HAN 39 TH E VESTRY OF THE Parish of Saint George HANOVER SQUARE Medical Officer's Report FOR The Year ended 25th March, 1890. JUNE, 1890. London: Printed by Wightman & co., 104 & 106, regency street, Westminster, s.w. 1890. HAN 39 REPORT ON Sanitary condition 0F THE Parish of St. George, Hanover Square, FOR THE YEAR 1889, BY W. H. CORFIELD, M.A., M.D. (Oxon.), F.R.C.P. (LonK) Professor of Hygiene and Public Health in University College, London; Past President of the Society of Medical Officers of Health; Honorary Corresponding Member of the Royal Society of Public Health of Belgium; MEDICAL OFFICER OF HEALTH. (BEING HIS EIGHTEENTH ANNUAL REPORT) To the Vestry of the Parish of Saint George, HANOVER SQUARE. My Lords and Gentlemen, The total number of deaths registered in the Parish during the 52 weeks ending December 28th, 1889, was 1664, a much smaller number than any registered in the Parish during the preceding ten years, and 201 less than the annual average during those ten years. Of these deaths 756 occurred in Public Institutions in the Parish, whereas the deaths of our Parishioners in Public Institutions in the Metropolis only amounted to 331, and those in the extra Metropolitan Asylums to 32, making a total of 363 deaths of Parishioners in Public Institutions outside the Parish, so that the corrected total of deaths of our Parishioners was only 1271, or over 200 less than the average during the preceding 10 years, and equivalent to a corrected death-rate of only 14.19 per thousand per annum, which is nearly 2½ per thousand per annum lower than the average annual deathrate during the preceding ten years. 2 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). 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 1886 1,900 797 *435 1,538 17.17 1887 1,727 762 *473 1,438 16.05 1888 1,817 861 *482 1,438 16.05 Average during ten years, 1879-1888 1,865 780 410 1,489 16.59 1889 1,664 756 *363 1,271 14.19 Average during ten years, 1880-1889 1,825 780 407 1,450 1619 * Actual numbers (not calculated as in former years). * Deaths of Parishioners in Public Institutions:— Fulham Road Workhouse 170 St. George's Union Workhouse 2 St. George's Hospital 57 Belgrave Children's ditto 4 St. Gabriel's ditto 11 Total in the Parish 244 In Public Institutions in London, outside of the Parish 87 In Extra Metropolitan Asylums 32 Total Deaths of Parishioners in Public Institutions 363 Table 1a. Death-rates per 1,000 per annum. N.B.—Those for 1880 have been re-calculated on the Revised Estimates of Population. 1880 1881 1882 1883 1884 1885 1886 1887 1888 1889 28 Large English Towns *227 *21.7 22.3 21.6 21.6 20.6 20.9 20.8 19.2 19.3 London 21.6 21.2 21.4 20.4 20.4 19.8 19.9 19.6 13.5 17.4 St. George's, Hanover sq, 16.64 16.91 16.73 15.70 16.30 16.11 17.17 16.05 16.05 14.19 * Twenty towns. 3 From Table 1a we see that the death-rate of London proper is also exceedingly low, viz.: 17.4, or more than 1 per thousand lower than in 1888, when the death-rate was lower than that of any preceding year; it is thus clear that the past year has been exceedingly healthy, not only in this Parish but in London generally. The death-rate of greater London, with a population of 5,642,015, was only 16.8, or 1 per thousand lower than the preceding year, but it will be observed over 2½ per thousand higher than the death-rate of this Parish. The death-rate of the 28 largest English towns was ID'S, or a trifle higher than it was in 1888. As usual the deathrate of this Parish was lower than that of any one of the 28 largest English towns, the nearest to it being— Brighton 15.1 Derby 16.4 Leicester 16.9 Nottingham 17.0 Bristol 17.6 Birkenhead 17.8 Portsmouth 18.1 Norwich 18.4 Birmingham 18.7 Huddersfield 18.8 as:d the highest being— Plymouth 25.2 Newcastle 25.2 