STMART 4 Destry of St. Martin-in - the-Fields. REPORT OF THE MEDICAL OFFICER OF HEALTH For the Year 1899. LONDON: HARRISON AND SONS, ST. MARTIN'S LANE, Printers in Ordinary to Her Majesty. 1900. MEDICAL OFFICER'S REPORT, 1899. Annual Report on the Health of the Parish of St. Martin-in-the-Fielils, for the Year 1899. To the Vestry of St. Martin-in-the-Fields. Mr Lord and Gentlemen, 1 have the honour of submitting to you my Thirtieth Annual Report on the health and sanitary condition of the Parish. Births. The Births registered during the year numbered 154, a diminution of 28 over the previous year, 1898. The following Table gives the number of Births registered in each month of the year:— 2  Males. Female. Total. January 3 8 11 February 7 8 15 March 5 8 13 April 2 4 6 May 5 6 11 June 6 3 9 July 11 9 20 August 7 6 13 September 6 9 15 October 9 5 14 November 7 6 13 December 5 3 8 - - - 73 75 148* - - - These 154 births will produce a birth-rate of 11.8 per 1,000. In London, during the year 1899, the births registered numbered 133,120, giving a rate of 29.4 per 1,000 of the population. This is the lowest London birth-rate on record. Deaths. The total Deaths registered in the Parish during the year 1899 were 358, an increase of 53 over the previous year, and due to the greater number of deaths in the Charing Cross Hospital. * To these 148 Births occurring in the Parish must be added 6 belonging to St. Martin's, which took place at the Bear Yard Receiving Ward, making a total of 154. 3 The following Table gives the number of deaths registered in each month of the year:— Males. Females. Total. January 14 6 20 February 13 10 23 March 17 18 35 April 18 7 25 May 26 12 38 June 18 8 26 July 11 9 20 August 20 16 36 September 15 18 33 October 13 14 27 November 24 16 40 December 21 14 35 210 148 358 These 358 deaths include those non-parishioners who died in the Charing Cross Hospital, and must therefore be omitted in estimating the death-rate; but, on the other hand, the deaths occurring in Public Institutions outside the Parish of persons belonging thereto must be added. The death-rate for the year 1899 will therefore be 14.1 per 1,000 of the population. In London, the deaths in the year 1899 numbered 89,689, and corresponded to a rate of 19.8 per 1,000 of the population, the average death-rate in the ten previous years having been 19.6. Infantile Mortality. Of the 185 deaths of parishioners occurring within and outside the Parish, 33 were under 5 years of age, equal to 17.8 per cent. of the total deaths. A 2 4 The deaths of Infants under 1 year of age numbered 27, equal to 14.6 percent. of the total deaths, and 175.3 to 1,000 registered births. In London, during the year 1899, the deaths of Infants under 1 year of age to 1,000 births were 167.0. The following Table shows the causes of death of these 27 infants under 1 year of age:— Atrophy and Debility 4 Diseases of Respiratory System 4 Diseases of Digestive System 2 Premature Birth 3 Measles 2 Diarrhoea 5 Diphtheria 1 Erysipelas 1 Tabes Mesenterica 2 Teething 1 Suffocation 1 Cerebral Meningitis 1 27 Old Age Mortality. The deaths of parishioners over 60 years of age, occurring within and out of the Parish, numbered 61. 29 were from 60 to 70 years of age. 26 ,, ,, 70 ,, 80 ,, ,, 6 ,, ,, 80 ,, 90 „ ,, Causes of Death. Zymotic Diseases.—The principal Zymotic Diseases are Smallpox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Typhoid Fever, Typhus Fever, Puerperal Fever, Cholera, and Diarrhoea. 5 The number of deaths occurring in the Parish from this class of disease was 30. 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 Parish, the mortality due to St. Martin's would be 14, against 11 of the previous year. Vide Table 5. Small-Pox.—No case was notified from this disease. In London, this complaint caused three deaths during 1899. Measles.—Three deaths from this malady occurred in the Parish and two in the Charing Cross Hospital, and of this latter number one was a non-parishioner, and there was one death of a parishioner recorded in the Sick Asylum. Scarlet Fever.—No death occurred from this disease. Diphtheria.—Four deaths from Diphtheria took place in the Charing Cross Hospital, all non-parishioners, and a death of a parishioner from this complaint occurred at Martlett's Court. Whooping Cough.—No death from this complaint was recorded. Typhoid Fever.