HAN 41 THE VESTRY of the Parish of Saint George, HANOVER SQUARE. Medical Officer's Report FOR THE YEAR ENDED 25th MARCH, 1892. JUNE, 1892. London: printed by wightaian & co., 104 & 106, regency street, and 31, victoria street, westminster, s.w. 1892. REPORT ON ANITARY CONDITION OF THE Parish of St. George, Hanober Square, FOR THE YEAR 1891, BY 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 oj the Society of Medical Officers of Health; Honorary Corresponding Member of the Royal Society of Public Health of Belgium; of the Imperial Society of Medicine of Constantinople; of the Royal Society of Hygiene of Italy; and of the Society of Hygiene of France; Fellow of the Medical Society of Sweden; MEDICAL OFFICER OF HEALTH, (BEING HIS TWENTIETH ANNUAL REPORT.) To the Vestry 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 2nd, 1892, was 1,877, against an average of 1,838 during the preceding ten years. Of these deaths, 904 were those of Non-Parishioners, leaving 973 deaths of Parishioners. To these, however, must be added 144 deaths of our Parishioners in Public Institutions in the Metropolis outside of the Parish and in the extra Metropolitan Asylums, so that the corrected total of deaths of our Parishioners was only 1,312, or 113 less than the average during the preceding ten years, and equivalent to a corrected death-rate of only 1465 per thousand per annum, as against an average annual deathrate of 15.16 during the preceding ten years. 2 In making the above calculations I have used the census population of 1881, as, for the reason I stated in my last report, I consider that the enumeration of the population of the Parish made in 1891 is useless for statistical purposes. As 1 am now able to give the actual numbers of deaths of Parishioners taking place, not only in the Parish, but in Public Institutions in London outside of the Parish, and in the Extra Metropolitan Asylums, I do not consider it advisable to prepare Table I. and some of the other Tables in the same manner as they have been heretofore prepared, so I, this year, commence the Tables in a somewhat different form, and the corrected total of deaths given in Table I. is no longer merely a calculated number, but is the actual number of deaths of Parishioners as shown in Table IX. Table I. year. Gross Total of Deaths. Deaths of NonParishioners Deaths ot' Parishioners in Public Institutions outside the Parish. Corrected Total of Deaths. (52 weeks). Corrected Death-rate per 1,000 per annum (52 weeks). Average during ten years, 1881-1890 1,838 — — 1,425 15.16 1891 1,877 904 144 1,312 14.66 Deaths of Parishioners in Public Institutions. Mayfair. Belgravia Sub- District not stated. Total. Fulhara Road Workhouse 15 71 19 105 St. George's Union Workhouse 1 4 — 5 St. George's Hospital 15 68 1 84 Belgrave Children's ditto — 1 — 1 St. Gabriel's ditto — — — — Other Places in the Parish — — — — Total in the Parish 31 144 20 195 In Public Institutions in London, outside of the Parish, and in the Extra Metropolitan Asylums 35 96 13 144 3 Table Ia. Death-rates per 1,000 per annum. 1882 1883 1884 1885 1886 1887 1888 1889 1890 1891 28 Large English Towns 22.3 21.0 21.6 20.6 20.9 20.8 19.2 19.3 21.3 22.5 London 21.4 20.4 20.4 19.8 19.9 19.6 13.5 17.4 20.3 21.4 Greater London 20.6 19.7 19.7 19.2 19.3 18.9 17.8 16.8 19.4 19.8 St. George's, Hanover sq. 16.73 15.70 16.30 16.11 17.17 16.05 16.05 14.19 14.56 14.65 From Table Ia we see that the death-rate of London proper amounted to 21.4, and was higher than in any year since 1882 (when it was also 21.4), and 4 per thousand higher than in 1889. The death-rate of greater London, with an estimated population of 5,656,909 was 19.8, or rather less than in the preceding year, but nearly 5 per thousand higher