STMART 11 City of Westminster, (PARISH OF ST. MARTIN -IN-THE-FIELDS.) final report under old vestry REPORTS OF THE MEDICAL OFFICER OF HEALTH For The Year 1900 AND THE First 3 Months of 1901, LONDON: HARRISON AND SONS, ST. MARTIN'S LANE, Printers in Ordinary to Her late Majesty. 1901. City of Westminster. MEDICAL OFFICER'S REPORT, 1900. Annual Report on the Health of the Parish of St. Martin-in-the-Fields for the Year 1900. To the Mayor, Aldermen and Councillors of the City of Westminster. Your Grace, My Lords and Gentlemen, I have the honour of submitting to you my Thirty-First Annua] Report on the health and sanitary condition of the Parish of St. Martin-in-the-Fields for the year 1900. Births. The births registered in the Parish during the year numbered 155, and to this number must be added 8 which occurred at the Bear Yard Receiving Ward and 5 at the Endell Street Lying-in Hospital, all belonging to St. Martin's, and making a total for the year of 168. A 2 The following Table gives the number of births registered in each month of the year:— Males. Females. Total. January 8 11 19 February 7 7 14 March 6 12 18 April 3 7 10 May 11 3 14 June 3 10 13 July 1 8 9 August 8 6 14 September 5 7 12 October 9 5 14 November 7 2 9 December 4 5 9 72 83 155 Bear Yard Receiving Ward 3 5 8 Lying-in Hospital, Endell Street 3 2 5 78 90 168 These 168 births will produce a birth-rate of 12.8 per 1,000. In London, in the course of the year under notice, 130,868 births were registered, giving a birth-rate of 28.6 per 1,000 of the population. Deaths. The total deaths registered in the Parish for the year were 307, a decrease of 51 over the previous year. These 307 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 1900 will therefore be 15.1 per 1,000. 3 In London during the year 1900 the deaths numbered 86,007, and corresponded to a death-rate of 18.3 per 1,000. Infantile Mortality. Of the 198 deaths of parishioners occurring within and without the Parish, 32 were under 5 years of age, equal to 16.2 per cent. of the total deaths. The deaths of Infants under 1 year of age numbered 23, equal to 11.6 per cent. of the total deaths, and 136.9 to 1,000 registered births. In London, the deaths of Infants under 1 year of age were 20,927. These deaths were in proportion of 160 in each 1,000 births. The following table shows the causes of death of these 23 infants under 1 year of age:— Atrophy and Debility 5 Diseases of Respiratory System 3 Premature Birth 5 Teething 1 Convulsions 3 Enteritis 1 Diarrhoea 3 Whooping-cough 1 Tubercular Disease 1 23 Old Age Mortality. The deaths of parishioners over 60 years of age, occurring within and out of the Parish, numbered 69. 32 were from 60 to 70 years of age. 28 „ „ 70 „ 80 „ „ 8 „ 80 „ 90 „ 1 above 90 years of age. a 2 4 Causes of Death. Zymotic Diseases.—The principal Zymotic Diseases are Smallpox, Measles, Scarlet. Fever, Diphtheria, Whooping-cough, Typhoid Fever, Puerperal Fever, Typhus Fever, Cholera and Diarrhoea. The number of deaths occurring in the Parish from this class of disease was 18. 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 will be 10, against 14 of the previous year. Vide Table 5. Small-Pox.—No case was notified from this disease. Measles.—No death was recorded of a parishioner, but there were two deaths of non-parishioners occurring in the Parish, one in the Charing Cross Hospital, and one at the Hotel Metropole. Scarlet Fever.—No death was registered from this complaint. Diphtheria.—Four deaths from this disease occurred in the Charing Cross Hospital, one of which was that of a parishioner, and one of a parishioner at the North-Western Hospital of the Metropolitan Asylums Board, making a total of two to the credit of St. Martin's. Whooping-cough.—One death from this disease was recorded. Typhoid Fever.—Six deaths from this complaint occurred in the Charing Cross Hospital, all of which deaths were those of non-parishioners, and three deaths of parishioners occurred in institutions outside the Parish. Typhus Fever.—No death was recorded from this malady. Puerperal Fever.—One death of a non-parishioner occurred from this complaint in the Charing Cross Hospital, and one of a parishioner in the Middlesex Hospital. Diarrhœa.