HAN 36 THE VESTRY OF THE Parish of Saint George HANOVER SQUARE Medical Officer's Report FOR THE YEAR ENDED 25th MARCH, 1887. JUNE, 1887. LONDON: PRINTED BY WIGHTMAN & CO., REGENCY STREET, WESTMINSTER. 1 8 8 7. REPORT on The sanitary condition OF THE Parish of St. George, Sanober Square FOR THE YEAR 1886, W. H. CORFIELD, M.A., M.D. (OXON.), F.R.C.P. (LOND.) Professor of Hygiene and Public Health in University College, London; Past President of the Society of Medical Officers of Health; Chairman of Council of the Sanitary Institute of Great Britain; Honorary Corresponding Member of the Royal Society of Public Health of Eelgium; MEDICAL OFFICER OF HEALTH. (BEING HIS FIFTEENTH ANNUAL REPORT.) To the Destin of the parish of St. George, HANOVER SQUARE. My Lords and Gentlemen, The total number of deaths registered in the Parish during the 52 weeks ending January 1st, 1887, was 1,900 the largest number recorded since the year 1881 (see Table I), and a larger number than the average during the 10 years, 1876 to 1885. Of these deaths, however, no less than 797 occurred in Public Institutions in the Parish, whereas the number of deaths of our Parishioners which occurred in all the Public Institutions in the metropolis 2 was only, as shown below,* 435; thus making the corrected total of deaths 1,538, equivalent to a corrected death-rate of 17.17 thousand per annum. Table I. • YEAR. Gross Total of Deaths. Deaths in Public Institutions. Proportional Share of Dentils in Public Institutions Corrected Total of Deaths. (52 weeks). Corrected Death-rate per 1,000 per annum (52 weeks). 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 1,855 713 347 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 1885 1,773 766 *436 1,443 16.11 Average during ten years, 1876-1885 1,871 721 385 1,540 17.05 1,900 797 *435 1,538 17.17 l886 Average during ten years. 1877-1886 1,874 744 392 1,527 16.94 * Actual numbers (not calculated as in previous years). It will be noticed that the corrected total of deaths is 95 higher than it was in 1885, and that the corrected death-rate is one per thousand higher than it was in that year, with which it can be fairly compared, as the calculations were made in the same way in the two years, the actual number of Parishioners dying in Public Institutions in the Metropolis having been used last year * Deaths of Parishioners in Public Institutions:— Fulham Road Workhouse 250 Buckingham Palace Road ditto 3 St. George's Hospital 77 Belgrave Children's ditto 7 St. Gabriel's ditto 8 Total in the Parish 345 In Public Institutions in London, outside of the Parish 90 Total Deaths of Parishioners in Public Institutions 435 3 for the first time. To compare the death-rate of 1886 with those of the years preceding 1885 it is necessary to calculate it in a similar manner to that employed in those years; viz.:—by using the proportional share of deaths in Public Institutions in London, which I find was only 367, instead of 435, our actual number. By this method we should get a corrected total of 1,470 deaths, equivalent to a corrected death-rate of 16.41 per thousand per annum, which it will be noticed is but a trifle over the death-rate of 1884, and is considerably lower than the average of the 10 years 1876 to 1885. Table Ia. Death-rates per 1,000 per annum. n.b.—Those for 1877-1880 have been re-ealculated on the Revised Estimates of Population. 1877 1878 1879 1880 1881 1882 1883 1884 1885 1886 Twenty Large English Towns 22.7 24.2 23.2 22.7 21.7 *22.3 *21.6 *21.6 *20.6 *20.9 London . . 21.5 23.0 22.7 21.6 21.2 21.4 20.4 20.4 19.8 19.9 St. George's, 1 Hanover sq, 17.46 18.17 18.25 16.64 16.91 16.73 15.70 16.30 16.11 17.17 * Twenty-eight towns. From Table Ia we see that the death-rate of London proper, with an estimated population of 5,306,508, was 19.9, being only 01 above that in 1885. That of the outer ring, with an estimated population of 1,156,975, was 17.0 (almost exactly the same as the death-rate of this Parish) being 0.5 lower than in 1884 and in 1885. The death-rate of this Parish was lower than that of either of the 28 largest English Towns, with the exception of Brighton, which had a death-rate of only 17.1 (the same as in 1885). The other Towns which came nearest to it were the following:— 4 Derby 18.2 Hull 18.8 Birkenhead 19.1 Bradford 19.2 Bristol 19.3 Sunderland 