Blackburn 25.5 Manchester 26.7 Preston 20.0 The average death-rate of 50 other large town districts in England was 18.7, being somewhat higher than in 1888 and 1.3 per thousand higher than in London 4 The death-rate of Edinburgh was 18.0 (exactly the same as in 1888), that of Glasgow 24.8, and that of Dublin 25.7, the two latter being higher than in 1888. As usual the lowest death-rates in foreign cities are much higher than the death-rate of this Parish, the nearest to it being those of— Baltimore 17.0 St. Louis 17.8 Brussels 19.4 The Hague 19.4 and the highest being— Munich 31.0 Moscow 39.6 Madras 43.0 Alexandria 44.3 Cairo 50.5 Table II. YEAR. Registered Births. Birth-rate per 1,000 per ann. (52 weeks Deaths of Children under 1 Year. Total. Percentage to Registered Births. Percentage to Total Deaths (uncorrected). 1879 (53 weeks) 2,168 23.26 298 13.75 14.48 1880 2,140 23.91 310 14.49 10.71 1881 2,092 23.30 280 13.38 14.49 1882 1,935 21.61 271 14.01 14.52 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 19.73 219 12.39 12.35 1880 1,761 19.60 269 15.28 14.10 1887 1,749 19.53 275 15.72 15.92 1888 1,079 18.74 236 14.05 12.98 1889 1,670 18.64 234 14.01 14.06 5 From Table II. we see that the number of births in the Parish still decreases, and that the birth-rate, 18.64 per thousand per annum, is even lower than that of last year, and, therefore, the lowest yet recorded. The birth-rate for London proper was 30 3, also the lowest yet recorded, that of greater London being 30.8, and that of the outer ring 32.3. The average birth-rate of the 28 largest English Towns was 31, or slightly lower than that of 1888, the highest being those of Sunderland, 36 0, Preston, 38.1, Newcastle, 38.2, and Cardiff, 38.6; and the lowest those of Nottingham, 28.0, Bradford, 26.8, Huddersfield, 24.6, and Brighton, 24.4. The number of deaths of children under one year of age was 234, a lower number than that recorded in any year, except in 1885, when it was only 219; the percentage of such deaths to registered births was 14.01 and to total deaths 14.06; thus the mortality of children under one year of age was 140 to a thousand births, the same as in 1888, while in London generally it was 141; and the average for the 28 largest English Towns was 161, the highest being Blackburn and Leicester with 204 each, and Preston with 264 deaths of children under one year of age to a thousand births. Table III. YEAR. A. B. c. D. Percentages to Gross Total of Deaths. Persona aged sixth years and upwards. Violence. Inquest Cases. Uncertified. A. B. C. D. 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 1.00 1882 525 80 102 29 28.12 4.29 5.5 1.55 1883 537 93 126 27 29.11 5.05 6.8 1.40 1884 543 106 132 31 28.99 5.66 7.0 1.66 1885 557 79 106 22 31.42 4.46 0.0 1.25 1886 604 79 135 41 31.79 4.16 7.1 2.15 1887 521 88 122 20 30.17 5.09 7.0 1.15 1888 541 90 124 22 29.77 4.95 0.8 1.21 1889 523 77 116 30 31.43 4.63 7.0 1.80 London 1889 18,346 2,928 5,763 801 24.24 3.87 7.6 1.06 6 From Table III. it appears that there were 523 deaths of persons aged 60 years and upwards, giving a percentage of 3143 of the gross total of deaths, as against a percentage for London generally of only 21.24. This shows, as usual, a high percentage of persons in the Parish living over 60 years, but taking the proportion of deaths of such persons to the population, we find that it is only 58.4 per thousand living, as against 67.3 in London generally and 7l.6 in the 28 largest English Towns, the lowest being Norwich, 65 4, Nottingham, 641, and Brighton, 61.4; and the highest, Halifax, 90.5, Blackburn, 91.l, and Manchester, 991. From this Table we also see that 77 Violent Deaths were registered in the Parish, being 4.6 per cent. of the total deaths, or less than the percentage of last year, but still, as usual, higher than that of London generally, which was 3.87, as against 378 in 1888. The Inquest cases held in the Parish numbered 116, or 8 less than in 1888. They were, however, equivalent to 7 per cent. of the total deaths as against 7.6 in London generally. The number of deaths uncertified as to cause was 30, or 8 more than in 1888, and equivalent to l.8 per cent. of the total deaths, as against only 1.06 per cent. in London generally. 