ROM 010 ANNUAL REPORT OF THE Medical Officer of Health FOR THE ROMFORD URBAN DISTRICT For the Year 1913 ROMFORD: Wilson and Whitworth Ltd., Printers, High Street. ANNUAL REPORT. To the Romford Urban District Council. Gentlemen. I have the honour to put before you my Annual Report on the sanitary condition of the Romford Urban District for the year 1913. This Report is arranged as follows:— 1.—Summary of action taken during year for preventing the spread of disease. 2.—An account of the sanitary condition of the district generally. 3.—Statement of enquiries made into the conditions injurious to health and proceedings thereon. 4.—Physical features and general character of the district and general condition of its population. 5.—Proceedings, &c., under the Factories and Workshops Act. Summary of Action taken during the Year to prevent the spread of Infectious Disease. No. Date. Locality. Disease. Action taken. Result. 1. Jan. 3. Norfolk Road Diphtheria One case. Sewer gas escaping from man-hole of sewer close to house. Defect remedied. Removed. No other case 2. ,, 7. George Street Enteric Fever One case. Origin obscure. Fatal. Patient declined to go into Hospital. Premises and bedding disinfected after termination of case. No other case 3. „ 10. Birkbeck Road Diphtheria One case. A leaky ventilation shaft of sewer close to house. Remedied. Removed. No other case 4. „ 12 &: 18 Catherine Road Diptheria Two cases in one family. Defective sanitary conditions. One case fatal. Removed. No other case 5. „ 27. Honiton Road Scarlet Fever One case notified. Not confirmed. 6. „ 27. Eastern Road Scarlet Fever One case. Isolated at home. 7. „ 28. Oldchurch Road Scarlet Fever One case. Origin obscure. Removed. No other case 8. „ 29. Albert Road Scarlet Fever One case. Mother recently returned . from Somerset. Scarlet Fever in the house visited. Removed. No other case 9. Feb. 2. Eastern Road Scarlet Fever One case. Child attending Moss Lane School where two children with suspicion of having had Scarlet Fever were excluded. ' Removed. See No. 22 10. ,, 9 Cotleigh Road Diphtheria One case. Origin obscure. A dubious case. 11. „ 19. Collier Row Scarlet Fever One case. Origin obscure. Child had been at Picture Palace a few days previously. Removed. No other case 4 12. Mar. 4. Margaret Road Scarlet Fever One case. A girl working at a local factory. On visiting the factory I found a girl presenting symptoms of having had an unrecognized attack of Scarlet Fever. Removed. No other case 13. „ 7. Hamilton Road Diphtheria One case. Local sanitary defect. Removed. No other case 14. ., 14. Collier Row Scarlet Fever One case. Origin obscure. Removed. No other case 15. „ 14. Collier Row Diphtheria One ease notified. A dubious case. No Diphtheria Bacilli being found on examination of culture from such. No other case 16. „ 18. Medora Road Diphtheria One case. Presumed to have been contracted away from home. See No. 20 17. „ 19. Waterloo Road Diphtheria One case. A doubtful one. 18. 19. Mawney Road Scarlet Fever One case. Infection imported. Iso- lated at home. No other case 19. „ 22. Richmond Road Diphtheria One case. Local insanitary defect. Removed. No other case 20. April 11. Medora Road Diphtheria One case in same house as No. 16. No other casa 21. ,, 11. Manor Road Diphtheria One case. A doubtful one. 22. „ 21. Eastern Road Scarlet Fever One case. A return case. Removed. No other case 23. May 2. Queen Street Diphtheria One case. Origin obscure. Removed. No other case 24. „ 31. Hare College, Hare Street Diphtheria One case. Local sanitary defect. Re- moved. No other case 25. June 4. North Street Puerperal Fever A mid-wife case. Report to Dr. Thresh. 26. „ 18. Grosvenor Road Scarlet Fever One case. Child visited a house out of the district where Scarlet Fever existed. Removed. No other case 27. „ 24. Ribbi Road Scarlet Fever A doubtful case. 28. July 1. Manor Road Scarlet Fever One case. Infection imported. Re- moved. No other case 29. „ 9. Mawney's Road Diphtheria One case. Origin obscure. Removed. No other case 30. „ 27. Mawney's Road Diphtheria One case. Removed. No other case 31. ,, 29. Union Workhouse Puerperal Fever One case. 32. Sept. 4. Market Place Scarlet Fever One case. Infection presumably imported from London. Removed. See No. 47 5 No. Date. Locality. Disease. Action taken. Result. 33. „ 9. Marks Road Scarlet Fever One case. A boy working on railway restaurant car. Another boy had had Scarlet Fever a few days previously. Removed. No other case 34. „ 15. Oldchurch Road Scarlet Fever One case. Notified from Shadwell Children's Hospital, where child was attending as an out patient. Removed to Tottenham Isolation Hospital. Fatal. 35. Oct. 20. Moore s Yard Diphtheria Two cases in one family. Children attending St. Edward's School. A child attending there from Collier Row had a suspicious throat a week ago. Removed. See No. 38 36. „ 20. Carlisle Road Scarlet Fever One case. Contracted away from home on a visit. Removed. No other case 37. „ 20. Victoria Road Diphtheria One case. Local sanitary defect. Removed. No other case 38. „ 27. Moore's Yard Diphtheria Another case in same family as No. 35. Removed. No other case 39. „ 27 and Nov. 4. Marlboro' Road Enteric Fever Two cases. Sanitary defect. Removed. No other case 40. „ 28. Market Place Diphtheria Two cases. Local sanitary defect. Removed. 41. Nov. 5. Willow Street Diphtheria One case. Local sanitary defect. Removed. No other case 42. „ 5. Pettiths Lane Diphtheria One case. Isolation at home. No other case 43. „ 6. Albert Road Polio Myclitis A doubtful case. Now well. 44. „ 3. Market Place Diphtheria Another case in same house as No. 40. No other case 45. „ 5. Gidea Estate Diphtheria One case. Defective drain. No other case 46. „ 5. Mawney's Rnad Scarlet Fever One case. Infection imported from London. Isolated at home. No other case 6 47. 8. Market Place Scarlet Fever One case in same house as No. 32. Removed. No other case 48. ,, 28. Factory Terrace Scarlet Fever Three cases. Mother works at a house in adjacent Rural District, where I found an unrecognized case of Scarlet Fever. Removed. Two of these children were malignant cases and died in hospital. No other case 49. Dec. 7. Collier Row Scarlet Fever One case. Origin obscure. Removed. No other case 50. „ 11. Waterloo Road Diphtheria One case notified. Not confirmed. 