AU4353 STMARY b THE SANITARY CHRONICLES oF St. Marylebone; BRING THE ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1901. BY ALEXANDER WYNTER BLYTH, Medical Officer of Health and Analyst of Food and Drugs for the Parish of St. Marylebone; Barrister-at-Law of Lincoln's Inn; Fellow of the Institute of Chemistry, &c. &c. VOL. XXI. London Printed by George Pulman & Sons, td., 24-26, Thayer Street, Manchester Square, W. 88910 PREFACE. The following Report is a brief summary of disease, mortality, and sanitary administration in the Borough of St. Marylebone during 1901. The arrangement is the same as that of previous Annual Statements. The Town Hall, St. Marylebone, .January, 1902. A REPORT OF THE METEOROLOGY, MORTALITY, AND SICKNESS ok ST. MARYLEBONE FOR THE YEAR 1901. By A. Wyntek Blyth. METEOROLOGICAL SUMMARY. MARCH QUARTER. The weather during the five weeks ending January 26th was of a disagreeable character. During three of the weeks more or less fog prevailed. On 11 days rain, with some snow, fell, giving a total rainfall for the month of 1.23 inch. The mean temperature was 25.50; maximum, 53.20; mean, 40.90. Sunshine was deficient. A wintry miserable February followed. On nine days snow or sleet or cold rain fell equal to 1.04 inch. The winds were W.N.W. and S.E. The temperature fell as low as 19.5° maximum, 54.O°; mean, only 34.9°. Sunshine generally deficient. March was cold and wintry. Minimum temperature, 29.5°; maximum, 56.0°; mean, 42.1°. On 13 days rain and occasional snow fell, the total measuring 1.24 inch. Strong N.W. winds prevailed in the first, and strong S.E. winds in the fourth week. The sunshine varied from 3 to 14 per cent. 4 JUNE QUARTER Four of the five weeks of April were wet; on 18 days, 2.63 inches of rain falling. Minimum temperature, 24.2°; maximum, 72.0° ; mean, 48.0°. The last April week was warm and summer-like. The sunshine generally was above the average, varying from 24 to 73 per cent. May was exceptionally mild, dry, and bright. Rain fell on only four days (0.61 inch). Winds generally easterly. The sunshine varied from 41 to 62 per cent. Minimum temperature, 34.0° ; maximum, 76.0° ; mean, 50.5°. June was generally fine and dry, with light variable winds. On five days slight rain fell (0.15 inch). Minimum temperature, 40.0" ; maximum, 8o.o° ; mean, 62.3°. Sunshine varied from 41 to 48 per cent. SEPTEMBER QUARTER The first four weeks of July were bright, warm, and almost rainless, on only one day 0.2 inches of rain, accompanied by thunder and lightning, falling, but during the fifth week storms of exceptional violence brought the rainfall up to 3.94 inches. Minimum temperature, 48.0° ; maximum, 86.8° ; mean, 67.5°. Sunshine varied from 28 to 61 per cent. August was dry and bright. During the four weeks ending the 24th, rain fell on only two days (0.26 inch), and the sunshine varied from 50 to 68 per cent. The minimum temperature was 45.0° ; maximum, 97.0° ; mean, 67.2°. Winds light and variable. September was a month of average weather. There were only five rainy days, but the rains were heavy (1.71 inch). The sunshine varied from 17 to 39 per cent The winds were mostly westerly. Minimum temperature, 45.0° ; maximum, 82.5° ; mean, 6o.1°. DECEMBER QUARTER. October was dull, and for the most part overcast. On eight days rain fell, but the fall measured only 0.87 inch. The winds were light and variable, but mostly S.E. and S.W. Minimum temperature, 33.5°; maximum, 73o° ; mean, 54.3°. The sunshine varied from 11 to 23 per cent. 5 November was a dark and generally foggy month. Only 30 hours of sunshine were registered in Regent's Park. Rain fell on two days (0.22 inch). The winds were light E. and N.E. Minimum temperature, 23.5° ; maximum, 59.0' ; mean, 43.5°. December was generally dry and cool. On only four days was there any rain (0.21 inch). Minimum temperature, 24.0° ; maximum, 56.0° ; mean, 33.5. Sunshine deficient. BIRTHS AND DEATHS. The number of births registered during the 52 weeks ending December 21st, 1901, when all essential corrections have been made, was 3,942. The number of deaths (corrected) of parishioners was 2,211 This gives a birth-rate of 29.3; a death rate of 16.6 per thousand. The birth and death-rates of the sub-districts for 1901 were as follows : — Birth-rate. Death-rate. All Souls 16.5 14.2 Rectory 19.4 15.4 St. Mary 25.9 16.6 Christ Church 29.8 17.8 St. John 20.9 18.9 The following is a statement of the average birth and deathrates for the five previous years, 1896—1900. Birth-rate. Death-rate All Souls 18.4 15.6 Rectory 22.6 22.0 St. Mary Christ Church 23.7 23.6 19.4 19.3 St. John 30.6 23.1 The whole district 23.4 19.5 The following table gives the distribution of the deaths of parishioners dying in various extra-parochial institutions, all of which are included in the mortality statistics :— St. Marylebone Infirmary, Notting Hill 469 Hospital Ship " Castalia " 4 Hospital Ship " Atlas " 3 Northern Fever Hospital 1 North-Eastern Fever Hospital I North-Western Fever Hospital 28 South-Eastern Fever Hospital 1 South-Western Fever Hospital 1 Western Fever Hospital 10 Carried forward 517 6 Brought forward 51 Fountain Fever Hospital 1 London Fever Hospital 2 St. Mary's Hospital 54 St. Thomas' Hospital 3 St. Bartholomew's Hospital 4 St. George's Hospital 2 University College Hospital 17 King's College Hospital 4 Charing Cross Hospital 3 Children's Hospital, Paddington 20 Children's Hospital, Great Ormonde Street 4 St. Saviour's Hospital 1 Brompton Hospital 7 German Hospital 4 French Hospital 4 West London Hospital 1 Belgrave Hospital 2 Italian Hospital 1 Camberwell House Asylum 3 Leavesden Asylum 12 Banstead Asylum 8 Colney Hatch Asylum 14 Hoxton Asylum 1 Clay bury Asylum 6 Cane Hill Asylum 4 Ilford Asylum 2 Darenth Asylum 2 Caterham Asylum 2 City of London Asylum, Dartford 4 Han well Asylum 29 Bethlem Asylum 1 City Infirmary 1 City of London Chest Hospital 1 City of London Hospital 1 St. Pancras Infirmary 3 St. Pancras Workhouse 5 Paddington Infirmary 1 Poplar Workhouse 1 Hospital for Women, Euston Eoad 1 Warrington Loage (private hospital) 1 St. Anne's Home, Stoke Newington 2 St. Joseph's Home 4 St. Luke's Home 2 Royal Hospital 1 Royal Chest Hospital 2 Royal Free Hospital 1 Royal Hospital for Incurables 1 Medical and Surgical Home, Fitzroy Square I Friedenheim 4 Central London Sick Asylum 2 Lying-in Hospital, Eudell Street 4 London Temperance Hospital 1 Cheyne Hospital 1 The " Nest," Upper Clapton 1 St. Pelaerias Crgche 3 H.M. Prison, Holloway 1 In various streets 12 797 SMALL-POX. Small-pox in the past has prevailed in intermittent waves. From the crest of one wave to the other there is in the Metro- 7 By far the most serious epidemic in the periods quoted was that of 1871. In that year nearly 8,000 persons died of small-pox in the Metropolis. St. Marylebone had its share, and the then Vestry isolated a number of cases in the Stoneyard in two temporary iron buildings. The temporary hospital was opened on January 11th, and closed June 27th. In the 24 weeks, 215 cases of small-pox were treated there; the deaths were 37, and therefore the case mortality, 17.2 per cent. It may be ungracious to criticise at this long distance well-meant efforts at isolation, but it cannot be denied that the site was unfortunate. Experience has amply proved that small-pox hospitals must be a considerable distance from populous centres, besides which hurriedly erected temporary buildings give poor and inadequate accommodation for the treatment of a specially serious malady. The late Medical Officer of Health, Dr. Whitmore, in his report, indeed confessed " that draughts of cold air would find their way through open doors and crevices to the occasional discomfort of the patients, and which rendered the use of screens and curtains necessary. Again, it was very difficult to keep males and females separate from each other after they had become sufficiently convalescent to leave their beds. The closet accommodation was also bad, as it was impossible to provide for the separate conveniences of either sex with all necessary regard to privacy." The actual number of cases, either in the Metropolis or in this district, in the great epidemic of 1871 is only a matter of polis a variable period of from three to five years, as the following table proves. ing table proves. The years selected are those from 1838 up to 1885, in which the Metropolitan deaths from small-pox exceeded 1000 in number. Year Numberof Deaths in Metropolis from Small-pox. Rate per Million of the 1 opulation. 1838 3,817 2,161 1840 1,235 671 1841 1,053 561 1844 1,804 887 1848 1,620 722 1851 1,062 448 1852 1,159 480 1855 1,039 408 1859 1,158 425 1863 1,996 687 1867 1,345 436 1871 7,912 2,421 1872 1,786 387 1881 2,367 617 1884 1,236 307 1885 1,419 347 8 inference from the deaths at that time, there being no notification of disease; but supposing the mortality be put at 10 per cent., there must have been no less than 79,000 cases. Thanks to notification, to the Asylums Board and to improved sanitary administration, although possible it is not probable that the Metropolis will again pass through a like experience. In 1884 and 1885 small-pox was epidemic in Marylebone, over 500 cases occurring in each of those years. In 1894 there were nearly 300 cases, and 29 deaths, but this last was rather a local outbreak than an epidemic, and was rapidly got under control. Since 1895 small-pox has been practically absent from the district until June, 1901, when a case of unrecognised small-pox, imported from Paris, infected a nurse in St. Mary's district, and the nurse, after a few days' illness, died of a malignant form of the malady. Three other cases followed in different parts of the borough, these having no bond of connection with the first case; then in the latter end of August came a flood of infection from St. Pancras, the district affected being a thickly-populated area in the neighbourhood of Tottenham Court Road. The preventive measures taken exercised a marked control, and from September 30th to the end of December the number of notifications did not reach 25. During the whole year the total number of cases was 63, of these 8 (that is 12 per cent.) have proved fatal. PREVENTIVE MEASURES. The first preventive measure is without doubt vaccination and re-vaccination. The public generally have no just ideas as to vaccination. On both sides—those who are against, and those who are for, have made statements tending to obscure the question. In the first place there is common ground in the belief that one attack of such infectious fevers as scarlet fever, measles, whooping cough, and so forth confers more or less immunity from a second attack, but the immunity is variable, and not always persistent through life. Most medical practitioners can, from their own experience, cite instances of persons having two and even three attacks of the same kind of fever. The writer has known a man badly pitted from a former attack of small-pox die from 9 pox contracted twenty years later. Vaccination is a local inoculation of an infection which is so nearly allied to small-pox that it confers the same kind of immunity as a previous attack—an immunity seldom lasting for more than a few years, but which has some definite relation between the interval elapsing between the operation and the exposure to infection, and varying with the individual. How long a thoroughly efficient vaccination will protect a person from a long-continued powerful infection, such as soaking day by day in the variolous atmosphere of rooms in which persons suffering from severe attacks of the disease are lying, is not known. It may be five, six, or more years. Hence all returns of mortality or spread of small-pox among so-called " vaccinated " persons tend to the confusion of the question, for the public by the term " vaccinated," understand it to mean " protected," whereas it may mean nothing of the sort. The term includes a child which has been vaccinated in four places a few months back, in which child the protection is absolute, and the term includes a man of 40 vaccinated 39 years back, in which the original immunity has probably worn itself out, and still more misleading, it