THE VESTRY of the Parish of St. George, HANOVER SQUARE. MEDICAL OFFICER'S REPORT for the YEAR ENDED 25TH MARCH, 1886. JUNE 1886. LONDON: PRINTED BY PHIPPS & CONNOR, 13 & 14, TOTHILL STREET, WESTMINSTER. 1886. REPORT on THE SANITARY CONDITION of the Parish of St. George, Hanober Square, FOR THE YEAR 1885. 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 offices of health and public analyst. (BEING HIS FOURTEENTH ANNUAL REPORT.) To the Vestry of the Parish of St. George. hanover square. My Lords and Gentlemen, Owing to the fact that I now receive from the Registrar-General returns of the deaths of our Parishioners occuring in Public Institutions outside of the Parish, and also from the Local Registrars weekly returns of the deaths occurring in Public Institutions in the Parish, in which the deaths of Parishioners are distinguished from those of NonParishioners, I am now able to state exactly how many deaths of our Parishioners have occurred in the Public Institutions throughout Loudon, and am no longer obliged 2 to resort to the method hitherto adopted, viz., that of assigning to the Parish a share of the deaths occurring in Public Institutions throughout London, proportional to the population of the Parish. This plan is of course more accurate than the old one, and may make a considerable difference in the corrected death-rate, as indeed was the case during the year under review. 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). 1875 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 1881 1,932 812 394 1,514 16.91 1882 1,867 730 361 1,498 16.73 1883 1,845 829 390 1,406 15.70 1884 (53 weeks) 1,873 769 384 1,460 16.30 Average during ten years, 1875 —1884 1,890 695 388 1,569 17.34 Year 1885 1,773 766 *436 1,443 16.11 Average during ten years, 1876 — 1885 1,880 771 385 1,592 17.15 * Actual number, as shown in foot-note on next page. 3 In the year 1885, there occurred, as will be seen from Table I., 1,773 deaths in the Parish, the smallest number recorded since 1877, and a number considerably lower than the average during the past ten years. Of these deaths, no less than 776 occurred in the Public Institutions in the Parish, whereas the number of deaths of our Parishioners which occurred in Public Institutions throughout the Metropolis was only, as shown in the foot-note,* 436, giving a corrected total of deaths of 1,443, equivalent to a deathrate of 16.11 per thousand per annum. This is the lowest death-rate that has been recorded for the Parish, except in the year 1883, when the death-rate, recorded by the old method of calculation, was 15.70 ; but if I had adopted the same method of calculation this year. I find that our proportional share of deaths in Public Institutions in London was only 378 instead of 436, our actual number. This would give a corrected total of deaths of 1,385, equivalent to a corrected death-rate of only 15 46 per thousand per annum. We may therefore, I think, fairly consider that during the year 1885 the lowest true death-rate yet arrived at by the Parish was reached. * Deaths of Parishioners in Public Institutions :— Fulham Road Workhouse 254 Buckingham Palace Road ditto 1 St. George's Hospital 70 Belgrave Childrens' ditto 8 St. Gabriel's ditto 7 Total in the Parish 310 In Public Institutions in London, outside of the Parish 96 Total Deaths of Parishioners in Public Institutions 436 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. ]880. 1881. 1882. 1883. 1884. 1885. Twenty Large English Towns 22.7 24.2 23.2 22.7 21.7 *22.3 *21.6 *21.6 *20.5 London 21.5 23.0 22.7 21.6 21.2 21.4 20.4 20.3 19.7 St. George's, Hanover Sq 17.46 18.17 18.25 10.64 16.91 16.73 15.70 16.30 10.11 * Twenty-eight towns. The death-rate of London proper (see Table Ia.), with an estimated population of 4,083,928, was only 19.7 per thousand per annum, the lowest death-rate yet recorded, being 0.6 per thousand less than in 1884, and 1½ per thousand less than in any year before 1883. The death-rate of Greater London (estimated population 5,199,166) was also lower than in previous years, being only 19.2 as against 19.7 in 1883 and 1884; in the Outer