—Ten deaths from this disease occurred in the Charing Cross Hospital, all of which were non-parishioners, and one of a parishoner outside the Parish. Typhus Fever.—No death was recorded from this malady. Puerperal Fever.—One death occurred in the Parish from this complaint. Diarrhœa.—Nine deaths from this disease were registered in the Parish, three of which were non-parishioners. For all other causes of death, vide Tables. 6 Inquests. During the year 1899, inquests were held in the Parish in reference to the deaths of 43 persons, of whom 10 were residents, and also 4 inquests were held respecting the deaths of parishioners outside the Parish. The causes which produced death were as follows:— Natural causes 13 Poison, Nitric Acid (suicide) 1 Burns 1 Privation 1 Intemperance 2 Drowning 6 Suffocation (infant), when in bed with parents 1 „ from the fumes of a conflagration 1 Shock from fright and a fall during attempted rescue at a fire 2 Hemorrhage from navel cord, newly born .. 2 Chloroform when about to undergo an operation 1 Injuries received when driving a cab 1 „ „ whilst attempting to enter a train when in motion 1 Injuries received by jumping from a window when of unsound mind 3 Injuries received from being run over by a train 1 Injuries received from falling over a piece of timber 1 Injuries received from a fall in the street 1 „ „ „ falling off a cab when in a fit 1 Injuries received from being run over or knocked down by vehicles in the street 4 Injuries received from falling down stairs 2 „ „ by an Acrobat when performing at the Empire Music Hall 1 47 7 Notification of Infectious Disease. During the year 1899 the number of cases of infectious diseases notified in accordance with The Public Health (London) Act, 1891, was 65, as against 38 of the previous year. On referring to Table 7 the diseases will be found specified, and the localities wherein the cases occurred. The fees paid to the Medical Practitioners for forwarding the notifications of these 65 cases amounted to £G 10.s. 6d., which sum is refunded to your Vestry by the Managers of the Metropolitan Asylums Board. Disinfection after Infectious Disease. During the year 70 rooms and the contents thereof were disinfected by your Contractor, at a cost of £82 5s. 2d. It is satisfactory to state that no claim for compensation has ever been made in respect of articles damaged in the course of disinfection. The Public Health (London) Act, 1891, renders the Sanitary authority liaDle for any such injuty. Castle Street Schools, Long Acre. In the latter part of the year, owing to the prevalence of Measles amongst the scholars of the infants' department of the above schools, I deemed it advisable to close that department for a time. A requisition addressed to the Managers of the schools, signed by two Members of the Vestry—your Chairman and Mr. Dudley W. H. James—was sent, and was as follows:— The Vestry of the Parish of St. Martin-in-the-Fields. Town Hall, Charing Cross Road. 31st October, 1899. To the Managers of the Castle Street Schools, Long Acre. Gentlemen, Acting under the advice of the Medical Officer of Health, we two Members of the Vestry require you to close the infants' department of your schools for three weeks, with a view to preventing the spread of disease, namely, Measles. (Signed) CLIFFORD PROBYN, DUDLEY W. H. JAMES. 8 Out of 160 scholars, 55 were said to be suffering from the complaint. So far as I could ascertain 14 of these cases belonged to St. Martin's, the rest were in the districts of the Strand Board of Works and St. Giles'. I had the schoolroom thoroughly disinfected, and afterwards white-washed. The above facts were reported to the Local Government Board and the London County Council. Bacteriological Examination of Suspected Cases of Diphtheria and Typhoid Fever. \ In the month of February your Public Health Committee requested me to report as to the advisability, or otherwise, of giving medical practitioners in the parish power to obtain at the Vestry's expense examination by a Bacteriologist of material from suspected cases of infectious diseases. I reported in favour of such facilities being given to medical practitioners, as often cases of Diphtheria and Typhoid in their early stages are difficult to diagnose, and only a bacteriological examination could clear up the doubt. I was further requested to communicate with the Director of the Laboratories of the