—Three deaths were due to diarrhœa. For all other causes of death, vide Tables, 5 Inquests. During the year 1900, inquests were held in reference to the deaths of 61 persons, of whom 23 were residents in the Parish, and also six inquests were held respecting the deaths of parishioners outside the Parish. • The causes which produced death were as follows:— Natural causes 31 Burns and Scalds 3 Poison (Prussic Acid) suicide 1 ,, (Hydrochloric Acid) taken by mistake when intoxicated 1 Pistol Shot Wounds (suicide) 3 Chloroform when undergoing an operation 1 Drowning 5 Cause not specified 1 Injuries received from a fall 2 Injuries received from falling on a fender 1 Injuries received in a boxing contest 1 Injuries received in a lift 3 Injuries received from being pushed off an omnibus (manslaughter) 1 Injuries received from being assaulted in the street (manslaughter) 1 Injuries received from being run over or knocked down by vehicles in the street 3 Injuries received from being thrown from a trap which was overturned by an omnibus 1 Injuries received from jumping from the roof of a house 1 Injuries received from fall from scaffold 1 „ „ „ down a spiral staircase 2 Injuries received when pulling down a house 1 „ „ from falling off cab 2 „ ,, „ from a window 1 67 6 Notification of Infectious Disease. During the year 1900 the number of cases of infectious diseases notified in accordance with The Public Health (London) Act, 1891, was 52, as against 65 of the previous year. On referring to Table 6 the diseases will be found specified, and the localities wherein the cases occurred. The fees paid to "the Medical Practitioners for furnishing the notifications of these 52 cases amounted to £5 4s. 0d., which sum is returned to your Council by the Managers of the Metropolitan Asylums Board. Disinfection after Infectious Disease. During the year 46 disinfections were carried out, at a cost of £60 19s. 7d. Bubonic Plague. In view of the outbreak of Plague in Glasgow, and the possible spread of the disease to London, the London County Council sent me the report of their Public Health Committee, respecting the precautions they were prepared to adopt against the Plague, should the disease unhappily visit us. In this Report, the London County Council Committee state that they are prepared to promptly remove all persons who have been in contact with a person suffering from the plague to a place of refuge, where they can be isolated and placed under medical supervision until it can be ascertained whether or not they, or any of them, have become infected by the disease. Of course, the actual cases of plague would be sent to the hospital of the Metropolitan Asylums Board. In this Report they further state that they have retained the services of Mr. James Cantlie, M. B. and F.R.C.S., formerly Medical Officer in one of the plague hospitals in Hong Kong, who has had large experience of the disease, to report upon every suspected case of plague in London in which there is any doubt as to the diagnosis, and to make post-mortem examinations when necessary, and an arrangement has been made with Dr. Klein for the bacteriological examination of material from suspected cases. 7 The Local Government Board ordered plague to be classed amongst the notifiable diseases, and accordingly I addressed letters to all legally qualified Medical Practitioners in the district informing them of their duties under this regulation. Housing of the Working Classes. The late Vestry of St. Martin-in-the-Fields requested me to report upon the sanitary condition of Turner's Court, with a view of dealing with it under the Housing of the Working Classes Act, 1890. The following is a copy of the Report:— The Vestry of St. Martin-in-the-Fields. The Report of the Medical Officer of Health upon the sanitary condition of Turner's Court. To the Members of the Housing of the Working Classes Committee. Gentlemen, In accordance with your request that I should submit a Report on the sanitary condition of Turner's Court, in order that action may be taken under the Housing of the Working Classes Act, 1890, I beg to submit the following particulars:— Turner's Court is situated on the east side of St. Martin's Lane, and is approached from that thoroughfare by a narrow entrance of about 4' 3" in width, extending as far as No. 4, when the Court widens out, and eventually ends in Bedfordbury. The Court consists of 11 houses and accommodates about 155 persons, of a very poor class, and who are very destructive and not very cleanly in their habits. The houses 1 to 4, situated in the narrow part of the Court, the lower rooms of which are dark, owing to a high wall in front of them, thus rendering light and air difficult of access. The other houses, 7 in number, are not quite so confined. The houses generally are old, and to keep them in anything like a habitable condition, constant supervision is necessary. 8 I have ascertained the death-rate of the Court, also of the Peabody Buildings, for the years 1895, 1896. 1897, 1898 and 1899, and tabulate them below, for comparison with the whole of the parish. It will be seen from the table appended that the death-rate in the Court is of a fluctuating character, for in 1897 it is as high as 83.9 per 1,000, and the next year, 1898, as low as 19.4, and the annual average for these 5 years is 47.8. In view of the high mortality of this Court, its contined position, and the houses being so ill adapted for letting in tenements to the class of people who inhabit them, it is a question whether it should not be dealt with by an improvement scheme. I am, Gentlemen, Your obedient Servant, JOHN J. SKEGG, Medical Officer of Health. 