ROMR 9 Romford Rural District Council. ANNUAL REPORT of the Medical Officer of health, 1906. To the Romford Rural District Council. Gentlemen, I have the honour to put before you my Annual Report on the Sanitary Condition of the Romford Rural District, for the year ending December 31st, 1906. In accordance with the plan adopted in previous Report, this Report is arranged in the following divisions:— I. Summary of Action taken during the year for Preventing the Spread of Disease. II. An account of the Sanitary Condition of the District generally. III. Statement of Enquiries made into Conditions Injurious to Health, and Proceedings thereon. IV. Table of Sickness and Mortality. 1.—Summary of Action taken to prevent the spread of Disease. No. Date. Locality. Disease. Source of Disease. Action taken. Result. 1 Jan. I Corbets Tey Scarlet Fever One ease, contracted from her sister, removed to Hospital four days ago. Removed to Hospital No other case 2 ,, 6 Ardley Green, Hornchurch Diphtheria Two cases. Origin obscure. Removed to Hospital No other case 5 ,, 8 South Hornchuich Diphtheria Ditto No other case 4 „ 9 Chad well Heath Searlet Fever Two cases. Supposed to have been contracted from a visitor. Removed See No. 19 5 ,, 10 Oxlow Lane, Dagenham Diphtheria A doubtful case 6 „ 10 Hornchurch Scarlet Fever One case, contracted from a previous case in the district. Removed No other case 7 ,, 11 Dagenham Diphtheria One case. Removed. Bad sanitary condition No other case 8 „ 12 South Hornchurch Diphtheria A doubtful case 9 „ 14 South Hornchurch Scarlet Fever One case. Contracted from a neighbouring case. Removed No other case 10 „ 25 South Hornchurch Scarlet Fever Ditto No other case 11 „ 29 South Hornchurch Diphtheria One case. Foul overflowing cesspool 12 Feb. 5 Douglas Road Diphtheria One case. Origin obscure No other case 13 Chad well Heath - Scarlet Fever - A case of measles notified as Scarlet Fever 14 „ 10 South Hornchurch Diphtheria One case. Origin obscure. Removed No other case 15 „ 20 Chadwell Heath Scarlet Fever One case. Imported. Removed No other case 16 „ 21 Rainham Diphtheria One case. Foul sanitary condition No other case 17 21 Rainham Diphtheria Ditto No other case 18 ,, 22-24 North Hornchurch Diphtheria Two cases. A filthy house Notice served on ten«nt. Cases removed No other case 4 No. Date. Locality. Disease. Source of Disease, Action taken. Result. 19 Mar. 1 Chad well Heath - Scarlet Fever - Four cases in same house as No. 9. Removed. Presumed to have been "return cases" from Hospital 20 1 Chadwell Heath Diphtheria Two cases in same house as No. 19 (Scarlet Fever) 21 ,, 3-5 Haro'd Wood Diphtheria Six cases in two adjoining houses. All three children attended Harold Wood School. On enquiry I found that a child had been attending school (same class-room) suffering from sore throat. Instructed the master to forbid the attendance of this child for a fortnight. All cases removed to hospital No other case 22 „ 3 Rainham Diphtheria One case. Not verified to be such on bacteriological examination 20 7 Cranham Scarlet Fever One case reported. On visiting I did not think it a case of Scarlet Fever 24 „ 8 Rainham Diphtheria One case 25 „ 18 Upmin6ter Scarlet Fever One case. Imported. Removed No other case 26 ,, 27 Cottage Homes, Hornchurch 8carlet Fever One case. Presumed to have been infected from a visitor. Removed to Eastern Hospital 27 ,, 27 Havering Diphtheria One case. Bad Sanitary surroundings which were remedied. Case removed No other case 28 „ 29 Dagenham Diphtheria Three cases notified. Doubtful cases. No D. bacilli found 29 „ 30 Beacontree Heath Enteric Fever One case. Origin obscure. Removed No other case 30 April 2 Rainham Diphtheria One case. Bad sanitary surroundings, Remedied No other case 31 ,, 6 Rainham Diphtheria Ditto No other case 32 M 8 South Hornchurch Scarlet Fever One case' A case in the same house several weeks ago See No. 34 33 ,,11 Chadwell Heath Diphtheria One case. Removed No other case 34 ,, 11 South Hornchurch Scarlet Fever Another case in same house as No. 32 5 No Date. Locality. Disease. Source of Disease. Action taken. Resuit, 35 April 22 South Hornchurch Scarlet Fever Another case in same house as No. 32. This case, a servant, was removed to Isolation Hospital 36 „ 25 Hornchurch Scarlet Fever One case. Isolated at home No other case 37 „ 25 Vicarage Road, Dagenham Scarlet Fever One case. Removed No other case 38 ,, 26 Chadwell Heath Diphtheria Ditto No other case 39 „ 29 Hornchurch Scarlet Fever Ditto No other case 40 May 15 North Hornchurch Diphtheria One case. Origin obscure 41 „ 15 Chadwell Heath Scarlet Fever One case. Imported. Removed 42 „ 10 Dagenham Scarlet Fever Ditto No other case 43 „ 10 South Hornchurch Diphtheria Ditto Not removed See No, 60 44 13 Chadwell Heath Scarlet Fever Two cases. On investigating them, and a piev'ous case in same family (No. 41) I found a boy of same family desquamating after Scarlet Fever unrecognized. Removed See No, 50 45 13 Hornchurch Diphtheria A notified case, not proved to be Diphtheria on bacteriological examination 46 „ 13 South Hornchurch Diphtheria One case 47 „ 15 South Hornchurch Diphtheria One case. Removed 48 „ 18 South Hornchurch Diphtheria Two cases. Removed 49 20 Chadwell Heath Diphtheria One case. Removed 50 „ 22 Chadwell Heath Scarlet Fever One case, contracted from No, 44. Removed See No. 51 51 „ 31 Chadwell Heath Scarlet Fever One case, contracted from home when a case had been removed (No. 56) No other case 52 June 1 Havering Diphtheria One case. A servant in a large house. Origin obscure. Presumed to have been contracted away from home. Removed No other case 53 „ 5 Rainham Diphtheria One case. Bad sanitary surroundings B 6 No. Date. Locality. Disease. Source of Disease. Action taken. Result, 54 June 9 Dagcnham Diphtheria One case Ditto 55 ,, 9 North Hornchurch Diphtheria One case. Contracted away from home 50 ,, 14 Upminster Enteric Fever One case. Defective sanitary surroundings. Removed Another case occurred here and was removed to Urban district 57 „ 17 New Road, Dagenham Diphtheria One case notified, not confirmed by bacteriological examination 58 „ 20 North Hornchurch Diphtheria One case. Origin obscure. Removed No other case 59 ,, 23 New Road, Dagenham Scarlet Fever A case in same house as No. 57 (Diphtheria) Removed No other case GO „ 26 South Hornchurch Diphtheria A case in same house as No. 43 61 „ 28 Havering School Scarlet Fever One case. Presumed to have been imported. The child having been to an entertainment beyond the district and sitting next to a child from an infected house. Case removed. School closed for a week No other case 62 July 2-5 Claremont Road Scarlet Fever Three cases in one family. Removed No other case 63 ». 