Vestry of St. Martin-in-the- Fields. REPORT of the MEDICAL OFFICER OF HEALTH For the Year 1893. LONDON: HARRISON AND SONS, ST. MARTIN'S LANE, Printers in Ordinary to Her Majesty. 1894. MEDICAL OFFICER'S REPORT, 1893. Annual Report on the Health of the Parish of St. Martin-in-the-Fields, for the Year 1893. To the Vestry of St Martin-in-the-Fields. Gentlemen, I have the honour of submitting to you my Twenty-fourth Annual Report on the health and sanitary condition of the Parish. Births. In the year 1893 the Births numbered 223, a number still lower than in the previous year. A gradual diminution of births in the Parish has been going on for some years, and is due, as mentioned in previous annual reports, to the less residential character of the district. 2 The following Table gives the number of Births registered in each month of the year:— Males. Females. Total. January 4 8 12 February 15 7 22 March 13 8 21 April 6 2 8 May 11 10 21 June 16 6 22 July 10 7 17 August 12 11 23 September 10 8 18 October 11 12 23 November 9 7 16 December 4 16 20 - - - 121 102 223 The Birth-rate of the Parish for the year 1893 is 15.3 per 1,000 of the population. In London, the number of births registered in the 52 weeks was 132,975, being in the proportion of 31.0 annually per 1,000 of the estimated population. Deaths. In St. Martin-in-the-Fields the total Deaths in the year 1893 were 367, against 331 of the previous year. This increase of mortality over the previous year is due to the fact of the Charing Cross Hospital having been closed for several weeks in 1892 for the purpose of repairs, therefore the deaths in that institution would be less during that year. 3 The following Table shows the number of Deaths registered in each mouth of the year 1893:— Males. Females. Total. January 19 21 40 February 15 12 27 March 23 11 34 April 19 10 29 May 15 18 33 June 17 6 23 July 17 11 28 August 28 8 36 September 14 7 21 October 22 8 30 November 18 12 30 December 21 15 36 228 139 367 These 367 Deaths include those non-parishioners who died in the Charing Cross Hospital, and therefore must be omitted in estimating the death-rate, but, on the other hand, the deaths occurring outside the Parish among persons belonging thereto must be added. On referring to Table 7, it will at once make clear what I have just stated. In calculating the Death-rate, I do so in two forms, the first in which are excluded the deaths of parishioners occurring in the Edmonton Workhouse and St. Martin's Almshouses, whom I consider have practically ceased to be parishioners, owing to the circumstance of many of them having been resident there many years prior to their death, and in the second form I have included them. Death-rate of St. Martin-in-the-Fields for the year 1893, excluding the 29 deaths which occurred in the Edmonton Workhouse and 2 in St. Martin's Almhouses 16.6 per 1,000 of the estimated population. a 2 4 Death-rate of St. Martin-in-the-Fields for the year 1893, including the 29 deaths which occurred in the Edmonton Workhouse and 2 in St. Martin's Almshouses 18.7 per 1,000 of the estimated population. In London, the deaths registered in the 52 weeks numbered 91,536, being in the proportion of 21.3 annually per 1,000 population. This rate was 1.2 per 1,000 in excess of the average rate in the previous five years, having been raised considerably by the mortality from diphtheria and influenza. Infantile Mortality. The mortality of children under one year of age in the year 1893 was at the rate of 179.4 per 1,000 births. Old Age Mortality. The deaths of parishioners over 60, in and out of the Parish, in the year 1893, numbered 72. 31 were from 60 to 70 years of age. 29 „ „ 70 „ 80 „ 10 „ „ 80 „ 90 „ 2 „ „ 90 „ 100 „ Causes of Death. Zymotic Diseases.—The principal Zymotic Diseases are Smallpox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Typhoid Fever, Typhus Fever, Cholera, and Diarrhœa. The total number of deaths occurring in the Parish from the above class of disease was 13. This number includes those nonparishioners who died in the Charing Cross Hospital. After deducting these, and adding those parishioners who died in Public Institutions outside, the mortality due to St. Martin-in-the-Fields would be 14 for the year. On referring to Table 5 it will be observed how enormously this class of disease has diminished in the Parish during the last 10 years. 5 Small-pox.