Soug 00 SOUTHGATE URBAN DISTRICT COUNCIL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1898, by A. SIDNEY RANSOME, B.A., M.B., B.C., D.P.H., Cantab. Fellow of the Royal Institute of Public Health, Medical Officer of Health. enfield: Meyers, Brooks & Co., Ltd., Printers. 1899. TO THE MEMBERS of the SOUTHGATE URBAN DISTRICT COUNCIL. Gentlemen, I have the honour to present to you my report for the year 1898. The general health of the district during the past year was good, and consequently the death returns are, on the whole, satisfactory, and will compare favourably with those of the previous year and the country generally. A noticeable feature of the vital statistics is the fact that although the population of the district has increased by 1,000 since the previous year, yet the number of births was considerably less, and the birth rate is the lowest on record for the district excepting that of 1890, which was about the same. The Report of the Sanitary Inspector, Mr. J. VV. H. Brown, is appended to this Report, and constitutes, in my opinion, a most satisfactory record of sanitary work performed during the year. I am, Gentlemen, Your obedient Servant, A. SIDNEY RANSOME; March, 1899. 4 POPULATION. The population of the district estimated to the middle of the year 1898, was 14,000 (excluding the occupants of the Metropolitan Asylums' Board Hospital, at Winchmore Hill). This estimation was obtained by taking the number of occupied houses in the rate books, and allowing ing an average of 5½ occupants to each. This is probably a minimum allowance for the district, and was purposely taken as a basis for calculation, so as not to make the vital statistics appear more favourable than they really are, as would be the case if the population was overestimated. This was an increase of 1,000 over that of the previous year, and was almost entirely due to the number of fresh people who have taken up their residence in the numerous houses that have recently been built in the district, more especially in the neighbourhood of Palmers Green. The natural increase of the population, by excess of births over deaths during the year, was only 160. Number of People to the Acre.—The area of the district amounts to 3,836 acres, which with a population of 14,000, gives an average of only 3.9 persons to the acre, although on the other hand the population is very unevenly distributed over this area. BIRTH RATE. During the year there were 310 births registered in the district, a decrease of 17 on the previous year. This gives a birth-rate of only 22.1 per 1,000 of the population, which is a very low one. The birth-rate for England and Wales was 29.4. The average rate for the previous 10 years was 25.9, as against 30.5 for England and Wales. MORTALITY. General Mortality and Death-Rate.—The number of deaths registered in the district (excluding 11 which occurred at the Metropolitan Asylums Board Hospital at Winchmore Hill) was 150, a decrease of 8 on the preceding year, and gives a death-rate of 10.7 per 1,000 of the population. This is a very satisfactory death-rate, the corresponding rate for England and Wales being 17.6. The average rate for the previous 10 years was 12; while that for England and Wales was 18.2. 5 Infantile Mortality.—There were 37 deaths registered of infants under one year of age. The infantile death-rate was, therefore, 122 per 1,000 of the births registered as against 147 per 1,000 in the preceding year. The rate for England and Wales for the past year was 161. These deaths form 24.6 per cent. of the total number of deaths, a decrease of 5 per cent. on the preceding year, while the average rate for the previous 10 years was 24.8 per cent. Senile Mortality.— There were 36 deaths, a proportion of 24 per cent. of the total number of deaths, of persons of 65 years of age and upwards, an increase of 2 5 per cent. on the preceding year. Of these deaths no less than 22 were of persons of 75 years of age and over, a fact which speaks well for the healthiness of the district. The average rate for the previous 10 years was 22.6 per cent. The Causes of Death.––These are fully set forth in Table A of the Local Government Board, in which it will be noticed that Winchmore Hill furnishes far fewer deaths in proportion to its population than any of the other three sub-districts. This is, to a great extent, accounted for by the fact that there is a much smaller proportion of the poorer classes residing there than in the other subdistricts, and it is amongst this class that the greatest mortality occurs. The causes of infantile mortality were as follows:— Diarrhœa 10 Diseases of Respiratory Organs 6 Convulsions 5 Prolonged and Premature Birth 8 Marasmus 3 Whooping Cough 1 Tuberculosis 1 Septiœmia 1 Heatstroke 1 Tetanus neonatorum 1 37 Many of these causes are preventible, and are due to the lack of intelligent parental control, and hygienic surroundings, the remedy for which can only be looked for in the better education of parents of the poorer classes in the rearing of their children and general laws of health. 