5 Hornchurch Enteric Fever One case, contracted away from home No other case 64 „ 11 Beacontree Heath Diphtheria One case. Removed No other case 65 ,, 16-17 Harold Wood Scarlet Fever Two cases in one family. Removed. Source obscure See No. 66 66 ,, 19 Harold Wood Scarlet Fever One case. Infected by No. 65. Removed 67 ,, 20, 22 & 24 Harold Wood Scarlet Fever Three cases in a family next door to No. 65. Removed See No, 72 68 „ 29 Great Walley Scarlet Fever One case 69 „ 29 Hacton Scarlet Fever Ditto 70 Aug. 3 Hornchurch Scarlet Fever Ditto See No. 86 71 „ 14 Hornchurch Scarlet Fever One case in same family where a child had been in the Isolation Hospital for two months. Removed 7 No. Date, Locality. Disease. Source of Disease. Action taken. Result. 72 Aug. 8 to 14 Harold Wood Scarlet Fever Two cases next door to No. 65. Removed No other case 73 ,, 22 South Hornchurch Scarlet Fever One case in same family as No. 32. None of these, except a servant in the house, were removed No other case 74 „ 23 Hornchurch Diphtheria One case. Origin obscure. Removed No other case 75 „ 28 Dagenham Enteric Fever One case. This was a doubtful case. There were faulty sanitary conditions which were remedied No other case 76 Sep. 1 Great Warley Scarlet Fever Two cases, infected by No. 68 Removed No other case 77 ,, 4 Claremont Road Diphtheria One case. Notified on the 4th. Parents objected to removal, but proving to be a bad case, was removed on Sept. 7t.h No other case 78 ,, 5 Upminster Common Scarlet Fever A woman recently confined. Source of infection obscure. Removed See No. 85 79 „ 6 Cheques' Lane, Dagenham Diphtheria One case. Origin of disease obscure Removed. This was a case of mixed infection, as the child developed Scarlet Fever 2 or 3 days after admission. This was a very bad case, and was in the hospital for three months. It was discharged from hospital, and within a few days three other members of the family contracted Scarlet Fever See No. 80 14 Chadwell Heath Scarlet Fever One case. Infection imported from beyond the district. Removed No other case 81 „ 16 Hornchurch Scarlet Fever One case. Source of infection presumably No, 32 82 „ 17-18 Dagenham Scarlet Fever Seven cases in one family, a bakers' shop. On visiting this house I found a child desquamating from Scarlet Fever, unrecognized All were removed to hospital See No. 87 83 „ 17 Chadwell Heath Scarlet Fever One case. Infection supposed to have been communicated from London. Removed No other case 84 „ 18-19 Park Lane, North Hornchurch Scarlet Fever Two cases. Source of infection obscure. Removed No other case 8 No. Date. Locality. Disease. Source of Disease. Action taken. Result. 85 Sep.19 Upminster Common Scarlet Fever One case. Sister of woman removed Sept. 5th. Removed No other case 86 „ 19 Hay Green, Hornchurch Scarlet Fever One case. Removed. A case not removed was notified from near here on Aug. 3rd 87 „ 20 Vicarage Road, Dagenham Scarlet Fever One case. Removed. Supposed to have been caught from No. 82 No other case 88 „ 21 Cottage Homes, Hornchurch Scarlet Fever One case. Disease presumed to have been brought in by a visitor. Removed to Eastern Hospital, M.A.B. See No. 92 89 „ 23 Great Warley Diphtheria One case. Presumed to have been infected by a case beyond the district. Removed No other case 90 „ 23-25 South Hornchurch Diphtheria Two cases, Origin obscure See No. 91 , 28 Chadwell Heath Scarlet Fever Infected by a case beyond the district 92 Oct. 1 Cottage Homes, Hornchurch Scarlet Fever One case. Removed 93 „ 4-12 South Hornchurch Diphtheria Nine cases. Infection presumed to have been caught in school from an unrecognized case. School closed No other case 94 ,, 12 Rainham Diphtheria One case notified. Bacteriological examination failed to confirm disease No other case 95 ,, 12 Great Warley Diphtheria Ditto 96 „ 15 Claremont Road Scarlet Fever Two cases in one family. Infection imported. Removed No other case 97 „ 15 Hornchurch Scarlet Fever Two cases. "Return case" from a child discharged from hospital. Removsd No other case 98 „ 15 Rainham Enteric Fever One case. Contracted away from home. Removed No other case 99 ,, 16 Hay Green, Hornchurch Scarlet Fever One case. Removed 100 ,, 17 Great Warley Diphtheria One case. Infected by a patient outside the district. Removed 101 ,, 17 Chadwell Heath Scarlet Fever One case. Removed See No. 104 9 No. Date. Locality. Disease. Source of Disease. Action taken. Result. 162 Oct. 17 Rainham Scarlet Fever Ditto No other case 103 ,, 20 Rainham Scarlet Fever Ditto 104 ,, 20 Ralnbam Scarlet Fever One case. Only one child in family. Not removed No other case 105 „ 22 Great Warley Diphtheria One case. Removed 106 „ 22 Harold Wood Enteric Fever One case. Removed. Sanitary conditions here not satisfactory. Remedied by notice No other case 107 „ 22 Hornchurch Scarlet Fever One case. Origin obscure. Removed No other case 108 „ 25 Chadwell Heath Scarlet Fever A case in same family as No, 99. Removed No other case 109 „ 25 Hay Green, Hornchurch Scarlet Fever A case in a farm house. Isolated at home. Infection presumed to have occurred from a neighbouring case 110 „ 30 Hornchurch Scarlet Fever One case. Removed 111 „ 31 Hornchurch Scarlet Fever A suspicious case, but not corroborated by me 112 Nov. 1 North Hornchurch Scarlet Fever A case notified, but found on visiting by me not to be Scarlet Fever 113 „ 2 Rainham Scarlet Fever One case. Removed 114 „ 3 Rainham Enteric Fever One case. Contracted away from home. Removed No other case 115 ,, 5 Hornchurch Scarlet Fever One case Origin obscure. Removed No other case 116 ,, 5 Squirrels Heath Scarlet Fever A notified case, but found on being visited, not to be Scarlet Fever 117 „ 5 Harold Wood Diphtheria A notified case, bnt found on barteriological examination not to be Diphtheria 118 „ 6 Great Warley Diphtheria One case. Infection from the adjoining district of Billericay 119 „ 10 Harold Wood Diphtheria One case. Bad sanitary surroundings. Notice served. Case removed c 10 No. Date. Locality. Disease. Source of Disease. Action taken. Result. 