sanders, Samuel, Esq 28, Gloucester Place. Smith, George James Philip, Esq. 55, Gloucester Place. 5 FOR TWO YEARS. Brunel, Isambard, Esq 15, Devonshire Terrace. Clarke, Henry Daniel, Esq 18, Gloucester Terrace. Pritchard, Thomas Sirrell, Esq. 8, Gloucester Place. Roche, Charles Mills, Esq 98, Gloucester Terrace. Russell, Mr. Edward 97, Queen's Road. Walker,Lieut.-Col.williamlarkins 84, Inverness Terrace. FOR THREE TEARS. Baylis, Thomas Henry, Esq 5, The Terrace, Kensington Gardens Square. Collyer, Col. Geo. Chancellor. 57,KensingtonGardens-Sq. Fisher, Mr. Thomas 24, Craven Terrace. Hawes, Mr. Robert 1a, Moscow Road. Hunter, John Humphrey, Esq. 40, Gloucester Crescent. Taylor, Mr. Henry 23, Craven Terrace. Auditor—Chilton, Mr. James, 36, Craven Road. WARD NO. 4. FOR ONE TEAR. ARBUTHNOT,ARCHiBALDFRANCis,Esq. 25, Hyde Park Gardens. Ferrier, Alexander John, Esq 6, Somers Place. Hollond, John Robert, Esq 57, Lancaster Gate. Hume, Col. Henry, C.B 29, Norfolk Square. Stratton, Mr. Stephen 34, Albion Street. FOR TWO TEARS. Gaselee, Mr. Serjeant Stephen 2, Cambridge Square. Griffith, Charles Marshall, Esq. 31, Hyde Park Square. Hall, Mr. Richard 1, Porchester Street. Parry, Mr. Thomas 79, Oxford Terrace. Prescott, Frederick Joseph, Esq. 13, Oxford Square. FOR THREE YEARS. Baker, Sir George, Bart 4, Hyde Park Square. Denny, Thomas Anthony, Esq. 7, Connaught Place. Peake, Frederick, Esq 3, Norfolk Crescent. Turner, Mr. Henry 139, Praed Street, Wilson, John, Esq 38, Norfolk Square. Auditor—Parker, Mr. William, 146, Praed Street. 6 The Officers of the Vestry are as follows, namely:— Vestry Clerk Frank Dethridge. First Assistant William Davison. Second do James William Cuff. Third do John Mitchell Huish. Fourth do Arthur Wm. James Russell. Surveyor George Frederick Stevens. First Assistant Surveyor Rimell Gadsden. Second do. do, Thomas White. Clerk of Works John Conway. Accountant George Weston. Clerk (Surveyor's Department) Arthur James Garner. Superintendent of Stone Yard James Stevens. Medical Officer of Health William Hardwicke, M.D. Inspector of Nuisances Thomas Reeves Clifford. Ditto Charles John Biorn. Assistant Overseer George Harttree. Collectors fWard 1 Robert Cheadle. ,, 2. (A-Division) Reuben Farrow. (B Division) john gordon. „ 3. Robert Jenkins. ,, 4 John Barrable. Vestry Hall Keeper Samuel Hardy. Beadles William Porter. George Darley Osterfield. The following Contracts have been entered into, namely:— Date when entered into. Name of Contractor. Nature of Contract. Price. 10th April, 1872. Mr. F. Manuelle for Guernsey Granite (unbroken) delivered by the side of the Wharf. 10s. 2d. per Ton. Ditto Ditto for ditto ( broken ) delivered on the Parish Roads. 16s. 9d. per Cubic Yard. Ditto Ditto for ditto ( ditto ) delivered by the side of the Wharf. 15s. 4d. per Cubic Yard. 17th Feb. 1873. Mr. Hobbs for Watering the Roads.—Both Districts of the Parish. The Contractor to receiveSs. 6d.perDay for each Man, Horse and Cart. 22nd Ditto Mr. Studds for Unsifted Gravel 3s. 3d. per Ton. Ditto Ditto for Sifted Gravel 2s. lld. per Ton. 3rd March, 1873. Mr. W. Boyer for Carting Materials 8d. per Ton. Ditto Ditto for Day Work 9s. per Day. Ditto Ditto for Working Street Roller £1: 16s. per Day for 2 Men & 4 Horses. Ditto Ditto for Working Road Scraper 9s. per Day for 1 Man and 1 Horse. Ditto Mr. Hobbs for removing Dust, Ashes and Refuse—Both Districts of the Parish. The Contractor to receive £300. Ditto Ditto for Carting Road Scrapings & Street Sweepings— Both Districts of the Parish. Ditto £4000. 17th Ditto Mr. W. Neave for Sewers Jobbing Works At 45 per Cent, above the detailed Scheduled Prices. 8 The following Rates have been levied, viz.:— Date. Poor. Lighting. General. Sewers. Consolidated. Total. d. d. d. d. d. s. d. April, 1872 10½ 1½ 4½ ½ 1½ 1 6½ October, 1872 11| i 5 4 1 1 7 1s. l0d. 2½ 9½. 1d. 2½d. 3s. 1½d. The present Assessment of the Parish to the Poor Rate is £968,340. The number of Borough Voters according to the present Register, is 6602. The number of County Voters is 68. The number of persons returned in the Jury List presented to the Justices of the Peace on the Thirtieth day of September last, amounted to 4826, During the year 34 Meetings of the Vestry and 143 Meetings of the various Committees have been held, making a total of 177 Meetings. The provisions of the Adulteration of Food and Drugs Act (1872) have been adopted, and an Analyst and Inspector appointed in accordance therewith; Rules for the guidance of the abovementioned Officers having been prepared by the Sanitary and Public Health Committee. The Works, Sanitary and otherwise, carried into effect during the year, appear in the reports of the respective Officers, hereunto annexed, and such reports are followed by the Documents required by the 198th Section of the Metropolis Local Management Act, with which Documents the present Report concludes. By Order, FRANK DETHRIDGE, Vestry Hall; Vestry Clerk. 24th June, 1873. Paddington. SANITARY REPORT FOR THE YEAR 1872-73. BY WM. HARDWICKE, M.D., Medical Officer of Health. CONTENTS. Birth-rate and Death-rates 5 Deaths from Zymotic Diseases 5 Deaths from Tubercular forms of Disease 6 „ under 5 years of age 7 Vital Statistics of the Population for 6 years 8 The Canal Nuisance 9 Improvement of the Mortuary 10 The Slaughter-houses and Cow-sheds 12 The Metropolis Building Act Amendment 13 Private Slaughter-houses in towns 13 Public Urinals, and Urinal Nuisances 15 Workshops Regulation Act 16 Systematic Sanitary Inspection 17 Sanitary districts 18 The Fever Ambulance 19 Cleansing and Disinfection, under the Sanitary Act of 1866 20 Improvements in the Sewers of the Parish 20 Removal of Manure 23 Water Supply and Surface Wells 25 Public Baths and Laundry 27 Summary of Sanitary Work 28 Appendix—Table of Works 29 REPORT TO THE VESTRY OF PADDINGTON. Vestry Hall; June 1st, 1873. Gentlemen, I have herewith the honor of placing before you my Sixth Annual Report, containing the vital and Sanitary Statistics of the population under my observation. I have followed the method hitherto adopted of giving you (1) Returns of the Births and Deaths, and (2) the Deaths from preventible diseases, and the relative position they occupy amongst the general mortality; and (3) Sanitary matters are brought before you, which I trust may be briefly alluded to, inasmuch as, under your control, they are calculated either to arrest the progress of disease, or to give increased comforts to the people. The population of the Parish, estimated at the ordinary rate of increase going on for several years, has now reached 100,984 up to April last; at the census it was 96,784, showing an annual increase of 2100. This increase is made up 4 partly by the surplus of births over deaths, being the natural increase of a mixed population in ordinary times; but there is also an artificial increase, made up by immigration, composed chiefly of the working class families coming from old neighbourhoods to the newly-built houses. This augmentation of population is not altogether a gain, and as it ought to be, a sign of increasing prosperity. Many of the newly-built houses, although originally designed and built for one family, are let out in tenements and single rooms to several families, in which there is a general tendency to over-crowding. In Praed Street, a large number of newly-built houses have become occupied since tjie census of 1871, thereby increasing the population of St. John's District somewhat beyond its normal rate. The class of persons living in Amberley Eoad, Netley Street, Shirland Eoad, and in Mewses and Streets adjacent, have a large proportion of young children living in unfavorable conditions for health, whilst Pauperism already exists in 30 per cent, of the houses. And although they are in a perfect sanitary state, clean and orderly now, it is suggestive for future consideration, whether any and what steps should be taken, to prevent the wholesale influx of a colossus of pauperism, with the consequent burdens of poverty and sickness. As your Officer of Public Health, it is my duty to point to the facts at present before me. Sanitary improvements of a District, and efforts to check the large amount of preventive sickness, will always have a popular interest. 5 At present, the Officers of Public Ilealth and the Local Authorities go but very little beyond the removal of Nuisances injurious to health, feeling their way cautiously in matters appertaining to drainage, water supply, gas, and improvement of dwellings. Much has been done by Vaccination, the abatement of over-crowding, and the checking of contagious disease by cleansing and disinfection. But by and bye they must go further; open spaces and building plots will be better regulated by municipal law; recreation grounds, gymnastics, and public baths for body culture, must be instituted; but more temperance in adults, and a better sense of maternal duty towards infants, will alone bring about a diminution of infantile mortality, and greater length of days for the living. Then shall it no longer be said with truth, "that the people are destroyed for lack of knowledge," and that there is no one to help them. TABLE I. The following Table shows the number of Births and Deaths, and the Birth-rate and Death-rate, in each of the last 4 Quarters. Quarter ending Births. Deaths. Excess of Births over Deaths. Total. Per 1000 of Pop. Total. Per1000 of Pop. Total. Per 1000 of Pop. June 29, 1872 668 26.8 464 18.64 204 2.05 Sept. 28, ,, 673 26.8 433 17.32 240 2.04 Dec. 28, ,, 700 27.6 390 15.52 310 3.01 March 29, 1873 776 30.68 549 21.72 227 2.22 Per Annum 2818 27.97 1836 18.30 981 2.32 6 TABLE II. The following Table shows the Annual, Quarterly, and Comparative Mortality from the Zymotic Diseases:— Causes of Death. April, May, June, July, August, Septem. October, Novem. Decern. January, February March. In the Year. Comparative Mortality of Zymotic Diseases. In 1000 Population. Propor. to Population. Small Pox 4 - 1 - 5 About 2.8 per 1000 or about 28 persons in every10,000 die from the Zymotic Diseases. One person in every 350 died from a Zymotic disease or about 10 in every 3566 persons. Measles 38 6 2 4 50 Scarlatina 13 2 1 3 19 Diphtheria and Croup 6 3 7 6 22 Whooping Cough 17 13 6 28 64 Erysipelas, Pyæmia 6 4 2 4 16 Fevers—Typhoid, &c. 9 6 7 8 30 Diarrhoea, Cholera, &c. 6 60 3 4 73 Totals 99 94 29 57 279 Whooping Cough and Measles were very fatal, but zymotic diseases do not increase in proportion with the increase of population, being 78 less than an average of five preceding years. TABLE III. The following table shows the Annual, Quarterly, and Comparative Mortality among the Children under 5 years of age:— Causes of Death. April, May, June, July, August, Septem. October, Novem. Decern. J anuary, February, March, In the Year. Comparative Mortality. Per 1000 of Population. Proportion of Population. Small Pox & Varicella 5 - - - 2 6.9, say, 7 out of every 1000 of the population are deaths under 5 years, One in every 143 of living population, or 10 in about 1430 deaths annually under 5 years of acre. Measles 35 6 - 4 45 Scarlatina 11 2 1 2 16 Diphtheria, Croup,&c. 1 2 2 4 9 Whooping Cough 14 13 6 27 60 Erysipelas 2 1 1 2 6 Fevers, Infantile, &c. 3 - - - 3 Diarrhœa, Cholera,&c. 5 56 3 2 66 Respiratory Organs 29 20 45 47 141 Tubercular Diseases 28 31 25 35 119 Nervous System 18 11 17 27 73 or 38.4 per cent. of total deaths. A very high proportion. Violent Deaths 7 14 3 8 32 Other Diseases 31 46 17 40 134 Totals 186 202 120 198 706 7 TABLE IV. The following Table shows the Annual, Quarterly, and Comparative Mortality from the Tubercular Class of Diseases:— Tubercular Diseases. April, May, June. July, August, Septem. October, Novem. Decern. J anuary, February, March. In the Year. Comparative Mortality. To Total Population. In 1000 Population. Scrofula, Tuberculosis, f Tabes Messenterica and Marasmus 22 16 18 21 77 17.1 per cent, of the total deaths, or 3.1 per 1000, or one in every 321 of the population. This is not an excessive proportion of tubercular diseases. Hæmoptysis 48 41 52 42 183 Consumption Tubercular Pneumonia Hydrocephalus, and Scrofulous Meningitis 14 17 8 15 54 Totals 84 74 78 78 314 The tubercular or wasting diseases exceeded in number the deaths from the zymotics. Young children who escape zymotic disease often fall victims to the tubercular. "They have a mortgage on life, with certain early foreclosure," says an American writer on Sanitary subjects. This class of disease is far too little understood: it ought to be known that close rooms—re-breathing bad air—leads to the deposit of a foreign matter either in the lungs or other delicate tissues of the body: if it cause disease in the joints or bones, or attacks the glands, it is often termed scrofula; if tubercular deposits take place in the lungs, it leads to blood-spitting, ulceration and consumption; if in the glands of the bowels, messenteric disease and atrophy; if the membranes of the brain are attacked, tubercular meningitis, hydrocephalus, convulsions, water or serum on the brain—are the consequences. These diseases are preventive, in some measure, by sanitary precautions. 8 TABLE V. Showing the Births and Deaths, and the Birth Rate and Death Rate, with the chief causes of Death, and ages of Death, for the last six years in the Parish of Paddington. 1868 1869 1870 Census year 1871 1872 1873 Estimated and Actual Population 90,484 92,584 94,684 96,784 98,884 100,984 Births during each year 2,662 2,784 2,720 2,687 2,835 2,818 Deaths ,, ,, 1,735 1,736 1,897 1,906 1,834 1,836 Birth-Rate per 1000 of Population 30.3 30.5 29.41 27.7 29.5 28.3 Death-Rate „ „ 19.18 18.6 20.0 19.7 18.5 18.17 Deaths from Zymotic Diseases 374 325 369 386 334 279 ,, „ Tubercular „ 300 281 322 323 303 314 „ „ other Diseases 1,061 1,130 1,206 1,197 1,197 1,130 „ of Children under 5 years 793 650 718 768 724 706 „ of persons between 5 & 20 129 140 155 169 116 105 ,, ,, ,, 20 „ 40 225 299 282 317 288 269 ,, ,, ,, 40 ,, 60 260 282 320 296 304 334 ,, ,, „ 60 ,, 80 206 290 334 293 325 332 „ „ upwards of 80 62 75 88 63 77 90 A progressive improvement is at once visible. Thus, with a constant annual addition of about 2000 to the population, the death-rate rather tends to diminish. And those forms of disease which we might naturally expect would increase with the increase of population, are stationary, indeed infantile deaths are rather lower every year, except 1869. The zymotic deaths are decreasing every year. It is also apparent that larger numbers of persons are living at middle and advanced ages. The above figures include all deaths in Hospitals and Workhouse Persons from other parts coming into the Hospital to die have not even been excluded from the calculation. 9 The Canal Nuisance. Attempts to secure a proper cleansing of the Basin were renewed this year. Several letters were written to the Company asking them to embrace the opportunity of effectually cleansing the Canal Basin during the cool weather. On the 12th of April, the water was, as usual, ordered to be let out of the Canal Basin for the cleansing according to the promise made to the Police Magistrate at the hearing of the case in 1872. I am sorry to say, that from want of previous arrangements on a scale of sufficient magnitude, a large portion of the mud forming the bed of the Basin was again left untouched. On'Monday, April 14th, the Sanitary Committee personally visited the Basin to ascertain what steps were actually taken, when it was computed that 39 boats only were available for the removal of the mud. The staff of men employed was also too small. A notice was therefore served upon the Company, under the Nuisances Removal Acts, to effectually cleanse the bed of the Basin, and in default of so doing forthwith, a summons was granted on the 15tli, the hearing being adjourned from the 22nd to the 29 th, at the request of the Canal Company. The case was argued at great length before Mr. D'Eyncourt, and after many formal objections taken by their Counsel, as to the form of procedure, all of which had been complied with, the Vestry gained a conviction against the Company, an order being made that the Company should cleanse the Basin to the satisfaction of the Vestryi weather permitting. The Counsel for B 10 the Company then gave notice of appeal to a Superior Court, which I regret to say had the effect of causing the Magistrate to reconsider his decision; and after a few days, the Vestry Solicitor had a communication from Mr. D'Eyncourt, stating that he could not sustain the order to convict the Company under the Nuisance Removal Act, inasmuch as he believed that Act did not contemplate dealing with a Canal Company. Our instructions for the future are to proceed by way of indictment when any actual nuisance occurs. Meanwhile, the Inspector makes daily visits, including Sundays, to the Wharves, and insisting upon the provision of the Local Act being strictly carried out, including the more careful loading of the boats, the undue detention of the barges and boats, or permitting of deposits and accumulations upon the wharves. All this, with the better attention and cleansing of those wharves where the offensive trades in manure are carried on, reduces the complaints to a minimum. But it will be impossible to entirely get rid of these nuisances without revising the whole system of conducting offensive trades, and placing them under the strictest supervision, or probably removing them into less populated and distant suburbs. Improvement of the Mortuary or Dead-house. Since my last Report, the enlargement of this place and its improved management, have been attended by good results. During the year, 83 bodies have been received into it, under the custody of officials who have endeavoured to discharge the very difficult duty 11 of keeping the air pure and the bodies fit for Jurors to view, when inquests have to be held upon them. We have been most anxious to prevent the Mortuarybeing a nuisance in hot weather to the inhabitants of Hall Park. I have been better enabled to do this by the Resolution of the Sanitary and Public Health Committee authorizing Inspector Clifford to employ whatever extra assistance he might require, to avoid complaint. This can only be done by visiting more than once daily; by the coffining of bodies immediately after post mortems; by the thorough cleansing and disinfecting and deodorizing; and by the prompt removal of bodies for burial. Immediate action must often be taken on the spot to avoid the risk of serious nuisance to adjoining premises. Bodies found drowned, or otherwise in a decomposed state, waiting for identification, require the most vigilant care and attention, and almost a staff trained for the work. A point is now reached that we have been a long time struggling for, and with its many imperfections, can only be surpassed by the erection of a New Public Mortuary in a more isolated situation in St. Mary's Church-yard, and attached to it, or close at hand, a resident keeper, who shall be the responsible custodian. It is gratifying to state that there is a growing disposition on the part of the poor, who live in single rooms, as well as other classes, to remove the corpse of a relative ; and the power now given me by the Sanitary Committee to order an undertaker, independently of the parish contractor, to remove a body that has died from a dangerous contagious malady, has worked remarkably well of late in 12 parison with former times; great delay often occurred in going through the Poor Law department, and in applying to the relieving officers, however prompt they may have acted. I have, on more than one occasion, been informed of a death late in the evening, and have been able to order the body to be removed immediately to the Mortuary, to the great satisfaction of those who lived in the house. Slaughter-houses and Cow-sheds. The number of slaughter-houses under inspection in this Parish is 29; they were all visited by the Sanitary and Public Health Committee in September last, previous to the renewal of their licenses. In spite of a very careful inspection during the year, 26 out of the 29 were not in a satisfactory state, such as the Committee thought necessary for the carrying on of an offensive business. Many drains had been untrapped and the covers broken or lost. The sheep and cattle pens were many of them defective in surface drainage, and some joints of the pavement of the slaughter-house had become loose through the constant flushing down and washings, and most of them had to be repointed or relaid. Those which had been done in Roman Cement were found to have become worn and unsolid. Good Portland Cement will scarcely stand the wear and tear of frequent washings and hardly suffice to prevent under-soakage. Bed-rooms in two or three cases over slaughter-houses were ordered to be disused as bed-rooms. The cow-houses, 13 in number, were also visited, 13 and very few escaped an order for improvements. Some of them are very strongly objected to on account of close proximity to dwellings. We have reduced the number of cows in some sheds. On the last occasion of re-licensing these places, the magistrates showed a greater disposition than usual to refuse the license, making it a condition, on renewing it, that the carrying out of the orders of the Vestry, and the keeping of these places in perfect sanitary order must be attended to. Private Slaughter-houses in Towns. In March the Vestry requested the Sanitary and Public Health Committee to