5049 008 Southgate Urban District Council. REPORT OF THE Medical Officer of Health, FOR THE YEAR i909, BY A. SIDNEY RANSOME, B.A., M.B., B.C., D.P.H., Cantab., Fellow of the Royal Institute of Public Health, Member of the Incorporated Society of Medical Officers of Health, MEDICAL OFFICER OF HEALTH. BARNET: E. Cowing & Son, Printers, "Press" Office. i9i0. To the Members of the Southgate Urban District Council. Gentlemen, I have the honour to present to you my Report for the year i909, to which is appended the Report of the Sanitary Inspector, Mr. J. W. H. Brown, which, as usual, constitutes an excellent record of good and useful sanitary work done by him and his assistants during the year, and to whom my thanks are due for valuable assistance in compiling this Report. I should also like to tender my thanks to the Health and Hospital Committee for their unfailing courtesy and support throughout the year. I am, Gentlemen, Your obedient Servant, A. SIDNEY RANSOME. February, i9i0. 3 DESCRIPTION AND TOPOGRAPHY OF THE DISTRICT. THE Urban District of Southgate is formed by a number of hamlets, previously—and some of them even now—called "villages." It is partly situated on what is sometimes called the Northern Heights, about eight miles from London, and is rapidly becoming essentially suburban in character. The District comprises an area of 3,596 acres, and may be said to consist of three valleys, running from west to east, the northern areas being somewhat higher than the southern, and the whole consisting of very undulating ground dipping off to a rather flat area on the eastern boundary, adjoining the Edmonton district. The highest Ordnance level is on the Enfield Road, and is 302 feet ; whilst the lowest is near the south.eastern boundary, and is 6i feet. The subsoil consists of various clays with large pockets of gravel and sand. On the south side is a bed of brick earth overlying a deep bed of gravel, which forms excellent building land, on which a building estate has recently been opened. Beneath these strata are beds of London clay, black sand, and chalk, more or less water.bearing, and from which the deep wells and borings of the New River Company derive their supply. The District may be roughly divided into four localities : (i) Southgate, (2) Winchmore Hill, (3) a large part of New Southgate and Bounds Green, and (4) Palmers Green and a large part of Bowes ; hitherto more or less distinct localities, but which, by continually and rapidly growing and extending, are gradually overlapping and becoming merged one into the other, more especially the two latter. The District is now, however, more' conveniently dealt with in the two county divisions of North and South South. gate, the dividing line of which passes from the Edmonton boundary in Hedge Lane, along Hedge Lane, and up Bourne Hill to Chase Side Corner, Southgate. This is a more or less natural boundary line with the major part of Southgate and Winchmore Hill, the more rural parts of the District, on the north side of the line, and Palmers Green, Bowes Park, and New Southgate, the more urban part of the District, on the south side. For the purposes of local administration the District was in i906 divided into four wards, which correspond roughly with the four localities above.mentioned, two wards in North South. gate and two in South Southgate. 4 POPULATION. The census returns of i90i showed that in this District the number of inhabitants to each occupied house averaged from 5T to 5.3 according to the locality. Taking this as the basis of calculation, the population at Midsummer, i909, was 35,000, an increase of 3,000 over that of the previous year. This increase is chiefly accounted for by the number of new houses occupied during the year, of which there were 46 in North Southgate and 383 in South Southgate. The natural increase of the population by excess of births over deaths was 442, as against 4i9 in the previous year. The population of North Southgate was i0,500, and that of South Southgate was 24,500. BIRTH—BIRTH.RATE. During the year 687 births were registered, an increase of 28 over the preceding year. This gives a birth.rate of i96 per i,000 of the population, a decrease of l.0 per i,000 on the preceding year. The average rate for the previous i0 years was 22.6. The birth.rate for North Southgate was 20.2, and that for South Southgate was i9.3. The birth.rate in England and Wales was 25.6, which is the lowest rate on record; compared with the average of the previous i0 years the birth.rate in i909 showed a decrease of 2.2 per i,000. MORTALITY. General Mortality and Death.rate.—The number of deaths which occurred in the District during the last year was 2i0. To these must be added the deaths of 40 "residents" who died in Institutions outside the district —i3 in Edmonton Union; 5 in Napsbury Asylum; 3 in the Great Ormond Street Children's Hospital; 2 in the Passmore Edwards' Hospital, Wood Green; and i7 in the various London Hospitals and Institutions; whilst the death of 5 "non.residents" who died in the District—2 in the Metropolitan Asylums Board Hospital, Winchmore Hill, and 3 elsewhere—must be subtracted, leaving a nett total of deaths belonging to the District of 245. The crude or recorded death.rate was therefore 7 0 per i,000 of the population. In order to obtain the corrected death. rate for the purposes of accurately comparing the death.rate with that of other Districts, it is necessary, in addition to the above corrections, to take into consideration the age and sex distribution of the population. 5 The "factor for correction" for this District is i.045. The corrected rate is obtained by multiplying the crude or recorded death.rate by this factor. The corrected death.rate was 7.3, a decrease of .5 per i,000 on the rate of the preceding year, and 2 3 below the average corrected rate for the previous i0 years. This is the lowest death.rate on record for this District. As compared with the previous year, there was a considerable increase in the rate of deaths from Measles, Influenza, and Diseases of the Respiratory Organs; and a very marked increase in that from Bright's disease—while there was a decided decrease in the rate of deaths from Scarlet Fever and Infantile Diarrhoea' In explanation of the above, it is very probable that the inclement weather experienced last year played an important part both in the increase of mortality in the diseases above mentioned, and also in the entire absence of deaths from Diarrhoea, to which a cold wet summer is unfavourable. Infantile Mortality.