120 Nov. 10 Dagenham Scarlet Fever One case. Removed 121 ,, 10 Great Warley Diphtheria One case. Presumably infected at school by No. 123 122 ,, 12 Hay Green, Hornchuich Scarlet Fever Another case here 12:'. „ 11 Great Warley Diphtheria One case. This child had been attending school for a week before the disease was recognized, with sore throat. I visited the school and examined the throats of all the children. hut failed to find any suspicious case No other case 124 ,, 9 Cranham Scarlet Fever One case. Infected by a case at Hay Green 125 ,, 12 Cranham Scarlet Fever One case in a farm house 126 „ 18 Rainham Scarlet Fever One case. Origin obscure 127 „ 18 North Hornchurch Scarlet Fever A notified case. Not confirmed on being visited by me 128 „ 18 Cranham Scarlet Fever One case. Presumably infected by No. 124 129 „ 20-21 North Hornchurch Scarlet Fever Two cases in one family. Infection from beyond district Removed No other case 130 „ 20-26 Harold Wood Diphtheria Five cases were reported during this period. All attending the same class-room at Harold Wood school. On enquiry, I found that a child had been attending the same class-room with sine throat. The school whs closed and thoroughly cleansed, &c. 131 „ 24 Great" Warley Scarlet Fever One case. Origin obscure 132 „ 26 Rainham Scarlet Fever One case. Presumably infected by No. '.26 133 ,, 27 Cranham Scarlet Fever One case in a farm house, presumably infected by No, 124 134 „ 29 Cranham Scarlet Fever A case next door to above 13E Dec. 1 Cranham Scarlet Fever Another case in same house as 1 No. 133 11 No Date. Locality. Disease. Source of Disease. Action taken. Result. 136 Dec. 1 Chadwell Heath Scarlet Fever A notified case, not verified on being visited by mc 137 ,, 1 Rainham Diphtheria A dubious case. Not verified by bacteriological examination 138 ,, 1 Rainham Scarlet Fever Another case in same house as No. 139 8-9 Dagenham Scarlet Fever Two cases. Presumably " return cases." Removed No other case 140 ,, 9 Rainham Scarlet Fever One case. Infected by No. 132. Removed No other case 141 ,, 9 Harold Wood Diphtheria Two cases next door to No. 130 142 ,, 11 Harold Wood Diphtheria Ditto 143 „ 12 Chadwell Heath Scarlet Fever One case 144 „ 16 Rainham Scarlet Fever One case. Removed 145 „ 17 Harold Wood Diphtheria One case next door to No. 132. Removed No oilier case 146 „ 20 Rectory Road, Dagenham Diphtheria One case. Overflowing cesspool. Remedied. Case removed See No. 147 147 „ 23 Rectory Road, Dagenham Diphtheria Another case in same family as No. 146. Removed No other case 148 „ 23 Ardley Green, Hornchurch Scarlet Fever Two cases. Origin obscure. Removed See No. 150 149 „ 25 Harold Wood Diphtheria Another case in same family as No. 132. Removed No other case 150 „ 27 Ardley Green Scarlet Fever Another case in same family as No. 148 151 „ 27 Chequers' Lane Scarlet Fever Three cases. “Return cases." Removed No other case 152 „ 27 Dagenham Scarlet Fever One case. Origin obscure. Removed 153 „ 30 Cranham Scarlet Fever Another case in same family as No. 124 154 „ 31 Dagenham Scarlet Fever Another case in same familv No. 152 12 I received notice of 236 oases of infectious disease during the year. The different diseases are thus tabulated :— Scarlet Fever 123 Enteric Fever 10 Diphtheria 76 Erysipelas 26 Puerperal Fever.. 2 236 146 of these cases were removed to the Isolation Hospital. In the previous year 305 cases of infectious disease were notified, showing a diminution for the past year of 69 cases. It will be noticed that of this total of infectious disease, Scarlet Fever numbered 123. The number of cases of those diseases more especially oonneoted with bad sanitary conditions (Diphtheria and Enteric Fever) being 101. The following is a succinct account of the different infectious diseases requiring action by your sanitary offcials during the year. In accordance with your instructions I have, since the time of receiving such instructions, visited every case notified for removal to the Isolation Hospital, before such removal, with the exception of a few instances of extreme urgency, where speedy removal was essential to the welfare of the patient, permission for such exceptions being granted by you, at my discretion. In a subsequent part of this report I append particulars of all these cases. I think this practice has been a judicious one as it has enabled me to correct the diagnosis of some erroneously notified, and to obviate the removal of others which could be safely isolated at home, thus saving, to a considerable extent, the hospital expenses. In all cases of infectious disease, the rooms occupied by the patients are disinfected by the Sanitary Inspector after removal or recovery of the patient; and in all cases, especially of Scarlet Fever, the bedding, etc., and all artioles not able to be washed at home are removed in a specially constructed van to the Isolation Hospital Disinfector, and returned home after disinfection. Small Pox.—No case of this disease was notified during the year. Scarlet Fever.—123 cases were notified. This disease did not assume an epidemic form. All parts of the district were affected, in common with other parts of the country and especially some adjacent districts. The origin of many of these cases could not be traced, many of them being no doubt, imported from distant localities. Some were infected by personal oontact but these instances were comparatively few, the 13 general practice being to remove all cases notified, where such cases occurred in thickly populated localities, and where isolation could not be safely conducted at home. Enterio Fever.—10 cases were notified. Diphtheria—76 cases of this disease ooourred, 43 of which occurred in the parish of Hornohurch, not in the Village itself, which was very free from infectious disease of any kind, but in the outlying parts of the parish, Harold Wood and South Hornchurch, where I found that the attendance of a child at school with an unrecognized sore throat was followed by the occurrence of cases of Diphtheria amongst children attending the same classroom. In these instances closure of the school for a brief period checked the further extension of the disease. In other outlying parts of this parish, abutting on and really forming part of the town of Romford, cases occurred, the majority of which were associated with local sanitary defects which were remedied. The subjoined table shows the degree in which infectious disease prevailed in the various parishes of the distriot. Infautile Diarrhoea prevailed extensively in the district during the very hot weather of 1906. The mortality from this disease in children under one year of age, being 1.6 per 1,000 of the population. A special report on this was made to the Council, by order of the Local Government Board. I attributed this unsual prevalence to the bacteriological changes undergone by the milk, owing to the extremely hot weather of that period of the year. Dagrenham Beacontree and Chadwell Heath-. Havering. Hornchurch. Upminster Cmnham, and Corbets Tey. Great Warley. Rainham and Wennington. Scarlet Fever 45 — 50 16 6 6 Diphtheria 15 2 43 - 6 10 Enteric Fever 3 - 4 1 - .2 Puerperal Fever 1 - - 1 - - Erysipelas 10 1 9 2 3 74 3 97 27 14 21 d 14 II.