report upon the Metropolis Building Amendment Bill, which contemplated perpetuating the nuisance of slaughter-houses within the metropolis. They were of an opinion that a Petition should be presented against the Bill, and that no adequate opportunity had been offered for examining into the truth of the statements and the opinions in favor of the Bill circulated by the Butchers' Trade Society. Considering the magnitude of the interest concerned, they thought more special inquiry would be expedient, when therefore this Bill came before the House of Commons for discussion at the Second Reading it was actually referred to a Select Committee, which at the present time is sitting—it is called, a Committee on "Noxious Trades," and it is hoped that some valuable evidence will be taken. The following is my expression of opinion in a Report ordered to be read at the Vestry on the 1st of April, 1873:— "As the object of all sanitary work is to secure fresh air 14 and perfect cleanliness by the prevention and removal of nuisances in and about private dwellings, the existence of private slaughter-houses in built-up parts of cities, even with strict inspection, renders this object difficult and practically impossible for those persons who reside near them. "Butchers perfectly well know this fact, and endeavour to purchase adjoining property to let out to a class of tenants who dare not complain, but tolerate a nuisance rather than run a risk of having notice to quit a cheap-rented dwelling which others are willing to occupy. "The most serious nuisance is in hot weather, when the polluted air attracts large numbers of blue-bottle flies, which after feeding on putrifactive refuse lay their eggs upon the meat on the tables and in the larders of adjoining houses. "These flies are also the carriers of infection. "Slaughter-houses are always infested by rats, burrowing from the drains, seeking for blood which in large quantities runs into them, while the putrifying action gives rise to an abominable stench, often extending for miles along the sewers. "The blood and offal, if transported in barrels and carts, has to pass through the public thoroughfares. "There are also other evils affecting the meat. The pounding of cattle in small close pens for days together is objectionable. Butchers are aware that the flesh of animals driven hurriedly through the streets, and kept sweating in close confinement, is not so good as when taken from an airy and well-ventilated cattle-pen of an abattoir, or from the open fields. "Cattle slaughtered in private slaughter-houses affords facility for the slaughtering of unhealthy animals. It is estimated that 100 tons of diseased meat are annually condemned in London, and a large amount is offered for sale from want of a proper inspection in a public abattoir. "The question of abolishing slaughter-houses and of erecting public abattoirs, under supervision, has been settled with satisfaction on the Continent, and the system imported into this country has been found to work well in Edinburgh, Glasgow, Leeds, Cardiff and many other places, whilst the change has not been proved detrimental to the poor either by 15 depriving them of cheap meat or offal parts of the carcase, an allegation which has been made by butchers without any foundation whatever. "The Bill of Dr. Brewer, now before Parliament, enacting 'that the slaughter of cattle and sheep by a butcher in private slaughter-houses, duly licensed, shall not be considered an offensive or obnoxious business,' is utterly at variance with sanitary laws and the common experience of local boards for the protection of the public health." Public Urinals and Urinal Nuisances. During last autumn the Sub-Committee of the Sanitary and Public Health Committee made a thorough inspection of the public urinals, those also attached to taverns and public-houses, as well as the urinal nuisance under inspection in various parts of the Parish. In their Report it was declared that the accommodation in the Parish was insufficient. There, are at present, besides the Railway Stations, but five public urinals in the Parish, and it was considered desirable, that at least five more should be provided. The best sites for their erection were pointed out. This report went further, in recommending that public w.c. accommodation should be provided for both sexes. I recommended in my Report of 1869 that each public urinal should, where it is possible, have two water closets attached to it, and placed in charge of an attendant during the day, and at night the key might be given to the policeman on the beat. By a very simple arrangement, a separate entrance could be made so that females might have similar accommodation to that enjoyed by the male sex. Other medical men, 16 besides myself, are of opinion that in this matter females are very much neglected. If this kind of public accommodation at all the cab ranks, were made a part of the police regulations the duty of attending to them could be well entrusted to the officers there, who at present have scarcely anything to do. The Workshops Regulation Act. It will be remembered that this Act, after being in the hands of the local authorities of the Metropolis for nearly three years, was taken out of their jurisdiction to be included in the work of the Sub-Inspectors of Factories in the Metropolis. Numerous complaints have come under my notice of overcrowding and of sanitary defects, which are either overlooked or not included in the routine of Factory Inspection. These complaints reach me chiefly from medical men in attendance upon cases of illness in females, arising from the vitiated air of over-crowded rooms, and from long hours of work. As, however, we still possess powers under the Sanitary Act of 1866, and under the Nuisances Removal Act, to inspect the sanitary condition of premises used as workshops, to inquire into the cubic space necessary to prevent overcrowding, the kind of w.c. accommodation, &c. ; the several cases that have become known have been visited by myself with Inspector Clifford and dealt with accordingly. In my Annual Report of 1870-71, the last year that the Workshop Regulation Act was entrusted to me, I prepared a return for H. M. S. Inspector of Factories, in which I reported that at least 700 females 17 were engaged in needlework and dress-making establishments in this Parish, besides a large number occupied in private houses unknown. Fifty large establishments in which numbers of females were employed were then under regular inspection, and it was hoped that when the return alluded to had been made to the Inspector of Factories, that all the shops where labor and handicraft of various kinds were carried on, would be brought under supervision by the Amended Act. I therefore now express my disappointment that so important a branch of the public health should not have been provided for by better legislation. The inspection, as at present conducted, (by only taking cognizance of the hours of work and ages of the workers,) must be of a very limited and imperfect character, in which the efficiency of ventilation, the cleanliness, the cubic space for each person, and a proper w. c. accommodation does not form part of the duty of the Inspectors. To keep a record of inspections, and to make suggestions for and carry out sanitary improvements, is ample work to occupy the time of a special officer; nor can the Act be well carried out—certainly not economically—except by officers of local authority, who possess superior local knowledge of all shops and places used as workshops, and who get casual information which it is impossible for a stranger to the place visiting at intervals to obtain. Systematic Sanitary Inspection. This work had to be suspended last year in consequence of Inspector Clifford taking in hand the Canal Basin inspection, and the prosecutions connected c 18 therewith. Afterwards he took up the work of Inspector Parsons, who resigned office. The new Inspector, C. Biorn, has, however, been steadily progressing with the work since his appointment. The streets already visited, from house to house, show traces of former inspection, inasmuch as landlords who let out houses in tenements are becoming aware of their responsibility and show a disposition to white-wash and cleanse, to keep down overcrowding, and get rid of dirty people. Sanitary Districts. Since the exact population of all the streets in the Parish has been obtained from the census return of 1871, I have been able to make a more perfect subdivision of the Parish in sections, forming Sanitary districts, having special reference to the social status of the inhabitants, and their kind of house accommodation. The necessity for this is very obvious when we find death rates widely differ in different parts of a Parish, containing a population of above 100,000. It avails little to know that the general death rate of the Parish is annually less than 20 per 1000 in the population, and stands lowest of any large Metropolitan district, when we find streets and whole districts, equal in population to good sized towns and villages, with a death rate of 30 to 40 per 1000 of their inhabitants. Large registration statistics are utterly useless for sanitary inquiries. By mixing up in the general statistics all kinds of populations widely differing in their pursuits and prominent characteristics, the sanitary observer loses the evidence which he should endeavour 19 to seek, to enable him to point out and control the influences affecting unfavorably or favorably the public health of his district. Districts are so formed in this Parish, as to have about the same density of population, viz., 300 to 400 per acre. Such are groups of streets on the North of the Canal Basin, North Wharf Road district; another on the South, the South Wharf Road district; a third on the Hall Park estate; a fourth, newly built streets in the Amberly Road district; again, Woodchester Street, CireDcester Street, and Clarendon Street, each having a population of above 1500 persons, are well defined; other Streets form also well known groups of a densely populated neighbourhood, all composed of a certain class of houses let out in tenements. Squares and mansions, with less density of population—a totally different material for the study of Vital Statistics—form a distinct Sanitary group, and are equally well defined, so are also the mews and stables. My Quarterly Reports contain more in detail the results furnished by house to house inspection; not only the Sanitary work done under the Inspector, but the social condition of the people of these groups. The Fever Ambulance. There has been no epidemic during the past year, since the small-pox died out, so that the Fever Ambulance was only used 24 times, 18 being small-pox cases, at the end of the epidemic, and 6 fever cases. Most of them were sent to Stockwell, since the Hampstead Hospital has been done away with. It may be mentioned that the risk of contagion 20 and the impropriety of conveying patients suffering from different contagious diseases by using the same vehicle was fully discussed in Committee, and it was decided to have two separate sets of fittings, each to be kept apart and always well aired and cleansed after using them. Cleansing and Disinfecting under Sanitary Act, 18G6. Very little has been required this year under this head. Our system has worked very well, viz., that of sending away blankets, bedding, garments, &c., at per cwt. to a Contractor, in default of having a disinfecting establishment of our own, or instead of destroying the articles, and paying the owners, as adopted in many parishes. The cost to the Parish this year is a little less than £20. Improvement of the Sewers of the Parish. The joint Committee, composed of the Sanitary and Public Health Committee, and Highway Committee, have been occupied some time with the question of ventilating and cleansing the Sewers of the Parish. The following were the subjects proposed for inquiry by the Chairman of the Sanitary Committee: — 1—As regards Sewers, of deposit, and what is the cause. 2.—Materials used in existing Sewers : where Bricks, or where Pipes are used. 3.-As regards (or where) Sewers manifestly insufficiently ventilated. 4.-As regards head-walls and other defects. 21 5.—As regards gulley-holes peculiarly offensive. 6. —To inquire into and report as to the use of Charcoal in Ventilators or gully-grates in other Parishes; with a particular account of the manner in which it has been applied and acted upon. 7. —As regards the use of Ventilating Shafts at Uxbridge, Croydon, or other places where they are in use; and that a detailed Report be made as to the methods employed, and as to the success attained. 8.—To report on all Sewers in streets that are not deep enough to properly drain the foundations of houses, and those streets that have small pipes for back drainage. These were referred to the Surveyor and myself. My first Report, presented on July 15th, 1872, referred chiefly to items 5, 6, and 7, viz.: (a) the causes of offensive effluvia arising from gulley holes and street gratings; (b) the application and operation of charcoal in deodorizing ventilators; and (c) the uses of ventilating shafts for the conveyance of foul gases from street drains. I would refer any person interested in this question to the report itself, also to a second Report presented and read to the Vestry on the 23rd January, 1873, in which questions 1, 2, and 3 were more especially gone into, and remedies suggested for Sewer nuisances, founded upon an extensive personal examination of the Sewers, both in this Parish and in other places that I visited for the purpose of the investigation. Every complaint of subterraneous nuisance that I have to investigate, (and last summer the smells 22 from gulley gratings and from ventilating grids were very numerous) amply satisfies me that it is indispensable to secure a better fall, and a more abundant water supply and periodical flushing in many of the Sewers. The natural water supply may be enough for this purpose in some houses and streets, but a supplementary flushing should be employed in others to remedy sluggish drainage and foul emanations, whether arising from structural defects in the original construction of the Sewer or not. The result of the investigation has not been fruitless. A large number of gullies have been reconstructed in lieu of the old and imperfect ones with open throats and no catch pits for the sand and dirt which find their way into the Sewers. A large number of new ventilating openings have been made. What however was the greatest and most dangerous nuisance of all, the large deposit in the Sewers, is now being removed by a staff of men employed in the Sewers department for the special purpose of flushing and cleansing. From long experience in Sanitary matters, I take the occasion to remark that the supervision of sewers and drains, whether of streets or private houses, must sooner or later be a department of Sanitary administration, and for several reasons. 1. The Inspector of Nuisances has to give an accurate opinion, and often suggest an immediate remedy for complaints that come before him, more especially of smells and nuisances from house-drains, respecting which he has to see the owner or occupier, and give advice. He should base his knowledge upon plans and data. At present he 23 has none to guide him. 2. When on the contrary complaints are made, as they frequently are at the Sewers department, of stoppage in a house-drain, (a payment of 4s. being demanded before the obstruction is attempted to be removed) the Sewer-men with their rods, in pursuance of their duty, do not pretend to take cognisance of those imperfections of housedrainage, which are not under their jurisdiction. The result of this is, when old brick drains of defective character are discovered by them, or badly constructed drains, or an untrapped w.c. admitting large articles to pass into the house-drain, or when combined drainage is found, the knowledge thereby acquired is seldom brought to account, or such a notice given to the Inspector as may enable him, whose duty it is, to propose the remedy against future obstructions, or such kind of nuisances. As the joint Committee are still watching the effect of works now in the hand of the Surveyor, and will again meet to consider further improvements, I trust the remarks here made will not be out of place, and more especially that the scheme of flushing and cleansing for the removal of underground nuisances will be fully carried out. Removal of Manure. In a parish like this, where in a comparatively small space several hundreds of horses, and almost as many dung pits, are so closely packed in behind the mansions of the rich, it should not be tolerated for the manure to be left over 2 or 3 days, or allowed to 24 accumulate in pits and brick receptacles, soon to ferment and pollute the air that should enter the open back windows. I have no hesitation in saying that the time will soon come when the Vestry must organize a plan for daily collection and removal of horse droppings from the streets, and manure from all stables and mews. Not less essential is it than dust removal and other refuse matters, or the excreta by efficient drainage. Nuisances are created, which although not absolutely injurious to health, ought never to be permitted in a well-governed community with a Medical Officer of Health preaching the value of fresh air. The Inspector of Nuisances at present insists upon the removal of manure every second day, or daily if it create a nuisance; he has already abolished many sunken pits, thereby preventing those offensive accumulations, which upon removal are real nuisances, polluting the air, as carts pass through the streets. All obstacles incidental to the removal of manure by the present irregular method of individual action, would be avoided by the parish having power to control the traffic, and contract for, or undertake daily removal in any district,ward, or mews. In every mews there should be one or more central dung receptacles, into which any coachman or stableman should be compelled to place the manure of his horses, and the people take dust, ashes, and refuse from their houses. Instead of this, there are in some mews 40 or 50 separate places of deposit, some in stables, some under the stairs, some outside in briek dung pits, some in small heaps steaming under the windows of the rooms above. 25 The advantages to all concerned are very obvious. Not the least important is this, that it would be a profitable undertaking for the rate-payers. Horsekeepers might receive 10s. per annum for every horse they kept—the parish, after paying that, besides the expenses of collecting, would hand over a good sum to the Treasurer. The duty of manure inspection would then be more simple and effective than it is at present, or can be hoped for. The Water supply and Surface Wells. No complaints have reached me of the quality of the water of the two Companies supplying the inhabitants of this Parish, nor do the monthly analyses of Dr. Frankland lead to any suspicion of impurities worth mentioning. In October last, Major Bolton reported that the state of the Thames at Hampton, Molesey and Sunbury, where the intake of the West Middlesex and Grand Junction is situate, was in a very satisfactory state; the West Middlesex was at one time the only Company that had storage conveniences to avoid the necessity of taking in water when the Thames was flooded, such being a cause of turbidity. The waters are now delivered in a clear and very transparent condition. Last year a return was asked for by the Secretary of State of the Public pumps supplied by surface wells, and how many had been permanently closed, or were in use. In preparing this return, I found that all the public pumps in the Parish have within the last 7 years been closed as unfit for domestic use. But at the time I discovered many private wells supplying D 26 pumps used by people in different parts. Soon after my appointment as Public Analyst, samples of these waters were collected for analysis, and I found most of them unfit for human consumption—containing, as shallow wells generally do, a larger proportion of organic elements than would be safe to allow in drinking water At my suggestion, some wells are disused, and those in use are for horses, and for washing vehicles at large stables. The Inspectors have instructions to collect water, and submit it to me for analysis, from cisterns exposed to foul and offensive emanations from water closets, dust holes, and cisterns without covers. In three instances of this kind the water was not found, upon analysis, to be contaminated, by ammonaical products, which may be presumed, rapidly dissolve from air in contact with the upper surface of water. Sanitary Work of the Year. The following are the Preliminary Orders issued:— 1872. October 65 April 189 November 218 May 183 June 86 1873. July 74 January 65 August 66 February 57 September 94 March 157 Vestry Orders 80 . Total 1365 The amount of orders for work goes on increasing year by year, but they get done more easily, for landlords become educated in the Sanitary requirements 27 of the day by our frequent visits. They are aware that orders are not issued unnecessarily, and that if once issued they must be obeyed, or would certainly be followed up by a Vestry Order, which, under the Metropolis Local Management Act, subjects them to a penalty for neglect. The cases which had to be litigated were few in proportion to the whole number, and in only one instance was the summons dismissed. Before rushing to legal tribunals to settle disputes and compelling owners to spend money in needful Sanitary improvement, a personal appeal seldom fails to convince them of an ultimate advantage, and that justice is intended for all parties. Owners of property fall into compliance with reasonable suggestions. Public Baths and Laundry. In my annual Report of 1868, and again in 1869, increased facilities for cleanliness of person and garments were strongly advocated, and the beneficial influence of ablution as a Sanitary agency upon the health and comfort of large numbers of artizans engaged in the smoky atmosphere of shops in this parish. It was then suggested to petition the Vestry to put into force the Act for erecting Public Baths and Washhouses, and that if some intelligent member appealed to the Vestry the proposition would almost unanimously meet with the support it merited. The Vestry were asked to do a great thing, and it is gratifying to me to mention that they have done it, and that I witnessed the ceremonial of laying the foundation stone of a noble edifice designed to secure the primary necessities of health and comfort. "Wash and be clean." 