—There were 25 deaths of infants under i year of age, which gives an infantile death.rate of 36'3 per i,000 births registered, as against 56.l in the preceding year, 72.7 in i907, and i04 9 in i906. The average rate for the i0 years i899.i908, was 9ii. This is by far the lowest infantile death.rate on record in this District, and is i9'8 below that of the previous year, which was the previous lowest rate on record for the District, and 54 8 below the average rate of the previous i0 years. This continually falling infantile death.rate is in itself very satisfactory, and although it is in part no doubt due to the constantly improving sanitation of the district, and to the fact that the very poor and ignorant form but a very small proportion of the population, which is chiefly a residential one, yet it must be borne in mind that the birth.rate is also steadily declining, and that there is, of course, a close relation between the two. Moreover, the cold and wet weather of last summer was very unfavourable to infantile diarrhoea, which in normal summers is an important cause of mortality from this disease. In Table V. are set forth the causes of deaths of infants under one year of age, in weeks and months. The infantile death.rate of North Southgate was i8 7, and that of South Southgate 44.3. The infantile death.rate in England and Wales was i09, which is ii per i,000 below the rate in i908, the lowest rate on record. Compared with the previous i0 years, the rate of infantile mortality in i909 showed a decrease of 29 per i,000. c Senile Mortality.—Among persons of 70 years of age and over, GO deaths occurred, and of these 25 were 80 years of age and over. This is a proportion of 24 per cent, of the total number of deaths at all ages as against 25 per cent, in the two preceding years. The percentage of deaths of persons of 70 years of age and over in North Southgate was 2i, and in South Southgate 25. Zymotic Mortality.—This includes the deaths from the seven principal zymotic diseases, viz.:—Smallpox, Scarlet Fever, Diphtheria, Typhoid Fever, Measles, Whooping Cough, and Diarrhœa. The rate affords useful evidence as to the general healthiness of the District, and as to the efficiency of its sanitary administration. There were i3 deaths from these diseases, as follows:—Diphtheria, 7; Measles, 5; and Whooping Cough, i. The zymotic death.rate was therefore .37 per i,000 of the population, as against .7i in the preceding year, .63 in i907, and i8 in i906. The average late for the i0 years, i899 to i908, was l.l. The rate for North Southgate was .09, and that for South Southgate .49. The zymotic death.rate in England and Wales was i.i2, which is lower than the three preceding years. The Public Mortuary.—During the year i0 bodies were deposited in the Mortuarv, as against i7 in the preceding year, and i4 in i907. Inquests held during: the Year i909 on deaths occurring in the District. No. Month. Sex. Age. Condition of Life. Cause of Death. i January Female 45 Married Natural Causes. 2 January Female 7 — Natural Causes. 3 February Female i9 Domestic Servant Suicide—temporary insanity. 4 March Male 9 months — Natural Causes. 5 March Male 67 Retired Outfitter Natural Causes. 6 March Female 59 Married Natural Causes. 7 April Female i2 — Natural Causes. 8 May Male 54 Gardener Misadventure. 9 August Male i3 — Accidental. i0 November Female 6i . .. Suicide—temporary insanity. 8 Table I. Vital Statistics of Whole District during i909 and previous Years. Year. Population estimated to Middle of each Year. Births. total deaths Registrred in the District. Total Deaths in Public Institutions in thk District. Deaths of Non.residents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. nett deaths at all ages belonging to the District. Under i Year of Age. At all Ages. Number. Rate.* Number. Rate per i,000 Births registered. Number. Rate.* Number. Rate.* i 2 3 4 5 6 7 8 9 i0 ii i2 i3 i899 .. i4,500 366 25.2 5i i40 i92 i3.2 i0 i0 † i82 i2.5 i900 .. i5,000 320 2i.3 38 ii8 i53 i0.2 2 2 .. i5i i0.0 i90i .. i5,200 375 24.6 35 93 i40 9.2 6 6 8 i42 9.3 i902 .. i5,800 390 25.0 33 83 i66 i0.5 7 7 4 i63 i0.3 i903 .. i7,000 367 2i.5 32 87.i i42 8.3 3 3 7 i46 8.5 i904 .. i9,000 44i 23.4 35 79 3 i8i 9.5 i0 i0 ii i82 9.5 i905 .. 22,400 463 20.6 36 77.7 i62 7.2 i3 i3 29 i78 79 i906 .. 25,500 562 22.0 60 i04.9 234 9i 8 8 47 276 i0.8 i907 .. 28,500 605 2i.2 44 72.7 i87 6.5 8 8 38 2i7 7.6 i908 .. 32,000 659 20.6 37 56.i i99 6.2 i2 6 4i 240 7.5 Averages for years i899.i908 20,490 455 22 5 40 9i.i i75 8.9 7.9 7.3 .. i87 9.3 i909 .. 35,000 687 i96 25 36.3 2i0 60 3 2 40 245 7.0 * Eates in Columns 4, 8, and i3 calculated per i,000 of estimated population. Note.—The deaths included in Column 7 of this Table are the whole of those registered during the year as having actually occurred within the district or division. The deaths included in Column i2 are the number in Column 7, corrected by the subtraction of the number in Column i0 and the addition of the number in Column ii. By the term "non.residents " is meant persons brought into the district on account of sickness or infirmity, and dying in public institutions there; and by the term residents" is meant persons who have been taken out of the district on account of sickness or infirmity, and have died in public institutions elsewhere. The "public institutions" to be taken into account for the purposes of these Tables are those into which persons are habitually received on account of sickness or infirmity, such as hospitals, workhouses, and lunatic asylums. A list of the Institutions in respect of the deaths in which corrections have been made is given on the next page. Total population at all ages i5,200 S Area of District in acres (exclusive of Number of inhabited houses 2,980 3,596 area covered by water). Average number of persons per house 5.i t No returns received until i90i, and then only those relating to the Edmonton Union Pull returns relating to all deaths of "residents" outside the District not received until i905. 9 I. Institutions within the District receiving sick and infirm persons from outside the District. II. Institutions outside the District receiving sick and infirm persons from the District. III. Other Institutions, the deaths in which have been distributed among the several localities in the District. Metropolitan Asylums Board Hospital, Winchmore Hill. Southgate Isolation Hospital. Palmers Green . Nursing Institute. Edmonton Union. Middlesex Asylum, Napsbury. Great Northern Hospital, Holloway. Passmore Edwards Hospital, Wood Green. Etc. The Union Workhouse is outside the District. Table III 10 Cases of Infectious Disease Notified during the Year i909. Notifiable Disease. Cases Notified in the Whole District. Total Cases Notified in Each Locality. No. of Cases Removed to Hospital from Eaoh Locality. At all Ages. Under i. i to 5. At Ages —Years. 