THE VESTRY of the Parish of Saint George HANOVER SQUARE. , MEDICAL OFFICER'S REPORT for the Year Ended 25th March, 1882. JUNE 1882. london: HUNTED BY phipps & connor, 13 & 14, tothill street, westminster 430 REPORT on THE SANITARY CONDITION of the Parish of St. George, Hanober Square, FOR THE YEAR 1881, by W. H. CORFIELD, M.A., M.D. (Oxon.), F.R.C.P. (Lond.), Professor of Hygiene and Public Health in University College, London, medical officer of health and public analyst. (being his tenth annual report.) To the Destry of the Parish of St. George, HANOVER SQUARE. My Lords and Gentlemen, The death-rate for the year 1881 was almost as low as the unprecedentedly low rate for 1880; this is more than I had expected, and shows, we may hope, that some of the causes of these very low rates are permanent sanitary improvements of one kind or another. The gross total of deaths registered in the Parish during the 52 weeks ending Saturday, December 31st, 1881, was Or 185 less than in 1871, the increase in Mayfair and Belgravia being more than counterbalanced by the decrease in Hanover Square, due, as stated in my last Annual Report, to the demolition of small houses, and the erection of workshops on their sites. Thus until the next Census is taken, we must, unless there are strong reasons for doing otherwise, regard the population of this Parish as stationary. It is to the enumerated population of London as 1 to 423/5, and to the estimated population of London for the middle of the year 1881 as 1 to 423/4. The high gross total of 1,932 deaths during the year is accounted for by the fact that no less than 812 deaths occurred in Public Institutions in the Parish; as our share of the deaths occurring in all the Public Institutions in London was only 394, our corrected total of deaths was only 1,514, as against an average of 1,663 during the preceding ten years; this is equivalent to a death-rate of 16.91 per thousand per annum, the average during the preceding ten years having been 18.32. The rate for 1881 is lower than that hitherto recorded for any year, except 1880, when it was 16-64. 2 1,932, or 103 over the annual average for the preceding 10 years. The enumerated populations of the Parish and its subdistricts given in my last Annual Report were uncorrected ; the corrected numbers are as follows:— Sub-District. Population. Hanover Square 16,862 Mayfair 13,491 Belgravia 59,220 Total for the Parish . 89,573 3 Table I. YEAR. Gross Total of Deaths. Deaths in Public Institutions. Proportional Share of Deaths in Public Institutions. Corrected Total of Deaths (52 weeks). Corrected Death-rate per 1,000 per annum (52 weeks). 1871 1,873 433 396 1,836 20.44 1872 1,675 332 325 1,668 18.53 1873 1,665 368 342 1,639 18.16 1874 (53 weeks) 1,694 345 355 1,679 18.56 1375 1,867 502 460 1,727 19.05 1876 1,868 573 362 1,675 18.20 1877 1,729 522 383 1,590 17.46 1878 2,007 741 392 1,658 18.17 1879 (53 weeks) 2,058 759 402 1,669 18.25 1880 1,855 713 847 1,489 16.64 Average during ten years, 1871—1880 . 1,829 529 376 1,663 18.32 Year 1881 . 1,932 812 394 1,614 16.91 Average during ten years, 1872—1881 . 1,835 567 376 1,631 17.96 4 Table Ia. Death-rates per 1,000 per annum. N.B.—Those for 1877-1880 have been recalculated on the Revised Estimates of Population. 1877. 1878. 1879. 1880. 1881. Twenty Large English Towns . 22.7 24.2 23.2 22.7 21.7 London 21.5 23.0 22.7 21.6 21.2 St. George's, Hanover Square 17.46 18.17 18.25 16.64 16.91 The death-rate of London proper, estimated population 3,831,719, was 21.2, and that of the 20 large English towns (including London) 21.7, both lower rates than those of preceding years (see Table Ia.), the rate for London being lower than that for any year since 1850, when it was 21 per thousand per annum. The death-rate of Greater London, estimated population 4,791,856, was 20.3 per thousand per annum (against 21 in 1880), being, as just stated, 21.2 in London proper, and 16.4 in the Outer Ring; or, when corrected for the deaths in the Middlesex County Lunatic Asylums, only 16 in the Outer Ring (estimated population 960,137). Neither of the 23 large towns of the united .Kingdom had nearly so low a death-rate as this Parish, the nearest to it being the following:— Brighton 19.0 Norwich 19.5 Bristol 19.6 Portsmouth . 