9th July, 1900. This table shows the death-rate per 1,000 in Turner's Court, Peabody Buildings, and the whole of the Parish during the years 1895, 1896, 1897, 1898 and 1899 Turner's Court. Peabody Buildings. Whole of Parish. 1895 38.7 12.3 16.5 1896 64.5 12.3 16.2 1897 83.9 17.6 15.2 1898 19.4 8.8 14.4 1899 32.3 15.8 14.1 Annual average for 47.8 13.4 15.3 the 5 years A copy of this Report was sent to the London County Council, with a proposition that they (the London County Council) should 9 deal with the court under Part I. of the Act, as the Vestry felt that there were difficulties in the way of taking action under Part II. of the Act. The London County Council replied stating that they were unable to agree with the Vestry that it would be extremely difficult for them to deal with the Turner's Court area under Part II. of the Act, but they are of opinion that, the area being so confined, should be dealt with by the Vestry. However, the dissolution of the Vestry being so near at hand, the further consideration of the matter dropped. The House-to-House Inspection. In the year 1893 the late Vestry of St. Martin's resolved upon a house-to-house inspection of all the houses in the parish. Three temporary qualified Sanitary Inspectors were engaged for the work. The drains were tested by means of Kemp's tester and the Sanitary arrangements examined, and when found defective, notices were served to remedy same. 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:— 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 (2 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, 5, 6, 9 1/2, 11, 12, 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, 12, 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. A 3 10 Carlton House Terrace, Nos. 5, 6, 9, 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, 20, 21, 25, 26, 27, 28,29, 32, 33, 45, 55, 57, 58, 60, 63, 64, 66 and 67. Charing Cross Hospital. 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, 26, 27, 30, 31, 32 and 33. Comedy Theatre. Conduit Buildings, Nos. 1 and 2. Conduit Court, Nos.2, 3, 9 and l0. Craig's Court, 1A, 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. 10,17,19 and 24. Drury Lane, Nos. 25, 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. 14, 16, 17, 18, 19, 20, 21, 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, 33, 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. 11 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, 51, 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, Nos. 5 and 6. 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. 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, 23 and Combes Brewery. Monmouth Court, Nos. 6 and 7. New Street, Nos. 1, 2, 4, 7, 8, 9, 11, 12, 14, 19, 20, 22, 27, 28 and 29 Northumberland Avenue— Craven House, Hotel Victoria, Society for Promoting Christian Knowledge, Grand Hotel, Hotel Metropole and P. and 0. Company. Northumberland Street, Nos. 1, 2, 3 and Annexe of Grand Hotel. Oxendon Street, Nos. 7, 15, 20, 21, 22, 24, 25 and 27. Pall Mall East, Nos. 3, 5a, 7, 13, 14, 15, 16, 17 and 18. Panton Street, Nos. 4, 6, 11, 14, 15, 17, 25, 27, 28, 29,30, 31 and 32. Prince's 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. 6, 7 and 9. a 4 12 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, 37 "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, 34, 35, 37, 45, 47, 50, 51, 55, 71, 72, 73,74, 75, 76, 80, 81, 366, 367, 371, 373, 374, 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. Suffolk Street, Nos. 3, 5, 6, 7, 8, 12, 13, 21, 23 and 25. Taylor's Buildings, Messrs. Benham & Proud. Tivoli Music Hall, Durham Street. Trafalgar Square, Morley's Hotel. Turner's Court, Nos. 5 and 6. University Club. Upper St. Martin's Lane, Nos. 6, 7, 8, 9, 11, 12, 13, 14, 15, 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 House, Stable Yard. Warwick Street, No. 14. Wellington Street, No. 21. Whitcomb Street, Nos. 7, 18, 20, 27, 29 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. In addition to the drainage works carried out at the above premises, there were a large number of houses where sanitary defects existed, such as rainwater pipes, sink wastes and overflow pipes directly connected to the drain, water-closets badly ventilated, and a variety of other minor defects which had to be remedied. 13 Milkshops and Dairies. The Loudon Government Act, 1899, transfers the powers of the London County Council of inspecting, registering- and enforcing the By-laws and Regulations with respect to Dairies, Cowsheds, Milkshops, Slaughter-houses and offensive businesses, to the new Borough Councils. I have received from the London County Council a list of the registered Dairies and Milkshops situated in this district. There are no Cowsheds, Slaughter-houses or offensive businesses in the Parish of St. Martin's. The regulations with regard to Dairies, Cowsheds and Milkshops (so far as they apply to Milkshops and Milkstores) provide for registration, cleanliness of premises and of utensils used in the businesses, also against contamination of milk from offensive effluvia and infectious disease. 