7 Table IV. SUB-DISTRICT. Population at middle of 1889. Births. Birth-rate. Total Deaths. Deaths in Public Institutions. Share of Deaths in Public Institutions Correction for Deaths in Public Institutions. Deaths (corrected). Death-rate (corrected). Hanover Square Mayfair Mayfair 30,353 359 11.83 592 348 123 — 225 367 12.09 Belgravia 59,220 1,811 22.14 1,072 408 240 — 168 904 15.27 Whole Parish 89,573 1,670 18.64 1,664 756 363 — 393 1,271 14.19 Table IVa. BIKTH-RATE8. DEATH-RATES. 1879. 1880. 1881. 1882. 1883. 1884. 1885. ISC 6. 1887. 1888. 1889. 1879. 1880. 1881. 1882. 1883. 1884. 1885. 1886. 1887. 1888. 1889. Hanover Sq... 19 05 19-45 17-85 17-26 17-08 16-46 15-36 14-00 j- 13-67 13-74 u-83 19-05 16-90 17-44 15-84 14-65 15-54 15-18 15-42 t 12-75 13-47 12 09 Mayfair 19-49 20-84 19-12 16-83 16-61 15-20 1416 14-45 13-59 12-39 11-79 11-87 11-34 12-44 11-19 11-49 Belgravia 25 32 25-87 25-89 23 93 23 07 23-87 22 24 22-46 22-53 21-31 22-14 19-01 17-53 17-92 18-09 16-99 17-40 17-49 18-79 17-75 17-38 15-27 Whole Pal ish 23-2g 23 91 23-36 -21-61 20-97 21-18 1973 19-66 19-53 18-74 18-64 18-25 16-64 16-91 16-73 15-70 16-30 16-11 17-17 16-05 16 05 1419 9 From Table IV it appears that the birth-rate of the Mayfair Sub-district was only 11.83, as against 1374 in 1888, while that of the Belgravia Sub-district was 22.14, as against 20 31 in 1888; and that the corrected death-rate of the Mayfair Sub-district was only 12.09, as against 1347 in 1888, and that of the Belgravia Sub-district only 15.27, as against 17.38 in 1888, the death-rate of both the Subdistricts being, as shown in Table IVa, the lowest yet recorded. From the birth and death rates in Table IVa I have calculated, as usual, the mean length of life. I use the term mean length of life instead of mean duration of life in order to prevent confusion, as the term "mean duration of life" is a technical expression, which means the mean length of life as calculated by the life-table method. The mean length of life stated in this report is calculated by means of Dr. Bristowe's formula. Mean Length of Life. Mayfair Sub-District 83.55 Belgravia 54.26 Whole Parish 61.43 The calculated mean length of life in this Parish during the last 15 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 „ 10 In 1884 it was 53.78 years. „ 1885 „ 56.11 „ „ 1886 „ 54.46 „ „ 1887 „ 56.49 „ „ 1888 „ 57.71 „ „ 1889 „ 61.43 „ So that the mean length of life in this Parish during those 15 years has averaged just over 53 years. The mean length of life in London during the last 12 years has been, according to my calculation, 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 „ „ 1887 „ 39.98 „ „ 1888 „ 41.77 „ „ 1889 „ 4327 „ I have only to repeat what I have said in my former Reports that the mean length of life in this Parish, and in London generally, is shown to be gradually increasing, both numbers being the highest yet recorded, a fact which is, I have no doubt, largely due to the improvements in household sanitary arrangements. 11 Table V. Showing the number of Deaths registered in the Parish in each of the ten yearn, 1879 to 1888, from the principal infectious Diseases and Diarrhœa, and, the number in 1889. DISEASE. 1879. 1880. 1881. 1882. 1883. 1881. 1885. 1886. 1887. 1888. Annual Average of ten years, 1870—1888. Proportion of Deaths to 1,000 Deaths in ten years, 1879—1888. 