19.7 Bradford 19.7 Plymouth 19.9 Birmingham 20.0 and these varying from 2 to 3 per thousand above it. 5 The death-rate of Dublin, which had increased from 28 in 1877 to 361 in 1880, has gone down to 27.1 in 1881, a very remarkable decrease. Liverpool comes next to it with 26.7, a slight decrease on its rate for 1880; and then Manchester with 25.5, and Glasgow with 25.3. The deathrate of Salford, which is usually higher than that of Manchester, and which was 28 in 1880, has gone down to 22.6 in 1881. N.B.—The rates for the years 1877-1880, mentioned above, are different from those given for the same years in previous Reports, on account of the corrections of the estimated populations of the towns made since the Census was taken. Of 50 large town districts in England (excluding the 20 largest towns already referred to), only the following had lower death-rates than this Parish in 1881:— Reading 14.2 Maidstone . 14.3 Dover 15.4 Cheltenham 15.9 Hastings 16.0 Walsall 16.5 Cambridge . 16.6 and these mostly include country districts, The average rate for these 50 towns was 19.6 per thousand per annum, and the highest was 24.6 for Merthyr Tydfil. Our death-rate was, as usual, considerably below that of any large foreign city; the lowest among these being Christiania 18.8, Geneva 21.2, Copenhagen 22.l, and Philadelphia 22.5 ; and the highest, Madrid 37.4, Madras 38.8, and St. Petersburg 51.4. The death-rate of Madras declined from 44'8 in 1880 to 37.4 in 1881, while that of St. Petersburg rose from 46-l in 1880 to 51.4 in 1881. 6 Table II. YEAR. Registered Births. Birth-rate per 1,000 per annum (52 weeks). Deaths of Children under 1 Year. Total. Percentage to Registered Births. Percentage to Total Deaths (uncorrected). 1873 2,144 23.76 333 15.53 22.70 1874 (S3 weeks) 2,266 24.59 333 14.69 19.57 1875 2,191 24.12 345 15.75 18.48 1876 2,174 23.88 328 15.09 17.56 1877 2,138 28.48 309 14.45 17.87 1878 2,172 23.85 309 13.04 15.40 1879 (53 weeks) 2,108 23.26 298 13.75 14.48 1880 2,140 23.91 310 14.49 16.71 1881 2,092 23.36 280 13.38 14.49 From Table II. we see that the number of registered births, 2,092, was rather lower than in either of the preceding eight years, and the birth-rate, 23.36, was consequently low. The birth-rate in London proper was 34.7, in Greater London, 34.6, and in the Outer Ring, 34.1. The average birth-rate of the twenty largest English towns was 35.6, the highest being those of Sunderland, 39.3, Salford, 38.8, Leicester, 38.4, and Sheffield, 38; and the lowest that of Brighton, 30.6. So that, as in 1880, Brighton has the lowest birth-rate and also the lowest death-rate among the large English towns. It should be mentioned also that the birth-rate of Dublin in 1881 was very low, only 29.1, which may partly account for its lowered death-rate. The deaths of children under one year of age were only On referring to Table III. we find that the number of deaths of persons of 60 years of age and upwards was 582, and the percentage of these to the total deaths 30-12, both higher numbers than those recorded for any previous year except 1879; the percentage being of course very much higher than that for London generally; but while the number of deaths of persons of 60 years of age and upwards Table III. YEAR. A. Persons aged sixty years and upwards. b. Violence. c. Inquest Cases. d. Uncertified. Percentages to Gross Total of Deaths. A. B. C. D. 1874 445 76 93 26.95 4.60 5.6 1875 469 84 112 25.20 4.50 6.0 1876 455 108 148 24.36 5.78 7.9 1877 441 82 114 25.51 4.74 6.6 1878 558 91 123 27.83 4.53 6.1 1879 625 89 120 30.37 4.32 5.8 1880 531 97 126 28.63 5.23 6.8 1881 582 107 129 31 30.12 5.54 6.7 1.60 London, 1881 16,906 3,025 5,537 1,051 20.85 3.73 6.8 1.30 7 280, or less than in any year previously recorded; the percentage of these deaths to the registered births was 1338, or lower than in any year except 1878, when it was lower on account of the high birth-rate, and the percentage of these deaths to the total deaths was 14.49, or lower than in any year except 1879, when it was 14.48. The mortality of children under one year of age is just under 134 to 1,000 births; this is surpassed only by Bristol, with 125, and Brighton, with 127, and it is equalled by Plymouth; while in Liverpool there were 173, and in Leicester 202 deaths of children under one year of age to 1,000 births. For London the number was 148, and the average for the 20 large English towns was 152. 