Ring, with an estimated population of more than a million persons, it was 175, the same as in 1884. As usual, the death-rate of this Parish was decidedly lower than that of either of the 28 largest English towns, the nearest to it being the following :— Brighton Hull 17.2 Bradford 17.7 Derby 18.1 Birmingham 19.1 Birkenhead 19.5 5 Norwich Bristol Halifax London 19.7 The average death-rate of the 28 largest English towns was 20.5, or nearly 4½ per thousand higher than the deathrate of this Parish. The highest death-rates among these towns were those of Preston with 27.l, Manchester with 26.5, Newcastle-on-Tyne with 26.l, and Cardiff with 25.7. The average death -rate in 50 other large town districts in England was 19.6, or just under the death-rate of London proper. The only one of these districts which had a lower death-rate than this Parish was Darlington, with 16.0; the others most nearly approaching it being Maidstone with 16.2, Cambridge with 16.4, Accrington with 16.6, and Southport with 16.9, and the highest of them being Stockport with 24.6, Merthyr-Tydfil with 24.3, and Wigan with 23.5. The death-rate of Glasgow was 25.8, or lower than in any year except 1882, when it was 25.4; that of Dublin was 28.5, a higher death-rate than that of any other large town in the United Kingdom, while that of Edinburgh was only 18.2. Among foreign cities no death-rate is to be found even approaching that of this Parish, the nearest to it being the death-rate of Baltimore with 19.8 per thousand, or just above that of London, Copenhagen with 20.4, Geneva with 20.7, and Christiania with 20.l, and the highest being Madras with 37.4. It is to be noted, however, that the death-rate of Madras was as high as 50.7 in 1884. 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). 1875 2,191 24.12 345 15.75 18.48 1876 2,174 23.88 328 15.09 17.56 1877 2,138 23.48 309 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 1882 1,935 21.61 271 14.01 14.53 1883 1,878 20.97 287 15.28 15.50 1884(53 weeks) 1,933 21.18 259 13.40 13.83 1885 1,767 l9.73 219 12.39 13.35 From Table II. it will be seen that the number of births registered in the Parish was less than in either of the previous 10 years, and that the birth-rate was only 19.73 per thousand per annum, whereas the lowest rate in any previous year was that in 1883, when it was 20.97, or 1½ per thousand higher. The birth-rate of London proper was 32.6, the lowest rate recorded since 1850. In Greater London the birth-rate was 32.9, and in the Outer Ring 34.2. The average birth-rate of the 28 largest English towns was 33.5, the highest being Cardiff 43.1, and Preston 39.2; and the lowest Brighton 26.1, and Halifax 28.8. The total number of deaths of children under one year 7 of age was only 219, the lowest number of such deaths yet recorded for any year, the nearest to it being 1884 (53 weeks) with 259 such deaths. The percentage of these deaths to the registered births was also decidedly lower than in any previous year, as also was their percentage to the total deaths; thus the mortality of children under one year of age was almost exactly 124 to a thousand births, while in London it was 148 (as against 155 in the year 1884), and the average for the 28 largest English towns was 155 (as against 168 in 1884), the highest being Preston 218, Leicester 193, and Cardiff 189. None of these 28 towns had a smaller percentage of deaths of children under one year of age to total deaths than this Parish, the nearest to it being Hull with 128; whereas in 1884 there was one town, and in 1883 twelve towns, which had lower numbers than this Parish. We may fairly regard this continually lessening infant mortality as a sign of general sanitary progress. 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. 