28 The following are the Works completed during the year ending March, 1873:— 1. Cleansing and Lime-washing of Areas, Yards, Basements, Rooms, Staircases and Passages 555 2. Provide or Repair Dust Bins, or remove Dust accumulations 212 3. Pave or amend Paving in Yards, Cellars, Open Spaces, &c 237 4. Domestic Water Supply, reinstate defective Receptacles, or Cleanse, Cover and provide Water Supply 145 5. Provide or reinstate the W. C. Apparatus 265 6. Repair, Open, Construct, or Trap Drain, or Open Ground, or fill a Cesspool 500 7. Ventilate Rooms, Staircases, Workshops, &c 115 8. Disinhabit Underground Dwellings 28 9. Abate Nuisance from Overcrowding in Single Rooms, &c 33 10. Miscellaneous, including—Disinfection of Rooms, Articles of Clothing, Bedding, close Infected Rooms, Repair Delapidations of Premises, Ceilings, Stairs and Roof, Remove Manure, Animals and Offensive Accumulations, &c.. 365 2455 J. Morton, Printer, Star Street, Paddington. REPORT OF THE WORKS EXECUTED IN THE PAVING, LIGHTING, AND SEWERS DEPARTMENTS. By GEORGE F. STEVENS, SURVEYOR, REPORT to the vestry of paddington. Surveyor's Department, Vestry Hall ; 30th June, 1873. Gentlemen, In accordance with your instructions, I beg to submit this Report on the several Works carried out, and the chief business transacted by this Department, during the year ending Lady-day, 1873. Paving. The Footway Pavements in several Streets being much worn by the increasing traffic, have been taken up, relaid and repaired to a larger extent than heretofore. The old Rag Stone and Pebble Paving laid down many years ago in Norfolk Mews and Upper Frederick Mews, have been removed, and new Granite Cube Paving substituted, thereby effecting an improvement 4 in the drainage of the surface, and a more easy passage for horses and vehicles. The old Stones have broken up and used for macadamizing purposes in other Streets. The Water Channels in various parts of the Parish, and Crossings at the intersections of Streets have been paved with the most approved description of Granite. The Channel Paving, to a considerable extent, has been taken up, relaid and made good with old Stones re-dressed for the purpose. The continued use of the Steam Road Roller and the temporary closing of Streets under the Authority of the Metropolitan Board of Works, have expedited the repairing of the Macadam Roads, and rendered them durable; consequently the draught of Vehicles has been less burdensome to Horses. Two new Streets and several portions of others have been paved by the Vestry, under the powers of "The Metropolis Management Acts," at the cost of Owners of Houses abutting on such Streets. The length of additional Streets completed at the cost of Owners of Property, and taken to by the Vestry, make, with the previous extent of Roads under their control, a total of 41 miles, 3 furlongs and 35 yards. The Streets have been opened by Gas and Water Companies and other parties in 2256 places, for the 5 purpose of laying and repairing Pipes, and effecting alterations and additions to Houses and other Buildings. The cost of re-instating such places have been paid to the Vestry. Lighting. Two Lamps formerly erected for temporary purposes were discontinued during the year, and nineteen additional Lamps have been stationed within the Parish, making a total of 1675. Twenty Lamps have been removed to new positions, consequent upon alterations and improvements of the line of Footpaths, and the completion of several Streets. Buildings, Sewers and Drains. Thirty-one Notices have been given to the Vestry, in accordance with the 76th Section of the Metropolis Local Management Act, 1855, for the erection of 90 Buildings, viz.:—1 Church; 66 Houses; and 23 Stables. The Orders of the Vestry for the drainage of such Buildings have been served upon the applicants and Copies thereof filed at the Vestry Hall. Ninety-five applications for the construction of Drains under the Public Roads and Footways to 116 Houses and Premises have been received, and the Works executed at the Owners' cost. 6 Two Connections with Sewers have been made in Fulham Place and Leinster Square, for the purpose of Ventilation, and obtaining ready access to such Sewers. One mile, three furlongs and 165 yards of Stoneware Drain Pipes have been laid down to new Buildings, at an estimated cost to the Owners of £432 :15:0. Four miles and 102 yards of Brick Sewers have been cleansed, and the hard deposits removed by the Contractor to the Vestry, at a cost of £ 95:18:8. Three side Entrances have been constructed in Porchester Terrace, Hereford Road and Richmond Road, as means of access to the Sewers for Cleansing purposes, and examination of Drains and Traps. Forty-six Air Openings have been formed in Man-holes and Sewers, and Cast Iron Ventilating Gratings fixed level with the surface of the Carriageways. Many of these Gratings are moveable, and of great service in the saving of labor during the Cleansing of the Sewers, as the Flushing Men are thereby enabled to remove the hard deposits by means of buckets to the surface of the Roads, from whence they are carted away. One hundred and sixty-nine Gulleys have been constructed and re-constructed, and forty-six repaired in various streets of the Parish. 7 The Sand or Catch Pits constructed beneath the grates of the Street Gulleys have been emptied and cleansed, and the deposits removed therefrom at the rate of 43 galleys per day; making an aggregate of 13,342 removals during the year. Five hundred and seventy-one distinct Works relative to the repair of Sewers and Gulleys, laying pipe drains, fixing traps, &c., have been executed at a cost of £2091:0:5. This amount includes the sum of £630:12:8 received from various parties for fixing traps at outlets of drains, constructing gulleys in new Streets, laying new drain pipes under Footways and Roadways in connection with House drains, and for examining drains as to cause of stoppage in them, and their want of traps. In addition to the above-mentioned Works, one hundred and seventy-eight subjects of Complaint have been received and entered in a Book kept for that purpose, with reference to stoppages in Gulleys and Drains. In most instances the drains were relieved and the cause of complaint removed. Ninety-nine examinations have been made, at a cost to the Applicants of £ 19:16:0. Re-naming Streets and Re-numbering Houses. The under-mentioned Orders of the Metropolitan Board of Works have been carried out in accordance with the 87th Section of the Act of 1862. 8 date of order. locality. no. of houses re-numbered. 1872. July 11th Craven Terrace 17 July 26th Woodfield Place 7 Schedules containing the names of the Occupier or Owner of each house have been forwarded to the Metropolitan Board of Works, and Copies of the Schedules are kept in this Department for the identification of Property affected by such Orders. I am, Gentlemen, Your most obedient Servant, GEORGE F. STEVENS, surveyor. 1 8 7 3. PADDINGTON, Middlesex STATEMENT IN ABSTRACT OP THE Parochial Accounts, Contracts & Liabilities, FOR THE YEAR ENDING 25th MARCH 1873; with the REPORT OF THE AUDITORS THEREON. ALSO A TABULAR STATEMENT of the PRINCIPAL WORKS EXECUTED under toe direction of the HIGHWAY AND SANITARY COMMITTEES. PRINTED AND PUBLISHED FOR THE INFORMATION OP TEE RATE-PAYERS. (By Order of the Vestry,) FRANK DETHRIDGE, VESTRY CLERK. SEWERS RATE ACCOUNT ??? ??? 9 2½ from the Burial Board, pursuant to Sec. 22 of the 15th and 16th Vic., Cap. 85 politan Burials Act) 2000 0 0 ??? ??? ??? ??? Commissioners for Public Baths and Wash houses 400 10 0 Salary 20 0 0 Commission 1027 18 5 Overseers' and Returning Officer's Expenses incurred in preparing Borough and County Lists 383 18 0 Expenses incurred in the Election of Vestrymen and Auditors of Accounts 21 3 0 Jury Lists 47 19 3 Law Expenses 42 10 4 Magistrate's Clerk 7 3 0 Balance in hand 109 15 5½ £91696 19 7½ £91696 19 7½ LIGHTING RATE ACCOUNT. Received on account of Rates 9764 10 0¼ Balance overpaid from last year's Account 1883 5 10¼ Lighting 7297 1 8 Lamp Removals 19 15 6 Lamps 5 5 O Commission 123 16 8 Balance in hand 435 5 4 £9764 10 0¼ £9764 10 0¼ GENERAL RATE ACCOUNT. Materials 9256 10 5 Balance in hand brought from last year's Account. 7547 16 1¼ Gully Drains in New Streets 136 5 2 Received on account of Rates 36817 12 3¼ Maintenace of Water Streets 39 7 0 ,, from the Metropolis Roads Commissioners 304 7 4 Street Roller and Road Scraper 102 8 10 Steam Road Roller, and working same 255 8 10 „ the Waywardens of the Edgware Highway Board 59 5 7 Wages to Men employed at the Wharf and on the Roads. 8956 0 0 Paving Works 1726 5 0 „ „ various Parties for the Repair of Roads. 601 12 4 Watering Road 3277 7 3 „ „ do. for Paving Works 1659 7 0 Carting and Day Work 1157 2 9 „ „ do. for supply of Water to Private Roads 81 0 3 Cleansing Streets 4832 15 0 Removing Dust, Ashes and Refuse 1642 10 0 „ „ The National Bank, Interest on the Vestry General Account 237 17 11 Balances due to Parishioners on Paving Accounts 126 17 11 Salaries 3060 11 9 ,, Balance transferred from the Church Rate 402 12 5 Superannuation Allowances 234 14 2 Rent, Rates and Taxes 444 0 10 „ on account of other sources 142 13 10 Commission 446 17 3½ Printing, Books, Stationery, Stamps for Rates, &c. 395 1 7 from the Vestry Solicitor, Cheque issued to him for payment of Balance due under Cooper's Contract for Road Watering 1216 15 8 Law Expenses 502 13 4 Assessment Committee 564 4 0 School Board for Landon 3644 11 6 Tradesmen's Bills 1544 15 3 Gas and Water Rates 23 5 9 Petty Disbursements 159 10 7 Vestry Solicitor, Cheque issued to him for payment of Balance due under Cooper's Contract for Road Watering 1216 15 8 Balance in hand 5325 0 10 £49071 0 8½ £49071 0 8½ Account £ s. d. £ s. d. Received on account of Rate 3630 1 5½ Balance overpaid from last year's Account 344 11 8½ „ „ of Drain Months 630 12 8 Sewers Jobbing Works 2037 3 9 „ „ of New Sewers 18 10 10 Payment to Metropolitan Board of Works 47 4 0 Wages 144 2 0 Commission 32 3 0½ Tradesmen's Bills 93 2 9 General Rate Account, Repair of Roads 52 16 11 Balance in hand 1528 0 9½ £4279 4 11½ £ 4279 4 11½ METROPOLITAN CONSOLIDATE RATE ACCOUNT. Balance in band brought from last year's Account. 118 18 11¼ Metropolitan Board of Works 9599 3 6 Received on account of Rates 9374 4 ll¾ Commission 99 8 4 Balance overpaid 205 7 11 ' £9693 11 10 £ 9698 11 10 CHURCH RATE ACCOUNT. Balance in hand brought from last year's Account. 396 1 1 7 Commission 3 3 2 Received on account of Rates 3 6 3 Balance transferred to the General Rate Account 402 12 5 „ „ of Interest on Church Rate Account. 5 17 9 £405 15 7 £405 15 7 [B] Summary Statement of Contracts entered by the Vestry of the Parish of Paddington, during the year ending on the 2???ay of March, 1873, namely:— Date when entered into. Name of Contractor. Nature of Contract. Price. 10th April, 1872 Mr. F. Manuelle Guernsey Granite (unbroken) delivered by the side of the Wharf. 105. 2d. per Ton. Ditto Ditto ditto ( broken ) delivered on the Parish Roads. 165. 9d. per Cubic Yard. Ditto Ditto ditto ( ditto ) delivered by the side of the Wharf. 15s. 4d. per Cubic Yard. 17th February, 1873 Mr. Hobbs Watering the Roads.— Both Districts of the Parish. The Contractor to receive 85. 6d. per Day for each Man, Horse and Cart. 22nd Ditto Mr. Studds Unsifted Gravel 35. 3d. per Ton. Ditto Ditto Sifted gravel 2s. 11d. per Ton. 3rd March, 1873 Mr. W. Boyer Carting Materials 8d. per Ton. Ditto Ditto Day Work 9s. per Day. Ditto Ditto Working Street Roller £1:I65. per Day for 2 Men and 4 Horses. Ditto Ditto Working Road Scraper 95. per Day for 1 Man and 1 Horse. Ditto Mr. Hobbs removing Dust, Ashes and Refuse.—Both Districts of the Parish. The Contractor to receive £300. Ditto Ditto Carting Road Scrapings and Street Sweepings.— Both Districts of the Parish. Ditto £4000. 17th Ditto Mr. W. Neave Sewers Jobbing Works At 45 per Cent. above the detailed Scheduled Prices. [C] Summary Statement of Moneys owing to, ??? and Liabilities owing by, the Vestry of the Parish of Paddington, on the ??? of March, 1873, viz.:— £ s. d. £ s. d. Balance in Treasurer's hands on " General Account" 7192 14 6 Police 6675 0 10 Outstanding Rates, as nearly as can be ascertained 10279 14 9½ Guardian Board 7000 0 0 £17472 9 3½ Metropolitan Board of Works 5109 6 2 ■ Salaries 667 18 6 Commission 425 0 8 Rent of Wharf 84 11 8 Rent of Engine Station 9 13 4 Contribution towards the cost of constructing the Carlton Terrace Bridge 2500 0 0 Sundries 96 14 0 £22568 5 2 9 We, the undersigned, being the Auditors appointed under the provisions of the Metropolis Local Management Act," for the purpose of auditing the Accounts of the Vestry of the Parish of Paddington, do state that we have audited and allowed the Accounts of the said Vestry for the year ending 25th March, 1873, of which the foregoing Account marked [A] is an Abstract. And we state that the several Contracts entered into by such Vestry during the year ending 25th March, 1873, are specified in the foregoing Statement of such Contracts marked [B]. And that the moneys owing to, and the Debts and Liabilities owing and incurred by such Vestry Respectively are specified in the foregoing Statement of such Credits, Debts and Liabilities respectively marked[C]. And we further wish to state that the manner in which the Accounts are kept have met with our entire approbation. And we beg to thank Mr. Dethridge and the Surveyor's Accountant (Mr. Weston) for the able and courteous assistance they have rendered us during the investigation. Original Debt. Pate of Interest. Paid off this year. Total paid off. Remaining unpaid. orkhouse Debt. 25500 4 per Cent. 450 24150 1350 Do. (further). 4500 150 600 3900 Do. ( do. ). 5000 5 „ 166:13*4 500 4500 1IENRY M. BROWN, JOSEPH J. WILLIAMS, JOHN REID, WALTER BIRD, Auditors. Commissioners for Public Baths and Wash-houses 9000 £4: 9s. per Cent. - - 9000 Tabular Statement of the principal Works executed in the Highway Department, for the Year ending 25th March, 1873. New Streets taken to. Streets paved under the Metropolis Local Management Acts. Granite Crossings laid down. Old Footways repaved. Mews repaved. mile. fur. yds. mile. fur. yds. mile. fur yds. mile. fur. yds. mile. fur. yds. - 2 55 — 1 69 - - 210 1 2 70 - *- 152 miles. fur. yds. Total length of Parish Roads 41 3 35 Tabular Statement of the principal Works executed in the Sewers Department, for the year ending 25th March, 1873. New Brick & Pipe Sewers constructed at the expense of the Vestry. Air Shafts & Openings constructed at the expense of the Vestry. Number of Gulleys Constructed and Reconstructed. Number of side Entrances constructed by Vestry. Cleansing Sewers. feet. 135 46 169 ■ 3 cubic yds. of soil removed. 682 Number of Drains constructed to New Houses, Stables, &c. Total length of Drain Pipe laid to New Houses and Stables and under Footpath and Roadway. No. of House Drains re-constructed under Footpath & Roadway. Number of Complaints received and attended to. Traps fixed to House and Gulley Drains. 90 mile. fur. yards. 1 3 165 116 178 398 Total length of Sewers under the jurisdiction of the Vestry ... 48 Miles 5 Furlongs 50 Yards. Tabular Statement of Inspections reported and Works of House Improvement completed under the Orders of the Sanitary Committee, for the Year ending 25th March, 1873. I. Systematic Inspections. Houses inspected with reference to their Sanitary condition 3427 Works executed 1944 Slaughter-houses under inspection during the year 27 Cow-houses ditto ditto 14 Bake houses ditto ditto 56 Urinals and Urinal Nuisances under Inspection 50 II. Inspections consequent on Complaints Houses or other Premises visited 730 Works executed 527 The above Statement does not include the Premises and Places inspected as to the execution of the 22nd, 27th, and 35th Sections of the "Sanitary Act, 1866," and "The Diseases Prevention Act, 1855," nor Vaccination Inspections which have since 1868 been entrusted to the Board of Guardians. No. 19. REPORT on the HEALTH OF PADDINGTON FOR THE QUARTER ENDING LADY-DAY 1872, WITH A SPECIAL REPORT OF THE SMALL POX EPIDEMIC OF 1871. BY WM- HARDWICKE, M.D., Medical Officer of Health. Vestry Hall; April 24th, 1872. TABLE I. Summary of Weekly Return of Births and Deaths from January to March 30th, 1872. St. Mart's. St. John's. Totals. Week ending Births. Deaths. Births. Deaths. Births. Deaths. Jan. 6 44 19 12 9 56 28 13 43 15 15 12 58 27 „ 20 39 22 10 13 49 35 „ 27 48 25 9 6 57 31 Feb. 3 45 26 25 18 70 44 „ 10 49 25 23 12 72 37 „ 17 38 15 17 13 55 28 „ 24 42 17 15 10 57 27 March. 2 35 30 6 13 41 43 „ 9 64 22 15 9 79 31 »> „ 16 43 28 16 16 59 44 „ 23 39 21 18 18 57 39 „ 30 42 18 15 16 57 34 Total 571 283 196 170 767 448 During the last quarter of 13 weeks, ending Saturday March 30th, 448 deaths were registered in the Parish, being 100 less than the corresponding quarter of 1871, and lower than any three previous years. The births during the quarter were 767, being 319 in excess of the deaths. The deaths are at the rate of 18 per 1000 of the population, and the births at 30.8 per 1000. Of Zymotic diseases 47 deaths are recorded, the corresponding quarter of previous years were 89 in 1868; 61 in 1869; 2 100 in 1870 ; 91 in 1871. Three persons died of Small Pox in the Hospitals out of the Parish. Amongst the most fatal forms of epidemic disease, whooping cough ranks high, having destroyed 23 young children in 3 months. The 13 fever cases are not well marked, being more or less complicated with local disease, described as bilious, purpura, mania, &c. Cases of Small Pox still linger in the Parish, but the epidemic is declining. 75 deaths are recorded in the group of consumptive or wasting maladies; besides 97 from the inflammatory and other chest diseases, one-third of this latter are in young children, Bronchitis and Pneumonia alone killing 33 children during the three present winter months. There were 50 deaths in St. Mary's Hospiital during the quarter; 31 in Paddington Workhouse, and 1 in the Lock Hospital. Inquests were held upon 34 persons, of which 12 were returned as deaths from natural causes; 22 were violent deaths; such as infanticide, suicide, accidental suffocation, drowning, burns, steeet and railway accidents. 18.3 per cent. of the total deaths were in the Hospital and Workhouse—which is the general proportion of deaths of persons dying in the public institutions of the country. TABLE II. Deaths from Zymotic and other Diseases during 13 weeks ending March 30th, 1872. Weeks, ending Small-Pox. Measles. Scarlatina. Diphtheria, Quinsy Group j Whooping Cough Typhus, Infantile and other Fevers. Carbuncle, Erysipelas and Pyæmia. Dysentery and Diarrhoea. Cholera. Phthisis and Tubercular Dis. Bronchitis and Pneumonia. Other Diseases. Accidents and Violent Deaths. Total. Jan. 6 ... ... ... ... ... ... ... ... ... 6 5 13 4 28 „ 13 ... ... 1 ... 1 1 2 ... ... 8 4 6 4 27 „ 20 ... 1 ... ... 3 3 1 ... ... 7 7 12 1 35 „ 27 ... ... ... ... 2 1 ... ... ... 3 9 15 1 31 Feb. 3 1 ... ... 1 1 ... 1 ... ... 8 9 17 6 44 „ 10 ... ... ... ... 3 1 ... ... ... 13 4 13 3 37 „ 17 ... ... ... ... 2 1 1 ... ... 6 5 11 2 28 „ 24 1 ... ... 1 1 1 ... ... ... 1 6 16 ... 27 March 2 ... ... ... 1 2 1 1 1 ... 3 12 21 1 43 „ 9 1 ... ... ... 3 ... ... ... ... 6 7 14 ... 31 „ 16 ... ... 1 ... 1 2 ... ... ... 3 11 24 2 44 „ 23 2 ... 2 1 ... ... ... 4 9 17 2 39 „ 30 ... 2 1 ... 2 1 ... ... ... 7 7 14 ... 34 Total 3 5 5 3 23 13 6 1 ... 75 95 193 26 448 3 TABLE IV. Mortality of the Parish- of Paddington during the Quarter ending March 30th, 1872.. Causes of Death. Ages. Total. Causes of Death. Ages. Total. Under 5 Years. 6 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above Under 5 Years. 6 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above. I. ZYMOTIC Brought forward 122 23 51 66 60 9 331 Order 1—Miasmatic. Order 4—Organs of Digestion. Small Pox 2 .. .. 1 .. .. 3 4 1 .. .. .. 5 Malignant Dis. of Stom. .. .. .. .. 2 .. .. Scarlatina 2 2 1 .. .. .. 5 Canstipation .. .. .. .. .. .. .. Diphtheria 1 .. 2 .. .. .. 3 Gastriiis .. .. .. .. .. .. .. Croup I .. .. .. .. .. 1 Peritonitis .. 1 1 .. .. .. 2 Whooping Cough 23 .. .. .. .. .. 23 Ulceration of Pylorus .. .. .. 