Conjoint Board of the Royal College of Physicians and the Royal College of Surgeons, Victoria Embankment, with a view to making arrangements for the carrying out of this scheme. I had several interviews, when it was finally arranged that they would provide the necessary materials for such examination, charging a fee of 3s. Gd. for each case. Your Committee accepted these terms, which were approved of by your Vestry. In order to make known your decision to the medical practitioners, letters were addressed by your Vestry Clerk and myself to those residing in the parish, and also to those residing on the fringe thereof, informing them of the fact, and giving details as to the mode of procedure. 9 The following are the copies of the letters: — The Vestry of St. Martin-in-the-Fields. Town Hall, Charing Cross Road, W.C. April, 1899. Sir, 1 am directed by the Vestry to inform you that they have recently had under consideration the question of whether it was desirable that they should make arrangements by which Medical Practitioners in the District could obtain, without expense to themselves or their patients, examination by a competent bacteriologist of material from suspected cases of Diphtheria and Typhoid Fever, with a view of aiding the diagnosis where the same did not clearly disclose the disease from which it was anticipated the person was suffering, and being of opinion that it is of great importance in the interests of public health that every reasonable facility should be provided for promptly dealing with even suspected cases of infectious disease, the Vestry have made arrangements by which, in all cases where approved by the Medical Officer of Health for this Parish, they will be enabled to secure an examination of suspected matter at the Laboratory of the Conjoint Board of the Royal College of Physicians and Surgeons. The conditions under which this examination will be made are as follows:— The examination will only be made on the written application of the Medical Practitioner called in to attend on any patient; such application to contain briefly the particulars of the case and to be transmitted to the Medical Officer of Health at this address. If the Medical Officer of Health is satisfied that the case is a proper one for the Vestry to bear the expense of the examination, sterilised tubes and swabs will be provided by him, and an order will be given with which the tubes and swabs should be transmitted to the Laboratory of the Royal College of Physicians and Surgeons, Examination Hall, Victoria Embankment, W.C. The fee will be paid by the Vestry. A 3 10 The result of the examination will be communicated to the Medical Practitioner through the Medical Officer of Health, immediately on receipt of the report from the Laboratory. I enclose a memorandum prepared by the Medical Officer of Health as to the taking of suspected matter. The Vestry rely upon your cordial co-operation in giving effect to these arrangements, and trust that you will see that no case in which the diagnosis is clear will be submitted. I am, Sir, Your obedient Servant, (Signed) G. W. MURNANE, Clerk to the Vestry. The Vestry of St. Martin-in-the-Fields. Town Hall, Charing Cross Road, W.C. April, 1899. Bacteriological Examinations in Suspected Cases of Diphtheria and Typhoid Fever. DIPHTHERIA. Dear Sir, For the purpose of obtaining a specimen of exudate in cases of suspected Diphtheria for Bacteriological Examination, I beg to submit to you the following suggestions:— The patient should be placed in a good light. Remove the cotton wadding stopper from the tube containing the iron wire. Depress the tongue with a spatula and rub the cotton wadding pledget fixed at the end of the rod, gently, but firmly against any visible exudate; or, in other cases, including those in which the exudate is confined to the larynx, pass the pledget as far back as possible and rub it firmly against the mucous membrane of the pharynx and tonsils. Still keeping the wire in one hand, withdraw the stopper from the tube containing the solidified blood serum, then rub the pledger 11 once or twice over the serum, taking care not to break the surface. Replace the plug, and then return the wire rod with its pledget to its tube, which should also be restoppered at once. Label the serum tube. Pack the two tubes in the box, taking care to put a little wadding at each end. TYPHOID