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 568 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 1882 525 80 102 29 2812 4.29 5.5 1.55 1883 537 93 126 27 29.11 505 6.8 1.46 1884 543 106 132 31 28.99 5.66 7.0 1.66 1885 557 79 106 22 31.42 4.46 6.0 1.25 London 1885 18,278 2,714 5,578 908 22.85 3.39 7.0 1.1 Table III. shows that the number of deaths of persons 8 aged sixty years and upwards was 577, or 14 more than in the 53 weeks of 1884. This number was 31.42 per cent. of the total deaths, or a higher percentage than that recorded in either of the previous ten years. The corresponding percentage for London was 22.85, or over 2 per cent. higher than in 1884, thus showing that the proportion of persons attaining a great age has increased in this Parish, and in London, being however, as usual, far higher in this Parish than in London generally; but if we look at this from another point of view, and consider the proportion of such deaths per thousand persons living, we find that it is only 62.18 per cent. in this Parish, while in London it is 71.5. The lowest numbers among the 28 large English towns are Birkenhead 66.6, and Brighton 66.8, and the highest, Preston 96.7, and Manchester 91.9, and the average of these 28 towns 74.5. All these numbers are higher than the corresponding numbers for 1884. The total number of violent deaths recorded during the year was 79, a lower number than any recorded since 1874, when it was 76. The percentage of these deaths to the total deaths was 4.46, a lower percentage than usual for this Parish, but, as is always the case, higher than that for London, which was 3.39. The number of deaths uncertified as to cause were for Hanover Square 3, Mayfair 2, and Belgravia 17; total 22, or 1.25 per cent. of the total deaths, as against 1.66 for this Parish in 1884, and 1.1 for London generally in 1885. 9 Table IV. SUB-DISTRICT. Population at middle of 1886. 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 16,862 259 15.36 174 0 82 + 82 256 15.18 Mayfair 13,491 191 14.16 447 362 66 - 29(5 151 11.19 Belgravia 59,220 1,317 22.24 1,152 404 288 - 116 1,036 17.49 Whole Parish 89,573 1,767 19.73 1,773 766 436 - 330 1,443 16.11 10 Table IVa. Birth-Rates. Death-Rates. 1875. 1876. 1877. 1878. 1879. 1880. 1881. 1882. 1883. 1884. 1885. 1875. 1876. 1877. 1878. 1879. 1880. 1881. 1882. 1883. 1884. 1885. Hanover Sq 20.55 17.97 18.88 19.81 19.05 19.45 17.85 17.26 17.08 16.46 15.36 18.36 17.97 16.58 17.07 19.05 16.90 17.44 15.84 14.65 15.54 15.18 Mayfair 16.54 21.53 19.45 21.49 19.49 20.84 19.12 16.83 16.61 15.20 14.16 13.40 13.06 13.04 13.26 13.59 12.39 11.79 11.87 11.31 12.44 11.19 Belgravia 26.93 26.27 25.76 25.50 25.32 25.87 25.89 23.93 23.07 23.87 22.24 20.52 19.46 18.70 19.57 19.01 17.53 17.92 18.09 16.99 17.40 17.49 Whole Parish 24.12 23.88 23.48 23.85 23.26 23.91 23.36 21.61 20.97 21.18 19.73 19.05 18.20 17.46 18.17 18.25 16.64 16.91 16.73 15.70 16.30 16.11 11 Tables IV. and IVa. show that the corrected birth-rate of the Parish and those of the Sub-Districts were not merely, as usual, very low, but quite exceptionally low even for this Parish, being lower in each instance than any previously recorded rate. They also show that the deathrates of the Sub-Districts were very low, that of Mayfair being the lowest yet recorded, viz., 11.19, that of Hanover Square 15.18, being lower than in any year except 1883, and that of Belgravia 17.49, being almost exactly the same as it was last year, and just 0.5 per thousand higher than in 1883, when the lowest rate yet attained by that SubDistrict, viz., 16.99, was recorded. From the birth-rates and death-rates in Table IVa. I have calculated the mean duration of life in the Parish, and in each of the Sub-Districts during the year 1885, and have found them as follows:— Mean Duration of Life. Hanover Square Sub-District 66.48 years. Mayfair 79.44 „ Belgravia 50.68 „ Whole Parish 56.11 „ The mean duration of life in this Parish during the last 11 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 „ 12 In 1882 it was 52 56 years. „ 1883 „ 55.09 „ „ 1884 „ 53.78 „ „ 1885 „ 56.11 „ So that the mean duration of life in this Parish during those 11 years has averaged just 51½ years. The mean duration of life in London during the last 8 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 „ „ 1882 „ 36.82 „ „ 1883 „ 37.88 „ ,, 1884 ,, 38.08 „ „ 1885 „ 39.29 „ It therefore appears that the mean duration of life in this Parish has increased by about 9½ years since 1875, and that in London by about 5 years since 1879. The steady and continual increase of the mean duration of life in London, as shown by the above figures, is very remarkable, and although the increase in this Parish is not so steady it is unmistakable. There can be no doubt that the steady diminution of the death-rates, the most important cause of the increased mean duration of life, is very largely due to improved sanitary conditions. 