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 266 premises were served upon the owners or occupiers of same, and legal proceedings had to be resorted to in two cases. Houses Let Out in Lodgings. Your Sanitary Inspector (Mr. W. Cooke) who was appointed 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. 15 TABLE I. TABLE OF DEATHS during the Year 1900, 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 118 18 8 2 3 60 27 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. 1 3 .. .. .. 5 .. 2 15 26 5 upwards .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 3 8 22 13 7 38 92 Charing Cross Hospital 187 21 17 12 18 109 10 Under 5 .. .. 1 .. .. .. .. .. .. .. .. 1 .. 1 .. .. 1 7 .. 3 24 38 5 upwards .. .. 3 .. .. 6 .. .. 1 .. 1 .. .. .. 1 2 11 10 12 15 87 149 Royal Westminster Ophthalmic Hospital 2 .. .. .. .. .. 2 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwards .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 2 Totals 307 39 25 14 21 169 39 Under 5 .. .. 1 .. .. .. .. .. .. .. .. 1 1 4 .. .. 1 12 .. 5 39 64 5 upwards .. .. 3 .. .. 6 .. .. 1 .. 1 1 .. .. 1 5 19 32 25 22 127 243 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 there to 91 4 2 3 5 46 31 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6 6 5 upwards .. .. 1 .. .. 3 .. .. 1 .. .. .. .. .. 2 4 19 24 10 1 20 85 Deaths occurring within the Parish among persons not belonging there to 200 20 18 12 20 115 15 Under 5 .. .. 1 .. .. .. .. .. .. .. .. 1 .. 1 .. .. 1 6 .. 4 24 38 5 upwards .. .. 2 .. .. 6 .. .. 1 .. 1 1 .. .. 1 2 10 11 17 16 94 162 16 TABLE II. TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS Coming to the knowledge of the Medical Officer of Health, during the year 1900, 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. Census 1896. Smallpox. Scarlatina. Diphtheria. Fevers. Cholera. Erysipelas. Smallpox. Scarlatina. Diphtheria. Fevers. Cholera. Erysipelas. Membranous Croup. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. Membranous Croup. 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 13,077 168 Under 5 .. 6 2 .. .. .. .. .. .. .. .. .. 3 2 .. .. .. .. .. .. .. .. 5 upwards .. 16 9 .. .. 10 .. .. .. .. 4 .. 15 8 .. .. 7 .. .. .. .. .. Charing Cross Hospital Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwards .. 1 4 .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. •• Totals Under 5 .. 6 2 .. .. .. .. .. .. .. .. .. 3 2 .. .. .. .. .. .. .. .. 5 upwards .. 17 13 .. .. 10 .. .. .. .. 4 .. 16 8 .. •• 7 .. .. .. .. .. 17 TABLE III. DEATHS in the different localities in ST. MARTIN-IN-THEFIELDS during the Year 1900. Total Deaths. Deaths from Zymotic Disease. Total Deaths. Deaths from Zymotic Disease. Adelaide Street 1 — Strand 6 - Adelphi Terrace 1 — Suffolk Place 1 - Bedfordbury 7 — Trafalgar Square 1 — Bedford Street 1 — Turner's Court 4 — Broad Court 1 — Villiers Street 1 - Buckingham Street 2 1 Whitcomb Street 3 — Carlton Gardens 1 — Whitehall 1 - Charing Cross Hospital 187 13 Whitehall Court 4 — Charing Cross Hotel and Station 1 — White Hart Street 4 - York Buildings 2 - Cockspur Street 1 — In a train 1 — Craven Street 2 — In the street, accidentally killed, or dying from natural causes 5 — Crown Court 1 — Drury Lane 1 — Endell Street 3 — Exeter Street 1 — Goodwin's Court 1 — Hanover Court 1 — Haymarket 2 — Horse Guards 1 — Hotel Cecil 3 — James Street, Haymarket 1 — James Street, Long Acre 1 — John Street, Adelphi 1 — Leicester Square 1 — Long Acre 6 — Martlett's Court 1 — Mercer Chambers, Neal St. 1 — Mercer Street 3 1 New Street 2 Northumberland Avenue 11 1 Orange Street 1 — Pall Mall East 1 — Panton Street 1 — Peabody Buildings 11 2 Prince's Court 1 — River Thames 6 — Royal Westminster Oph- thalmic Hospital 2 - Russell Street 1 — St. James's Palace 2 — 307 18 St. Martin's Lane 1 — 18 TABLE IV. Showing the localities wherein the 18 deaths occurred from the seven principal Zymotic Diseases during the year 1900. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fever. Diarrhoea. Total. Buckingham Street .. .. .. .. .. .. l 1 Charing Cross Hospital .. l .. †4 .. ‡7 §1 13 Mercer Street .. .. .. .. .. .. 1 1 Northumberland Avenue .. l .. .. .. .. .. 1 Peabody Buildings .. .. .. .. 1 •• l 2 .. *2 .. 4 l 7 4 18 * Both these deaths from Measles were those of non-parishioners. †Three of these deaths from Diphtheria, occurring in the Charing Cross Hospital, were those of non-parishioners. ‡These seven deaths from Fever, occurring in the Charing Cross Hospital, were those of non-parishioners. §This death from Diarrhoea, occurring in the Charing Cross Hospital, was that of a nonparishioner. 