25 to 65. 65 and upwards North Southgate. South Southgate. North Southgate. South Southgate. 5 to i5. i5 to 25. Small.pox .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. Diphtheria 55 .. 25 22 7 i .. i6 39 i3 20 Membranous Croup .. .. .. .. .. .. .. .. .. .. .. Erysipelas i8 2 .. .. .. i4 2 4 i4 .. .. Scarlet Fever i06 i 37 55 9 4 .. 42 64 33 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 3 .. .. .. i 2 .. 2 i .. .. Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .... .. .. Puerperal Fever i .. .. .. .. i .. .. i .. .. Plague .. .. .. .. .. .. .. .. .. .. .. Totals i83 3 62 77 i7 22 2 64 ii9 46 60 Isolation Hospital—Tottenhall Road, Palmers Greeu (in the District), provided by the Scuthgate Urban District Council. 11 Table Ilia. Cases of Infectious Disease Notified each Month of the Year i909. Notifiable Diseases. | Small.apox. Scarlet Fever. Diphtheria. Typhoid Fever. Puerperal Fever. Erysipelas. Totals. January .. 9 ii .. .. 3 23 February .. ii i0 .. .. .. 2i March .. 9 .. .. .. 2 ii April .. i6 3 .. .. i 20 May .. i3 6 i .. i 2i June .. i3 .. i .. i i5 July .. 3 2 .. .. 2 7 August .. 2 i .. .. i 5 September .. i 4 •• .. i 6 October .. i4 8 i .. .. 23 November .. i2 6 .. .. 2 20 December .. 3 4 .. .. 4 ii Totals .. i06 55 3 i i8 i83 12 Table IV. i2 Causes op and Ages at Death during the Year i909. Causes of Death. Deaths at subjoined ages of " Residents" whether occurring in or beyond the District. Deaths at all ages of " Residents " belonging to localities whether occurring in or beyond the District. Total deaths whether of " Kesidents " or "Non-Residents" in Public Institutions in the District. All ages. Under i year. i and under 5. 5 and under i5. i5 and under 25. 25 and under 65. 65 and upwards. North Southgate. South Southgate. Small-pox .. .. .. .. .. .. .. .. .. .. M easles 5 2 2 i .. .. .. .. 5 .. Scarlet Fever .. .. .. .. .. .. .. .. .. 2 Whooping Cough i .. i .. .. .. .. .. i .. Diphtheria (including .. .. .. .. .. .. .. .. .. .. Membranous Croup) .. 7 .. 4 3 .. .. .. i 6 i Croup .. .. .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. .. .. .. .. .. Epidemic Influenza ii 2 i .. 2 3 3 2 9 .. Diarrhiea .. .. .. .. .. .. i .. .. .. .. Enteritis i .. .. .. .. .. .. i .. Gastritis 2 2 .. .. .. i .. .. 2 .. Puerperal Fever i .. .. .. .. .. .. i .. Erysipelas .. .. .. .. .. .. .. .. .. .. Phthisis (Pulmonary i i2 ii Tuberculosis) i7 .. .. 4 .. 6 .. Other Tuberculous Diseases 8 i 4 i .. 2 .. 3 0 .. Cancer (malignant i8 2i ease) 28 .. .. i .. y 7 .. Bronchitis 8 i .. .. i 2 4 2 6 .. Pneumonia i5 2 4 .. .. 4 5 3 i2 .. Pleurisy 2 .. .. .. .. 2 .. i i .. Other Diseases of spiratory Organs 3 .. .. .. i i i .. 3 .. Alcoholism—Cirrhosis of Liver 3 .. .. .. .. .. 3 2 i .. Venereal Diseases .. .. .. .. .. .. .. .. .. .. Premature Birth 4 4 .. .. .. .. .. .. 4 .. Diseases and Accidents of Parturition 3 i .. .. .. 2 .. .. 3 .. Heart Diseases 20 .. i i .. i0 8 7 i3 .. Accidents 3 .. .. i i i .. .. 3 .. Suicides i .. .. .. .. i .. i i2 .. Bright's Disease i7 .. .. .. .. i2 5 5 .. Appendicitis 5 .. .. 2 .. 2 i 2 3 .. Senile Decay 20 .. .. .. .. i 25 3 23 .. Diseases of Nervous System, including plexy and Convulsions i5 i .. .. l 5 8 6 9 .. Wasting and Debility from Birth, including Developmental Defects 8 8 .. .. .. .. .. 3 o .. All other causes 3i i 3 i 2 ia 6 6 25 .. All causes .. 245 25 2! ii i2 98 78 60 i85 3 * B.—As to the meaning of "Residents " and" Non.Residents" and as to "Public Institutions to be taken into account for the purposes of this Table, see note on Table I. 13 Table IVa. Showing the Causes of Death during each of the Four Quarters of the Year i909. Cause of Death. ist Quarter 2nd Quarter 3rd Quarter 4th Quartet Measles 2 2 i .. Whooping Cough .. .. i .. Diphtheria .. i i 5 Enteric Fever .. .. .. .. Influenza 5 4 .. 2 Enteritis i .. .. .. Gastritis i .. i .. Puerperal Fever .. .. i .. Appendicitis i i 2 Phthisis 5 4 i 7 Other Tubercular Diseases .. 3 2 3 Cancer i0 5 6 7 Bronchitis i i i 2 Pneumonia 8 2 .. 5 Pleurisy .. i .. i Other Diseases of the Respiratory Organs .. .. i 2 Alcoholism—Cirrhosis .. i i i Premature Birth i 3 .. .. Diseases & Accidents of Parturition i i i .. Heart Disease i0 3 2 5 Accidents i .. 2 .. Suicides .. .. i Senile Decay i3 3 3 7 Diseases of Nervous System, ing Apoplexy and Convulsions 4 5 3 3 Bright's Disease 5 5 i 6 Wasting and Debility from Birth, including Developmental fects 4 i i 2 All other Causes 9 5 9 8 All Causes j 85 5i 4i fi8 245 14 Table V. Infantile Mortality During the Year i909. Deaths rom stated Causes in Weeks and Months under One Year of Age. CAUSE OF DEATH. Under i Week. | i—2 Weeks. 2 —3 Weeks. 3—4 Weeks. Total under I Month. i —2 Months. 2—3 Months. 3—4 Months. 4—5 Months. | 5—6 Months. 6—7 Months. 7 —8 Months. 8 — 9 Months. 9—i0 Months. i i0 — ii Months. i ii—i2 Months. | Total Deaths under One Year. All Causes— Certified 7 3 i 3 i4 i i i i i i i i ... 2 ... 2 5 Uncertified l. Common Infectious Diseases— Small-pox Chicken-pox Measles ... ... ... ... ... ... ... ... ... ... ... ... i ... ... ... i 2 Scarlet Fever Diphtheria : Croup Whooping Cough ... ii Diarrhotal Diseases— Diarrhoea, all forms Enteritis, Muco-enteritis, Gastro-enteritis ... ... ... ... ... ... ... ... i ... ... ... ... i ... ... 2 Gastritis, Gastro-intestinal Catarrh iii Wasting Diseases— Premature Birth 4 ... ... ... 4 ... ... ... ... ... ... ... ... ... ... ... 4 Congenital Defects i ... ... ... i ... ... ... ... ... ... ... ... ... ... ... i Injury at Birth ... ... ... i i ... ... ... ... ... ... ... ... ... ... ... i Want of Breast-milk,St'v'tion ... ... ...!... ... ... ... ... ... ... ... ... ... ... i ... ... i Atrophy, Debility, Marasmus i 2 i i 5 i ... i ... ... ... ... ... ... ... ... 7 iv Tuberculous Diseases— i Tuberculous Meningitis Tuberculous Peritonitis: Tabes Mesenterica Other Tuberculous Diseases . ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... i i v. Other Causes— Erysipelas... Syphilis Meningitis (not Tuberculous)... Convulsions i ... ... ... i ... ... ... ... ... ... ... ... ... ... ... i Bronchitis... ... ... ... ... ... ... ... ... ... i ... ... ... ... ... ... i Laryngitis... Pneumonia ... ... ... ... ... ... i ... ... ... i ... ... ... ... ... 2 Suffocation, overlying Other Causes ... i ... i 2 ... ... ... ... ... ... ... ... ... ... ... 2 7 3 i 3 i4 i i b i ii ii i 2 ... i2 25 Population (estimated to the middle of i909) ... ... 