than the death-rate of this Parish. The death-rate of the 28 largest English towns was 22.5, or more than 1 per thousand higher than it was in 1890. As usual the death-rate of this Parish was lower than that of any one of the 28 largest English towns, the nearest to it being:— Brighton 18.2 Portsmouth 19.0 Derby 19.1 Norwich 19.3 Nottingham 19.9 Birkenhead 20.9 Bristol 20.9 Hull 21.0 and the highest being— Blackburn 25.8 Salford 26.0 Manchester 26.5 Liverpool 27.0 Preston 27.3 4 The death-rate of Edinburgh was 21.6 (or almost the same as that of London), that of Glasgow 25.3, and that of Dublin 26.5, the two latter being almost exactly the same as in 1890. 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— The Hague 19.5 Dresden 19.5 Christiania 19.8 Berlin 20.9 and the highest being— Trieste 30.5 Moscow 37.0 Alexandria 45.4 Madras 52.5 Cairo 53.7 Most of these rates are much higher than those in 1890, the rates for Madras and Cairo being each nearly 10 per thousand above those in 1890. 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 of Parishioners 1891 1,610 17.96 216 13.41 16.45 From Table II. we see that the number of births in the Parish was 1,610, and that the birth-rate was only 17.96 per thousand per annum, as against 17.49 in 1890, 5 The birth-rate for London proper was 31.8, or 1 per thousand higher than the corrected rate for 1890, that of greater London being 31.7, and that of the outer ring 31.2. The average birth-rate of the 28 largest English towns was 32.6, or 2.6 per thousand higher than that of 1890, the highest being those of Preston, 36.0; Salford, 36.4; Cardiff, 36.5; Sheffield, 36.6; and Sunderland, 37.8; and the lowest those of Bradford, 28.7; Brighton, 26.3; Halifax, 26.2; and Hudderstield, 24.4. The number of deaths of children under one year of age (Parishioners; see Table IX.) was 216; the percentage of such deaths to registered births was 13.41, and to total deaths of Parishioners, 16.45; thus the mortality of children under one year of age was 134 to a thousand births, or 30 less than in 1890, while in London generally it was 154, and the average for the 28 largest English towns was 167, the highest being Blackburn with 204, Leicester with 214, and Preston with 227 deaths of children under one year of age to a thousand births. 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. 0. d. 1881 582 107 129 31 30.12 5.54 6.7 1.60 1882 525 80 102 29 28.12 4.29 5.5 1.55 1883 537 93 126 27 29.11 0.05 6.8 1.46 1884 543 106 132 31 28.99 5.66 7.0 1.66 1885 567 79 106 22 31.42 4.46 6.0 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 6.8 1.21 1889 523 77 116 30 31.43 4.63 7.0 1.80 1890 650 94 130 22 32.73 4.73 6.5 1.10 1891 627 80 144 17 33.38 5.05 7.6 0.97 London 1891 23,504 3,223 6,644 938 26.05 3.57 7.4 1.03 6 From Table III. it appears that there were 627 registered deaths of persons aged 60 and upwards, giving a percentage of 33.38 of the gross total of deaths, as against a percentage for London generally of only 26.05. There were, however (see Table IIIa.), only 405 deaths of Parishioners of 60 years and upwards, giving a percentage of 30.85 of the corrected total of deaths, or a proportion of only 45.2 to a thousand persons living, as against 88.9 in London generally and 91.3 in the 28 largest English towns, the lowest being Leicester, 81.0; Portsmouth, 78.5; and Norwich, 70.9; and the highest, Blackburn, 106.9; Salford, 108.7; and Oldham, 108.9. From Table III. we also see that 95 violent deaths were registered in the Parish, being 5.05 per cent, of the total deaths, but of the 95 deaths registered under this heading, only 37 were those of Parishioners (see Table IIIa.), giving a percentage of only 2.8 of the corrected total of deaths, which is nearly 1 