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 1890-91-92-93-94-95-96-97-98-99, also the number in 1900. DISEASE. 1890. 1891. 1892. 1893. 1894. 1895. 1896. 1897. 1898. 1899. Annual Average for 10 Years, 1890 to 1899. 1900. Sid all-Pox — - — 1 — 1 — — — — 0.2 — Measles 8 6 9 1 9 2 11 1 1 5 5.3 — Scarlet Fever 1 1 6 1 1 2 4 2 1 - 1.9 — Diphtheria 1 5 11 6 5 7 2 3 3 1 4.4 2 Whooping Cough 6 8 1 2 5 6 5 5 1 - 3.9 1 *Fever 4 2 — 1 3 1 5 2 1 2 21 4 Diarrhoea 3 2 2 2 3 3 4 2 4 6 31 3 Totals 23 24 29 14 26 22 31 15 11 14 20'9 10 *Under this head is included Typhus, Typhoid, Continued, Relapsing and Puerperal. 20 TABLE VI. NOTIFICATION OF INFECTIOUS DISEASE. This Table shows the different localities wherein the specified cases of disease occurred during the year 1900, and lohich 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. Adelphi Terrace .. .. l .. .. .. .. .. .. .. 1 Bedfordbury .. .. l .. .. 1 .. .. .. .. 2 Charing Cross Hospital .. .. 4 .. .. 1 .. .. .. .. 5 Charing Cross Road .. .. .. .. 1 1 .. 1 .. .. 3 Conduit Court .. .. 1 .. .. .. .. .. .. .. 1 Exetra Street .. .. .. .. .. l .. .. .. .. 1 Hotel Cecil .. .. .. .. .. 1 .. .. .. .. 1 Long Acre .. .. .. .. .. .. .. 1 .. .. 1 Martlett's Court .. .. 1 .. .. .. .. .. .. .. 1 May's Building .. .. .. .. l 2 .. .. .. .. 3 Mercer Street .. .. .. .. .. 4 .. .. .. .. 4 New Street .. .. 1 .. .. .. .. .. .. .. 1 Northumberland Avenue .. .. 1 .. .. .. .. 2 .. .. 3 Panton Street .. .. .. .. .. 1 .. .. .. .. 1 Peabody Buildings .. .. 2 .. .. 3 .. 1 .. .. 6 Rssell Street .. .. .. .. .. 1 .. 1 .. .. 2 St. George's Barracks .. .. .. .. l .. .. .. .. .. 1 Scotland Yard .. .. .. .. .. 3 .. .. .. .. 3 Strand .. .. .. .. 1 .. .. .. .. .. 1 Suffolk Street .. .. 1 .. .. .. .. 1 .. .. 2 Turner's Court .. .. 1 .. .. .. .. .. .. .. 1 Upper St. Martin's Lane .. .. .. .. .. 2 .. .. .. .. 2 Villiers Street .. .. .. .. .. 1 .. 1 .. .. 2 Whitcomb Street .. .. 1 .. .. 1 .. 1 .. .. 3 Whitehall Court .. .. .. .. .. .. .. 1 .. .. 1 .. .. 15 .. 4 23 .. 10 .. .. 52 Number of Cases of Infectious Disease notified during the previous year, 1899 .. .. 17 .. 9 31 .. 7 .. 1 65 21 TABLE VII. This Table shown the Population, the Birth and Death Hates, the rate of Births as compared to Deaths tinder one year of age, the deaths in Public Institutions, the deaths of Parishioners outside the Parish, also the deaths of Non-parishioners occurring within the Parish during the 10 years (1890-1899), also for the year 1900. Year. Population estimated to Middle of each Year. Births. Deaths usder One Year of Age. Net. Deaths at all Ages. Total. Deaths in Public institutions. Deaths of Nonresidents registered in District. Deaths of Residents registered beyond District. Deaths at all Ages. Net. Number. Rate. Number. Rate per 1,000 Births registered. Number. Rate. Number. Rate. 1890 17,508 267 15.3 60 224.7 382 21.8 174 171 114 325 18.6 1891 14,574 252 17.3 41 1627 420 28.8 207 209 115 326 22.4 1892 14,574 243 16.9 33 134.1 331 22.7 141 151 114 294 20.2 1893 14.574 223 15.3 40 179.4 367 25.2 185 189 95 273 18.7 1894 14,574 233 16.0 48 206.0 341 23.4 169 176 91 256 17.6 1895 14,574 189 13.0 48 253.9 367 25.2 201 208 81 240 16.5 1896 13,077 221 16.9 32 144.8 340 26.0 182 192 64 212 16.2 1897 13,077 175 13.4 28 160.0 297 22.7 173 189 91 199 15.2 1898 13,077 182 13.9 26 142.9 305 23.3 191 194 77 188 14.4 1899 13,077 154 11.8 27 175.3 358 27.4 237 243 70 185 14.1 Averages for Y ears 1890-1899 14,268.6 2142 1498 38.3 178.38 350.8 24.65 186.0 192.2 91.2 249.8 17.39 1900 13,077 168 12.8 23 136.9 307 23.5 189 200 91 198 15.1 22 TABLE VIII. This corrected table shows the population and the births and deaths registered during the last 10 years (1890 to 1899). Year. Population estimated to middle of each Year. Births registered. Deaths at all Ages. Deaths under 1 year. 1890 17,508 267 325 60 1891 14.574 252 326 41 1892 14,574 246 294 33 1893 14,574 223 273 40 1894 14,574 233 256 48 1895 14,574 189 240 48 1896 13,077 221 212 32 1897 13,077 175 199 28 1898 13,077 182 188 26 1899 13,077 154 185 27 Averages of Years 1890 to 1899. 14,268.6 214.2 249.8 38.3 1900 13,077 168 198 23 23 TABLE IX. CASES OF INFECTIOUS DISEASE NOTIFIED DUKING THE YEAR 1900. Notifiable Disease. Cases notified in Whole District. Total Cases notified in each Locality. No. of Cases removed to Hospital from each Locality. At all Ages. At Ages—Years. St. Martin's. Charing Cross Hospital. St. Martin's. Charing Cross Hospital. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Smallpox .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. Diphtheria 15 .. 2 5 3 5 .. 11 4 10 .. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. Erysipelas 4 l .. .. .. 3 .. 4 .. .. .. Scarlet Fever 23 .. 6 13 3 1 22 1 18 1 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 10 .. .. 1 5 4 .. 10 .. 7 .. Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. Totals 52 1 8 19 11 13 .. 47 5 35 l 24 TABLE X. THIS TABLE SHOWS THE CAUSES OF DEATH at Various Ages Of persons dying in the parish, excluding non-parishioners, and including those parishioners who died in public institutions out of the parish, during the year 1900. CAUSES OF DEATII. All Ages. Under. 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Deaths in Public Institutions. Small-pox - - - - - - — — Measles - - - - - - - - Scarlet Fever - - - - - - - - Whooping-cough 1 1 .. .. .. .. .. .. Diphtheria and Membranous Croup 2 .. .. 1 .. 1 .. 2 Croup - - - - - - - - Fever Typhus — — — — — — — — Enteric 3 .. .. 1 2 .. .. 3 Other Continued — — — — — — — — Epidemic Influenza 7 .. .. .. .. 6 1 4 Cholera — — — — — — — — Plague — — — — — — — — Diarrhoea 3 3 .. .. .. .. .. .. Enteritis 2 2 .. .. .. .. .. .. Puerperal Fever 1 .. .. .. .. 1 .. 1 Erysipelas — — — — — — — — Other Septic Diseases 1 .. .. .. .. 1 .. .. Phthisis 28 .. .. .. 1 23 4 21 Other Tubercular Diseases 2 1 1 .. .. .. .. .. Cancer, Malignant Disease 5 .. .. .. .. 5 .. 3 Bronchitis 38 3 3 .. 1 15 14 18 Pneumonia 13 .. .. .. .. 7 6 6 Pleurisy 2 .. .. .. .. 1 1 .. Other Diseases of Respiratory Organs 1 .. .. .. .. .. 1 .. Alcoholism 1 Cirrhosis of Liver 7 .. .. .. .. 7 .. 3 Venereal Diseases - - - - - - - - Premature Birth 5 5 .. .. .. .. .. 2 Diseases and Accidents of Parturition - - - - - - - - Heart Diseases 18 .. .. .. .. 10 8 8 Accidents 8 .. .. 1 1 4 1 3 Suicides 3 .. .. 1 1 1 .. .. All other Causes 50 8 4 1 .. 18 19 22 All Causes 198 23 9 5 6 100 55 96 25 TABLE XI. Copied from the Registrar- General's Annual Summary of Births, Deaths, and Causes of Death in London for the year 1900. DIMINUTION OR EXCESS OF DEATHS in 1900, Compared with the Average Annual Deaths in 1890-99. CAUSES OF DEATH. Diminution in 1900. Excess in 1900. Small-pox 41 - Measles 886 — Scarlet Fever 554 — Typhus 4 — Influenza — 488 Whooping-cough 483 - Diphtheria 705 — Simple Fever 11 — Enteric Fever — 116 Diarrhœal Diseases — 136 Cancer - 451 Phthisis and Tubercular Diseases 888 - Premature Birth 24 — Diseases of Nervous System 974 — Diseases of Circulatory System 78 - Diseases of Respiratory System 1,045 — Diseases of Urinary System — 181 Childbirth and Puerperal Fever 114 - Accident — 158 Homicide 11 — Suicide 12 — All other Causes 118 — Net Diminution or Excess 4,418 — This Table shows in a summary form the number of lives saved or the number lost in the year 1900, as compared with the preceding decennium, under each of the more important headings in the list of causes. City of Mestminster. Report, of the Medical Officer of Health of the Parish of St. Martinin-the-Fields, for the months of January, February and March, 1901. To the Mayor, Aldermen and Councillors of the City of Westminster. Your Grace, my Lords and Gentlemen, In the Order of the Local Government Board, dated 8th December, 1891, respecting the duties of the Medical Officer of Health, it says:— (15) "He shall also make an Annual Report to the Sanitary Authority, up to the Thirty-first day of December in each year, comprising a summary of the action taken, or which he has advised the Sanitary Authority to take during the year, etc." And it further says:— "Provided that, if the Medical Officer of Health shall resign or be removed before the Thirty-first day of December, in any year, he shall thereupon make the like Report for that part of the year during which he has held office." By your direction my Office as Medical Officer of Health having been abolished, and the duties thereof to cease on the last day of March, 1901, I therefore, in conformity with the above regulation of the Local Government Board, beg to submit to you my Report for the months of January, February, and March, 1901. Births. The births registered during these three months, numbered 29—Males 16, Females 13. This number is equal to an annual birth-rate of 8.9 per 1,000. 28 Deaths. The total deaths occurring in the Parish were 70, and of this number 30 were parishioners and 40 non-parishioners. Of residents dying in institutions outside the district, the number was 26. The deaths due to St. Martin's for these three months will therefore be 56, and this number will give a death-rate per 1,000 equal to 17.1 per annum. Infectious Disease. During these three months the parish has been comparatively free from infectious disease, only 6 cases having been notified. They were, 3 Typhoid, 1 Diphtheria, and 2 Scarlet Fever. Measles. Your Town Clerk received the following letter from the Clerk of the London County Council, in reference to the advisability of including Measles in the term "Dangerous and Infectious Disease":— LONDON COUNTY COUNCIL. Spring Gardens, S.W. l.sf December, 1900. Measles. Sir, 1 am directed to inform you that the Public Health Committee of the Council have under consideration the question whether it is advisable that the Council should include "Measles" in the term "Dangerous and Infectious Disease," for the purposes set out in the following sections of the Public Health (London) Act, 1891:— Section 68, which prohibits, under a penalty, the exposure of infected persons and things. Section 60, which gives power to sanitary authorities to require the cleansing and disinfection of infected premises, and the disinfection or destruction of infected articles, and contains other provisions as to compensation and shelter during disinfection. 