13 Table V. Showing the number of Deaths in each of the ten years, 1875 to 1884, from the principal infectious Diseases and Diarrhœa, and the number in 1885. DISEASE. 1875. 1876. 1877. 1878. 1879. 1880. 1881. 1882. 1883. 1884. Annual Average of ten years, 1875—1884. Proportion of Deaths to 1,000 Deaths in ten years, 1875—1884. 1885. Proportion of Deaths to 1,000 Deaths in 1885. Small-pox 0 2 12 5 0 0 9 1 0 2 3.1 1.6 2 1.1 Measles 30 21 30 11 34 16 21 30 13 40 24.6 13.0 21 11.8 Scarlet Fever 40 22 19 9 36 40 18 13 11 7 21.5 11.4 10 5.6 Diphtheria 16 3 9 4 14 18 14 15 27 25 14.5 7.7 35 19.7 Whooping Cough 42 45 19 64 33 50 15 63 21 43 39.5 20.9 19 10.7 Typhus Fever 37 33 2 4 2 1 3 0 0 1 25.9 0 0.0 Enteric (orTyphoid)Fever 17 24 12 15 20 21 21 22 13.7 8 4.5 Simple Continued Fever 6 4 2 2 1 0 8 1 2 1.1 Diarrhœa 60 47 35 54 32 39 33 34 27 44 40.5 21.4 37 20.8 Cholera 2 1 2 4 1 1 2 2 1 0 1.6 0.8 2 1.1 Total 227 174 151 183 166 182 136 179 129 185 171.2 90.5 136 76.4 14 From Table V. we find that the total number of deaths from the principal infectious diseases and diarrhoea in 1885 was only 136, the lowest number yet recorded, except in 1881, when it was also 136, and in 1883 when it was only 129, and lower by no less than 49 than the number of such deaths in 1884, when it was 185 during 53 weeks. The 136 deaths are equal to a zymotic death-rate of l.52 per thousand persons living, as against 2.06 in 1884, or a lowering of about 25 per cent. on that rate. The rate for London was 277, also decidedly lower than in 1884 when at was 3.34, and that for the 28 largest English towns was 2.71 as against 3.50 for 1884; thus it will be seen that the zymotic death-rates were generally lower in 1885 than in 1884. Of the largest towns only 5 had lower rates than this Parish, the lowest being Halifax with 1.12; the other 23 had higher zymotic death-rates than ours, the highest being Cardiff with 4.98, or more than 3¼ times the zymotic death-rate of this Parish. To consider these diseases separately :— Small Pox caused 2 deaths in the Parish, and there were 4 deaths of Parishioners from this disease in Public Institutions outside the Parish. One of these fatal cases, however, was that of a gentleman who was only 2 or 3 hours in a hotel in the Parish, having just come from the Continent. He was removed to the Highgate Small-Pox Hospital and died there; it is obvious that he should not be reckoned as a Parishioner. Measles caused only 21 deaths, as against 40 in 1884, and an average of 24.6 during the previous 10 years. There have been no important outbreaks of this disease in the Schools' in the Parish the year. Scarlet Fever caused 10 deaths, as against an average of 21.5 during the previous 10 years. But of these 10 deaths 3 were those of non-parishioners dying in St. George's 15 Hospital from Kidney Disease after Scarlet Fever. One Parishioner died from this disease in a Public Institution outside the Parish. Diphtheria caused no less than 35 deaths, being the largest number recorded in the Parish in any year, and nearly 2½ times the annual average for the preceding 10 years; being also an increase of 10 on the number for 1884. Of these 35 deaths, however, no less than 12 were those of non-parishioners dying in St. George's Hospital; 1 was that of a case contracted in that Hospital, and another is known to have been imported from the country ; 1 was certified as from " Diphtheritic Sore Throat." Only one Parishioner died from this disease in a Public Institution outside the Parish. Diphtheria has been exceedingly prevalent in London generally since 1883; there were in 1885 no less than 147 deaths from Diphtheria and Croup above the annual average of such deaths during the previous 10 years. Whooping Cough caused only 19 deaths as against 43 in 1884, and an annual average of 39.5. Typhus Fever.