1 2 .. 3 Fever, Typhoid .. 1 5 .. .. .. 9 Ulceration of Stomach . .. .. .. .. 1 .. 1 Acute Rheumatism .. .. .. 1 .. .. 3 Ulceration of Intestines. .. .. .. 2 .. 1 3 Erysipelas and Pyoemia . 2 1 1 1 .. .. 6 Hernia .. .. I.. 2 .. .. 3 Metria (Puerperal Fever) .. .. 1 .. .. .. 1 Cirrosis .. .. .. 1 2 .. 3 Dysentry .. .. .. , . Icterus .. .. .. .. .. .. .. Diarrhœa 1 .. .. .. .. .. 1 Cancer of Rectum .. .. .. 1 .. .. 1 Diseases of Liver .. .. 3 1 1 .. 5 Order 2—Enthetic. Cancer of Liver .. .. .. .. .. .. .. Syphilis 2 .. 1 .. .. .. 3 Hydrophobia .. .. .. .. .. .. .. Order 6—Urinary Organs. Order 3—Dietic. Bright's Disease .. .. 2 4 1 .. 7 Privation .. .. .. .. .. .. .. Disease of Kidneys .. .. .. 2 .. .. 2 Want of Breast Milk .. .. .. .. .. .. .. Disease of Bladder .. .. .. .. .. .. .. Purpura .. .. .. .. .. .. .. Diabetes .. .. .. .. .. .. .. Alcoholism:— Albumenuria .. 1 .. 1 2 1 5 a. Del. Tremens .. .. .. .. .. .. .. Uræmia .. .. 1 1 .. .. 2 b. Intemperance .. .. 1 1 .. .. 2 Disease of Prostate .. .. .. .. .. .. .. Lead Poisoning .. .. .. .. .. .. .. Nephritis .. .. .. .. .. .. .. Order 4—Parasitic. Order 6—Uterus and Ovaries. Thrush .. .. .. .. .. .. .. Disease of Ovaries .. .. .. 1 .. .. 1 II. CONSTITUTIONAL. Ovarian Dropsy .. .. .. 1 .. .. 1 „ Tumour .. .. .. 4 .. .. 4 Order 1 -Diathetic. Disease of Uterus 2 .. .. 1 .. .. 3 Gout .. .. .. 1 .. .. 1 .. .. .. 1 1 .. 2 Order 7- Organs of Locomotion. Cancer & Scirrhus .. .. 1 4 4 .. 9 Haemorrhage .. .. .. .. .. .. .. Disease of Bones .. .. .. .. .. .. .. Order 8—Integument. Order 2 -Tubercular . Ulcers, Gangrene .. .. .. .. .. .. .. Scrofula 7 1 .. .. .. .. 8 Cutaneous Disease .. .. .. .. .. .. .. 5 1 2 .. .. .. 8 IV. DEVELOPMENTAL. Tabes Mesenterica 3 .. .. .. .. .. 3 Consumption 6 5 18 15 2 .. 46 Order 1—Of Children. Hydrocephalus and 7 2 .. 1 .. .. 10 Premature Birth 6 .. .. .. .. .. 6 Meningitis Atelectasis 1 .. .. .. . . .. 1 III. LOCAL. Other Malformations 1 .. .. .. .. .. 1 Ord.l- Nervous System Teething 5 .. .. .. .. .. 5 Tetanus 1 .. .. .. .. .. 1 Order 2—Of Adults. Apoplexy .. .. 1 8 8 .. 17 Childbirth .. .. 2 .. .. .. 2 Paralysis .. .. 1 2 7 .. 10 Order 3—Of Old People. Epilepsy .. 1 1 .. 1 .. 3 Convulsions 12 1 .. 1 .. .. 13 Effusion of Blood on Brain 4 .. .. 2 1 .. 7 Old Age, natural decay . .. .. .. .. 9 .. 16 Paraphleria .. .. 1 1 .. .. 2 Order 4—Diseases of Nutrition. Other Diseases 1 .. .. 2 .. .. 3 Order 2—Organs or Circulation. Atrophy 7 .. .. .. .. .. 7 Exhaustion, Anœmia 7 .. .. .. .. .. 7 Pericarditis .. 1 .. .. .. .. 1 V. VIOLENT DEATHS. Embolism .. .. .. 1 .. .. 1 Order 1—Accidents and Negligence. Aneurism .. .. .. .. .. .. 22 Disease of Heart .. 2 5 9 9 .. .. Fract.& Contusions from Rail. Street Accident, &c. 2 1 4 4 .. .. 11 Degen of Heart .. .. .. .. 2 .. 2 Burns and Scalds 2 .. .. .. .. .. 2 Order 3—Organs or Respiration. Drowning .. .. 1 .. .. .. 1 Suffocation in Bed and Accidental 5 .. .. .. .. .. 5 Laryngitis 1 .. 1 .. .. .. 2 Pul. Apoplexy .. .. 1 .. .. .. 1 Order 2.—Homicide. Bronchitis i18 1 3 10 22 8 62 Infanticide 3 .. .. .. .. .. 3 Pleurisy .. .. .. .. .. .. .. Suicides—Hanging .. .. 1 1 .. .. 2 Pneumonia 15 1 4 2 2 .. 24 Poisoning by Morphia. .. .. l .. .. .. 1 Asthma .. .. .. 2 .. .. 2 Suicide—Drowning .. .. .. 1 .. .. 1 Pul. Cong .. .. .. .. 1 .. 1 Other Diseases 4 .. .. 1 .. .. 5 No Specified Cause .. Carried forward 122 23 61 66 60 9 331 TOTAL 163 26 68 95 78 18 448 4 TABLE III. Summary of Sanitary Work, Quarter ending March 30th, 1872. I,— Inspections consequent on Nuisances, Complaints, and Offensive and Injurious Trades. Houses stables and Mews Inspected 337 Orders issued for Sanitary Works 235 Works done 193 Works in progress 29 Inspection of Offensive Trades 17 „ Manure Wharves 30 „ Sundry Inspections since February Cow-houses 13 „ Slaughter-houses 24 „ Bake-houses 3 „ Mortuary or Dead-house almost daily — „ Provision Markets every Saturday — „ Churches, Chapels and Schools 3 „ Factories, Work-rooms and other Public 7 „ Fever and Small-Pox Conveyance used . 28 II— Systematic Sanitary Inspection of Dwellings Houses and Premises visited and inspected 613 Re-inspection 705 Orders issued for Sanitary works 312 Works executed 280 Formal Orders issued by the Vestry 24 III.— Attendances upon Magistrates, Surveyor, at the Police, Coroner's Courts, and Licensing Meetings. Attendances 1 Summonses 4 For obtaining Summonses hearing 1 1 Letters written and received 55 Nuisances and Complaints during the Quarter ending March 30th, 1872. The register book of complaints and nuisances contains 195 cases, which admit of the following classification:— Defects of drainage and untrapped gulleys. 54 „ „ water supply 7 Dirty state of premises, water closets, urinals, stagnant water, percolations, &c 32 Offensive trades, marine stores, frying of fish, ballast burning, bad meat, &c. 5 Overcrowding and bad ventilation 5 Smoke nuisances 4 Animals being dirtily kept, and noises from . 4 Smells from the Canal Basin — Accumulation and deposit of manure, garbage, refuse, dust, dung, &c 22 Smells from decaying and putrid substances . 13 Defective cleansing of Roadways 12 Dangerous Structures and Places unfit 10 Miscellaneous, & cases of Contagious diseases reported 27 Total 195 These complaints received almost immediate attention. 5 TABLE V. Localities in which Deaths from Zymotic and other Diseases have been recorded during the Quarter ending March 30th, 1872. Streets, Districts and Hospitals. Small-Pox. Measles. Scarlet Fever. Diphtheria, &c. Whooping Cough. Typhus & other Fevers. Erysipelas, &c. Diarrhœa, &c. Phthisis, &c. Bronchitis, Pneumonia, &c. Violent Deaths. Other Diseases. Total. St. Mary's Hospital .. .. .. .. .. 1 1 .. 2 7 13 26 50 Paddington Workhouse .. .. .. .. 1 2 3 .. 7 7 .. 11 31 Lack Hospital .. .. .. .. .. .. .. .. .. .. .. 1 1 Praed Street, including (1) .. .. 1 .. .. 1 .. .. 7 4 1 9 23 Harrow Road & N. W. Road (2) .. 1 1 .. 1 .. .. .. 5 4 3 4 19 Hall Park District (3) 1 1 .. .. 1 .. .. .. 3 8 2 6 22 Amberley Road District (4) 1 1 .. .. .. .. .. .. 1 1 .. 4 8 Kilburn district(5) .. 1 .. .. 1 .. .. .. .. 3 .. 4 9 Clarendon Street .. .. .. .. .. .. .. .. .. 8 .. 1 4 Woodchester Street .. .. .. .. 3 .. .. .. 2 2 .. 2 9 Cirencester Street .. .. .. .. 2 .. .. .. 1 3 .. 3 9 brindley Street .. .. .. .. .. .. .. .. 1 1 .. 2 4 Hampden Street &c. (6) .. .. .. 1 .. 2 1 .. 4 4 .. 6 18 Westbourne Terrace North, &c. (7) .. .. . . .. 2 1 .. .. 1 3 1 6 14 Woodfield road &c. (8) .. .. .. .. 1 .. 1 . • 1 1 1 8 13 Moscow Road Salem Gardens,&c. (9) .. 1 .. 1 1 .. .. .. 3 2 .. 4 12 Squares and Mansions (10) .. .. 1 .. 1 4 .. 1 5 19 .. 39 70 Mews and Stables .. .. .. .. 2 1 .. .. 11 5 .. 8 28 Other Places, including (11) 1 .. 2 1 7 1 .. .. 21 18 4 49 104 Total 3 5 5 3 23 13 6 1 75 95 26 193 448 [1.] South Wharf Road, Union-PL, Stanley-St., Francis-St., Cambridge-PL, Junction-PL Newland Row, Market-St., Sale-St., Star-St., Bouverie-St., York Row, Titchborne Row, Jamea-Pl. and Katherine-Pl. [2.] Edgware Place, Church Place, Hermitage Street, Dudley Street, Kent's Place, Willinga Place, Victoria and Albert Street, Green Street,North Wharf Road, Iron GateWh.-Rd., White Lion Place and Passage, Alfred Place, Vine Cottages. [3.] Hall-Pl. & Park, Hall-PL West, Cuthbert-St., Howell-St., Charlotte-PL, Church-St., Crompton-St., Braithwaite-Pl., Campbell-St., Hethpool-St-, Hero-PL [4.] Netley-St., & Amberley Wharves, Formosa-St., Brandon-St., Vale-Ter., Shirland-Rd. [5.] Andover-Pl.,Kilburn Park-Rd.,Queen's ArmsYard, Elgin-Ter., MaidaVale, Carlton-PL, Canterbury-Ter., Lanark-PL and Villas, Elgin-Kd., Portsdown-Pl. [6.] Alfred-Rd. & PL, Waverly-Rd., Orchard-St., Waverly-Ter. and Desboro'-Ter. & PL [7.] Senior-St., Emily-St., Philip-Ter., Dartington-Ter., Hasboro'-St., Ranelagh-Rd., Westbury-Ter. & Rd., Cottage-Rd., Westbourne Park-Cres. [8.] Woodfield.PI. & Rd., Windsor Gardens-PL & St.,John-St, Chippenham-Ter. & Rd., Frankfort-Ter., Kensal New Town, Carlton-Ter., Goldney-Rd., Edbroke-Rd. [9.J Pickering-PL, Albert-Ter., Douglas-PL, Caroline-PL,DoveCottagea, Bark-Pi.,Poplar-PL, Chapel Side,Victoria-PL, Salem-Gards. & Rd. [10.] Westbourne-Ter.,Glouce8ter-Pl., Sq & Terr.,Porchester-Ter., & Square, Craven Hill & Gardens,Lanca8terGate,Hyde-Pk.-Sq.,Hyde-Pk.-Gar.,Inverness-Ter.,Queensboro'-Ter., Kensington-Palace-Gardens and Kensington-Gards.-Sq., The-Terrace, Cleveland-Ter. Sq., and-Gards, Sussex-Gards., Westbourne-St. & Cres. [11.] HouaeB in Streets not under special inspection, inhabited generally by one family only. 6 The Small Pox Epidemic in 1871. The epidemic of Small Pox whilst raging to an alarming extent in the Metropolis, and has since visited most of the large towns throughout the country, prevailed in this Parish during the whole of 1871. During several years previous to 1871, comparatively few cases were observed. In 10 vears the following cases were treated at the Small Pox Hospital, and charged to the Parish:— Years. Cases known. Deaths Registered. 1859 12 — 1860 8 - 1861 4 - 1862 2 - 1863 19 - 1864 8 - 1865 24 - 1866 38 20 1867 23 4 1868 14 3 1869 3 nil. 1870 — 1 1871 265 46 It will be seen that in 1865, '66, and '67, Small Pox was slightly epidemic in this Parish, but in 1868, '69 and '70, scarcely any cases were known. In fact, before the epidemic had reached Paddington, I mentioned in my fortnightly Report that the Small Pox Hospital was quite full, and that, if any cases occurred we should lack the means of removal and isolation required to prevent the spreading of the disease. The .Vestry therefore under powers conferred by the Sanitary Act of 1866, at once voted the sum required for the erection of a temporary Iron Hospital in the grounds of the Workhouse. The Guardians, meanwhile, received into Wards, isolated fur the purpose, cases that sought prompt removal, so that until the accommodation which the Metropolitan Asylum Boards afterwards provided at the Hospitals of Hampstead, Homerton and Stockwell, every facility was offered for the isolation of cases that cropped up almost daily from the first outbreak of the epidemic in the early part of January to the end of December. The first cases actually began a few days after my warning, and it must be a source of gratification to know that the prompt and united action taken by the Vestry and Board of Guardians to meet the impending danger has been attended with marked success by allaying fears, and averting a great risk of the spreading of this horrible disease in houses where early cases occurred. This will be best understood by stating that from the 7 3rd of January to the end of December no less than 511 cases were made known to the Sanitary Department of the Vestry; and of these, 265, or above 50 per cent of the whole, were removed at an early stage of the complaint to the hospitals provided for them, while other steps were taken calculated to prevent the further spread of the malady. TABLE VI. TABLE VI., showing the localities, ages, occupations, &c. of the cases of Small Pox in this Parish during the Epidemic in 1871. Streets, Districts, &c. Cases reported. Ages. Occupations. Vaccination. Males. Females. Total. Treated at Home. Removals to Hospitals. Under 5. 5 to 20. 20 to 40. 40 to 60. 60 upwards. Domestic Servants. Artizans and Labourers. Tradesmen. Profession & Merchants. Children under 15. Unknown. I Vaccinated when young. Un vaccinated. Vaccination uncertain. St. Mary's Hosp.—Lock Hosp. & Workhouse 4 2 6 .. 6 .. 2 4 .. .. .. 2 1 .. 2 1 2 .. 4 Praed Street District 26 34 60 17 43 8 24 27 1 .. 7 20 11 1 15 6 29 11 20 Harrow Road District and Streets 67 66 153 71 62 39 43 43 7 1 7 32 13 6 69 6 57 37 39 Hall Park District 12 10 22 7 15 3 5 12 1 1 5 10 3 .. 4 .. 10 I 11 Amberley Road District 8 8 4 4 4 1 3 .. .. .. 2 1 .. 5 .. 7 .. 1 Kilburn District 9 9 18 6 12 .. 9 9 .. .. 4 5 6 1 1 1 7 1 10 Clarendon, Woodchester & Cirencester Streets 17 17 34 12 22 3 14 13 4 .. 3 15 7 .. 8 1 16 1 17 Hampden Street District 8 6 14 4 10 2 7 5 .. .. 2 9 1 .. • • 2 8 1 5 Westbourne Terrace North District 11 12 23 22 11 2 9 12 .. .. 5 9 4 2 1 2 10 5 8 Westbourne Park District 13 17 30 8 22 .. 11 17 1 1 9 8 6 5 2 .. 17 2 11 Woodfield Road District 14 10 24 12 12 1 3 16 4 .. 5 8 4 2 4 1 11 4 9 Moscow Road District 10 8 18 4 14 1 7 7 3 .. .. 7 5 1 2 3 13 1 4 Squares and Mansions 12 30 42 15 27 .. 8 27 6 1 35 1 .. 5 1 13 2 27 Mews and Stables 31 23 54 28 26 8 22 18 6 .. 13 10 10 .. 13 8 21 7 26 Other Places 9 16 25 1 17 .. 10 14 1 .. 14 2 4 5 .. .. 12 13 243 268 511 208 303 71 175 227 34 4 109 140 76 28 127 31 233 73 205 8 It may be mentioned that besides these 511 cases, there may have probably been another 100 cases that have escaped observation, through the imperfect means which we possess of registering contagious diseases. A few cases were unknown to the Inspectors; for instance, when patients walked direct to the Hospital and presented themselves for admission; or in a few solitary instances where the friends of a patient were reluctant to report the caes for fear of removal to the hospital. I have, however, to thank the Medical men of the District for their willingness and courtesy in giving information, for reporting cases and for recommending removal. Cases of Small Pox removed to Hospital. Admission in No. of Cases. Deaths. Discharged. Result unknown. January 18 3 10 5 February 31 5 24 2 March 20 5 15 — April 22 1 8 13 May 47 6 27 14 June 46 12 28 6 July 25 4 14 7 August 15 2 6 7 September 4 1 3 — October 9 3 6 — November 17 2 8 7 December 11 2 — 9 265 46 149 63 18.02 per cent, were known to be fatal cases—that is a high mortality, including vaccinated and un-vaccinated cases. The average duration of cases in the hospital was 20 days. A few cases remained for longer period, probably to be useful in the service of the hospital. And of fatal cases more than half died within 5 days after admission; the average time of fatal cases in the hospital is 7 days—a few appear to have lingered 10 or 12 days: 5 from 20 to 30: one 60 days. Out of the ages recorded in 139 Hospital cases, the following table shows the number at different periods of life:— Under 5. 5 to 20. 20 to 40. 40 to 60, 60 to 80. 9 57 65 6 2 It will be seen that most attacks are between 5 & 40; in fact, between 5 to 30 years is the greatest liability to danger in persons attacked with regard to the ages. 9 63 cases are not accounted for, they have in all probabibility recovered, and gone into different Parishes or houses, where their parents or friends reside, and the return perhaps sent to that parish, at any rate it was not sent to Paddington, and the result is not known whether any of these were fatal cases—but if so, the mortality will be higher than that estimated. Out of 511 known cases, 215 occurred in the worst streets of the districts, North and South of the Canal Basin. In Harrow Road District 133 cases; Praed Street District 60; Hall Park District 22; making 215, or 38 per cent, of the whole. The remainder were scattered over 150 streets and places, more or less clean, and very favourably situated. I have obtained a record of the exact population of these groups of streets; and of Hall Park estate, where the population is estimated at about 3500, and where 22 cases occurred, the deaths do not appear to exceed that of the general population of the whole Parish. Woodchester Street, Clarendon Street and Cirencester Street, where the estimated population is nearly 5000, and with 34 cases, the proportion is about the same as that throughout the Parish, viz.:— about 6 attacked out of every 1000 persons living. This comparative immunity in some of our most crowded streets, can only be attributed to the very general practice of vaccination by parents, and to measures taken for prompt removal and isolation, cleansing and disinfection of rooms. It will be seen from Table VI., that 15 of 22 persons were sent from Hall Park district; 62 out of 133 from North Wharf Road District; 43 out of 60 cases in the South Wharf Road Streets; thus, 120 out of 215 attacked, being speedily removed, must have materially lessened the foci of contagion and risk to their neighbours in these crowded districts. More cases would have been removed, but for very young children, it was necessary to have their mothers to take care of them. In some instances mothers and children were taken off together in the carriage. The small pox cases have upon the whole been distributed over all parts of the parish, taking the extreme number at 600 (including the concealed cases), the proportion to the population will be at the rate 6 per 1000 persons of all ages. The inhabitants of squares and mansions have not escaped, but the dirty houses and streets have most suffered. Houses let out to more than one family, and where an entire family was living in a single room, have been, as may be expected, the greatest sufferers. In the houses of the rich and well to do, nearly the whole of the cases were domestic servants, described as butler, footman, housekeeper, housemaid, cook, nurse, &c. Out of 10 42 cases— 12 males, 30 females, reported to the Sanitary Department from large family mansions, 36 were domestics, of whom 25 were removed to hospital, the others treated at home. Why spreading Diseases are so easily transferred from one person to another. With regard to the spreading of contagious disease, and of the manner in which small-pox in particular is often conveyed, it must be noted that in some streets and places cases have frequently been found in close proximity, or behind the houses in squares and mansions. A butler is perhaps living at home with his family in an adjoining street, or the coachman in the mews at the back, while tailors, milliners, or workwomen, living in close rooms, have to send home work, or go to work, from an infected room ; children again often take these diseases to school.* We have numerous examples of the dangerous facility for propagating contagious diseases by the absolutely poor and indigent, who live in rooms, close and foul, with deficient air, light, and ventilation, or go about without means for personal or household cleansing. They lack not only coals, hot-water, soap, and proper utensils; but the old, infirm, or sick people want physical power to do washing for themselves, and have no means of paying others. These are matters of serious consideration in any attempts to check the ravages of spreading diseases amongst young children of the very poor in large towns. In my annual report for 1868-69, page 15, I suggested sanitary missionaries to supplement our methods of assisting the struggling and deserving poor. Out-door poor-law relief alone is necessarily inadequate to meet all domestic wants. Fate condemns many poor, but highly respectable people to live in the cheapest rooms, and most suspected houses of a poor neighbourhood. There are a number of persons who submit to any amount of privation rather than the degradation incidental to their entering a parish workhouse. The very conditions they live in deprive them of the kindly services of delicate ladies and friends who would be more inclined to visit and help them, if they lived in cleaner rooms, or even in a well-ordered alms house. * The explosion of gunpowder killing a few people is looked upon as a dreadful affair, and the legislation has no scruples in isolating and depriving of their civil right, dangerous lunatics who destroy only a score or so of people annually; it is equally fair to separate people affected with small pox and malignant fevers, so that death may not fall upon innocent persons who come into contact with them. Children going to school infected or imperfectly cured, observed Sir James Simpson, are more dangerous than a tiger, or a cobra escaping from a travelling menagerie. 11 The Registration of Contagious Diseases. Without a Registration of Contagious Diseases, all Sanitary organization must be very imperfect. At present, Officers of Health rarely get information of epidemic diseases at their early stages, 'and (often when it is too late to be of any real service. In Bristol Mews, for instance, the information of a death from Small Pox was first known through the Registrar Generals Returns; upon inspection it was found that a woman with G children, had 4 of them suffering from Small Pox; next door, a lad fresh from the country caught it and died, giving it to 3 other children in a house in this mews. Altogether 20 cases occurred, some of which were removed. This place is a cul-de-sac, it lies low, surrounded by lofty houses, entered by a covered archway; there is no current of air; it is closely packed with horses and dirty people. Thorough inspection has since been made from house to house, and a number of Sanitary Orders issued. In the epidemic of Scarlet Fever 3 years ago, many young children in this mews suffered severely. I brought the subject of the Registration of Disease, before the Health Section of the Social Science Congress in 1869,* and as the present time is again favorable for discussing a question of so much importance I may be excused for repeating some of the suggestions, and express the hope that such a Clause will be inserted in the Public Health Bill now before Parliament as shall be workable and satifactory to future Officers of Health. It could be readily shown that the legal registration of zymotic disease is an essential feature of public health legislation, and of any sound system of sanitary organization, and how its operation would benefit the community in checking contagious maladies. Means that might be employed for carrying it out, are fully adverted to in the paper. Curative skill applied to the contagious forms of preventable diseases has reached its maximum success. Medical services should now be directed to "prevention, rather than cure." Especially ought public school teaching, as well as medical practice, be directed to this end, if medical men are to be credited with sound doctrine and honest practice. In the last 10 years scarlet fever killed 280,000 children; measles 130,000; whooping cough 150,000 ; by 4 diseases alone 600,000. * "How the Government may beneficially interfere to limit the spread of infectious disease." — Social Science Transactions, 1869. 