— An Account of the Sanitary Condition of the District at the end of 1906. In complying with this section of the Local Government Board's instructions to Medical Officers of Health, I proceed to give, as in former years, a short account of the sanitary state of the district, under the same heads of localities as are given in the statistical tables. Dagenham, Beacontree and Chadwell Heaths.—Villages and scattered groups of houses, all situate in the Parish of Dagenham, and occupying a very wide area, standing on gravel and London day, some (part of Dagenham village and immediate neighbourhood) on alluvium. Population estimated 7,500. Maindy agricultural, some (Dagenham Village) employed in a large ammunition factory, and some on riverside labour. At Chadwell Heath an increasing number of persons employed in London. Water supply mainly from South Essex Water Compauy. An extensive system of sewerage, nearly completed for Dagenham and Beaoontree Heath, Chadwell Heath having been severed for some years into the Ilford system. Pending the completion of this system, the sanitary conditions remain much the same as reported in previous years. This work has been very extensive, many miles of sewers having to be laid and many difficulties having had to be surmounted, involving much delay in the completion of the system. Until the connection of houses with the sewers are made, the system in vogue for some years, pail olosets, still exists. These are emptied once a week by the Sanitary Authority, as are also all cesspools as required. Scavenging done by contract. Dustbins periodically emptied. Birthrate, 29.4 per 1,000. Death-rate, 11.4. Death-rate from zymotic disease, 0.5. Noak Hill stands high on London clay. Population 260. Agricultural. Water supply indifferent. AVater area very diffioult to tap. Birth-rate, 19.2. Death-rate, 7.6. Death-rate from zymotic disease, Nil. Havering stands high on pebble sand bounded by London and Boulder clay. Population 420. Agricultural. Birth-rate, 22.1. Death-rate, 11.1. Death-rate from zymotic disease, Nil. Privies. Water supply mainly from wells. Supply not good. Some of the 15 outlying parts supplied by ponds Negociations have been conducted with the South Essex Water Compauy to extend their mains to the village, but without success, hitherto. Hornchurch.—Large village and scattered groups of houses extending over a large parochial area. Part of the parish adjoining and actually forming part of the town of Romford. Stands mostly on gravel, partly on clay, and some small part, running down to the river Thames, on alluvium. Population (estimated) 7,700. Principally agricultural. Foundry and brewery in the village, and an increasing number of residents having their occupation in London. The village itself has been fairly free from zymotic disease this year, but outlying parts, Harold Wood, South and North Hornchuroh, have had rather a large number of cases of infectious disease, notably Scarlet Fever and Diphtheria. Birth-rate, 29.5. Death-rate, 10.5. Death-rate from zymotic disease, 0.4. Upminster, Cranham, and Corbets Tey.—Adjacent villages standing on high ground, mostly brick earth, some gravel. Population 2,100. Agricultural. Water supply from South Essex Water Company. Some parts badly supplied, and negociations now going on to improve this condition in possible localities. Birth-rate, 19.04. Death-rate 8.5. Death-rate from zymotic disease, 04. A large tract of land at Upminster is being laid out for building, on which it is expected that a large number of houses will shortly be erected. This will necessitate some extension or alteration of the present sewerage outfall works. Great Warley stands high on London clay. The most thickly populated part of the parish forms part of the town of Brentwood, the large and less populated area having scattered houses and groups of houses. Population 2,110. Agricultural. Water supply mainly from South Essex Water Company. Birth-rate, 36.01. Death-rate, 8.5. Death-rate from zymotic disease, Nil. Rainham and Wennington lie low on gravel and alluvium at the edge of the Thames. Marshy. Villages of 2,400 inbabitauts, employed in agriculture, factory, and riverside work. Tidal stream 16 runs through Rainham to the Thames, about a mile distant. Sewerage works for Rainham now completed. Birth-rate, 34.1. Death-rate, 137. Death-rate from zymotic disease, Nil. Rainham, in years past, has borne an unenviable reputation for infectious disease, notably Diphtheria. There has been a marked improvement this year in this respeot. HI.—Statement of enquiries made into conditions injurious to health and proceedings thereon. Dagbnham, Rracontrre and Chadwell Hraths.— Jan. Ath.— Chadwell Heath.—Blocked drains, defective w.o.'s, defeotive water supply. Notice. Remedied. Jan. 6th—Dagenham.—Accumulation of manure near houses. Notice. Removed. Jan. 8th. — Ditto.—Foul ditch. Notice. Cleansed. Jan. 8th.— Ditto.—Ditto. Ditto. Jan. 10th.—Ditto.— Ditto. Ditto. Jan 10th—Chadwell Heath.—Foul ditch. Notice. Cleansed. Jan. 11th.—Dagenham.—Ditto. Ditto. Jan. 17th.—Ditto.—Overcrowding. Notice, Remodied. Jan. 17th.— Ditte.—Acoumulatiou of manure. Notice. Remedied. Jan. 22nd.—Ditto.— Ditto. Ditto. Jan. 24th.—Ditte.—Foul ditch. Notice. Cleasned. 17 Feb. 6th.—Dagenham.—Dump cottages. Defective wafer supply and sanitary accoramodation. Notice. Remedied. Feb. 7th.— Chadwell Heath.—Accumulation of manure. Notioe Removed. Feb. 8th.—Ditto.—Overcrowding. Notice. Remedied. Feb. 8th.—Ditto.—Filthy promisor Ditto. Feb. 14th.—Ditto.—Aooumulation of manure. Notioe. Remedied- Feb. 16th.—Ditto.—Five houses with defective sanitary accommodation, damp, and with defective paving in yards. Notice. Remedied. Feb. 23rd.—Dagenham.—Defective water supply. Notice. Remedied. Feb. 28th.—Chadwell Heath.—Blocked drain and defective sanitary accommodation in a public house. Notice. Remedied. March 10th—Ditto.—Houses undrained. Notice. Remedied. March 20th.—Beacontree Heath.—Foul ditch. Notice. Cleansed. March 20th.—Ditto.