51. „ 24 and ,, 30 Pretoria Road Scarlet Fever Two cases. Origin obscure. Removed. No other case 52. ,, 24. Collier Row Diphtheria One case. Removed. A doubtful case. No D.B. 53. „ 29. Collier Row Scarlet Fever One case. Contracted from a child living near. A case was notified from this house in January, and on visiting I found another child who had evidently had Scarlet Fever unrecognized a fortnight previously. Removed. No other case 7 8 During the year 95 cases of infectious disease (excluding Measles and Polyomyclitis and Tuberculosis) were notified. The different diseases are thus tabulated:— Scarlet Fever 30 Diphtheria 31 Erysipelas 28 Enteric Fever 3 Puerperal Fever 2 Polyomyclitis 1 Total 95 During the previous year 99 cases were notified—19 cases of Diphtheria, 20 of Scarlet Fever, and 2 cases of Enteric Fever were removed to the Isolation Hospital. In all cases notified for removal I visit, prior to removal, with the exception of one or two instances when immediate removal was imperative in the interest of the Patient. In doubtful cases of Diphtheria, swabs are, as a rule, taken from the throats of suspected cases by their Medical Attendants, who are supplied with sterile swabs from the Isolation Hospital for this purpose, and the swabs sent to the Isolation Hospital. Laboratory for cultivation and bacteriological examination by me. In all cases of infectious disease (and after death or removal of a case of Pulmonary Tuberculosis), the rooms occupied by the Patient, the bedding, &c., are disinfected by the Sanitary Inspector, after removal to the Hospital or termination of the case. In cases which have been treated at home, the bedding, &c., is removed for disinfection to the Hospital steam disinfector, but in cases removed to the Hospital promptly it is considered sufficient to disinfect the bedding, &c., at home; the occurrence of a second case in the house after the prompt removal of the first case, is, in my experience, practically nil. This practice ensures a considerable saving in the Hospital expenses, and is, in my opinion, quite consistent with safety to the public health. 9 Smallpox.—No case of this disease'was notified; 1 receive occasional notices from Port Medical Officers of Health apprising me of the occurrence of any case of smallpox on board a ship arriving in port, giving names and addresses of any person amongst passengers or crew who have stated their intention of coming into this district. Such persons are visited. Scarlet Fever.—Thirty cases were notified. All these were isolated cases, the source of infection being, in most instances, imported. School children had not so much influence in spreading this disease as in the previous year. Twenty were removed to the Isolation Hospital. Two deaths were caused by this disease. Diphtheria—Thirty-one cases occurred, of which 19 were removed to the Isolation Hospital. Two cases were fatal. Most of these cases were connected with some local sanitary defect, discovered and remedied by the Sanitary Inspector. Enteric Fever.—Three cases were notified, one a fatal one; the patient refused to go into the hospital until she became too ill to be removed. The others were removed. The latter cases were associated with sanitary defects of the local drains, the former case was attributed to the eating of shell fish. Measles prevailed to a very considerable extent, as it did in the Rural District, and in most parts of the country. The epidemic extended from the early part to the middle of the year. Fortunately the mortality was nil, doubtless owing to the absence, in most cases, of Bronchitis or Pneumonia, the usual causes of death from this disease; this was probably due to the abnormal mildness of the weather, and possibly also to the distribution of leaflets by the Council to all houses in the district, giving short instructions as to isolation and management to those parents who did not (as in the majority of instances) call in medical aid. 227 cases were notified. Several of the schools were closed for a period. I am afraid that the notification of the disease was not a potent element in checking the disease, and' I suggest that, on the onset of any future outbreak, if it is found that the instructions of the Education Board with regard to exclusion of children from 10 school who are suffering from Measles do not suffice to check the disease, the affected school should be closed at an earlier period. Infantile Diarrhoea was unusually non-prevalent, undoubtedly due to the absence of any abnormal summer heat. Four deaths were caused by this disease, all in children under 2 years of age. Pulmonary Tuberculosis.—This became a notifiable disease in the early part of the year; 28 cases were reported. The steps taken to prevent the spread of this disease are detailed in a subsequent part of this report. III.—Statement of enquiries made into conditions injurious to the public health and proceedings thereon. The following are the chief insanitary conditions which caused official interference, for the most part discovered by your Sanitary Inspector, who reports to me those insanitary conditions in which he requires my advice and assistance. January 3.—Mawneys Road. Defective sanitary arrangement. Notice. Remedied. January 3.—Balgores Lane. Blocked drain. Notice. Remedied. January 4.—London Road. Defective W.C. Notice. Remedied. January 4.—St. Andrew's Road. No dust bin to I louse. Notice. Remedied. January 4.—St. Andrew's Road. No dust bin to house. Notice. Remedial. January 7.—Western Road. Defective W.C. and sink drain. Notice. Remedied. January 8.—Eastern Road. Flooded cellar. Notice. Remedied. January 8.—London Road. Defective drain. Notice. Remedied. January 8.—George Street. Defective drain. Notice. Remedied. January 10.—High Street. Defective sink pipe. Notice. Remedied. January 10.—Grosvenor Road. No dust bin to house. Notice. Remedied. January 10.—Grosvenor Road. House insanitary. Notice. Remedied. January 10.—Western Road. No cover to water tank. Notice. Remedied. January 10.—Birkbeck Road. Water suspected; analyzed and found to be good. January 15.—Catherine Road. Insanitary house and no dust bin. Notice. Remedied. January'15.—Insanitary house and water tank insanitary. Direct supply. 11 January 17.—Mawneys Road. Defective drain. Notice. Drain re-laid. January 21.—Catherine Road. Defective drain. Notice. Drain re-laid. January 21.—Catherine Road. Defective drain. Notice. Drain re-laid. January 24.—Eastern Road. Blocked drain. Notice. Remedied. January 24.—North Street. Defective guttering to house. Notice. Remedied. January 27.—Western Road. Defective ceiling to house. Notice. Remedied. January 27.—Horuchurch Road. No dust bin to house. Notice. Remedied. January 31.—Lawrence Road. Complaint of smell from dust bin refuse deposited in a gravel pit. Practice discontinued and refuse covered with earth. February 4.—Heath Park Road. Defective drain. Notice. Re-laid. February 5.—Linden Street. Blocked drain. Notice. Remedied. February 8.—Jutsoms Lane. Enormous quantities of dust bin refuse from llford Urban Council area, deposited in a field by roadside. Several visits and reports to Council. Discontinued after correspondence between Romford and Ilford Councils. February 13.—Mildmay Road. Accumulation of refuse. Notice. Remedied. February 13.—Mildmay Road. Stable dirty and ill-ventilated. Notice. Remedied. February 13.—Mildmay Road. Stable dirty and ill-ventilated. Notice. Remedied. February 14.—Factory Road. Overcrowding in a house. Notice. Remedied. March 8.—Mawneys Road. Van dwellers on unoccupied land. Notice. Remedied. March 10.