12 What we now propose is this: to put into action by our present future sanitary laws, a simple machinery, by which contagious maladies, or those diseases termed pestilential, contagious infectious, or catching and spreading— such as small pox, scarlet fever, measles, whooping cough, typhus, typhoid, and puerpreal fevers, erysipelas, and cholera, should at all events, if required by the santitary authorities, be made known to the medical officer of the district. With small pox and typhus, the plan would soon extend to the other forms of catching diseases. Not merely by the registration of Deaths (as we now have), but an early notice of the origin, and locality of these diseases, so that measures may, if necessary, be taken for the protection of public health, by preventing a further extension, and removing an obvious and threatening danger to the community. It would benefit all alike, rich and poor, to have larger powers for compelling strict isolation, whether at people's own dwellings, or by removal to hospitals.* Other diseases will be sufficiently known for statistical purposes by the simple registration of death. My belief is that at present we require only a registration of the epidemic or zymotic diseases. It should be compulsory for prompt information relating to all such cases in hospitals, dispensaries, refuges, workhouses, schools and tenant houses, let out to more than one family, to be reported to an officer of Public Health of the District. This return must be compulsory as to the name, address, and condition of people suffering from the said contagious diseases. In this way very few cases would escape observation. Penalties would have of course to be inflicted for concealment, or for refusing to give all reasonable information to the sanitary authority. The returns should be sent periodically to a central office by the registrar of the district. These data would form the basis of work for administrative action, that could not fail to be attended with excellent results. Separation and Isolation of persons suffering from Contagious Maladies. Large hospitals at a distance, and exclusively intended for paupers, are ill adapted as a permanent arrangement for carrying * "It surely could not be reckoned a hard measure," said Sir James Simpson, "for the public safety that every householder should by himself, or through his medical attendant, be obliged by the legislature to report upon the existence of any case of small pox that might appear in his establishment. In the same spirit every medical practitioner might be bound to report immediately any case of the disease so found in his practice." 13 out the separation and isolation of patients suffering from contagious diseases in this Parish. During the last four years more than four-fiths of all cases of contagious diseases requiring removal, were of a non-pauper class, and during the late small pox epidemic, the majority were nominally made paupers, and unwillingly treated at the Rate-payers’ expense. It is quite time a Cottage Hospital, or Sanitary retreat for non-pauper class was established; and what also could be combined, and almost of equal advantage, is a small children's hospital, with facilities of access for parents, who living in one room, would gladly take children to be nursed and cared for when suffering from contagious maladies; much of the danger to others in the same family could be avoided by separation and isolation. Sanitary authorities have the power to do this, and the expense would be trilling. A small establishment in the suburbs could be maintained at less than £ 500 per annum, and with payments for patients, would be almost self-supporting. It should be kept free from the pauper element. Cost of an Epidemic. The cost of this epidemic of small pox, light as it has been in this Parish in comparison with others adjoining, must have been very considerable, if all items entering into the calculation were fully ascertained, such as the following:— a. A sanitary supervision. b. Removal to Hospitals, c. Disinfection and cleansing of clothing, bedding, furniture, papering of rooms and places, d. Cost of treatment in Hospitals, and the nursing, with medical attendance at home in private practice. e. Cost of burial, mourning, &c. f Loss of work in wages and services, g. Loss of life to the community. h. Cost of widows and children, either to friends, or for poor law relief, education, &c. The costliness of preventible disease is enormous, and unfortunately falls most on those least able to bear it [vide Annual Report 1872, p. 16 and 17). But the poor are not the only sufferers. 16 The following Publications and Reports on Public Health have been received, and are acknowledged with thanks:— Reports of Medical Officers of Health of Wandsworth; of Marylebone, by J. Whitmore, M.D., &c.; of Manchester, by John Leigh, Esq.; Dr. Parkes and Dr. Sanderson on the Sanitary condition of Liverpool; of Liverpool, by W. S. Trench, M.D.; St. Giles,' by Q. Ross, M.D.; St. Pancras, by Thos. Stevenson, M D., Lond.; Whitechapel, by J. Liddle, Esq.; Hackney, by J. W. Tripe, M.D , and Surveyor's Department, by Jas. Lovegrove, Esq., Assoc. C.E. Report of the Charity Organization Society, and of the Charities of Paddington, for 1871. Report of the National Sanatorium for Consumption at Bournemouth. The Religion of Health, a Lecture, by Dr. Elizabeth Blackwell. Sanitary Rhymes, by A. Power, Esq., C.B.; Personal Precautions against Cholera and all kinds of Fever. Concerning Sewage and its economical disposal, by T. II. Danehell, Esq., C.E. Can Scarlet Fever and Small Pox be extinguished in three months, and at what expense? B. Clarke, F.L.S , &c. First Lessons on Health, J. Berners; Sewer Gas, and how to keep it out of the houses, by O. Reynolds, M.A.; the Hygiene of Air and Water, W. Procter, M.D , &c.; Healthy Houses, with 300 Illustrations, by Win. Essie, C.E., F.L S, &c.; the Philosophy of the Bath; on Air and Water in Health and Disease, D. Dunlop, M.R.J.A., &c. The Lancet; the Doctor; the Milk Journal; the Food Journal; Food, Air, and Water in relation to Public Health; the Medical Record, New York, August 1872; Proceedings of the National Association for the promotion of Social Science; the Alliance News. First Report of the Local Government Board, formerly Poor Law Report. Letter of J. N. Radcliffe, Esq., to the Medical Officer of the Privy Council. Returns of Vestries and District Boards on Works and Improvements under Metropolitan Local Management Act. No. 20. REPORT on the HEALTH OF PADDINGTON FOR THE QUARTER ENDING MIDSUMMER 1872, JUNE 29-th, BY WM. HARDWICKE, M.D., Medical Officer of Health. Estimated, Population 99,409 St. Mary's 61,162. St. John's 38,247. TABLE I. Summary of Weekly Return of Births and Deaths from April 6th to June 29th, 1872. St. Mart's. St. John's. Totals. Week ending Births. Deaths. Births. Deaths. Births. Deaths. April 6 42 26 7 17 49 43 „ 13 30 24 15 20 45 44 „ 20 48 20 9 10 57 30 „ 27 43 22 13 19 56 41 May 4 42 22 22 18 64 40 „ 11 32 24 11 8 43 32 ,, 18 28 26 11 10 49 36 „ 25 38 24 17 9 55 33 June 1 30 27 12 12 42 39 „ 8 37 23 10 12 47 35 „ 15 44 17 11 10 55 27 „ 22 45 19 9 20 54 39 ,, 29 35 16 17 9 52 25 Total 504 290 164 174 668 464 The deaths are remarkably low during the last quarter; births exceed by 204 the deaths during the same period, so that the death-rate will be at 18.64 per 1000, and the birth-rate 26.8. Measles, Scarlet fever and Whooping Cough have been fatal to 38, 13 and 17 young children, but they have scarcely amounted to an epidemic tendency. The Small Pox epidemic has subsided. 2 a, case here and there being heard of. Fever eases arc very little known, the 9 deaths recorded are not well-marked cases, but complicated with other diseases. Consumption and the tubercular diseases allied to it, including 84 cases, are in truth not the whole of this class. The 14 cases of convulsions, the 5 cases registered under the head of teething, and 7 under atrophy, are probably in their true character entitled to a place with tubercular diseases. This form of death is very common to the population in streets closely packed with people; an equally large number, 78 persons died from the inflammatory chest diseases which attacked the very young, and the aged during this quarter. The deaths of children under 5 years of age amount to 186, or 40 per cent, of the total deaths, which is a high proportion. Out of the 175 deaths occurring between ages of 5 and 60, consumption carried off 31; other chest diseases 45; heart diseases 13; and 26 deaths are from violence, and accidents, half of which were in St. Mary's Hospital, In 108 persons dying from natural causes at ages above 60; 25 were over 80 years; 16 from consumption; 21 from apoplexy and paralysis; 11 heart disease; 60 chronic chest and other diseases. The quarter has, however, been unusually healthy. TABLE II. Deaths from Zymotic and other Diseases during 13 weeks ending June 29th, 1872. Weeks. ending Small-Pox. Measles. Scarlatina. Diphtheria, Quinsy & Croup Whooping Cough Typhus, Infantile and other Fevers. Carbuncle, Erysipelas and Pyæmia. Dysentery and Diarrhoea. Cholera. Phthisis and Tubercular Dis. Bronchitis and Pneumonia. Other Diseases. Accidents and Violent Deaths. Total. April 6 2 7 3 ... 1 2 1 ... ... 5 9 10 3 43 „ 13 ... 2 1 ... 3 1 ... ... ... 7 6 22 2 44 „ 20 1 8 ... ... ... ••• ... ... ... 4 5 10 2 30 „ 27 ... 4 4 ••• 3 ... ... ... ... 6 9 13 2 41 May 4 ... 1 1 1 1 ... ... ... ... 12 6 14 4 40 „ 11 ... 2 1 1 2 1 ... ... ... 5 5 13 2 32 „ 18 1 2 ... ... 1 2 1 ... ... 8 4 13 4 36 „ 25 ... 1 ... ... 2 ... ... ... ... 5 10 14 1 33 June 1 ... 2 1 1 1 ... 2 1 ... 8 10 13 ... 39 „ 8 1 1 ... 1 ... 2 3 6 2 18 2 35 „ 15 ... 1 ... 1 1 2 ... ... ... 5 1 15 1 27 „ 22 ... 5 1 1 1 ... ... 1 ... 8 6 13 3 39 „ 29 ... 2 1 ... 1 1 ... 1 ... 5 5 9 ... 25 Total 4 38 13 6 17 9 6 6 ... 84 78 177 26 464 3 TABLE III. Mortality of the Parish of Paddington during the Quarter ending June 29th, 1872. Causes of Death. Ages. Total. Causes of Death. Ages. Total. Under 5 Years. 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above Under 5 Years. 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above. I. ZYMOTIC. Order 1—Miasmatic. Brought forward 156 19 30 68 64 16 353 Order 4—Organs of Digestion. Small Pox 2 .. 1 1 .. .. 4 Measles 36 3 .. .. .. .. 38 Malignant Dis. of Stom. .. .. .. 1 .. .. 1 Scarlatina 11 2 .. .. .. .. 13 Constipation 1 .. .. .. .. .. 1 Diphtheria 1 .. .. .. .. .. 1 Gastritis and Enteritis .. 1 1 2 i .. 6 Croup 4 1 .. .. .. .. 5 Peritonitis 1 .. 3 1 1 .. 6 Whooping Cough 14 3 .. .. .. .. 17 Ulceration of Pylorus .. .. .. .. .. .. .. Fever 3 .. .. 3 .. .. 9 Ulceration of Stomach. .. .. .. .. .. .. .. Rheumatic Fever .. .. 1 .. .. .. 1 Ulceration of Intestines. .. 1 1 .. .. .. 2 Erysipelas and Pyœmia 2 .. 3 1 .. .. 6 Hernia .. .. .. .. • • .. 1 Metria (Puerperal Fever) .. .. 3 .. .. .. 3 Cirrosis .. .. .. 2 1 .. 3 Dysentry .. .. .. .. .. .. .. Icterus—Gall Stones 1 .. .. .. .. .. 2 Diarrhœa 5 l .. .. .. .. 6 Diseases of Liver .. .. 2 4 4 i 11 Cholera .. •• •• .. .. .. .. Cancer of Liver .. •• •• 1 .. •• 1 Order 2—Enthetic. Disease of Rectum .. .. •• 2 .. .. 2 Syphilis 2 .. 1 .. .. .. 3 Order 5—Urinary Organs. Hydrophobia .. .. .. .. .. .. .. Order 3—Dietic. Nephritis .. .. .. .. .. .. .. Bright's Disease .. .. 4 2 2 .. 8 Privation .. .. .. .. .. .. .. Disease of Kidneys 1 .. 1 .. .. .. 2 Want of Breast Milk .. .. .. .. .. .. .. Diabetes .. .. 1 1 .. .. 2 Alcoholism:— Albumenuria .. .. .. .. .. .. .. a. Del. Tremens .. .. .. 1 .. .. 1 Uraemia .. .. .. .. b. Intemperance .. .. .. .. .. .. .. Dis. of Bladder & Prostate .. .. .. .. 2 1 3 Lead poisoning .. .. .. .. .. .. .. Order 6—Uterus and Ovaries. Order 4—Parasitic. Thrush 1 .. .. .. .. .. .. Diseases of Ovaries .. .. .. .. .. .. .. II. CONSTITUTIONAL. Metritis • • .. • • •• .. .. .. Disease of Uterus .. .. 2 .. 1 .. 3 Order 1-DIATHETIC Cancer of „ .. .. .. .. .. .. .. Gout .. .. 1 1 .. .. 2 Order 7-Organs of Locomotion. Dropsy .. .. .. .. 1 .. 1 Cancer &, Scirrhus .. .. .. 4 1 .. 5 Disease of Bones & joints .. .. .. .. .. .. .. Purpura Hæmorrhagica. .. .. .. 1 .. .. 1 Order 8—Integument. Order2 -Tubercular. Senile Gangrene .. .. .. .. 1 2 3 Abscess—Phlegmon .. .. .. .. 1 .. 1 Scrofula&TubercularDis. 3 3 1 .. .. .. 7 IV. DEVELOPMENTAL. Marasmus 13 1 1 .. .. .. 15 Tabes Mesenterica Consumpt & Hœmoptysis 1 6 95 12 .. 48 Order 1—Of Children. Hydrocephalus and Scof. Meningitis 11 3 .. .. .. .. 14 Premature Birth 5 .. .. .. .. .. 6 Malform. of the Heart 1 .. .. .. .. .. 1 III. LOCAL. Atelectasis 1 .. .. .. .. .. 1 Other Malformations .. .. .. .. .. • • .. Ord .1—Nervous System Teething .. .. .. .. .. .. 5 Tetanus .. .. .. .. .. .. .. Order 2—Of Adults. Apoplexy .. .. .. 1 9 2 12 Paralysis .. .. .. 2 2 3 7 Children •• .. •• .. .. 1 Epilepsy .. .. .. 1 .. 1 2 Order 3—Of Old People. Convulsions 14 .. 1 1 .. .. 16 Effusion of Blood on Brain .. .. .. 9 .. 2 Old Age, natural decay . .. .. .. .. 5 3 8 Effus. of Serum on Brain. 2 .. 1 .. 1 .. 4 Other Diseases 2 .. •• •• 1 •• 3 Nutrition. Order 2—Organs of Circulation. Atrophy, Inanition 7 .. .. .. .. •• 7 Exhaustion .. .. .. .. .. .. Pericarditis .. .. 1 .. .. .. 1 V. VIOLENT DEATHS. Order 1—Accidents and Negligence. Embolism .. .. .. .. .. .. .. Aneurism .. .. .. 1 .. .. 1 Fatty Heart .. .. .. 2 .. 2 Disease of Heart 1 1 2 10 6 3 23 Fract. & contusions from .. .. .. .. .. .. .. Order 3—Organs of Respiration. Rail. Street Accident,&c. 2 4 .. .. .. .. 2 Drowning .. 1 1 1 .. .. 3 Laryngitis .. 1 .. .. .. .. 1 Suffocation 1 .. .. .. .. .. 1 Laryngisims 4 .. .. .. .. .. 4 Order 2.—Homicide. Bronchitis 16 .. 1 8 21 3 49 Infanticide 4 .. .. .. .. .. 4 Pleurisy .. .. .. 1 .. .. 1 Suicides—Hanging .. .. 1 .. .. .. 1 Pneumonia 9 .. 8 4 2 .. 23 Manslaughter I 1 Asthma .. .. 1 1 .. .. 2 Pistol-shot .. .. .. .. .. .. .. Pulmon. Congestion.... .. .. .. .. .. .. .. Drowning .. .. 1 .. .. .. 1 Other Diseases .. .. .. .. .. .. •• Cutting Arm .. .. .. 1 .. •• l Carried forward 156 19 30 68 64 16 353 TOTAL 186 26 54 90 83 25 | 464 4 TABLE IV. Summary of Sanitary Work, Quarter ending June 29th, 1872. I.— Inspections consequent on Nuisances and Complaints, Offensive and Injurious Trades, inspection of cases of Contagious Diseases. Inspections of Offensive Trades, Marine Stores, &c. 48 ,, Nuisances and Manure Wharves 26 „ Cow-houses 16 „ Slaughter-houses 24 „ Bake-houses 6 „ Mortuary or Dead-house almost daily — „ Provision Markets every Saturday 13 „ Churches, Chapels and Schools — „ Factories, Work-rooms and other public Institutions - „ Cases of Contagious Diseases 10 ,, Fever and Small-Pox Conveyance used 8 times Orders issued for Sanitary Works 105 Work done 87 ii.— Systematic Sanitary Inspection of Dwellings, Mews End Stables. Houses and Premises visited and inspected 2491 Re-inspections 158 Orders issued for Sanitary Works (34 Formal Orders of the Vestry) 304 Work executed 99 Work in progress 81 III.— Attendances upon Magistrates, Surveyor, at the Police,Coroner's Courts, and Licensing Meetings. 1 Attendances 18 Summonses 2 For obtaining Summonses 2 „ hearing 2 Letter written and received 111 Nuisances and Complaints investigated during the Quarter ending June 29th, 1872. The register 193 cases, which admit of the following classification:— Defects of drainage and untrapped gulleys. 58 „ „ water supply — Dirty state of premises, water closets, urinals, stagnant water, percolations, &c,. 46 Offensive trades, marine stores, frying of fish, ballast burning, bad meat, and fruit 5 Overcrowding and bad ventilation 3 Smoke nuisances 10 Animals being dirtily kept, and noises from. 3 Smells from the Canal Basin — Accumulation and deposit of manure, garbage, refuse, dust, dung, &c 24 Smells from decaying and putrid substances. 15 Defective cleansing of Roadways 8 Dangerous Structures and Places unfit 3 Miscellaneous, & cases of Contagious diseases reported 18 Total 193 5 TABLE V. Localities in which Deaths from Zymotic and other Diseases have been recorded during the Quarter ending June 29th, 1872. Streets, Districts and Hospitals. Small-Pox. Measles. Scarlet Fever. Diphtheria, & c. Whooping Cough. Typhus & other Fevers. Erysipelas, &c. Diarrhoea, &c. Phthisis, &c. Bronchitis, Pneumonia, &c. Violent Deaths. Other Diseases. Total. St. Mary's Hospital 1 .. .. .. • • .. 1 1 9 6 12 16 46 Paddington Workhouse .. .. .. .. .. 1 .. .. 6 5 .. 17 29 Lock Hospital .. .. .. • • .. .. .. .. 1 .. .. .. 1 Praed Street, including (1) .. 1 4 .. • • 1 .. • • 9 4 1 10 30 Harrow Road & N. W. Road (2) .. 10 .. • • 2 1 .. 1 4 5 • • 5 28 Hall Park District (3) 1 5 .. • • 2 1 .. , , 3 4 • • 4 20 Amberley Road District (4) l .. 1 • • .. l .. 1 3 .. .. 3 10 Killburn District .. .. .. 1 .. .. .. .. .. 4 1 5 11 Clarendon Street, 107 h., 1788 p. .. 1 .. . . 1 • • .. 1 3 1 .. 4 11 Woodchester Street, 95 h., 1427 p. .. 2 • • .. 1 .. 1 .. 4 3 .. 2 13 Cirencester Street, 97 h., 1511 p. • • 4 .. 1 .. .. .. 1 1 1 .. 3 11 Westbourne Park District (6) 3 • • 2 3 l . . 1 4 4 2 18 38 Hampden Street, &c. .. .. .. .. .. I .. .. 6 2 • • 6 15 Westbourne Terrace North, &c. (8) .. 4 .. .. .. .. .. • • 4 5 .. 8 21 Woodfield Road, &c. (9) • • 1 1 2 .. .. .. .. 5 2 1 4 16 MoscowRoad, Salem Gardens, & c. (10) .. 1 .. .. 1 .. 1 .. 4 3 1 11 22 Square and Mansions(11) .. .. 3 .. • • • • 1 .. 1 10 2 29 46 Mews and Stables (12) .. 3 2 .. 1 .. .. • • 5 5 3 5 24 Other Places, including (13) 1 3 2 •• 6 2 2 • • 12 14 3 27 109 Total 4 38 13 6 17 9 6 6 84 78 26 177 464 Population in 1871. [1.] South Wharf Road, Union-Pi., Stanley-St., Francis-St., Cambridge-PL, Junction-PL, Newland Row, Market-St., Sale-St., Star-St., Bouverie-St., York Row, Titchborne Row, James-Pi. and Katherine-Pl. 3223 [2.] Margaret, Romily & Wellington-Ter, Church-Pi., Hermitage-St.,Dudley-St., Kent's-Pl., Willing's-Pl., Victoria & Albert-St., Green-St., North Wharf Road, Iron GateWh.-Rd., White Lion Place and Passage, Alfred Place, Vine Cottages 3238 [3.] Hall-Pl. & Park, Hall-Pl. West, Cuthbert-St., Howell-St., Charlotte-Pl. Church-St., Crompton-St, Braithwaite-Pl., Campbell-St., Hethpool-St, Hero-Pi., Edgware-Pl. 3950 [4.] Netley-St., AmberlyWhar. Rd. &Mews, Formosa-St., Brandon-St.,Vale-Ter., Shirland-Rd., Pindock Mews, Bristol Mews & Elnathan Mews 2474 [5.] Andover-Pl., Kilburn Park-Rd., Queen's Arms Yard, Elgin-Ter., MaidaVale, Carlton-Pl., Canterbury-Ter., Clarendon-Ter. & Road, Lanark-Pi. & Villas, Elgin-Hd., Portsdown-Pl. and Mews 2864 [6.1 Westbourne Park District ; 54 Streets and Mews adjoining 12552 [7.] Brindley-St., Alfred-Rd. & PL, Orchard-St., Waverly-Ter. Waverly-Rd., Desboro'-Ter., & PL (197) Jonson's Mews 4069 Woodchester, Cirencester & Clarendon Streets 4796 [8.] Senior-St., Emily-St., Philip-Ter., Dartington-Ter., Hasboro'-St., RanelaghRd., Westbury-Ter. & Rd., Cottage-Rd., Westbourne Park-Cres. & Bury-Ter. 2691 [9.] Woodfield-Pl., Rd., Cottages & Ter., Windsor Gardens-PL & St , John-St., Chippenham-Ter. and Rd., Frankfort-Ter., Streets in Kensal New Town, Carlton-Ter.,Goldney-Rd. & Edbroke-Rd. 3804 [10.] Queen's-Rd., Douglas-PL, Caroline-Pl. & Mews, Dove Cottages, Bark-PL, Poplar-PL, Chapel Side, Vincent-PL, Salem-Gards. & Rd. & Cresc 3252 [11.] Gloucester-PL, Sq., Ter., Porchester-Ter., & Sq., Craven Hill and Gardens, Lancaster Gate, Hyde-Pk.-Sq., Gard.,Ter., Inverness-Ter ,Qaeensboro'-Ter., Kensington-Palace-Gardens and Kensington-Gards.-Sq., The-Terrace, Ken- sington-Gar.-Sq., Kensington-Gar.-Ter., Cleveland-Ter., Sq., & Gards., Sussex-Gards, Westbourne-St., Cres. & Ter., Leinster-Sq. & Gardens, Princee-Sq., Queen's Gardens,Connaught-Sq. & PL, Stanhope-Pl. & Ter. 14088 [12.1 Mews adjoining and behind Squares & Mansions above mentioned 2211 [13.] Other Houses, Streets & Mews not included in any of the above groups 33671 6 TABLE VI., Showing the localities, ages, occupations, &c. of the cases of Small Fox in this Parish during the Epidemic in 1871. Streets, Districts, &c. Cases reported. Ages. occupations. Vaccination. Males. Females. Total. Treated at Home. Removals to Hospitals. Under 5. 5 to 20. 20 to 40. 40 to 60. 60 upwards. Domestic Servants. Artizans and Labourers. Tradesmen. Profession & Merchants. Children under 15. Unknown. vaccinated when young. Unvaccinated. Vaccination uncertain. St. Mary's Hosp.—Lock Hosp. &"VVorkhouse 4 2 6 .. 6 • • 2 4 .. .. .. 2 1 •• 2 1 2 • • 4 26 34 60 17 43 8 24 27 1 •• 7 20 11 1 15 6 29 11 20 Harrow Road District and Streets 67 66 153 71 62 39 43 43 7 1 7 32 13 6 69 6 57 37 39 Hall Park District 12 10 22 7 15 3 5 12 1 1 5 10 3 •• 4 .. 10 1 11 Amberley Road District .. 8 8 4 4 4 1 3 • • • • •• 2 1 • • 5 •• 7 .. 1 Kilburn District 9 9 18 6 12 .. 9 9 .. • • 4 5 6 1 1 1 7 1 10 Clarendon,Woodchester & Cirencester Streets 17 17 34 12 22 3 14 13 4 • • 3 15 7 • • 8 1 16 1 17 Hampden Street District 8 6 14 4 10 2 7 5 .. • • 2 9 1 • • • • 2 8 1 5 Westbourne Terrace North District 11 12 23 22 11 2 9 12 .. • • 5 9 4 2 1 2 10 5 8 Westbourne Park District 13 17 30 8 22 • • 11 17 1 1 9 8 6 5 2 .. 