—One parishioner died of this disease. She was a young woman residing in Bedfordbury. On the case coming to my notice I had her at once removed to the Metropolitan Asylums Board Hospital, where she died nine days after admission. I subsequently learnt that she had been vaccinated in infancy only. During the year, 11 cases of this complaint were notified, in accordance with the Public Health Act. Small-pox was very prevalent in London during the year. I have reason to believe that these periodical outbreaks of this disease are due to the neglect of vaccination, and I am sorry to see the silly prejudice springing up against so beneficient a measure. In March a letter was addressed to your Clerk, by the London County Council, calling attention to the dissemination of Small-pox by persons frequenting Casual Wards, Salvation Army Shelters, and Common Lodging Houses, and urging the desirability of special facilities being afforded for the vaccination of the employes and lodgers of all such houses. The letter was subsequently handed to me for the purpose of taking action. I, therefore, called upon Mr. Snell, the Vaccination Officer to the Strand Union, to ask him to grant facilities for this object. He very willingly, and readily, assented to my request, and promised that the Medical Officer would attend in the evening at auy of the Common Lodging Houses and vaccinate any persons who so wished. Measles.—Only 1 death was due to this disease. Scarlet Fever.—Again, this year, we had another epidemic of this complaint, and, as in the previous year, 1892, caused a great strain on the Managers of the Metropolitan Asylums Board in finding accommodation for so large a number of cases. One death only, of a young man belonging to this Parish, occurred in the London Fever Hospital. During the year 100 cases were notified, against 54 of the previous year. 6 Diphtheria.—From this disease 4 deaths occurred within the Parish, 3 of which were non-parishioners, who died in the Charing Cross Hospital; and, in addition, 5 parishioners died in Hospitals outside the Parish, making in all 6 for the year to the credit of St. Martin's. Whooping Cough.—Two deaths were due to this complaint. Typhoid Fever.—Four non-parishioners died in the Charing Cross Hospital of Typhoid Fever, and 1 death of a parishioner occurred in St. Thomas's Hospital. Diarrhœa.—From this disease 2 deaths were recorded, both young children. The deaths from all causes, with the ages at death of those who died in the Parish, and also of those parishioners who died in institutions outside the district will be found fully detailed in Tables 2 and 6. Inquests. In the year 1893, there were held 56 inquests. The causes which produced death were as follows:— Natural causes 23 Pistol shot wound (suicide) 3 Injuries received from falling downstairs 2 „ „ „ being knocked down or run over by vehicular traffic in the street 3 Injuries received from falling from a roof whilst at work 1 Injuries received from failing from a platform whilst at work 1 Injuries received from falling from a window 3 „ „ „ „ an omnibus 1 „ „ „ stone work falling from the parapet of a house 1 Injuries received from machinery in motion at a paper mill 1 Carried forward 39 7 Brought forward 39 Injuries received in a lift 2 „ „ from being compressed between a van and wall 2 Injuries to head 2 Burns—Clothes ignited accidentally 2 Suffocation (infant) caused by smoke from 2 a fire 1 Suffocation (infant) when in bed with mother—accidental 1 Drowning 3 Poison, narcotic (suicide) 1 2 „ carbolic acid (suicide) 1 Wound of throat (suicide) 2 56 Notification of Infectious Disease. The number of cases of infectious disease notified during the year 1893, in conformity with the Public Health (London) Act, 1891, was 151, against 102 of the previous year. The fees paid to the Medical Practitioners for certifying to these cases amounted to £15 2s. 0d., which sum is repaid to the Vestry by the Metropolitan Asylums Board. Cholera. This malady again threatened us, but, happily, with little effect. In London several suspicious cases occurred, some ending in death. Dr. Shadwell, Cholera Superintendent to the Metropolitan Asylums Board, in a report states that four undoubted cases of cholera occurred in Loudon during the year 1893, all ending in death. They were as follows:— Date of Death. 1. September 6th 2. „ 11th 3. „ 12th 4. „ 26th Locality. Westminster. Fulham. Lambeth. Southwark. 