—Balgores Lane. Cottage dilapidated. Notice. Pulled down. March 11.—Mawneys Estate. Van dwellers. Notice. Removed. March 11.—Mawneys Estate. Defective drain. Notice. Remedied. March 13.—Mildmay Road. House in bad repair. Notice. Remedied. March 13.—Low Shoe Lane. Foul pigstyes and ditch. Notice. Remedied. March 13.—Factory Road. House insanitary. Notice. Remedied. March 19.—Carlisle Road. House insanitary. Notice. Remedied. March 20.—High Street. Blocked drain. Notice. Remedied. March 20.—Mawneys Road. No dust bin to house. Notice. Remedield. March 22.—Manor Road. Foul ditch. Notice. Remedied. March 22.—Eastern Road. Room of house requiring re-papering, &c., after Scarlet Fever. Notice. Remedied. March 24.—Hornchurch Road. Room of house requiring re-papering, &c., after Scarlet Fever. Notice. Remedied. March 24.—Nelson Place. House inspected after being repaired under notice and reported fit for habitation. March 24.—Wray Square. House inspected after being repaired under notice and reported fit for habitation. 12 March 28.—Hamilton Road. Eight houses damp and insanitary. No damp course. Yards requiring paving. Notice. Remedied. March 28.—Richmond Road. House insanitary. Notice. Remedied. March 28.—Richmond Road. Defective drain. Notice. Remedied. March 28.—Richmond Road. Defective drain. Notice. Remedied. April 4.—Cross Road. No dust bin to house. Notice. Remedied. April 4.—Hainault Road. No dust 'bin to house. Notice. Remedied. April 4.—Western Road. Damp wall to house. No dust bin. Notice. Remedied. April 4.—Western Road. House dirty and insanitary. Notice disregarded. Occupier summonsed. Case dismissed! April 4.—Richmond Road. House insanitary and W.C. defective. Notice. Remedied. April 4.—Richmond Road. House insanitary and W.C. defective. Notice. Remedied. April 5.—Laurie Square. Defective drain. Notice. Re-laid. April 7.—Mawneys Estate. Van dwellers. Notice. Removed. April 11.—Mawneys Road. House requiring cleansing, 4tc., after Scarlet. Fever. Notice. Remedied. April 11.—Mawneys Estate. Van dwellers. Notice. Removed. April 14.—Catherine Road. Three houses with no dust bins. Notice. Remedied. April 14.—Defective drain. Notice. Remedied. April 14.—Defective drain. Notice. Remedied. April 14.—Wray Square. Accumulation of refuse. Notice. Remedied. April 14.—Wray Square. Four houses insanitary. Notice. Remedied. April 14.—Nelson Place. Four houses insanitary. Notice. Remedied. April 14.—Queen Street. Four houses insanitary. Notice. Remedied. April 18.—Risebridge Farm. Cow shed inspected by request of owner. April 24.—Factory Road. Eight houses insanitary owing to unpaved yards. Notice. Remedied. April 24.—London Road. Lodging house requiring cleasing. Notice. Remedied. April 28.—Mildmay Road. Blocked .drain. Notice. Remedied. April 30.—Mawneys Estate. Van dwellers. Notice. Removed. April 28.—Mildmay Road. Blocked drain. Notice. Remedied. May 1.—Queen Street. Defective W.C. Notice. Remedied. May 1.—Marks Road. Foul smell in house, ascertained to be caused by a projecting brick in chimney becoming heated and giving off a foul odour. Remedied. May 2.—Inspected two houses after being restored. May 2.—Waterloo Road. Foul odour from gas plant in adjoining brewery yard. Notice. Remedied. May 5.—Hainault Road. Insanitary house. Notice. Remedied. May 6.—Mildmay Road. Accumulation of refuse. Notice. Remedied. 13 May 9.—Mercury Gardens. Three houses with blocked drains. Notice. Remedied. May 9).—Marks Road. Defective sink pipe. Notice. Remedied. May 13.—Mawneys Estate. Van dwellers. Notice. Removed. May 14.—Mawneys Estate. Van dwellers. Notice. Removed. May 15.—Reed Pond Walk. Foul pond. Filled in. May 16.—Mawneys Estate. Van dwellers. Notice. Removed. May 19.—Carlisle Road. Blocked drain. Notice. Remedied. May 19.—Essex Road. Pigs kept so as to be a nuisance. Notice. Remedied. May 20.—Victoria Road. Nine houses insanitary owing to defect ve W.C., tin paved yards, no dust bius. Notice. Remedied. May 22.—Albion Terrace. Accumulation of refuse. Notice. Remedied. May 26.—Brentwood Road. Accumulation of refuse in Rural District causing a nuisance to adjacent houses in Urban District. SawSanitary Inspector who caused nuisance to be abated. May 27.—South Street. Accumulation of refuse. Notice. Remedied. May 28.—Romford Common. Six houses with overflowing cesspool. Notice. Remedied. June 2.—Hare Hall. Defective drain (Diptheria). Notice. Remedied. June 3.—High Street. Oil soaking through wall of adjoining house from oil stores. Notice. Remedied. June 3.—High Street. Cellar with blocked drain. Notice. Remedied June 3.—High Street. Blocked drain. Notice. Remedied. June 3.—High Street. Blocked drain. Notice. Remedied. June 3.—High Street. Defective spouting to house. Notice. Remedied. June 4.—Reed Pond Walk. Defective drains. Notice. Re-laid. June 4.—Mawneys Estate. Van dwellers. Notice. Removed. June 6.—Queen Street. Accumulation of refuse. Notice. Remedied. June 6.—Mawneys Estate. Van dwellers. Notice. Removed. June 9.—Mawneys Estate. Van dwellers. Notice. Removed. June 10.—Waterloo Road. Blocked drain. Notice. Remedied. June 10.—Waterloo Road. Defective W.C. Notice. Remedied. June 11.—Mawneys Estate. Van dwellers. Notice. Removed. June 13.—St. Andrew's Road. Insanitary house. Notice. Remedied. June 13.—Waterloo Road. Insanitary house. Notice. Remedied. June 13.—High Street. Four insanitary houses. Notice. Remedied. June 16.—Margaret Road. Foul water tank. Direct supply provided. June 16.—Prospect Place. Four insanitary houses. Notice. Remedied. June 17.—Prospect Place. Seven houses with foul privies. Notice. Remedied. lune 17.—George Street. Defective drain. Notice. Re-laid. June 18.—Mawneys Estate. Van dwellers. Notice. Removed. June 19.—Grosvenor Road. Four houses with defective W.C.s and no dust bins. Notice. Remedied. 14 June 19.—Willow Street. Defective drain. Notice. Remedied. June 19.—Margaret Road. Foul water cistern. Direct supply provided. June 23.—New Hall. Insanitary cow shed. Notice. Remedied. June 25.—Marshall Road. Defective drain. Notice. Re-laid. June 25.—Goosehayes Cottages. Overflowing cesspool. Notice. Remedied. July 1.—High Street. Defective urinal to public house. Noticc. Remedied. July 3.—Marks Road. Animal improperly kept. Notice. Remedied. July 3.—St. Andrew's Road . Dirty house and W.C. Notice. Remedied. July 3.—Moss Lane. Four dirty houses. Notice. Remedied. July 3.—Moss Lane. Overcrowding. Notice. Remedied. July 3.—Milton Road. Three houses with defective W.C.s. Notice. Remedied. July 4.—Medora Road. House requiring cleansing after Scarlet Fever. Notice. Remedied. July 7.—Angel Road . Foul swill tub. Notice. Remedied. July 7.—Prospect Place. Blocked drain. Notice. Remedied. July 8.—North Street. House insanitary. Cleansed, drain re-laid, and dust bin provided. July 11.—High Street. Defective W.C. Notice. Remedied. July 11.—Mawneys Estate. Van dwellers. Notice. Removed. July 16.—Marks Road. Nine houses out of repair and with no dust bins. Notice. Remedied. July 19.