6 Zymotic Mortality.—There were 27 deaths, a percentage of 18 of the total number of deaths against 19.6 in the preceding year, due to the 7 principal zymotic diseases, viz , Diphtheria 1, Typhoid Fever 3, Diarrhoea 13, Measles 3, Whooping Cough 6, Puerperal Fever 1. The zymotic death-rate was, therefore, 1.9 per 1,000 of the population, against 24 in the preceding year; whilst that for England and Wales was 2.2. The average rate for the previous 10 years was 10.7 per cent. of the total number of deaths, and 1.2 per 1,000 of the population. Inquests held during the year on deaths that have occurred in the Southgate District.—There were 9 inquests, and the causes of death were as follows:— Natural Causes, 6; Accidental 3; and Suicide, 1. Public Mortuary and Post Mortem Room.—I am glad to report that a very adequate public mortuary and separate post mortem room, the need of which for so long a time has been felt in the district, have now been provided, and arrangements made for inquests to be held at the Council's Offices, much to the convenience of the Coroner and all others concerned. It is a matter for congratulation that post mortem examinations made in stable outbuildings, and inquests held at public-houses will now be a thing of the past. Table A.—Table of DEATHS during the Year 1898, in the Southgate Urban District, classified according to Diseases, Ages and Localities. Names of Localities adopted for the purpose of these Statistics: public institutions being shown as separate localities. Mortality from am. Causes at Subjoining Ages. Mortality from subjoined causes, distinguishing Deaths of Children under Five Years of Age. At all Ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25.1 25 and under 65. 65 and upwards. Scarlatina. Diphtheria. Fevers. Measles. Whooping Cough. Diarrhœa and Dysentry. Rheumatic Fever. Phthitis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease. Influenza. Injuries, All other Diseases. Total. Enteric or Typhoid. Puerperal. Southgate 58 11 6 1 2 23 15 Under 5 •• ... 2 5 ... 3 2 1 7 17 5 upwds. 1 1 1 7 4 24 41 New Southgate 33 9 2 3 2 7 1° Under 5 ... ... ... 2 ... 1 ... 2 ... ... 6 11 5 upwds. 1 1 3 4 13 22 Winchmore Hill 22 5 2 0 0 9 6 Under 5 ... ... ... ... ... 2 9 ... ... ... 3 7 5 upwds. 1 2 1 3 8 15 Palmers Green and Bowes 37 13 7 2 2 8 5 Under 5 ... ... 1 4 ... ... 10 19 5 upwds. 1 i 1 1 3 2 1 8 18 Totals 150 37 18 6 6 48 36 Under 5 ... 1 ... 3 6 10 9 26 65 5 upwds. 3 3 2 6 13 4 8 2 53 95 The subjoined numbers are not taken into account in judging of the above records of mortality. Deaths occurring within the district among persons not belonging thereto. 12 6 4 2 Under 5 2 4 6 5 upwds 1 1 ... ... 1 ... ... 1 ... ... ... ... 1 1 6 8 TABLE A 1. Vital Statistics for the year 1898 tabulated. Estimated Population 14,000. (Last Census 10,970.) Area of District 3,836 acres. Births. 310 Birth rate (per 1000 of the population). 22.1 Deaths. 150 Death-rate (per 1000 of the population). 10.7 Infantile death-rate (deaths under 1 year per 1000 births registered). 122 Zymotic death rate (per 1000 of the population). 1.9 Percentages of Deaths to Total Deaths. Under 1 year. 24.6 Over 65 years. 24 0 The seven principal Zymotic diseases. 18.0 Phthisis. 4.0 Other diseases of respiratory organs. 14.0 Cancer. 6.6 Influenza. 5.3 Measles. 2.0 Diarrhoea. 8.6 Whooping Cough. 4.0 The II deaths which occurred at the Metropolitan Asylums Board Hospital, at Winchmore Hill, are not taken into account in this table. 9 TABLE A 2. Comparison of the Vital Statistics of the Southgate District with those of England and Wales, and London, for the Year 1898. RATES PER 1000 OF THE POPULATION. Birth-Rate. General Death-Rate. Infantile Death-Rate (per 100 Births.) Zymotic Death-Rate. Small-pox Death-Rate. Scarlet Fever Death-Rate. Diphtheria Death-Rate. Diarrhoea Death-Rate. Measlee Death-Rate. Whooping Cough Death-Rate England and Wales 29.4 17.6 161 2.22 .01 .11 .24 .96 .41 .31 London – 18.7 167 2.78 .00 13 .39 .97 .68 .48 Southgate District 22.1 10.7 122 1.9 .00 .00 .07 .90 .21 .42 TABLE A 3. The Principal Vital Statistics of the Southgate District for the past 10 Years. Birth-Rate. Death-Rate. Zymotic Death-Rate. Infantile Death-Rate. Per 1000 Births. Percentage t0 Total Deaths. 