29 Section 61, under which sanitary authorities can require bedding, clothing, etc., to be delivered up to them for disinfection, and must pay compensation for any unnecessary damage. Section 62, which prohibits, under a penalty, the casting of infectious rubbish into ashpits without previous disinfection. Section Go, which prohibits, under a penalty, persons from knowingly letting houses in which infected persons have been lodging, until such premises have been disinfected. Section 64, which provides for a penalty on persons letting houses who make false statements as to infectious disease. Section 65, which provides for a penalty on persons ceasing to occupy houses without disinfection or notice to owner, or making false answer. Section 66, which provides for the removal to hospital of infected persons without proper lodging. Section 69, which prohibits infected persons from carrying on any occupation in such a manner as to be likely to spread disease. Section 70, which prohibits the conveyance of infected persons in public conveyances. Section 72, which prohibits, in certain cases, the retention of the body of a person who has died of any dangerous infectious disease. Section 73, as to the body of a person who has died in hospital of any dangerous infectious disease being removed only for burial. Section 74, as to the disinfection of a public conveyance if used for carrying the body of a person who has died of any infectious disease. In 1898 a letter was received from the School Board for London on the subject, and in accordance with a resolution of the Committee I addressed a circular letter to the various vestries and district boards, asking for their views on the question. The replies received 30 showed a considerable divergence of opinion, and in these circumstances the Committee think it desirable to consult the Councils of the Metropolitan Boroughs with reference to the proposal. I am accordingly to ask that your Council will be so good as to state whether they are in favour of the extension to Measles of the provisions contained in any or all of the sections above mentioned. You will observe that these sections do not relate to the question of "notification," which is dealt with in sections 55 and 56. ♦ 1 shall be glad to be favoured with a reply by the end of January, 1901. I am, Sir, Your obedient servant, G. L. Gomme, Clerk of the Council. The Town Clerk, Metropolitan Borough of City of Westminster. This letter was referred to the Public Health Committee for consideration, when they requested the Medical Officers of Health of the Council to consider and report upon the subject. In accordance with the above decision of the Committee, the Medical Officers of Health presented the following joint Report:— REPORT BY THE MEDICAL OFFICERS OF HEALTH. Measles. To the Health Committee. Mr. Chairman, Lords, and Gentlemen, We, the Medical Officers of Health of the City, beg to report that the following are the grounds upon which we recently reported in favour of the inclusion of "Measles" in the term "Dangerous and Infectious Disease," for the purposes set out in the letter of the Clerk of the London County Council, of the 1st December, 1900. 81 At the same time we desire to point out that we do not report in favour of Measles being added to the list of legally notifiable diseases, and that the adoption of these sections of the Act by the Countv Council would not make it a notifiable disease. The sections of the Public Health Act quoted in the letter give power to Local Authorities to require disinfection after cases of Measles, and to prevent children suffering from Measles attending school, or being exposed in public. YVe find that disinfection is now carried out after Measles in most London Boroughs, where possible, and it is obviously desirable that Local Authorities should have power to deal with any cases that may be reported, or with any cases of exposure of infected persons or thiDgs. Many persons look upon Measles as a trivial disease, and therefore take no precautions, whereas at the present time it causes a greater mortality than any other infectious disease. Thus, in London, in 1899, there were, according to the Report of the Registrar-General, 398 deaths from Scarlet Fever, 1,946 from Diphtheria, 1,728 from Whooping Cough, 759 from Enteric Fever, and 2,141 from