—Angel Road. Accumulation of rotten fruit. Notice. Destroyed. July 22.—Mawneys Estate. Van dwellers. Notice. Removed. July 22.—Mawneys Road. House with defective W.C. and no dust bin. Notice . Remedied. August 7.—Essex Road. Defective drain. Notice. Remedied. August 8.—Mawneys Lane. House insanitary, defective W.C., foal water cistern, unpaved yard, no dust bin. Notice. Remedied. August 8.—Mawneys Lane. House with no bust bin, and foul cistern. Notice. Remedied. August 8.—Mawneys Lane. House with no bust bin, and foul cistern. Notice. Remedied. August 8.—Mawneys Lane. House with no bust bin, and foul cistern. Notice. Remedied. August 8.—James Place. House with no dust bin. Notice. Remedied. August 8.—Birkbeck Road. Dirty house, and defective paving to yard. Notice. Remedied. August 8.—Birkbeck Road. Dirty house, and defective paving to yard. Notice. Remedied. August 9.—James Place. Two houses damp and dilapidated. Notice. Remedied. August 10.—Birkbeck Road. Dirty house and defective yard paving. Notice. Remedied, 15 August 10.- Birkbeck Road. Dirty house and defective yard paving. Notice. Remedied. August II.—Mawneys Estate. Van dwellers. Notice. Removed. August 14.—Market Place. Foul water cistern. Direct supply provided. August 14.—Mawneys Estate. Van dwellers. Notice. Removed. August 16.—Meadway. Accumulation of refuse. Notice. Removed. August 16.—Manor Road. Defective paving, foul cistern. Notice. Remedied. August 18.—Wolsley Road. Eighteen houses with defective yard paving, W.C.s, and no dust bins. Notice. Remedied. August 16.—Wolsey Road. Two houses with defective yard paving, W.C.s, and no dust bins. Notice. Remedied. August 16.—Wolsey Road. Two houses' with defective yard paving, W.C.s, and no dust bins. Notice. Remedied. August 16.—Wolsey Road. Two houses with defective yard paving, W.C.s, and no dust bins. Notice. Remedied. August 19.—Mawneys Estate. Van dwellers. Notice. Removed. August 20.—Market Place. Accumulation of trade refuse. Notice. Removed. August 29. Knighton Road. Fowls improperly kept. Notice. Remedied. August 29.—Knighton Road. Defective W.C. Notice. Remedied. September 9.—London Road. Foul urinal at public house. Notice. Remedied. September 11.—Catherine Road. Damp wall to house, foul cistern. Notice. Remedied. Direct supply provided. September 11.—Marks Road. House with foul cistern and no dust bin. Notice. Remedied. September 11.—South Street. Dirty house. Defective W.C. Notice. Remedied. September 11.—Dagenham Road. Two damp and dilapidated houses. Notice. Closed. September 15.—Wolselcy Road. House out of repair. Pump defective. Notice. Remedied. September 17.—James' Place. Foul W.C., unpaved yard. Notice. Remedied. tSeptember 17.—White Hart Lane. Dilapidated house. Notice. Remedied. September 19.—Brentwood Road. Dirty house, defective W.C. Notice. Remedied. September 22.—Chase Cross Road. Suspected water. Analysis good. September 23.—Market Place. House out of repair. Notice. Remedied. September 23.—Brentwood Road. Accumulation of dung and filthy yard. Notice. Remedied. September 25.—Milton Road. Defective drain and W.C. Notice. Remedied. September 25.—Shakespeare Road. Six houses with defective W.C.s, no dust bins, and unpaved yards. Notice. Remedied. 16 September '25.—Queen Street. Six houses damp and dilapidated. No dust bins. Notice. Remedied. September 25.—St. Andrew's Road. Three houses damp and dilapidated. No dust bins. Notice. Remedied. September 27.—High Street. House with no W.C. Notice. Remedied. September 29.—Queen Street. House out of repair. Notice. Remedied. September 29.—High Street. Accumulation of refuse on river bank. September 30.—Mawneys Estate. Van dwellers. Notice. Removed. October 4.—High Street. Blocked drain. Notice. Remedied. October 7.—Poplar Street. Blocked drain. Notice. Remedied. October 7.—Wray Square. Accumulation of refuse. Notice. Remedied. October 7.—Collier Row. Four houses damp, unpaved yards. Notice. Remedied. October 16.—Mawneys Estate. Van dwellers. Notice. Removed. October 17.—London Road. Three houses, pump out of order. Notice. Remedied. October 20.—Mercury Gardens. House out. of repair. Unpaved yard. Notice. Remedied. October 21.—Carlisle Road. House overcrowded. Notice. Remedied. October 23.—Carlisle Road. Foul cistern. Direct supply provided. October 23.—Victoria Road. Foul cistern and no dust bin. Notice. Remedied. October 23.—Mildmay Road. Defective yard paving, foul cistern. Notice. Remedied. October 23.—Moore's Yard. House damp and dilapidated. Notice. Remedied. October 23.—Old Church Road. Defective paving to yard. Notice. Remedied. October 27.—London Road. Impure well water. Notice. S.E. water laid on. October 27.—Mawneys Road. Defective roof to house, foul W.C., unpaved yard, no dust bin. Notice. Remedied. October 28.—Hare Street. Dirty house. Notice. Remedied. November 5.—Balgores Lane. Blocked drain. Notice. Remedied. November 7.—Market Place. House damp and dilapidated, unpaved yard. Notice. Remedied. November 7.—Drummond Road. Foul W.C., no dust bin. Notice. Remedied. November 8.—Meadway. Defective drain, unpaved yard, damp wall. Notice disregarded. Action now (February) being taken. November 10.—Moore's Yard. Drain defective. Diphtheria. Notice. Remedied. November 11.—North Street. Five houses, insufficient W.C. accomodation. damp and dilapidated. No dust bins. Notice. Remedied. November 11.—Moore's Yard. Two damp and dilapidated houses, unpaved yards. Notice. Remedied. 17 November 11.—Prospect Place. Damp house, no guttering, no dust bin. Notice. Remedied. November 11.—Marlborough Road. House with no dust bin. Notice. Remedied. November 11.—Willow Street. Dirty W.C., unpaved yard. Notice. Remedied. November 11.—Albert Road. Damp house, defective roof, foul cistern. Notice. Remedied. November 12.—Waterloo Road. Defective W.C. and scullery floor. Notice. Remedied. November 12.—St. Andrew's Road. Defective W.C. and scullery floor. Notice. Remedied. November 13.—Poplar Street. Accumulation of refuse in an old gravel pit. Notice. Remedied. November 14.— Reed Pond Walk. Blocked drain. Notice. Remedied. November 14.—Collier Row. Two houses with defective W.C.s, foul cisterns, no dust bins. Notice. Remedied. November 15.—Heath Drive. Refuse in fish pond. Notice. Remedied. November 15.—Reed Pond Walk. Unpaved yard. Notice. Remedied. November 17.—Market Place. Five houses with defective drains, damp walls, unpaved yards, defective W.C.s. Notice. Remedied. November 18.—Peartree Court. Three houses out of repair, insufficient W.C. accomodation, unpaved yards. Notice. Remedied. November 18.—High Street. Deflective roof to house, defective W.C. Notice. Remedied. November 20.—Marks Road. No dust bin to house. Notice. Remedied. November 22.—James' Place. Two houses with blocked drains. Notice. Remedied. November 22.—White Hart Lane. House damp and dilapidated. Notice. Remedied. November 22.—Prospect Place. House damp and dilapidated. Notice. Remedied. November 25.