per cent, below that of London generally. This shows the importance of reckoning only the deaths of Parishioners under this heading, which I am now able to do. The Inquest cases held in the Parish numbered 144, being more than in any year mentioned in the Table. They were equivalent to 7.6 per cent. of the gross total deaths, as against 7.4 in London generally. Table IIIa. Non-Parishioners excluded. Year. A Persons aged sixty yea^s and upwards. B Violence. Percentages to corrected Total of Deaths. A B 1890 404 33 30.82 2.5 1891 405 37 30.85 2.8 7 The number of registered deaths uncertified as to cause was 17, or 5 less than in 1890, and equivalent to 0.97 per cent, of the gross total of deaths, as against 1.03 per cent, in London generally. Only 3 of these 17 deaths were those of Parishioners (see Table IX.) Table IV. SUB-DISTRICT. Population at middle of 1891. Births. Birth-rate. Deaths of Pariehioners. Deaths (corrected). Death-rate (corrected). Hanover Square Mayfair Mayfair 30,353 272 8.95 294 306 10.08 Belgravia 59,220 1,338 22.59 982 1,006 17.00 Sub-district not stated 36 Whole Parish 89,573 1,610 17.96 1,312 1,312 14.65 8 Table IVa. BIRTH-RATES. DEATH-RATES. 1882. 1883. 1884. 1885. 1886. 1887. 1888. 1889. 1890. 1891. 1882. 1883. 1884. 1885. 1886. 1887. 1888. 1889. 1890. 1891. Hanover Sq 17.26 17.08 16.46 15.36 14.00 13.67 13.74 11.83 9.95 8.95 15.84 14.65 15.54 15.18 15.42 12.75 13.47 12.09 9.32 10.08 May fair 16.83 16.61 15.20 14.16 14.45 11.87 11.34 12.44 11.19 11.49 Belgravia 23.93 23.07 23.87 22.24 22.46 22.53 21.31 22.14 21.34 22.59 18.09 16.99 17.40 17.49 18.79 17.75 17.38 15.27 17.24 17.00 Whole Parish 21.61 20.97 21.18 19.73 19.66 19.53 18.74 18.64 17.49 17.96 16.73 15.70 16.30 16.11 17.17 16.05 16.05 1419 14.56 14.65 9 From Tables IV. and IVa it appears that the birth-rate of the Mayfair Sub-District was only 8.95, as against 995 in 1890, while that of the Belgravia Sub-District was 22.59, as against 21.34 in 1890, and that the corrected death-rate of the Mayfair Sub-District was 10.08, as against 9.32 in 1890, and that of the Belgravia Sub-District was 17.00, as against 17.24 in 1890. 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" (as I explained in my last Annual Report) in order to prevent confusion, as the term "mean duration of life" is a technical expression, which means the length of life as calculated by the life-table method. The "mean length of life" state 1 in this report is calculated by means of Dr. Bristowe's formula. Mean Length of Life. Mayfair Sub-District 104.95 Belgravia 51.00 Whole Parish 61.62 The extraordinary figure calculated for the Mayfair SubDistrict is due to the abnormally low birth rate (8.95) and this is caused partly by the fact that there are a very large number of unmarried domestic servants, and partly because so many of the children of the inhabitants are born in the country. 10 The calculated mean length of life in this Parish during the last 17 years has been as follows:— In 1875 it was 46.67 years. „ 1876 „ 47.96 ,, „ 1877 „ 49.52 „ „ 1878 „ 48.03 „ „ 1879 „ 48.55 „ „ lb80 „ 58.01 ,, „ 1881 „ 50.26 „ „ 1882 „ 52.56 „ „ 1883 ,, 55.09 „ „ 1884 „ 53.78 „ „ 1835 ,, 56.11 „ „ 1886 „ 54.46 „ „ 1887 „ 56.49 „ „ 1888 „ 57.71 „ „ 1889 „ 61.43 „ „ 1890 „ 62.67 „ „ 1891 „ 61.62 „ So that the mean length of life in this Parish during those 17 years has averaged over 54 years, while during the last ten years it has averaged over 57 years. The mean length of life in London during the last 14 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 „ 11 In 1882 it was 36.82 years. „ 1883 „ 37.88 „ „ 1884 „ 38.08 „ „ 1885 „ 39.29 „ „ 1886 „ 39.31 „ „ 1887 „ 39.98 „ „ 1888 „ 41.77 „ „ 1889 „ 43.27 „ „ 1890 „ 41.10 „ „ 1891 „ 38.28 „ N.B.