FEVER. In order to obtain the blood for examination in cases of suspected Typhoid Fever the following is the mode of procedure:— The skin of the back of the index or middle finger is first washed with soap and water and then with alcohol when available. Meanwhile the finger can be prepared by causing congestion in one of the usual ways, viz.: by tying a piece of tape, not too tightly, round the root of the finger. The tightened congested skin, just above the root of the nail should now be sharply pricked with a clean needle or fine lancet. A pretty deep puncture can be made with a sharp needle without causing the patient much pain. Or, if preferred, the lobe of the ear, after compressing it, may be pricked to obtain the blood. Then take one of the small tubes from the test tube and draw up a sufficient amount of blood to fill, or nearly fill the small bulb, then draw the blood from the point of the pipette, and seal off in the flame of a candle or gas, or even of a wax vesta. Always obtain two such tubes if possible. Return these to the test tube and reinsert the cotton wadding plug. Label the tube containing the pipettes. Pack the two tubes in a box, taking care to put a little wadding at each end. I am, Dear Sir, Yours faithfully, (Signed) JOHN J. SKEGG, Medical Officer of Health. 12 Up to the present time only two applications have been made for a bacteriological examination—one was a case of suspected Diphtheria, which proved to be a genuine case of the disease ; the other Typhoid Fever, which was, on examination found not to be the complaint suspected. The House to House Inspection. The following is a list of those premises where notices and plans have been sent in of intention to lay down new drains since the commencement of this inspection down to the end of April, 1900:— Adam Street, Nos. 11, 11a, 14, 15 and 16. Adelaide Street, Nos. 1, 5 and 6. Adelphi Arches, The Cottage. Adelphi Terrace, Nos. 1, 2 and 5. Adelphi Theatre. Agar Street, Nos. 2, 3, 6, 7, 8 and 10. Alhambra Theatre (two plans). Arundel Place, Nos. 12 and 13. Avenue Theatre. Bear Street, No. 11 and "Old King's Head" (P.H.). Bedfordbury, Nos. 1, 2, 3, 4, 9½, 13 15, 16, 22, 23, and Chapel. Bedford Street, Nos. 1, 45, 49 and 50. Blue Cross Street, Nos. 2, 4, 7, 8, 11 and 12. Bow Street, No. 8. Brewer's Lane, Ticket Office, S.E.R. Co. Broad Court (North side). Buckingham Street, Nos. 2, 3, 4, 8, 9, 10, 11, 14, 16, 17, 18, 19 (North and South Side) 21, 23 and 24. Bull Inn Court, Nos. 14, 15, and Electricity Supply Station. Carlton Gardens, No. 3. Carlton House Terrace, Nos. 5, 6, 11, 13, 14,15, 16, 18 and Stables, and 20 and Stables. Carlton Mews, Nos. 6, 8, 9 and 10. Castle Street, Long Acre, Queen's Mansions, Messrs. Morgan & Co. and Nos. 22 and 23. Cecil Court, South Block. Chandos Street, Nos. 36, 37, 38, 39, 47 and 48. Charing Cross, Nos. 9, 10, 11, 12, 15,25, 26, 27, 28,29, 32, 33, 45, 55, 57, 58, 60, 63, 64, 66 and 67. Charing Cross Road, Nos. 5, 9, 11, 13, 16, 36 and 48. Charles Buildings, Nos. 1,2,and 3. Cockspur Street, Nos. 1, 2, 14, 17, 20, 21, 22, 23, 24, 25, 30, 31, 32 and 33. Comedy Theatre. Conduit Buildings, Nos. 1 and 2. Conduit Court,Nos.2,3, 9 and 10. 18 Craig's Court, HarriNgton House. Cranbourn Street, Nos. 16, 17, 18, 19, 21, 22, 23, 25, 27, 28, 29,31,32, 33, 34 and 37. Craven Court, "Craven Arms." Craven Street, Nos. 4, 7, 8, 14, 15,17, 26, 30,31,32,33, 34, 35, 37, 38, 40, 42 and Craven Hotel. Crown Court, Nos. 10, 17 and 24. Drury Lane, Nos. 30, 31, 32, 33, 34, 35, 39, 40, 45, 46, 54, 82 and Burial Ground Lodge. Drury Lane Theatre (2 plans). Duke Street, Nos. 1, 2, 10, 11, 12 and 13. Duncannon Street, Nos. 3, 4, 5 and 6. Eagle Court, "Old Fountain" (P.H.). Endell Street, No. 15. Exeter Hall, Strand. Exeter Street, No. 36. Floral Street (late Hart Street), Nos. 48, 49, 50 and 51. Garrick Hotel. Garrick Street, Nos. 16, 18, 20, 22 and 23. Garrick Theatre. Goodwin's Court, Nos. 1, 2, 3, 4, 5, 6, 7 and 8. Great Scotland Yard, Nos. 1, 6, "Rising Sun" (P.H.) and Fire Station. Green Street, Nos. 1, 2, 3, 4, 5, 6, 7, 8, 9, 11, 12, 15, 16, 17 and 20. Hanover Court, No. 14. Harvey's Buildings, Nos. 1, 2 and 3. Haymarket, Nos. 8, 23, 25, 26, 29, 31,32, and Civil Service Co-Operative Stores. Haymarket Theatre. Heathcock Court, Nos. 2 and 3. Hop Gardens, No. 11. Hotel Cecil (2 plans). James Street, Covent Garden, Nos. 11 and 12. James Street, Haymarket, Nos. 3 and 14. John Street, Adelphi, No 14. King William Street, Nos. 3, 6, 8, 9, 13, 15. 