—Ditto. Ditto. April 3rd. - Ditto.— Ditto. Ditto. April 18th.—Chadwell Heath.—Impure water supply. Water closed and S.E. water laid on. April 19lh.—Dagenham.—Privies to 26 houses foul. Notice. Remedied. April 25th.—Ditto.—Foul ditch. Notice. Remedied. April 25th.—Beacontree Heath.—Ditto. Ditto. April 26th.—Ditto.—Four ditto. Ditto. E 18 May 9th.—Chadwell Heath—House with defective sanitary accommodation. Notice. Remedied. May 10th.—Ditto.—Swine kept so as to be a nuisance. Fat and bone boiling carried on on these premises, causing a serious nuisance. Notice. This business was removed to another part of the district, but was ultimately stopped under threat of proceedings. May 1 Rth.—Dagenham.—Swine kept so as to be a uuisance. Notice. Remedied. May 21st.—Chadwell Heath.—Ditto. Ditto. May 28th.—Dagenham.—Accumulation of refuse. Notioe. Remedied. May 28th.—Beacontree Heath.—Foul ditch. Notioe. Cleaneed. June 1st.—Chadwell Heath.—Aooumulation of refuse. Notioe. Removed. June lstf.—Ditto.—Ditto. Ditto. June 5th.— Ditto.—Defective ventilation to sewer. Notice. Removed. June 20th.—Dagenham.—Foul drain, Notioe. Cleansed. June 20th.—Marks Gate.—Defective and dirty cowsheds. Notice. Cleansed. July 2nd.—Dagenham.—Accumulation of manure. Notioe. Removed. July 11th.— Chadwell Heath.—Ditto. Ditto. July 23rd.—Beacontree Heath.—Blocked drain to eight houses. Notice. Remedied. 19 Aug. 8th.—Beacontree Heath.—Fat and bone boiling business, and swine kept so as to be a nuisance. This was the business alluded to before, and was stopped after notice. Aug. 28th.—Chadwell Heath.—Stables undrained, causing a nuisance. Notice. Remedied. Sep. 7th.—Dagenham.—Defective drains. A case of Enteric Fever here. Notice. Remedied. Sep. 14th.—Ditto.— Foul ditch. Notice. Remedied. Sep. 14th.—Ditto.—Accumulation of manure. Notice. Remedied. Oct. 1st.—Ditto.—Defective sanitary accommodation. Ditto. Oct. 15th.—Chadwell Heath.—Two cottages reported to Council to be unfit for habitation, by reason of dampness and proper sanitary accommodation. Notice. Repairs now being done (Jan. 1907). Nov. 5th.—Dagenham.—House damp owing to defective roof guttering. Notice. Remedied. Nov. 7th. — Ditto.—Animals kept so as to be a nuisance. Notice. Remedied. Nov. 8th.— Ditto.—Swine kept so as to be a nuisanoe. Notice. Remedied. Nov. 10th.—Chadwell Heath.—Drains blocked. Notioe. Remedied Nov. 12th.—Ditto.—Defective water supply. Ditto. Dec. 2nd.—Beacontrce Heath.—Foul ditoh. Ditto. Rainham and Wkunington.— May 3rd.—Rainham.—Drains to 15 houses blocked. Notice. Remedied. May 11th.—AVennirigton.—Defective oesspool. Notice. Remedied. 20 May 11th.—Wennington.—Defective Sanitary Accommodation. Notice. Remedied. June 14 th.—Rainham.—Overcrowding. Notice. Remedied. July 31th.—Wennington.—5 railway carriages used as dwelling without proper sanitary accommodation. Notice. Remedied. Aug. 9th.—Rainham.—Defootive drains. Notice. Remedied. Oct. 12 th.—Ditto.—Overcrowding. Notice. Remedied. Oct. 15th. — Ditto.—Seven houses dilapidated. Notice. Remedied. Nov. 26th.—Ditto.—Two cottagts condemned for want of proper ventilation and sanitary accommodation. Nov. 26th.—Ditto.—House dilapidated. Notice. Remedied. Rainham.—Several visits paid to a new soap and bone boiling factory (Wickers, Dean & Co., Ltd.), on the bank of the river. A large bone boiling and fat boiling business being done here. No means adapted of treating the vapours arising therefrom, which escape through the roof of building, and are very offensive. Report to Council. Upminster, Cranham, and Cokbets Tey. Jan. 1st.—Cranham—Foul ditch, Butcher's Shop overflow draining into ditch. Notice. Connected with sewer. Feb. 13th.—Ditto. —Foul cesspool. Notice. Cleansed. Feb. 23rd.—Corbets Tey.—Defective w.c. Notice. Remedied. March 7th.—Cranham Sohools.—Closet Pans emptied by the Scholars, Managers' attention drawn to this and a man appointed to do the work. March 7th.—Cranham.—Foul cesspool. Notioe. Cleansed. April 8th.—Upminster.—Overflowing cesspool. Notioe. Cleansed. 21 June 18th.—Upminster.—House with impure water supply. Notice. Well cleaned out. July 2nd.—Ditto—Blocked drain. Notice. Cleansed. Sept. 3rd.—Corbets Tey.—Cottage with infected water supply. Notice. Owner repaired pump and supply was improved. Sept. 18th.—Cranbam.—Foul cesspool. Notice. Cleansed. Sept. 20 th.—Upminster Common.— Ditto Sept. 22nd.—Corbets Tey.—Ditto Ditto Oct. 23rd.—Cranham.—Ditto Ditto Nov. 1st.—Upminster.—Ditto Ditto Hornchurch.— Jan. 12th.— Lower Moss Lane.—Foul w.c. and drain. Notice. Cleansed. Jan. 15th.—South Hornohurch.—Inspection. Water found, on analysed, to be good. Jan. 19th.—Blewett's Cottages.—Cesspool and drain to their cottages (40) frequently full and overflowing, suggested drainage into Eainham system. Standing over. Meanwhile arrangement for fortnightly empties of cesspools. Feb. 3rd.—Harold Wood.—Cowshead fillhy. Report to Council. Partial improvement effective, but later in the year defects returning. Notice served on proprietor that unless matters were improved to the satisfaction of the Sanitary Inspection (Jan., 1907), proceeding would be taken. Feb. 17th.—Sherbourne Dust Shoot.—Several visits made here and report to Council. 22 March 9th.—South Hornchurch.—Suspected water found, on analysed, to be good. March 12th.—Ardleigh Green.—Filthy house. Notice. Cleaused. March 19th.—Church Street.—Blocked drain. Ditto May 3rd.— South Hornchurch.—Foul cesspool. Ditto May 3rd.—Ardleigh Green.—Foul ditoli from drain. Notice to provide cesspool complied with. May Wth.--Hornchurch.—Blocked drain. Notice. Cleansed. May 11 th.—Hornchurch.—Cottage with defective sanitary arrangements. Drain discharging into an open ditch. Much trouble with owner in this case, but defects ultimately remedied. May 31s/.—Hornchurch.—Cottage without dust bin. Notice. Remedied. May 31 at.—Dymoke Road.— Defective w.c. Notice. Remedied. June 7th.—Craigdale Road.—Blooked drain. Ditto June 8th.—South Hornchurch.—Water supplying three cottages suspected to be impure. Found, on analysis, to be good. June 21 at.—Harold Wood.—River polluted by sewage from Brentwood sewage outfall works, Several visits and reports to Council. Correspondence with Billericay Council. Proceedings stayed on the assurance by that Authority that they were awaiting the sanction of the Local Government Board for means of improving the sewage at the outfall works, and that meanwhile, the effluent should be made as pure as possible. June 25th.—Hornchurch Sohools.—Defective closets. Notice. Cleansed. 