includes a person who a day or two after contact with smallpox infection is re-vaccinated ; in this latter case it may modify, but it will not kill the infection already there. If, however, returns were made of the prevalence of the disease among children and persons who had been successfully vaccinated or re-vaccinated within five years, there would not be a scrap of evidence in support of those who declare that vaccination does not protect. A second ground of opposition is that vaccination causes in itself disease—this contention is disproved on so large a scale by common experience that it need not be dwelt on. As stated before, the first preventive measure is vaccination and re-vaccination. If every inhabitant in the Metropolis was vaccinated or re-vaccinated within the next few weeks, the Asylums Board would not be required to make any further provision ; the unprotected persons coming to the Metropolis would be the only victims. The next preventive is the measures to be taken in relation to " contacts," that is to say with those who are known to have been in contact with the disease, but are not themselves suffering from it. In this district there are facilities for the treatment of 10 such cases—they are sent to the depot, and there they take a hot bath. During the time they are in the bath their clothes are disinfected, and after re-vaccination there is no reason why they should not follow their employment. Since the infection, before developing, remains in the system 14 days or thereabouts, they are examined at the end of 12 to 13 days, to see whether they show any signs of illne'ss. Such a course neither interferes with the business of life nor pauperise those poor working persons who may, from no fault of their own, come into contact with cases of small-pox. Many employers of labour in this district have, however, compelled workers exposed to infection to cease work for a fortnight or until such time as they consider they are safe from fear of spread. So long as the wages are not stopped there is no objection to this course, but it is seldom necessary. Other measures taken to prevent spread are arrangements so that immediately on receipt of information the Asylums Board Authorities are communicated with and the case rapidly removed. This has been managed by officers constantly on duty from 9 a.m. to a late hour at night. In the great majority of cases removal has been effected within the hour. Two-thirds have been removed after ordinary office hours. In two cases the removal was delayed from accidental causes two or three hours. No little assistance has been given to the Metropolitan Health officers generally by the existing facilities of rapid intercommunication by the telephone. Not a day passes without messages relating to cases of small-pox being transmitted from and to various districts. In this district the fact that Dr. Climson Greenwood, the public vaccinator, is on the list of subscribers has been taken full advantage of. SCARLET FEVER. Scarlet fever, as shown graphically by the curve opposite page 17, was slightly above the average from January to May, the number of cases notified then sank below the average during June, July, August, and the first part of September. During the second week of September the cases suddenly increased to rise above the mean number reaching a well-marked maximum in the last week of September. The cases then declined to again rise much above the normal during the first week of November, the remainder of the year being normal. 11 The small-pox outbreak indirectly decreased the accommodation for scarlet fever at the Asylums Board Hospitals, and for a short period cases were accepted in order of their merit, an inspector having to go down each morning to make personal application, supporting the application with details as to the patient's environment. This task was performed most efficiently by Mr. Richard Phillips, and as a fact, no really urgent case was treated at home. Of the 401 cases notified during the year, 333, or practically 84 per cent., were isolated in hospital. The deaths from scarlet fever amount to 18, which gives a case mortality of 4.4 per cent. DIPHTHERIA. Diphtheria, with the exception of a burst in the third week of March, was generally below the average. 258 cases were notified; of these 194 or 75 per cent, were treated in hospital. The deaths from diphtheria amount to 33, giving a case mortality of 12.8 per cent. TYPHOID FEVER. Seventy-seven cases were notified during the year of enteric fever. This is almost the same number as in 1900. A few of these cases did not originate in the district, but came to be nursed in the numerous nursing homes. 55 or 71 per cent, were removed to and isolated in hospital. The case mortality was 11.8 per cent. DISINFECTION. The disinfecting apparatus for the disinfection of clothes, bedding, and other articles presumably infected by disease, is entirely separate from the apparatus used for the disinfection of filthy clothing of persons who take the baths. The latter apparatus was erected in 1900; the former in 1899, so that the one has been in almost continuous use for two years, and the other for three years. other for three years. The list of articles during 1901 shows an increase on those of the previous year, as the following table shows: — List of articles disinfected during 1900 and 1901. 1900. 1901. Beds 335 508 Mattresses 732 623 Bolsters 516 516 Pillows 1,295 1,431 Sheets 916 896 Blankets 2,399 2,276 Other articles — 2,863 The vans were used in 1900, 580 times; in 1901, 618 times. 12 CLEANSING OF PERSONS ACT. During 1901 the cleansing baths have been in full operation. 3,967 males and 135 females have had the use of the baths, and their clothes simultaneously disinfected. This is an increase on the previous year, when 3,352 males and only 28 females underwent the same process. But it must be remembered that during the latter part of 1901 the baths have not been confined to dirty persons, they have been used by "contact" cases, that is to say by those who have been in contact with small-pox or other infectious disease, and desire to be free from suspicion of infection. This quite legitimate use of the baths it is wise to encourage. THE ST. MARYLEBONE SHELTER. The St. Marylebone Shelter, established tor the purpose of receiving during short periods persons temporarily evicted from their homes during disinfecting operations, continues to do good service. During 1901 it was used 27 times, accommodating for various periods 38 adults and 29 children. The periods during which these persons were detained and the diseases which necessitated the disinfection are as follows: — 1901. Days or hours of Occupation. Disease. No. of Persons Jan. 3rd and 4th 24 hours Scarlet Fever 4 adults „ 5th and 9th 24 „ " 1 adult, 1 child Feb. 6th and 7th 18 „ Diphtheria 2 adults, 5 children March 13th and 16 th 16 „ Scarlet Fever 2 adults, 1 child „ 29th and 31st 16 „ Diphtheria 1 adult, 8 children April 25th 2 „ .. 1 adult April 29th 16 „ Supposed Small-pox 2 adults, 2 children June 16th and 17th 16 „ Scarlet Fever 2 adults, 2 children Aug. 24th 9 „ Small-pox 1 adult Sept. 2nd 12 „ " 1 adult, 2 children „ 7 th to 9 th 36 „ " 2 adults, 4 children „ 13th and 14th 10 „ " 1 adult „ 16th and 17th 6 „ " 1 adult „ 16th—18th 16 „ " 1 adult „ 28th and 29th 16 „ " 1 adult „ 29th—Oct. 1st 48 „ " 2 adults, 1 child Oct. 15th—17th 50 „ " 1 adult, 2 children „ 20th—22nd 36 „ " 1 adult „ 30th 36 „ " 1 adult „ 31st—Nov. 1st 12 „ " 1 adult Nov. 3rd 16 „ " 2 adults „ 22nd 18 „ " 1 adult „ 23rd 14 „ " 1 adult, 1 child „ 22nd - 25th 67 „ " 1 adult Dec. 8th—10th 65 „ " 1 adult „ 16th 4 ,, " 1 adult „ 28th—29th 17 „ " 1 adult „ 31st 6 „ " 1 adult 13 PROSECUTIONS UNDER THE PUBLIC HEALTH (LONDON) ACT. As usual, the great majority of the sanitary notices during the year have been fairly promptly complied with, and no legal proceedings have been necessary. There have been two " closing orders " during the year— 33, Little Marylebone Street was found in an indescribable state of filth, with drains and closet stopped up, three families living therein paying no rent, and, so far as could be ascertained, the house had no immediate owner. The house was ordered by the magistrate to be closed. No. 15, High Street, St. John's Wood, was found to be generally dilapidated, with bad drains, and containing various nuisances. The owner was in prison for rates. A magistrate's order was granted to close the house. The Public Health Committee issued a notice to the owner of 28, Union Street, with regard to laying new drains and other works. The owner was in Holloway for three months for non-payment of rates. The magistrate made an order for the work to be done in 28 days. A notice to drain Golden Horse Yard was not complied with, and the defence before the stipendiary was the technical one that the houses in Golden Horse Yard were not in the same curtilage. The magistrate decided in favour of the defendants, but granted a case. The appeal was not proceeded with, for so little confidence as to the result of the appeal was felt that the Yard was afterwards drained by the owners. An instance of spending much money in law without definite result. Nos. 2T and 22, Nightingale Street were found to be without closet accommodation. The owner was ordered to do the necessary work in 24 hours. A case of overcrowding under the Factory Acts was also dealt with by summons. The defendant was fined 40s. The offence was repeated, a second summons issued, and the case adjourned. 14 CLERICAL WORK OF THE SANITARY DEPARTMENT. Mr. H. E.Curtis, Senior Clerk, and Mr. W.J. Howe, Junior Clerk, have performed during the year their clerical duties in a most satisfactory manner under circumstances of much inconvenience. The whole of the work has to be performed in a miserably small apartment, occupied in common with the inspectorial staff, and those of the public who have occasion to visit the department for the purpose of gaining information or for other purposes. Hence the duties are carried on for a portion of the day in a continual din of talk, amid the frequent intermittent ringing of the adjacent telephone bell, and subject to constant interruption. The writer suggested to the Council the necessity of providing temporary offices for the department, but the consideration of the suggestion has been unfortunately postponed, under the mistaken idea that it is practicable to structurally alter the present building. Tabulation of the entire work done by the staff, who work long hours, is not practicable, but an example of some of the work done is as follows:— REGISTER OF CLERICAL WORK. Number of Notifications of Infectious Diseases entered in Register, copied and sent to Metropolitan Asylums Board and Schools, receipt acknowledged and filed 1,113 Number of Complaints of Nuisances received, entered in Nuisance Register, and filed 985 Number of Letters despatched from Department 2,111 Number of Council Orders issued 215 Number of Meetings of Public Health Committee prepared for, attended, and Minutes drafted and written 24 THE FACTORY AND WORKSHOP ACTS. The details with regard to the carrying out of these Acts have been entrusted to Mr. Richard Phillips and to Miss O'Kell. Mr. Phillips has also special duties with regard to nuisances from 15 smoke. Both these officers have given in the form of a report a summary of the work done in their respective departments during the year 1901. The reports are as follows: — Town Hall, Marylebone Lane, 1st January, 1902. To the Medical Officer of Health. Sir,—I beg to present to you a Report of my work during the year 1901. FACTORY AND WORKSHOP ACTS. There are in the Borough 129 registered work-rooms, which are occupied exclusively by men. The principal trades engaged in are tailoring and out-fitting. These work-rooms have been measured up for allotment of cubic space, and certain drainage matters attended to. All new workshops have also been " cubed " and registered in the usual way. I have assisted in the measurement of some of the larger work-rooms under Miss O'Kell's care. The registered bakehouses in the Borough number 92; these have been repeatedly visited, and I can report them all clean. There are some 10 other bakehouses which are registered, but only bake occasionally. NUISANCES FROM SMOKE. The number of nuisances from smoke, detected or complained of during the year, show a marked decrease as compared with those of last year. All places where such nuisances have occurred are vigilantly watched, and a recurrence seldom takes place. TRADE NUISANCES. Complaints of trade nuisances have been received and investigated, and when a nuisance has been found or proved it has in every case been abated. My regular work has been for the past four months considerably interrupted by the assignment of special duties in connection with the epidemic of scarlet fever and small-pox. 16 Appended is a statement of that part of my work which admits of tabulation: — No. of Visits. Workshops and Workrooms 156 Bakehouses 291 Smoke Nuisances 151 Complaints 41 Intimations sent out 17 Council orders served 2 I am, Sir, Your obedient Servant, RICHARD PHILLIPS. Town Hall, St. Marylebone, W. 1st January, 1902. To the Medical Officer of Health for the Borough Council of St. Marylebone. Sir,—I beg to submit to you a report of my work during the year 1901. WORKSHOPS AND LAUNDRIES IN WHICH WOMEN AND GIRLS ARE EMPLOYED. Number of Workrooms on Register, Dec. 31st, 1900 1,318 Number of Workrooms added to Register during year ending Dec. 31st, 1901 . 