19.5 Huddersfield 19.6 Sheffield 19.8 Birmingham 19.9 London 19.9 The average death-rate of the 28 largest English Towns was 20.9, or nearly 4 per thousand higher than that of this Parish. The highest death-rates among these Towns were the following:— Blackburn 25.5 Manchester 26.3 Preston 28.9 The average death-rate in 50 other large Town Districts in England was 19.9, or exactly the same as the death-rate of London proper. Of these the following had lower deathrates than this Parish :— Gloucester 14.7 Hastings 14.8 Barrow-in-Furness 15.2 Burton-on-Trent 15.2 Darlington 15.4 Southport 16.2 Rotherham 16.8 Reading 16.9 Accrington 17.0 5 But it must be noted that these include country districts in which the towns are situated. The highest death-rates found among the 50 large Town Districts were those of— Newport (Mon.) 24.1 Stockport Ashton-under-Lyne 25.1 Ystradyfodwg 26.3 Merthyr-Tydfil 26.5 The death-rate of Edinburgh was 19.2 or 1 per thousand higher than in 1885; that of Glasgow was 25.1, being 0.7 lower than in 1885; and that of Dublin 27.0, or 1.5 lower than in 1885, but still higher than that of any other Town in the United Kingdom, the nearest to it being MerthyrTydfil with 26.5. No Foreign city approaches the death-rate of this Parish, the lowest being Chicago 19.5 (or 0.4 lower than London proper); Baltimore, 20.1; Philadelphia, 20.7; Christiania, 21.4; and Stockholm, 21.9; and the highest being Marseilles, 35.0; Madras, 36.5; Budapesth, 37.8; Trieste, 38.0; Alexandria, 44.2; and Cairo, 47.3. With regard to these high death-rates it is to be observed that in Marseilles there were no less than 2,051 deaths from Small-Pox during the year; that the death-rate of Madras, although high, was nearly 1 per thousand lower than in 1885, and 14 per thousand lower than in 1884; and that in Alexandria and in Cairo, Diarrhoea and Typhoid Fever were prevalent during the year. 6 Table II. YEAR. Registered Births. Birth-rate per 1,000 per ann. (52 weeks) Deaths op 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) 2,168 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 14.52 1883 1,878 20.97 287 15.28 15.56 1884 (53 weeks) 1,933 21.18 259 13.40 13.83 1885 1,767 19.73 219 12.39 12.35 1886 1,761 19.66 269 15.28 14.16 From Table II it appears that the number of births registered in the Parish continues to decrease slightly, being 6 lower than in 1885, and giving a birth-rate of only 19.66 per thousand per annum, being the lowest birth-rate yet recorded for the Parish. The birth-rate of London proper was 32.3, the lowest rate recorded since 1850; that of Greater London was 32.8; and that of the Outer Ring 34.5, very nearly the same as in 1885. The average birth-rate of the 28 largest English towns was 33.2, the highest being those of Cardiff, 42.6; Preston and Newcastle, 39.5; and the lowest those of Brighton 20.5 and Huddersfield 27.0. 7 The total number of deaths of children under one year of age was 269, the lowest number recorded during the last 10 years, with the exception of 1884 and 1885. The per-centage of these deaths to the registered births was 15.28 as in 1883, being the highest number recorded since 1875, when it was 1575. The per-centage of deaths of children under one year of age to the total deaths was 14.16, a lower number than any recorded, with the exception of 1884 and 1885; thus the mortality of children under one year of age was almost 153 to a thousand births; whereas in London generally it was 159; and the average for the 28 largest English towns was 169, the highest being Preston with 233, and Leicester with 211. The only towns having a lower ratio than this Parish were Bristol with 149, Derby with 150, and Sunderland with 131 deaths of children under one year of age to a thousand births. No doubt the prevalence of Diphtheria, Whooping-cough, and Diarrhœa, had much to do with the comparatively high infantile death-rate during the year. Table III. year. a. b. c. d. Percentages to Gross Total of Deaths. Person 8 aped sixty years and upwards. Violence. Inquest Cases. Uncertified. a. b. c. d. 1875 469 84 112 — 25.20 4.50 60 — 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 61 — 1879 625 89 120 — 30.37 432 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 28.13 4.29 5.5 1.55 1883 537 93 126 27 2911 5.05 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 