1889 25 10.1 .2 100 23.8 1890 21.8 10.5 1.7 116 25.3 1891 28.8 14.3 1.2 114 22.9 1892 26.2 12.5 .78 115 24.3 1893 27.7 13.4 1.4 95 19.5 1894 25.8 11.5 2.3 133 22.9 1895 30.3 13.4 .8 156 35.4 1896 25.2 9.3 1.0 80 21.3 1897 25 12.1 2.4 147 3 0.0 1898 22.1 10.7 1.9 122 24.6 10 TABLE B.— Table of Population, Births, and of New Cases of Infectious Sickness, coming to the knowledge of the Medical Officer of Health during the year 1898, in the Southgate Urban District; classified according to Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics; public institutions being shown as separate localities. Population at all ages Registered Births. Aged under 5 or over 5. New Cases of Sickness in each Locality, coming to the knowledge of the Medical Officer of Health. Number of such Cases removed from their Homes in the severa Localities for Treatment in Isolation Hospital. Last Census. 1891 Estimated to middle of 1898. Scarlatina. Diphtheria. Fevers Erysipelas. Scarlatina. Diphtheria. Fevers Erysipelas. Enteric or Typhoid. Puerperal. Enteric or Typhoid. Puerperal. Southgate 3027 3550 79 Under 5 3 2 Totals ... 1 ... ... ... ... ... 5 16 5 upwds 5 1 1 4 11 New Southgate 3102 3381 88 Under 5 3 3 26 4 1 ... ... ... ... ... 5 upwds 15 3 2 ... 3 23 Winchmore Hill 2762 3656 68 Under 5 ... 1 ... ... 1 5 5 upwds 2 2 4 Bowes 1731 3413 75 Under 5 2 3 ... ... 5 32 1 ... ... ... ... ... ... 5 upwds 10 13 4 27 Metropolitan Asylums Board Hospital at Winchmore Hill 348 800 Under 5 [3119 854] ... ... ... ... ... ... ... ... ... ... ... 5 upwds Totals 10970 14000 310 Under 5 8 5 1 ... ... 14 79 ... ... ... ... ... ... ... 5 upwds 27 21 9 1 7 65 ... ... ... ... ... ... ... ‡ These Figures are not taken into account in estimating the population of the District. "Notification of Infectious Disease" has been compulsory in the District since 1889. The Isolation Hospital used by the District is situated at Enfield (outside the District). 11 INFECTIOUS DISEASES AND THE MEANS TAKEN TO PREVENT THEIR SPREAD. On referring to table B. it will be seen that 79 cases of infectious disease were notified during the year, as against 102 in the previous year. Of these, 16 were from Southgate, 26 from New Southgate, 32 from Bowes and Palmers Green, and 5 from Winchmore Hill. These cases represent infection in 64 different houses, 54 of which were subsequently disinfected by the Sanitary Authority. In all cases disinfectants were supplied, instructions given as to the carrying out of isolation as efficiently as possible, and the sanitary conditions of the premises inspected, in 11 of which defects were found. These have all been remedied, after the serving of notices. Five cases of Scarlet Fever were removed to the Enfield Infectious Hospital—4 from New Southgate and 1 from Bowes—whilst two cases of Diphtheria were removed to other hospitals. Many more cases, which required it, would have been removed if accommodation for them had been forthcoming, but unfortunately this was not so; consequently they had to be isolated at home as well as circumstances would permit, often, perforce, most inadequately. This state of things, especially now that the district is so rapidly increasing in population, urgently calls for the erection of our own Infectious Hospital as speedily as possible. In order to check the spread of, and danger resulting from Measles and Whooping Cough as much as possible, I adopted, with your sanction, the following plan, which I consider is more practicable and efficient and very much less costly than compulsory notification would be under the Infection Diseases Notification Act. (1) The School Attendance Officers, who find at once the cause of the absence of any child from school, were supplied with stamped and addressed forms on which to send to me the names and addresses of any child absent from school suspected of suffering from infectious disease, especially Measles and Whooping Cough. In this way from September, when the system was begun, to the end of the year, the occurrence of 10 cases of Measles (as well as 15 cases of Chicken-pox), were brought to my notice, many of which I should otherwise probably not have known of, even if Measles were notifiable. (2) A handbill was drawn up pointing out the nature of these diseases, the dangers liable to result therefrom, the 12 methods to be adopted to check their spreading to other children, and how to avoid, or minimise as much as possible, the dangerous complications that may arise. Whenever a case of Measles or Whooping Cough becomes known to me copies of these handbills are left at the house and also at all neighbouring houses. Now as those chiefly attacked by these complaints are children, it is confidently hoped by this system—which aims at just that class whose parents often do not call in a doctor, regarding Measles and Whooping Cough as trivial and unavoidable complaints of childhood, and do not take sufficient care to check their spread to other children or to guard against the complications that may arise—to considerably check the spread of these diseases and the mortality resulting from them. Small Pox.