35,000 Births in the Year, {legitimate 68i illegitimate 6 legitimate infants 25 Deaths in the Year of illegitimate _ Deaths from all Causes at all Ages 245 15 Table VI. Comparison of the Rates of the Southgate District with those. of En.gland and Wales, the 76 Great Towns, and England and Wales less the 2i8 Largest Towns. Bates per i,000 of the Population. Birthrate. Death.rate (corrected). Deathsunder i year per i,000 Births. Zymotic Death.rate. Enteric Fever. Scarlet Fever. Diphtheria. Measles. Whooping Cough. Diarrhoea. England and Wales 25.6 i4.5 i09 i.i2 006 0.09 0.i4 0.35 0.20 0.28 76 Great Towns 25.7 i5.6 ii8 i.42 0.06 0.ii 0.i5 0.48 0.24 0.38 England and Wales less 2i8 Largest Towns 25.6 i3.6 98 0.80 0.06 0.06 0.i4 0.2i 0 i6 0.i7 Southgate District i9.6 7.3 36. 3 0. 37 0. 00 0.00 0.2 0.i4 0.02 0.00 16 INFECTIOUS DISEASES AND THE MEANS TAKEN TO PREVENT THEIR SPREAD. It will be seen from Table III. that i83 cases of infectious diseases were notified during the year, as compared with 248 in the preceding year, i92 in i907, and 2i4 in i906. Of these i06 were Scarlet Fever, 55 Diphtheria, i Puerperal Fever, i8 Erysipelas, and 3 Enteric Fever. Of these, 64 were notified from North Southgate, and ii9 from South Southgate. These i83 cases represent infection in i40 houses, all 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 in cases of non.removal to the hospital, and the sanitary condition of the premises inspected. In 29 houses sanitary defects were found, consisting chiefly of defective water.closets and defective yard pavings. These defects have all been remedied under the supervision of the Sanitary Authority. The notification of these diseases was, therefore, the means of causing the inspection, apart from the ordinary inspections, of i40 premises, and the remedy of insanitary conditions in 29. One hundred and six cases were removed to tho Isolation Hospital at Palmers Green. Of these 73 were Scarlet Fever and 33 Diphtheria. Five cases were removed to tho Liverpool Road Hospital, Islington, and seven cases to the Enfield Hospital. The Infectious Sickness Rate of the District was 5.2 per i,000 of the population, as against 7.7 in the preceding year, 6.7 in i907, and 8.3 in i906. The rate for North Southgate was 6.0, and that for South Southgate was 4.8. Methods of Disinfection.—(i) For disinfection of rooms, "Formalin" is used (a) by spraying and (b) with "Paraform" tablets in the" Alformant" lamp. (2) Bedding, etc., is disinfected in the steam disinfecting apparatus established on the premises of the Isolation Hospital. For taking the bedding, etc., to and fro, special vans are kept, one for the infected and the other for the disinfected articles. (3) After rooms have been disinfected, the wall papers are stripped from the walls and burnt, and ceilings, walls, and all surfaces are thoroughly washed. 17 Diagnosis Outfits.—The diagnosis outfits provided by the Council for the use of the medical practitioners in the District for sending morbid specimens from suspected cases of Diphtheria, Typhoid Fever, and Phthisis to St. George's Hospital for bacteriological examination and report have been made extensive use of, and continue to prove of great service in establishing a correct diagnosis in these diseases, to the advantage of the general public health, as well as of those more immediately concerned. During the year, 2i.i specimens were sent and reports received as follows:— Diseases Suspected. Report. Total. Positive. Negative. Diphtheria 54 i24 i78 Typhoid Fever 2 6 8 Phthisis 9 i9 28 Total 65 i49 2i4 N.B.—These were not all from different cases, but in many instances, chiefly of Diphtheria, were further specimens taken from the same cases at intervals for re.examination to determine when the case in question ceased to be infectious. In many cases this has to be repeated several times before a negative result is reported. Diphtheria Antitoxin.—The supply of diphtheria antitoxin provided by the Council and kept available for use at any time at the Council's Offices has been made full use of as occasion required, to the great advantage of those suffering from the disease and the public in general. Handbills Concerning Infectious Diseases.—Handbills giving instructions as to the danger of, and precautions to be taken to avoid spreading infection in, cases of Phthisis, Measles, and Whooping Cough—not being notifiable diseases — are always kept in readiness, and have been left at all houses where it came to my knowledge that these diseases were present; and, in the case of the two latter, have also been 18 distributed to all other houses in the immediate neighbourhood. The necessary knowledge as to where the two latter diseases are present is supplied to me chiefly by the School Attendance Officers and the School Authorities. This system of notification of non.notifiable diseasas by the School Attendance Officers and the School Authorities instituted in 1898 continues to work as satisfactorily as can be expected. SMALL.POX. No cases were notified. With regard to the provision of accommodation for the effective isolation of cases of Small.pox, Southgate is one of the thirteen Councils comprised in the district of the Middlesex Joint Small.pox Hospital Board by which the Clare Hall Small.pox Hospital has been purchased for the use of the inhabitants of the constituent district. SCARLET FEVER. There were i06 cases notified from 73 houses, as against 185 in the preceding year, 148 in 907, and 85 in 1906 Of these, 42 were notified from North Southgate, and 64 from South Southgate. In i4 houses sanitary defects were found. Five of the cases were "imported"; i5 were "secondary'' cases, occurring in 14 houses, from which previous cases had been notified; and 7 were "return" cases from 6 houses to which previous cases had returned directly or indirectly after discharge from the Isolation Hospital. Seventy.three cases were removed to the Isolation Hospital, 5 cases to the Liverpool Road Hospital, Islington, and 5 cases to the Enfield Isolation Hospital. The disease was somewhat prevalent, in common with many other parts of the Metropolitan area, during the first six months of the year throughout the District, more especially in North Southgate, aithough at no time did it assume anything like epidemic form. The type of the disease was much less severe than it was during the preceding year, and there were no deaths. DIPHTHERIA. There were 55 cases notified from 48 houses, as against 48 in the preceding year, 32 in 1907, and 3i in 1906. Of 19 these 16 were notified from North Southgate, and 39 from South. Southgate. Seven were "secondary" cases