—These figures are too high, being calculated from erroneous estimates of the Population. It will thus be seen that the calculated mean length of life in this Parish was higher than in any previous year, except 1890, while that of London generally was apparently lower than it was in any year since 1884, but it must be remembered that the rates for those previous years were calculated on the estimated population which the result of the 1891 census has shown to be too high; thus the figure for 1890, calculated on the estimated population for that year, corrected by the census of 1891, would be only 38.92, instead of 41.10. 12 Table V. Showing the number of Deaths registered in the Parish in each of the ten years, 1881 to 1890, from the principal infections Diseases and Diarrhoea, and the number in 1891. DISEASE. 1881. 1882. 1883. 1884. 1885. 1886. 1887. 1888. 1880. 1890. Annual Average of ten years, 1881—1890. Proportion of Deaths to l,00o Deaths in ten years, 1881—1800. 1891. Proportion of Deaths to 1,000 Deaths in 1891. Small-pox 9 1 0 2 2 0 0 0 0 0 1.4 0.8 0 0 Measles 21 30 13 40 21 20 30 12 49 49 28.5 15.5 13 6.9 Scarlet Fever 18 13 11 7 10 2 16 8 1 1 8.7 4.7 1 0.5 Diphtheria 14 15 27 25 35 32 22 52 36 29 28.7 15.6 16 8.5 Whooping Cough 15 63 21 43 19 40 23 28 31 48 33.1 18.0 24 12.7 Typhus Fever 3 0 0 1 0 0 0 0 0 0 0.4 0.2 0 0 Enteric (orTyplioid)Fever 20 21 21 22 8 12 15 5 18 12 15.4 8.3 14 7.4 Simple Continued Fever 1 0 8 1 2 1 2 1 1 2 1.9 1.0 1 0.5 Diarrhœa 33 34 27 44 37 45 58 27 31 29 36.5 19.8 39 20.7 Cholera 2 2 1 0 2 1 0 0 0 1 0.9 0.4 0 0 Total 136 179 129 185 136 153 166 133 167 171 155.5 84.3 108 57.2 13 From Table V. it will be seen that the total number of deaths from infectious diseases and diarrhoea registered in the Parish (including deaths of Non-Parishioners) was 108, a smaller number than in any previous year and 49 below the averge of the previous 10 years. The 108 deaths from these diseases is equivalent to a zymotic death-rate of only 1.21, as against 1.88 in 1890, the rate for London being 2.30, and that for the 28 largest English towns 2.42. If, however, we only consider the deaths of our Parishioners from the principal zymotic diseases, they amount (as will be seen from Tables Va. and Vb.) to only 100, equivalent to a zymotic death-rate of only 1.116. The only large town which has a lower zymotic death-rate than this is Brighton with 1.05. The nearest to it are Derby, 1.44; Birkenhead, 1.71; Hull, 1.72; Norwich, 1.77; and Bristol, 1.96; all the rest have a zymotic deathrate of over 2. The highest zymotic death-rates in the Country are furnished by Leicester with 3.45, Salford with 3.46, and Preston with 3.77. These rates are lower than the highest rates for 1890, in which year the zymotic death-rate of Preston was 4.28, while in 1889 it was as high as 7.70. Table Va. Deaths of Parishioners from the principal Infectious Diseases in the Mayfair Sub-District:— Disease. 1891. Small Pox 0 Measles 2 Scarlet Fever 0 Diphtheria 10 Whooping Cough 3 Typhus Fever 0 14 Disease. 1891. Enteric (or Typhoid) Fever 3 Simple continued Fever 0 Diarrhœa 3 Cholera 0 Total 21 There were also 11 deaths from Influenza. Table Vb. Deaths of Parishioners from the principal Infectious Diseases in the Belgravia Sub-District:— Disease. 1891. Small Pox 0 Measles 11 Scarlet Fever 6 Diphtheria 9 Whooping Cough 18 Typhus Fever 0 Enteric (or Typhoid) Fever 6 Simple continued Fever 1 Diarrhœa 28 Cholera 0 Total 79 There were also 35 deaths from Influenza. Taking these diseases separately according to 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: only 13 deaths were caused by this disease, as against 49 in 1890 and 49 in 1889, the average for the previous 10 years being 28.5. 