—Carlisle Road. House requiring cleansing. &c., after Scarlet Fever. No dust bin. Notice. Remedied. November 25.—Mawneys Road. House requiring cleansing after Scarlet Fever. Notice. Remedied. November 25.—Reed Pond Walk. Yard damp. Notice. Remedied. November 28.—Eastern Road. Dirty house. Notice. Remedied. December 1.—Factory . Road. Dirty house. Notice. Remedied. December 2.—High Street. Fish condemned as unfit for food. December 2.—High Street. Stable out of repair and insanitary. Notice. Remedied. December 5.—Salisbury Road. Three houses with foul water cisterns. Notice . Direct supply provided. December 5.—Salisbury Road. Blocked drain. No dust bin. Notice. Remedied, 18 December 10. High Street. Defective W.C. Notice. Remedied. December 12.—Salisbury Road. Three houses with foul water cisterns. Notice. Direct suppy provided. December 12.— Hamilton Road. Twelve houses with foul water cisterns. Notice. Remedied. December 12.—Collier Row. Four houses with foul water cisterhns. Dilapidated privies. Notice. Remedied. Direct suppy provided. December 12.—Chase Cross. House with foul water cistern. Notice. Direct supply provided. December 15.—Rooms requiring cleansing, &c., after Scarlet Fever. Notice. Remedied. December 16.—Victoria Road. Damp wall 1o house. Defective W.C. Notice. Remedied. December 16.—Princes Street. Defective drain. Notice. Remedied. December 29.—Mawneys Road. Foul water cistern to house. Notice. Direct supply provided. Special reports were made by me to the Council on various local sanitary defects, which were remedied on the Council's instructions to the Sanitary Inspector. Particulars of these are enumerated in the previous summary, No. 3. Samples of drinking water, when suspected, have been submitted to me by the Sanitary Inspector, and, when found to be contaminated, the South Essex Co.'s water has been laid on. The cases of infectious disease notified for removal to the Isolation Hospital were visited by me and removed, except in a few instances where the diagnosis was not confirmed. The School Medical Officer and the School Authorities notify to me the cases of children attending school who are suspected of suffering from infectious disease, and these are visited by me, where no medical man is attending them, and the proper steps taken to prevent the spread of the disease in those instances where the suspicion is confirmed and the School Authorities cautioned not to admit children from the same family until the infection is over, or the case removed and the house, &c., disinfected. There has not been so much infectious disease (with the exception of Measles) caused by school attendance as in the previous year, the Masters and Mistresses of the various schools being very careful in the admission of suspected children and giving me information at once. The various bake-houses, slaughter-houses, dairies and milk shops are periodically inspected, and any insanitary condition remedied. The Inspector also keeps observation on the Market 19 stalls and shops where food is exposed for sale, in order to detect any unsound food which may be disposed of. The Inspector attends each Market, viz., Wednesday and Saturday, and examines the food and provisions exposed for sale, and during the year nothing liable to seizure has been exposed for sale. He is also in attendance during the holding of the Cattle Market, for the purpose of enforcing the Bye-laws with respect to the over-stocking of milch cows, and has on numerous occasions compelled the owners of cattle to cause their cows to be milked to relieve undue or painful distension of the udder. The gipsy encampments, especially on unoccupied land on the Mawneys Estate, take up a good deal of the Inspector's, time; it is difficult to know what to do to abate this, which is a serious nuisance, complained of by the permanent residents near. The practice is to serve notice on the dwellers in these vans to provide proper sanitary accommodation, and the effect of this is to cause them to decamp, but others come in their place, and are served in the same way. In cases of suspected but indefinite Diphtheria, swabs from suspected throats have been sent to me by the Medical Attendant, and bacteriological examination of the culture from the swab made at the Isolation Hospital laboratory is made by me, and the result reported to the Medical Attendant of the Patient. The above record of enquiries and action in the case of condition injurious to the public health does not include the many minor instances of intervention on the part of the Sanitary Inspector, a record of which is shown in the Inspector's report to the County Council required by the Local Government Board to be attached to this Report. The main public sanitary improvements effected in the district during the year have been as follows:— Extension of the South Essex Co.'s water main in the following roads:—Crossway, Balgores Crescent, Cross Road, Forest Road, and Hare Hall Lane. Road improvements (widening, &c.) have been carried out in Station Road, Squirrels Heath, and Balgores Lane, south 20 of the railway; Kingston Road has been taken over by the Council and is now (February) in course of being made up. No extension of sewers has been effected during the year. In accordance with the instructions of the Local Government Board, requiring information to be given by Medical Officers of Health on the following subjects, I proceed here to comply with such instructions: — Physical features and general character of the district and general conditions of its population. The Urban District comprises the larger portion of the town of Romford and the outlying districts (all in Romford Parish) known as Collier Row, Squirrels Heath, Romford Common, and part of Noak Hill. Romford is situate partl[y on clay and partly on gravel, Collier Row mqstly on clay, Squirrels Heath on gravel, Romford Common and Noak Hill on clay. The town itself is the lowest level, the outlying parts of the district gradually increasing in elevation. The population is of the usual varied class, resident gentry, many residents engaged in local businesses and in London, employees of a large brewery in the town, and working classes, some agricultural, some in building trades, &c. There are no trades exercising influence on the public health. House Accommodation, &c. There is a decided want of house accommodation for the working classes, especially in the neighbourhood of Squirrels Heath. 1 am told that if a cottage becomes vacant in this district, 10 or 12 applicants are ready to take it. There (is also a dearth of cottages in Collier Row to a more limited extent. As far as I am able to ascertain there appears to be a reluctance on the part of builders to put up cottages for some reason or other, and' I hape the Legislature will speedily devise some means by which this undoubted requirement is effected for the working classes. As far as the sanitary condition of the existing cottage is concerned, there is not much to complain of; there are certainly two or three courts in the town which are objectionable in a sanitary sense, but these houses are occupied by the poorer amongst the working class who could not pay the higher rent that a better cottage would entail. They are periodically examined by the Sanitary Inspector, and under the " Artizans' Dwelling, &c., Act," insanitary conditions are abated as far as possible. 