16, 17, 18, 20. 21, 23 and 29. Langley Court, Nos. 1, 2, 3 and 4. Leicester Square, Hotel Provence, No. 21, and Dental Hospital. Lemon Tree Yard, Bedfordbury, Nos. 1, 2 and 3. Long Acre, Nos. 8, .9, 10, 12, 13, 14, 17, 18, 19, 20, 21, 30, 31, 32, 33, 34, 36, 41,50, 54, 55. 56, 57, 58, 59, 65, 66, 80, 81, 82, 85, 87, 89, 91, 96, 99, 111, 112,116, 117, 118,119, 120, 121, 122, 125, 126,127, 128, 129, 130, 137, 140 and 141. Long's Court, No. 5. Lower John Street, Messrs. Hatch and Mansfield. Lowther Arcade, Nos. 3, 4, 5, 6, 7, 8, 9, 10, 11, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23 and 24. 14 Lumley Court, Nos. 1, 2, 3, 4 and 5. Lyceum Theatre. Martlett's Court, No. 10. May's Buildings, Nos. 4, 5, 6, 7 and 12. Mercer Street, Nos. 5, 20, 21, 22 and 23. Monmouth Court, Nos. 6 and 7. New Street, Nos. 1, 2, 4, 7, 8, 9, 11, 12, 14, 19, 20, 27, 28 and 29. Northumberland Avenue— Craven House, Hotel Victoria, Society for Promoting Christian Knowledge, Grand Hotel, Hotel Metropole and P. and O. Company. Northumberland Street, Nos. 1, 2, 3 and Annexe of Grand Hotel. Oxendon Street, Nos. 7, 15, 20. 24 and 27. Pall Mall East, Nos. 3, 5a, 7, 13, 14, 15,16 and 17. Panton Street, Nos. 4, 6, 17, 25, 27, 28, 29, 30, 31 and 32. Princes Court, Nos. 6 and 7. Russell Court, No. 16. Russell Street, Nos. 30, 37 and Board School. St. James's Palace, No. 1, Stable Yard (2 plans). St. James's Place, No. 22. St. Martin's Church. St. Martin's Church Vestry Hall. St. Martin's Court, Nos. 7, 8, 9, 10, 20 and 21. St. Martin's High School for Girls. St. Martin's Lane, Nos. 29, 30, 31, 32, 33, 35, 37, 40, 41, 42, 44, 45, 46, 48, 50, 51, 53, 54, 62, 63, 64, 65, 66, 68, 69, 70, 79, 80, 81, 86, 108, 110, 112 and Free Library. St. Martin's Mews, Nos. 7 and 9. St. Martin's National Schools. St. Martin's Northern Schools, Castle Street. St. Martin's Place, Nos, 6, 7, 8 and 9. St. Martin's Street, Nos. 3, 4, 5, 6, 8, 9, 16, 17, 18, 19, 23, 24, 25, 31, 32 "Duke's Head ' (P.H.), and "Horse and Dolphin" (P.H.). Southampton Street, No. 39. Spring Gardens, Nos. 5, 7, 8, 9, 10, 13,15,17,19, 21 and 29. Spur Street, Nos. 1 and 2. Stafford House, St. James's. Strand, Nos. 6, 9, 10, 11, 14, 15, 32, 35, 37, 45, 50, 51, 55, 71, 72, 73,74, 75, 76, 80, 81, 366, 367,371, 373, 375,377, 378, 379,388,389, 390,391, 392, 393, 395, 396,399, 400, 401,402, 407, 408, 413, 421, 422, 425, 426, 427, 428, 429, 430,431,432, 433, 434, 437, 438,439, 441,444, 445, 450, 453, 454, 455, 456, 457 and Golden Cross Hotel. Strand Buildings, Eagle Court. Suffolk Place, Nos. 4 and 5. 15 Suffolk Street, Nos. 3, 5, 6, 7, 8, 12, 13, 21, 23 and 25. Taylor's Buildings, Messrs. Benham & Froud. Tivoli Music Hall, Durham Street. Trafalgar Square, Morley's Hotel. University Club. Upper St. Martin's Lane, Nos. 6, 7, 8, 9, 11, 12, 13, 14, 17, 18, 19 and Sussex Stores (P.H.). Vaudeville Theatre. Victoria Embankment Electric Lighting Station. Villiers Street, Nos. 24, 25, 26, 27, 28, 28a, 29, 33, 35, Bound's, Fishmonger, and Gatti's Music Hall. Warwick Street, No. 14. Wellington Street, No. 21. Whitcomb Street, Nos. 7, 20 and Messrs. Macmillan & Co. Whitcomb Court, No. 2. Whitehall, No. 4. Whitehall Court, No. 4. Whitehall Place, Nos. 3, 6, 7, 8, 8a and 22. Wilson Street, Nos. 3, 4, 6, 8 and 10. Wyndham's Theatre. York Buildings, Nos. 4, 13, 14. 15, 16, 17, 18, 19 and 20. York Place, Nos. 6 and 11. Workshops and Bake-Houses. The workshops and bake-houses have been duly inspected, and have been found in a clean and satisfactory condition. Sanitary Notices. Sanitary notices in reference to 213 premises were served upon the owners or occupiers of same, and legal proceedings had to be resorted to in seven cases. Houses Let Out in Lodgings. Your Sanitary Inspector (Mr. W. Cooke) 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, Your obedient Servant, JOHN J. SKEGG, Medical Officer of Health. TABLE I. BIRTHS, DEATHS, and INQUESTS for the last Ten Years, In St. Martin-in-the-Fields. 