1889. Proportion of Deaths to 1,000 Deaths in 1889. Small-pox 0 0 9 1 0 2 2 0 0 0 1.4 0.8 0 0. Measles 34 16 21 30 13 40 21 20 30 12 23.7 12.7 49 29.3 Scarlet Fever 36 40 18 13 11 7 10 2 16 8 16.1 8.6 1 0.6 Diphtheria 14 18 14 15 27 25 35 32 22 52 25.4 13.6 36 21.6 Whooping Cough 33 50 15 63 21 43 19 40 23 28 33.5 18.0 31 18.6 Typhus Fever 2 1 3 0 0 1 0 0 0 0 0.7 0.4 0 0. Enteric (or Typhoid) Fever 12 15 20 21 21 22 8 12 15 5 15.1 8.1 18 10.8 Simple Continued Fever 2 2 1 0 8 1 2 1 2 1 2.0 1.1 1 0.6 Diarrhœa 32 39 33 34 27 44 37 45 58 27 37.6 20.2 31 18.6 Cholera 1 1 2 2 1 0 2 1 0 0 1.0 0.5 0 0. Total 166 182 130 179 129 185 136 153 166 133 156.5 84.0 167 100.2 12 From Table V it will be seen that the total number of deaths from infectious diseases and diarrhœa is somewhat higher than the average of the previous 10 years, this being duo to an excess of deaths from Measles; the deaths from the other infectious diseases being in every case (with the exception of Enteric, or Typhoid, Fever, which is slightly above the average), below the average of the previous 10 years. The 167 deaths from these diseases is equivalent to a zymotic death-rate of 1.86, as against 1.48 in 1888, the rate for London being 2.24, and that for the 28 largest English towns 2.73. The only towns with a lower zymotic death-rate than our Parish are Derby, 1.51; Brighton, 1.53: and Halifax, 1.67. The highest zymotic death-rates in the country are furnished by Salford, with 4.57; Blackburn, 4 74; Plymouth, 5.76; and Preston, 770. These rates are very much higher than any of the rates for 1888, in which year the highest rate furnished by any town was 4.13. Taking these diseases separately from the order in which they are placed in Table V., we find that:— Small-Pox caused no death in the Parish, and no deaths of our Parishioners in Public Institutions outside of the Parish. Measles caused no less than 49 deaths, a higher number than any recorded during the previous 10 years, and more than twice the average number of those years, and it is owing to this fact that the zymotic death-rate of the past year has been somewhat higher than the average of the previous 10 years. Scarlet Fever caused only one death in the Parish during the year, and that was one of a non-parishioner at St. 13 George's Hospital from "Nephritis" (Kidney disease) after Scarlet Fever. There were, however, 3 deaths of our Parishioners from this disease in Public Institutions outside the Parish. Diphtheria caused 36 deaths, being 16 less than in 1883, but nearly 11 above the annual average for the previous 10 years. Among the 36 deaths registered in the Parish, there were, however, 16 deaths of non-parishioners, leaving 20 deaths of Parishioners from this disease. Of these, moreover, one was that of a child who contracted the disease from a case imported into the Parish, another was described as "Croup with Bronchitis," and a third was that of a man, 56 years of age, who died from " Pneumonia with a diphtheritic sore throat." On the other hand there were 2 deaths from this disease of Parishioners in Public Institutions outside the Parish. I must remark that Diphtheria is still exceedingly prevalent in London, and seems to be taking a hold of London and of some of our great towns, as mentioned in my last report, for reasons that have not yet been explained. Thus in the 28 largest English towns, including London, the diphtheria death-rate in 1889 was half as high again as the death-rate for the previous 10 years. In Plymouth and Manchester it was nearly 4 times as high, in Bolton it was nearly 5 times as high, in Salford it was 6 times as high, and in Newcastle twice as high, as in the previous 10 years. Whooping Cough caused 31 deaths, as against 28 in 1888, and an average of 33.5 during the previous 10 years. Typhus Fever was not. so far as I am aware, present in the parish during the year, and only one death from it has been recorded in the parish since 1881. 