8 is high when compared with the total deaths, it is low when compared with the population living; thus in this Parish the 582 deaths are equivalent to 65 per 1,000 persons living, while in London generally there are 71 such deaths to every 1,000 persons living. In no one of the 20 large English towns is the mortality of persons of 60 years of age and upwards per 1,000 persons living as low as in this Parish, the nearest being Nottingham and Leicester, with 66, the highest Manchester, with nearly 97, and the average for the 20 towns between 74 and 75. The percentage of Violent Deaths was higher than previously recorded in any year except 1876, and, as usual, considerably higher than in London generally. The number of Inquest Cases, 129, was also higher than in any year except 1876; and the percentage of these cases to the total deaths, viz., 6.7, was a trifle under that for 1880, and under that for London generally. The uncertified deaths, mentioned for the first time in my Annual Report, were 31, or 1.6 per cent, of the deaths, while in London generally they were only 1.3 per cent, of the total deaths. Table IV. shows that, as usual, Hanover Square SubDistrict has the lowest birth-rate, and Mayfair the lowest death-rate, while Belgravia has the highest birth-rate and the highest death-rate of the 3 Sub-Districts. 9 Table IV. SUB-DISTRICT. Population at middle of 1881. Births. Birth-rate. Total Deaths. Deaths in Public Institutions. Share of Deaths in Public Institutions of London. Correction for Deaths in Public Institutions. Deaths (corrected). Death-rate (corrected.) Hanover Square . 16,862 301 17.85 880 0 74 + 74 294 17.44 Mayfair 18,491 258 19.18 491 891 59 - 338 159 11.79 Belgravia . 59,220 1,933 85.89 1,221 421 261 - 160 1,061 17.92 Whole Parish 89,573 2,092 83.36 1,932 812 394 - 418 1,514 16.91 o Table Iv a. BIRTH.RATES. DEATH.RATES. 1875. 1876. 1877. 1878. 1879. 1880. 1881. 1875. 1876. 1877. 1878. 1879. 1880. 1881. Hanover Sq.. 20.66 17.97 18.86 19.81 19.06 19.45 17.85 18.36 17.97 16.58 17.07 19.05 16.90 17.44 Mayfair 16.54 21.58 19.45 21.49 19.49 20.84 19.12 13.40 13.06 1804 13.26 13.59 12.39 11.79 Belgravia 26.93 26.37 25.76 25.50 25.32 25.87 25.89 20.52 19.46 18.70 19.57 19.01 17.53 17.92 Whole Parish 24.12 23.88 23.48 23.85 23.85 23.91 23.36 19.05 18.20 17.46 18.17 18.25 16.64 16.91 11 From Table IVa. we find that, while the birth-rates of the Hanover Square and Mayfair Sub-Districts are lower that of the Belgravia Sub-District is higher than in recent years; that the death-rates of all the Sub-Districts are lower than usual, although those for Hanover Square and Belgravia are somewhat higher than they were last year, and that the death-rate for Mayfair is even lower than those previously recorded, being only 11.79 per thousand per annum. From the birth-rates and death-rates in the above Table I have calculated the mean duration of life in the Parish and in each of the Sub-Districts during the year 1881, and find them to be as follows:— Mean Duration of Life. Hanover Square Sub-District 57.01 Mayfair „ 66.20 Belgravia „ 46.35 Whole Parish 50.26 The mean duration of life in this Parish, during the last 7 years, has been as follows:— In 1875 it was 46-67 years. „ 1876 „ 47-96 „ „ 1877 „ 49-52 „ „ 1878 „ 48.03 „ „ 1879 „ 48.55 „ „ 1880 „ 58.01 „ „ 1881 „ 50.26 „ So that the average mean duration of life in this Parish, during those 7 years, has been almost exactly 50 years. The mean duration of life in London, during the last 4 years, has been, according to my calculations, as follows:— In 1878 it was 34.24 years. „ 1879 „ 34.23 „ „ 1880 „ 35.17 „ „ 1881 „ 35-87 „ 12 Table V. Showing the number of Deaths in each of the ten years, 1871 to 1880, from the principal infectious Diseases and Diarrhoea, and the number in 1881. DISEASE. 