23 July 9th.—Bertha Road.—Foul drain and cesspool. Notice to connect with sewer complied with. Aug. 2nd.—Prince's Farm.—Water supply impure. Bad throats amongst the family residing here. Notice to lay on the South Essex Company's water complied with. Aug.13th.—Hacton Lane—Foul cesspool. Notice. Cleansed. Aug. 15th. — Craigdale Road.— Ditto. Ditto. Aug. 20th. — Abbs Cross. — Ditto. Ditto. Aug. 24th.—Dover Cottage.—Impure water supply. South Essex Company's water laid on. Sept. 3rd.—Harold Wood.—Foul cesspool and drain. Notice to connect with sewer complied with. Sept. 4th.—Hornchurch Station.—Complaint having been made of a nuisance caused by manure brought from London, several visits were made but as nothing but stable manure was found nothing was done. Sept. 21st.—Hay Green.—Defective closet and drain. Notice. Remedied. Sept. 21st.—Hay Green.— Ditto. Ditto. Oct. 12th. —South Hornchurch School.—Attended the School and examined the throats of all children attending. Several cases of Diphtheria being notified from the locality. Nothing found. Schools were closed and disease checked. Oct. 12th.—Hornchurch.—Blocked drain. Notice. Cleansed, Oct. 12th.—Station Road.—Ditto. Ditto. Oct. 24th.—Harold Wood.—Dirty Cottage. Ditto. Nov. 2nd.—Ardleigh Green.—Foul cesspool. Ditto. 24 Nov. 23rd.—Claiemont Road.—Defective w.c's. Notice. Cleansed. Nov. 24th.—Ardleigh Green. —Blocked drain. Ditto. Dec. 7th.—Squirrels Heath.—Ditto. Ditto. Dcc. 20th.—Station Lane.—Ditto. Ditto. Great Warlby.— Feb. 28th.—Accumulation of manure. Notice. Removed. April 5th.—Defective closet pans. Notice. Remedied. May 12th—Epidemic of Measles. School closed. Aug. 30th.—Bakehouse dirty. Notice. Cleansed. Sept. 24th.—Black Huts.—Cottages with defective ventilation, back to back. Condemned. Notice served to close. No notice taken and proceedings now (Jan., 1907) pending. Sept. 28.—House refuse accumulation close to back door of house. Notice. Removed. Nov. 19th.—Sink of house in direct connection with drain. Notice. Remedied. Havering.— March 27th.—Jews Row.—Foul cesspits. Cleansed. March 28th. —Insanitary cottages. Diphtheria here. Notice to provide new closets, &c., complied with. June 28th.—Havering School. Defective closets. Notice. Remedied. Noak Hill.— Nov 12th.—Water from School House, Baker's Cottages, and Raison's Farm, suspected to be impure, found on analysis to be good. 25 Record of cases of infectious diseases notified by Medical Practitioners for removal to the Isolation Hospital and visited by me. All such cases are seen by me prior to removal, with the exception of a few cases in which I was advised, by telegram, that urgenoy demanded speedy removal. April 11th.—H.A Chadwell Heath. Scarlet Fever. Removed. „ 25th.—E.D. Dagenham. do. do. „ 26th.—M.G. Chadwell Heath. do. do. „ 29th.—J.C. Hornchurch. do. do. May 1st.—M.E. Chadwell Heath. do. do. „ 6th.—E.Y. Dagenham. do do. „ 13th.—C.E. Chadwell Heath. do do. „ 15th.—E.O. South Hornchurch. Diphtheria. do. „ 18th.—W.M. do. do. do. „ 18th.—A.P. do. do. do. „ 20th.—S.M. Chadwell Heath. do. do. „ 22nd.—S.H. do. Scarlet Fever. do. „ 19th.—H P. Dagenham. Diphtheria. do. „ 27th.—Mrs. M. Chadwell Heath. Scarlet Fever. do. „ 30th.—Mrs. D. do. do. do. June 1st.—Miss C. Havering. Diphtheria. do. ,, 14th.—F.C. Upminster. Enteric Fever. do. ,, 20th.—Mrs. G. North Hornchurch. Diphtheria. do „ 23rd.—W.V. Dagenham. Scarlet Fever. do. „ 28th.—H.D. Havering. do. do. July 2nd.—J.C. North Hornchurch. do. do. „ 2nd.—W.C. do. do. do. 26 July 5th—Mrs. C. North Hornchurch. Scarlet Fever. Removed. „ 16th.—H.H. Harold Wood. do. do. „ 17th.—E.H. do. do. do. „ 17th.—A.H. do. do do. „ 18th.—A.H. do. do. do. „ 19th.—E.T. do. do. do. „ 20th.—E.B. do do. do. „ 23rd.—A.H. do. do do. „ 23rd.—F.B, do do. do „ 24th.—E.B. do. do. do. Aug. 4th.—A.C. Hornchurch. do. do. „ 8th.—Mrs. M. Chadwell Heath. do. do. „ 14th.—E.M. do. do. do. „ 23rd.—M.K. South Hornohuroh. Diphtheria. do. Sept. 1st.—M.D. Great Warley. Scarlet Fever. do. „ 1st.—E.D. do. do. do. „ 5th.—Mrs. G. Upminster Common. do. do. „ 6th.—R.G. Dagenham. Diphtheria. do. „ 14th.—A.F.W. Chadwell Heath. Scarlet Fever. do. „ 17th.—L. A. Dagenham. do. do. „ 17th.—F.A. do. do do „ 17th.—W.A. do. do do. „ 19th.—E.T. Chadwell Heath. do. do. „ 19M.—W.A. Dagenham. do. do. „ 19th.—A.A. do. do. do. 27 Sept. 19th.—H.A. Dagenham. Scarlet Fever. Removed. „ 19th.—K.A. do. do do. „ 19th.—S.N. Hornchurch. do. do. „ 20th.—H.K. Dagenham. do. do. „ 23rd. — F.W. Great Warley. Diphtheria. do. ,, 28th.—E.R. Chadwell Heath. Scarlet Fever. do. Oct. 4th.—J.R. South Hornchurch. Enteric Fever. do. „ 5th.—A.H. Harold Wood. Diphtheria. do. „ 5th.—C.H. do. do. do. „ 5th.—Mrs. H. do. do. do. „ 12th.—*G.K. South Hornchurch. do. Not removed". „ 12th.—*Mrs. K. do. do. do. „ 13th.—*E.K. do. do. do. „ 13th.—*A.G. do. do. do „ 13th.—W.K. North Hornchurch. do. Removed. „ 13th.—J. K. do. do. do. „ 13th.—A.Y. South Hornchurch. do. do. „ 14th.—M.C. Hornchurch. Scarlet Fever. do. „ 14th.—A.C. do. do. do. ,, 15th.—R.E. Rainham. Enteric Fever. do. ,, 16th.—E.D Hornchurch. Scarlet Fever. do. „ 17th.—N.S. Great Warley. Diphtheria. do. ,, 17th.—A.R. Chadwell Heath. Scarlet Fever. do. „ 17th.—*J.C, Rainham. do. Not removed. „ 20th.—J.S. do. do. Removed. „ 20th.—B.B. do. do. do. 28 Oct. 22nd.—K.E. Great Warley. Diphtheria. Removed. „ 22nd.—J.B. Harold Wood. Enteric Fever. do. „ 22nd.—O.B. Hornchurch. Scarlet Fever. do. „ 15th.—S.A.R. Chadwell Heath. do. do. „ 25th.—*E.K. Hornchurch. do. Not removed. „ 30th.—RC. do. do. Removed. „ 31st.—†A.D. do. do Not removed. Nov. 1st.—W.H. North Hornchurch. do. do. ,, 2nd.—M.F. Rainham. do. do. „ 3rd.—G.B. do. Enteric Fever. do. , „ 6th.—J.H. Hornchurch. Scarlet Fever. do. „ 5 th.—fM.C. do. do. Not removed. „ 5th.—tF.F. Harold Wood. Diphtheria. do. „ 10th.— A.S. do. Scarlet Fever. Removed. „ 10 th.—S.B. Dagenham. do. do. „ 7th.—D.C. Great Warley. Diphtheria. do. „ 11th.—*D.P. do. do. Not removed. „ 12th.—*H.M. Cranham. do. do. „ 12th.—*H.P. do. Scarlet Fever. do. „ 13th.—E.B. Harold Wood. Enteric Fever. Removed. „ 18th.—†E.K. North Hornchurch. Scarlet Fever. Notremoved. „ 20th.—A.W. do. Diphtheria. Removed. „ 20th.—I.W. do. do do. „ 20th.—H.H. Harold Wood. do. do. „ 21st—E.S. do. do. do „ 23rd.—N.A. do. do. do 29 Dec. lstf.—†L.S. Chadwell Heath. Scarlet Fever. Notremoved. „ 7th.—†L.V. Rainham. Diphtheria. do. ,, 8th.—A.S. Dagenham. Scarlet Fever. Removed. „ 9th.—J.S. do. do do. „ 4th.—S.S. Harold Wood. Diphtheria. do „ 16th.—R.B, Rainham. Scarlet Fever. do. ,, 20 th.—E.B. Dagenham. do. do ,, 22nd.