15 Scarlet Fever: although only one death from this disease was registered in the Parish during the year, there were 5 deaths of our Parishioners from it in Public Institutions outside of the Parish. Diphtheria: only 16 deaths were (according to the Registrar General) registered in the Parish from this disease, the smallest number since 1882, being 13 less than in 1890, and nearly 13 below the annual average for the previous 10 years. Among the 16 deaths registered in the Parish, there was one death of a Non.Parishioner. On the other hand there were 6 deaths from Diphtheria of Parishioners in Public Institutions outside the Parish. (My Tables, however, show that only 14 deaths from this disease were registered in the Parish, one being that of a Non. Parishioner, leaving 13 deaths of Parishioners, which, together with the 6 deaths of Parishioners from this disease in Public Institutions outside of the Parish, make 19 deaths of Parishioners altogether, as shown in Tables 5a and 5b.) Diphtheria is still exceedingly prevalent in London and in some of the other great towns, although the average death.rate from it in the 28 largest English towns in 1891, was only a little above the average of the preceding 10 years. In London, however, the death.rate from it was 23 per cent above the average, in Norwich nearly twice the average, in Derby nearly 3 times the average, in Manchester 41 per cent, above the average, and in Newcastle over 69 per cent, above the average. On the other hand, in some towns it was below the average, as in Portsmouth, where it was only about a third of the average, Plymouth, where it was less than half the average, and Bristol and Cardiff, where it was about two.thirds of the average. 16 Whooping Cough: only 24 deaths were registered (3 being those of non.parishioners), as against 48 in 1890, and an average of 33.1 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. Enteric (or Typhoid) Fever: 14 deaths were registered, or two more than in 1890, but less than the corrected average for the previous 10 years. Of these 14 deaths, however, 5 were those of non.parishioners, in St. George's Hospital, leaving 9 deaths of Parishioners, one of which was certified as from " Gastric Fever." None of our Parishioners died of this disease in Public Institutions outside of the Parish. Simple Continued Fever: one death appears under this heading, having being registered as from " Low Fever." Diarrhæa; 39 deaths were registered, being 10 more than in 1890, and 25 above the average of the previous 10 years. Of these deaths, however, 8 were those of non. parishioners, leaving 31 of parishioners (one of which was certified as from Dysentery), or only 2 more than in 1890. I may note that the temperature of the fourth quarter was 45 1, or 14 degrees above the average of the previous 120 years, and 0.8 degrees above the average of the previous 50 years, while the temperature of the rest of the year was below the average. The mean temperature of the year was 48'4 degrees, or slightly below the average of 120 years, and 0.8 below the average of the previous 50 years. No death from English Cholera was registered. Influenza: no less than 46 deaths were registered in the Parish from this disease (as against 27 in 1890), and of these 42 were those of persons over 20 years of age, and 17 17 of them over 60. As I remarked last year, the large number of deaths from diseases of the lungs is no doubt attributable to a certain extent, to the results of attacks of this disease. Cases of Infectious Diseases. The following table shows the number of cases certified by Medical Attendants in 1890 and 1891:— Table Vc. Name of Disease. No. of Cases certified. 1890. 