— No death from this disease was registered in the Parish during the year. Enteric (Typhoid) Fever.— Only 8 deaths from this disease were recorded, a smaller number than in any previous year since these deaths were separately registered, the lowest previously-recorded number having been 12 in 1879. Of these 8 deaths, moreover, no less than 3 were those of nonParishioners in St. George's Hospital, 2 others were those of imported cases, and one was that of a very doubtful case in a person 74 years of age. On the other hand, 3 Parishioners died from Enteric Fever in Public Institutions outside the Parish. An outbreak of this disease occurred at the Home of the House-Boy Brigade in November, and one of the cases from this Home died at the Westminster Hospital. On 16 inspecting the premises I found certain important sanitary defects, which have since been remedied under my directions. Simple Continued Fever.— Two deaths were registered from this disease; one of them, however, was that of a nonParishioner who died in St. George's Hospital, from Puerperal Fever. So that there were together only 10 deaths from Continued Fevers (including those of Parishioners and nonParishioners) registered in the Parish during the year, as against an annual average of 25.9, and of these 10 deaths, only 4, viz., 2 from Enteric, 1 from Simple Continued Fever, and 1 doubtful case, were those of Parishioners. Diarrhoea caused 37 deaths, or 7 less than in 1884, and 3 5 less than the annual average for the previous 10 years. Two deaths from English Cholera or Choleraic Diarrhoea were also registered. Small Pox in London. The annual numbers of deaths from Small Pox in London since 1880 have been as follows:— 2,371 in 1881, 431 in 1882, 134 in 1883, 913 in 1884 (53 weeks), and 899 in 1885, from which we see that the mortality from this disease has been about the same during the last 2 years. Sanitary Work. For the Year ending March 31st, 1886. The following Table has been compiled for me by Mr. Joseph Snook, your Senior Sanitary Inspector, from the Report Book:— 17 TABLE VI. Various kinds of Complaints of Nuisances, &c., from lst April, 1885, to 31st March, 1886. Total number of Complaints 460 Notices served 47 Houses and premises limewhited 49 Houses disinfected after infectious diseases 74 Old brick drains abolished, and pipes substituted 18 New drains constructed - 8 Drains unstopped and repaired 45 Drains trapped and ventilated, sinks disconnected, &c. 57 Closets supplied with water - 37 Closets unstopped and repaired 42 Roofs repaired 7 New dustbins provided 5 Dustbins renewed, repaired, new covers, &c. 18 New cisterns provided - 11 Waste pipes disconnected 34 Removal of animals improperly kept 2 Meat, fish, &c., condemned (cases of) 1 Overcrowding abated 2 Cesspools abolished 7 Accumulation of dung, straw, &c., removed 22 Various nuisances removed 56 No cause for complaint 23 Legal proceedings taken 0 Cases could not assist 7 Cases referred to Surveyor 12 Cases referred to Police 3 Licensed cow-houses 4 Licensed slaughter-houses 7 18 Inspection of houses after cases of infectious diseases, viz.— Typhoid and Low Fever 10 Typhus Fever 0 Scarlet Fever 55 Small Pox 30 Diphtheria 15 The articles disinfected in the hot-air disinfecting chamber belonging to the Parish were as follows :— 44 Beds 80 Mattresses 25 Palliasses 63 Quilts 185 Blankets 18 Waistcoats 30 Trowsers 62 Carpets 35 Hearth Rugs 72 Curtains 6 Suits of Clothing 133 Sheets 65 Bolsters 121 Pillows 36 Dresses 12 Shawls 38 Coats 65 Towels 40 Cushions 28 Table Covers 26 Rugs And a quantity of Sundry Articles. The total number of complaints attended to, and of notices served, was considerably less than in 1884, and it was not necessary to take legal proceedings in any case during the year. The markets have been regularly inspected and kept in good order, so that it has only been necessary to condemn food exposed for sale in one instance. The slaughter-houses and cow-sheds