—L.C. Ardleigh Green. do. do. „ 23rd.—W.C. do. do. do „ 24th.—B.B. Harold Wood. Diphtheria. do. „ 25th.—W.P. do. do. do. „ 27th.—E.C. Ardleigh Green. Scarlet Fever. do. „ 27th.—E.G. Dagenham. do. do. „ 27th.—N.C. do. do. do. „ 27th.—J.G. do. do. do. „ 28th.—H.N. do. do. do. „ 30th.—*C.P. Cranham. do. Not removed. „ 30th.—D.W. Harold Wood. Diphtheria. Removed. ,, 3lst.—R.N. Dagenham. Scarlet Fever. do. † Disease not as notified. * Isolated at home. 30 The following is a complete list of the nuisances, &c., reported by the Sanitary Inspectors, in which action has been taken by them, my aid being called in in those instances which were considered necessary. Nuisances abated 211 Filthy houses cleansed 2 Overcrowding abated 8 Houses repaired 11 Houses closed 1 Wells closed, water impure 1 Pail closets provided 1 W.C's repaired 17 Samples of water analysed 13 Wells cleansed 2 Animals improperly kept 11 Offensive trade stopped 1 Total 279 The various bake-houses, dairies, cowsheds and slaughter-houses have been periodically visited and with one exception, been found satisfactory.— Sanitary improvements have been continued during the year, the Council always responding to complaints from the Sanitary Officials and from private persons, and giving instructions for official action towards remedying insanitary conditions, as far as is possible. New roads have been and are being constructed in various recently developed localities. The system of sewerage for Rainham is now in working order, nearly all houses in the sewage area having been connected. The Dagenham sewerage system, a very extensive system over a very wide area, and one which I believe has been met with many difficulties, is now completed and the connection will shortly be commenced. 31 Tables of mortality, &c., compiled according to the requirements of the Local Government Board, are included with this report The birth and death-rate for the last five years are shown in the following table. Locality. 1902. 1903. 1904 I905. 1906. BirthRate. DeathRate BirthRate. DeathRate, BirthRate. DeathRate. BirthRate. DeathRate. BirthRate. DeathRate. Dagenliam, Beacontree and Chadwell Heaths 35.8 11.08 35.2 12.7 36.2 15.04 31.5 13.1 29.4 11.4 Havering 13.6 11.4 10 Nil 26.9 4.9 21.9 12.1 22.1 11.1 Horncburch - 27.6 12.9 22 9 8.5 23.7 11.7 26.5 10.0 29.5 10.3 Upminster, Cranham, and Corbets Tey- 22.1 10.0 21.4 12.04 23.5 14.3 14.1 7.3 19.04 8.5 Great Warley 29 . 5 8.7 92.9 14.7 26.3 7.0 33.4 12.1 36.01 8.5 Rainham & Wennington 35.2 17.1 48.3 18.2 26.5 17.7 32.4 11.1 34.1 13.7 Diseases of a zymotic character proved fatal in 12 instances. The death-rate from this class of diseases for the entire district having been 0.6 per 1,000 of the population. 32 The following table shows the nature and distribution of fatal zymotic disease in the localities of the district. , Dagenham. j Havering. Upminster. Hornchurch. Rainham. Great Parley. Measles 3 - - - - 1 Diphtheria - - 1 3 - - Enteric Fever - - - - - - Scarlet Fever 8 - - 3 - - ISOLATION HOSPITAL. The following cases were admitted into the Isolation Hospital from the Rural District during the year. Recovered. Died. Scarlet Fever 89 82 7 Diphtheria 44 41 3 Enteric Fever 12 10 2 I have, as in previous reports, much pleasure in testifying to the at isfactory way in which, as far as I know, the duties of inspection, &c., are carried out by the Sanitary Inspectors. Area and population of district: Area, in acres 32,245 Population 21,500 General death-rate 11.2 per 1,000 Infant death-rate (under 1 year) 4.04 per 1,000 I am, Gentlemen, Your obedient Servant, The Lodge, Romford, ALFRED WRIGHT. February 11th, 1907. 33 TABLE I. Vital. Statistics of Whole District during 1906 and Previous Years. ROMFORD RURAL DISTRICT. Year. Population estimated to Middle of each Year. Births. Totai. Deaths Registkrkd in the District. Total Deaths in Public Institutions in the District. Deaths of Non-residents registered in public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all ages belonging to the District. Under 1 yr. of age At all Ages. Number. Rate * Number. Rate per 1000 Births registered. Number. Rate.* Number. Rate.* 1 5 3 4 5 6 7 8 9 10 11 12 13 1896. 1897. 1898. 16,100 551 33.5 66 101.6 250 15.2 12 262 15.9 1899. 16,770 593 35.3 84 141.6 256 15.2 9 265 15.3 1900. 17,380 476 27.3 26 54.6 255 14.6 11 266 15.3 1901. 18,990 569 28.9 90 157.9 266 14.0 16 7 5 271 14.2 1902. 19,500 585 30.0 62 105.9 235 22.3 11 7 241 12.2 1903. 20,000 623 36.1 68 109.01 248 12.4 13 6 22 264 13.2 1904. 20,415 551 26 8 96 174.2 274 13.4 16 2 21 293 14.3 1905. 21,000 654 31.1 86 130.5 256 12.1 8 1 23 256 11.9 Averages for years 18961905 1906. 21,500 634 29.4 87 137.06 211 11.1 8 3 24 262 12.1 * Rates in columns 4, 8, and 13, calculated per 1,000 of estimated population. Area of District in acres (exclusive of area covered by water), 32,245. Total population at all ages, 18,990 Number of inhabited houses, 3.955 Average number of persons per house, 4.7 At Census of 1901. Is the Union Workhouse within the District ?—No. 34 1 2 3 Institutions within the District receiving Sick and Infirm persons from outside the District. Institutions outside the District receivingSick and Infirm Persons from the District. Other Institutions, the deaths in which have been aistributed among the several localities in the District. Isolation Hospital. Union Workhouse. Romford Cottage Hospital. TABLE II. Vital Statistics of Separate Localities in 1906 and previous years. ROMFORD RURAL DISTRICT. Names of Localities- Dagenham, Beacontree, and Chadwell Heath. Noak Hill. Havering. Hornchurch. Upminster, Cranham, and corbets Tey. Great Warley. Rainham and Wennington. Year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. a. b. c. d. a. b. c. d. a. b c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. 1896 1897 1898 5,020 160 83 33 500 7 3 4,700 131 61 13 1,990 43 31 4 1,890 62 22 3 2,300 72 17 4 1899 5,200 18 J 6i 23 500 13 1 4,800 166 76 27 2,000 40 24 5 1,930 69 29 3 2,340 62 33 14 1900 5,500 181 90 3) 504 5 5 3 5,000 168 70 15 2,020 51 31 4 1.970 30 30 12 2,390 79 25 10 1901 6,000 223 87 41 259 5 2 407 11 4 6,100 165 76 25 1,874 20 20 3 1,900 56 30 11 2,080 65 39 14 1902 6,300 223 69 18 259 4 4 406 7 6 1 6,610 177 83 24 1,900 19 19 6 1,910 59 17 11 2,100 74 36 13 1903 6,5C0 229 83 35 260 6 8 40 4 6.800 191 58 13 1,910 41 28 4 1,930 59 29 8 2,160 93 33 6 1904 6,700 216 102 3b 260 2 1 405 7 2 69,00 164 88 32 1,950 46 28 5 2,000 53 14 6 2,200 54 39 15 1905 6,900 25 2 91 41 260 3 6 410 9 5 2 7,500 199 75 16 2,000 39 15 6 2,060 51 14 6 2,300 73 39 11 Averages of Years 1896 to 1905. 