1886 604 79 135 41 31.79 4.16 7.1 2.15 London 1886 19,365 2,863 5,891 949 23.54 3.48 7.2 1.15 8 Table III shows that the number of deaths of persons aged 60 years and upwards was 604, or no less than 47 more than in 1880. This number was equivalent to 31.9 per cent.of the total deaths, a higher per-centage than any previously recorded. The per-centage for London was 23.4, or 5¼ per cent. less than that for this Parish. If, however, we consider the proportion of such deaths per thousand persons living we find that they amount in this Parish to 67.43, whereas in London generally they amount to 74.5, and in the 28 largest English towns to an average of 77.1, the lowest being Brighton, with 63.8; Hull with 66.1; and Nottingham with 67.9; and the highest, Manchester with 101.4 ; and Blackburn with 106.8. The number of violent deaths recorded during the year was 79, the same number as in 1885, the lowest number hitherto recorded; the per-centage of these deaths to the total number of deaths was 4.16, the lowest per-centage yet recorded for the Parish, but, as usual, higher than that recorded for London generally—which was 3.48. The number of Inquest Cases was 135, equivalent to a per-centage of 7.1 of the total deaths, or almost exactly the same as the per-centage in London generally. The number of deaths uncertified as to cause amounted to no less than 41, or 2.15 per cent. of the total deaths, being nearly twice as high as the per-centage for London generally, and as will be seen by referring to the Table, considerably higher than that recorded in any previous year. 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 16,862 236 14.00 189 1 82 + 81 260 15.42 Mayfair 13,491 195 14.45 458 368 65 — 303 155 11.49 Belgravia 59,220 1,330 22.46 1,253 428 288 — 140 1,113 18.79 "Whole Parish 89,673 1,761 19.66 1,900 797 435 — 362 1,538 17.17 10 Table IVa. BIRTH -RATES. DEATH-RATES. 1876. 1877. 1878. 1879. 1880. 1881. 1882. 1883. 1884. 1885. 1886. 1876. 1877. 1878. 1879. 1880. 1881. 1882. 1883. 1884. 1885. 1886. Hanover Sq 17.97 18.86 19.81 19.05 19.45 17.85 17.26 17.08 16.46 15.36 14.00 17.97 16.58 17.07 19.05 16.90 17.44 15.84 14.65 15.54 15.18 15.42 Mayfair 21.53 19.45 21.49 19.49 20.84 19.12 16.83 16.61 15.20 14.16 14.45 13.06 13.04 13.26 13.59 12.39 11.79 11.87 11.34 12.44 1119 11.49 Belgravia 26.27 25.76 25.50 25.32 25.87 25.89 23.93 23.07 23.87 22.24 22.46 19.46 18.70 19.57 19.01 17.53 17.92 18.09 16.99 17.40 17.49 18.79 Whole Parish 23.88 23.48 23.85 23.26 23.91 23.36 .21.61 20.97 21.18 19.73 19.66 18.20 17.46 18.17 18.25 16.64 16.91 16.73 15.70 16.30 16.11 17.17 11 Table IV shews the number of births and deaths, and the birth-rates and corrected death-rates of each of the SubDistricts and of the whole Parish, while in Table IVa these birth-rates and death-rates are compared with those of previous years ; from this Table we see that the birth-rate of Hanover Square is lower than it was in any previous year, while the birth-rates of Mayfair and Belgravia, although very low, are each a little higher than they were in 1885, but lower than in any year before that. The birth-rate of the Parish generally was 19.66, being the lowest on record. The birthrate of London generally was 32.3, and that of the 28 largest English towns 33.2; it will be remembered that the birthrate of this Parish has always been exceptionally low. The death-rates of each of the Sub-Districts and of the whole Parish were higher than those of 1885, but those of Hanover Square and Mayfair were lower than the corresponding rates during any previous year with the exception of 1883, when the death-rate was the lowest that has ever been recorded; but when, as before stated, the method of correcting the total number of deaths was not as correct as the one now employed, and gave a somewhat lower death-rate than the true one. The death-rate of the Belgravia Sub-District was 18.79, a higher number than any recorded since 1879, the deathrate of the whole Parish, as before stated, 1717, also higher than that in any year since 1879. If, however, the same method of correction had been used in previous years, there is no doubt that the death-rate of 1880,-81 and 82, and, perhaps that of 1884, would have been as high or higher than the death-rate in 1886. 