—No cases were notified. Scarlet Fever.—There were 35 cases notified from 28 houses—18 from New Southgate, 12 from Bowes, 3 from Southgate, and 2 from Winchmore Hill. Two of the cases were directly imported. The general type of the disease was very mild, and no deaths occurred. Diphtheria.—There were 26 cases notified from 18 houses—16 from Bowes, 7 from Southgate, and 3 from New Southgate. The type of this disease also was generally mild, but caused 1 death. In 9—i.e., one-half — of the infected houses sanitary defects were found. Two of the cases were imported. The 16 cases from Bowes were not confined to any one street or group of houses, and had no apparent connection or common cause. Four of the cases were from one house. Typhoid Fever.—There were 10 cases notified from 10 houses—4 from Bowes, 3 from Winchmore Hill, 2 from New Southgate and 1 from Southgate. There were 3 deaths. In two of the infected houses sanitary defects were found. Four of the 10 cases were clearly imported, and in one case the infection was traced to the eating of oysters. Puerperal Fever.—There was only 1 case notified. The patient was attended by a midwife, and the case ended fatally. The house was subsequently disinfected, and the 13 midwife forbidden to attend any further case for at least one month. Erysipelas.—There were 7 cases notified—4 from Southgate and 3 from New Southgate. There were no deaths. Diarrhoea was very prevalent during the prolonged heat of the summer, and caused 13 deaths, or 8.9 per cent. of the total number of deaths, in 10 of which the victims were infants under one year of age. This is equal to a rate of .9 per 1,000 of the population. The same rate for England Wales was .96. Measles.—There was very little Measles during the year in any part of the district excepting quite at the beginning of the year at New Southgate, where an epidemic had broken out in the last quarter of the previous year, which ended in January of last year, causing 2 deaths in that month. During the rest of the year only 1 death was recorded. This immunity from Measles during the past year was no doubt due to the general prevalence of the disease the year before, culminating in the above-mentioned epidemic at New Southgate, whereby the majority of those susceptible to the disease contracted it. Hence there was very little susceptible material left last year. The question of adding Measles to the list of notifiable diseases was again brought before your notice in the form of a motion proposed by one of your members that it should be. I recommended you not to do so for reasons of which the following are the chief. (1) The main object of Notification is to check the spread of disease by the prompt information to the Sanitary Authority of the occurrence of the earliest cases, so that steps can be taken to prevent their spread by immediate isolation of these first cases, and if necessary by the closing of the schools. But in the case of Measles this object is defeated, because it is during the first four days of indefinite illness before the chaacteristic rash appears by which Measles declares itself, that it is most infectious : and, therefore, by the time information of the earliest cases can be received and acted upon the infection has had time to spread widely, and notification is then too late to be of any service. (2) The chief mortality from Measles is amongst the poorer classes, who are chiefly responsible for the bulk of the spread, 14 and in whose dwellings isolation is generally quite impossible ; and therefore, if isolation is to be carried out efficiently (without which notification is robbed of three-fourths of its value) sufficient isolation accommodation must be provided. This would be quite impracticable, owing to the large numbers (and those mostly very young children) that are attacked at once when Measles breaks out, thereby rendering necessary the provision of a very large amount of isolation accommodation and administrative staff at an enormous cost, that for many months at a time would not be required at all. (3) Many cases would never be notified, because parents often do not call in a doctor for Measles, and even if they were notified, mothers would frequently refuse to part with their children at the tender age at which they are mostly attacked. After due discussion the motion was withdrawn, and it was unanimously agreed not to add Measles to the list of notifiable diseases, but to adopt the system described in an earlier part of this Report. Whooping Cough.