occurring in 6 houses from which cases had previously been removed to the Isolation Hospital, and one was an "imported" case. In 15 houses sanitary defects were found. Thirty.three cases were removed to the Isolation Hospital, and 2 cases to the Enfield Hospital. There were 7 deaths, one of which occurred in the Isolation Hospital, and 6 amongst patients isolated at home. TYPHOID FEVER. Three cases were notified, as against none in the preceding year, 1 in 1907, 79 in i906, an 1 4 in 1905. These cases occurred in Southgate, Winchmore Hill, and Bowes, and had no connection with each other. One was an "imported" case, in another the infection was probably derived from polluted water from a surface well which had been pumped up into the cistern, while in the third case no evidence of the source of infection could be obtained. DIARRHCEA. This disease, which in normal years is usually more or less prevalent amongst infants under one year of age, was happily conspicuous by its absence, and there were no deaths recorded due to it. This is the first year on record in which there have been no deaths from this cause. It is accounted for chiefly by the wet and cold summer and autumn experienced last year, whereby the chances of infection of milk and other goods by infective dust and dust carriers, such as flies, is reduced to the minimum. The rate of death in the preceding year from this disease was .25 per i,000, in 1907 .14, and in 906 1.0. TUBERCULOSIS. During the year there were 25 deaths from Tubercular diseases, i7 of these being from Phthisis, as against 27 and i8 respectively in the preceding year. In all cases of Phthisis that have come to my knowledge, leaflets have been left pointing out fully the nature and danger of the disease, and the means to be taken for the prevention of the 20 spread of infection to others; and where rooms occupied by consumptive persons have been evacuated by death or otherwise, a visit has been paid by one of the sanitary officials, and an offer to disinfect, free of cost, by the Sanitary Authority has been made and in most cases carried out. The provisions of the Public Health (Tuberculosis) Regulations, 1908, should prove of valuable assistance (L) in bringing to my knowledge the occurrence of Phthisis amongst those seeking Poor Law medical relief (four cases were thus notified during the past year; and (2) in conferring upon you the power under certain conditions of taking all such measures with regard to the destruction and disinfection of infected articles, and the cleansing and disinfection of infected premises, as are authorised in any case of infectious disease. ISOLATION HOSPITAL. The Hospital is built on a site of nine acres of land situated in Tottenhall Road, Palmers Green. It is a fine open and airy site, admirably adapted for the purpose. Only a portion of the site is at present occupied by the Hospital premises, the remainder being let off in allotments. The Hospital premises are entirely closed by a close.boarded fence, and there is one entrance only, in Tottenhall Road. The Hospital was opened in January, 1902, and consists of (1) an administrative block for the Staff; (2) a ward block; (3) an isolation block; (4) a laundry block with steam disinfecting apparatus and mortuary attached ; and (5) an entrance lodge. The following amounts were sanctioned by the Local Government Board to be borrowed for the purpose of the Hospital:— (1) Purchase of land £2,500 (2) Fencing, draining, etc., of site, and building entrance lodge 1,600 (3) Erecting Hospital Buildings 8,400 (4 Furniture 600 £13,100 The ward block is used entirely for Scarlet Fever cases, and consists of two wards, one 36ft. by 26ft. and 13ft. in height, for women and children, and the other 26ft. by 24ft. and i3ft. in height, for men, with a nurses' duty room between them, arranged so that the nurse.in.charge can look through a small fixed window into each ward. The male ward was designed to accommodate four beds and one cot, and the female ward six beds and one cot. 23 But the air and floor space allowed was so ample that I find I can put up several extra beds and cots in each ward and still maintain sufficient air space. Lavatory and w.c. accommodation are provided at the ends of each ward, accessible from the ward only, but provided with a cross ventilation lobby. The wards are lighted and ventilated by large windows reaching to the ceiling 0n each side of the wards, and provided Avith fanlights which open inwards. Thorough cross ventilation is thus obtained. The wards are heated by special stoves in the centre of each, having downward flues carried under the floors to external chimney shafts attached to the building. The floors are of two kinds, that of one ward consisting of Terazzo, and the other of pitch.pine blocks. The walls are distempered with Duresco, with a dado of oil paint. There is also in this block a store cupboard for linen, bedding, etc., and a bath.room, arranged with a door leading outside, enabling it to be used as a discharging room. The bath is a portable one, and mounted on rubber wheels. The nurses' duty room is fixed with a kitchen stove with hot water apparatus, a sink, small larder, a large cupboard, kitchen dresser, medicine cupboard, and a telephone communicating with the administration block. The Isolation Block is used for Diphtheria and Typhoid Fever, and consists of two wards, or half a block; the other half to be completed when more accommodation is required. Each ward is 24ft. by i8ft. and 13ft. in height, and accommodates three beds and a cot in each ward. A duty room similar to that of the ward block is provided between the wards. The sanitary accommodation is outside and separate from the block, but is under a verandah which runs along one side of the block. The doors of the wards and duty rooms open on to verandah only. These Avards are heated by open regenerating grates, and lighted and ventilated by windows similar to those of the ward block. All angles of walls, floors, ceilings, and woodwork in both blocks are constructed with rounded surfaces. The Administrative Block contains dispensary, Matron and Nurses' sitting room, store room, kitchen, scullery, coal store, and bedrooms for nine persons—the nursing staff and servants. The building is so designed that it can readily be enlarged to accommodate an increased staff. 