17 2 11 Woodfield Road District 14 10 24 12 12 1 3 16 4 .. 5 8 4 2 4 1 11 4 9 Moscow Road District 10 8 18 4 14 1 7 7 3 .. .. 7 5 1 2 3 13 1 4 Squares and Mansions 12 30 42 15 27 .. 8 27 6 1 35 1 .. 5 1 .. 13 2 27 Mews and Stables 31 23 54 28 26 8 22 18 6 • • 13 10 10 .. 13 8 21 1 7 26 Other Places 9 16 25 1 17 .. 10 14 1 .. 14 2 4 5 .. .. 12 .. 13 243 268 511 208 303 71 175 227 34 4 109 140 76 28 127 31 233 73 205 7 The Small Pox Epidemic of 1871. Before closing an account of the small pox epidemic of 1871 in this Parish—which appeared in my last Quarterly Report— I take an opportunity of reproducing the table herewith appended, and some additional information from the recently published Annual Reports of the Hospitals under the management of the Metropolitan District Asylum Board, at Hampstead, Hommerton and Stockwell. These reports are interesting in many points, and the statistical tables are valuable. No-where can be found proofs more decisive as to the protective power of good Vaccination. Whilst the lesson of a small pox epidemic is still fresh, the following facts ought to be made as widely known as possible to the public:— The rate of Mortality in 14,800 cases admitted into Hospitals was 10.15 per cent, in vaccinated cases, and 44.8 in the unvaccinated persons. The general death rate was 18.66 per cent. In 3,085 cases treated at the Hommerton and Stockwell Hospitals, the mortality of the un-vaccinated was 47.5 per cent., and 25 per cent, in badly vaccinated, whilst in well vaccinated cases it was from 5.3, and only 1.1 where 4 good marks were observed. In 420 well vaccinated small pox cases uuder 15 years of age the mortality was only 0.47, showing a comparative immunity from fatal results. Furthermore, conclusive evidence of the power of re-vaccination, is afforded by the fact, "that all the servants and nurses about the Hospitals, to the number at one time of about 300 persons, where they were hourly brought into contact with the disease, and who constantly breathe its atmosphere, and than whom none can be more exposed to its contagion, have with but few exceptions, enjoyed complete immunity from its attacks. These exceptions were cases of nurses and servants, whose re-vaccination in the pressure of the epidemic was over-looked, and who speedily took the disease. One was that of a nurse, who having previously had small pox, was not re-vaccinated, and took the disease a second time." Vaccination is still imperfectly appreciated, when we find that in 1871, the small pox killed 23,000 persons; in London alone nearly 8,000 fell victims to this easily preventible disease. One of the most telling arguments for a perfect system of Vaccination is that which appeals to the pockets of rate-payers in the additional cost of Non-Vaccinated patients. The average duration of the small pox cases, modified by vaccination, was 8 about three weeks, while cases of small pox in unvaccinated persons, were seven or eight weeks under treatment in the hospital. The cost of which at 1s. 4¾d. per diem for maintenance (exclusive of salaries to the Hospital Staff) amounted to £9, 300; or 33,000 days treatment beyond what would have been the expense and time of well vaccinated small pox cases. Early removal of Cases of Fever, Small Pox, &c. In the Report of Dr. P. M'Cann, there is much experience on questions yet undecided, which ought to be better known to those who are entrusted with sanitary administrative functions, whether Vestrymen, or Guardians of the Poor. One of these is the mode of conveying patients from their homes to the Hospitals with safety and comfort, and as early as possible. This question has been fully considered at various times, and provided for by the Sanitary and Public Health Committee. Our fever ambulance is constructed on a good model, running easily; it has a soft air bed and pillow; it is well ventilated and warmed with hot-water bottles in cold weather. There are two sets of fittings, and every precaution is taken to cleanse, aerate and disinfect after using them. Lastly, we insist upon the recumbent position, and object to friends journeying with the patient, thus breathing the poisoned atmosphere. I would remark upon another matter of most importance in our Sanitary duties, viz., that of endeavouring to facilitate the isolation and removal of patients suffering from contagious forms of disease. So very desirable is it that early steps should be taken in such cases by Medical men who have to recommend a removal to the Hospital, that they need not be ashamed to confess an early diagnosis to be difficult, or almost impossible. It appears from the returns of the Hommerton Hospital, that 170, or nearly 25 per cent, of admissions were patients suffering from "other diseases," and 29 persons were in a very exhausted state, and died within 48 hours after admission; probably to some extent this was owing to a reluctance, either on the part of patient or friends to the removal from home. Unless we run some risk of diagnosing the case, patients will often be kept at home in the early stages of contagious diseases until it is too late to remove them at all, and great danger to the health of others, as well as themselves is the result of any doubt and delay, until some prominent symptom shows itself and determines the nature of the case. No. 21. REPORT on the HEALTH OF PADDINGTON FOR THE QUARTER ENDING MICHAELMAS 1872, SEPTEMBER 2m, BY WM. HARDWICKE, M.D., Medical Officer of Health. Estimated Population 99,934 St. Mary's 61,654. St. John s 38,280. TABLE I. Summary of Weekly Return of Births and Deaths from July 6th, to September 28th, 1872. St. Mary's. St. John's. Totals. Week ending Births. Deaths. Births. Deaths. Births. Deaths. July 6 42 28 19 15 61 43 „ 13 25 14 20 9 45 23 „ 20 39 30 9 16 48 46 >> _ „ 27 43 29 12 7 55 36 Aug. 3 35 21 17 23 52 44 „ 10 33 23 19 15 52 38 „ 17 38 30 15 9 53 39 „ 24 30 16 18 16 48 32 „ 31 37 25 17 10 54 35 Sept. 7 34 15 15 10 4y 25 ,, 14 37 21 8 lo 45 34 „ 21 39 8 17 10 56 18 „ 28 46 13 9 7 55 20 Total 478 273 195 160 673 433 The number of deaths registered during the last quarter is 433—20 less than the corresponding quarter of last year, and less than the average for 5 years—with an increasing population. The actual mortality being 453, 467, 436, 449. The death rate per 1000 of the population is 17.32; the birth rate 26.8. No deaths have occurred from small pox; only 6 from measles, and 6 from scarlet fever; while whooping cough was fatal to 13 young children; and diarrhoea, as is usual in the Summer months, proved fatal to 60 persons, nearly all young children. Only six deaths are registered under the heading of fevers, 2 viz.:— such as typhoid, bilious and low fever. Deducting the diarrhoea cases, included wrongly in the list of zymotic diseases, this latter class of deaths would be only 34, of which 13 are from whooping cough. Out of the 60 fatal diarrhoea cases in this quarter, 54 occurred within six weeks; viz., two weeks of July, and four of August, when the temperature of the air was at the highest. From the middle of July the daily average temperature was 69° to 71°; or from 7 to 9 degrees of Fahr. above the average for 50 years. On some days the thermometer stood at 91° to 96° in the shade, and as high as 168° in the sun. The ages of the diarrhoea cases were as follows :— 3 under 16 days; 18 under 3 months; 28 from 3 to 12 months; 7 from 1 year and 18 months; and 4 Adults, ages 68, 78, 75, 76. The deaths from consumption and allied diseases, are numerous and proportionally as usual, very high, viz.:—74. 33 deaths were from violence, including 4 suicides, 4 scalds and burns, 3 accidental suffocation, 4 of newly-born infanticides, other accidents, as through railways, &c. Although the deaths of young children under 5, amounting to 298, or G8.8 per cent, of the total deaths, is a shamefully high proportion, and never ought to be overlooked, it may be said that the public health during the quarter was upon the whole very satisfactory. TABLE II. Deaths from Zymotic and other Diseases during 13 weeks ending September 28th, 1872. Weeks, ending Small-Pox. Measles. Scarlatina. Diphtheria, Quinsy & Croup Whooping Cough Typhus, Infantile and other Fevers. Carbuncle, Erysipelas and Pyæmia. Dysentery and Diarrhoea. Cholera. Phthisis and | Tubercular Dis. Bronchitis and Pneumonia. Other Diseases. Accidents and Violent Deaths. Total. July 6 ... 2 1 ... 1 ... 2 2 ... 5 3 23 4 43 „ 13 ... ... ... ... 3 ... ... 2 ... 5 1 10 2 23 „ 20 ... ... ... ... 3 1 ... 10 ... 6 4 18 4 46 „ 27 ... ... 1 ... 1 ... ... 7 ... 8 1 17 1 36 Aug. 3 ... ... ... ... ... ... ... 12 ... 9 1 16 6 44 „ 10 ... ... ... ... ... ... 1 10 ... 8 3 16 ... 38 „ 17 ... 3 ... 1 1 ... 1 5 ... 5 1 21 1 39 „ 24 ... ... ... 1 1 ... ... 4 ... 6 1 13 6 32 „ 31 ... ... ... 1 1 ... ... 1 ... 4 2 22 4 35 Sept. 7 ... 1 ... ... ... 2 ... 5 ... 5 2 9 1 25 „ 14 ... ... ... ... 1 1 ... ... ... 5 10 15 2 34 „ 21 ... ... ... ... ... ... ... 1 ... 4 3 10 18 „ 28 ... ... ... ... 1 2 ... 1 ... 4 3 7 2 20 Total ... 6 2 3 13 6 4 60 ... 74 35 197 33 433 3 TABLE III. Mortality of the Parish of Paddington during (he Quarter ending September 28th, 1872. Causes of Death. Ages. Total. Causes of Death. Ages. Total. Under 6 Years. 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above Under 5 Years. 5 and under 20 20 and under40 40 and under 60 60 and under 80 80 and above. I. ZYMOTIC. Brought forward 148 12 50 41 40 5 296 Order 1—Miasmatic. Order 4—Organs of Digestion. Small Pox .. .. .. .. .. .. .. Measles 6 .. .. .. .. .. 6 Malignant Dis. of Stom. 1 .. 1 .. .. .. 2 Scarlet Fever 2 .. .. .. .. .. 2 Constipation .. .. 1 •• .. .. 1 Diphtheria 1 .. 1 .. .. .. 2 Gastritis and Enteritis.. 1 .. 2 1 1 .. 7 Croup 1 .. .. .. .. .. 1 Peritonitis 1 .. 1 • • .. .. 2 Whooping Cough 13 .. .. .. .. .. 13 Ulceration of Pylorus . . .. .. .. .. .. .. Fever .. .. 1 2 .. .. 5 Ulceration of Stomach . .. .. •• .. 1 .. 2 Rheumatism .. .. .. 1 .. .. 1 Ulceration of Intestines. .. .. .. .. I •• 1 Erysipelas and Pyœmia . I .. 2 .. .. .. 4 Hernia .. .. •• .. .. •• .. Metria (Puerperal Fever) .. .. .. • • .. .. .. Cirrosis .. .. 1 .. .. .. 1 Dysentry .. .. .. .. .. .. .. Icterus—Gall Stones 1 .. .. 1 1 .. 4 Diarrhoea 56 .. .. 4 .. .. 60 Diseases of Liver .. .. 1 1 1 .. 3 Cholera .. .. .. .. .. .. .. Cancer of Liver .. .. 3 .. .. .. 3 Order 2—Enthetio. Disease of Rectum .. .. .. 1 .. 1 Order 5—Urinari Organs. Syphilis 3 1 1 .. .. .. 5 Hydrophobia .. .. .. .. .. .. .. Order 3—Dietic. Nephritis .. •• .. .. .. •• .. Bright's Disease .. .. 1 .. .. .. 1 Privation 1 .. .. .. .. .. 1 Disease of Kidneys 1 .. .. 3 .. •• 4 Want of Breast Milk .. .. .. .. .. .. .. Diabetes .. .. .. .. 1 .. 1 Alcoholism:— Albumenuria .. 1 .. 2 1 •• 4 a. Del. Tremens .. .. 4 1 .. .. 5 Uraemia . . .. 1 •• •* 1 b. Intemperance .. .. .. .. .. .. .. Dis. of Bladder&Prostate .. .. •• .. 1 1 Lead Poisoning .. .. .. .. .. .. .. Order 6—Uterus and Ovaries. Order 4—Parasitic. Diseases of Ovaries .. .. .. .. .. .. .. Thrush .. .. •• •• •• •• .. Metritis .. .• .. .. .. • • .. II. CONSTITUTIONAL. Disease of Uterus .. .. 1 1 1 •• 3 Cancer of .. .. 1 1 .. •• 2 Order 1—Diathetic. Order 7- Organs of Gout .. .. .. .. .. .. .. Dropsy .. .. .. .. 1 .. 1 Disease of Bones&Joints • • .. 2 .. .. .. 2 Cancer & Scirrhus .. .. 1 3 4 .. 8 Purpura Hemorrhagica .. .. .. .. .. .. .. Order 8_Integument. Order 2— Tubercular Senile Gangrene 1 .. .. .. .. .. 1 Abscess—Phlegmon 1 .. .. .. .. .. 1 Scrofula&TubercularDis. 1 1 .. 1 1 .. 4 IV. DEVELOPMENTAL. Marasmus 15 •• .. 1 .. •• 16 Tabes Mesenterica Order 1—Of Children. Consumpt &Hcemoptysis 3 2 20 8 2 .. 41 Premature Birth 12 .. .. .. .. •• 12 Hydrocephalus and Scrof. Meningitis 13 2 2 .. .. .. 17 Malform. of the Heart .. 1 .. .. .. .. 1 Atelectasis .. .. .. .. .. •• TIT. LOCAL. Other Malformations 1 .. .. .. .. .. 1 Ord ,1-NervoussY stem Teething .. .. .. .. .. .. .. Tetanus .. .. .. .. .. .. .. Order 2 Of Adults Children .. 1 2 .. .. .. 3 Apoplexy .. .. 1 2 4 .. 7 PAralysis .. .. .. 1 5 2 8 Order 3—Of Old People. Epilepsy .. .. 1 2 .. 3 Convulsions 11 .. .. 1 .. .. 12 Etfnsion of Blood on Brain .. .. .. 5 .. .. 5 Old Age, natural decay .. .. .. .. 7 9 16 Effus.of Serum on Brain. .. .. .. .. .. .. .. Order 4—Diseases of Nutrition. Other Diseases •• 1 • • 2 •• •• 3 Order 2—Organs of Circulation. Atrophy, Inanition 10 .. 2 1 •• .• 13 Exhaustion 10 .. .. .. .. •• 10 Pericarditis .. .. 1 .. .. .. 1 V. VIOLENT DEATHS. Order 1—Accidents and Embolism .. .. .. .. .. .. .. Aneurism 1 .. 1 1 .. .. 3 tatty Heart Disease of Heart .. 3 2 6 7 2 20 Fract.& Contusions from 2 2 3 .. 1 .. 8 Order 3—Organs or Respiration. Burns and Scalds 2 1 1 .. .. .. 4 Drowning 1 1 1 .. .. .. 3 Suffocation—newly-born 4 .. .. .. .. .. 4 Laryngitis 2 .. .. .. .. .. 2 Laryngisimus .. .. .. .. .. .. .. Order 2.—Homicide. Bronchitis 11 .. .. 3 4 1 19 Infanticide 4 .. .. .. .. 4 Pleurisy .. .. .. .. .. .. .. Suicides—Hanging .. .. 1 .. 1 Pneumonia 3 .. .. .. .. .. 5 Manslaughter .. • • • • .. •• Asthma .. .. 1 .. .. .. 1 Fracture of Neck .. 1 •• .. 1 Pulmon. Congest on 4 .. 2 1 3 .. 10 Drowning 1 .. 2 3 2 • • 8 Other Diseases .. .. .. 1 .. .. 1 Cutting Throat .. .. .. .. .. .. .. Carried forward 148 12 60 41 40 5 296 TOTAL 202 21 77 53 59 16 433 4 TABLE IV. Summary of Sanitary Work, Quarter ending September 28th, 1872. —Inspections consequent on Nuisances andComplaints, Offensive and Injurious Trades, inspection of cases of Contagious Diseases. Inspections of Offensive Trades, Marine Stores, &c. 50 ,, Nuisances and Manure Wharves 29 „ Cow-houses 20 „ Slaughter-houses 22 „ Bake -houses 8 ,, Mortuary or Dead-house almost daily — „ Provision Markets every Saturday 10 „ Churches, Chapels and Schools 7 „ Factories, Work-rooms and other Public Institutions 8 „ Cases of Contagious Diseases 22 ,, Fever and Small-Pox Conveyance used 3 times Orders issued for Sanitary Works 601 Work done 573 II.— Systematic Sanitary Inspection of Dwellings, Mews and Stables. Houses and premises visited and inspected 1803 Re-inspections 172 Orders issued for Sanitary Works (38 Formal Orders of the Vestry) 340 Work executed 74 Work in progress 66 III.— Attendances upon Magistrates, Surveyor, at the Police,Coroner's Courts, and Licensing Meetings. Attendances 20 Summonses 2 For obtaining Summonses 2 „ hearing „ 2 Letter written and received 117 Nuisances and Complaints investigated during the Quarter ending September 28th, 1872. The register 244 cases, which admit of the following classification :— Defects of drainage and untrapped gulleys. 69 „ „ water supply — Dirty state of premises, water closets, urinals, stagnant water, percolations, &c 50 Offensive trades, marine stores, frying of fish, ballast burning, bad meat, and fruit 4 Overcrowding and bad ventilation 7 Smoke nuisances 2 Animals being dirtily kept, and noises from 13 Smells from the Canal Basin 13 Accumulation and deposit of manure, garbage, refuse, dust, dung, &c 39 Smells from decaying and putrid substances . 28 Defective cleansing of Roadways 5 Dangerous Structures and Places unfit 3 Miscellaneous, & cases of Contagious diseases reported 11 Total 244 5 TABLE V. Localities in which Deaths from Zymotic and other Diseases have been recorded during the Quarter ending September 29th, 1872. Streets, Districts and Hospitals. Small-Pox. Measles, Scarlet Fever. Diphtheria, &c. Whooping Cough. Typhus & other Fevers. Erysipelas, &c. Diarrhoea, &c. Phthisis, &c. Bronchitis, Pneumonia, &c. Violent Deaths. Other Diseases. Total. , St. Mary's Hospital .. .. .. .. .. 1 .. .. 2 .. 22 23 48 Paddington Workhouse .. .. .. .. .. .. 1 • • 6 .. 2 16 25 Lock Hospital .. .. .. • • .. .. .. • • .. .. .. 1 1 Praed Street, including (1) .. .. .. .. .. .. .. 6 2 3 1 9 21 Harrow Road & N. W. Road (2) .. .. 2 .. • • 1 1 .. 10 4 2 .. 11 31 Hall Park District (3) .. .. 1 • • 1 1 .. 5 3 2 .. 9 22 Amberley Road District (4) • • .. 1 .. 1 .. .. 3 1 .. 1 4 11 Killburn District (5) .. .. .. .. .. .. .. 3 6 1 .. 12 22 Clarendon Street, 107 h., 1788 p. .. .. .. .. .. .. .. 4 1 .. .. 5 10 Woodchester Street, 95 h., 1427 p .. .. .. .. .. .. .. 6 3 3 .. 4 16 Cirencester Street, 97 h., 1511 p. .. .. .. .. .. .. .. 2 1 .. .. 2 5 Westbourne Park District (6) .. 1 .. .. 1 1 .. 5 3 3 .. 3 17 Hampden Street, &c. (7) .. 1 .. .. 3 .. .. 2 2 3 .. 15 .. Westbourne Terrace North, &c. (8) .. .. .. 2 .. .. .. 2 3 2 1 15 25 Woodfield Road, &c. (9) .. 1 .. .. 3 • • 2 4 2 2 .. 8 22 MoscowRoad,SalemGardens,&c.(10) .. .. .. .. 1 .. .. 1 3 .. 1 5 11 Square and mansions(11) .. .. .. .. 1 .. .. 1 3 4 2 32 43 Mews and Stables (12) .. 1 .. 1 1 1 1 2 2 2 2 19 32 .. .. .. .. .. 1 .. 4 2 1 1 36 45 Total 6 2 3 13 6 4 60 49 28 33 229 433 Population in 1871. [1.] South Wharf Road, Union-Pi., Stanley-St., Francis-St., Cambridge-PL, Junction-PL, Newland Row, Market-St., Sale-St., Star-St., Bouverie-St., York Row, Titchborne Row, James-PL and Katherine-Pl. 3223 [2.] Margaret, Romily & Wellington-Ter , Church-Pl., Hermitage-St.jDudley-St., Kent's-Pl., Willing's-PL, Victoria & Albert-St., Green-St., North Wharf Road, Iron GateWh.-Rd., White Lion Place and Passage, Alfred Place, Vine Cottages 3238 [3.] Hall-Pl. & Park, Hall-Pl. West, Cuthbert-St., Howell-St., Charlotte-PL, Church-St, Crompton-St, Braithwaite-Pl,, Campbell-St., Hethpool-St, Hero-PL, Edgware-Pl 3950 [4.] Netley-St., AmberlyWhar. Rd. &Mews, Formosa-St., Brandon-St.,Yale-Ter., Shirland-Rd., Pindock Mews, Bristol Mews & Elnathan Mews 2474 [5.] Andover-PL, Kilburn Park-Rd., Queen's Arms Yard, Elgin-Ter., MaidaVale, Carlton-Pl., Canterbury-Ter., Clarendon-Ter. & Road, Lanark-PL & Villas, Elgin-Kd., Portsdown-PL and Mews 2864 [6.] Westbourne Park District ; 54 Streets and Mews adjoining 12552 [7] Brindley-St., Alfred-Rd. & PL, Orchard-St., Waverly-Ter. Waverly-Rd., Desboro'-Ter., & Pl. (197) Jonson's Mews 4069 Woodchester, Cirencester & Clarendon Streets 4796 [8.] Senior-St., Emily-St., Philip-Ter., Dartington-Ter., Hasboro'-St., RanelaghRd., Westbury-Ter. & Rd., Cottage-Rd., Westbourne Park-Cres. &Bury-Ter. 2691 [9.] Woodfield-Pl., Rd., Cottages & Ter., Windsor Gardens-PL & St , John-St., Chippenham-Ter. and Rd., Frankfort-Ter., Streets in Kensal New Town, Carlton-Ter.,Goldney-Rd. & Edbroke-Rd 3804 [10.] Queen's-Rd., Douglas-PL, Caroline-Pl. & Mews, Dove Cottages, Bark-PL, Poplar-PL, Chapel Side, Vincent-PL, Salem-Gards. & Rd. & Cresc 3252 [11.] Gloucester-PL, Sq., Ter., Porchester-Ter., & Sq., Craven Hill and Gardens, Lancaster Gate, Hyde-Pk.-Sq., Gard., Ter., Inverness-Ter.,Queensboro'-Ter., Kensington-Palace-Gardens and Kensington-Gards.-Sq., The-Terrace, Kensington-Gar.-Sq., Kensington-Gar.