556 1,874 Number of Workrooms removed from Register during year ending Dec. 31st, 1901 192 1,682 These 1,682 workrooms are registered to accommodate about 15,000 workers, and during the season many of the rooms are occupied to their extreme limit. 914 businesses are here represented, of which about 40 are laundries, while the remainder are principally dressmaking, millinery, and tailoring businesses with a few miscellaneous trades. 1901. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA. TYPHOID FEVER & SMALLPOX DURING 1901, AS COMPARED WITH A FIVE YEARS' AVERAGE. DECEMBER. 19O1. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA. TYPHOID FEVER & SMALLPOX DURING 1901, AS COMPARED WITH A FIVE YEARS' AVERAGE. DECEMBER. 17 During the year I have paid 379 first visits, and 1,895 visits of re-inspection, to workshops and laundry workshops. I have also paid 635 calls on miscellaneous business (leaving workroom cards, making enquiries, etc.) In the course of these visits I have found many new workshops which had not been notified to the authorities, and, consequently, had never been visited by an inspector. No new workroom is placed upon the register until the premises have been thoroughly examined. If the sanitary conditions are found to be satisfactory, each room is measured, and a card issued showing the number of persons legally permitted to occupy the room according to its cubic capacity. In the measurement of the larger workrooms, I have had Mr. Phillips' assistance, and I would take this opportunity of thanking him for this special help, and also for the benefit of his ready advice and experience in other matters. HOMEWORKERS. In addition to the workshops referred to above, there is a separate register of those persons residing in the Borough who are engaged in the making of wearing apparel, upholstery, and so forth, in their own homes. The number at present on this register is 255. The premises have been duly inspected, and those that are unsatisfactory have to be kept under constant observation. Owing to the passing of the new Factory and Workshops Act (I. Edward VII., Ch. 22), official supervision will have to be considerably extended; hitherto it has been attended with such difficultes that many local authorities have preferred to ignore their duties in this direction altogether. During the year I have sent to other Boroughs 159 names and addresses of home-workers. I have received only about 30. WORKS CARRIED ON UNDER SUPERVISION. I have endeavoured to classify, as far as possible, the nuisances abated and the improvements carried out as a result of my inspections. CLEANSING, LIMEWASHING, &C. The walls and ceilings of 103 rooms have been cleansed. In many cases (particularly in laundries), staircases, passages, yards, leading to or adjoining business premises have been cleansed, lime-washed, and otherwise made sanitary. 18 SANITARY CONVENIENCES. Additional sanitary accommodation was required and has been provided in 6 work-places. In several establishments where both sexes were employed I have been able to suggest some improvement in the existing arrangements. 12 new water-closets have been substituted for old and insanitary ones, while 29 others, found to be defective as regards water supply, were repaired. In cases where the water-closets or lavatories were found dirty and neglected, I frequently found on inquiry that the employers were quite unaware of the condition of things, and were only too glad to be informed. VENTILATION, HEATING, AND LIGHTING. Improvement in the means of ventilation has been effected in 10 work-rooms, while 3 have been discontinued as unsuitable. In 11 rooms, where the workers were suffering from the effects of cold, the temperature has been improved by the adoption of proper means of warming : on the other hand in several laundries it has been found possible to considerably reduce the abnormally high temperature by inducing air currents, screening or removing stoves, and other means. I am glad to be able to report the increasing use of electricity for lighting all classes of workrooms; the gain in purity of atmosphere is very great. In workrooms, as in many other places, the question of ventilation is a vexed one. It is comparatively easy to induce employers to provide sufficient means of ventilation—the real difficulty often lies with the workpeople themselves, who are unable to dissociate the idea of fresh air from that of draught and its consequences; their determined efforts to block up all air-inlets are truly ingenious. Patience and persuasion on the part of the inspector is, however, sometimes rewarded by good and lasting results. DRAINAGE OF FLOORS. In several wash-houses the surface drainage has been improved ; stone and concrete floors have been repaired, wooden floors have been removed and replaced by a flooring of some impervious material. 19 OVERCROWDING. 18 cases of overcrowding have been detected during the year. A caution to the employer has been found usually sufficient to prevent a repetition of the offence, but one employer was so persistent in her defiance of the law that she was twice prosecuted and fined within six months. (See page 13). COMPLAINTS. 94 complaints of nuisances said to exist in workshops have been investigated. Many others relating to overtime have been forwarded to H.M. Inspector of Factories. PUBLIC CONVENIENCES. In obedience to your instructions, I have, during the year, continued my regular inspections of the Women's Public Conveniences in the Borough. I have always found these places clean and well-ordered ; those few improvements which I have been able, from time to time, to suggest, have been sanctioned by the Public Health Committee, and duly carried out. CLERICAL WORK. The clerical work in connection with my duties occupies a considerable time daily. It includes the keeping of the detailed Registers, the issuing of Registration Cards, and the sending out of intimations of nuisances and letters. 266 intimations and letters have been despatched during the year, and 27 statutory notices for the abatement of nuisances have been served. Each new workshop has been duly notified to H.M. Inspector of Factories, as the Factory and Workshop Act of 1891 requires. The names and addresses of homeworkers dwelling in other boroughs have been forwarded to the proper quarter. Reports have been made from time to time, and various necessary returns have been kept. It was satisfactory to find St. Marylebone especially mentioned in the Annual Report of the Chief Inspector of Factories and Workshops, London, 1901, wherein appears the following table: — Three Local authorities who alone have Notified New Workshops in 1901. Kensington 265 workshops Marylebone 404 ,, Hammersmith 22 ,, 20 In another part of the same report is an acknowledgment of the ready co-operation and help of the Medical Officer of Health of St. Marylebone, resulting in " most effective work which was done by joint visits with the lady sanitary inspector in cases where the jurisdiction of local and central authority appears to be closely interwoven." Reviewing the year's work I cannot but remark the absence of friction which has on the whole characterised it. I have found employers and owners, with few exceptions, willing to conform to the regulations imposed upon them I beg to remain, Sir, Your obedient Servant, L. MARGUERITE O'KELL, Sanitary Inspector. HOUSING OF THE WORKING CLASSES ACT. A report was made during 1901 under the Housing of the Working Classes Act, Part II., but at the request of the Council the report was afterwards made under Part I. to the London County Council. No action as yet has been taken by the London County Council, but the matter is still under their consideration. An important conference of local authorities took place at Spring Gardens in June, 1901, and the writer was one of the representatives appointed for St. Marylebone. As is too often the case the members of the conference held such widely different views that no useful conclusion was arrived at. The Housing and Improvements Committee recommended during the year the purchase of what is known as the John Street Site, an area (see plan) of 9,000 square feet, a frontage of 107 feet 6 inches, for the sum of .£7,000. The report was adopted. On this site will be erected artisans' dwellings. Whether, after payment of the costs of clearing the site, of architect's fees, of construction and legal expenses, suitable dwellings constructed to house that class of poorly-paid labour which demands low rents, the buildings will pay sufficiently to gradually pay off capital and yield a small interest, actual experience will shortly prove. The writer's ideas on the general subject were published in the June report. Plan of John Street Site-. JO H N STREET 21 SANITARY LEGISLATION, 1901. The only sanitary legislation affecting the Borough passed during 1901 was the Factory and Workshop Act, 1901 (I., Edward VII., Ch. 23). This Act practically repeals the whole of the legislative muddle known as the Factory and Workshop Acts from 1878 to 1895, as well as the Cotton Cloth Factories Act, and re-enacts their various provisions with occasional additions and amendments. The defects of the Consolidated Act, as it now stands, are the duplication of authorities, with, as a consequence, the duplication of expense, the obscurity of definition and the ambiguity of phraseology. There is no sufficient reason for the cumbrous machinery of factory inspectors attempting to supervise huge districts under the immediate direction of the Home Secretary. The Local Sanitary Authorities could do all the work and would not have the slightest difficulty in obtaining qualified persons with a sufficient knowledge of engineering and of sanitation to be efficient officers. The law places the duty of inspecting factories under the inspectors attached to the Home Office, of workshops under the local authority. A place may be one day a factory, another a workshop. For example, if a milliner drives a single one of twenty sewing machines by any kind of power—say, for example, electricity, the workshop becomes a factory; if, for some reason, the single power driven machine is disused and personal effort substituted, it becomes a workshop. It has before now happened that the local inspector after taking great pains to inspect an establishment, has found in some obscure corner a small motor of some kind or other, and only then discovered that the inspection by him was unnecessary, the whole establishment, by means of the little power driven machine, coming primarily under the supervision of the Home Secretary. The most important alteration of the 1901 Factory Act is the sections relating to bakehouses. No new bakehouse can be constructed or used if underground, and after January 1, 1904, no underground bakehouse is to be used as such unless certified by the district council to be suitable for that purpose. That is to say each of the 102 22 houses in Marylebone will have to be carefully examined, and it will be in the power of the Council to say that such and such bakehouse shall be closed. The grounds for certification or not are somewhat vague. The section states that no certificate is to be granted unless the " Council is satisfied that it is suitable as regards construction, light, ventilation, and in all other respects." It is quite obvious that under this section the procedure will be unequal in different districts, for what will satisfy one Council will fail to satisfy another. The underground bakehouses in this district have been regularly inspected year by year, and as a rule have been found to favourably compare with those of other districts. What, if any, alterations structurally are necessary to conform to the 1901 Act, is a matter for future consideration. SALE OF FOOD AND DRUGS ACT. (See Table II.) The work under these Acts has been somewhat extensive during the past year, the large number of 646 samples having been analysed. These comprised 115 samples of milk, 5 samples of butter, and one sample of French beans. The latter contained an undue amount of copper. Only 21 samples were reported as adulterated. In most of the above instances prosecutions were instituted, and the vendors fined small sums, the minimum fine being 10s., the maximum £5. The fines recovered under the Acts amounted to £29 2s. 6d. A definite standard having been now fixed for milk and margarine, these articles in future are likely to be more uniform in quality, besides which the analyst has definite rules for guidance and differences of opinion are not so likely to take place. 