21 I append here the information required by the Local Government Board, in tabular form, as to the carrying out of their instructions in reference to the Regulations under Section 17 of the Housing, Town Planning, &c., Act, 1909." These proceedings do not include all the instances of house and premises improvement effected by your sanitary officials, particulars of which are stated in a previous part of this Report. Action taken under the Housing, Town Planning, &c. Act, 1909. 1. Number of Houses inspected 370 2. Number of Houses unfit for human habitation 3 3. Representations made for Closing Orders Nil. 4. Closing Orders made Nil. 5. Houses remedied without Closing Orders being made 312 6. Houses remedied after Closing Orders were made Nil. The defects found in the houses were dampness arising from defective damp-courses, floors esting on the ground, defective roofs, defective sanitary arrangements, &c. The repairs required to put the premises in all respects fit for human habitation were of considerable magnitude, entailing the putting in of proper damp-courses, the taking up and re-laying of ground floors, excavating for air space and concrete over site of floors, stripping roofs, re-slating and tiling, repairs to ceilings and walls, and the provision of new sanitary accommodation. Water Supply. The district is mainly supplied by the South Essex Water Company. The supply is good and constant. The water is a very good potable water. There are few private wells in the town, and these are gradually becoming fewer, action being taken to enforce the laying of the public water when the private supply is found to be impure, samples being brought to me for analysis by the Sanitary Inspector as occasion requires. The outlying parts of the district are also mainly supplied by the South Essex Company, with the exception of Noak Hill. Noak Hill is partly in the Urban and partly in the Rural district of Romford. The S.E. Co's water main will, 1 understand, shortly be extended to this disstrict. 22 Milk Supply. This is provided by numerous dairy farmers in the district. Its freedom from addition of water is looked after by the County Council, whose officer visits the district periodically and takes samples for analysis by the County Analyst. A few convictions for this offence have been obtained. The condition of the dairies, cow-sheds and milk-shops is regularly ascertained by the sanitary officials, and it has only been necessary to serve a notice for abatement of insanitary conditions in two instances. Other Foods, &c. The shops and market are regularly inspected by the Sanitary Inspector. There has been no occasion for official intervention during the year. Sewerage and Drainage. The whole of the district, with the exception of the outlying part, Noak Hill, is well sewered. Local drains occasionally give trouble, through becoming blocked, &c., and requiring intervention from the Inspector. The sewage discharges into reservoirs on a farm called " Briton's Farm," about two miles from the town, and from these reservoirs the sewage is pumped through raised open iron troughs on to the land. This " sewage irrigation farm " is the property of and worked by the Council. Pollution of Rivers and Streams. There is no pollution of watercourses in the district. Excrepent Disposal, &c. In all parts of the district where it is practicable to drain into the sewer, excrement disposal is by water closets. In all dwellings built subsequently to the provision of Bye-laws, water closets are provided with a flushing tank, but in those in existence before the Bye-laws 1882, this provision does not exist, except in those instances where the non-existence of a flushing tank has been found to cause a nuisance, in whicth case flushing tanks are provided. Removal and Disposal of House Refuse. This is done by the Council, removal being effected weekly in summer and fortnightly in winter, in covered vans, and 28 deposited, some in brickfields and some in disused gravel pits. As far as I am aware, no nuisance has been caused by the manner of the disposal of house refuse. After April, a weekly collection both in summer and winter will be provided. Nuisances, Proceedings for their abatement, &c. These are brought to light by frequent visits of the Sanitary Inspector, who reports to me cases which he considers require my co-operation with him. Steps taken to remedy the various nuisances found by or reported to your sanitary officials are recorded, with a list of the main instances in which intervention was necessary, in a previous part of this Report. Lodging Houses, Offensive Trades, &c. There are two public lodging houses in the district. These are periodically inspected. It was only necessary in one instance to call for the amendment of sanitary defects. There are no offensive trades carried on in the district. Schools. The sanitary condition of the public elementary schools is satisfactory. The water supply to the schools is from the South Essex Company's mains. A special Medical Inspector, appointed by the County Council, visits at stated times, and in cases of impaired health of children (eyes, adenoids, &c.) the parents are instructed to seek medical advice. In cases of children suffering from adenoids most of them are operated on at the Cottage Hospital here. Eye defects mainly go for treatment to the London eye hospitals. Cases of infectious disease and bad condition of verminous trouble in children are reported to me by the School Medical Officer when discovered by him, and in all cases of suspected infectious disease notice is sent to me by the school authorities, and also, in the case of infectious disease occurring in families where any of the children attend school, I give notice to the master or mistress of the school (as the case may be), advising the exclusion of children from that family for a specified time. A Nurse is now provided to look after children suffering from Whooping Cough, Ringworm, Vermin, &c. 24 Method of dealing with Infectious Diseases, &c. Cases of notifiable disease desired to be removed are visited by me (by instruction of the Council) prior to removal. There is accommodation for 40 patients in the Isolation Hospital (Romford Joint Urban and Rural), situated about a mile from )the town, and in the rural district. The Hospital is very popular, and there is usually little difficulty in persuading parents to have cases removed. The practice of disinfection is as follows:—Where a case is kept at home, the rooms, &c., are disinfected by the Sanitary Inspector by Formalin, and the bedding, clothing, &c., is