8 No doubt we owe our immunity in a great measure to the zeal and vigilance displayed by the Port Sanitary Authorities in the inspection of passengers and crews of all vessels coming from cholera-infected countries. However, the disease showed itself at Grimsby, where several cases occurred, and spread to other localities, where a direct connection with Grimsby could foe traced. The precautions adopted in St. Martin's the previous year stil held good, and by your directions I selected three resident medical gentlemen for the purpose of giving advice and medicine to the poorer class of parishioners should the disease invade us. With our improved sanitation, and the precautions exercised at our several ports when cholera is threatening us, it is my opinion that this disease will never again obtain any appreciable foothold in this country. The House to House Inspection. This is the only parish in London, so far as I can ascertain, which has adopted this sanitary measure. Three temporary qualified Inspectors were selected for the work, the number shortly afterwards being reduced to two, owing to one of them resigning for the purpose of taking a permanent appointment of a similar nature elsewhere. They commenced their duties on the 2nd of January, 1893, at three different points of the Parish. Before beginning their task, I instructed them not to put the Parishioners to unnecessary expense; but, at the same time, any grave sanitary defects must be dealt with, drains in particular. We made large use of Kemp's drain tester for ascertaining the soundness of the drains. In a great many cases old, worn out, brick drains were discovered; and, in the case of pipe drains, the joints were frequently very defective, being destitute of cement or stopping of any kind. In houses of comparatively recent construction, and of a good class, drainage defects were found; strange to say, the Inspectors 9 reported to me that they considered the drainage more faulty in the butter class of houses than in the poorer. Other sanitary defects were not neglected, such as sink, lavatory, and bath wastes, and rain-water pipes directly communicating with the soil pipe or drain, they being made to discharge over properlytrapped gullies; old, obsolete fittings of water closets, where creating a nuisance, were abolished, and more modern and sanitary ones substituted; several water closets badly situated were done away with, and others improved in the matter of ventilation and light. The number of premises which have been inspected up to the present time (the end of May, 1894) is 1,641, and out of these, 1,312 were found to have defects. There are a few more still remaining which will have to be examined; but, practically speaking, the inspection is finished. Of the above houses in which defects were found, the necessary measures to remedy them have been carried out in 811 instances, thus leaving 501 incompleted; but about 157 of this incompleted number belong to the Adelphi area, and therefore nothing could be done to these houses until the proposed new sewers have been finished in that locality. The above figures just quoted, and if tabulated as follows, will render them more easily understood:— Number of houses inspected in which defects were found 1,312 Number of houses inspected in which no defects were found 329 Total number of houses inspected 1,641 Deduct from the total number of defective houses those wherein the necessary works have been completed, and the result will give the figures of those still to be finished:— Total number of defective houses 1,312 Defective houses in which the works have been completed 811 501 This, therefore, leaves 501 houses still incompleted; but, as before stated, about 157 of them belong to the Adelphi area, and a 3 10 until the new sewerage is carried out, the work in these houses cannot be commenced. In many of these incompleted houses the works are in course of progress, and I hope shortly to be able to add them to the list of completed. Theatres.—These places of entertainment were all inspected, aud in some of them serious drainage defects were found, which have been rectified at a considerable outlay; also, in several of them, the lavatory accommodation was improved, both for the audience and artistes. The following were the theatres examined:—Adelphi, Avenue, Vaudeville, Garrick, Comedy, Drury Lane, Trafalgar, Lyceum, Prince of Wales', Haymarket, Toole's and Alhambra. Appended is a list of those premises where notices and plans have been sent in of intention to lay down new drains, up to the end of May, 1894. Adelphi Theatre. Agar Street, Nos. 2, 3, 6, 7, 8 and 10. Alhambra Theatre. Avenue Theatre. Bedfordbury, Nos. 4 and 23. Bedford Street, Nos. 1, 45, 49 and 50. Blue Cross Street, Nos. 4, 7, 8, 