1890 1891 1892 1893 1894 1895 1896 1897 1898 1899 Births 267 252 246 223 233 189 221 175 182 154* Deaths, total 382 420 331 367 341 367 340 297 305 358 „ under 5 years 96 121 89 84 87 99 70 66 51 75 „ from 5 to 60 years 214 222 179 223 202 209 212 174 195 214 „ over 60 years 72 77 63 60 52 59 58 57 59 69 „ from Small-pox 0 0 0 0 0 0 0 0 0 0 „ „ Measles 7 7 8 1 8 4 9 1 2 5 „ „ Scarlet Fever 0 0 2 0 0 1 2 0 0 0 „ „ Whooping - Cough 5 8 0 2 4 7 6 3 2 0 „ „ Diarrhœa 3 4 3 2 3 3 4 2 6 9 „ „ Fever 4 3 0 4 4 10 12 8 10 11 „ „ Consumption 29 41 29 24 33 31 32 25 19 21 „ in Charing Cross Hospital 173 204 141 184 168 201 182 173 189 236 54 58 60 56 58 54 47 63 52 43 * Six of these births occurred at the Bear Yard Receiving Ward of the Strand Union. 16 17 TABLE II. TABLE OF THE CAUSES OF DEATH at Various Ages In the Parish of St. Martin-in-the-Fields, during the Year 1899 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 Yean to 60. From 60 Years to 80. 80 Years and upwards Measles 5 2 3 - — — — — Diphtheria 5 1 4 — — — — — Typhoid Fever 10 — — 3 7 — — — Erysipelas 1 1 — — — — Pyæmia and Septicæmia 6 — — — 4 2 — — Puerperal Fever. 1 — — — 1 — — — Influenza 5 — — — — 3 2 — Diarrhœa 9 8 1 — — — — — Rheumatism 3 — — 1 1 1 — — Syphilis 3 2 — — 1 — — — Disease of Female Organs of Generation 2 — — — ] 1 — — Privation 1 — — — — — 1 — Intemperance 3 — — — 1 2 — Gout 1 — — — — 1 — — Cancer 36 — — — 3 20 13 — Sarcoma 3 — — — 1 1 1 — Mortification 1 — — — — — 1 — Scrofula 3 — 1 1 — — — — Tabes Mesenterica 1 1 — — — — — — Phthisis 21 — 2 4 5 10 — — Leucocythemia 1 — — — 1 — — — Hydrocephalus 2 — 2 — — — 2 — Apoplexy 2 — — — — — — Paralysis 1 — —• — — — 1 — Disease of Brain 9 — — 3 4 i 1 — Cerobral Meningitis 9 1 2 5 1 — — — Aneurism 3 — — — 2 1 — — Disease of Heart 39 — 1 5 9 12 12 — Bronchitis 26 4 3 1 1 6 11 — Pneumonia 19 1 — — 5 11 2 — Pleurisy 8 1 — — 4 1 2 — Disease of Stomach 6 — — 1 4 1 — — ,, ,, Intestines 26 14 3 — 3 4 2 -• Peritonitis 2 — — — 1 — 1 — Hernia 3 — — — — 2 1 — Disease of Liver 13 — — — 2 9 2 — „ „ Kidney 15 — — 1 5 6 3 — „ ,, Bladder 1 — — — 1 — — „ „ Joints and Bones 4 1 — 2 — 1 — — „ „ Spine 1 — — — l — — — „ „ Thyroid 1 — — — — — 1 — Diabetes 2 — — — 1 — 1 — Premature Birth 3 3 — — — — — — Teething 1 1 — — — — — — Congenita] Malformation 1 — 1 — — — — — Old Age 1 — — — — — — 1 Atrophy and Debility 6 5 — — — 1 — Injuries 18 1 — — 7 2 8 — Burns and Scalds 1 — — — — 1 — — Poison 1 — — —.. 1 — — — Suffocation 2 1 — — — 1 — — Drowning 6 — — — 2 4 — — Neglect at Birth 2 2 — — — — — — Childbirth 1 — — — 1 — — — Abscess 1 — 1 — — — — — Chloroform 1 — 1 — — — — — 358 50 25 27 81 106 68 l 19 TABLE III. DEATHS in the different localities in ST. MARTIN-IN-THEFIELDS during the Year 1899. Total Deaths. Deaths from Zymotic Disease. Total Deaths. Deaths from Zymotic Disease. Bedfordbury 4 — Royal Westminster Ophthalmic Hospital 1 — Bedford Street 1 — Blue Cross Street 1 — Russell Street 1 - Broad Court 1 1 St. James's Palace 2 - Buckingham Street 3 — St. Martin's Lane 4 - Carlton House Terrace 1 — St. Martin's Street 2 - Castle Street 3 1 Scotland Yard 2 - Catherine Street 1 - Spring Gardens 1 - Chandos Street 1 — Strand Buildings, Eagle Court 1 — Charing Cross 1 - Charing Cross District Railway 1 — Suffolk Street 1 - Turner's Court 1 - Charing Cross Hospital 236 19 Villiere Street 1 - Charing Cross Hotel and Railway Station 2 — Warwick Street 1 - Wellington Arch Lodge 1 - Charing Cross Road 3 1 Whitehall 2 - Craig's Court 1 - Whitehall Court 2 - Cranbourn Street 1 — White Hart Street 3 1 Craven Street 1 — York Buildings 1 - Crown Court 2 — In the street, accidentally killed, or suddenly dying from natural causes 11 Drury Lane 3 1 Endell Street 2 — Garrick Street 3 1 George Court 1 — Goodwin's Court 1 — Great Newport Street 1 1 Harvey's Buildings 1 - Haymarket 1 — James Street, Long Acre 2 — Long Acre 7 — Marlborough House Stables 1 — Martlett's Court 3 1 May's Buildings 2 - Mercer Chambers, Neal St. 3 1 Mercer Street 2 - Neal Street 1 1 New Street 1 — Northumberland Avenue 7 — Northumberland Street 1 — Oxendon Street 1 — Peabodv Buildings 4 — 358 30 River Thames 8 — 20 TABLE IV. Showing the localities wherein the 30 deaths occurred from the seven principal Zymotic Diseases during the year 1899 in St. Martin-in -the-Fields. Small-pox. Measles. Scarlet Fever Diphtheria Whooping Cough. Fever. Diarrhoea. Total. Broad Court .. .. .. .. .. .. 1 1 Castle Street .. 1 .. .. .. .. .. 1 Charing Cross Hospital .. *2 .. †4 .. ‡10 ¶3 19 Charing Cross Road .. 1 .. .. .. .. .. 1 Drury Lane .. .. .. .. .. .. 1 1 Garrick Street .. .. .. .. .. l .. 1 Great Newport Street .. .. .. .. .. .. 1 1 Martlett's Court .. .. .. 1 .. .. .. 1 Mercer Chambers, Neal Street .. 