removed in the Hospital special van for disinfection in the Hospital disinfector, being returned home afterwards by the van. In cases promptly removed to the Hospital it is considered sufficient to disinfect the bedding, &c., in the patient's house. There has been no further outbreak in such instances from this plan. Method of control of Tuberculosis. Tuberculosis, now being a notifiable disease, cases are notified to. me as they occur, and particulars, &c., entered in my Tuberculosis Journal. These are visited. The County Council Tuberculosis Committee having arranged with the Romford Joint Hospital Board for the erection of a Pavilion for the treatment of cases of Tuberculosis, this has been done in the ground of the Isolation Hospital, where there is ample room for such a building at a safe distance from the infectious wards. Eight patients (4 male and 4 female) have been accommodated here since May, 1913. The Council Committee have now altered this arrangement so as to take in only female patients, as it is found to be a better arrangement to confine the various sanatoria in the county to one sex. The Pavilion is doing good work. Patients are admitted not exclusively from the Romford Urban and Rural Districts, but are sent to the different Sanatoria in the county as vacancies occur. In the case of domiciliary patients, these, when visited, are informed that they can receive advice at the Tuberculosis Dispensary. This Dispensary, established in the early part of the year, is open twice weekly, and is worked by the Tuberculosis Officer of this area. A leaflet of instruction is left with the Patient when visited, and any insanitary condition of the home, if existing, attended to by the Sanitary Inspector. Provision is made for pauper cases in the Romford Union Infirmary where they are treated, some in the general wards, some in specially erected shelters. 25 Tables of mortality and of sickness, compiled in accordance with the requirements of the Local Government Board, are appended to this report. ISOLATION HOSPITAL. This Hospital is controlled by the "Joint Hospital Board," a body, composed of members of the Urban and Rural District Councils, to whom', I beg, as before, to express my warmest thanks for the readiness with which all suggestions from the matron and myself, for the well-being of the Hospital and its patients, are responded to. During the year 19 cases of Diphtehria, 20 of Scarlet Fever, and 2 of Enteric Fever, were admitted from the Urban district. 1 am pleased to say that the Hospital continues to maintain its good position in public favour. I am sure that lives have been saved which must have been sacrificed if left to unskilled home nursing, and the utility of the hospital may be judged of by the fact that when a case of infectious disease has been promptly removed from a family, no other member of that family has contracted the disease. There has been, fortunately, a less number of "Return Cases" this last year. Afo I have explained on former occasions, such" cases occur in all infectious hospitals, and in practically all such cases, it is the occurrence of nasal or ear discharge after the Patient's discharge from the hospital, which renders the subject again infectious to other members of the family. All fear of infection from cases discharged from hospital is obviated, as far as is possible, by the detention of a convalescent in a block separate from the Scarlet Fever Ward, for several days before being discharged. Amongst the cases treated last year less than two per cent, caused return cases. Three deaths occurred in the hospital amongst cases admitted from the urban district, one from Scarlet Fever and two from Diphtheria. Summary of work done through the Sanitary Inspector and under the H.W.C. Acts, in the Urban District of Romford during the year ending December 31st, 1913. ESSEX COUNTY COUNCIL. 1. Complaints received 29 2. Nuisances detected without complaint 399 3. Nuisances abated 402 Unabated last year 17 — 419 26 4. Nuisances remaining unabated 45 5. Formal notices served 471 6. Summonses issued 3 1 Dismissal 7. Convictions obtained 2 8. No. of cottages inspected 370 9. No. of cottages found unfit for human habitation 3 10. No. of representations made with the wiew of Closing Orders being made Nil. 11. No. of Closing Orders made Nil. 12. No. of cottages in which defects were remedied without a Closing Order 312 13. No. of cottages in which defects were remedied after making Closing Order Nil. 14. No. of cottages closed voluntarily 3 15. No. of cottages demolished by order Nil. Voluntarily 1 16. No. of Common Lodging Houses in District 2 Frequency of inspection Monthly 17. No .of Slaughter Houses in District 10 Frequency of inspection Frequently 18. No. of Bakehouses in District 15 Frequency of inspection Monthly 19. No. Dairies and Milkshops 24 Frequency of inspection 77 20. No. of Cowkeepers 13 Frequency of inspection 49 21. No. of samples of milk taken for examination for cleanliness, etc. Nil. 22. Filthy houses cleansed 24 23. Houses disinfected 55 24. Cases of overcrowding abated 2 25. New houses. No. of water certificates applied for veyor 26. No. of certificates granted do. 27. Public wells sunk Nil. 28. Privies. No. in district 58 No. abolished during the year Nil. 29. No. of pail closets 100 30. No. of W.Cs. with proper flushing arrangement 2604 31. No. of hand-flushed W.Cs. 1252 32. Animals improperly kept removed 2 33. Samples of water taken for analysis 2 34. Compensation paid for bedding, clothing, etc., stroyed Nil. 35. Seizures of unsound food Nil. GEO. R. BAILEY, Sanitary Inspector. Annual Report of the Medical Officer of Health for the year 1913, for the Urban District of liomsord, Essex, 011 the administration of the Factory and Workshop Act, 1901, in connection with Factories, Workshops, Workplaces, and Homework. 1.—Inspection of Factories, Workshops, and Workplaces. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections Written Notices. Prosecutions. Factories (Including Factory Laundries) 26 Workshops (including Workshop Laundries) 302 Workplaces (other than Outworkers' premises included in Part 3 of this Report) 17 Total 345 2.—DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecutions. Found Remedied Referred to H.M. Inspector Nuisances under the Public Health Acts : Want of Cleanliness 4 4 Want of Ventilation Other Nuisances Sanitary Accommodation Dirty condition 1 1 Offences under the Factory and Workshop Act: Breach of Special Sanitary Requirements for Bakehouses (as. 97 to 100). Total 5 5 28 3.—HOME WORK. NATURE OF WORK. OUT WORKERS' LISTS. Lists received from Employers. Once in the year. Twice in the year. Lists. Outworkers. Lists. Outworkers. Contractors. Workmen. Contractors. Workmen. Wearing- Apparel— Making-, &c. 14 18 2 2 Brush making 1 3 Total 15 21 2 2 4.—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. Number. Workshops 92 Workshop Bakehouses 14 Total number of workshops on Register 106 5.