1871. 1872. 1873. 1874. 1875. 1876. 1877. 1878. 1879. 1880. Annual Average of ten years, 1871—1880. Proportion of Deaths to 1,000 Deaths in ten years, 1871—1880. 1881. Proportion of Deaths to 1,000 Deaths in 1881. Small-pox 59 3 1 0 0 2 12 5 0 0 8.2 4.5 9 4.7 Measles 12 38 23 17 30 21 30 11 34 16 23.2 12.7 21 10.9 Scarlet Fever 39 15 9 32 40 22 19 9 36 40 26.1 14.3 18 9.3 Diphtheria 10 9 2 2 16 3 9 4 14 18 8.7 4.8 14 7.2 Whooping Cough 43 66 32 22 42 45 19 64 33 50 41.6 22.7 15 7.8 Fever 30 25 23 25 37 33 25a 32b 16c 18 d 26.4 14.4 24e 12.4 Diarrhæa 65 71 58 61 60 47 35 54 32 39 52.2 28.5 33 17.1 Cholera 5 1 2 8 2 1 2 4 1 1 21 1.1 2 1.0 Total 263 228 150 161 227 174 151 183 166 182 188.5 103.0 136 70.4 а. Viz., Typhus, 2; Enterio (Typhoid), 17; and simple continued Fever, 6. b. Viz., „ 4; „ „ 24; „ „ „ 4. c.. Viz., „ 2; „ „ 12; „ „ „ 2. d. Viz., „ 2; „ „ 15; „ „ „ 2. e. Viz., „ 3; „ „ 20; „ „ „ 1. 13 From Table V. we find that the total number of deaths from Infectious Diseases and Diarrhoea, viz., 136, was less than in either of the preceding 10 years, and considerably less than the annual average, which is 188-5. The 136 deaths are equivalent to 1.5 per 1,000 persons living, at all ages, while the rate for London was 3.6, and that of the 20 large English towns 3.4 per 1,000 living. The only town whose zymotic death-rate was as low as that of this Parish was Plymouth, where it was also 1.5 per 1,000 living. The numbers of deaths from Measles, Scarlet Fever, Whooping Cough, Fever, and Diarrhoea were below the decennial averages, while those from Small-pox were slightly above the average, and from Diphtheria considerably above it. As compared with last year, there was an increase in the deaths from Small-pox, Measles, and Fever, and a decrease in those from Scarlet Fever, Diphtheria, Whooping Cough, and Diarrhoea. The epidemic of Small-pox, which prevailed in London generally, caused 9 deaths in this Parish, the largest number recorded in any year since 1871, when there were 59, except 1877 when 12 were recorded. The Scarlet Fever epidemic of 1879-80 ended in October 1880 ; and during 1881 there were only 18 deaths from this disease in the Parish, as against 40 in 1880, and an annual average of 26. Of the 18 deaths from Scarlet Fever, 2 were deaths of non-parishioners, at St. George's Hospital, from Kidney Disease after Scarlet Fever. Of the 14 deaths from Diphtheria, 6 were those of nonparishioners, at St. George's Hospital; 2 were imported; and 1 was registered as " Sloughing Sore Throat." There were only 15 deaths from Whooping Cough, as against 50 in 1880, and a decennial average of nearly 42 ; 14 this is the lowest annual number recorded since 1870, the nearest to it being 19 in 1877. The number of deaths from the Continued Fevers, viz., 24, although less than the decennial average, was higher than in either 1879 or 1880. Of the 24 deaths, 3 were recorded as from Typhus, 20 from Enteric (Typhoid) Fever, and 1 from Simple Continued Fever. Of the 3 recorded as from Typhus Fever, one was that of a non-parishioner, who died in St. George's Hospital, and whose death was certified as from "Fever, probably Typhus;" one was, I believe, really from Enteric Fever, a child of the same family having died of that disease only 6 days before; and the third was that of a servant, who had not been away anywhere for a fortnight before her illness. Of the 20 deaths from Enteric (Typhoid) Fever, 6 were those of non-parishioners, in St. George's Hospital; one was shown to have been imported, one was merely registered as " Fever," one as "Bilious Fever," and another was a very doubtful case—I believe not Typhoid at all. Diarrhoea caused only 33 deaths, a smaller number than in any year except 1879, when there were 32 deaths from Diarrhoea; the average annual number is 52. Small-Pox in London. No less than 2,371 deaths from Small-pox occurred in London during 1881, as against only 475 in 1880; the numbers for the last 5 years have been as follows:— 1877 2,544 deaths. 