Measles. Moreover, nearly all the deaths from Measles are in young children, who, if they could be protected from it until after the age of six years, would be much less likely to succumb to the complaint. We are of opinion that the placing of Measles among "Dangerous Infectious Diseases," with the consequent warnings which would be issued to parents during times of epidemic, would lead the public to look more seriously upon this disease, and to take steps to avoid the fatal complications which ensue from improper exposure and want of care. We would point out that Board School Teachers are bound to inform Medical Officers of Health of any case of Measles or other infectious disease among the children, and that many Church and private schools do so voluntarily, thereby obtaining the Government grant for such children as have to be excluded in consequence. 32 We find that the Vestries of the Parishes of St. George, Hanover Square, and St. Martin-in-the-Fields, and the Board of Works for the Strand District, passed resolutions, in 1898, approving of the course being taken which we recommend. We beg to append copies from our past Reports, in so far as they relate to Measles. We have the honour to be, Mr. Chairman, Lords, and Gentlemen, Your obedient Servants, W. H. CORFIELD, M.A., M.D., P.R.C.P. JAMES EDMUNDS, M.D., M.R.C.P. J. J. SKEGG, M.R.C.S., L.R.C.P.E. JOHN NORTON, M.D., D.P.H. F. J. ALLAN, M.D., D.P.H., F.R.S.E. Medical Officers of Health for the City. Inquests. Twelve inquests were held of persons dying in the parish during these three months. The causes of death were as follows:— 1. An infant, one month old, was accidentally suffocated from being over-laid while in bed with its mother, at 8, Mercer Street. 2. A male, 47 years of age (non-parishioner), died in the Charing Cross Hospital of pleurisy and bronchitis. 3. A male, 64 years of age (non-parishioner), died in the Charing Cross Hospital of delirium tremens, following fracture of the ribs, caused by a fall downstairs. 4. A male, 48 years of age, of the Corps of Commissionaires, died of heart disease as he was being conveyed to the Charing Cross Hospital. 5. A male, 22 years of age (non-parishioner), died in the . Charing Cross Hospital of shock from burns. The deceased having broken a bottle of pure spirits in his trousers pocket, which he then set light to with a match. 33 6. A male, 81 years of age, died at 6, Bedfordbury, of heart disease, 7. A male, 72 years of age (non-parishioner), died in the Charing Cross Hospital after amputation of the leg. 8. A male, 62 years of age, died in the Charing Cross Hospital from burns of the body and limbs, caused by his nightclothes catching fire from the bed-room fire. 9. A male, 36 years of age (non-parishioner), died in the Charing Cross Hospital of fracture of the skull, caused by falling on some stone steps. 10. A male, 74 years of age (non-parishioner), was found dead of drowning in the River Thames. 11. A male, 40 years of age (non-parishioner), was found dead in the River Thames. 12. A male, 37 years of age (non-parishioner), died of heart disease at the Hotel Cecil. Sanitary Notices. During these three months, 50 sanitary notices were served upon owners or occupiers of property to remedy sanitary defects, and legal proceedings had to be resorted to in three cases. I have the honour to be, Your obedient servant, JOHN J. SKEGG, Medical Officer of Health. 34 TABLE XII. THIS TABLE SHOWS THE CAUSES OF DEATH at Various Ages Of persons dying in the parish, excluding non-parishioners, and including those parishioners who died in Public Institutions outside of the parish during the months of January February and March, 1901. Causes of Death. All Ages. Under 1. 1 and under 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Deaths in Public Institutions. Small-pox - - - - - - - - Measles - - - - - - - - Scarlet fever - - - - - - - - Whooping-cough — - - - - - - - Diphtheria and Membranous Croup — — — — - — — — Croup - - - - - - - - Fever Typhus — - - - - - - - Enteric — - - - - - - - Other Continued — — - - - - - - Epidemic Influenza — — — — — — — — Cholera — - - - - - - - Plague — - - - - - - - Diarrhoea — — — — — — - — Enteritis 1 .. 1 .. .. .. .. .. Puerperal Fever — — — — — — — — Erysipelas — — — — — — — — Other Septic diseases — — — — — — — — Phthisis 4 .. .. .. .. 3 1 4 Other Tubercular diseases - - - - - - - - Cancer, malignant disease 2 .. .. .. .. 2 .. .. Bronchlitis 15 1 .. .. .. 6 8 11 Pneumonia 3 .. .. .. .. 3 .. 1 Pleurisy - - - - - - - - Other diseases of Respiratory Organs — — — — — — — — Alcoholism Cirrhosis of Liver 1 .. .. .. .. 1 .. .. Venereal diseases — — — — — — — — Premature birth — — — — — — — — Diseases and accidents of Parturition — — — — — — — — Heart disease 7 .. .. .. 1 4 2 3 Accidents 2 1 .. .. .. 1 .. 1 Suicides — — — — — — All other causes 21 1 .. l 1 10 8 10 All causes 56 3 1 l 2 30 19 30