—OTHER MATTERS. CLASS. NUMBER. Matters notified by H.M. Inspector of Factories 1 Reports (of action taken) sent to H.M. Inspector 1 ALFRED WRlGHT, March 10th, 1914. Medical Officer of Health, 29 TABLE I. Vital Statistics ok Whole District during 1913 and previous Years. ROMFORD URBAN DISTRICT. Year. Population estimated to Middle of each Year. Births. Total. Deaths Registered in the District. Transferable Deaths. Nett Deaths Belonging To the District. Under 1 yr.of age At all Apes. Uncorrected Number. Nett. Number. Rate. of Nonresidents registered in the District. of Residents not registered in the District. Number. Rate per 1,000 Nett Births. Number. Rate. N umber. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1908. 16,300 418 25.6 285 17.5 108 11 38 90 188 11.5 1909. 16,600 418 25.9 291 17.8 111 6 35 78 186 10.3 1910. 16,900 393 23.1 283 17.6 105 4 27 68 180 10.5 1911. 17,100 412 397 23 325 17.6 132 15 49 123 208 12.1 1912. 17,600 391 401 22.2 289 16.4 121 9 33 84 177 10.03 1913. 17,850 413 389 21.8 283 15.8 101 29 21 54 211 11.8 Area of District in acres (land and inland water), 5629. Total population at all ages, 16,972 Number of inhabited houses, 4,050 Average number of persons per house, 4 At Census of 1911. 30 TABLE II. Casks of Infectious Disease notified during the Year 1913. in the. Romford Urban District. Notifiable Disease. Number of Casks notified. Total cases removed to Hospital. At all Ages. At Ages—Years. Under 1. 1 to 5. 6 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Small-pox ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup) 31 ... 8 12 8 3 ... ... 19 Erysipelas 28 ... ... ... 2 18 6 2 ... Scarlet Fever 30 ... 6 19 4 1 ... ... 20 Typhus Fever ... ... ... ... ... ... ... ... ... Enteric Fever 3 ... ... 1 1 1 ... ... 2 Relapsing Fever ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... Puerperal Fever 2 ... ... ... 1 1 ... ... ... Poliomyelitis 1 ... ... 1 ... ... ... ... ... Pulmonary Tuberculosis 37 ... 2 5 9 16 2 3 ... Other forms of Tuberculosis 25 ... 5 13 3 3 ... 1 ... Measles 227 ... ... ... ... ... ... ... ... Totals 384 ... 21 51 28 43 8 6 ... Rompord Joint Hospital, Rush Green, Dagenham Urban and Rural.) table III. Causes op, and Ages at Death during 1913 in the Romford Urban District. Causes of Death. Deaths at the subjoined ages ok "Residents" whether occurring in or beyond the district Total Deaths whether op "Residents" or 'non-residents ' in Public Institutions in the District All Ages. Under 1 year. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. All Causes Certified (c) 207 20 7 3 10 9 29 32 97 Uncertified 4 1 1 1 2 Enteric Fever 1 ... ... ... ... ... 1 ... ... ... Small-Pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... Scarlet Fever 2 ... ... ... 2 ... ... ... ... ... Whooping-cough 4 2 1 1 ... ... ... ... ... ... Diphtheria (including Membranous Croup) 2 ... 1 1 ... ... ... ... ... ... Influenza 4 ... ... ... ... ... ... 2 2 2 Erysipelas ... ... ... ... ... ... ... ... ... ... Phthisis (Pulmonary Tuberculosis) 13 ... 1 ... ... 3 6 2 1 17 Tuberculous Meningitis 3 1 1 1 ... ... ... ... ... ... Other tuberculous Diseases 6 1 ... ... ... ... 3 2 ... 2 Cancer, Malignant Disease 18 ... ... ... ... ... 3 4 11 9 Rheumatic Fever ... ... ... ... ... ... ... ... ... 1 Meningitis 1 ... ... ... 1 ... ... ... ... ... Orgauic Heart Disease 33 ... ... ... 1 3 1 3 25 25 Bronchitis 9 ... ... ... ... ... ... 1 8 8 Pneumonia (all forms) 12 3 2 ... ... ... 1 4 2 6 Diarrhoea and Enteritis 4 3 1 ... ... ... ... ... ... ... Appendicitis and Typhlitis 3 ... ... ... 1 ... 1 1 ... ... Cirrhosis of Liver 4 ... ... ... ... ... 1 3 ... 1 Nephritis and Bright's Disease 6 ... ... ... ... ... 4 ... 2 2 Puerperal Fever 1 ... ... ... ... 1 ... ... ... 1 Other accidents and Diseases of Pregnancy and Parturition 2 ... ... ... ... ... 2 ... ... 1 Congenital Debility and Malformation, includPremature Birth 11 11 ... ... ... ... ... ... ... 2 Violent Deaths, excluding Suicide 4 ... ... ... 2 ... 1 ... 1 3 Suicides 3 ... ... ... ... 1 ... 1 1 ... Other Defined Diseases 36 ... ... ... 1 5 9 18 20 Diseases ill-defined or unknown 3 ... ... ... ... ... ... 1 2 ... Senile Decay 26 ... ... ... ... ... ... ... 26 17 Totals 211 21 7 3 10 9 29 33 99 117 TABLE IV. INFANT MORTALITY, 1913.—ROMFORD URBAN DISTRICT. Nett Deaths from stated Causes at various Ages under One Year of Age. CAUSE OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-3 Months. 3-6 Months. 6-9 Months 9-12 Months. _ Total Deaths un der One Year. All Causes Certified 10 .... .... .... 10 4 2 2 3 21 Uncertified 1 1 1 Common Infectious Diseases. Small-pox .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Chicken-pox .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Measles .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Scarlet Fever .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Diphtheria Croup .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Whooping Cough .... .... .... .... .... .... .... .... 2 .... .... .... .... .... .... Diarrhœal Diseases. Diarrhœa, all forms .... .... .... .... .... .... 1 .... .... .... .... .... .... .... .... Enteritis. Mucoenteritis Gastro-enteritia .... .... .... .... .... 2 .... .... .... .... .... .... .... .... .... Gastritis, Uastrointestinal Catarrh .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Wasting Diseases. Premature Birth Congenital Defects 11 .... .... .... 11 .... .... .... .... .... .... .... .... .... .... Injury at Birth .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Want of Breast-milk Starvation .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Atrophy, Debility, Marasmus .... .... .... .... .... .... .... 1 .... .... .... .... .... .... .... Tuberculous Diseases. Tuberculous Meningitis .... .... .... .... .... .... .... .... 1 .... .... .... .... .... .... Tuberculous Abdominal ; Tabes Mesenterica .... .... .... .... .... .... 1 .... .... .... .... .... .... .... .... Other Tuberculous Diseases .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Atelectasis .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Other Causes. Erysipelas .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Syphilis .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Rickets .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Meningitis (not Tuberculous) .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Convulsions .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Bronchitis .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Laryngitis .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Pneumonia .... .... .... .... .... 2 .... 1 .... .... .... .... .... .... .... Suffocation, overlaying .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Other Causes .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Totals 11 .... .... .... 11 4 2 2 3 .... .... .... .... .... .... 22 Nett Births in the year, legitimate, 389; illegitimate, 6. Nett Deaths in the year, legitimate Infants, 18 ; illegitimate, 4.