23 TABLE I. REPORT OF MORTUARY KEEPER FOR THE YEAR 1901. Number of bodies received from January 1st to December 31st, 1901. Males. Females Males. Females, January 25 20 July 20 20 February 20 15 August 21 14 March 29 18 September 16 11 April 25 17 October 18 14 November 14 18 May 20 19 December 29 26 June 20 12 257 204 Total 461 Number of Inquests from January 1st to December 31st, 1891. January 20 Forward 108 February 16 July 14 March 27 August 18 April September 16 18 October 15 May 17 November 15 June 10 December 26 108 212 Total 212 Infectious cases received. Diphtheria 2 Scarlet Fever 2 Small-Pox 1 5 24 TABLE II.—Samples Analysed during the Year 1901. Genuine. Adulterated. Total. DAIRY PRODUCTS— Milk 228 15 243 Butter 73 5 78 Margarine 17 17 Cream 2 2 Cheese 4 4 ALCOHOLIC BEVERAGES— Whisky 42 42 Brandy 15 15 Rum 5 5 Gin 14 14 Sloe Gin 1 1 Port Wine 2 2 Beer 54 54 NON-ALCOHOLIC BEVERAGES— Tea 8 8 Coffee 13 13 Cocoa 3 3 CONDIMENTS— Pepper 7 7 Mustard 8 8 Ketchup 2 2 Worcester Sauce 1 1 Pickles 1 1 Curry Powder 1 1 Capers 1 1 Vinegar 3 3 DRUGS— Tartaric Acid 1 1 Quinine 1 1 Rhubarb 1 1 Liquorice Powder 2 2 Sodic Bicarbonate 2 2 Quinine and Orange Wine 1 1 SACCHARINE SUBSTANCES— Sweets 14 14 Golden Syrup 3 3 Honey 6 6 Jam 20 20 Lemon Syrup 3 3 CANNED FOODS— Apricots, Pineapples, Sardines, Bottled Peas, Bottled Beans, Bloater Paste, etc. 47 1 48 MISCELLANEOUS— Lard 3 3 Pea Flour 1 1 Corn Flour 1 1 Desiccated Soup 1 1 Essence of Ginger 1 1 Salad Oil 3 3 Custard Powder 1 1 Ginger Bread 1 1 Lime Juice 2 2 Lemon Squash 3 3 Baking Powder 1 1 Tapioca 1 1 625 21 646 25 TABLE III.—TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, in the Sanitary District of ST. MAHYLEBONE, during 1901; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals Population at all age. (b) Census 1901 35,394 19.869 18,099 39,541 20,426 133,329 (c) Registered Births 135 90 116 260 128 729 (d) Aged under 5 or over 5. Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards New Cases of Sickness in Such Locality coming to the knowledge of the Medical Officer of Health. 1. Smallpox 1 38 .. 6 .. 7 .. 9 .. 2 .. 63 2. Scarlatina 17 57 8 24 18 55 39 81 31 69 113 288 3. Diphtheria 18 41 5 9 16 29 31 47 21 41 91 167 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid 1 26 .. 2 .. 6 1 19 .. 22 2 75 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. 3 .. .. .. .. .. 1 .. .. .. 4 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 25 3 66 .. 19 2 48 3 35 8 193 Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospitals. 1. Smallpox 1 88 .. 5 .. 7 .. 9 .. 2 1 61 2. Scarlatina 17 41 8 20 16 45 34 68 28 56 103 230 3. Diphtheria 16 30 3 5 16 17 22 39 17 29 74 120 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid 1 16 1 1 .. 3 1 18 .. 14 3 52 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. 8 .. 28 .. 3 1 13 1 6 1 58 26 TABLE IV.— Giving the Causes of Deaths during the 52 Weeks ending December 21st., 1901, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, and the Marylebone Infirmary, Sotting Hill, W. Middlesex Hospital. Queen Charlotte's Hospital. Samaritan Hospital. Workhouse. Notting Hill Infirmary. Influenza • • • • • • • • • • Scarlet Fever • • • • • • • • • • Diphtheria 1 • • • • • • 1 Typhoid Fever 8 • • • • • • 2 Diarrhœa 4 • • • • 1 5 Erysipelas • • • • • • • • 4 Pneumonia and Pleurisy 31 3 • • 1 22 Pyæmia 4 • • • • • • • • Syphilis 3 2 • • • • 5 Cancer 128 • • 4 • • 36 Phthisis and Tuberculosis 36 1 • • 4 113 Rheumatism • • • • • • 1 1 Apoplexy 3 l • • 2 6 Paralysis • • • • • • • • 28 Bronchitis 12 l • • 9 83 Asthma • • • • • • 2 1 Peritonitis 14 • • 1 • • 4 Disease of Brain • • • • • • 2 8 ,, Heart 22 • • • • 11 36 „ Kidney 13 • • • • • • 12 ,. Liver 10 • • • • • • 3 „ Uterus 1 • • 4 • • • • „ Ovary 2 5 1 • • • • Parturition • • • • • • • • • • Diabetes • • • • • • • • •• Fractures and Injuries 19 • • • • • • 7 Old Age • • • • • • 3 36 Low Vitality, Infants • • 6 • • 4 2 Premature Birth • • 9 • • 1 2 Other causes 68 7 2 5 52 Total *379 †35 ‡12 46 469 * Of the 379 deaths in the Middlesex Hospital, 285 were those of non-parishioners, † 31 of the deaths in Queen Charlotte's Hospital were those of non-parishioners. ‡ The 12 deaths in the Samaritan Hospital were those of non-parishioners. 27 TABLE V. Causes of, and Ages at, Death during 1901, in the Borough of St. Marylebone.* CAUSES OF DEATH. Deaths in whole District at subjoined Ages. Deaths in Localities (at all Ages.) Deaths in Public Institutions. All Ages. Under 1. 1 and under 5. 5 and under 15. | 15 and under 25. j 25 and under 65. 65 and upwards. All Souls. Rectory. St. Mary. Christ Church. St. John. Smallpox 8 ... ... 2 1 5 ... 1 2 2 2 1 ... Measles 9 1 7 ... 1 ... ... 6 ... ... 3 ... ... Scarlet Fever... 18 1 11 3 ... 3 ... 2 1 2 11 2 ... Whooping Cough 40 20 20 ... ... ... ... 6 4 7 14 9 ... Diphtheria and Membranous Croup 33 4 24 5 ... ... ... 2 4 6 12 9 2 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric 9 ... ... ... 3 6 ... 5 ... ... 3 1 10 Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza 10 3 ... 1 ... 3 3 3 2 3 2 ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa 121 103 13 ... ... 3 2 24 9 12 61 15 10 Enteritis 6 4 1 ... ... 1 ... 2 1 1 2 ... ... Puerperal fever 1 ... ... ... ... 1 ... ... 1 ... ... ... ... Erysipelas 7 ... ... ... ... 4 3 4 ... ... 2 1 4 Other Septic Diseases 14 1 1 2 1 7 2 5 3 1 2 3 23 Phthisis 223 1 1 3 23 184 11 71 31 29 56 36 154 Other Tubercular Diseases 69 14 20 4 3 25 3 20 9 7 20 13 ... Cancer, Malignant Disease 138 ... ... ... 1 89 48 52 21 21 22 22 168 Bronchitis 265 39 15 2 2 96 111 56 45 38 93 33 105 Pneumonia 173 46 27 4 9 63 24 33 23 31 62 24 57 Pleurisy 8 ... ... ... ... 6 2 1 2 2 2 1* ... Other Diseases of Respiratory Organs 20 4 1 ... 2 9 4 5 6 4 2 3* ... Alcoholism Dirrhosis of Liver 46 ... ... ... ... 40 6 12 5 9 11 9 ... Venereal Diseases 14 12 ... ... ... 2 ... 6 1 2 2 3 ... Premature Birth 33 33 ... ... ... ... ... 7 5 2 14 5 10 Diseases and Accidents of Parturition 13 ... ... ... 3 10 ... 4 1 2 3 3 ... Heart Diseases 227 3 1 11 12 112 88 ' 46 36 31 68 45 13 Accidents 52 14 3 3 2 25 5 11 5 12 14 10 26 Suicides 13 ... ... ... 1 12 ... 7 1 2 2 1 ... All other causes 641 146 28 12 31 229 195 123 89 74 219 136 398 All causes 2211 449 173 52 95 935 507 514 307 300 704 386 971 *The deaths include deaths in the Public Institutions, enumerated in Table VI., with the exception of deaths of non-residents in the district. †These 941 deaths include 328 deaths of non-residents. 28 TABLE VI.—District Births and Deaths for the 52 weeks ending Dec. 21 st, 1901. Population in 1901. Births. Deaths. Males. Fmls. Males. Fmls. All Souls 35,394 292 291 252 262 Rectory 19,869 192 194 158 149 St. Mary 18,099 249 219 149 151 Christ Church 39,541 590 588 366 338 St. John 20.426 214 213 206 180 Total 133,329 1,537 1,505 1,131 1,080 Note.—In the above the births and deaths have all been properly corrected, strangers have been eliminated, and extra-parochial deaths and others have been allotted to their proper sub-district. 29 REGISTER OF SANITARY WORK Year ending December 31st, 1901. PUBLIC HEALTH DEPARTMENT. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. D. J. Andrews, No. 3 District. Mr. T. Gorniot, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell. Total Number of Complaints received 102 111 206 203 176 41 88 927 Inspections Of Dwelling Houses 412 350 398 309 338 201 — 2008 „ Kitchens (separately occupied) 72 15 219 20 144 — — 470 „ Schools 10 16 1 7 14 — — 48 „ Houses registered under Public Health (London) Act, 1891 338 — 225 115 294 — — 972 ,, Dairies and Cow-houses 27 12 20 14 48 — — 121 „ Bakehouses 6 1 1 — 6 545 — 559 „ Slaughterhouses 26 10 4 18 14 — — 72 „ Miscellaneous Inspections 1849 1730 1610 2090 1636 1914 2751 13580 Notices issued for Abatement of Nuisances, etc. 67 33 61 44 75 — 27 307 Letters written relating to Abatement of Nuisances 240 176 326 201 194 17 266 1420 Proceedings taken before Magistrates under Sanitary Acts 1 1 1 2 2 — 4 11 Reports made to Medical Officer of Health 398 396 345 533 586 156 119 2533 Infectious Patients removed to Hospital 136 56 196 135 121 — — 644 Rooms Disinfected after Infectious Disease 233 138 248 338 241 — — 1198 New Pipe Drains (feet) 12970 13078 7999 11218 14956 — — 60221 Houses where defects in Drainage have been detected and remedied 85 59 96 63 67 — 6 376 Unwholesome Food—Number of Seizures made — — 2 2 — 4 Food Adulteration. Samples collected for Analysis 110 103 122 120 113 — — 568 Proceedings taken before Magistrates 1 1 — 7 3 — — 12 Removal of Bodies to Mortuary 2 — 6 — — — — 8 INDEX TO MONTHLY REPORTS. A page II Souls, Birth and Death-Rate— January 2 F ebruary 16 March 29 April 42 May 52 June 64 July 80 August September90 October 106 November116 ???ndrews, D. J. I., rearrangement of district of 45 ???rsenic in Beer32 B ???sans, Copper in 33 Births and Deaths— January2, Table IV. 11 February 6, „ V. 25 March 28, „ IV. 36 April 42, „ IV. 48 May 52, „ V. 61 June 64, „ V. 74 July 80, „ V. 86 August 90, „ V. 99 September 90, „ V. 99 October 106, „ V. 113 November 116, „ V. 121 ???undaries of District, alteration of 5 ???tter, Adulteration of 33 ???re-laws as to Houses let in Lodgings (Weatherall v. Cantley) 68 c ???nsus, 1901 44; 54 ???rist Church, Birth and Death-Rate of— January 2 F ebruary 16 March29 APril 42 May 52 June 64 July 80 August September 90 October 106 November 116 page Cleansing of Persons Act 30, 54, 82 Copar, Wm., of 14, Sherborne Place, Prosecution of, for Milk Adulteration32 Curtilage, What is? 7 D Derry, Madame, Prosecution for Overcrowding 82 Devonshire Place, Report on 55 Devonshire Place, Representation of, under Part I Housing of Working Classes Act 66 Dust, See Household Refuse F Factories and Workshops Acts, Prosecution under 82 Factories and Workshops, Warming of 31 G Golden Horse Yard, Drainage of 7, 8 Gorniot, T., Re-arrangement of District of 45 H Hodges, J. District of 45 Household Refuse, Collection of . 