11, and 12. Board School, Russell Street. Bow Street, No. 8. Bull Inn Court, Nos. 14, 15, and Electricity Supply Station. Carlton Gardens, No. 3. Carlton House Terrace, Nos. 11, 14, 15 and 20. Carlton Mews, Nos. 6, 9 and 10. Castle Street, Long Acre, Nos. 25, 26, 27, 28, 29, 30, 31, 32, 33 and Messrs. Morgan & Co. Chandos Street, Nos. 36, 37, 39, 47 and 48. Charing Cross, Nos. 9,10,15, 25, 26, 29, 32, 33,45,55, 57, 60, 63, 64, 66 and 67. Charing Cross Hospital. Charing Cross Road, Nos. 16, 36 and 48. Charles Buildings,Nos. 1,2,and 3. Church Vestry Hall. Cockspur Street, Nos. 1, 2, 14, 17, 20, 21, 22, 23, 24, 25, 30, 31, 32 and 33. Comedy Theatre. Cranbourn Street, Nos. 16, 17, 18, 19, 21, 22, 23, 25, 32, 34 and 37. Craven Court, "Craven Arms." Craven Hotel. Craven House, Northumberland Avenue. 11 Craven Street, Nos. 4, 7, 14, 15, 17, 26, 30,31,32,33, 34, 35, 37 and 42. Crown Court, Nos. 10 and 24. Drury Lane, Nos 30, 31, 32, 33, 34, 35, 39 and 40. Duncannon Street, Nos. 3, 6, 4 a and 4b. Garrick Street, Nos. 18, 20 and 23. Garrick Theatre. Goodwin's Court, Nos. 1, 2, 3, 4, 5, 6, 7 and 8. Great Scotland Yard, "Rising Sun." Green Street, Nos. 12 and 17. Hanover Court, No. 14. Harvey's Buildings. Nos. 1 and 2. Haymarket, No. 23, and Civil Service Co-Operative Stores. Haymarket Theatre. Hotel Victoria James Street, Covent Garden, Nos. 11 and 12. James Street, Haymarket, No. 3. John Street, Adelphi, No. 14. King William Street, Nos. 3, 6, 8, 9, 13, 15. 17, 18, 20, 21, 23 and 29. Leicester Square, Hotel Provence. Long Acre, Nos. 18, 19, 20, 21, 26, 30, 33, 34, 55, 87, 91, 111, 112,125,128, 129, 137, 140 and 141. Lumley Court, No. 5. Lyceum Theatre. Martlett's Court, No. 10. May's Buildings, No. 12. Monmouth Court, Nos. 6-and 7. New Street, Nos. 1, 2, 4, 11, 12, 14, 27, 28 and 29. Northumberland Street, No. 3. Oxendon Street, No. 15. Pall Mall East, Nos. 13, 14, 16, 17 and G.E Ry. Office. Russell Court, No. 16. St. Martin's Court, Nos. 7, 8, 9' 20 and 21. St. Martin's Lane, Nos. 31, 35, 37, 40, 41,44,45, 46, 48, 51, 54, 62, 63, 64, 65, 66, 68, 69, 70, 79, 86 and 112. St. Martin's Place, Nos. 6, 7, and 8. St. Martin's Street, Nos. 3, 4, 5, 6, 23, 24, 31 and "Duke's Head." Southampton Street, No. 39. Spring Gardens, Nos. 7, 8, 9, 10, 19, 21 and 29. Spur Street, Nos. 1 and 2. Stafford House, St. James'. Strand, Nos. 9, 11, 14,15, 45, 76, 367, 377, 378,379,388, 390, 391, 392, 393,395, 396, 401, 407, 408, 421, 422, 425, 427, 428, 429,430,431,432, 433, 434,437, 438, 439, 441, 444, 445, 453, 454, 455, 456 and 457. Strand Buildings, Eagle Court. Suffolk Street, Nos. 2, 6, and 25. Trafalgar Square, No. 1. Upper St. Martin's Lane, Nos. 7, 8, 9, 11, 12, 14 and 17. Vaudeville Theatre. 12 Villiers Street, Nos. 25, 26, 27, 28, 28a, 29 and Gatti's Music Hall. Warwick Street, No. 14. Wellington Street, No. 21. Whitcomb Street, No. 7. Whitehall, No. 4. Whitehall Court, No. 4. Whitehall Place, Nos. 6 and 22. York Buildings, Nos. 4, 13, 14, 15, 16, 17, 18, 19 and 20. The above notices for laying down new drains number 337. I need hardly point out that these works considerably enhanced the duties of your officers; the works had to be supervised whilst in course of progress, and when finished tested with the water test. In connection with this inspection, magisterial proceedings had to be taken in four instances. At the time this undertaking was proposed, it was thought that a few months would be sufficient in which to complete the business, but as the work progressed its magnitude and difficulties were discovered. One great difficulty we experienced was in finding out who was the responsible party to do the works ordered, then again some were very reluctant to commence the requirements; others again, for various reasons, requested an extension of time, which could not be very well refused. Another serious drawback was that the two inspectors who had been carrying out this inspection resigned their appointments in the early part of this year, 1894, for the same reason which the third one did shortly after he commenced his duties in 1893. This unfortunate circumstance caused a great deal of confusion, as you must be well aware it is no easy matter to pick up the thread of another man's work; however, another inspector was appointed in their place. By the time all these sanitary improvements are comp'eted the cost will have been very great to the parishioners, as some of the works have been on a very expensive scale, amounting probably to some thousands of pounds. In conclusion, I trust the parishioners will reap the reward of their great expenditure and inconvenience in increased health and freedom from sickness. 