1906 7,130 221 87 33 260 5 4 415 9 6 2 7,700 210 75 33 2,100 40 18 3 2,110 76 18 4 2,400 73 33 16 36 TABLE III. Cases of Infectious Disease notified during the Year 1906, in the Romford Rural. District. Notifiable Disease. Cases notified in Whole District. Total Cases notified in each Locality. No. of Cases Removed to Hospital from each Locality. At all Ages. At Ages —Years. Dagenham, Beacontree and Chadwell Heaths Noak Hill. Havering. Hornchurch. Upminster, Cranham, and Corbets Tey. Great Warley. Rainham and Wennington. Dagenham, Beacontree and Chadwell Heaths Noak Hill. Havering. Hornchurch. Upminster. Cranham. and Corbets Tey.. Great Warley. Rainham and Wennington. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 75 2 31 39 3 ... ... 15 ... 1 43 ... 6 10 ... ... ... ... ... ... ... Membranous Croup 1 ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... Erysipelas 25 ... ... ... 3 16 6 10 ... 1 ... 9 2 3 ... ... ... ... ... ... ... Scarlet Fever 123 6 52 60 2 3 ... 45 ... ... 50 16 6 6 ... ... ... ... ... ... ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 10 ... ... 4 2 4 ... 3 ... ... 4 1 ... 2 ... ... ... ... ... ... ... Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal fever 2 ... ... ... ... 2 ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 236 8 84 103 10 25 6 ... ... 3 98 26 14 21 ... ... ... ... ... ... ... Isolation Hospital—Rush Green, Dagenham. 37 TABLE IV. Causes or, and Ages at, Death during Year 1906. Romford Rural District. Causes of Death Deaths at the subjoined ages of "Residents "whether occurring in or beyond) the district Deaths at all, ages of Residents " beLonging to Localities, whether occurring in or beyond the district. Tota1 Deaths Whether of Residents" o 'non-resident' public Institution the District. All Ages, Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Dagenham, Beacontree. and Chadwell H'ths Hornchurch. Havering. Noak Hill Great Warley. Rainham and Wennington. Upminster, Cranham. and Corbets Tey Small-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 4 1 3 ... ... ... ... 3 ... ... ... 1 ... ... ... Scarlet Fever 5 1 2 2 ... ... ... 2 3 ... ... ... ... ... 5 Whooping-cough ... ... ... ... ... ... ... ... 3 ... ... ... ... 1 3 Diphtheria and Membranous Croup 4 ... 2 2 ... ... ... ... ... ... ... ... ... ... ... Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other contin'd ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa 42 36 4 ... ... 2 ... 17 10 ... ... ... 13 2 ... Enteritis 1 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 1 ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... Other septic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Phthisis (Pulmonary Tuberculosis) 12 ... ... 1 3 8 ... 5 5 ... ... 2 ... ... ... Other tubercular Diseases 13 5 3 1 1 3 ... 3 6 ... ... 3 ... 1 ... Cancer, Malignant Disease 6 ... ... ... 1 1 4 1 2 ... ... 1 1 1 ... Bronchitis 15 3 1 1 1 2 7 5 6 ... ... 1 1 2 ... Pneumonia 15 4 5 ... ... 5 1 4 6 1 ... ... 2 2 ... Pleurisy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Respiratory Organs ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cirrhosis of Liver Venereal Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 17 17 ... ... ... ... ... 4 9 2 ... ... 2 ... ... Diseases and Accidents of Parturition 1 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... Heart Diseases 25 1 1 1 1 11 10 12 8 1 2 4 2 1 ... Accidents 7 ... 3 ... ... 3 1 3 1 ... ... ... 2 1 ... Suicides ... ... ... ... ... ... ... ... ... ... ... ... ... ... Senile decay 16 ... ... ... ... ... 16 4 4 1 2 2 3 ... All other causes 57 17 4 3 2 11 20 21 12 1 2 4 8 4 •• All Causes 241 87 29 11 9 46 59 87 75 16 4 18 33 18 8 38 TABLE V. INFANTILE MORTALITY DURING THE YEAR, 1906. Death from stated Causes in Weeks and Months under One Year of Age. CAUSE OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3- 4 Weeks. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under One Year. All Causes Certified 16 .... 4 2 2 10 13 7 .... 7 1 7 3 7 2 81 UncertiSed 2 1 .... .... 2 .... .... .... 1 .... .... .... .... .... .... 6 Common Infectious Diseases. Small-pox .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Chicken-pox .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Measles .... .... .... .... .... .... .... .... .... .... .... 1 .... .... .... 1 Scarlet Fever .... .... .... .... .... .... .... .... .... 1 .... .... .... .... .... 1 Diphtheria: Croup .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Whooping Cough .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Diarrhœal Diseases. Diarrhœa, all forms .... .... 1 .... 2 6 10 1 .... 7 .... 3 2 3 1 36 Enteritis (not Tuberculous) .... .... .... .... .... .... .... 1 .... .... .... .... .... .... .... 1 Gastritis, Gastrointestinal Catarrh .... .... .... .... .... 1 .... .... .... .... .... 1 .... .... .... 2 Wasting Diseases. Premature Birth 14 2 .... .... .... .... .... .... .... .... .... .... .... .... .... 16 Congenital Defects .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Injury at Birth 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 Want of Breast-milk Starvation .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Atrophy, Debility, Marasmus .... .... .... .... 1 .... .... .... .... .... .... .... .... 1 .... 2 Tuberculous Diseases. Tuberculous Meningitis .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Tuberculous Perit. onitis ; Tabes Mesenterica .... .... .... .... .... .... 1 1 .... .... 1 .... 1 .... .... 4 Other Tuberculous Diseases .... .... .... .... .... 2 .... .... .... .... .... 2 .... .... .... .... Other Causes. Erysipelas .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Syphilis .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Rickets .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Meningitis (not Tuberculous) .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Convulsions 3 1 .... .... .... .... .... 2 .... .... .... .... .... .... .... 6 Bronchitis .... .... .... .... .... .... 1 .... .... .... .... 1 .... 1 .... 3 Laryngitis .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Pneumonia .... .... .... .... .... .... 1 1 .... .... .... .... .... 2 .... 4 Suflocation, overlaying .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Other Causes 1 .... 1 1 1 .... .... .... .... .... .... .... .... .... .... 5 Total 19 3 2 1 4 9 13 6 8 1 8 3 7 2 86 printed at the " essex times" office, romford.