14 Enteric (or Typhoid) Fever caused 18 deaths, or 13 more than in 1888, and 3 more than the corrected average for the previous 10 years. Of these 18 deaths, however, 6 were those of non-parishioners in St. George's Hospital; another was a death from Enteritis, due to Tubercular Consumption (not Enteric Fever at all), another that of a man 77 years of age, whose death was certified as from "Gastric Bilious Fever with acute Bronchitis," and another was that of a case contracted in Scotland. On the other hand one of our parishioners died of this disease in a public institution outside the parish. A limited outbreak of Enteric Fever occurred in the parish almost entirely in the Mayfair Sub-district (and also in some of the adjoining parishes) during the last week of July, all the cases commencing on or about July 25th. The outbreak was limited to houses of the better class, including some of the largest houses in the parish. From the uniformity in the date of the attacks, and from the fact that the sanitary arrangements of most of the houses where there were cases of this disease were in excellent condition, I came to the conclusion that the outbreak was not due to any defective sanitary arrangements, but to some temporary cause, which ceased to operate as suddenly as it had shewn itself. I made a most careful investigation with the object of finding out the cause of this outbreak, the cases of which were limited (as far as this parish was concerned), so far as I was able to ascertain, to 18 houses, but which caused quite a scare, owing to the social position of the inhabitants of some of those houses. I naturally at once turned my attention to the milk supply, but was not able to find any connection with it. The Local Government Board was applied to, and sent an Inspector to investigate the outbreak, but beyond suggesting that some improvements might be 15 made in the main drainage of the district, which in my opinion had nothing to do with the question, or the outbreak would not have been of so very limited a character, nothing was suggested. On the other hand, the fact that so much Enteric Fever poison was suddenly thrown into the sewers without any further spread of the disease, speaks strongly in favour of the drainage arrangements of the parish. Simple Continued Fever caused only one death, as in 1888. There was, however, also a death of an infant from "Infantile Remittent Fever." Diarrhœa caused 31 deaths, being 4 more than in 1888, but against an average of 37.6 during the.previous 10 years. I may note that the temperature of the summer quarter was 0 8 degrees below the average of the previous 118 years, and no less than 1.3 degrees below the average of the previous 48 years. No death from English Cholera was registered. Infectious Disease (Notification) Act, 1889. The Infectious Disease (Notification) Act, was passed during the year. By this Act it was made compulsory on Medical Attendants to certify, and on householders to notify, the existence of cases of Small-Pox, Cholera, Diphtheria, Membranous Croup, Erysipelas, Scarlet Fever, Scarlatina, and the fevers known by any of the following names:— Typhus, Typhoid, Enteric, Relapsing, Continued, or Puerperal, and also any infectious disease to which the Act has been applied by the Local Authority in manner provided by the Act. It was anticipated by some that great opposition would be offered to this Act by the medical profession, and not 16 only so, but that great evil would result from it in the concealment of cases of Infectious Diseases. I have always maintained that