have also been regularly inspected and kept in good condition. No application for a license has been opposed, and no new application has been made. The number of articles of clothing, bedding, &c., disinfected, has been much less than in 1884, on account of the disappearance of the epidemic of Small Pox, and the diminution of the number of cases of infectious diseases generally. The Architect of the new Vestry Offices in Mount Street has consulted me with regard to the drainage and sanitary 19 arrangements generally of those buildings, and I have given him my advice on the matter. Forms have been prepared under my direction, and with the approval of the Sub-Committee, for the registration of houses let in lodgings. I asked permission from his Grace the Duke of Westminster for the use of a sufficient part of his vacant land near Chelsea Bridge for the purposes of a temporary Cholera Hospital, should it have been necessary to construct one in the autumn of 1885. This permission was, as on the occasion of a former application in 1884, immediately granted, but, fortunately, it was not necessary for the Parish to avail itself of it. Before 1885 the Parish had arranged for the removal of non-pauper cases to the London Fever Hospital and to the Highgate Small-Pox Hospital, by contracting to pay a certain sum for the maintenance of such cases during their stay in the Hospital; but in that year the Metropolitan Asylums District Board proposed and the Parish accepted an agreement by which the Parish contracted to pay the sum of four guineas for each non-pauper patient removed to a hospital under the control of the Managers. This sted was rendered necessary by the faot that the authorities of the London Fever Hospital gave notice that they could no longer receive any patients sent by the Vestry. I drew up a handbill of directions for the prevention of summer Diarrhoea and Cholera, and it was largely distributed throughout the Parish by direction of the Committee of Works. The Metropolitan Board of Works issued a new order of Regulations as to dairies, cow-sheds, and milkshops, the most important regulation of which was that "which requires a purveyor of milk to discontinue keeping milk for sale in a building in which there has been infectious or contagious disease, until such building has been disinfected, and declared by the Medical Officer of Health for the district to be free from infection." No. 3 of our Regulations for houses let in lodgings provides that "every owner and keeper of a lodging-house, if served 20 with a notice in writing, signed by the Vestry Clerk, requiring him to supply the information necessary for the registration of such house, shall be bound, within a period of 14 days after such service, to attend, either personally or by his agent duly authorised, at the offices of the Vestry during office hours, and then and there to furnish and sign a true statement of "certain particulars." It will be remembered that the Sub-Committee charged with the framing of the regulations, acting on the advice of their Chairman (Lord Hobhouse), reported against the admission of the one in question when proposed by the Local Government Board, and that the Vestry adopted that view. Their reason was that the legislature has only empowered the Vestry to make regulations for registration, and they did not think that such terms included a power to call a man away from his business or his home to the Vestry Office, to give information to the officials whenever they thought fit. This view was communicated to the Local Government Board, first by writing and afterwards by interview, but that Board was advised differently, and insisted on the insertion of the regulation. A similar clause having been inserted among the regulations for the Parish of St. Giles, that Parish summoned a landlord who declined to comply with it, when the Magistrate before whom the case was tried decided that the regulation in question exceeded the powers conferred on the District Board by the Act, and was altogether null and inoperative. I make this statement for two reasons— first, to show that if it turns out that one of our regulations is illegal, it is not due to error on the part of the Vestry; secondly, for the purpose of adding that the Regulation in question should in my opinion, not be acted on unless and until higher judicial authority has declared that the opinion of the magistrate is erroneous. 