13 Food and Drugs Act. Under this Act your Analyst examined 24 samples, as follows:— Milk Butter Bread Coffee Sugar (Moist) Sugar (Loaf) Cocoa Whiskey 3 samples. 3 „ 3 „ 3 „ 3 „ 3 „ 3 „ 3 „ Result—One of the samples of milk was found to be poor—the vendor was cautioned; and one sample of whiskey was one point below the standard. All the rest were genuine. Bake-Houses. There have been of late many sensational reports in the Press of the insanitary condition of some of the London bake-houses, and the subject has been referred to in the House of Commons. No doubt the underground position of these places is not conducive to their well being. There is a deficiency of daylight, and proper ventilation is difficult to obtain, consequently the men employed suffer more or less in health. In my opinion no future bake-houses should be allowed to be constructed underground. Our own bake-houses have been regularly and systematically inspected, and as a rule I have found them in a very satisfactory condition. During the time (23 years) I have held my present position, it has never been necessary to resort to legal proceedings to enforce cleanliness in any one of them. The Mortuary. The Mortuary, which is situated under the churchyard, has been completely transformed; anyone who knew it in its former condition would hardly now recoguise the place, so great has been the improve- 14 meat. The light has been greatly augmented by the adoption of prismatic lights, and the use of white glazed tiles. The room where the post mortem examinations are conducted is supplied with two revolving slate tables, a desk and table for writing, &c., hand basins with a supply of hot and cold water. The electric light is laid on for use on dark days and in the evening. Your Surveyor informs me that the cost has been about £730. Sanitary Notices. Sanitary Notices, to the number of 212, were served upon the owners or occupiers of property; and, in addition, ordinary or friendly notices were served upon the owners or occupiers of all the houses found defective in the course of the House-to-House Inspection. Houses Let Out in Lodgings. Your Sanitary Inspector, whom you appointed permanently to inspect these houses, has regularly carried out this duty, and has reported to me all sanitary defects coming under his notice. I have the honour to be, Gentlemen, Your obedient Servant, JOHN J. SKEGG, Medical Officer of Health. 2'J, Craven Street, June, 1894. TABLE I. BIRTHS, DEATHS, and INQUESTS for the last Ten Years, In St. Martin-in-the-Fields. 1884 1885 1886 1887 1888 1889 1890 1891 1892 1893 Births 401 350 356 302 276 283 267 252 246 223 Deaths, total 469 426 425 415 399 380 382 420 331 367 „ under 5 years 142 113 119 115 100 127 96 121 89 84 ,, from 5 to 60 252 233 215 218 225 200 214 222 179 223 „ over 60 years 75 80 91 82 74 53 72 77 63 60 „ from Small-pox 0 0 0 0 0 0 0 0 0 0 „ „ Measles 8 9 5 5 9 6 7 7 8 1 „ „ Scarlet Fever 1 1 0 2 1 1 0 0 2 0 „ „ Whooping-Cough 13 7 11 5 4 7 5 8 0 2 „ „ Diarrhœa 14 6 15 11 5 5 3 4 3 2 „ „ Fever 7 4 4 3 1 5 4 3 0 4 „ „ Consumption 46 51 47 29 31 26 29 41 29 24 „ „ in Charing Cross Hospital 178 177 160 175 195 174 173 204 141 184 Inquests 73 63 60 67 62 57 54 58 60 56 15 16 TABLE II. TABLE OF THE CAUSES OF DEATH at Various Ages In the Parish of St. Martin-in-the-Fields, during the Year 1893. CAUSES. Total Deaths at all Ages. Under 1 Tear. From 1 Year to 5. From 5 Years to 20. From 20 Years to 40. From 40 Years to 00. From 60 Years to 80. 80 Years and upwards. Small-pox - - - - - - - - Measles 1 .. 1 — — — — — Scarlet Fever — — — — — — — — Diphtheria 4 .. 4 — — — - — Croup I .. 1 — — — - — Whooping Cough 2 .. 2 — — — — — Enteric or Typhoid Fever 4 .. .. 3 1 — — — Fevers of a Doubtful Nature — — — — — — — — Erysipelas 1 .. .. .. .. .. l — Pyæmia 1 .. .. .. 1 — — — Puerperal Fever — — — — — — - — Carbuncle — — — — — — - — Influenza 4 .. 1 .. 1 1 l — Dysentery — — — — — — — — Diarrhœa 2 1 1 — — — — — Cholera (Simple) — - — — — — — — Cholera (Asiatic) — - — — — — — — Ague — - — — — — — — Rheumatic Fever 1 .. .. .. 1 — — — Syphilis — - — - — — - - Disease of Male Organs of Generation 2 . . .. .. 1 1 — — „ Female „ „ 4 .. .. .. 1 2 1 — Hydrophobia — - — — — — — — Glanders — - — — — — — — Privation — - — — — — — — Want of Breast Milk — - — — — — — — Purpura and Scurvy — - — — — — — — Delirium Tremens — - — — — — — — Intemperance 3 .. .. .. 