this would not be so, and that, on the contrary, great advantage would be obtained by the carrying out of the Act. As a matter of fact not the slightest friction has occurred, and the Act has been carried out by the medical practitioners in the most loyal manner. I was from the first opposed to the principle of "dual notification" as it is called, that is to say, of notification by the householder, as well as certification by the medical attendant, as I consider that an unnecessary complication was thereby introduced, and the event has justified my anticipation, for, as a matter of fact, the Act is now made effective entirely through the certificates given by the medical attendants, as we scarcely ever receive any notifications from householders, nor do we want them. So far from cases being concealed owing to the operation of the Act, as a matter of fact, we hear of numbers of cases that we should not have heard of if it were not for the operation of the Act. Sanitary Work. For the year ending March 31 st, 1890. The following table has been compiled for me by Mr. Joseph Snook, your Senior Sanitary Inspector, from the Report Book: — Table VI. Various kinds of Complaints of Nuisances, &c., from, lst April, 1889, to 31st March, 1890. Total number of Complaints 619 Notices served 137 Houses and premises limewhited 59 Houses disinfected after infectious diseases 90 Old brick drains abolished, and pipes substituted 33 New drains constructed 35 17 Drains unstopped and repaired 33 Drains trapped and ventilated, sinks disconnected, &c. 100 Closets supplied with water and repaired 39 Closets unstopped and repaired 45 New Closets provided 31 Roofs repaired 5 New dustbins provided 6 Dustbins renewed, repaired, new covers, &c. 29 New Cisterns provided 18 Cisterns repaired, new covers, &c. 15 Waste Pipes disconnected 27 Removal of animals improperly kept 1 Meat, Fish, &c., condemned (cases of) 1 Overcrowding abated 3 Cesspools abolished 17 Accumulation of dung, straw, &c., removed 30 Various nuisances removed 125 No cause for complaint 28 Legal proceedings taken 0 Cases could not assist 6 Cases referred to Surveyor 19 Cases referred to Police 2 Licensed Cow-houses 4 Licensed Slaughter-houses 5 Cases removed to Hospitals ... 112 Inspection of houses after cases of infectious diseases viz.:— Small Pox 0 Scarlet Fever 60 Typhoid and Low Fever 35 Typhus Fever 0 Diphtheria 43 I have prepared the following Table showing the number of cases of these diseases removed to Hospital, and the number treated at home, during the twelve months ending March 31st, 1890. 18 Description of Case. Removal to Hospital. Treated at Home. Total. Recovered. Died. Small Pox 0 0 0 0 Scarlet Fever 60 20 0 80 Enteric (Typhoid) Fever 13 12 12 37 Diphtheria 23 8 16 47 The articles disinfected in the hot-air disinfecting chamber belonging to the Parish were as follows:— 57 Beds 122 Sheets 79 Mattresses 64 Bolsters 34 Palliasses 171 Pillows 102 Quilts 23 Dresses 211 Blankets 16 Shawls 10 Waistcoats 23 Coats 14 Trowsers 50 Towels 36 Carpets 65 Cushions 21 Hearthrugs 30 Table Covers 41 Curtains 20 Rugs 12 Suits of Clothing and a quantity of Sundry Articles. The total number of complaints attended to, and also that of notices served was considerably greater than in 1888; it was not, however, necessary to take legal proceedings in any case to enforce compliance with the notices served, this being the strongest argument that could possibly be given to show that the notices were not served without good reason. The markets have been regularly inspected and kept in good order, so that it has been only necessary to condemn articles exposed for sale in one case. The slaughter-houses and cowsheds have also been regularly inspected and kept in good condition. There are however, as