1 .. .. .. .. .. 1 Neal Street .. .. .. .. .. .. 1 1 White Hart Street .. .. .. .. .. .. 1 1 In the street .. .. .. .. .. .. §1 1 .. 5 .. 5 .. 11 9 30 *One of these death from Measles, occurring in the Charing Cross Hospital, was that of a non-parishioner. †All these four deaths from Diphtheria, occurring in the Charing Cross Hospital, were those of non-parishioners. ‡These ten deaths from Typhoid Fever, occurring in the Charing Cross Hospital, were those of non-parishioners. Two of these deaths from Diarrhoea, occurring in the Charing Cross Hospital, were those of non-parishioners. $ This death from Diarrhœa, occurring in the street, was that of a non-parishioner. 21 TABLE V. Showing the number of deaths occurring in the Parish from the seven principal Zymotic Diseasest 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 1889-90-91-92-93-94-95-96-97-98, also the number in 1899. DISEASE. 1889. 1890. 1891. 1892. 1893. 1894. 1895. 1896. 1897. 1898. Annual Average of 10 Years. 1889 to 1898. 1899. Small-Pox — — — — 1 — 1 — — — 0.2 — Measles 6 8 6 9 1 9 2 11 1 1 5.4 5 Scarlet Fever 3 1 1 6 1 1 2 4 2 1 2.2 — Diphtheria 2 1 5 11 6 5 7 2 3 3 4.5 1 Whooping Cough 8 6 8 1 2 5 6 5 5 1 4.7 — *Fever 1 4 2 — 1 3 1 5 2 1 2.0 2 Diarrhœa 4 3 2 2 2 3 3 4 2 4 2.9 6 Totals 24 23 24 29 14 26 22 31 15 11 21.9 14 *Under the head Fever is included Typhus, Typhoid, Continued, Relapsing and Puerperal. 22 TABLE VI. Death-Rates from the Principal Zymotic Diseases per 1,000 persons living in 1899 in St. Martin-in-the-Fields and London. Diseases. St. Martinin-the-Fields. London. Small-pox .. 0.00* Mcasles 0.38 0.47 Scarlet Fever .. 0.09 Diphtheria 0.08 0.43 Whooping Cough .. 0.38 Typhoid Fever 0.08 0.17 Diarrhœa 0.46 0.92 * This 0.00 indicates that the deaths were too few to give a rate of 0.005. 23 TABLE VII. NOTIFICATION OF INFECTIOUS DISEASE. This Table shows the different localities wherein the specified cases of disease occurred during the year 1899, 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 & Continued Fever. Puerperal Fever. Total. Bedfordbury .. .. 1 .. .. 1 .. .. .. .. 2 Buckingham Street .. .. .. .. 1 .. .. .. .. .. 1 Charing Cross Hospital .. .. 3 .. .. 1 .. 1 .. .. 5 Charing Cross Road .. .. .. .. .. 2 .. .. .. .. 2 Craven Street .. .. 1 .. .. 4 .. .. .. .. 5 Crown Court .. .. .. .. .. 1 .. .. .. .. 1 Drury Lane .. .. .. .. .. 1 .. .. .. .. 1 Endell Street .. .. 1 .. .. 2 .. .. .. .. 3 Garrick Street .. .. .. .. .. .. .. .. .. 1 1 Haymarket .. .. .. .. .. 1 .. 1 .. .. 2 Hotel Cecil .. .. .. .. 1 .. .. .. .. .. 1 James Street, Long Acre .. .. 1 .. .. .. .. .. .. .. 1 Long Acre .. .. .. .. 2 4 .. .. .. .. 6 Martlett's Court .. .. 1 .. .. .. .. .. .. .. 1 Mercer Street .. .. .. .. 1 .. .. 1 .. .. 2 New Street .. .. .. .. 1 1 .. .. .. .. 2 Northumberland Avenue .. .. 1 .. .. 2 .. 2 .. .. 5 Peabody Buildings .. .. 2 .. .. 4 .. 1 .. .. 7 Princes Court .. .. .. .. .. .. .. 1 .. .. 1 Russell Street .. .. 2 .. 1 1 .. .. .. .. 4 St. Martin's Lane .. .. 2 .. .. .. .. .. .. .. 2 St. Martin's Street .. .. .. .. .. 1 .. .. .. .. 1 Scotland Yard .. .. .. .. .. 3 .. .. .. .. 3 Strand Buildings .. .. 1 .. .. .. .. .. .. .. 1 Turner's Court .. .. 1 .. .. .. .. .. .. .. 1 Upper St. Martin's Lane .. .. .. .. 1 2 .. .. .. .. 3 No Home .. .. .. .. 1 .. .. .. .. .. 1 .. .. 17 .. 9 31 .. 7 .. 1 65 Number of Cases of Infectious Disease notified during the previous year, 1898 .. .. 8 .. 7 11 .. 12 .. .. 38 25 TABLE VIII. In accordance with the requirements of the Local Government Board. TABLE OF DEATHS during the Year 1899, 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 65. 65 and upwards. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever Influenza. Phthisis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Injuries. All other Diseases. Total Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a) (b) (c) (d) (e) (f) (g) (h) (i) 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 121 25 3 .. 1 66 26 Under 5 .. .. 1 .. .. .. .. .. .. .. 1 3 .. 6 .. .. .. 2 .. 1 14 28 5 upwards .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 5 10 21 17 6 33 93 Charing Cross Hospital 236 25 22 14 27 133 15 Under 5 .. .. 4 .. .. .. .. .. .. .. .. 2 .. 3 .. .. 2 7 1 .. 28 47 5 upwards .. .. .. .. .. 10 .. .. .. .. .. .. .. .. 3 .. 9 22 21 12 112 189 Royal Westminster Ophthalmic Hospital 1 .. .. .. .. 1 .. Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwards .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 Totals 358 50 25 14 28 200 41 Under 5 .. .. 5 .. .. .. .. .. .. .. 1 5 .. 9 .. .. 2 9 1 1 42 75 5 upwards .. .. .. .. .. 10 .. .. 1 .. .. .. .. .. 3 5 19 44 38 18 145 283 The subjoined numbers have also to be taken into account in judging of the above records of mortality. Deaths occurring outside the Parish among persons belonging thereto 70 2 1 2 3 38 24 Under 5 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. 1 3 5 upwards .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 12 8 9 .. 37 67 Deaths occurring within the Parish among persons not belonging thereto 243 25 20 13 26 141 18 Under 5 .. .. 4 .. .. .. .. .. .. .. .. 1 .. 3 .. .. 2 5 1 1 28 45 5 upwards .. .. .. .. .. 10 .. .. .. .. .. .. .. .. 3 1 8 21 23 16 116 198 26 TABLE ix. 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 1899, in the Sanitary District of St. Martin-in-the-Fields, classified according to Diseases, Ages and Localities. Localities. Population at all Ages. Registered Births. Aged under 5 or over 5. New Cases of Sickness in each Locality coming to the knowledge of the Medical Officer of Health Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospital. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Census 1896. 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. St. Martin-in-the-Fields 13,077 154 Under 5 .. 5 9 .. .. .. .. .. .. .. 1 .. 5 .. .. .. .. .. .. .. .. .. 5 upwards .. 25 5 .. .. 6 .. .. 1 .. 8 .. 17 .. .. .. 4 .. .. .. .. 1 Charing Cross Hospital Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwards .. 1 3 .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. Totals Under 5 .. 5 9 .. .. .. .. .. .. .. 1 .. 5 .. .. .. .. .. .. .. .. .. 5 upwards .. 26 8 .. .. 7 .. .. 1 .. 8 .. 18 .. .. .. 4 .. .. .. .. 1 27 TABLE X. 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 1899. 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. 80 years and upwards. Measles 1 .. 1 - - - - - Typhoid Fever 1 .. .. .. 1 — — — Ague 1 .. .. .. .. .. 1 — Intemperance 2 .. .. .. 1 1 — — Cancer 2 .. .. .. 1 .. 1 — Tabes Mesenterica 1 1 — - — — — — Scrofula 1 .. .. .. 1 — — — Phthisis 12 .. .. .. 5 4 3 - Epilepsey 2 .. .. 1 .. .. 1 — Disease of Brain 6 .. .. 1 .. .. 4 1 Paralysis 4 .. .. .. 1 .. 3 - Disease of Heart 9 .. .. 1 3 2 1 2 Bronchitis 6 1 .. .. 2 2 1 — Pneumonia 3 .. .. .. .. 2 1 — Disease of Intestines 1 .. .. .. .. 1 — — Peritonitis 1 .. .. .. 1 — — — Disease of Liver 2 .. .. .. 1 1 — Disease of Kidney 8 .. .. .. 1 4 3 — Old Age 7 .. .. .. .. .. 5 2 70 2 1 3 17 17 25 5 28 TABLE XI. Copied from the Registrar-General's Annual Summary of Births, Deaths, and Causes of Death in London for the year 1899. DIMINUTION OR EXCESS OF DEATHS in 1899, Compared with the Average Annual Deaths in 1889-98. CAUSE OF DEATH. Diminution in 1899. Excess in 1899. Small-pox 42 - Measles 697 — Scarlet Fever 557 — Typhus 5 — Influenza - 545 Whooping-cough 714 - Diphtheria 260 — Simple Fever 21 — Enteric Fever - 189 Diarrhœal Diseases — 1,013 Cancer — 565 Phthisis and other Tubercular Diseases 376 - Premature Birth - 143 Diseases of Nervous System 1,021 - Diseases of Circulatory System - 455 Diseases of Respiratory System 663 - Diseases of Urinary System - 279 Childbirth and Puerperal Fever 83 - Accident - 301 Homicide 17 - Suicide - 34 All other Causes — 1,661 — — Balance of Diminution or Excess — 727 This Table shows in a summary form the number of lives saved or the number lost in the year 1899, as compared with the preceding decennium, under each of the more important headings in the list of causes. The net loss of life in the year 1899 amounted to 727; in other words, had the average death-rate in 1889-98 continued throughout the year under present notice, 727 lives would have been saved which, as it is, have been lost by death. In the year 1899 there was, as compared with the decennial average, an excess of 545 deaths from influenza, 189 from enteric fever, 1,013 from diarrhœal diseases, 565 from cancer, 143 from premature birth, 455 from diseases of the circulatory system, 279 from diseases of the urinary system, 301 from accident, and 34 from suicide. The following diseases accounted for a mortality below the average:— Diseases of the nervous system by 1,021 deaths, whooping-cough by 714, measles by 697, diseases of the respiratory system by 663, and scarlet fever by 557.