2 1 — — Gout — - — — — — — — Dropsy — - — — — — — — Cancer 15 .. .. .. 2 12 1 — Sarcoma 2 .. .. .. .. 2 — — Mortification — - — - — — — — Scrofula 3 .. .. 2 1 — — — Tabes Mesenterica — - — — — — — — Phthisis 24 .. .. 3 15 5 1 — Leucocythemia — - — — — - — — Hydrocephalus — - — — — — — — Apoplexy 7 .. .. .. 1 1 5 — Paralysis — - — — — - — — Chorea — - — — — — — — Epilepsy 2 .. .. 2 — — — — Convulsions 7 5 1 .. 1 — — — Disease of Brain 8 .. 1 2 1 3 — 1 Cerebral Meningitis 11 3 7 1 — — — — Aneurism 8 .. .. .. 1 6 1 — Disease of Heart 27 .. .. 3 9 9 6 — Bronchitis and Asthma 56 12 6 2 1 23 12 — Disease of Lungs 1 .. .. .. .. 1 — — Pneumonia 37 4 2 2 6 17 6 — Pleurisy 3 .. .. .. .. 2 1 — Laryngitis 1 .. .. .. .. 1 — — Disease of Stomach 1 .. .. .. 1 — — — „ „ Intestines 16 9 .. 1 4 2 — — Peritonitis 5 .. 1 l 3 — — — Hernia 5 .. .. .. 1 .. 4 — Disease of Liver 13 .. .. .. 1 6 6 — „ „ Spleen and Pancreas 1 .. .. .. .. 1 — — „ „ Kidney 18 .. 1 1 3 9 4 — „ „ Bladder 3 .. .. .. 1 1 1 — „ „ Joints and Bones — - - - — — — — „ „ Spine — — — — — — — — „ „ Skin — - - - — — — — Diabetes 4 .. .. 1 .. 3 — — Premature Birth 1 1 - - — — — — Congenital Malformation 1 1 — — — — — — Teething 2 1 1 — — — — — Childbirth — - - - — — — — Old Age 5 .. .. .. .. .. 3 Atrophy and Debility 16 14 1 .. .. .. 1 — Injuries 21 .. .. 1 8 10 2 — Burns and Scalds 2 .. .. l 1 — — — Poison 3 .. .. .. 2 1 — — Suffocation 2 2 - - - — — — Drowning 3 .. .. 2 .. 1 — — Hanging — — — — — — — — Pistol Shot Wound 3 .. .. .. 2 1 - - 367 53 31 28 73 122 57 3 17 TABLE III. DEATHS in the different localities in ST. MARTIN-IN-THEFIELDS during the Year 1893. Total Deaths. Deaths from Zymotic Disease. Total Deaths. Deaths from Zymotic Disease. Adam Street 1 — Northumberland Avenue 7 — Bedfordbury 5 1 Orange Street 2 — Bedford Street 1 — Panton Street 1 — Blue Cross Street 3 — Peabody Buildings, Bedford bury 5 — Broad Court 1 — Broker's Alley 1 — Red Lion Court, Russell Court 1 — Buckingham Street 1 — Burleigh Street 1 — River Thames 2 — Carlton Gardens 1 — Royal Westminster thalmic Hospital 1 — Carlton House Terrace 1 — Castle Street 2 — Russell Court 9 — Chandos Street 1 — Russell Street 3 — Charing Cross Hospital 184 7 Scotland Yard 2 — Charing Cross Hotel and Railway Station 4 — St. James' Palace 2 — St. James' Park 1 — Cockspur Street 2 — St. Martin's Court 3 — Conduit Court 1 — St. Martin's Lane 3 — Cot entry Street 1 — St. Martin's Street 8 — Craven Street 3 — Spring Gardens 2 — Cross Court, Broad Court 1 — Stafford House, St. James' 1 — Drury Lane 4 — Strand 4 — Duke's Court 4 — Strand Buildings 2 — Duke's Street 1 1 Suffolk Place 1 — Eagle Court.. 1 Suffolk Street 1 — Endell Street 2 Trafalgar Square 2 Green Street 1 Turner's Court 5 1 Hanover Court 2 Upper St. Martin's Lane 1 Haymarket 1 Villiers Street 2 James Street, Adelphi 2 Yinegar Yard 2 11 James Street, Haymarket 1 Whitcomb Street 4 1 John Street, Adelphi 2 Whitehall Court 1 King William Street 1 Whitehall Place 1 Langley Court 1 White Hart Street 2 7 Wilson Street 2 Long's Court 2 York Buildings 2 Lumley Court 3 In the street, accidentally Filled or suddenly dying from natural causes 15 — Marquis Court 2 Martlett's Court 1 May's Buildings 4 1 Mercer Street 8 1 367 13 New Street .. 2 – 18 TABLE IV. Showing the localities wherein the 13 deaths occurred from the seven principal Zymotic Diseases during the year 1893 in St. Martin-in-the-Fields. Small-pox. Measles. Scarlet Fever. Diphtheria Whooping Cough. Fever. Diarrhoea. Total. Bedfordbury .. l .. .. .. .. .. 1 Charing Cross Hospital .. .. .. *3 .. *4 .. 7 Duke Street .. .. .. .. l .. .. 1 May's Buildings .. .. .. .. .. .. l 1 Mercer street .. .. .. 1 .. .. .. 1 Turner's Court .. .. .. .. .. .. l 1 Whitcomb Street .. .. .. .. 1 .. .. 1 .. l .. 4 2 4 2 13 • All these deaths from Diphtheria and Fever occurring in the Charing Cross Hospital were those of non-parishioners. 19 TABLE V. Showing the number of deaths occurring in the Parish from the seven principal Zymotic Diseases, excluding those non-residents who died in the Charing Cross Hospital, and including those parishioners who died in public institutions outside the Parish during the years 1883-84-85-86-87-88-89-90-91-92, also the number in 1893. DISEASE. 1883. 1884. 1885. 1886. 1887. 1888. 1889. 1890. 1891. 1892. Annual Average of 10 Years. 1883 to 1892. 