20, 30 Housing of Working Classes Act, Report under 55 Housing of Working Classes Act, Conference as to 67 I Infectious Diseases during— January Table III. 10 February „ III. 23 March „ II. 34 April „ III. 47 May ,, III. 59 June „ IV. 73 July V. 85 August & September „ IV. 98 October ,, II. 110 November ,, II. 118 INDEX TO MONTHLY REPORTS—continued. K page Klomb, Rosina, of 10, Charlton Street, Prosecution of, for Milk Adulteration 32 M Meteorology of— January February15 March 27 April 41 May 51 June 63 July 70 August 89 September 89 October 105 November 115 Middlesex Hospital, Causes of Death— January 9 February 24 March 35 April 46 May 60 June 71 July 83 August and September 96 October 111 November 120 Milk Adulteration 32, 94 Milk, Standard for 32 N Neville, Eliz, of 3, Glentworth Street, Prosecution of, for Milk Adulteration 94 o Overcrowding, Prosecution for 82 P Plague, Bubonic 44, 109 Q Queen Charlotte's Lying-in Hospital, Causes of Death— January 9 February 24 March 35 April 46 May 60 June 71 July 83 August and September 96 October 111 November 120 R page Rats and Plague 109 Rectory—Birth and Death-Rate— January 2 February 16 March 29 April 42 May52 June 64 July 80 • August Septembe 90 October106 November116 Rotto, •Burnett, of 48, Upper Rathbone Place, Prosecution of, for Milk Adulteration 95 s St. John—Birth and Death-Rate— January 2 February 10 March 29 April 42 May 52 June 64 July 80 August September 90 October106 November 110 St. Mary—Birth and Death-Rate— January 2 February 16 March29 April 42 May 52 June 64 July 80 August September 90 October 106 November 116 St. Marylebone—Birth and Death-Rate— January 2 February 16 March 29 April 42 May 52 June 64 July 80 August September 90 October 106 November 116 St. Marylebone Infirmary, Notting Hill, Causes of Death in— January 9 February 24 INDEX TO MONTHLY REPORTS—continued. page March 35 April 46 May 60 June 71 July 83 August and September 96 October 111 November 120 Sale of Food and Drugs Act 32 Table VI 38, 70 Table VIII 76, 94 Table VI 100 Samaritan Hospital, Causes of Death in— January 9 February 24 March 35 April 46 May 60 June 71 July 83 August and September 96 October 111 November 120 Sanitary Inspectors' Districts, Re-adjustment of 45 Sanitary Work done in— January 13 February 26 March 39 April 50 May 62 June 78 July 37 August 101 September 102, 103 October 114 November 122 page Scarlet Fever and Diphtheria 94 Shanly, Mrs., of Princes Pavilion, Regent's Park, Prosecution of, for Milk Adulteration 94 Small-pox 60, 92 108, 117 T Temperature, Reasonable, in Factories and Workshops 31 Thomas, T., of 41, Barlow Street, Prosecution of, for Milk Adulteration 94 w Weatherall v. Cantlay 68 Workhouse, Causes of Death in— January 9 February 24 March35 April 46 May 60 June71 July 83 August and September 96 October 111 November 120 Water Company's Regulations 18 Y Yeo W., Re-arrangement of District of 45 INDEX TO ANNUAL REPORT. A All Souls, Births and Deaths in, Table VI. 28 ,, „ Birth and Death-Rate of 5 ,, Infectious Diseases in, Table III. 25 » ,, Causes of Death in, Table X 27 Andrews, D. J., Register of Sanitary Work in 29 B Bakehouses Affected by New Legislation 21 ,, Number of on Register 15 Births and Deaths . 5, Table VI. 28 G Christ Church, Births and Deaths in, Table VI. 28 „ ,, Birth and Death-Rate of 5 ,, ,, Infectious Diseases in, Table III. 25 „ ,, Causes of Death in, Table X. 27 Cleansing of Persons Act . 12 Clerical Work of Miss O'Kell 19 >, ,, Register of 14 Curtis, H. E., Clerical Work of 14 D Deaths, Causes of, Table V. 27 Deaths, Extra Parochial 5, 6 Devonshire Place Area 20 Diphtheria .11, Table III. 25 Disinfection 11 INDEX TO ANNUAL REPORT—continued. E page Electricity Supplanting Gas in Workshops 18 F Factory and Workshop Act, 1901 21 Factory and Workshop Acts, Work done Under 13, 20 G Golden Horse Yard, Drainage of 13 Gorniot, T., Sanitary Work of 29 H Hodges, J., Sanitary Work of 29 High St., St. John's Wood, No. 15, Closing Order as to 13 Home Workers 17 Housing of Working Classes Act 20 Howe. W. J., Clerical Work of 14 I Infectious Notifiable Sickness, Table III 25 J John Street site 20 L Laundries on Register 16 Little Marylebone St., No.53 Closing Order as to 13 M Meteorology 3, 5 Mortuary Keeper's Report 23 N Nightingale St., Nos. 21 and 22, Prosecution of Owner of13 Nuisances Connected with Trades 15 o O'Kell, Miss, Report on Factories and Workshops 16, 19, 20 O'Kell, Miss, Sanitary Work of 29 Overcrowding in Workrooms 19 P page Perry, A., Register of Sanitary Work Done by 29 Phillips, R., Report of 15, 16 ,. Register of Sanitary Work Done by 29 Prosecutions Under Public Health Acts 13 „ ,, Sale of Food and Drugs Act 22 Public Conveniences 19 R Rectory, Births and Deaths in, Table VI 28 „ Birth and Death-Rate of . 5 ,, Infectious Disease in, Table III. 25 ,, Causes of Death in, Table X. 27 s St. John, Births and Deaths in, Table VI. 28 ,, Birth and Death Rate of 5 ,, Infectious Diseases in, Table III. 25 Causes of Death in, Table X. 27 St. Mary, Births and Deaths in, Table VI 28 ,, Birth and Death-Rate of 5 ,, Infectious Diseases in, Table III. 25 ,, Causes of Death in, Table X. 27 Sale of Food and Drugs Act 22, Table II. 24 Sanitary Conveniences in Workshops 18 Sanitary Legislation in 1901 21 Sanitary Work, Register of 29 Scarlet Fever 10, Table III. 25 Shelter, Occupation of 12 Small-pox 6, 7, Table III. 25 Small-pox, Preventive Measures Against 7, 10 Smoke, Nuisances from 15 T Typhoid Fever . 11, Table III. 25 u Union St. M.H., No. 28, Closing Order with regard to 13 V Ventilation of Workshops 18 W Workrooms, Male 15 Workrooms, Female 16 Workshops and Laundries 16 Y Yeo, W., Register of Sanitary Work done by 29 THE sanitaryCHronicles of the BOROUGH OF ST. MARYLEBONE DURING JANUARY, 1901. Vol. XXI. Town Hall, St. Marylebone, February 9tii, 1901. No. 1. The week ending December 29th, 1900, was overcast and of moderate temperatures, the minimum being 30°.7 ; maximum, 53°'2 ; mean, 40o.1 On three days rain fell (0.30 inch). The winds were. SW. The sunshine received 8.4 per cent. of the total time the sun was above the horizon. Mean barometer, 29.9 inches. The week ending January 5th, 1901, was a gloomy, foggy week. Minimum temperature, 28°.0 ; maximum, 51°.0; mean, 37°.8. On three days rain fell (0.6 inch). The winds were SW. Only 3 per cent: of sunshine was received. Mean barometer, 29.9 inches. The week ending January 12th was also gloomy and foggy. Minimum temperature, 25°.5 ; maximum, 48°.8 ; mean, 35°.9. On two days snow and rain fell (0.2 inch). No direct sunshine was received. Mean barometer, 29.9 inches. The week ending January 19th was sunless and foggy. Minimum temperature, 30o.0; maximum, 48°.5; mean, 41°9. On one day only slight rain fell (0.05 inch). SE. and E. airs. Mean barometer, 29.9 inches. The week ending January 26th was mild and brighter. Minimum temperature, 33°.0; maximum, 50o.0; mean, 49°.2. On two days rain fell (0.08 inch.) Winds SW. Sunshine registered in Regent's Park 9.2 per cent. Mean barometer, 30.0 inches, 2 Births and Deaths. During the five weeks ending January 26th there have been registered 284 births and 221 deaths. These births and deaths are divided among the five sub-districts, as set forth in Table IV. 69 of the deaths were extraparochial, as follows:— St. Marylebone Infirmary, Netting Hill 40 North-Western Fever Hospital 3 Children's Hospital, Paddington 1 St. Mary's Hospital 4 Brompton Hospital 1 Cheyne Hospital 1 St. Thomas Hospital 1 St. George's Hospital 2 University Hospital 1 German Hospital 1 West London Hospital 1 Banstead Asylum 2 Hanwell Asylum 3 Colney Hatch Asylum 1 Central London Sick Asylum 1 St. Pancras Workhouse 1 St. Pancras Infirmary 2 St. Luke's Home (Osnaburgh Street) 1 In the Streets 2 Total 69 The birth and death-rates, as deduced from the five weeks' statistics, are as follows :— All Souls, birth-rate 14-1: dealh-rate 14*3. Kectory, birth-rate 20 5 ; death-rate 16'4. St. Mary, birth-rate 17"8 ; death-rate 14-0. Christ Church, birth-rate 34'4; death-rate 20'6. St. John, birth-rate 20'8; death-rate 14-2. The whole district, birth-rate 20'9; death-rate 16*3. 3 The average death-rates for five years (1895 to 1900), for the corresponding period were as follows:—All Souls, 12.8; Rectory, 26.7; St. Mary, 20.7; Christ Church, 21.5; St. John, 22.3; the whole district, 20.8. The following table gives, as usual, facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes: TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE FIVE WEEKS ENDING JANUARY 26th, 1901, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 5 weeks ending Jan. 26th, 1901. Proportion of the deaths to 1,000 deaths from all causes. 5 weeks ending Jan. 26, 1901. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1895-1900. 1. Deaths from the chief Zymotic Diseases 14 63 1.02 2.76 2. Pulmonary, other than Phthisis 58 262 4.26 5.76 3. Tubercular 30 136 2.20 2.40 NOTES. 1, includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza, Whooping Cough Erysipelas, Croup, Fever, and Diarrhoea. 3, includes Phthisis, Scrofula, Rickets, and Tabes. 4 Health of the District. The number of notifications of infectious maladies, the total deaths and the death rates compare very favourably with former years. For example the mortality from zymotic diseases is about a third less than the average of the five years ending 1900, and the fatality from chest complaints one-and-a-half per 1,000 less than for the same period Alteration of Boundaries. The boundaries of the Borough by the operation of the Local Government Act are slightly altered, and there is a corresponding change in the population. The chief alterationsare in the Registration District of St. John's Wood, and in All Souls. It will be seen from the annexed details that 176 houses are received from Hampstead and 94 are given up, leaving a balance in favour of St. Marylebone of 82. It is a reasonable assumption that the 82 households represent 400 persons; that number has therefore been added to the population (estimated) of the St. John's Wood District. On the other hand, in the SE. part of the Borough the alteration of the boundaries leaves the number of houses within eight of the old number. No correction for these eight houses has been made. The census will this year be taken, so that errors of estimation can then be adjusted. 5 LONDON GOVERNMENT ACT, 1899. ALTERATION OF BOUNDARIES PREMISES TRANSFERRED FROM ST. MARYLEBONE TO HAMPSTEAD. Avenue Road. 12, 14, 16, 18, 20, "The Elms," 22, 24, 26, 28, 30, 32, 34. Bolton Road. 1, 2, 3, 4, 5, 6, 7. Greville Place. 1, la, 3, 5, 7, 9, 9 (stable), 11, 11 (stable), 13, 15, 17, 10. Greville Road. 29, 31, 33, 35, 37, 12, 14, 16 18, 20, 22, 24. Maida Vale. 128, 130, 132, 134, 136, 138. Mortimer Road. 1, 2, 3, 3a, 4, 5, 6, 7. Norfolk Road. 1, 2, 3. Queen's Road. 34, 35, 36, 37, 38, 39a, 39, 40, 41, 42, 43, 44, 45, 46, 46a, 47, 48, 49, 49a. St. Edmund's Terrace. 26, 27, 28. St. John's Wood Park. "Holmefield," "Ravensworth," 38, 39, 40, 41, 42, 43, 44, 45, 46, ''Manor House." West Middlesex Water Co. Reservoir, House, Premises, etc. PREMISES TRANSFERRED FROM HAMPSTEAD TO ST. MARYLEBONE. Abbey Road. 59b. 61a, 61, 63, 65, 67, 69, workshop, stable and yard, 71, 73, 75, 77, 79, 81, 62, 64, 66, 68, 70, 72, 74, 76. Belgrave Road. 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 29, 30, 31, 32, 33, 34, 35, 36, 37. Belgrave Mansions. 6 to 10, 1 to 5. Boundary Road. 3, 5, 7, 9, 11, 13, 15,17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, 39, 41, 43, 45, 47, 49, 51, 53, 55, 57, 59, 61, 63, 65, 87, 69, 71, 73, 75, 77, 79, 83, 85. 87, 89, 91, 93, 95, 97, 99, 101, 103, 105. 107, 109, 111, 113, 115, 117. 6 Loudoun Road. 25, 27, 29, 31, 33, 35, 37, 39, 58, 60, 62, 64. 66, 68. Springfield Road. 1, 3, 5, 7 9, 11 13, 15, 17, 19, 21, 23, 25, 27, 29, 2, 4, 6, 8, 10, 12, 14, 16. 18, 20, 22, 24, 26, 28, 30, 32, 34, 36, 38, 40, 42, 44, 46, 48, 50, 52, 54, 56, 58, 60, 62, 64. PREMISES TRANSFERRED FROM ST. MARYLEBONE TO ST. PANCRAS. Albany Mews. 1, 2. 3, 4, 5, 6, 6A, 7, 8, 9, 10, 11, 12, 13, 14. Albany Street. 1, 1a, 3, 5. 7, 9, 11, 13. Albany Terrace. 1, 2, 3, 4, 5, 6. Park Square East. 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24. Cleveland Street. 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 26, 28, 30, 32. Goodge Street. 62, 64, 66, 68. Hanway Place. 2, 3, 4, 5. Hanway Street. 14, 16, 18, 20, 22, 24, 26, 28, 30, 32. St. Andrew's Place. 1, 2, 3, 4,15, 6, 7. Garden of Cambridge House. PREMISES TRANSFERRED FROM ST. PANCRAS TO ST. MARYLEBONE. Bennett Street. 6, 7, 8, 9. Charlotte Place, Fitzroy Square. 1, 2, 3, 4, 5, 6, 7, 8. Charlotte Street, Fitzroy Square. 