—An extensive epidemic of this disease broke out in June, more especially in the district of Chase Side, Southgate, making it necessary for me, in order to check the spread of the disease, to recommend the School Authorities to close the Schools in Southgate for a period ot six weeks, i.e., to the end of the Summer term. This was accordingly done, and, as far as could be judged, had a marked effect in checking the spread of the disease. By the end of the summer holidays the epidemic had practically died out, and the schools at the beginning of the winter term were on the whole well attended. This epidemic caused 6 deaths. Influenza.—Although no serious outbreak occurred, influenza was more or less prevalent throughout the year, and caused altogether 8 deaths. Tuberculosis.—There were n deaths due to tubercular diseases (including phthisis). This is a proportion of 7^4 per cent, of the total number of deaths, and is equal to a rate of '8 per 1000 of the population. Of these deaths 5 occurred at New Southgate, 3 at Bowes, 2 at Southgate, and 1 at Winchmore Hill. It will be noticed, therefore, that the majority of the deaths took place in the most populous parts of the district, as would be expected from the nature of the disease. Many of these deaths, 15 together with the large amount of permanent ill-health that they represent, are preventible; and, although the death-rate from this disease in this district will compare favourably with that of the country in general—which is over 2 per 1000 of the population—yet there is reason to hope that it may be considerably lowered. During the past year a national crusade against Tuberculosis was inaugurated under most distinguished auspices, and it behoves you, as Guardians of the health of this district, to forward this good work by every means in your power. It is right, therefore, that I should take this opportunity of dwellingupon this important matter. Tuberculosis is now a recognised infectious disease, due to the entrance into the body from without of a germ or microbe, either directly from man to man or indirectly through food, especially milk and meat. The disease being proved to be infectious, it is of the greatest importance that disinfection should be thoroughly carried out. I therefore beg to offer the following suggestions for your consideration and trust that you will sanction their being carried out. (1) That a circular letter be sent round to all the medical men in the district pointing our that the Council is prepared to disinfect, free of cost, all rooms recently occupied by persons suffering from Tuberculosis, and that a similar letter be sent to the occupiers of those houses in which deaths from Tuberculosis are reported to me week by week by the Registrar. (2) The issuing of leaflets, pointing out in simple language the nature and danger of the disease and the ready means at hand for its prevention, for distribution where it may be considered useful. For this purpose the co-operation of Clergymen, District Visitors, School Teachers and others might be advantageously sought. With regard to the spreading of Tuberculosis bv infected milk and meat—especially, and to an alarming extent, by milk—preventive measures in respect of these two sources of infection must be left to Parliament to legislate for the whole of London and the country generally. All that can be done at present is to continue looking carefully after the sanitary condition of cowsheds, dairies and slaughter-houses in the district. Measures for the more stringent examination of animals before and after slaughter, for the systematic carrying out of the tuberculin test, for the establishment of public in place of private slaughterhouses, and for the protection of milk by a systematic 16 bacteriological examination of doubtful samples, etc , belong clearly to a Central Authority. Infectious Disease Hospital.—The plans have been prepared in accordance with the regulations and suggestions of the Local Government Board. Quantities are being got out, and tenders will shortly be invited, and the commencement of the building operations may be expected at an early date. Return of the Metropolitan Asylums Board Hospital.