1878 1,416 „ 1879 458 „ 1880 475 „ 1881 2,371 „ 15 thus the epidemic only abated in severity in 1879 and 1880, and became again extremely severe in 1881, so severe that the Small pox death-rate of 1881 was only exceeded seven times in the previous 43 years. " In 885 of the 2,371 fatal cases of Small-pox, no reliable statement was made as to previous vaccination or nonvaccination. Of the remaining 1,486, only 524, or 35.3 per cent., were certified to have been vaccinated, while 962, or 64.7 per cent., were certified to have been unvaccinated." Among the unvaccinated about three-quarters of the deaths occurred in persons under 20 years of age, while among the vaccinated three-quarters of the deaths occurred in persons over 20 years of age; this shows quite clearly that vaccinated people are protected during the early years of life, and that the protection diminishes, and requires to be renewed by revaccination. On account of the interest attaching to the question of Small-pox Hospitals in the Metropolis, the Registrar-General has compiled a Table, showing the deaths from Small-pox in the various Metropolitan Districts during the 5 years 1877 to 1881. From this table it appears that, on dividing the Districts into 5 groups—Central, Western, Southern, Northern, and Eastern, the mortality was least in the Central Group and greatest in the Eastern Group; and in neither of these groups is there a Small-pox Hospital. " The group with the lowest Small-pox death-rate is the one which contains no Hospital, but sends the largest proportion of its cases to Hospitals outside its limits. The group with the highest Small-pox death-rate is that which has no Hospital within its limits, and makes less use than any other of the Hospitals outside its limits." These results are particularly interesting to our Parish, as we have no Small-pox or Fever Hospital within our 16 limits, and make the most use we can of those outside our boundaries; your Committee of Works having arrived at the conclusion that this was the best plan, and having my full concurrence in that view. Sanitary Work. For the Year ending March 31st, 1882. The following Table has been compiled for me by Mr. Joseph Snook, your Sanitary Inspector, from the Report Book:— Table VI. Various kinds of Complaints of Nuisances, &c.,from April 1st, 1881, to March 31.st, 1882. Total number of Complaints 597 Notices served85 Houses and premises limewhited 42 Houses disinfected after infectious diseases 227 Old brick drains abolished, and glazed stoneware pipes substituted 27 New drains constructed 7 Drains unstopped and repaired 71 Drains trapped and ventilated, sinks disconnected, &c32 Closets supplied with water 33 Closets unstopped and repaire 52 Roofs repaired 3 New dust bins provided 6 Dust bins renewed, repaired, new covers, &c. 19 Cisterns repaired, new covers, &c 22 New cisterns provided 8 Waste pipes disconnected 41 Removal of animals improperly kept (cases of) 0 17 Meat, fish, &c., condemned (cases of) 7 Overcrowding abated 6 Cesspools abolished 10 Accumulation of dung, straw, &c., removed 49 Various nuisances removed 62 No cause for complaint on inspection 43 Legal proceedings taken 0 Cases could not assist 4 Cases referred to Surveyor 21 Cases referred to Police 3 Licensed cow-sheds 6 Licensed slaughter-houses 12 Cases removed to Hospitals 157 Inspection of houses after cases of infectious diseases, viz.— Typhoid and low fever 13 Typhus fever 1 Scarlet fever 103 Small-pox 113 Diphtheria 6 The articles disinfected in the hot-air disinfecting chamber belonging to the Parish were as follows:— 180 Beds 220 Bolsters 195 Mattresses 424 Pillows 95 Palliasses 165 Carpets 315 Quilts 50 Hearth-rugs 420 Blankets 75 Curtains 326 Sheets 160 Towels 70 Dresses 50 Cushions 50 Shawls 81 Table Covers 90 Coats 70 Rugs 70 Waistcoats And a large quantity of sundry articles. 