-Ter., Cleveland-Ter., Sq., & Gards., Sussex-Gards , Westbourne-St., Cres. & Ter., Leinster-Sq. & Gardens, Princes-Sq., Queen's Gardens,Conuaught-Sq. & PL, Stanhope-PL Sc Ter. 14088 [12] Mews adjoining and behind Squares & Mansions above mentioned 2211 [13] Other Houses, Streets & Mews not included in any of the above groups 33671 6 Systematic Inspection of Stables and Mews by Inspector Parsons, continued from Quarter ending March 1872. Mews & Stables. Houses and Stables. Inhabitants. Orders. Remarks. London General Omnibus Company Stables 2 130 Horses 9 Very clean, ventilated above stables, newly built, well paved and good water tank, and w.c , 2 dwelling houses, 14 stable-men employed besides drivers, conductors, &c Southwick Mews 13 60 8 Rooms small, with low ceilings Douglas or Hamilton Mews • • • • 4 High buildings surround. Iron steps and a gallery for entering the rooms outside the stables—a good plan Charles Mews 31 67 7 Fair state, shops, trades, and a livery stable Brook Mews North 23 163 15 Small rooms, ceilings low, many stables been converted into shops Little Brook Mews 8 81 6 Much sanitary work done at various times, rooms small, w.c. badly situate, ceilings low Upper Brook Mews 21 106 31 Better state, trades carried on Frederick Mews 16 70 4 Paving and gullies bad, overcrowding abated, works ordered and completed Connaught Mews 12 18 • • Much improved, a wheelwright's forge, and other trades are carried on here Westbourne Terrace Mews 13 82 • • Very clean and perfect in the management of stables, but discontinue to deposit manure against rear of wall of Gloucester Terrace Houses Eastbourne Mews 44 187 10 Very fair and clean Here ford Mews North 5 27 • • Provide better receptacles, and remove dung more frequently Po rchester Mews 37 66 10 Several rooms dirty and close Rickard's Stables • • • • • • Abate overcrowding, repairs, dilapidations, and improved drainage Conduit Mews 23 166 7 Very dirty, cleansing, & covers to water cisterns 7 Systematic Inspection of Stables and Mews (continued). Mews & Stables. Houses and Stables. Inhabitants. Orders. Remarks. Elnathan Mews 39 186 4 Sloppy, sickness, for want of paving, ventilation of w.c. Princes Mews 19 84 5 Clean, very few defects Junction Mews 9 52 7 Covers to 2 cisterns,paving and draining amended, ventilation improved Norfolk Square Mews 15 85 5 Cleansing, ventilation of rooms, drains amended, &c. Burwood Mews 13 55 9 Tolerably clean, deficient of w.s. and w.c. remedied 5 17 6 Great improvement of late Torrington Mews 21 105 13 Cleansing, dilapidations, w.s. and w.c. very defective, repairs, &c. ordered Jonson's Mews 7 34 3 Paving amended, great improvement since last year's work was ordered Sovereign Mews 11 115 5 Chiefly cleansing and whitewashing done Polygon Mews North and South 48 202 21 Much cleansing and whitewashing done,cisterns, stalkpipes and other dilapidations repaired, and drains trapped Westbourne Park Crescent Mews 1 2 1 Badly paved, fowls kept dirtily, a rag shop complained of, and garbage in dung bin, cleansing throughout, &c. Westbourne Park Villas Mews 13 85 4 Several houses in a bad state have been taken down by Great Western Railway Cleveland Mews 27 106 11 Cisterns without covers, some rooms dirty, improved since last inspection Frederick Mews 6 21 5 Improved of late, work done Richmond Mews 14 71 11 Dirty, dilapidated, no proper receptacles for dung, fowls dirtily kept Victoria Grove Mews • • • • 1 Ground opened, drains improved 8 The following Publications and Reports on Public Heatlh have been received, and are acknowledged with thanks:— Summary of a Comprehensive Measure for the improvement of the Sanitary Laws, by W. H. Rumsey, M.D., &c., F.R.C.S., &c. Hospital Out-Patient Reforms, No. I. Facts and Figures, by H. Nelson Hardy, Esq., F.R.C.S.E, &c. On Out-Patient Relief, by one of the Governors of St. George's Hospital. Model Houses for the Industrial Classes; Plans for adaptations of existing dwellings for letting in Flats, by Banister Fletcher, Esq.; on the Warming of Houses, by J. P. Seddon, Esq., M.I.B.A., &c.; Homes for the Working Classes, with suggestions for their improvements, by James Hole, Esq., from the Author; Domestic Sanitary Hints and Arrangements, necessary to comfort and health, by Robert Rawlinson, Esq., C.B., C.E. Social Economy for the Upper Classes of Primary Schools, by J. E. Thorold Rogers, M.A., Tooke Professor of Economic Science at Oxford. Reports of Medical Officers of Health:—on the Sanitary Condition of Whitechapel, by John Liddle, Esq.; of St. Mary Abbotts, Kensington, by Dr.T.O. Dud field; of St. James,' Westminster, by Dr. Lankester; of the Poplar District, by Drs. Woodforde and Ellison; of Mile End Old Town, by Dr. Corner; of the Thames' Shipping Committee, Oct. 1872; of Islington, by W. H Corfield, M.A., of the Metropolitan District Asylum Board on the Small Pox Epidemic of 1871; of the Stockwell Fever and Small Pox Hospital; of the Hommerton Fever Hospital. Report of the Sewage Inquiry Committee of Birmingham in 1871. Journals received:—The Dublin Magazine; Article on Juvenile Smoking; Lancet; Medical Times & Gazette; British Medical Journal; The Medical Record; Air, Food and Water, in relation to Public Health; the Food Journal. Drake and Stridder's Illustrations of Sanitary and Hydraulic Articles. Report on Gas impurities, by T. H. Adamson, Esq.; Report of T. W. Keates, F.C.S., and W. Odling, F.R.S., &c., on Dr. Eveleigh's Patent system of Manufacturing Gas, and F. R. Mellor's Remarks thereon. No. 22. REPORT on the HEALTH OF PADDINGTON FOR THE QUARTER ENDING CHRISTMAS 1872, DECEMBER 28th, BY WM. HARDWICKE, M.D., Medical Officer of Health. Estimated Population 100,459 St. Mary's 62,146. St. John's 38,313. TABLE I. Summary Of Weekly Return Of Births and Deaths from October 5th, to December 28th, 1872. St. Mary's. St. John's. Totals. Mean Temp Week ending Births. Deaths. Births. Deaths. Births. Deaths. Oct. 5 39 19 9 4 48 23 52.4 „ 12 47 18 15 8 62 26 47.3 „ 19 44 23 12 11 56 34 44.4 „ 26 40 28 9 10 49 38 47.4 Nov. 2 35 30 14 15 49 45 49.7 9 34 14 13 12 47 26 53. „ 16 47 16 21 12 68 28 37.9 „ 23 41 21 15 11 56 32 37.8 „ 30 45 22 18 4 63 26 48. Dec. 7 31 15 17 6 48 21 41.9 „ 14 46 18 11 11 57 29 38.6 „ 21 48 18 11 11 59 29 41. „ 28 26 21 12 12 38 33 47.7 Total 523 263 177 127 700 390 The 13 weeks of the quarter just passed have shown a most favorable record of public health in London, and nearly all parts of the Country. In this Parish the number of deaths, 390, is far below anything that has been recorded for many years,* the death rate being only 15.5 per 1000 of the population, including 16 deaths from some adjoining districts, chiefly of persons brought into St. Mary's Hospital—Archer Street, Latimer Load, Southam Street, &c. 4 cases were from Kensington; Finchley, Acton, Hampstead, Surbiton, Pinner, and Berkshire, 6 cases; *Total deaths during Xmas. quarters 1867. 1868. 1869. 1870. 1871. 1872 Average of 6 years, 442.4. 457 41/ 436 436 469 390. 2 4 cases from Marylebone; 1 from Long-A ere. Inquests were held on 25 persons during the quarter; 30 deaths took place in the Workhouse; 33 in St. Mary's Hospital; 2 in Lock Hospital; thus 16.6 per cent. of all deaths were in public Institutions, which is a little less than the general average throughout large towns. The birth rate is 27.6 per 1000—the number of births being; 700, or almost double the number of deaths The small pox epidemic has almost disappeared. The zymotic diseases were extremely low; that is, only 7.4 per cent. of the total deaths, a remarkable and almost unprecedented fact for town population; 1 small pox, 1 measles, 6 whooping cough, 7 diphtheria, and 7 doubtful fever cases. The deaths under 5 years of age are less than usual, almost half the last Summer quarter, and below the quarter's average for many years, a diminition this Winter, probably owing to the to the extremely mild state of the weather. The tubercular forms of diseases, including consumption, were fatal to 78 persons, and other chest diseases, 77, are about the average of previous corresponding quarters. 15 deaths are from accidents, and violence, including suicide, infanticide, &c. There must be a very large proportion of aged persons in this Parish, judging from the register of deaths at advanced ages, viz.:—78 persons between 60 and 80 years of age; 16 upwards of 80; 1 above 90. Deaths under 5 years in quarters ending Christmas 1867, 68, 69, 70, 71, 72, were—139, 162, 174, 151, 121 respectively. TABLE II. Deaths from Zymotic and other Diseases during 13 weeks ending December 28th, 1872. Weeks. ending Small-Pox. Measles. Scarlatina. Diphtheria, Quinsy & Croup Whooping Cough Typhus, Infantile and other Fevers. Carbuncle, Erysipelas and Pyæmia. Dysentery and Diarrhoea. Cholera. Phthisis and Tubercular Dis. Bronchitis and Pneumonia. Other Diseases. Accidents and Violent Deaths. Total. Oct. 5 ... 1 ... 2 ... ... ... ... ... 7 6 7 ... 23 „ 12 ... ... ... ... ... ... 1 ... ... 6 4 15 ... 26 „ 19 ... ... 1 ... ... ... ... 2 ... 7 8 14 2 34 26 Nov. 2 ... ... ... ... ... 1 ... 1 ... 9 5 21 1 38 ... ... ... 1 1 2 ... ... ... 7 9 19 5 45 „ 9 ... ... ... 1 3 ... ... ... 4 5 14 1 26 „ 16 ... ... ... 1 ... ... ... ... ... 4 5 18 ... 28 „ 23 ... ... ... ... 1 ... ... ... ... 4 11 16 ... 32 „ 30 1 l ... ... 1 ... ... ... ... 5 6 12 ... 26 Dec. 7 . . . ... ... ... 1 1 ... ... ... 4 1 12 2 21 „ 14 ... ... ... 1 1 1 ... ... ... 4 8 13 1 29 „ 21 ... ... ... ... 1 ... 1 ... ... 6 5 15 1 29 „ 28 ... ... ... 1 ••• ... ... ... 11 4 17 ... 33 Total 1 2 1 7 6 *7 2 3 ... 78 77 193 13 390 *3 Rheumatic Fever. 8 TABLE III. Mortality Of the Parish Of Paddington during the Quarter ending December 28th, 1872. Causes of Death. Ages. Total. Causes of Death. Ages. Total. Under 5 Years. 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above Under 5 Years. 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above. I. ZYMOTIC Brought forward 104 21 49 56 51 4 285 Order 1—Miasmatic. Order 4—Organs of Digestion. Small Pox .. .. 1 .. .. .. 1 Scarlatina 1 .. .. .. .. .. 1 Malignant Dis. of Stom. .. .. .. 1 1 .. 2 Measles .. 2 .. .. .. .. 2 Constipation .. .. .. 2 .. .. 2 Whooping Cough 6 .. .. .. .. .. 6 Gastritis .. .. .. .. .. Diphtheria .. 5 .. .. .. .. 5 Peritonitis .. .. 2 1 1 .. 7 Croup 2 .. .. 2 Ulceration of Pylorus .. .. .. .. .. .. Acute Rheumatis .. 1 2 .. .. .. 3 Ulceration of Stomach .. .. 1 1 .. .. 2 Diarrhœa 3 .. .. .. .. .. 3 Gall Stone .. .. .. .. 1 .. 1 Fever Typhoid .. .. 3 1 .. .. 4 Hernia .. .. .. 2 l .. 3 Erysipelas and Pyœmia. 1 .. .. 1 .. .. 2 Cirrosis .. .. 1 1 1 .. 3 Metria (Puerperal Fever) .. .. 1 .. .. .. 1 Icterus—Jaundice .. .. .. 1 2 2 5 Rheumatism .. .. .. .. .. .. .. Diseases of Liver .. .. .. .. .. .. .. Fever .. .. .. .. .. .. .. Cancer of Liver .. .. .. 2 3 1 6 Order 2—Entsetic. Disease of Rectum .. .. .. 4 .. .. 4 Order 5—Urinary Organs. Syphilis 4 .. 2 .. .. .. 6 Hydrophobia .. .. .. .. .. .. .. Order 3—dietic. Nephritis .. .. .. .. .. .. .. Bright's Disease .. 2 1 2 .. .. 5 Privation .. .. .. .. .. .. .. Disease of Kidneys 1 .. 1 .. 1 .. 3 Want of Breast Milk .. .. .. .. .. .. .. Diabetes .. .. .. 1 .. .. 1 Alcoholism:- Albumenuria .. .. 1 1 .. .. 2 a. Del. Tremens .. .. .. 1 1 .. 2 Uræmia .. .. .. .. .. .. .. b. Intemperance .. .. .. .. .. .. .. Dis. of Bladder .. .. .. 1 3 i 5 Lead Poisoning .. .. .. .. .. .. .. Order 6—Uterus and Ovaries. Order 4—Parasitic. Disease of Ovaries .. .. .. .. .. .. .. Thrush .. .. .. .. .. .. .. Metritis .. .. .. .. .. .. .. II. CONSTITUTIONAL. Order 1—Diathetic. Disease of Uterus .. .. l 1 3 .. 5 Ovarian Tumor .. .. 2 .. .. .. 2 Order 7- Organs of Locomotion. Gout .. .. .. .. .. .. .. Cancer & Scirrhus .. .. 2 2 1 1 6 Disease of Bones& Joints .. .. .. .. .. .. .. Dropsy .. .. 1 .. 3 .. 4 Purpura Hæmorrhagica. .. .. .. .. .. .. .. Order 8—Integument. Order 2 Tubercular . Phlegmon Absces .. .. .. l .. .. 1 Ulcers, Gangrene .. .. 1 .. .. .. 1 Scrofula& TubercularDis. 4 1 1 2 .. .. 8 IV. DEVELOPMENTAL. Order 1-Of Children. Marasmus 10 .. .. .. .. .. 10 Tabes Mesenterica Consumpt.&Hœmoptysis 6 4 22 15 5 • • 52 Premature Birth 7 .. .. .. .. .. 7 Hydrocephalus and 5 2 1 .. .. .. 8 Malform of the Heart .. .. .. .. .. .. .. Scrof. Meningitis Atelectasis 2 .. .. .. .. .. 2 III. LOCAL. Ord.l--Nervous System Other Malformations 1 .. .. .. .. .. 1 Teething .. .. .. .. .. .. .. Tetanus .. .. .. .. .. .. .. Order 2—of Adults. Apoplexy .. .. .. 2 4 .. 6 Paralysis .. .. 1 2 10 .. 13 Childbirth .. .. 2 1 .. .. 3 Epilepsy .. 1 .. .. .. .. 1 Order 3—of Old People. Convulsions 12 .. .. .. .. .. 12 Effusion of Blood onBrain 2 1 1 .. 1 .. 5 Old Age, natural decay . .. .. .. 1 8 8 17 Other Diseases of Brain .. .. .. .. .. .. .. Order 4—Diseases of Nutrition. Other Diseases 3 .. 1 4 2 .. 10 Order 2—organs of Circulation. Atrophy 2 .. .. .. .. .. 2 Exhaustion .. •• •• .. .. .. .. Spasm of Heart .. 1 .. .. .. .. 1 v. violent deaths. Order 1—Accidents and Negligence. Embolism .. 1 .. .. .. .. 1 Aneurism .. .. .. 1 1 .. 2 Fatty Heart .. .. 1 .. .. .. 1 Disease of Heart .. 2 6 15 7 .. 30 Fract.& Contusions from Rail. Street Accident, &c. 1 .. 5 .. .. .. 6 Order 3—Organs of Respiration. Burns and Scalds .. .. .. .. 1 .. 1 Drowning 1 .. .. .. .. .. 2 Laryngitis 1 .. .. .. .. .. 1 Suffocation 1 .. .. .. .. .. 1 Laryngisimus .. .. .. .. .. .. .. Shooting .. 1 .. .. .. .. 1 Bronchitis 33 .. l 4 9 2 49 Poisoning .. .. .. .. 1 .. 1 Pleurisy .. .. .. .. .. .. .. Order 2.—Homicide. Pneumonia 8 .. 2 3 4 1 18 Infanticide .. .. .. .. .. .. .. Asthma .. .. .. 1 3 .. 4 Suicides—Oxalic Acid .. .. .. .. .. .. .. Pulmon. Congest on .. .. .. .. .. .. .. Poison .. .. 1 .. .. .. 1 Other Diseases 3 .. .. 2 .. •• 5 Fracture of Neck .. .. .. .. .. .. Carried forward 104 21 49 56 51 4 285 TOTAL 120 27 68 81 78 16 390 4 TABLE IV. Summary of Sanitary Work, Quarter ending December 28th, 1872. I.—Inspections consequent on Nuisances and Complaints, Offensive and Injurious Trades, inspection of cases of Contagious Diseases. Inspections of Offensive Trades, Marine Stores, &c. 50 „ Nuisances and Manure Wharves 220 „ Cow-houses 14 „ Slaughter-houses 28 „ Bake-houses 12 „ Mortuary or Dead-house almost daily — „ Provision Markets every Saturday — „ Churches, Chapels and Schools 4 „ Factories, Work-rooms and other Public Institutions 8 „ Cases of Contagious Disease „ Fever and Small-Pox Conveyance used 4 times Orders issued for Sanitary Works - „ Works done — II.—Systematic Sanitary Inspection of Dwellings, Mews End Stables. Houses and Premises visited and inspected 426 Re-inspections 760 Orders issued for Sanitary Works (16 Formal Orders of the Vestry) Works executed 400 Works in progress 26 III.— Attendances upon Magistrates, Surveyor, at the Police,Coroner's Courts, and Licensing Meetings. Attendances 12 Summonses 4 For obtaining Summonses 2 „ hearing „ — Letters written and received 79 Nuisances and Complaints investigated during the Quarter ending December 28th, 1872. The register of 183 cases, admits of the following classification:— Defects of drainage and untrapped gulleys. 38 „ „ water supply 16 Dirty state of premises, water closets, urinals, stagnant water, percolations, &c 30 Offensive trades, marine stores, frying of fish, ballast burning, bad meat, and fruit 3 Overcrowding and bad ventilation 12 Smoke nuisances Animals being dirtily kept, and noises from 14 Smells from the Canal Basin Accumulation and deposit of manure, garbage, refuse, dust, dung, &c 20 Smells from decaying and putrid substances 13 Defective cleansing of Roadways 10 Dangerous Structures and Places unfit 3 Miscellaneous, & cases of Contagious diseases reported 24 Total 183 6 TABLE V. Localities in which Deaths from Zymotic and other Diseases have been recorded during the Quarter ending December 28th, 1872. Streets, Districts and Hospitals. Small-Pox. Measles. Scarlet Fever. Diphtheria, &c. Whooping Cough. Typhus & other Fevers. Erysipelas, &c. Diarrhœa, &c. Phthisis, &c. Bronchitis, Pneumonia, &c. Violent Deaths. Other Diseases. Total. St. Mary's Hospital .. .. .. 1 .. .. .. .. 1 3 4 24 33 Paddington Workhouse .. .. .. .. .. 1 1 .. 4 4 1 19 30 Lock Hospital .. .. .. .. .. .. .. .. .. .. .. 2 2 Praed Street, including (1) .. .. .. 1 .. .. .. .. 3 8 .. 8 20 Harrow Road & N. W. Road (2) .. .. .. .. 2 1 .. 2 6 4 3 6 24 Hali Tark District (3) .. 1 .. .. .. .. .. .. 4 4 .. 10 19 Amberley Road District (4) .. .. .. .. .. .. .. .. 8 2 1 5 16 Kilburn District (5) .. .. .. 1 .. 1 .. .. 6 4 • • 14 26 Clarendon Street, 107 h., 1788 p. .. .. .. .. .. .. .. .. 1 .. .. 3 4 Woodchester Street, 95 h., 1427 p .. .. .. .. .. 1 .. .. 2 .. .. 2 5 Cirencester Street, 97 h., 1511 p. .. .. .. .. .. .. .. .. 5 6 .. .. 11 Westbourne Park District (6) .. .. .. .. .. .. .. .. 8 5 1 18 32 Hampden Street, &c. (7) .. .. .. .. 1 .. .. .. 3 4 .. 9 17 Westbourne Terrace North, &c. (8) 1 .. 1 .. .. .. .. 1 1 3 .. 5 12 Woodfield Road, &c. (10) .. .. .. .. 1 1 1 .. 6 3 .. 8 20 MoscowRoad,SalemGardens,&c.(10) .. .. .. .. 2 .. .. .. 3 3 1 2 11 Squares and Mansions (11) .. 1 .. .. .. 1 • • .. 8 4 1 26 41 Mews and Stables (12) .. .. .. 1 .. .. .. .. 4 5 1 7 18 Other Places, including (13) .. .. .. 3 .. 1 .. .. 5 15 •• 25 49 Total 1 2 1 *7 6 †7 2 3 78 77 13 193 390 * 2 Gtroup Cases. 3 Rheumatic Fevers. Population in 1871. [1.] South Wharf Road, Union-PL, Stanley-St., Francis-St., Cambridge-Pl.' Junction-Pl, Newland How, Market-St., Sale-St., Star-St., Bouverie-St., 3223 York Row, Titchborne Row, James-PL and Katherine-Pl. [2.] Margaret, Romily & Welliugton-Ter , Church-Pi, Hermitage-St ,Dudley-St., Kent's-Pl., Willing's-PL, Victoria & Albert-St, Green-St., North Wharf 3238 Road, Iron GateWh-Rd., White Lion Place and Passage, Alfred Place, Vine Cottages [3.] Hall-Pl. & Park, Hall-Pi. West, Cuthbert-St., Howell-St., Charlotte-PL, Church-St., Crompton-St, Braithwaite-Pl., Campbell-St., Hethpool-St, 3950 Hero-PL, Edgware-Pl [4.] Netley-St., AmberlyWhar. Rd. & Mews, Formosa-St., Brandon-St.,Vale-Ter., Shirland-Rd., Pindock Mews, Bristol Mews & Elnathan Mews 2474 [5.] Andover-PL, Kilburn Park-lid., Queen's Arms Yard, Elgin-Ter., MaidaVale, Carlton-Pl., Canterbury-Ter., Clarendon-Ter. & Road, Lanark-PL & Villas, 2864 Elgin-lid., Portsdown-Pl. and Mews [6.] Westbourne Park District ; 54 Streets and Mews adjoining 12552 [7.] Brindley-St., Alfred-Rd. & Pl., Orchard-St., Waverly-Ter. Waverly-Rd., Desboro'-Ter., & Pl. (197) Jonson's Mews 4069 Woodchester, Cirencester & Clarendon Streets 4796 [8.] Senior-St , Emily-St., Philip-Ter., Dartington-Ter., Hasboro'-St., Rauclngh- 2691 Rd., Westbury-Ter. & Rd., Cottage-Rd , Westbourne Park-Cres. & Bury-Ter. [9.] Woodfield-Pl., Rd., Cottages & Ter., Windsor Gardens-PL & St , John-St., Chippenham-Ter. aud Rd., Frankfort-Ter., Streets in Kensal Now Town, 3804 Carlton-Ter.,Goldnoy-Rd. & Edbroke-Rd [10.] Queen's-Rd., Douglas-PL, Caroline-PL. & Mews, Dove Cottages, Bark-PL., Poplar-PL, Chapel Side, Vincent-PL, Salem-Gards. & Rd. & Cresc 3252 [11.] Gloucester-PL, Sq., Ter., Porchester-Ter., & Sq., Craven Hill and Gardens, Lancaster Gate, Hyde-Pk.-Sq., Gard., Ter., Invernoss-Ter.,Qaeensboro'-Ter., Kensington-Palace-Gardons and Kensington-Gards.-Sq., The-Terrace, Ken- 14088 sington-Gar.-Sq., Kensington-Gar.-Ter., Cleveland-Ter., Sq., & Garde., Susaex-Gards., Westbourne-St., Cres. & Ter., Leinster-Sq. & Gardens, Princes-Sq., Queen's Gardens, Connaught-Sq. & PL, Stanhope-Pl. & Ter [12.1 Mews adjoining and behind Squares & Mansions above mentioned 2211 [13.] Other Houses, Streets & Mews not included in any of the above groups 33671 6 Systematic Sanitary Inspection of Streets by Inspector T. R. Clifford, continued from Quarter ending March 1872. Streets. Houses. Inhabitants. Orders issued. Remarks. Woodchester Street 102 Census 95 1497 80 Very good sanitary condition— far better than Clarendon-St. or Cirencester St.; better class of people Carlton Terrace 25 253 6 Defective drainage—remedied by constructing new pipe drains in lieu of rotten pipes put in when the houses were built Asburn Cottages and 25 222 11 • Overcrowing, bad paving in yards, no covers to water receptacles, windows not made to open from top, no draw off tap to some of the water receptacles, ladling water out with any dirty vessel, an underground tank to be discontinued, and cistern provided. Irongate Wharf Road Defective w.c. and ventilation, and dirty walls, &c. One water closet removed from underneath stairs into yard, defective drains repaired. Discontinue keeping horses in stables, not being properly drained Lanark Place 12 50 7 Cleansing, repairing, paving yards, dust bins, w.s., w.c., &c.; houses otherwise clean Wharves North side . • • • • 12 For cleaning out mud and offensive maters thoroughly from bed of the Canal Basin Clarendon Terrace . 1G 185 14 Pave yards, trap drains, defective w.s. to w.c.; in some houses water supply pipes enter at top of cistern in place of near the bottom, consequently no water to w.c. occasionally 7 Systematic Inspection of Streets by Inspector T. R. Clifford. (continued). Streets. Houses. Inhabitants. Orders issued. Remarks Brindley Street 65 801 40 This street was much better than expected, in consequence of a large number of Orders formerly; the nuisances found here were of a slight nature Frances Street 6 77 7 Scarcely anything but cleansing &c. of some rooms South Wharf Road 31 150 21 Cleansing of rooms, overcrowding abated Hampden Street 78 876 42 Repairs, dilapidations, cleansing, all kind of work to w.c., w.s., yards, drains, &c. These houses were originally badly built with brick drains, imperfect foundations Chapel Side & Stables 14 76 10 Cleansing, repairs, the windows made to open at upper sash, &c.; small, but comfortable houses Market Street 63 645 61 Old and imperfectly constructed, roofs dilapidated in some houses, removed w.c. from living room, 14 of the back kitchens disinhabited, houses let out in tenements, overcrowding abated, and ventilation improved Sale Street 27 323 19 Many houses are let out in tenements, some having large families, repairs and constant cleansing required to keep them in good order Junction Place 4 34 4 Bouverie Street 14 256 11 Westbourne Buildings (15 tenements in a block) 15 100 10 Intended to be a model block dwelling. Covers are wanted to cisterns. Imperfections in construction of dust shaft, &c. There has been a great deal of sickness here Amberley Road 72 1136 7 Underground kitchens disinhabited— Inspection only partial York Row and 17 122 6 Small houses in Mewses inhabited by poor people, but in fair condition Titchborne Row . 11 96 • • 8 The following Publications and Reports on Public Heatlh have been received, and are acknowledged with thanks:— The Public Health Act for 1872, by C. Bulteel, Esq., F.R.C.S. Plymouth, Surgeon to the Royal Albert Hospital. The Solicitor's Report to Metropolitan Board of Works, on the Regulation of the Water Companies for the constant Water supply, October 1872; Regulations proposed by the Metropolitan Board of Works for the consideration of the Board of Trade, and Water Companies. Report of the Joint Committee of British Medical Association and Social Science Association, on State Medicine, 1872. Second Report of the Conference of the Boards of Guardians, November 1872. J. T. Hibberd, Esq., M.P. in the Chair. Second Report of the Paddington Committee of the Charity Organisation Society, and of all the Charities in the. Parish of Paddington. Sixth Report of the Municipal Reform Association. The Liquor Trades in relation to National prosperity, &c. Reports of the Medical Officer of Healtlt on the Vital Statistics and Health of Paddington. Annual Reports for 1868-69-70-71-72. Quarterly Reports and Statistical Returns—No. 1 to 21. Report on the Pollution of the Water and cleansing of the Canal Basin—1868. Report on the means of carrying out Disinfection in an adequate and effectual manner in the Parish—1869. Report on the erection of a Public Mortuary in the Parish, and upon the Management there of—1867. Practical Sanitary Hints as to the best measures for [preventing the spread of the catching or epidemic diseases. Report and Catalogue of Sanitary Articles exhibited at Leeds in 1871, prepared by Dr. Hard wicke. Report of the Medical Officer of Health on the ventilation and condition of the Sewers of the Parish—1872 On the duties of the Sanitary Inspectors, and Systematic Sanitary Inspection, Memorandum on Overcrowding in single rooms, and in houses let out and sub-let by absentee landlords—April, 1872. No. 23. REPORT ON THE HEALTH OF PADDINGTON FOR THE QUARTER ENDING LADY-DAY 1873, MARCH 29th, BY WM. HARDWICKE, M.D., Medical Officer of Health. Estimated Population 100,984 St. Mary's 62,646. St. John's 38,338. TABLE I. Summary of Weekly Return of Births and Deaths from December 28th, to March 29th, 1873. St. Mart's. St. John's. Totals. Week ending Births. Deaths. Births. Deaths. Births. Deaths. Jan. 4 61 21 17 19 78 40 „ 11 42 23 22 11 64 34 „ 18 50 25 17 11 67 36 „ 25 43 27 14 17 57 44 Feb. 1 44 21 14 18 58 39 „ 8 39 20 9 20 48 40 „ 15 43 29 14 17 57 46 „ 22 49 38 15 20 64 58 March 1 42 41 12 15 54 56 „ 8 51 28 11 20 62 48 „ 15 32 24 16 15 48 39 „ 22 41 29 16 12 57 41 ,, 29 43 18 19 10 62 28 Total 580 344 196 205 776 549 The returns of Deaths, and the death-rate during the last quarter, show a very considerable increase over the previous Winter quarter, which was unusually low. The March quarter is always trying, but this was more so than usual for old people. The deaths in St. Mary's Hospital were 55 ; in the Workhouse Infirmary 40 ; inquests were held upon 47 persons, of whom 28 were deaths from violence. There were no deaths from Small Pox, Measles, Scarlet Fever and Fever were very few indeed; but Whooping Cough may be almost looked upon as epidemic in its character. 