—During the past year 3973 cases were admitted to the Hospital. Of these 3119 were Scarlet Fever and 854 Diphtheria. The total number of deaths was 11, of which 2 were due to Scarlet Fever, 1 to Diphtheria, 5 to Measles, following on Scarlet Fever, one to Rheumatic Fever, and 1 (a nurse) to Gastric Ulcer. SEWERS. The work of reconstructing the various branch sewers, principally at New Southgate, has been completed Nearly every house draining into them has had the house drains entirely reconstructed on the dual system, and numerous ventilating shafts have been erected. The work of laying the new main sewer in the Green Lanes is well advanced. These are great and much-needed improvements, and will, no doubt, have a beneficial effect on the health of the district. Flushing of the sewers has been systematically carried out, and very few complaints have been received of bad smells arising from sewer ventilators. The chief complaint was of the ventilating shafts close to the head of the sewer in the High Street, Southgate. This matter was thoroughly investigated, and, according to my recommendation, the head of this sewer has been flushed daily from that time, instead of weekly, as heretofore. Since then no further complaints have been received. WATER SUPPLY. Wells. —Owing to the prolonged drought of last summer, many of the wells constituting the only souice of water to the premises in which they are situated became very short of water, 17 and in some cases quite dry, most of these wells being surface wells only. After the drought ended, and the wells had re-filled, samples of the water from wells supplying 27 different premises situated on the Chase, Southgate, were submitted to me by the Sanitary Inspector, and, being regarded with suspicion, were sent to the County Analyst for examination. All, with one exception, were found to be unfit for dietetic purposes, and were consequently condemned, and the wells from which they were taken were ordered to be closed, and the New River Company's water to be laid on. Watercourses.—During the summer the condition of some of the watercourses, especially Pymmes Brook, was most offensive, owing partly to the prolonged drought. Numerous inspections were made at different times by myself and the Sanitary Inspector, and large quantities of crude sewage were found in Pymmes Brook, which no doubt came from the East Barnet Sewage Farm. On my reporting this matter to you, the Middlesex County Council was communicated with, and caused a thorough examination of the Brook to be made, and were the means of urging the East Barnet District Council to take steps to prevent the contamination ot the Brook by their sewage. As a result of this some improvement has taken place, but the Brook is still much polluted, and it is to be hoped that the Middlesex County Council will take further steps to prevent a repetition of the most serious condition the Brook was in last summer, and the continual nuisance it has been to the district for so many years. Several other brooks were cleaned out when their condition was pointed out to those responsible for them. Housing of the Working Classes Act.—Plans have been prepared for the erection of twelve cottages under this Act at Highfield Eow, Winchmore Hill. Such cottages, built on hygienic principles, are much needed, and I trust that, as opportunity arises, you will see that the many obsolete and unhygienic cottages that still remain about the district are replaced by such model dwelllings. Roads,—The work of making up Palmerston, Marlboro', Granville and Pymmes Roads at Bowes Park, under the 150th section of the Public Health Act, has been completed, and is a great improvement to that part of the district. 18 NOTES ON SANITARY WORK PERFORMED DURING THE YEAR. 1976 Inspections were made, and a large number of sanitary improvements have been carried out. 229 Notices were served for the abatement of nuisances, remedying sanitary defects, insufficient water supply, cleansing premises, etc., and refer to about 492 houses and premises. Nine Cottages have been closed as unfit for human habitation, as the result of representations made to the respective owners by the Council. Thirteen Cottages have been demolished, and eleven new ones erected on the same sites. All the Cowsheds, Dairies, Slaughterhouses, and Bakehouses of the district have been inspected periodically, and are kept, on the whole, in a satisfactory condition, in accordance with the Bye-laws. URBAN DISTRICT COUNCIL OF SOUTHGATE. Table of Sanitary Work, 1898. Sanitary District, Southgate. INSPEC HONS. Complaints Received 61 Cases of Infectious Disease Notified (visits) 237 Number of Premises periodically Inspected 180 Houses Inspected from House to House 152 Total Number of Houses, Premises, &c., Inspected 629 Total Number of Re-Inspections after Order or Notice 1347 