1, 3, 5, 7, 9,11, 13,15,17, 17A, 19, 21, 23, 25,27, 29, 31. Goodge Street. 55, 57, 59. Gresse Street. 1, 2, 3, 4, 5, 6, 7, 8, 9,10, 11, 12, 13, 14, 15, 16, 17, 18, 19. Hanway Street. 1,3,5,7,9,11,13. Percy Street. 38. Tottenham Court Road. Oxford Music Hall, 2, 3, 4, 5. Upper Rathbone Place. 38, 39, 40, 41, 43, 44, 45, 46, 47, 48, 49. 1 9 O 1 . CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, AND TYPHOID FEVER DURING 1901, AS COMPARED WITH A FIVE YEARS' AVERAGE. JANUARY. 7 What is a Curtilage? The word "drain" under the Metropolis Management Acts is defined to mean and include any drain of and used for the drainage of one building only "or premises within the same curtilage," it also includes drains for draining any block of buildings by a combined operation under the Order of a local authority. The word "sewer" is only defined in the Statute by a process of exclusion, pipes for draining premises must apparently be either sewers or drains, and if they are not drains then they are "sewers." It is hardly necessary to observe that sewers are under the jurisdiction of local authorities, drains are private matters. Golden Horse Yard consists of a group of stables with living rooms over them, enclosing a yard approached from Taunton Mews, there is also a way into the yard through two houses in Linhope Street, the back doors of these houses opening on to the yard. The yard is entirely enclosed by the stables and the two houses in Linhope Street. The drainage of the stables and houses was found to be defective, and a notice from the Council duly served upon the owners to remedy the defect. Thereupon the owners sought to cast the responsibility on the Council, arguing that the drain in this confessedly private yard was "a sewer." The owners were informed by the officers of the Sanitary Department that the yard was "a curtilage," and the stables, &c., were all situated in the same curtilage, and, therefore, the various conduits were private drains and not sewers. 8 This question on summons Avas heard before the Stipendiary and ably argued on both sides. The Solicitor to the Council relied upon certain leading cases and the facts to prove the yard was a curtilage to the stables generally. On the other side it was contended that the houses being more of the nature of stables than houses, this common yard could not be said to be the curtilage of any one of them or the curtilage of all of them, and that the idea of curtilage was insuperably connected with that of dwelling house and could not be applied to stables. The Stipendiary adopted this view and gave his judgment in favour of the defendants, but granted a "case." 9 TABLE II.— Giving the Causes of Deaths during the 5 Weeks ending January 6th, 1901, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital. Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill Infirmary. Inlluenza ... ... ... ... ... Scarlet Fever ... ... ... ... ... Diphtheria ... ... ... ... ... Typhoid Fever 2 ... ... ... ... Diarrhœa 1 ... ... ... 1 Erysipelas ... ... ... ... ... Pneumonia and Pleurisy 6 ... ... 1 3 Pyæmia 1 ... ... ... ... Syphilis ... ... ... ... ... Cancer 15 ... 1 ... 3 Phthisis and Tuberculosis 2 ... ... 1 10 Rheumatism ... ... ... 1 ... Apoplexy 1 ... ... ... 1 Paralysis ... ... ... ... 2 Bronchitis 3 ... ... ... 9 Asthma ... ... ... 1 ... Peritonitis 1 ... ... ... ... Disease of Brain ... ... ... ... ... „ Heart 2 ... ... 3 3 „ Kidney 2 ... ... ... 1 „ Liver 3 ... ... ... ... „ Uterus ... ... ... ... ... „ Ovary 1 ... ... ... ... Parturition ... ... ... ... ... Diabetes ... ... ... ... ... Fractures and Injuries 1 ... ... ... 1 Old Age ... ... ... 2 3 Low Vitality, Infants ... ... ... ... ... Premature Birth ... 2 ... ... ... Other causes 7 2 ... 1 3 Total *48 †4 ‡1 10 40 * Of the 48 deaths in the Middlesex Hospital, 37 were those of non-parishioners. † The 4 deaths in Queen Charlotte's Hospital, were those of non-parishioners, 3 of them were infants. ‡ The death in the Samaritan Hospital was that of a non-parishioner. 10 TABLE III— TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, in the Sanitary District of ST. MARYLEBONE, during January, 1901; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals Population at all ages. (b) Census 1896 36,495 19,798 19,637 32,547 32,611 141,188 (c) Registered Births 51 40 33 110 60 284 (d) Aged under 5 or over 5 U nder 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards New Cases of Sickness in bach Locality coming to the knowledge op the medical Officer of Health. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 3 3 1 2 1 6 1 2 1 8 7 21 3. Diphtheria 4 2 .. .. .. 1 .. .. 1 .. 5 3 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid 1 3 .. .. .. .. .. 1 .. 1 1 5 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 1 .. 1 .. .. .. 4 .. 2 .. 8 Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospital. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 3 3 1 2 1 5 1 2 1 5 7 17 3. Diphtheria 3 2 .. .. .. 1 .. .. 1 .. 4 3 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid 1 3 .. .. .. .. .. 1 .. 1 1 5 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. \9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. .. 5 .. .. .. 1 .. .. .. 6 11 TABLE iv.—District Births and Deaths for the five weeks ending january 27TH, 1901. Population in 1896 Population in 1901. Births. Deaths. Males. Frals Males Fmls. All Souls 36,595 36,595 26 25 26 26 Rectory 19,798 19,798 19 21 11 21 St. Mary 19,637 19,637 20 13 12 14 Christ Church 32,547 32,547 65 45 31 35 St. John 32,611 33,011 23 27 22 23 Total 141,188 141,588 153 131 102 119 Note.—In the above the births and deaths have all been properly corrected, strangers have been eliminated, and extra-parochial deaths and others have been allotted to their proper sub-district. 12 TABLE V.— Causes of, and Ages at, Death during the five weeks ending January 26th, 1901, in the Borough of St. Marylebone. CAUSES OF DEATH. Deaths in whole District at subjoined Ages. Deaths in Localities (at all Ages). Deaths in Public Institutions. All ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. All Souls. Rectory. St. Mary. Christ Church. St. John. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever 1 .. 1 .. .. .. .. .. .. .. 1 .. .. Whooping Cough 4 1 3 .. .. .. .. .. 1 .. 2 1 .. Diphtheria and Membranous Croup 1 .. 1 .. .. .. .. .. 1 .. .. .. .. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fever 'Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric 1 .. .. .. .. 1 .. 1 .. .. .. .. 2 Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 1 1 .. .. .. .. .. .. .. 1 .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 2 2 .. .. .. .. .. 1 .. 1 .. .. 2 Enteritis 3 3 .. .. .. .. .. .. 1 1 1 .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. Other Septic Diseases. 1 .. .. .. .. .. 1 1 .. .. .. .. 2 Phthisis 26 .. .. .. 6 20 .. 12 2 .. 8 4 13 Other Tubercular Disease 4 1 1 .. .. 1 1 1 1 .. .. 2 .. Cancer, Malignant Disease 11 .. .. .. .. 8 3 6 2 1 1 1 19 Bronchitis 26 3 3 1 .. 10 9 2 3 6 11 3 12 Pneumonia 22 5 2 .. .. 8 7 4 3 3 6 6 10 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Respiratory Organs 10 3 .. .. 2 4 1 2 3 3 1 1 .. Alcoholism 4 .. .. .. .. 4 .. .. .. 1 2 1 .. Cirrhosis of Liver Venereal Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. Premature Birth .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases and Accidents of Parturition 4 .. .. .. 1 3 .. .. .. 1 1 2 .. Heart Diseases 23 .. .. 1 1 10 11 3 6 2 7 5 .. Accidents .. .. .. .. .. .. .. .. .. .. .. .. 2 Suicides .. .. .. .. .. .. .. .. .. .. .. .. .. 3 3 .. .. .. .. .. .. .. .. .. .. .. All other causes 74 23 7 1 1 21 21 19 9 6 25 19 41 All causes 221 45 18 3 11 90 54 52 32 26 66 45 103* * Of the 103 deaths in Public Institutions, 50 were non-residents, and are not included in the Statistics of the District. 13 REGISTER OF SANITARY WORK, Month ending 31st January, 1901. PUBLIC HEALTH DEPARTMENT. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. T. Gorniot, No. 3 District. Mr. D. J. Andrews, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. R. Phillips. Special Duties. Miss L. M. O'Kell. Total. Number of Complaints received 3 9 8 19 16 5 1 61 Inspections. Of Dwelling Houses 35 42 20 30 32 60 — 219 „ Kitchens (separately occupied) 7 — — 20 13 — — 40 „ Schools 2 1 — — — — — 3 „ Houses registered under PublicHealth(London) Act, 1891 30 — 18 22 27. — — 97 „ Dairies and Cow-houses 2 1 1 — — — — 4 „ Bakehouses 1 — — — — 20 — 21 „ Slaughterhouses 2 1 1 — — — — 4 „ Miscellaneous Inspections 140 136 230 120 146 130 247 1149 Notices issued for Abatement of Nuisances, etc. 4 3 4 3 — — 2 16 Letters written relating to Abatement of Nuisances 24 26 16 32 7 2 20 127 Proceedings taken before Magistrates under Sanitary Acts — — 1 1 1 — — 3 Reports made to Medical Officer of Health 28 30 35 30 51 20 14 208 Infectious Patients removed to Hospital 8 3 4 1 12 15 — — 42 Rooms Disinfected after Infectious Disease 16 9 6 11 27 — — 69 New Pipe Drains (feet) 964 840 680 782 1126 — — 4392 Houses where Defects in Drainage have been detected and remedied 6 5 7 8 5 — — 31 Unwholesome Food — Number of Seizures made — — — — — — — — Food Adulteration Samples collected for Analysis — — — — — — — — Proceedings taken before Magistrates — — — — — — — — Removal of Bodies to Mortuary — — — 1 — — — 1 THE SANITARY CHRONICLES of the BOROUGH OF ST. MARYLEBONE DURING FEBRUARY, 1901. BY ALEXANDER WYN'PER BLYTH, Medical Officer of Health, and Analyst of Food and Drugs, for the Borough of St. Marylebone. PRINTED BY ORDER OF THE COUNCIL. Vol. XXI. Town Hall, St. Marylebone, March 11th, 1901. No. 2. The week ending February 2nd was the first of four wintry inclement weeks. Minimum temperature, 29°.5; maximum, 54°.0; mean, 36.9. On two days there was rain, hail, or sleet, the total rainfall being 0.12 inch, Wind WSW, and during the early part of the week a gale. Sunshine, 10'9 per cent, of the possible. Mean barometer (low), 29.3 inches. The week ending February 9th was also wintry. Minimum temperature, 25°.0; maximum, 40o.0; mean, 35°.6. On two days snow fell, equal to 0'65 inch of rain. Winds mostly WNW. 6 per cent, of the possible sunshine was received. Mean barometer, 29.7 inches. The week ending February 16th was a week of frost and snow. Minimum temperature, 19°.5; maximum, 42o.0; mean, 33°.8. On three days rain or snow fell, equal to 0.12 inch. The sunshine registered was equal to 21 per cent. Winds NE. Mean barometer, 30.3 inches. The week ending February 23rd was similar in weather to the preceding. Minimum temperature, 23°.5; maximum, 45°.0; mean, 33°.3. On two days snow and on two days rain fell, the whole equalling 0.15 inch of rain. Winds variable. Sunshine, 5.6 per cent. Mean barometer, 30.1 inches. 2 Births and Deaths. During the four weeks ending February 23rd there have been registered 240 births and 213 deaths. These births and deaths are divided among the five sub-districts as set forth in Table IV. 75 of the deaths were extraparochial, as follows:— St. Marylebone Infirmary, Notting Hill 42 North-Western Fever Hospital 4 St. Mary's Hospital 3 University Hospital 4 St. Thomas Hospital 1 Children's Hospital, Paddington 1 Hanwell Asylum 2 Leavesden Asylum 3 Camberwell House Asylum 2 Colney Hatch Asylum 5 Ilford Asylum 1 Banstead Asylum 2 Bethlem Hospital 1 Royal Chest Hospital 1 St. Pancras Infirmary 1 In the Streets 2 Total 75 The birth and death-rates, as deduced from the four weeks' statistics, are as follows:— All Souls, birth-rate 17.0: death-rate 19.5. Rectory, birth-rate 17.7; death-rate 23.6. St. Mary, birth-rate 27.1; death-rate 18.5. Christ Church, birth-rate 37'9; death-rate 27.2. St. John, birth-rate 11.4' death-rate 10.2. The whole district, birth-rate 22.0; death-rate 19.6. 3 The average death-rates for five years (1895 to 1900), for the corresponding four weeks were as follows:—All Souls, 17.9; Rectory, 23.7; St. Marys 22.2; Christ Church, 23.5; St. John, 22.7; the whole district, 21.7. The following table gives, as usual, facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes: TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE FOUR WEEKS ENDING FEBRUARY 23rd, 1901, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. - 4 weeks ending Feb. 23rd, 1901. Proportion of thedeaths to 1,000 deaths from all causes. 