1891. Scarlet Fever 145 122 Enteric Fever 40 26 Continued Fever 5 2 Diphtheria 64 74 Erysipelas 37 41 Membranous Croup 1 2 Small Pox 0 1* Puerperal Fever 0 2 292 270 Of the above 270 cases certified last year only 7 were notified by householders. The Act continues to work quite satisfactorily, and none of the friction that was foretold by its opponents has occurred. An outbreak of Diphtheria occurred in Bourdon Buildings in October and November, chiefly among children attending the South Street Schools. Proper precautions were taken and the disease stamped out. An inspection was subsequently made on behalf of the Local Government Board by Mr. Sweeting, who concluded that the disease * This case, however, on being removed to the Small Pox Hospital was found not to be a case of that disease. 18 was probably introduced from South Street Schools, in spite of the fact that none of the 260 scholars in those schools were attacked by it except those living in Bourdon Buildings. These buildings have been for years past exceptionally healthy, only one case of infectious disease having been reported in them during the last 10 years. The sanitary arrangements of the buildings are good, but admitted of some slight improvements, which have been carried out at my suggestion. Public Health (London) Act. I submitted to the Vestry a special report on this Act, which came into operation on the 1st of January, 1892. Sanitary Work. For the year Ending March 31st, 1892. The following tables have been compiled for me by Mr. Albert Taylor, your Chief Sanitary Inspector, from his Report Book:— Table VI. Houses and Premises inspected 867 „ ,, „ reinspected 2,080 References to Surveyor 43 Notices issued 293 Summonses taken out 0 Table VIa. Nuisances dealt with. Soil Pipes ventilated 65 Bath, Sink and other waste pipes disconnected 139 Drains unstopped or repaired 111 Old brick drains abolished and pipes substituted 164 New trapped gullies fixed 263 19 Water Closet apparatus cleaned and repaired 91 New Water Closets fixed 148 New Water Waste Preventer Cisterns fixed 219 Water Store Cisterns cleaned and repaired 42 Houses provided with drinking water 15 Water Supply of W.C.'s separated from drinking water 48 Ashpits and dustbins repaired 28 New moveable dustbins provided 16 Yard surfaces paved or repaired 27 Cesspools abolished 8 Overcrowding abated 8 Houses and premises cleansed 22 Roofs and rain water.pipes repaired 23 Offensive accumulations removed 49 Dung.pits abolished and moveable wire cages substituted 16 Nuisances from the keeping of animals 12 Miscellaneous nuisances 78 Total 1,492 Drains tested and found defective 73 „ ,, ,, ,, satisfactory 12 ,, of new premises superintended and tested 57 A great many more notices were served than in 1890. It was not, however, necessary to take legal proceedings in any case to enforce the abatement of a nuisance. Table VIb. Infectious Diseases and Disinfection. Number of infectious cases reported 289 Do. medical certificates received 338 Do. houses in which infectious disease occurred 261 Do. patients removed to the hospitals 159 Do. houses disinfected 192 Do. rooms disinfected 239 Do. articles of clothing, bedding, &c., disinfected 1954 20 Description of Articles of Bedding, &c. Disinfected. Articles. Totals. Beds 144 Mattresses 120 Palliasses 47 Quilts 217 Blankets 401 Sheets 251 Bolsters 115 Pillows 318 Dresses 20 Shawls 33 Coats 11 Waistcoats 1 Trowsers 8 Carpets 27 Towels 23 Cushions 124 Table Covers 6 Rugs 45 Suits of Clothing 5 Curtains 15 Miscellaneous Articles 627 2,558 Disinfectants have been distributed to the public when required and personal instructions given as to their proper use. The number of articles of clothing, &c., disinfected was considerably more than in 1890. There are 30 bake.houses on the register; they have been inspected twice during