Total Number of Inspections and Re Inspections 1976 NOTICES. Letters Written 376 Cautionary Notices Given 193 Statutory Orders Issued 36 Summonses Served — Convictions Obtained — DWELLING HOUSES. Houses, Premises, &c., Cleansed, Repaired, &c. 96 Closed as unfit for Habitation 9 Reopened after Repairs, Alterations, &c. — Demolished 13 MOVABLE DWELLINGS, CARAVANS, TENTS, &c. Number of Nuisances therefrom Abated — Number Removed from District 157 URBAN DISTRICT COUNCIL OF SOUTHGATE. Table of Sanitary Work, 1898. Sanitary District, Southgate. SCHOOLS. Number in District 6 Periodical Frequency, or Number of Inspections Freqt. Number found Defective 1 BAKEHOUSES. Number in District 11 Periodical Frequency, or Number of Inspections Freqt, Contraventions of Factory Acts — SLAUGHTER-HOUSES. Number on Register 7 Periodical Frequency, or Number of Inspections Freqt. Contraventions of Bye-Laws — COWSHEDS. Number on Register 12 Periodical Frequency, or Number of Inspections Freqt. Contraventions of Bye-Laws — DAIRIES AND MILKSHOPS, Number on Register 17 Periodical Frequency, or Number of Inspections Freqt. Contraventions of Bye-Laws — MORTUARIES. Accommodation 1 Number of Bodies Received 1 Note.—Mortuary nob completed until Dec., 1898. URBAN DISTRICT COUNCIL OF SOUTHGATE. Table of Sanitary Work, 1898. Sanitary District, Southgate. WATER SUPPLY AND WATER SERVICE. Wells. New Sunk — Cleansed. Repaired, Etc. — Closed as Polluted — Houses, Water Laid on to 27 Percentage of Houses Supplied from Main — Cisterns. New, Provided — Cleansed. Repaired, Covered, Etc. 41 Overflow Pipes Disconnected from Drains — Flush Cisterns provided to W C.'s 93 Draw Taps Removed from Cisterns to Mains 116 Percentage of Houses Supplied on Constant System 97% EARTH CLOSETS. Water Closets Substituted for Dry Receptacles Water Closets. DRAINAGE AND SEWAGE. New Constructed 3 New Apparatus Provided 143 Repaired, Cleansed, Etc. 89 Supplied with Water, or Supply Rendered Efficient 44 Ventilated – Percentage of Houses Provided with Water Closets Practically the w'le. Drains. Examined, Tested, Exposed, Etc. 97 Unstopped, Repaired, Trapped, Etc. 30 Waste Pipes, Rain Water Pipes, Etc., Disconnected. 172 Soil Pipes and Drains Ventilated. 123 Disconnecting Traps or Chambers Inserted 155 Reconstructed 142 Cesspools. Rendered Impervious, Emptied, Cleansed, Etc. 2 Abolished, and Drain connected with Sewer — Percentage of House Draining into Sewers 99% Sewers. Yards of New Sewers Laid — Yards of Sewers Reconstructed 1500 URBAN DISTRICT COUNCIL OF SOUTHGATE. Table of Sanitary Work, 1898. Sanitary District, Southgate. DISINFECTION. Rooms Fumigated 64 Rooms Stripped and Cleansed 61 Articles Disinfected or Destroyed 26 DUST. Dust-bins Repaired — New Movable Bins Provided 105 Periodical Frequency of Dust Removal Weekly Number of Complaints of Non Removal Received 21 Roofs Repaired, &c. 61 DAMPNESS. Guttering and Rain Pipes Repaired, &c. 47 Gardens, Area, &c., Levelled and Drained 5 Yards Paved and Drained 129 Surface adjoining Houses Paved — Dry Areas Provided 1 Ventilation below Floor Provided 63 Basements Rendered Impervious 1 SUNDRY NUISANCES ABATED. Overcrowding 3 Smoke 1 Accumulations of Refuse 9 Foul Ditches, Ponds, &c., and Stagnant Water 3 Foul Pigs and other Animals 2 Other Nuisances 6 J. W. H. BROWN, Sanitary Inspector. SOUTHGATE URBAN DISTRICT COUNCIL. OFFICES : PALMERS GREEN, N. Measles and Whooping Cough. Important Advice to Parents and Guardians. Measles and Whooping Cough are very infectious, and although, when care is taken, generally mild diseases, are very liable to be attended with dangerous complications; chiefly on this account, these diseases cause many deaths, and in London alone over 2,500 deaths each occur every year from Measles and Whooping Cough. These two diseases, therefore, kill more children than Typhoid Fever, Smallpox, and Diphtheria combined; and where death does not result, it may happen, through neglect, that the child's constitution is injured for life. Most of these deaths and permanent ill effects could be easily prevented if those in charge of children possessed the necessary knowledge and exercised the necessary care, and the object of this handbill is to shew how children may be saved from permanently weakened constitutions or death when Measles or Whooping Cough attacks them. How to tell when a Child has caught Measles. About a week after exposure to the infection the child becomes unwell and feverish, with red and watery eyes, running at the nose, and sometimes headache, sneezing, and a slight cough—just as if the child had caught a bad cold. Not till 3 or 4 days after this does the rash appear, beginning on the face