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 1886, and have found them as follows :— 12 Mean Duration of Life. \ Hanover Square Sub-District 68.00 years Mayfair 77.77 „ Belgravia 48.73„ Whole Parish 54.46 „ The mean duration of life in this Parish during the last 12 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 „ „ 1882 „ 52.56 „ „ 1883 „ 55.09 „ „ 1884 „ 53.78 „ „ 1885 „ 56.11 „ „ 1886 „ 54.46 „ So that the mean duration of life in this Parish during those 12 years has averaged just 51¾ years. The mean duration of life in London during the last 9 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 „ „ 1886 „ 39.31 „ Here again, the new and more accurate method of correcting the death-rate has no doubt made the calculated figure for the mean duration of life in the Parish lower than it would have been with the old method of correction. It may very safely be said, that considering the figures of the last few years, the average duration of life in this Parish is at present not far short of 55 years. The remarkable way in which the mean duration of life in London continues steadily to increase will be noticed. 13 Table V. Showing the number of Deaths in each of the ten years, 1876 to 1885, from the principal infectious Diseases and Diarrhoea and the number in 1886. DISEASE. 1876. 1877. 1878. 1870. 1880. 1881. 1882. 1883. 1884 1885. Annual Average of ten years, 1870—1885. Proportion of Deaths to 1,000 Deaths in ten years, 1876—1885. 1886. Proportion of Deaths to l,000] Deaths in 1886 Small-pox 2 12 5 0 0 9 1 0 2 2 3.1 1.6 0 0.0 Measles 21 30 11 34 16 21 30 13 40 21 23.7 12.6 20 10.5 Scarlet Fever 22 19 9 36 40 18 13 11 7 10 18.5 9.8 2 1.0 Diphtheria 3 9 4 14 18 14 15 27 25 35 16.4 8.7 32 16.8 Whooping Cough 45 19 64 33 50 15 63 21 43 19 37.2 19.8 40 21.0 Typhus Fever 33 2 4 2 1 3 0 0 1 0 23.2 12.3 0 0.0 Enteric (or Typhoid)Fever 17 24 12 15 20 21 21 22 8 12 6.3 Simple Continued Fever 6 4 2 2 1 0 8 1 2 1 0.5 Diarrhœa 47 35 54 32 39 33 34 27 44 37 38.2 20.3 45 23.7 Cholera 1 2 4 1 1 2 2 1 0 2 1.6 0.8 1 0.5 Total 174 151 183 166 182 136 179 129 185 136 161.9 85.9 153 80.3 14 From Table V it will be seen that the total number of deaths from the principal infectious diseases and diarrhoea during the year 1886 was 153, a larger number than in 1885, when it was 136, and just over the average of the previous three years, viz. 150, but decidedly below the average of the previous 10 years. The 153 deaths are equal to a zymotic death-rate of 1.71 per thousand persons living, as against a rate of 1.52 in 1885, and of 2.06 in 1884. The corresponding rate for London was 2.69, being slightly lower than in 1885, when it was 2 77, and that for the 28 largest English towns was 2.88, or rather higher than in 1885 when it was 2.71. It will be observed that the zymotic death-rate of this Parish is almost 1 per thousand persons living less than that of London generally. Of the largest towns only one had a lower rate than this Parish, viz.: Huddersfield with 1.62, whereas in 1883 five of these towns had lower zymotic death-rates than our Parish; the highest rates among these towns were those of Preston 5.65 (or almost exactly 3½ times the rate for this Parish) and Portsmouth 5.07. Taking these diseases separately in the order in which they are placed in the Table, we find that— Small Pox caused no deaths in the Parish, and no deaths of our Parishioners in Public Institutions outside of the Parish. Measles caused 20 deaths, as against 21 in 1885, and an average of 23.7 during the previous 10 years. Four of the deaths from this disease occurred in the Infirmary, Fulham Road, during the month of December. Scarlet Fever caused only 2 deaths in the Parish, the smallest number yet recorded, as against 10 deaths in 1885, and an average of 18'5 during the previous 10 years; moreover, of these two deaths one was registered as "Kidney Disease after Scarlet Fever," and the other as "probably Scarlatina." On the other hand 3 deaths of our Parishioners 15 occurred from this disease in Public Institutions outside of the Parish. Several cases of this disease occurred in Clayton's Yard, which induced me to make a thorough inspection of the whole of the dwellings there and to order a number of sanitary improvements, which have all been carried out by the owner. Several cases of this disease having also occurred in one of the Model Dwellings