the year, and the sanitary condition of three of them has been greatly improved, but legislation is necessary to compel the closing of all bake.houses that are situated in underground rooms. The slaughterhouses, of which there are five licensed in ' the parish, and the two licensed cowhouses have been regularly inspected and found to be satisfactorily conducted, 21 The same may be said of the street stalls and butchers' shops to which frequent visits are paid, but it has not been necessary to seize any article of food as unfit for human consumption. Houses Let in Lodgings. There are now only 49 houses upon the Register, as many of the houses formerly on it have been pulled down and so taken off the list; many more will, however, be probably added in the next few years, as, during the house to house inspection which has been initiated, no doubt houses will be visited which it will be desirable to place upon the List. The following Table shows the number of bodies received in the Mortuary during the 12 months ending March 31st, 1892, as compiled from the returns furnished to me monthly by the Mortuary.keeper, Mr. Coles. TABLE VII. Return showing the number of bodies received into the Mortuary, Ebury Bridge, from 1st April, 1891, to 31st March, 1892. Cause of Death. Number. Post Mortems. Inquests. Deaths from Scarlet Fever 0 0 0 Ditto Diphtheria 3 0 0 Found Drowned 4 3 3 Found Dead 6 6 6 Born Dead 5 3 2 Murder 4 4 3 Suicide 13 13 13 Deaths from Natural Causes 51 45 38 Deaths from Accidents 28 27 26 Totals 114 101 91 22 Table VIII Showing the results of Me. Cassal's Analyses of the Water supplied by the Grand Junction and Chelsea Water Companies, from April, 1891, to March, 1892. I Chelsea Company's Water. 1 Grand Junction Co.'s Water. Date of Collection April 30. May 29, 30. June 30. July. August5. August 31. Sept. 30. Oct. 31. Nov. 30. Dec. 31. Jan. 30. Feb. 29. March 31. Average. Total Solid Matters 34.4 31.2 27.6 27.6 23.2 35.4 38.8 39.2 32.8 34.0 33.2 86.0 32. 8 a. Volatile 17.2 11.2 10. 0 12.0 11.2 15.6 11.2 11.2 15.8 12.8 13.6 16.8 13.2 b. Fixed 17.2 20.0 17.6 15.6 12.0 19.8 27.6 28.0 17.0 21.2 19.6 19.2 19.6 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 Saline Ammonia 1.4 1.4 0.8 2. 2 1.4 1.8 3. 6 1.4 2.0 0.8 1.4 2. 2 1.7 Organic Ammonia 11.2 10.4 10.2 8.6 12.6 9.6 20.8 10.6 11.4 9.2 13.6 8.6 11.4 Total Solid Matters 32.4 31.2 28.0 24.4 22.0 30.8 29.8 38.4 34.0 37.6 31.6 33.6 31.1 a. Volatile 13.2 10.4 11.6 10.4 10.6 13.6 9.4 17.2 10.8 13.2 10.8 13.6 12.0 6. Fixed 19.2 20.8 16.4 14.0 11.4 17.2 20.4 21.2 23.2 24.4 20.8 20.0 19.1 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 Saline Ammonia 1.4 1.4 0.8 0.8 0.8 1.5 3.4 1.4 1.0 1.6 1.4 1.6 1.4 Organic Ammonia 9.2 11.6 11.6 7.8 10.4 11.0 23.0 14.6 14.8 9.8 12.6 9.4 12.1 23 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. The average quality of the water supplied by the Grand Junction Company was better, than, but that supplied by the Chelsea Company not so good as, during the 12 months ending March, 1891. The average quality of the Grand Junction Company's water was, as will be seen from the table, rather better than that of the Chelsea Company's water, a reversal of the position reported during the previous two years. All the samples, when seen through a depth of 2ft., were clear and had a slight greenish tint, except the samples collected on October 31st, 1891, which had a "strong marked greenish yellow colour," and one of which, the Grand Junction Company's sample, was reported as "very slightly cloudy." I described these samples in my monthly report as " the worst samples I have yet reported on, each containing about twice the average amount of organic pollution." 