4 weeks ending Feb. 23, 1901. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1895-1900. 1. Death? from the chief Zymotic Diseases 13 61 1.04 2.94 2. Pulmonary, other than Phthisis 60 228 5.52 6.24 3. Tubercular 31 145 2.85 1.08 NOTES. 1, includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza, Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. 3, includes Phthisis, Scrofula, Rickets, and Tabes. 4 General Health of the District. The curve showing the course of the notifiable infectious diseases, the death-rate, and the tabular statements as to the causes of death, all show that the month of February was fairly healthy. In one of the sub-districts (St. John), the birth and death-rate are both abnormally low. It may, however, be well to mention that the addition to the population of the district of St. John of so much good-class residential property, as detailed in the Report for January, will tend to permanently lower the death-rate of that particular district, and hence render the comparison with the rates of former years of little value. The Water Regulations. The various Water Companies acting in combination, having, in the face of the determined front of all the Municipalities of the Metropolis, withdrawn the regulations, the discussion of the scope of these regulations rather belongs to past than present history. As it is, however, quite possible that they may be re-introduced under a different form, the writer would like to take an opportunity of recording his view of the two regulations which excited the greatest interest and opposition, viz., the one destined to limit a waste water preventer to two gallons, the other the compulsory provision of cisterns of a particular size. The principle of the first is entirely wrong. If it be once admitted that a Water Company has the power to dictate what quantity of water shall be allotted to cleanse a closet pan, to be perfectly consistent they should have the power of saying how much or how little water should be used to wash a yard, a room, or even for personal ablution. The necessary amount of water for use in closets depends on circumstances, and the particular pattern and type of closet. The closets that conform most perfectly to the hygienic conditions laid down in the London County Council byelaws, are what is known as valve closets; these closets cannot 5 be properly cleansed with so small a flush as two gallons. There are also special forms of closets, which, for purposes of health under particular circumstances, are necessary to put into old buildings, where the closet is in an unfortunate position and cannot be removed elsewhere ; these absolutely prohibit a limit of the amount of flushing water. The writer is therefore strongly of opinion that any limit to the use of water for cleansing purposes is wrong in principle, and in practice liable to produce a nuisance. Next, as to the provision of sufficient storage accommodation to each house in the way of cisterns. A special inspection of types of houses throughout the district.has shown that but a small percentage of the houses in St. Marylebone possess such an amount of cistern accommodation as the regulation, if it had been approved, would have required. It may be roughly estimated that at least £20 per house would have had to be expended in order to conform to the regulation. Supposing any decided hygienic advantage would result, however hard on individual owners, leaseholders and so forth, it yet might have been defended and even supported. If the matter is carefully examined, the only reason for the innovation suggested, is the temporary inconvenience to householders when service pipes and mains are under repair—a contingency which may always be met by the Company providing a sufficient number of stand pipes in convenient positions. As the writer was ready to point out in evidence, it is of great importance to keep water moving in the mains to allow of no stagnation. There are streets in the Borough composed of large houses tenanted by single families; these houses would have had to provide cisterns not in proportion to the population but to the size of the houses. During summer months, when the residents of such streets are out of town, the cistern water would be so little drawn upon that the water in the mains and service pipes would become stagnant and impure. In any case it should be left to the owner, so long as there is a constant supply, to provide as little or as great an amount of local storage as he thinks advisable. Finally, it would have been more prudent for the Companies to have provided against negligent waste, by adopting the 6 meter principle. If, through faulty fittings, an owner or occupier is obliged to pay a higher rate, the fittings are soon seen to. From a strictly hygienic standpoint there is no such thing as waste of water, so long as the waste goes directly into the drains; leakages into walls or basements is a different matter. The more water a town uses, the better for health. The water supply of the Metropolis should be practically unlimited; if the present sources are not sufficient, then they must be supplemented with others. Possibly at some future time, we shall see the water of the Channel brought into London for certain municipal purposes and thus economise legitimately the ordinary supply. The Collection of Household Refuse. The ordinary Ratepayer probably is absolutely ignorant of the great practical difficulties of this question. The number of available contractors who have invested several thousands of pounds in the requisite plant, depots, and wharves may be counted on the fingers. An advertisement for tenders year by year is only replied to by this limited number, hence, so far as getting tenders, a dozen halfpenny postcards would have the same effect as public advertisement. The limited number of contractors favours combination and all kinds of private arrangements. Capital has always endeavoured to take care of its own interests, and always will. The net result is that the Council has to make the most advantageous bargain it can, but can never be master of the situation. Any breakdown in the arrangements for the collection of refuse is certainly not the fault of the governing body or of the Public Health Committee. The latter body, since its term of office, has never failed at each meeting to consider any complaints, and, where no proper explanation of neglect has been given, to inflict fines under the contract. A private individual under such circumstances, would, within three months, have provided depots and plant, and 1 9 0 1 . CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, AND TYPHOID FEVER DURING 1901, AS COMPARED WITH A FIVE YEARS' AVERAGE.. FEBRUARY. 7 have done the dusting himself, but a private individual can always act more promptly than any public body; the writer is intimately acquainted with the perfectly honest and strenuous efforts of a committee of the old Vestry to acquire a site, and the apparent impossibility of pushing the matter to a satisfactory conclusion. The position has however now become so intolerable that the Council will be bound to face the difficulty, and to do its own collection and disposal of refuse. Probably the annual outlay will be quite as costly, and even less economical than the present system, but the results will be, from other points of view, infinitely better. 8 TABLE II.—Causes of, and Ages at, Death during the four weeks ending February 23rd, 1901, in the Borough of St. Marylebone. CAUSES OF DEATH. Deaths in whole District at subjoined Ages. Deaths in Localities (at all Ages). Deaths in Public Institutions. All ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. All Souls. Rectory. St. Mary. Christ Church. St. John. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever 1 .. 1 .. .. .. .. .. .. .. 1 .. .. Whooping Cough 4 1 3 .. .. .. .. 1 .. 1 1 1 .. Diphtheria and Membranous Croup 2 .. 2 .. .. .. .. .. .. 1 .. 1 .. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric 3 .. .. .. 1 2 .. 2 .. .. 1 .. 2 Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 1 .. .. .. .. 1 .. .. 1 .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa .. .. .. .. .. .. .. .. .. .. .. .. .. Enteritis 1 1 .. .. .. .. .. .. .. .. 1 .. .. Puerperal Fever 1 .. .. .. .. 1 .. .. 1 .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. Other Septic Diseases 2 .. 1 .. .. 1 .. 1 1 .. .. .. .. Phthisis 29 .. .. .. 3 23 3 4 6 6 9 4 14 Other Tubercular Diseases 2 .. .. .. 1 1 .. 1 .. .. 1 .. .. Cancer, Malignant Diseases 11 .. .. .. .. 7 4 6 1 .. 4 .. 15 Bronchitis 29 7 2 .. .. 2 18 3 7 4 14 1 11 Pneumonia 27 5 6 1 1 9 5 7 3 4 8 5 4 Pleurisy 1 .. .. .. .. .. 1 .. .. 1 .. .. .. Other Diseases of Respiratory Organs 3 .. .. .. .. 1 2 1 1 .. .. 1 1 Alcoholism 7 .. .. .. .. 5 2 2 1 2 1 1 .. Cirrhosis of Liver Venereal Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. Premature Birth 9 9 .. .. .. .. .. 2 2 .. 4 1 1 Diseases and Accidents of Parturition .. .. .. .. .. .. .. .. .. .. .. .. 2 Heart Diseases 20 .. .. 1 4 12 3 8 2 1 5 4 2 Accidents 4 .. .. .. .. 3 1 2 1 .. .. 1 .. Suicides 2 .. .. .. .. 2 .. 2 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. All other causes 54 9 4 1 5 21 14 13 9 8 18 6 32 All causes 213 32 19 3 15 91 53 55 36 28 68 26 84 9 TABLE III.—TABLE OF POPULATION, BIRTHS, AND OF NEW CASE OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, in the Sanitary District of ST. MARYLEBONE, during February, 1901; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals Population at all Ages. (b) Census 1896 36,495 19,798 19,637 32,547 32,611 141,188 Registered Births. 48 27 41 95 29 240 (d) Aged under 5 or over 5 Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards New Cases of Sickness in each Locality coming to the knowledge of thE medical Offices of Health. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina .. 2 .. 2 1 5 6 5 2 3 9 17 3. Diphtheria 1 2 .. .. 1 2 4 2 1 6 7 12 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 1.. .. 1 .. .. .. 1 .. .. .. 3 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .... 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 2 1 2 .. 3 .. 8 1 3 2 18 Number of such Cases REMOVED from their Homes in the several Localities for Treat ment in Isolation Hospital. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina .. 2 .. 1 1 4 6 3 2 3 9 13 3. Diphtheria 1 2 .. .. 1 1 4 2 1 5 7 10 4.. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. FEVERS. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 1 .. 1 .. .. .. 1 .. .. .. 3 7. Continued .. .. .. .. .. .. .. .. .. .. .. 8.. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas .. 2 .. 2 .. 1 .. 5 1 1 1 11 10 * Of the 33 deaths in the Middlesex Hospital, 22 were those of non-parishioners. Two of the 3 deaths in Queen Charlotte's Hospital, were those of non-parishioners, The death in the Samaritan Hospital was that of a non-parishioner. TABLE IV.— Giving the Causes of Deaths during the 4 Weeks ending February 23rd, 1901, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital. Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill Infirmary. Influnza ... ... ... ... ... Scarlet Fever ... ... ... ... ... Diphtheria ... ... ... ... ... Typhoid Fever 2 ... ... ... ... Diarrhœa ... ... ... ... ... Erysipelas ... ... ... ... ... Pneumonia and Pleurisy 1 ... ... ... 3 Pyæmia ... ... ... ... ... Syphilis ... ... ... ... ... Cancer 11 ... 1 ... 3 Phthisis and Tuberculosis 2 ... ... 1 11 Rheumatism ... ... ... ... Apoploxy ... ... ... ... ... Paralysis ... ... ... ... 3 Bronchitis 3 .... 1 7 Asthma ... ... ... 1 ... Peritonitis ... ... ... ... ... Disease of Brain ... ... ... ... ... „ Heart 2 ... ... ... 1 „ Kidney 3 ... ... ... 2 „ Liver 1 ... ... ... ... „ Uterus ... ... ... ... ... „ Ovary ... ... ... ... ... Parturition ... 2 ... ... ... Diabetes ... ... ... ... ... Fractures and Injuries 2 ... ... ... ... Old Age ... ... ... ... 3 Low Vitality, Infants ... 1 ... ... 2 Premature Birth ... ... ... ... Other Cause 6 ... ... 1 7 Total *33 †3 ‡1 5 42 11 TABLE V.