in the Parish, I found, on investigation, that the only circumstance common to all the families attacked was that they used condensed milk of a particular brand. I obtained some tins of this milk from the same sources and forwarded them to Dr. Klein, F.R.S., of the Brown Institution, he examined them, and reported that in one of them he found the organism which has been recently shewn to be the cause of Scarlet Fever in human beings, and also the cause of a comparatively mild disease in cows: which discovery, I may remark, is obviously of the highest importance, as it gives us some hope of being able to check the ravages of this very prevalent, and often very fatal disorder. Diphtheria caused 32 deaths, a rather lower number than in 1885 when it caused 35 deaths, but still a large number for the Parish, being nearly twice the annual average of the previous 10 years. Of these 32 deaths, however, no less than 12 were those of non-parishioners dying in St. George's Hospital; 2 others occurred in Peabody's Buildings, the disease having been introduced there; only one of our Parishioners died of this disease in a Public Institution outside of the Parish. Whooping Cough caused no less than 40 deaths during the year, as against only 19 in 1885 (during which year the Parish was exceptionally free from this disease), and an annual average of 372 during the preceding 10 years. Typhus Fever.—No death from this disease was registered in the Parish during the year. Enteric (Typhoid) Fever caused only 12 deaths in the Parish during the year, a larger number than in 1885, but 16 still much lower than the average. Of these 12 deaths, however, 2 were those of non-parishioners in George's Hospital, one was registered as "Gastric Fever, doubtful if Typhoid." and one was that of a case contracted abroad. On the other hand, 4 deaths of our Parishioners, one being that of a case contracted out of town, and one that of a doubtful case, which was, I believe, not Typhoid Fever at all, occurred in Public Institutions outside of the Parish. Simple Continued Fever caused only one death during the year. The total number of deaths from Continued Fevers during the year was therefore only 13, as against an average of 23.2 during the previous ten years, shewing a remarkable decline in the number of deaths from these diseases. Diarrhoea caused no less than 45 deaths, a higher number than any recorded since the year 1876, (when it caused 47 deaths), and therefore, of course, higher than the average of the previous 10 years, which was 38.2. Diarrhœa was exceedingly prevalent in London during 1886, indeed, it caused no less than 720 deaths more than the average annual number for the previous 10 years. This high mortality was no doubt due to the hot weather during the months of July, August, September and October, when the mean temperature was considerably above the average. One death from English Cholera, or Choleraic Diarrhoea was also registered. Small Pox in London. From the Registrar General's Annual Summary I find that the numbers of deaths caused by this disease during the past 10 years have been the following:— 1875 46 deaths 1876 736 „ 1877 2,551 „ 1878 1,417 „ 1879 450 „ 17 1880 471 deaths 1881 2,367 „ 1882 430 „ 1883 136 „ 1884 1,236 „ 1885 1,419 „ 1886 24 „ The numbers given for 1884 and 1885 differ considerably from those in my last report, as the deaths of London residents from this disease in the Metropolitan Asylum Hospitals outside registration London have been added to the numbers previously given; the number for 1886, viz. 24, also includes such deaths, and is the smallest number recorded in London in any year, the nearest to it being 46 in 1875, and 57 in 1874. Sanitary Work. For the Year ending March 31st, 1887. The following Table has been compiled for me by Mr. Joseph Snook, your Senior Inspector, from the Report Book:— TABLE VI. Various kinds of Complaints of Nuisances, &c., from lst April, 1886, to 31 st March, 1887. Total number of Complaints 482 Notices served 63 Houses and premises lime-whited 65 Houses disinfected after infectious diseases 48 Old brick drains abolished and pipes substituted 16 New drains constructed 8 Drains unstopped and repaired 40 Drains trapped and ventilated, sinks disconnected, &c. 100 18 Closets supplied with water and repaired 30 Closets unstopped 24 