2 The deaths, 549, were at the rate of 21.7 per 1000 of the population. The 776 births, were at the rate of 30.6 of the population. The deaths averaged 42.2 weekly, whilst in the previous quarter they were only 30 every week. There is an excess of 159 deaths to account for at a time when no epidemic has prevailed in the Parish, showing that epidemic maladies may be materially lessened without any very great improvement upon a general death-rate. The Zymotic diseases, including the epidemic forms have, for instance, been very low, viz., 54 only, of which whooping cough forms the half. Consumption, bronchitis, and other diseases of the respiratory organs, 159 cases, were not excessive for the season. Where then is to be explained the increased mortality ? The most perceptible influence appears to be the cold weather and dearness of fuel duriug the 8 or 9 weeks in February and March, when the deaths rose 15 to 17 a-week beyond the usual average of previous quarters. The mortality affected the very young and the very aged, who require most warmth—19.5 per cent, of the whole deaths were young children under or about one year old, whose vitality was sadly imperilled by the cold—it was not extreme either, but lowering of the thermometer and of animal heat is always a delicate test, and a severe trial, not only for infants, but for adults who suffer from either chronic, functional, or organic disease. Out of 154 old people above GO, who were carried off this quarter, 36 were over 80, and G were nonogenarians. TABLE II. Deaths from Zymotic and other Diseases during 13 weeks ending March 29th, 1873. Weeks. ending Small-Pox. Measles. Scarlatina. Diphtheria, Quinsy & Croup Whooping Cough Typhus, Infantile and other Fevers. Carbuncle, Erysipelas and Pyaemia. Dysentery and Diarrhoea. Cholera. Phthisis and Tubercular Dis. Bronchitis and Pneumonia. Other Diseases. Accidents and Violent Deaths. Total. Jan. 4 ... 1 ... ... 3 ... ... ... ... 7 7 19 3 40 „ 11 ... 1 1 1 1 ... ... ... ... 5 11 10 4 34 „ 18 ... ... 1 ... 2 ... • • • ... ... 5 7 19 2 36 „ 25 ... 2 ... ... 2 1(1) ... 1 ... 9 8 20 1 44 Feb. 1 ... ... ... ... 2 2(1)(2) 1 1 ... 5 7 19 2 39 „ 8 ... ... ... ... 1 ... ... 1 ... 4 11 21 2 40 „ 15 ... ... ... ... 1 1(1) ... ... ... 10 14 20 ... 46 ,, 22 ... ... ... 3 1 (1) ... ... ... 8 12 31 3 58 March 1 ... ... ... 2 2 1(1) ... ... ... 7 10 30 4 56 ,, 8 ... ... ... ... 4 1 2 ... ... 7 11 22 1 48 „ 15 • . . ... i 4 ... 1 ... ... 5 8 19 1 39 „ 22 ... ... ... ... 4 l(2) ... 1 ... 3 10 17 5 41 „ 29 ... ... ... ... 1 l(1) ... ... ... 3 8 15 ... 28 Total ... 4 3 6 28 8 4 4 ... 78 124 262 28 549 (1) Rheumatic Fever. (2) Typhoid. 3 TABLE III. Mortality of the Parish of Paddington during the Quarter ending March 29th, 1873. Causes of Death. Ages. Total. Causes of Death. Ages. Total. Under 5 Years. 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above Under 5 Years. 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above. 1. ZYMOTIC Order 1—Miasmatic. Brought forward 153 23 55 68 70 20 391 Order 4—Organs of Digestion. Small Pox .. .. .. .. .. .. .. Measles 4 .. .. .. .. .. 4 Malignant Dis. of Stom. .. .. .. 1 3 .. 4 Scarlatina 2 1 .. .. .. .. 3 Gastipation .. 1 1 .. 1 .. 3 Whooping Cough 27 1 .. .. .. .. 28 Gastritis .. .. .. .. .. .. .. Diphtheria 2 1 .. .. .. .. 3 Peritonitis .. .. .. .. 1 .. 1 Croup 2 .. .. .. .. .. 2 Ulceration of Pylorus .. .. .. .. .. .. .. Acute Rheumatism 2 1 2 .. .. .. 4 Ulceration of Stomach .. .. .. .. 1 .. 3 Diarrhœa 2 .. .. 1 .. 1 4 Ulceration of Intestines .. .. .. .. 1 .. 1 Cholera .. .. .. .. .. .. .. Hernia .. .. .. .. .. .. .. Fever, Typhoid, &c. .. 3 .. 1 .. .. 4 Cirrosis .. .. .. .. 2 .. 5 Erysipelas and Pyœmia . 2 .. .. 2 .. .. 4 Icterus-Jaundice .. .. .. .. .. .. .. Metria (Puerperal Fever) .. .. .. .. .. .. .. Diseases of Liver .. .. .. 2 6 .. 9 Rheumatic Fever .. 1 2 1 .. .. 4 Cancer of Liver .. .. .. 2 3 . . 5 Order 2—Enthetic. Disease of Rectum .. .. .. 2 .. .. 2 Order 5—Urinarst Organs. Syphilis .. .. 1 .. .. .. 1 Hydrophobia .. .. .. .. .. .. .. Order 3—Dietic. Nephritis .. .. • • 1 .. .. 1 Bright's Disease .. 1 .. 4 2 .. 7 Privation .. .. .. .. .. .. .. Diabetes .. 2 2 .. 4 Want of Breast Milk 2 .. .. .. .. .. 2 Albumenuria .. .. 1 2 1 .. 4 Alcoholism:— Other Disease of Kidneys .. .. 1 .. .. .. 1 a. Del. Tremens .. .. .. .. .. .. .. Other Disease of Kidneys .. .. .. 2 .. 1 3 b. Intemperance .. .. .. .. .. .. .. Dis. of Bladder • • 2 .. .. 2 1 5 Lead Poisoning .. .. .. .. .. .. .. Order 6—Uterus and Ovaries. Order 4—parasitic. Disease of Ovaries .. .. l 1 .. .. 2 Thrush .. .. .. .. .. .. .. Metritis .. .. .. .. .. .. .. II. CONSTITUTIONAL. Order 1—Diathetic. Disease of Uterus .. .. 1 1 .. .. 2 Cancer of Uterus .. .. • • 3 1 .. 4 Order 7- Organs of Locomotion. Gout •• •• .. .. 2 .. 2 Cancer &. Scirrhus .. .. .. 9 .. .. 9 Disease of Bones&Joints 1 .. 3 1 .. .. 5 Dropsy .. .. 1 1 .. 3 Order 8—Integument. Purpura Hæmorrhagica. .. .. .. .. 2 .. 2 Order 2—Tubercular Phlegmon Absces .. .. 1 .. .. .. 1 Ulcers, Gangrene .. .. .. .. 1 .. 1 Scrofula&TubercularDis. 3 1 1 .. .. .. 5 IV. DEVELOPMENTAL Marasmus 19 8 19 11 •• .. 57 Tabes Mesenterica Order 1—Or Children. Consumpt. &Hœmoptysis .. •• .. .. .. .. .. Premature Birth 16 .. .. .. .. .. 16 Hydrocephalus and 13 •• 2 .. .. .. 15 Malform. of the Heart 2 .. .. .. .. .. 2 Scrof. Meningitis Atelectasis 2 .. .. .. .. .. 2 III. LOCAL. Ord.1-Nervous system Other Malformations 3 .. .. .. .. .. 3 Teething 4 4 Tetanus. .. .. .. .. .. .. .. Order 2—Of Adults. Tetanus. .. .. 3 3 4 .. 10 Paralysis 1 .. 1 1 6 3 12 Childbirth .. .. .. 1 .. .. 1 Epilepsy 1 .. 1 .. 1 .. 2 Order 3—Of Old People. Convulsions 23 .. .. .. .. .. 23 Effusion of Blood on Brain .. .. .. .. i .. 1 Old Age, natural decay . .. .. .. .. 8 14 22 Effu. of Serum on Brain 3 .. .. 1 2 .. 6 Order 4—Diseases of Nutrition. Other Diseases of Brain. 1 .. 3 4 2 •• 10 Order 2—Organs of Circulation. Atrophy 7 .. .. .. .. .. 7 Exhaustion 2 .. .. .. .. .. 2 Pericarditis .. .. .. .. .. .. 2 V. VIOLENT DEATHS. Order 1—Accidents and Negligence. Embolism 1 1 .. 1 .. 3 Aneurism . . .. 1 1 .. .. - 2 Fatty Heart .. .. 3 1 .. 4 9 Fract.& Contusions from Rail. Street Accident,&c. .. 2 4 3 1 .. 10 Other Disease of Heart. .. 2 6 7 7 1 23 Order 3—Organs of Respiration. Burns and Scalds 1 2 .. 1 1 .. 5 Drowning .. 1 1 .. .. .. 2 Suffocation 3 .. .. .. .. .. 3 Laryngitis .. .. 1 .. .. .. 1 Shooting .. •• .. .. •• .. .. Laryngisimus 3 .. .. .. .. .. 3 Bronchitis 81 2 l 13 28 8 83 Poisoning .. .. .. .. .. .. .. Pleurisy .. .. .. .. .. .. .. Order 2.—Homicide. Pleurisy 11 1 4 5 4 2 27 Infanticide 4 .. .. .. .. .. 4 Asthma .. .. 1 3 6 .. 10 Suicides .. .. .. 1 .. .. 1 Pulmon. Congestion 2 .. 1 1 1 1 6 Drowning .. .. 2 1 .. .. 3 Other Diseases of Lungs. .. .. .. 1 1 •• 2 Poison—Oxalic Acid .. .. .. .. .. .. .. Carried forward 153 23 55 68 70 20 391 TOTAL 198 32 73 102 110 37 551 4 TABLE IV. Summary of Sanitary Work, Quarter ending March 29th, 1873. I.—Inspections consequent on Nuisances and Complaints, Offensive and Injurious Trades, inspection of cases of Contagious Diseases. Inspections of Offensive Trades, Marine Stores, &c 60 „ Nuisances and Manure Wharves 190 „ Cow-houses 26 „ Slaughter-houses 20 „ Bake-houses 9 „ Mortuary or Dead-house almost daily — „ Provision Markets every Saturday 9 „ Churches, Chapels and Schools 10 „ Factories, Work-rooms and other Public 25 „ Cases of Contagious Diseases „ Fever and Small-Pox Conveyance used 4 times Orders issued for Sanitary Works - Works done — II.—Systematic Sanitary Inspection of Dwellings, Mews and Stables. Houses and premises visited and inspected 874 Re-inspections 1570 Orders issued for Sanitary Works (26 Formal Orders of the Vestry) 315 Works executed 300 Works in Progress 15 III.— Attendances upon Magistrates, Surveyor, at the Police,Coroner's Courts, and Licensing Meetings. Attendances 18 Summonses 4 For obtaining Summonses 4 „ hearing 6 Letters written and received 119 Nuisances and Complaints investigated during the Quarter ending March 29th, 1873. The register of 267 cases, admits of the following classification:— Defects of drainage and untrapped gulleys. 6 7 „ „ water supply — Dirty state of premises, water closets, urinals, stagnant water, percolations, &c 56 Offensive trades, marine stores, frying of fish, ballast burning, bad meat, and fruit 6 Overcrowding and bad ventilation 10 Smoke nuisances 4 Animals being dirtily kept, and noises from 18 Smells from the Canal Basin 6 Accumulation and deposit of manure, garbage, refuse, dust, dung, &c 41 Smells from decaying and putrid substances 32 Defective cleansing of Roadways 5 Dangerous Structures and Places unfit 3 Miscellaneous, & cases of Contagious diseases reported 19 Total 267 5 TABLE V. Localities in which Deaths from Zymotic and other Diseases have been recorded during the Quarter ending March 29th, 1872. Streets, Districts and Hospitals. Small-Pox. Measles. Scarlet Fever. Diphtheria, &c. Whooping Cough. Typhus & other Fevers. Erysipelas, &c. Diarrhœa, &c. Phthisis, &c. Bronchitis, Pneumonia, &c. Violent Deaths. Other Diseases. Total. St. Mary's Hospital .. .. .. 1 .. 1 2 • • 6 6 12 27 55 Paddington Workhouse .. .. .. .. .. .. .. .. 7 5 .. 28 40 Lock Hospital .. .. .. .. .. .. .. .. .. 1 .. .. 1 Praed Street, including (1) .. .. .. .. 1 .. .. .. 3 11 2 15 32 Harrow Road & N. W. Road (2) .. .. .. .. 1 .. • • 2 4 6 .. 7 20 Hall Park District (3) , . 1 . . 1 4 .. , , • • 5 6 1 10 28 Amberly Road District (4) • • 1 .. .. 4 .. .. .. 3 7 • • 18 33 Lo;nirm Dostroct (5) .. .. 1 1 1 4 3 • • 20 30 Clarendon Street, 107 h., 1788 p. .. 1 • • .. 2 .. .. .. 3 5 .. 6 17 Woodchester Street, 95 h., 1427 p • • . . 1 . . 1 1 1 • • 4 7 .. 2 17 Cirencester Street, 97 h., 1511 p. .. .. .. .. 2 , , , .. 3 3 .. 7 15 Westbourne Park District (6) , , .. 1 1 2 1 1 .. 6 7 .. 25 44 Hampden Street, &c. (7) .. .. .. .. 2 1 .. .. 3 9 . . 7 22 Westbourne Terrace North, &c. (8) .. .. .. .. 1 1 • • 3 8 .. 4 17 Woodfield Road, &c. (9) .. .. .. .. .. .. .. .. 4 6 .. 5 15 MoscowRoad,Salem Gardens,&c.(10) .. 1 .. . . 1 1 • • .. 5 3 1 7 19 Squares and Mansions (11) .. .. .. .. 1 . . • • 2 4 12 4 26 49 Mews and Stables (12) .. .. .. .. 2 1 .. .. 3 5 3 16 30 Other Places, including (13) .. .. .. 2 3 1 1 .. 8 14 5 32 66 Total 4 3 6 28 8 5 4 78 124 28 262 550 Population in 1871. [1.] South Wharf Road, Union-PL, Stanley-St., Francis-St., Cambridge-Pl., Junction-PL, Newland Row, Market-St., Sale-St., Star-St., Bouverie-St., 3223 York Row, Titchborne Row, Jamea-Pl. and Katherine-Pl [2.] Margaret, Romily & Wellington-Ter , Church-PL, Hermitage-St.,Dudley-St.," Kent's-Pl., Willing's-PL, Victoria & Albert-St., Green-St., North Wharf Road, Iron Gate Wh.-Rd., White Lion Place and Passage, Alfred Place, 3238 Vine Cottages [3.] Hall-Pl. & Park, Hall-Pl. West, Cuthbert-St., Howell-St., Charlotte-PL, Church-St., Crompton-St, Braithwaite-Pl., Campbell-St., Hethpool-St, 3950 Hero-Pl., Edgware-Pl [4.] Netley-St., AmberlyWhar. Rd. &Mews, Formosa-St., Brandon-St.,Vale-Ter., Shirland-Rd., Pindock Mews, Bristol Mews & Elnathan Mews 2474 [5.] Andover-Pl., Kilburn Park-Rd., Queen's Arms Yard, Elgin-Ter., Maida Vale, Carlton-Pl., Canterbury-Ter., Clarendon-Ter. & Road, Lanark-PL & Villas, 2864 Elgin-Hd., Portsdown-Pl. and Mews [6.] Westbourne Park District ; 54 Streets and Mews adjoining 12552 [7.] Brindley-St., Alfred-Rd. & PL, Orchard-St., Waverly-Ter. Waverly-Rd., Desboro'-Ter., & Pl. (197) Jonson's Mews 4069 Woodchester, Cirencester & Clarendon Streets 4796 [8.] Senior-St., Emily-St., Philip-Ter., Dartington-Ter., Hasboro'-St., Ranelagh- Rd., Westbury-Ter. & Rd., Cottage-Rd., Westbourne Park-Cres. & Bury-Ter. [9.] Woodfield-Pl., Rd., Cottages & Ter., Windsor Gardens-PL & St , John-St., Chippenham-Ter. and Rd., Frankfort-Ter., Streets in Kensal New Town, 3804 Carlton-Ter.,Goldney-Rd. & Edbroke-Rd [10.] Queen's-Rd., Douglas-PL, Caroline-Pl. & Mews, Dove Cottages, Bark-PL, Poplar-PL, Chapel Side, Vincent-PL, Salem-Gards. & Rd. & Cresc 352 [11.] Gloucester-PL, Sq., Ter., Porchester-Ter., & Sq., Craven Hill and Gardens, Lancaster Gate, Hyde-Pk.-Sq., Gard., Ter., Inverness-Ter.,Queensboro'-Ter., Kensington-Palace-Gardens and Kensington-Gards.-Sq., The-Terrace, KenBington-Gar.-Sq., Kensington-Gar.-Ter., Cleveland-Ter., Sq., & Gards., Sussex-Gards., Westbourne-St., Cre3. & Ter., Leinster-Sq. & Gardens, Princes-Sq., Queen's Gardens, Connaught-Sq. & PL, Stanhope-Pl. & Ter 14088 [12.] Mews adjoining and behind Squares & Mansions above mentioned 2211 [13 ] Other Houses, Streets & Mews not included in any of the above groups 33671 6 Irongate Wharf Road. This road, a private road maintained by the Grand Junction Canal Company, was for many years in a shameful state. Stagnant water, defective scavengering, allowing dead animals and refuse to remain, were constant complaints. It has at length been channelled, and a good granite roadway laid down, and is now properly cleansed by a man told off for that purpose. The Manure-loading Nuisance. The manure-loading wharves have somewhat improved by their constant inspection, including Sundays. The fear of being summoned under the Local Act for undue deposit and retention of dung in transit, compels traders to be more vigilant and prompt in getting off their loaded boats into the country. Still the nuisance exists and more must be done. Report of Relapsing Fever. Soon after the end of the hop-picking season, when the wandering poor return to their low-lodging houses, cases of relapsing fever shew themselves in the Metropolis. It ought to be at once checked by watchful sanitary inspection. In my fortnightly Report, January 2nd, I requested that the Poor Law Medical Officers should give early information of fever cases, and of sanitary nuisances capable of removal, and especially those in the dwellings of the very poor. To notice and report to the Sanitary Authority, and seek for removal of nuisances affecting the health, or recovery from sickness, of any or such of the patients under their care, is evidently an important element of successful treatment. I suggested that marginal notes should be made in the books kept by the Poor Law Medical Officers attending the Dispensary; that their remarks should refer to overcrowding, uncleanly habits, bad ventilation, drainage, &c. The attention of the Sanitary Inspector, who examines the books weekly, would thus be directed towards their removal. Landlords of houses let out, and sublet to more than one family, cannot be too frequently reminded by Sanitary Inspectors of the responsibility they owe to their weekly tenants living on this class of property. The New Inspector. Inspector Biorn, immediately after his appointment, commenced the regular systematic inspection of those streets and districts of the Parish in which the houses are let out in tenements to more than one family. This work has now been carried on for some years, but was in some degree suspended by the 7 additional duty thrown upon the Inspectors during the Small Pox Epidemic. During the month of March he was occupied with the North Wharf Road District; it comprises the following streets, places, and populations:— Streets and Places. No. of Population. No. of Families living in Single Rooms. No. of Rooms. under inspection. Houses. Males. Females. Total. Dudley Street 31 161 169 330 49 116 North Wharf Road 49 273 236 509 70 210 Wharves on Canal 17 68 • • 68 .. Church Place 22 165 182 347 50 115 Hermitage Street 25 123 114 237 15 125 Welling's Place 12 70 84 154 15 76 8 46 68 114 12 46 Victoria Street 25 131 145 276 33 150 Albert Street 22 125 117 242 31 132 Green Street 18 65 71 136 10 74 Iron Gate Wharf Road 25 120 101 221 34 .. Vine Cottages 6 7 11 18 • • 12 White Lion Place and Passage 22 72 75 147 26 70 Alfred Place 10 42 39 81 10 22 Wellington Terrace 8 25 29 54 2 64 Margaret Terrace 10 26 46 72 3 80 Romily Terrace 5 .. • • 54 5 40 315 1519 1487 3060 365 1332 The condition of this District is far from satisfactory. Every thing that could be done has been done again and again by the Sanitary Department of the Vestry. Constant inspection with Sanitary Orders have been issued year after year, and fully carried out by landlords. Drinking habits, Nuisances injurious to Public Health. The class of persons living here are engaged on the wharves of the canal as dustmen and women, carmen, and coal-porters, who earn good wages, and are able as a rule, with economy, to maintain themselves and families, "but for the drink." The Poor Law Medical Officer and the Relieving Officer are never long absent from these streets; Clergymen, Medical men, Scripture Readers, Visiting Ladies, and the Sanitary Officers must all agree with me, that these poor people cannot overcome the great temptations to spend their hard-earned money in drink at the public-houses, so conveniently near their own dwellings. There is a peculiarity in common with North Wharf Road and many other places, which should not be lost sight of in granting a licence. Where drinking places are in out-of-the-way streets, and few respectable persons pass, the evils are greatly aggravated. Police supervision in such cases is generally very inefficient, and fails to repress those disgraceful scenes in which bad language, fighting, gambling, and drinking at late hours, may be witnessed. Gatherings, or " Friendly Meetings" by a card, on the 8 pretence to collect for a deceased friend, is an occasion for the worst display of debauchery by drink, it being very common for boys and girls to be made to drink and seen drunk. I have known men with their families earning £ 2 a-week living in one miserable overcrowded room. They could well afford two rooms. The waste of money and destruction to health and comfort by drink is incredible to those who do not care to study the question in its relation to public health and pauperism. If only half the money spent in low neighbourhoods were directed from the drink shop and appropriated by the wives of the men to domestic comfort, how changed would be the aspect of some of these streets and their denizens. The licensed public-houses are too often a veritable nuisance to a working-man's family So injurious are they to health and morals, that respectable inhabitants will sooner or later regard them as their common enemy. They begin to complain, that after working hard all day they cannot sleep from disturbances of people leaving publics at a late hour. I have extensive personal knowledge of working men who have suffered, and become the victims of drink, and I mostly find them honest hard - working men, generally from the country, intending to do well on higher wages, but in a very short time became unconsciously degraded. I am certain that, if they were appealed to in sober moments, and were allowed, as other sober-minded people ought to be allowed, to express an opinion as to the necessity for a public-house, they would request magistrates to put down the allurements to drunkenness, which are now so cruelly permitted to exist near their homes—homes which are made miserable by the licensed system of temptation placed near their very door-steps. An Improvement Committee suggested. The Vestry has however power to undertake, and certainly ought to initiate, improvements to promote public health, which I would venture to suggest. Dudley Street, Albert Street, Victoria Street, Welling's Place, and Kent's Place are all culs de sac, in which there is no proper ventilation—a current of air cannot pass through, blocked up as they are at each end. These streets have always a very high death rate, and epidemics are worst in them in comparison with other more open streets. The property that would have to come down would open up sites for a few model dwellings, capable of receiving a greater number of inmates than would have to be displaced by the demolitions. The improvement I suggest would not be costly, and might be made a remunerative investment of public money, and it would set an example of what could be done by Local Authority to improve the homes of the working class.