stated in the last report, only five licensed 19 slaughter-houses and four licensed cowsheds in the parish. No application for a license has been opposed, and no new applications have been made. The bake-houses, which are now again placed under our supervision, have been inspected twice during the year and found in a sufficiently satisfactory condition. The number of articles of clothing, etc., disinfected, has been still less than it was in the previous year, chiefly on account of the great diminution in the cases of Scarlet Fever. The following is the return of the number of bodies received in the Mortuary during the twelve months ending 31st March, 1890, as furnished to me by the Mortuary Keeper, Mr. Coles. Table VII. Return showing the number of bodies received into the Mortuary Ebury Bridge, from 1st April, 1889, to 31st March, 1890. Cause of Death. Number. Post Mortems. Inquests. Deaths from Scarlet Fever 0 0 0 Ditto Diphtheria 2 0 0 Found Drowned 6 6 6 Found Dead 10 10 10 Born Dead 5 5 4 Murder 1 1 1 Suicide 11 10 11 Deaths from Natural Causes 43 29 20 Deaths from Accident 22 17 18 Totals 100 78 70 Houses Let in Lodgings. There are now only 50 houses upon the Register, as against 74 in 1888, as many of these houses have been pulled down and turned into workshops and so taken oft' the list. 20 Table VIII Showing the results of Mr. Cassal's Analyses of the Water supplied by the Grand Junction and Chelsea Water Companies, from April, 1889, to March, 1890. Grand Junction Cow's Water. Date of Collection April 24. May 23. June 27. July 20. August 22. Sept. 26. Oct. 18. Nov. 21. Dec. 20. Jan. 23. Feb. 17. March 24. Average. Parts per 100 Thous. Total Solid Matters 36 29.2 25.2 29 20 26 32 36.8 34 38 36 34 31.8 a. Volatile 14 9.2 9.2 12 10 14 16 12.8 18 10 14 14 13.2 b. Fixed 22 20.0 16.0 17 16 12 16 24.0 16 22 22 20 18.6 Chlorine 1.8 1.8 1.8 1.8 1.8 1.8 1.8 1.8 1.8 1.8 1.8 1.8 1.8 Equivalent to Common Salt 2.96 2.96 2.96 2.96 2.96 2.96 2.96 2.96 2.96 2.96 2.96 2 96 2.96 Nitrogen as Nitrates 0.233 0.20 0.107 0.117 0.145 0.108 0.09 0.155 0.23 0.20 0.175 0.155 0.159 Saline Ammonia 2.2 2.2 1.4 2.2 08 2.2 1.6 2.2 1.4 2.2 1.4 1 6 1.8 Parts Per 100 Mill. Organic Ammonia 10.6 14.6 15.2 12.0 8.6 104 9.4 16.0 10.8 15.2 14.2 121 12.4 Chelsea Company's Water. Total Solid Matters 32 32 20 26 23 32 30 32 32 38 36 42 31.2 Parts per 100 Thous. a. Volatile 12 18 12 9 11 12 14 16 12 16 16 16 13.6 b. Fixed 20 14 8 17 12 20 16 16 20 22 20 26 17.6 Chlorine 1.8 1.8 1.8 1.8 1.8 1.8 1.8 1.8 1.8 1.8 1.8 1.8 1.8 Equivalent to Common Salt 2.96 2 96 2.96 2.96 2.96 2.96 2.96 2.96 2.96 2.96 2.96 2.96 2.96 Nitrogen as Nitrates 0.14 0.20 0.093 0.117 0.116 0.2 0.16 0.155 0.164 0.20 0.162 0.155 0.155 Saline Ammonia 1.34 2.2 0.8 1.4 0.8 2.2 1.6 2.2 1.8 2.2 1.4 1.6 1.6 Parts Per 100 Mill. Organic Ammonia 1.24 12.8 13.4 9.6 8.8 9.6 8.6 13.2 12.0 14.4 14.0 11.2 11.7 21 Table VIII. shows the result of the analyses of the water supplied to the Parish by the two companies during each of the twelve months. The average quality of the water supplied by both Companies was better than during the twelve months ending March, 1889. The average quality of the Chelsea Company's water was, as then, better than that of the Grand Junction Company's water. All the samples when seen through a depth of two feet were clear and had a slight greenish tint; they were all free from copper, lead, and iron. For the information of the Parishioners, I may mention that a hospital carriage for removing persons suffering from infectious diseases (including Diphtheria) 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 at the London Fever Hospital, Liverpool Road, Islington ; or, in case of small-pox, at the Highgate Smallpox 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, 1890.