and rapidly spreading over the whole body, and gradually dying away again in 3 or 4 days. Dangerous Complications which may arise from Measles- The chief danger is from inflammation of the lungs. Sometimes also inflammation of the eyes or ears occur, which may lead to blindness or deafness. What to do when a Child has caught Measles. As soon as Measles is suspected, the child should be separated from all other children, clothed in a flannel garment, put to bed in a warm room out of all draughts, and a doctor consulted. Owing to the frequency of grave complications, parents or guardians who neglect to place their children under medical care act very unwisely and wrongly. While feverish and thirsty the child may have as much cold water or home-made lemonade as it likes, in small quantities at a time. The diet should be light and nutritious. It is very important to keep the child warm and confined to one room until convalescent. When the child is up and about again it should be very carefully guarded against chills for some weeks. Manuel should be worn next the skin, and if the child does not soon regain its good health, medical advice should be sought. How to tell when a Child has caught Whooping Cough. Whooping Cough also begins like a cold, with feverishness and a dry cough. The cough gradually becomes more noisy and occurs in sudden outbursts, ending generally with the well-known whoop, the face becoming dusky and the eyes watery. Often the child coughs itself sick. Sometimes there is no whoop, and very young children often do not whoop at all. In between the attacks of coughing the child often appears quite well. Dangerous Complications which may arise from Whooping Cough. The chief cause of danger in Whooping Cough, as with Measles, is from inflammation of the lungs. Many also die from convulsions. What to do when a Child has caught Whooping Cough. As soon as Whooping Cough is suspected the child should be kept apart from all other children and a doctor consulted. If really ill with the complaint, the child should be put to bed clothed in flannel, in a warm airy room; but otherwise, the child should not be confined even to the house, but, when the weather permits, should be in the open air as much as possible, away from other children. Light and nutritious food should be given at frequent intervals, and especially directly after sickness, so that as much nourishment may be absorbed before the child is sick again. When the caugh goes on for two months or more nothing does so much good as a change of air, and, when possible, this should be obtained. How to stop the Spread of Measles and Whooping Cough. Seeing that Measles and Whooping Cough cause so many deaths, we are morally bound to do all in our power to prevent other children catching it when it occurs in our homes. It is necessary, therefore, to bear in mind the following facts: (1) That Measles is most infectious during the stage when the child appears to have a bad cold only, and before the rash comes out. Therefore when Measles is about parents should keep any child, with symptoms of a bad cold, apart from others for 3 or 4 days. (2) That Measles and Whooping Cough remain infectious till the child gets well, usually 2 or 3 weeks for Measles and 6 weeks for Whooping Cough, and the infection is carried by the breath, discharges, and clothing. To protect others, the child must be kept quite apart from other children as soon as it is suspected of sickening from Measles or Whooping Cough until it is well again. It will not always be possible for parents to do this, but every healthy child under 4, and every delicate child must always be protected from the infection to the very utmost, for the risk of these diseases ending fatally is especially great in such. When there is Measles or Whooping Cough in a house, the children living there should not be allowed to mix with other children, or to attend day or Sunday School, or places of worship or amusement, and it is dangerous for the parents to visit among their friends, or to receive visits (especially of children). Disinfection. On recovery of the patient, the room requires a little simple disinfection. It generally suffices if the bedding and clothing are hung over the chairs and bed, the windows and doors are thrown wide open, and the fresh' air allowed to blow through the room for about six hours, after which the child's body linen and bed linen should be well boiled in the copper, and the floors, window sills, mantle pieces, shelves, cupboards, drawers, tables, and chairs scrubbed with plenty of soap and water. (Signed) A. SIDNEY RANSOME, M.B., D.P.H., Camb., The Medical Officer of Health