18 The total number of complaints attended to, and of notices served, was rather smaller than in 1880; in many instances, however, several nuisances are abated at one house and put down as one complaint; thus in one house several waste pipes of cisterns and sinks may be disconnected from the drains and not entered separately. It was not necessary to take out any summons, as all the notices were complied with. The number of houses and of articles of clothing, &c., disinfected after cases of infectious diseases, and the number of cases of such diseases removed to hospitals, were considerably higher than in 1880, owing to the epidemic of Small-pox. A localized outbreak of Small-pox of rather a serious character took place in Aylesford Street, Pulford Street, and St. George's Square, Pimlico, at the end of May and in the first half of June 1881. The cases occurred as follows in those streets : — In March 2 cases. „ April 2 „ „ May 6 „ „ June 23 „ By careful isolation and thorough disinfection, combined with re-vaccination of susceptible persons, it was stamped out, and no cases occurred after June 16th. There were 4 deaths among these cases, and besides these only 4 were treated at home, all the rest being removed to Hospital with one exception, that of a servant girl, who sent a fellow-servant for a fly while the ambulance was being fetched, and drove away in it. The fly was found and disinfected, but it was not thought advisable to take any further proceedings. 19 The number of houses inspected after cases of Enteric (Typhoid) fever was rather less than in 1880. The Markets have been regularly inspected and kept in good order, so that in only 7 instances has it been necessary to condemn articles of food exposed for sale. The Slaughter-houses and Cow-sheds are also regularly inspected and kept in a cleanly condition. No license was opposed either by the Parish or by the Metropolitan Board of Works. I prepared, by order of the Committee of Works, a Special Report on " the Sanitary Condition of the houses in George Street, Hart Street, Brown Street, Providence Court, and Tom's Court, Grosvenor Square, and the immediate neighbourhood," from which it was seen that infectious diseases were of rare occurrence there; and " that the sanitary condition of the houses, whether as regards overcrowding, or the removal of refuse matters, or the water supply, is, at any rate, not such as to cause the slightest anxiety." A new Disinfecting Station has been built at the Parish Yard in Pimlico Road, and one of Dr. Ransom's Selfregulating Disinfecting Ovens fixed in it; this is a great improvement on the old station and apparatus, and has been constructed so that there is no air communication between the chamber in which the infected articles are received, and that in which the disinfected ones are put before their return home, except through the interior of the stove. The Alkali, &c., Works Regulation Act, to Consolidate the Alkali Acts of 1863 and 1874, which provides for the registration and inspection of various chemical works, &c., came into operation on January 1st, 1882; but there are no works affected by it in this Parish. 20 Table VII. Showing the results of the Analyses of the Water supplied to the Parish by the Grand Junction and Chelsea Water Companies. Grand Junction Company's Water. / N Parts per 100,000. Parts per 100 Millions. month. , Total Solid Residue. Chlorine Common Salt. Saline. Ammonia. Organic Ammonia. April 1881 30 1.6 2.0 3.2 12.6 May 32 1.4 2.2 4.3 4.0 June „ 31 1.5 2.5 2.0 8.0 July „ 27 1.8 30 0.4 13.8 August „ 28 1.6 2 6 1.0 11.8 September „ 36 1.6 2.6 0.5 8.2 October „ 28 1.6 2.6 2.2 7.8 November „ 30 1.6 2.6 1.1 12.8 December „ 32 1.0 2.0 1.6 9.6 January 1882 33 1.6 2.6 2.1 10.8 February „ 41 1.6 2.6 0.8 10.8 March „ 30 1.6 2.6 2.8 11.2 Average 31.5 1.0 2.6 2.4 10.2 Chelsea Company's Water. April 1881 22 1.6 2.6 2.6 9.2 May „ 30 1.5 2.5 3.2 10.6 June „ 28 1.5 2.5 1.2 