New W. C.'s provided 15 Roofs repaired 8 New dustbins provided 6 Dustbins renewed, repaired, new covers, &c. 8 Cisterns repaired, new covers, &c. 20 New cisterns provided 11 Waste-pipes disconnected 16 Removal of animals improperly kept 0 Meat, fish, &c., condemned (cases of) 2 Overcrowding abated - 3 Cesspools abolished 5 Accumulation of dung, straw, &c., removed 33 Various nuisances removed 110 No cause for complaint 34 Legal proceedings taken 0 Cases could not assist 7 Cases referred to Surveyor 17 Cases referred to Police 3 Licensed cow-sheds 4 Licensed slaughter-houses 6 Cases removed to Hospital 59 Inspection of houses after cases of infectious diseases viz.:— Typhoid and Low Fever 14 Typhus Fever 0 Scarlet Fever 48 Small Pox 0 Diphtheria 18 The articles disinfected in the hot-air disinfecting chamber belonging to the Parish were as follows :— 43 Beds 68 Sheets 71 Mattresses 46 Bolsters 30 Palliasses 108 Pillows 19 66 Quilts 19 Dresses 124 Blankets 15 Shawls 14 Waistcoats 17 Coats 15 Trousers 40 Towels 50 Carpets 23 Cushions 19 Hearth Rugs 30 Table Covers 20 Curtains 10 Rugs 11 Suits of Clothing 32 Skirts And a quantity of Sundry Articles. The total number of complaints attended to, and of notices served, was rather higher than in the previous year, but it was not necessary to take legal proceedings in any case. The markets have been regularly inspected and kept in good order, and it has been only necessary to condemn articles of food exposed for sale in two instances. The licensed cow-sheds and slaughter-houses have also been regularly inspected and kept in good condition. There are only four cow-sheds and six slaughter-houses now in the parish, the owner of one of the seven slaughter-houses licensed last year not having applied for a renewal. No application for a license has been opposed, and no new application has been made. The duty of inspecting the bake-houses has been again very properly placed upon the Sanitary Authority; they have been inspected periodically, and all Sanitary work required has been carried out in a satisfactory manner. The number of articles of clothing, bedding, etc., disinfected has been even less than in 1885, on account of the absence of Small Pox, not a single case of which disease was reported during the year. A new Mortuary has been built at Ebury Bridge, and the following is the return of the number of deaths received in it from the 9th September, 1886 to the 31st March, 1887, as furnished to me by the Mortuary Keeper, Mr. H. Coles. 20 TABLE VII. Return shewing the number of bodies received into the Mortuary, Ebury Bridge, from 9th September, 1886, to 31st March, 1887. Found Drowned 2 ,, Dead 5 Cases without Inquests 14 Born Dead 1 Accidental Deaths 6 Infectious Cases 1 Natural Causes 1G Suicides 5 Murders 1 Total 51 Total number of post mortems made 30 A register of houses let in lodgings has been commenced, and 38 houses have been entered upon it. 21 Table VIII Showing the results of the Analyses of the Water supplied by the Grand Junction and Chelsea Water Companies. Month. Tarts per 100,000. Tarts per 100 Millions. Total Solid Residue. Chlorine = Common Salt. Saline Ammonia. Organic Ammonia. Grand Junction Company's Water. April 1886 31.2 1.8 3.0 2.4 13.0 May ,, 30.0 1.8 3.0 3.6 23.0 June ,, 31.2 1.8 3.0 2.4 13.4 July ,, 29.0 1.8 3.0 2 .2 12.4 August ,, 25.0 1.8 3.0 1.4 7.8 September ,, 24 0 1.8 3.0 2.2 11.8 October ,, 33 2 1.8 3.0 2.2 13.2 November ,, 320 1.8 3.0 2.2 15.6 December ,, 33.0 1.8 3.0 2.4 16.0 January 1887 31.0 1.8 3.0 0.8 14.4 February ,, 38.0 1.8 3.0 2.2 9.2 March ,, 36.0 1.8 3.0 3.6 11.2 Average 31.1 1.8 3.0 2.3 13.5 Chelsea Company's Water. April 1886 28.0 1.8 3.0 2.4 11.2 May ,, 31.0 1.6 2.6 1.4 15.4 June ,, 30.0 1.8 3.0 0.8 14.0 July ,, 30.0 1.8 3.0 1.3 8.6 August ,, 28.0 1.8 3.0 2.2 6.8 September ,, 31.0 1.8 30 2.2 9.8 October ,, 28.0 1.8 3.0 4.8 10.6 November ,, 32.0 1.8 3 0 1.4 13.6 December ,, 35.0 1.8 3 0 1.4 12.2 January 1887 37.0 1.8 3.0 2.2 13.2 February ,, 34.0 1.8 3.0 2.2 10.4 March ,, 34.0 1.8 3.0 4.0 11.6 Average 31.5 1.8 3.0 2.2 11.4 Table VIII shows the results of the 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. 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 22 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 at 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, 1887.