1893. Small-Pox 1 2 4 — — — — — — — .7 1 Measles 29 10 10 6 5 10 6 8 6 9 9.9 1 Scarlet Fever 6 3 1 — 3 9 3 1 1 6 3.3 1 Diphtheria 6 1 4 1 3 3 2 1 5 11 3.7 6 Whooping Cough 2 13 7 13 4 4 8 6 8 1 6.6 2 Fever 5 1 1 3 1 3 1 4 2 — 2.1 1 Diarrhœa 9 14 6 14 8 4 4 3 2 2 6.6 2 Total 58 44 33 37 24 33 24 23 24 29 32.9 14 20 TABLE VI. TABLE OF THE CAUSES OF DEATH at Various Ages, Of Parishioners of St. Martin-in-the-Fields occurring in Public Institutions outside the Parish during the Year 1893. CAUSES. Total Deaths at all ages. Under 1 year. From 1 year to 5. From 5 years to 20. From 20 years to 40. From 40 years to 60. From 60 years to 80. 1 80 years and upwards. Small-Pox 1 .. .. .. l — — — Scarlet Fever 1 .. .. .. l — — — Diphtheria 5 .. 4 l — — — — Typhoid Fever 1 .. .. .. .. l — — Erysipelas 1 .. .. .. l — — Pyæmia 1 .. .. .. .. l — — Influenza 3 .. .. .. .. .. 2 1 Congenital Syphillis 1 1 — — — — — — Privation 1 .. .. .. .. l — — Cancer 7 .. .. .. 2 4 1 — Sarcoma 1 .. .. .. .. 1 — — Scrofuls 1 .. .. .. .. .. 1 — Tabes Mesenterica 1 1 — — — — — — Phthisis 10 .. .. 1 3 4 2 — Amyloid Disease 1 .. .. .. .. 1 — — Apoplexy 2 .. .. .. .. .. 1 1 Paralysis 7 .. .. .. 1 4 1 1 Epilepsy 4 .. .. .. .. 3 1 — Disease of Brain 2 .. .. .. .. 2 — — Cerebral Meningitis 1 .. .. .. .. .. — — Aneurism 1 .. .. .. .. 1 — — Disease of Heart 3 .. 1 1 .. 1 — — Bronchitis 15 .. .. .. 1 4 7 3 Pneumonia 3 .. .. .. 1 1 1 — Pleurisy 1 .. .. .. .. 1 — Disease of Intestines 1 1 – – – — — Peritonitis 1 1 — — Disease of Liver.. 3 – — — ,, Kidney 9 .. .. .. 1 3 4 1 Old Age 4 .. .. .. .. ... 1 3 Injuries 1 .. .. .. .. 1 — Drowning 1 1 — — — 95 4 5 4 12 37 23 10 21 TABLE VII. In accordance with the requirements of the Local Government Board. TABLE OF DEATHS during the Year 1893, In the Sanitary District of St. Martin-in-the-Fields, classified according to Diseases, Ages, and Localities. LOCALITIES. Mortality from all causes, at subjoined Ages. Mortality from subjoined causes distinguishing Deaths of Children under Five Years of Age. At all Ages. Under 1 Year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 60. 60 and upwards. Smallpox. Scarlatina. Diphtheria. Membranous cr )up. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Injuries. All other Diseases. Total. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a) (6) (c) (c) (d) (e) (f) (g) (0 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20 21. 22. St. Martin-in-the-Fields 182 33 19 7 6 76 41 Under 5 .. .. 1 1 .. .. .. .. .. .. .. 1 2 2 .. .. .. 12 .. .. 33 52 5 upwards .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. 17 35 12 7 57 130 Charing Cross Hospital 184 20 12 11 17 106 18 Under 5 .. .. 3 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 12 .. .. 17 32 5 upwards .. .. .. .. .. 4 .. .. .. .. .. .. .. .. .. .. 7 37 16 19 70 152 Royal Westminster Ophthalmic Hospital 1 .. .. .. .. .. .. Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwards .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 Totals 367 53 31 18 23 182 60 Under 5 .. .. 4 1 .. .. .. .. .. .. .. 1 2 2 .. .. .. 24 .. .. 50 84 5 upwards .. .. .. .. .. 4 .. .. .. .. 1 .. .. .. 1 .. 24 72 27 26 128 283 The subjoined numbers have also to be taken into account in judging of t.be above records of mortality. Deaths occurring outside the Parish among persons belonging thereto 95 4 5 3 3 47 33 Under 5 .. .. 4 .. .. .. .. .. .. .. .. .. .. ,. 1 4 9 5 upwards 1 1 1 .. .. 1 .. .. .. .. 1 .. .. .. .. .. 10 19 2 1 49 86 Deaths occurring within the Parish among persons not belonging thereto 189 17 12 12 16 113 19 Under 5 .. .. 3 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 8 .. .. 18 29 5 upwards .. .. .. .. .. 4 .. .. .. .. .. .. .. .. 1 .. 7 37 17 20 74 160 22 TABLE VIII. In accordance with the requirements of the Local Government Board. TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS Coming to the knowledge of the Medical Officer of Health, during the year 1893, in the Sanitary District of St. Martin-in-the-Fields, classified according to Diseases, Ages and Localities. Localities. Population at all Ages. Registered Births. New Cases of Sickness in each Locality coming to the knowledge of the Medical Officer of Health. Number of such Casks Removed from their Homes in the several Localities for Treatment in Isolation Hospital. Census 1891. Aged under 5 or over 5. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a) b) (c) (d) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Martin-in-the-Fields 14,574 223 Under 5 .. 21 10 1 .. .. .. .. .. .. .. .. 14 9 .. .. .. .. .. .. .. .. 5 upwards 11 74 13 1 .. 6 .. .. .. .. 9 .. 53 10 .. .. 4 .. .. .. .. 1 Claring Cross hospital .. .. Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwards .. 5 .. .. .. .. .. .. .. .. .. .. 