7.6 July „ 24 1.6 2.6 0.8 8.2 August „ 25 1.6 2.6 3.5 7.2 September „ 36 1.6 2.6 1.8 8.8 October „ 27 1.6 2.6 3.2 9.2 November „ 30 1.6 2.6 3.2 11.8 December „ 33 1.0 2.6 2.1 10.8 January 1882 32 1.6 2.6 2.1 11.6 February „ 37 1.6 2.6 1.1 10.0 March „ 33 1.6 2.6 0.8 9.4 Average 29.75 1.6 2.6 2.1 9.6 Table VII. shows the results of my analyses of the water supplied by the two Companies in the Parish during each of the twelve months. In both cases the average quality was decidedly superior to that of the preceding year, and the improvement in the winter months was very marked. During the hot weather in July, the Grand Junction 21 Company's supply was not sufficient for the wants of the districts supplied by it; and this deficiency was aggravated by the bursting of a 30-inch main. A deficiency of water is an especially serious matter in hot weather, and the public have a right to insist that the arrangements made by the Water Companies shall be such as to render such an occurrence practically impossible. The common gas supplied by the London Gas Company has been examined by me from time to time at their testing room, and has always been found to be above the required standard of illuminating power, and to satisfy the prescribed tests for ammonia and sulphuretted hydrogen. For the information of the Parishioners, I may mention that a hospital carriage for removing persons suffering from infectious diseases is kept at the Workhouse, in Mount Street; but those who are in a position to bear the expenses of their support should apply to the London Fever Hospital, Liverpool Road, Islington; or, in case of small-pox, at the Highgate Small-pox Hospital, where they can be accommodated on favourable terms. I have the honour to be, My Lords and Gentlemen, Your obedient Servant, W. H. CORFIELD, M.A., M.D. (Oxon.), F.R.C.P. (London). 10, Bolton Row, Mayfair, W., June 1882. 22 APPENDIX TO THE REPORT OF THE Medical Officer of Health. Summary of Analytical Work for the Year ending March 25th, 1882. name of sample. Genuine. Of doubtful Quality. Adulterated. Total. Milk 17 3 4 24 Bread 26 — — 26 Butter 1 — 1 2 Tea 10 — — 10 Coffee 3 — 9 12 Mustard 11 — 4 15 Pepper 1 — 3 4 Flour 20 — — 20 Sugar 22 — — 22 Brandy — — 1 1 Port Wine 1 — — 1 Vinegar 10 — — 10 Sweetmeats 7 — — 7 129 3 22 154 Of these 154 samples, only 2, namely, one of Milk and one of Port Wins, were bought by private purchasers ; they were both genuine, that of Milk being a very rich one. The other 152 samples were all purchased under my direction by your Inspector. 23 Of the 4 adulterated samples of Milk, 3 were bought for information, and on purchasing other samples for the purpose of prosecution these were found in two cases to be genuine, and in the third to be skimmed but not watered (making the fourth adulterated sample). The vendor was warned by order of the Committee of Works. The adulterated Coffees contained chicory to greater or less extent, and some were labelled to that effect. A number of cases of adulteration of Coffee with chicory have recently been dismissed with costs, on the ground that prejudice to the purchaser was not proved. The adulterated Mustards contained wheat starch and turmeric, and, in one instance, gamboge—a very rare and a serious adulteration. A second sample bought at the same shop (for prosecution) was genuine. The adulterated Peppers merely contained small quantities of rice starch. Most of the samples of Tea contained small quantities of " Lie" tea, but no foreign leaves. The adulterated sample of Brandy was purchased at a house where a watered sample had been previously obtained. The vendor, Edmund Pinder, of the Globe Public-house, 43, North Audley Street, was convicted and fined 5s. and 23s costs, for selling a sample of brandy 31 degrees under proof (25 degrees under proof being the minimum allowed by the Act). The number of samples analysed, and the number found adulterated, were almost exactly the same as during the preceding 12 months. W. H. CORFIELD, Fellow of the Institute of Chemistry, Public Analyst.