21 Table VII. Showing the results of the Analyses of the Water supplied by the Grand Junction and Chelsea Water Companies. MONTH. Parts per 100,000. Parts per 100 Millions. Total Solid Residue. Chlorine = Common Salt. Saline Ammonia. ic Ammonia. Grand Junction Company's Water. April 1885 32.0 1.8 3.0 1.6 6.6 May „ 28.0 1.8 8.0 3.2 8.0 June „ 27.0 1.8 3.0 1.3 13.2 July „ 25.0 1.8 3.0 1.4 8.4 August „ 22.0 1.8 3.0 1.3 7.8 September „ 28.0 1.8 3.0 1.4 11.8 October „ 33.0 1.8 3.0 0.8 12.8 November „ 39.2 1.6 2.6 2.2 14.2 December „ 37.0 1.8 3.0 0.8 12.6 January 1886 „ 32.4 1.6 2.6 2.8 16.4 February „ 22.0 1.8 2.6 2.4 15.8 March „ 34.0 1.6 2.6 2.1 14.0 Average 29.9 1.7 3.9 1.8 11.8 Chelsea Company's Water. April 1885 30.0 2.0 3.8 3.4 14.6 May 25.0 1.8 3.0 2.2 10.6 June „ 24.0 1.8 3.0 2.1 19.0 July „ 24.0 1.8 3.0 2.2 12.2 August „ 27.0 1.8 3.0 1.3 7.6 September „ 29.0 1.8 8.0 2.2 11.0 October „ 26.0 1.6 2.6 1.3 11.2 November „ 26.0 1.6 2.6 2.2 17.6 December ,, 34.0 1.8 3.0 0.8 15.0 January 1886 „ 34.8 1.6 2.6 4.2 17.0 February „ 18.0 1.6 2.6 2.4 15.4 March „ 41.8 1.8 3.0 2.4 15.6 Average 28.3 1.7 2.9 2.2 13.9 Table VII. shows the result of my analyses of the water supplied to the Parish by the two Companies during each of the twelve months. In both cases the average quality was inferior to that of the preceding year. By direction of the Committee of Works I prepared a Code of Regulations for the management of the Public 22 Mortuary recently built at Ebury Bridge. These Regulations were, after revision by the Mortuary Sub-Committee, approved by the Vestry: they will be found elsewhere in the Report of the Vestry. 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 Wallis's Yard, Buckingham Palace Road, and that the Ambulance belonging to the Metropolitan Asylums Board is kept at Seagrave Road, Fulham; 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). 19, Savile Row, London, W., June 1886. 23 APPENDIX TO THE REPORT of the Medical Officer of Health. Summary of Analytical Work for the Year ending March 25th, 1886. NAME OF SAMPLE. Genuine. Of doubtful Quality. Adulterated. Total. Bread 20 — — 20 Coffee 4 — 12 16 Cream 1 — — 1 Flour 20 — — 20 Milk 12 6 5 23 Mustard 5 — 13 18 Pepper 8 2 2 12 Sugar 17 3 — 20 Tea 8 — — 8 95 11 32 138 24 Of these 138 samples, only 2, viz., 1 sample of Milk and 1 of Cream, were brought by private purchasers ; the former was poor, and the latter genuine. Of the 12 adulterated samples of Coffee, only 3 were labelled " Mixtures." Of the 5 samples of Milk certified as adulterated, 4 contained from 13 to about 25 per cent. of added water, and the other was skimmed and a little water added; they were all samples obtained for information. The 6 samples of Milk classed as "of doubtful quality" were poor or skimmed. The 13 samples of Mustard found to be adulterated contained wheat-flour and turmeric. The 2 samples of Pepper certified as adulterated contained wheat-flour and rice-flour. The 2 samples of Pepper classed as "of doubtful quality" contained traces of wheat-flour (no doubt accidental). The 3 samples of Sugar classed as "of doubtful quality " contained fragments of cane, acari, &c. Finding that the work of Public Analyst was too great a tax upon my time, I this year (1886) resigned that office, and recommended that Mr. Charles E. Cassal, F.I.C., F.C.S., who has been my private assistant and demonstrator in the Hygieaic Laboratory at University College for a number of years, should be appointed Public Analyst. I have to thank the Vestry for kindly acceding to this request and appointing Mr. Cassal, on the understanding, however, that I should still exercise a general superintendence over the collection of samples. I have no doubt that the new arrangement will be of great advantage to the Parish. W. H. CORFIELD, Public Analyst.