5 .. .. .. .. .. .. .. .. .. Total .. .. Under 5 .. 21 10 1 .. .. .. .. .. .. .. .. 14 9 .. .. .. .. .. .. .. .. 5 upwards 11 79 13 1 .. .. .. .. .. .. .. .. 58 10 .. .. 4 .. .. .. .. 1 TABLE IX. NOTIFICATION OF INFECTIOUS DISEASE. This Table shows the different localities wherein the specified cases of disease occurred during the year 1893, and which were notified to the Medical Officer of Health, in accordance with the Public Health (London) Act, 1891. Small-pox. Cholera. Diphtheria. Membranous Croup. Erysipelas. Scarlet Fever. Typhus Fever. Typhoid Fever. Relapsing and Oontin ued Fever. Puerperal Fever. Total. Adam Street .. .. .. .. .. l .. .. .. .. 1 Bedfordbury 1 .. .. .. .. 1 .. .. .. .. 2 Blue Cross Street 1 .. .. .. .. l .. .. .. .. 2 Broad Court .. .. .. .. .. .. .. 1 .. .. 1 Buckingham Street .. .. .. .. .. 1 .. .. .. .. 1 Castle Street .. .. .. .. .. 10 .. .. .. .. 10 Charing Cross Hospital .. .. .. .. .. 5 .. .. .. .. 5 Charing Cross Road .. .. 3 .. ... .. .. .. .. .. 3 Cockspur Street .. .. .. .. .. 2 .. .. .. .. 2 Cranbourn street .. .. 1 .. .. .. .. .. .. .. 1 Craven Street .. .. .. .. .. 2 .. .. .. .. 2 Cross Ct., Broad Ct:.. .. .. 1 ... ... 1 .. ... .. ... 2 Cross Ct., Russell Ct... .. .. 1 .. .. .. .. .. .. .. 1 Drury Lane l .. 2 .. .. 4 .. .. .. .. 7 Duke's Court .. .. .. .. l .. .. .. .. .. 1 Eagle Court .. .. 1 .. .. .. .. .. ... .. 1 Exchange Court .. .. 1 .. .. .. .. .. .. .. 1 Garrick Street .. .. .. .. .. 1 .. .. .. .. 1 Goodwin's Court l .. .. .. .. .. .. .. .. .. 1 Hanover Court 1 .. .. .. .. .. .. .. .. .. 1 Haymarket .. .. .. .. .. 2 .. .. .. .. 2 James St., Long Acre .. .. .. .. .. 2 .. .. .. .. 2 King William Street .. .. 1 .. .. .. .. 9. 3 Langley Court 1 .. .. .. .. .. .. .. .. .. 1 Langley Street .. .. .. .. .. 2 .. .. .. .. 2 Long Acre .. .. .. .. .. 6 .. .. .. .. 6 Martlett's Court .. .. .. .. l .. .. .. .. .. 1 Mercer Street .. .. 1 .. .. 18 .. .. .. .. 19 New Street 1 .. .. .. .. 2 .. .. .. .. 3 Northumberland Av .. .. 1 .. l 7 .. 2 .. .. 11 Pall Mall .. .. .. .. .. 1 .. .. .. .. 1 Panton Street .. .. .. .. .. 1 .. .. .. .. 1 Peabody Buildings, Bedfordbury 1 .. .. .. 2 .. .. .. .. .. 3 Red Lion Yard, Cockspur Street .. .. .. .. .. 1 .. .. .. .. 1 Russell Street .. .. .. .. 1 .. .. .. .. .. 1 St. Martin's Court .. .. 1 .. .. 5 .. .. .. .. 6 St. Martin's Lane .. .. .. .. .. 3 .. .. .. .. 3 St. Martin's Mews .. .. 1 .. .. .. .. .. 1 St. Martin's Street .. .. .. .. .. 6 .. 1 .. .. 7 Scotland Yard .. .. .. .. .. 1 .. .. .. .. 1 Southampton Street .. .. .. l .. .. .. .. .. .. 1 Spring Gardens .. .. 1 .. 2 .. .. .. .. .. 3 Strand 9 .. .. l .. 9 .. .. .. .. 5 Strand Buildings 1 .. 3 .. .. 3 .. .. .. .. 7 Turner's Court .. .. .. .. .. 1 .. .. .. .. 1 Upp. St. Martin's Lane .. .. 1 .. 1 .. .. .. .. .. 2 Vinegar Yard .. .. 1 .. .. .. .. .. .. .. l Warwick Street .. .. .. .. .. 1 .. .. .. .. 1 Whitcomb Street .. .. 9 .. .. 3 .. .. .. .. 5 Whitehall Court .. .. .. .. .. 1 .. .. .. .. 1 Wilson Street .. .. .. .. .. 3 .. .. .. .. 3 11 .. 23 2 9 100 .. 6 .. .. 151 24 TABLE X. Copied from the Registrar-General's Annual Summary of Births Deaths, and causes of death in London for the year 1893. DIMINUTION or EXCESS of DEATHS in 1893, compared with the Average Annual Deaths in 1883-92. Cause of Death. Diminution in 1893. Excess in 1893. Small-pox 97 — Measles 1,053 — Scarlet Fever — 449 Typhus 16 — Influenza — 970 Whooping cough 443 — Diphtheria — 1,985 Simple Fever 36 — Enteric Fever — 10 Diarrhoeal Diseases — 391 Cancer — 374 Phthisis and other Tubercular Diseases 917 — Premature Birth — 365 Diseases of Nervous System 498 — Diseases of Circulatory System — 403 Diseases of Respiratory System — 662 Diseases of Urinary System — 170 Childbirth and Puerperal Fever — 173 Accidents — 249 Homicide 17 — Suicide — 40 All other Causes — 825 3,077 7,066 Balance of Diminution or Excess — 3,989 The net loss during the year amounted to 3,989 lives; that is to say, if the death-rate in 1893 had not exceeded the average rate in the preceding decennium, the deaths of 3,989 fewer persons would have been registered in London. Among the causes of death contributing to this excess were again diphtheria, cancer, premature birth, and diseases of the circulatory and urinary systems, which diseases have, for several successive years, shown an increased mortality. Besides these, in 1893 there was a considerable excess under the heads of scarlet fever, influenza, diarrhœal and respiratory diseases; childbirth, puerperal fever, and accident also showing increased mortality.