24 The Laundry Block is supplied with a high.pressure boiler, which supplies steam for boiling all water required in the Laundry. All steeping and washing of clothes is done in glazed stoneware troughs. A set of clothes.horses on runners are provided in a special chamber, heated with steam, for drying and airing clothes and linen when outdoor drying is unavailable. The same boiler also supplies steam for the steam disinfecting apparatus. Adjoining the Laundry is a Mortuary. The Entrance L')dge contains a parlour, kitchen.living.room with enclosed sink and bath, and one bedroom with usual accommodation, all under one roof and on the ground floor. The sanitary arrangements of the whole premises are perfect. Provision is made for thoroughly flushing all the foul.water drains and special ventilating shafts have been erected. All refuse is either burned or disposed of on the enclosed area. The water supply passes through a meter on a bye.pass into a 4.in. main with 3.in. branches, and is provided with a 4.in sluice valve which would be open to supply the three hydrants in case of fire. As a protection against fire, a Hose Reel containing fire.hose, stand.pipes, etc., has been provided, and communication with the Council's Chief Fire Siation can be made by telephone. The Medical and Nursing Staff consist of Medical Superin tendent (non.resident), Matron (nursing), two Staff Nurses, and one Probationer Nurse ; and the Domestic Staff of Cook. Ward. maid, Laundrymaid, Housemaid, and Entrance Lodge Porter and his wife The Medical Superintendent's residence is connected with the Hospital by telephone. The Porter's duties consist of looking after the Entrance Lodge, checking all entries and exits, and working the steam disinfector, etc. His spare time is spent in the gardens. The Porter's wife assists, when required, in the Laundry, etc. Visitors are allowed to visit patients on Sundays from two to four o'clock, but are only allowed to communicate with the patients through the windows. If any patient is dangerously ill, special arrangements are made. The name of every person entering or leaving the premises, and the time of entry and exit, are entered in a book at the porter's lodge Patients from outside districts are admitted when there is sufficient accommodation for them; the authorities of the Districts from which they come paying the Southgate Council for their maintenance. 25 The cost of feeding staff and patients varies from 8d. to Is. 3d. per head per day, according to the number of patients in Hospital. During the year 143 cases were admitted; of these i0i were notified to be suffering from Scarlet Fever, and 42 from Diphtheria. In three of the latter no clinical symptoms of Diphtheria were apparent on admission, and no Diphtheria bacilli were obtained from swabs taken from their throatsmoreover one of these cases had all the symptoms of Measles on admission, so that one for certain and probably all three of these were cases of mistaken diagnosis in the first instance. Twenty.nine of the Scarlet Fever and 9 of the Diphtheria cases were admitted from Friern Barnet. In February and May there were outbreaks of Measles and Chicken Pox respectively in the Scarlet Fever wards due to children developing these diseases some days after their admission for Scarlet Fever, the infection of which they caught before admission into the Hospital, either at the same time or before they contracted Scarlet Fever. This prevented the admission of other cases of Scarlet Fever for several weeks into the infected wards, which were disinfected before the admission of any further cases. There was one death during the year from Diphtheria. The average times of detention in Hospital, excluding the case which ended fatally in a few days after admission, were:— For Scarlet Fever 48 days, and for Diphtheria 36 days. Number of Patients in Isolation Hospital during each Month, i909. Average number. Lowest number. Greatest number Jan. 19 i5 25 Feb 24 21 27 Mar 2 18 25 April 23 18 26 May 22 19 26 June 14 11 18 July 17 13 21 Aug 8 5 14 Sept. 8 6 11 Oct. 16 12 24 Nov 23 21 25 Dec. 5 12 21 Average for year 21.0 17.1 263 24 I referred in my last Report to the pressing necessity for the provision of additional Hospital accommodation. I am glad to say that now that the preliminary formalities have been complied with the work of enlarging the Hospital has been rapidly proceeded with, and the buildings, which will provide additional accommodation for patients, nurses, and domestic staff to the number of 16 and 12 respectively, will, it is confidently anticipated, be completed and ready for occupation by the 25th March next, the date on which the Agreement recently concluded with the Friern Barnet Urban District Council takes effect. The Council has, thereunder, to reserve from that time six beds for the exclusive use of Friern Barnet patients in consideration of an annual payment by the Friern Barnet Council of £360 plus 1s. per day per patient in respect of the patients' maintenance. MISCELLANEOUS. Return of the Metropolitan Asylums Board.— During the past year 4,910 cases were admitted into this Hospital, situated at Winehinore Hill; of these, 4,638 were Scarlet Fever, and 272 Diphtheria. There were two deaths from Scarlet Fever. Sewerage and Sewage Disposal.—The District is drained by the dual system. The surface-water sewers discharge at convenient points into the nearest watercourses, and as the fields adjoining the smaller courses become converted into building land, suitable sewers and culverts are provided. Where possible and necessary the surface-water sewers are laid at such depths as will enable the subsoil under cellars and basements to be drained and connected thereto, thus ensuring dry dwellings, and avoiding any accumulations of stagnant water inside any dwelling-house. The main foul sewers traverse as much as possible the natural valleys, and run from the higher lands on the west towards the east, where they join up to the sewers of the Edmonton District at three points along the boundary between the Southgate and Edmonton Districts. By the Edmonton Local Board Separation Act, 1881, by which Southgate became a separate district, the Edmonton District is required to receive, convey, and dispose of the sewage of Southgate. Only one length of sewer, apart from culverts, is now constructed of brickwork, that length being the southern main joining the Edmonton sewers. The sewers are laid principally in open trenches, but as their depth is in some cases as much as 30 feet below the surface, the driving of short tunnels as headings is occasionally resorted to. Pymmes Brook is crossed in several places by means of inverted 25 syphons. These have been constructed with iron pipes from special designs, which permit the smallest area of sewage being exposed in the manholes, and have worked very