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 24 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, 1892. TABLE IX. 26 TABLE IX. Deaths of Parishioners of St. George, Hanover Square, during the 52 weeks ending Saturday, January 2nd, 1899 cause of death. mayfair. BELGRAVIA. All Ages. Under 1. 1-5. 5-20. 20-60. 60 and over. All Ages. Under 1. 1.5. 5-20. 20-60. 60 and over. ALL CAUSES 294 32 19 20 122 101 982 169 76 48 385 304 Zymotic. Small Pox ... ... ... ... ... ... ... ... ...• ... ... ... Measles 2 ... 1 1 ... ... 11 4 6 1 ... ... Scarlet Fever ... ... ... ... ... ... 6 1 4 1 ... ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... Influenza 11 ... ... ... 7 4 35 2 1 1 18 13 Whooping Cough 3 ... 3 ... ... ... 18 5 13 ... ... ... Diphtheria 10 1 2 5 1 1 9 ... ... ... ... ... Simple Continued & Ill-defined Fever. ... ... ... ... ... ... 1 ... ... 1 ... ... Enteric Fever 3 ... ... ... 3 ... 6 ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea, Dysentery 3 1 ... ... 1 1 28 19 4 1 2 2 Remittent Fever ... ... ... ... ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... ... ... ... ... ... ... Glanders ... ... ... ... ... ... ... ... ... ... ... ... Cowpox and Effects of Vaccination ... ... ... ... ... ... ... ... ... ... ... ... Venereal Affections ... ... ... ... ... ... 2 2 ... ... ... ... Erysipelas ... ... ... ... ... ... 4 2 ... ... 1 ... Pyaemia and Septicaemia 1 ... 1 ... ... ... 6 ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... Other Zymotic Diseases ... ... ... ... ... ... ... ... ... ... ... ... Para- |sitic. Thrush and other Vegetable Parasites ... ... ... ... ... ... ... ... ... ... ... ... Worms and other Animal Parasites ... ... ... ... ... ... ... ... ... ... ... ... Dietetic. Starvation, Want of Breast - milk, Debility from Birth 7 7 ... ... ... ... 36 34 2 ... ... ... Alcoholism 3 ... ... ... 2 1 9 ... ... ... 9 ... 27 TABLE A-Contune..  CAUSE OF DEATH. MAYFAIR. BELGRAVIA. All Ages. Under 1. 1.5. 5.20. 20.60. 60 and over. All Ages. Under 1. 1.5. 5.20. 20.60. 60 and over. Constitutional. Rheumatic Diseases 4 ... ... 1 1 2 5 ... ... 1 3 1 Gout 1 ... ... ... ... 1 3 ... ... ... 1 2 Rickets ... ... ... ... ... ... 2 2 ... ... ... ... Cancer 12 ... ... ... 8 4 34 ... ... ... 21 13 Phthisis and Scrofula 34 2 3 5 22 2 126 10 6 15 88 7 Diabetes 3 ... ... ... 2 1 4 ... ... ... ... 4 Other Constitutional Diseases 1 ... ... 1 ... ... 4 ... ... ... 3 1 Develop .mental Premature Birth, &c, 4 4 ... ... ... ... 28 28 ... ... ... ... Accidents of Child.birth 1 ... ... ... 1 ... 3 ... ... ... 3 ... Old Age 13 ... ... ... ... 13 36 ... ... ... ... 36 Local. Diseases of Brain, &c. 22 4 1 ... 10 7 78 12 6 4 20 36 ,, Heart, &c. 36 ... ... 3 17 16 96 ... ... 4 47 45 ,, Lungs, &c. 71 8 6 ... 27 30 249 33 18 5 83 110 „ Stomach, Liver, &c. 20 2 1 2 8 7 55 7 2 2 32 12 „ Kidneys, &c. 12 ... ... ... 6 6 25 ... ... ... 16 9 ,, other Organs 10 2 1 1 3 3 30 2 7 6 7 8 Violent. Fractures, Contusions 5 ... ... 1 3 1 8 ... ... ... 7 1 Gunshot Wounds ... ... ... ... ... ... 4 ... ... ... 2 2 Cut, Stab 1 ... ... ... ... 1 5 ... ... ... 5 ... Scald, Burn ... ... ... ... ... ... 1 ... ... ... 1 ... Poison ... ... ... ... ... ... 2 ... ... ... 2 ... Drowning 1 1 ... ... ... ... 4 ... ... 2 1 l Hanging ... ... ... ... ... ... 1 ... ... ... 1 .. Suffocation ... ... ... ... ... ... 5 4 ... ... 1 ... Other Forms of Violence ... ... ... ... ... ... ... ... ... ... ... ... Doubt .ful. Causes Ill.defined ... ... ... ... ... ... 2 2 ... ... ... ... Causes not defined ... ... ... ... ... ... 1 ... 1 ... ... ... Sub.district not stated, 36. N.B.—The deaths of Non.Parishioners occurring in the Public Institutions in the Parish are excluded ; those of Parishioners in the other Public Institutions in London and in the Extra.Metropolitan Asylums are included.