satisfactorily. The sewers are also carried at several points under the New River, and recently the late New Rivor Company insisted upon a special system being adopted, by which large cast-iron shield pipes are forced by means of powerful hydraulic jacks through the soil under the river, thus forming tunnels in which the sewage pipes are laid. In the case of new streets, not a pipe is permitted to be covered up until the work has been thoroughly inspected and the foul sewers tested with water. The pipes used have special joints, are made of the strongest stoneware clays, and laid upon a thick bed of cement concrete. In addition, they are laid to absolutely straight lines from point to point, and by means of manholes can be examined and seen through from end to end. At the head of every branch sewer means for flushing are provided by lamplioles and flushing chambers, through which thousands of gallons of clean water are systematically delivered in order to prevent any deposit within the sewers. There are upwards of 100 of these flushing chambers within the district. Fortunately, all the sewers may be said to be self-cleansing, and within an hour or two of any foul matter being discharged into a drain or sower it is delivered to the Edmonton Sewage Works. The sewers are ventilated by means of gratings over the manholes and by upcast shafts; but the gratings intended to be inlets for fresh air sometimes also discharge foul air, in consequence of which many of them have been closed in, and extra upcast shafts erected at points of vantage in their place. During the past seventeen years no drains of any house have been permitted to be connected with the sewers unless they have been provided with a chamber just within the boundary adjoining the street or road containing a trapped interceptor. Although the District is scattered over so large an area, there are very few houses which are not near a sewer, so that fortunately very few cesspools now exist, and they are becoming less every year. In the District there are now 43 miles of foul sewers, and 39½ miles of surface-water sewers, and no less than 39 miles of these have been constructed during the past eight years. Sewers.—During the past year a total of 7,230 yards of sewers were laid as follows :— New foul sewers 920 yards. New surface-water sewers 2,981 „ New Estate Sewers. Foul sewers 1,693 „ Surface-water sewers 1,636 „ 26 Water Supply.— Practically the whole District is now supplied by the Metropolitan Water Board. There are now only 9 wells left from which water is obtained for drinking. These are scattered about North Southgate. There was reason to analyse the water from 5 wells, all of which proved to be unsatisfactory. Two of these will be closed and the remainder cleansed. Watercourses —Bounds Green Brook and Pymmes Brook remain in about the same condition. The periodical cleaning by the Middlesex County Council helps to keep them from getting very foul. House Refuse Collection.—Refuse and dust are collected from almost every house weekly and taken to the Dust Destructor which was opened in May. This is a very great addition to the sanitary works of the District, and does away with much trouble and anxiety in the disposal of house refuse. Collection of Fish Offal.—Air-tight receptacles have been provided by the Council, in which fish offal is collected fish shops from one to three times a week, according to the weather and the quantity of fish consumed locally. It is then carted to a convenient shoot acquired by the Council for the purpose, and there disposed of. A small charge is madefcthe fishmongers to cover expenses. During the year 1,041 pails were collected, as against 1,126 in the preceding year. Roads.—In the District there are now over 44 miles of roads, made up as follows :— Miles. Yards. County Main Roads 4 562 Other Roads (repairable by the inhabitants at large) 30 660 Private Roads (repairable by the owners of property abutting on such Roads) 9 1,537 Total 44 999 The following roads were made up during the year:— Arlow Road, Winehmore Hill. Orpington Road, „ ,, Radcliffe Road, ,, ,, Derwent Road, Palmers Green Conway Road, ,, ,, Ulleswater Road, ,, „ Park Avenue, ,, 27 HOUSING OF THE WORKING CLASSES ACT, 1890. During the year 6 cottages were closed—2 in Tottenliall Road, and 4 on Bourne Hill. These have all been demolished. The ground adjacent to and on which the two cottages in Tottenliall Road stood has been purchased by the District Council, and 34 workmen's cottages are to be erected theieon during the coming year. Public and Private Urinals.—The Council has not provided public conveniences in the District. An inspection was made in 1906 of the whole of the sanitary conveniences attached to the various publichouses, with the result that many urinals have been rebuilt and put in a better sanitary condition. The Council also improved the lighting of a number of such urinals which are available for public use. This work was, however, done more as a temporary measure pending the time when public sanitary conveniences would be provided. The need of these in various parts of the District is being felt more and more each year. The Surveyor and Sanitary Inspector have reported on several positions in which public sanitary conveniences might advantageously be provided, and have also suggested the provision of those for both sexes in Broomfield Park, with access thereto from adjoining public highways. The question is still under the consideration of both the Health and Park Committees. Dairies, Cowsheds, and Milkshops.—These have been inspected by the Sanitary Department. Veterinary Examination of Milch Cows.—The Council have suggested that the County Council should endeavour to obtain concerted action in this matter by all local authorities in the county, and, failing this, that the work should be undertaken by the County Council, but nothing so far has been definitely arranged. Bakehouses.—These have been inspected. SLAUGHTER HOUSES. There are eight slaughter-houses in the district. Several of these slaughter houses, as mentioned in my last Annual Report, are in unsuitable positions owing to their close proximity to dwelling-houses. Some of them are little used, and the others have been systematically inspected, particularly at slaughtering times. No carcases were found to be tuberculous. PUBLIC HEALTH ACTS AMENDMENT ACT, 1907. This Act will shortly be in force in the District. 28 ANNUAL REPORT On the Administration of the Factory and Workshop Act, 1901, in connecticn with l-actories, Workshops, Laundries, Workplaces and Homework. 1.—INSPECTION. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. (1) Number of Inspections. (2) Written Notices. (3) Prosecutions. (4) Factories (including Factory Laundries) 26 2 Workshops (including Workshop Laundries) 120 11 — Workplaces (other than Outworkers' premises, included in Part 3 of this Report) 20 — Total 166 13 — 2.—DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. (1) (2) (3) (4) (5) Nuisances under the Public Health Acts :— Want of Cleanliness 16 16 — — Want of Ventilation — — — — Overcrowding — — — — Want of Drainage of Floors 1 1 — — Other Nuisances 2 2 — — † Sanitary Accommodation (Insufficient — — — — Unsuitable or Defective 8 8 — — , Not separate for sexes.. — — Offences under the Factory and Workshop Act:— Illegal occupation of Underground Bakehouse (s. 101) — — — — Breach of special sanitary requirements for Bakehouses (ss. 97 to 100) — — — — Other Offences — — — — (Excluding offences relating to outwork which are included in Part 3 of this Report). Total 27 27 — — * Including those specified in Sections 2, 3, 7, and 8 of the Factory and Workshop Act as remediable under the Public Health Acts. † Section 22 of the Public Health Acts (Amendment) Act, 1890, was adopted in 1890. 3.—HOME WORK. Nature of Work. (1) Outworkers' Lists, Section 107. Inspections of Outworkers' premises. (12) Lists received from Employers. Addresses of Outworkers. Prosecutions. Twice in the year. Once in the year. Failing to keep or permit inspection of lists. (10) Failing to send lists. (11) Received from other Councils. (8) Forwarded to other Councils. (9) Lists. (2) Outworkers. Lists. (5) Outworkers. Contractors. (3) Workmen. (4) Contractors. (6) Workmen. (7) Wearing Apparel— (1) Making, &c. 10 — 30 •• •• •• 23 30 •• •• 40 4.—REGISTERED WORKSHOPS. 5.—OTHER MATTERS. Workshops on the Register (s. 181) at the end of year. (1) Number. (2) Class. (1) Number. (2) Matters notified to H.M. Inspector of Factories :— Workshop Bakehouses 17 Failure to affix Abstract of the Factory and Workshop Act (s. 133) Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5) j Notified by H.M. Inspector 2 Laundries 14 Reports (of action taken) sent to H.M, Inspector a Other Workshops 104 Other Underground Bakehouses (s. 101) :— •• Total number of workshops on Register .. 135 Certificates granted during the year •• In use at the end of the year •• 29 COUNTY OF MIDDLESEX—SANITARY WORK, 1909. DISTRICT OF SOUTHGATE. 30 Inspections. Notices. Dwelling Houses. Houses Let in Lodgings (Tenement Houses). Common Lodging Houses. Canal Boats used as Dwellings. Movable Dwellings, Caravans, Tents, Ac. Number of Premises Inspected on Complaint. Number of Premises Inspected in connection with Infectious Diseases. Number of Premises under Periodical Inspection. Houses Inspected from House-toHouse. Total Number of Inspections and Re-inspections made. Cautionary or Intimation NoticesGiven. Statutory Orders Issued. Summonses Served. Convictions Obtained. Houses, Premises, <tc., Cleansed, Repaired, Ac. Closed as Unfit for Habitation. (a) As result of action under //. W.C. Acts, (b) Otherwise. Re-opened after Repairs, Alterations, &'C. j Demolished. Illegal Underground Dwellings Vacated. Number Registered under Byelaws. Number of Contraventions. Number Registered under Byelaws. Number of Inspections made. Number of Contraventions. Number Registered under the Acts. Number of Contraventions of Regulations. Number Observed during the Year. Number of Nuisances therefrom abated. Number Removed from District. (1) (2) (3) (4) (5) a b 93 143 178 166 3157 204 7 Nil. Nil. 176 Nil. 6 Nil. 6 Nil Nil. Nil. Nil. Nil. Nil. Nil. Nil. 148 7 148 * N.B.—(3) Includes all classes of premises under periodical supervision, such as Cowsheds, Dairies, Slaughterhouses, Workshops, and Workplaces, &c. (5) Includes all visits and re-visits made by Sanitary Inspectors in connection with 1—4. 31 County of Middlesex.— Sanitary Work, 1908. District of South gate. Bakehouses. Slaughterhouses. Cowsheds. Dairies and Milk-shops. Unsound Food. Adulterated Food. Offensive Trades. Water Supply and Water Service. Wells. Percentage of Houses supplied from Public Water Service. Cisterns. Draw-Taps placed on Mains. Percentage of Houses supplied on Constant System. Number of Samples obtained for analysis (a) from Local Wells, (b) from Public Supply. Number in District. Contraventions of Factory Acts. Number on Register. Number of Inspections made. Contraventions of Rye laws. Number on Register. Number of Inspections made. Contraventions of Regulations. Number of Milch Cows in District. Number on Register. Number of Inspections made. Contraventions of Regulations. (a) Animals seized, (b) Articles or Parcels seized. Condemned by Magistrate (a &. b). Articles or Parcels surrendered. Samples taken (if any) by the District Local Authority. Found Adulterated. Number of Premises in District. Number of Inspections made. Contraventions of Byelaws. New Sunk. Cleansed, Repaired, &c. Closed as Polluted. New, Provided. Cleansed, Repaired, Covered, &e. 17 5 8 135 Nil. 12 67 1 about 200 23 85 Nil. a b a b 6 Cases of Fish. Nil. Nil. Nil. Nil. Nil Nil. 3 2 Practically all. Nil. 3 6 Practically all. a b Nil. Nil. 5 2 County of Middlesex.— Sanitary Work, 1910. District of South gate. Drainage and Sewerage of existing Buildings. Disinfection. Dust. Sundry Nuisances Abated. Water Closets. Drains. Cesspools. Number of Water Closets substituted for Dry Receptacles. Repaired, Supplied with Water, or otherwise Improved. Percentage of Houses provided with Water Closets. Examined, Tested, Exposed, &c. Unstopped, Repaired, Trapped, &c. Waste Pipes, Rain Water Pipes Disconnected, Repaired, &c. New Soil Pipes or Ventilating Shafts fixed. Existing Soil Pipes or Ventilating Shafts Repaired. Disconnecting Traps or Chambers Inserted. Reconstructed. Rendered Impervious, Emptied, Cleansed, Ac. Abolished, and Drain connected to Sewer. Percentage of Houses Draining into Sewers. Rooms Disinfected (a) ordinary infectious diseases, (/•) Phthisis. Rooms Stripped and Cleansed. Articles Disinfected or Destroyed, (a) Ordinary infectious disease, (b) Phthisis. New Bins provided. How frequently is Dust Removed from each house? Number of Complaints of Non-Removal received. Methods of Disposal (a) Destructor, (b) by Tipping, (c) Other, state method. Overcrowding. Smoke. Accumulations of Refuse. Foul Ditches. Ponds, &c., and Stagnant Water. Foul Pigs and other Animals. Dampness. Yards Re-paved or Repaired. Other Nuisances. 6 114 Practically all. 118 42 63 33 1 66 30 4 4 Practically all. a b 136 a b 45 Weekly. 7 a 2 3 4 5 3 2 66 36 5215 14 612 153 J. W. H. BROWN, Sanitary Inspector.