—District Births and Deaths for the four weeks ending february 23rd, 1901. All Souls Rectory St. Mary Christ Church St. John Population in 18%. Population in 1901. Births. Deaths Males. Fmls Males Fmls. 36.595 36.595 24 24 25 30 19.798 19.798 20 7 17 19 19.637 19.637 21 20 16 12 32.547 32.547 51 44 35 33 32.611 33.011 15 14 17 9 Total 141.188 141.588 131 109 110 103 Note.—In the above the births and deaths have all been properly corrected, strangers have been eliminated, and extra-parochial deaths and others have been allotted to their proper sub-district. 12 REGISTER OF SANITARY WORK, Month ending 28th February, 1901. PUBLIC HEALTH DEPARTMENT. ] Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. T. Gorniot, No. 3 District. Mr. D. J. Andrews, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. R. Phillips. ' Special Duties. Miss L. M. O'Kell. Total. Number of Complaints received 5 12 25 13 20 3 2 80 Inspections. Of Dwelling Houses 37 34 30 35 31 29 — 196 Kitchens (separately occupied) 11 — 3 20 18 _ - 52 Schools 1 1 1 — - — — 3 Houses registered under PublicHealth(London) Act, 1891 28 14 22 29 — . 93 Dairies and Cow-houses 2 1 1 — 3 — - 7 Bakehouses 1 — — — — 78 — 79 Slaughterhouses 2 — 1 — — — — 3 Miscellaneous Inspections 130 132 139 100 137 107 219 964 Notices issued for Abatement of Nuisances, etc 4 6 4 4 5 - 1 24 Letters written relating to Abatement of Nuisances 22 18 12 35 19 - 30 136 Proceedings taken before Magistrates under Sanitary Acts... — — — — — — — — Reports made to Medical Officer of Health 30 32 45 28 47 18 12 212 Infectious Patients removed to Hospital 13 2 10 8 4 — 37 Rooms Disinfected after Infectious Disease 21 9 16 15 17 — — 78 New Pipe Drains (feet) 854 960 186 288 987 — 3275 Houses where Defects in Drainage have been detected and remedied 6 6 7 4 5 — - 28 Unwholesome Food—Number of Seizures made — — — — — — — — Food Adulteration Samples collected for Analysis 9 6 13 15 — — — 43 Proceedings taken before Magistrates — — — — — — — — Removal of Bodies to Mortuary — — 1 — — — 1 THE SANITARY CHRONICLES of the BOROUGH OF ST. MARYLEBONE DURING MARCH, 1901. Containing a Quarterly Summary of the Mortality Statistics for the Quarter ending March 23rd, 1901, and the Quarterly Statement of Analytical Work done under the Sale of Food and Drugs Act, &c. BY ALEXANDER WYNTER BLYTH, Medical Officer of Health, and Analyst of Food and Drugs, for the Borough of St. Marylebone. PRINTED BY ORDER OF THE COUNCIL. Vor,. XXI. Town Hall, St. MARYLEBONE, April 10th, 1901. No. 3. The week ending March 2nd was stormy and unsettled. Minimum temperature, 38o.0; maximum, 56o.0: mean, 44c.o. On four days rain fell, 0-38 inch. Winds NW. Sunshine, 13*7 per cent. Mean barometer, 29 2 inches. The week ending March 9th was cold and wet. Minimum temperature, 35°.0; maximum, 54o.0; mean, 43°.3. On six days rain or snow fell, 0.49 inch. Winds, WNW. Sunshine about 12 per cent. Mean barometer, 29.3 inches. The week ending March 16th was, for the season, cold. Minimum temperature, 29°.5, maximum, 52°.5; mean, 40°.9. On one day snow fell, 0.07 inch. Winds, NE. Sunshine, 2.8 per cent. Mean barometer, 29.8 inches. The week ending March 23rd was also cold, with strong NE winds. Minimum temperature, 30o.5; maximum, 47°.5; mean, 39.8. On two days rain and sleet fell, equal to 0.30 inch. Sunshine, 8.4 per cent. Mean barometer, 29.8 inches. The climate of the whole four weeks was colder and more unpleasant than usual. 28 2 Births and Deaths. During the four weeks ending March 23rd, 1901, there have been registered 268 births and 179 deaths: equal to a birth-rate of 24.7 per thousand, and a death rate of 16.5 per thousand. The average death-rate for the corresponding period was 26.3 per thousand. QUARTERLY SUMMARY. During the quarter ending March there have been registered 792 births and 613 deaths. These births and deaths are divided among the five subdistricts as set forth in Table VI. 208 of the deaths were extra-parochial, as follows:— St. Marylebone Infirmary, Notting Hill 117 Western Fever Hospital 1 North-Western Fever Hospital 8 St. Mary's Hospital 7 St. George's Hospital 2 St. Thomas' Hospital 2 Children's Hospital, Paddington 5 Children's Hospital, Great Ormond Street 1 St. Bartholomew's Hospital 1 University College Hospital 6 King's College Hospital 1 Charing Cross Hospital 1 West London Hospital 1 St. Saviour's Hospital 1 Hospital for Women, Euston Road 1 French Hospital 1 German Hospital 2 Royal Chest Hospital 1 Hanwell Asylum 9 Colney Hatch Asylum 8 Leavesden Asylum 5 Camberwell Asylum 2 Bethlem Hospital 1 Caterham Asylum 1 Ilford Asylum 2 Banstead Asylum 4 St. Anne's Home, Stoke Newington 1 Central London Sick Asylum 2 Royal Hospital for Incurables 1 St, Luke's Home, Osnaburgh Street 1 Lying-in Hospital, Endell Street 1 St. Pancras Infirmary 1 St. Pancras Workhouse 2 Brompton Hospital 1 Cheyne Hospital 1 In the Streets 5 Total 207 The birth and death-rates, as deduced from the thirteen weeks' statistics, are as follows:— All Souls, birth-rate 15.5 : death-rate 16.3. Rectory, birth-rate 20.0; death-rate 19.4. St. Mary, birth-rate 24.25: death-rate 18.1. Christ Church, birth-rate 39.0: death-rate 23.0. St. John, birth-rate 13.9; death-rate 11.1. The whole district, birth-rate 22.4; death-rate 17.36. The average death-rates for five years (1894 to 1899), for the corresponding Quarter were as follows:—All Souls, 13.8; Rectory, 27.0; St. Mary, 22.3; Christ Church, 23.7; St. John, 21.9; the whole district, 2T9. The following table gives, as usual, facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes: TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE THIRTEEN WEEKS ENDING MARCH 23rd, 1901, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 13 weeks ending Mar. 23rd, 1901. Proportion of the deaths to 1,000 deaths from all causes. 13 weeks ending Mar. 23,1901. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1895-1900. 1. Deaths from the chief Zymotic Diseases 46 75 1.30 2.99 2,Pulmonary,other than phthisis 151 246 4.26 5.95 3,Tuberculer 91 148 2.57 2.33 NOTES. 1, includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza, Whooping Cough Erysipelas, Croup, Fever, and Diarrhoea. 3, includes Phthisis, Scrofula, Rickets, and Tabes. 3 The Dust Contract. The contract for the removal of dust in the Borough, has been put into the hands of the contractors (Messrs. Ballard) for one year at the somewhat heavy cost of £10,600. From circumstances which it is unnecessary to enter into, the arrangement was only definitely completed some two days before the contract with the last contractor expired. In other words, Messrs. Ballard had suddenly to organise a staff, to provide horses, carts, and appliances for the complicated purpose of removing the house refuse from at least 1,400 houses once a week, besides collections from the kerbs of the main streets daily and from a large number of Public and quasi-public institutions. It is not to be expected that so great an undertaking, entered into with such little time for preparation, will be performed with absolute success for a few weeks; by the time however that this Report is printed and circulated, it is to be hoped that there will be no real cause of complaint. Large as the sum of £10,600 is, it may be interesting to note for what small sum yearly every ratepayer in the Borough can insist upon a horse, cart, and two men visiting, at least once in every week, his premises and clearing away his household dust. £10,600 is approximately a three halfpenny rate, therefore a householder rated at £50 pays in rates for this service 6s. 3d., a ratepayer assessed at £100 a year pays 12s. 6d., and so on. It necessarily follows that those ratepayers who "tip" the dustmen regularly in the majority of cases pay a sum equal or superior to the actual rate for the service. Cleansing of Persons Act. A considerable amount of money has been expended on appliances for the cleansing of women as well as men, but until the last few months very few women have availed themselves of the baths. 4 The number of men who have bathed and had their clothes disinfected during the thirteen weeks of the first quarter of 1901 is 1,117, the number of women 20; or, put in another way, about 50 men have been cleansed to every woman. There is therefore every probability of increase, considering that during the whole of 1900 only 28 females underwent the cleansing process. The Warming of Factories and Workshops. Under the 32nd section of the Factory and Workshops Act of 1895 "In every Factory and Workshop adequate measures shall be taken for securing and maintaining a reasonable temperature in each room in which any person is employed." There is no definition in the Act as to the meaning of a "reasonable temperature," obviously this must vary according to the nature of the employment: persons engaged in working on wood or metal, that is to say sawing, drilling, turning, riveting, or any other process demanding more or less continuous muscular exertion may feel quite comfortable in open sheds in a temperature at or below freezing point; on the other hand persons like milliners and seamstresses, sitting perfectly quiet and only moving their hands, will suffer considerable discomfort unless the workroom in winter is warmed up to a certain point. In a recent prosecution by the Home Office, in which the Sanitary Officers of this district gave evidence, it was proved that a particular workroom was on several occasions below sixty degrees and that, from the appearance of the workers, there were signs of general chilliness. It was the opinion of the writer as well as that of Dr. Legge, who has had special experience in the matter, that for this class of work, a temperature of at least sixty degrees Fahrenheit should be maintained. The magistrate adopted this view and issued an order accordingly for the defendant in future to Avarm her rooms up to that extent. It is important, therefore, for the various employers of that class of labour to note that in this district a "reasonable temperature" in winter, when artificial warming is necessary, will be interpreted to mean a temperature of about 60 degrees. 5 The Laboratory. SALE OF FOOD AND DRUGS ACTS. There have been a large number of samples analysed during the quarter, of which a tabular statement is to be found at page 12. ARSENIC IN BEER. Of the 54 samples analysed specially with regard to arsenic, all were arsenic-free This appears to be the common experience of analysts in the Metropolis. The writer has not heard of a single case in the Metropolitan area of arsenical contamination of beer. The unfortunate occurrence of the use of an arsenical glucose for brewing purposes produced illness in only well-defined localities, and happily the contaminated certain product did not find its way into the London area. MILK. Only two samples of milk were certified to be adulterated. Rosina Klumb, 10 Charlton Street, was fined 40s. with 12s. 6d. costs, for selling milk deficient in milk fat 13 per cent. William Copar, of 14 Sherborne Place, was fined £3 and 23s. costs, for selling milk adulterated with 21 per cent, of water. A Parliamentary Committee* have recently issued a Report recommending that the standard for milk fat be raised to 3.25 per cent. At present there is no standard fixed by law, but only a general agreement among analysts that there should be a presumption of abstraction, if the milk fat fall below 3 per cent. Should the proposal be adopted by the legislature, it is interesting to enquire how far the milk supply of the Borough conforms at present to such a standard. I have therefore tabulated 100 consecutive analyses of milks bought under the Act in St. Marylebone with the following result: 1 or 1 per cent. ♦Report of the Departmental Committee appointed by the Board of Agriculture on regulations desirable to be made, under Section 4 of the Sale of Food and Drugs Act, 1899, for milk and cream, 1901. 6 1901. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, AND TYPHOID FEVER DURING 1901, AS COMPARED WITH A FIVE YEARS' AVERAGE. MARCH. 7 gave over 6 per cent, milk fat; 12 per cent, gave 4.5 per cent, milk fat; 16 per cent, fell below the proposed standard of 3.25 per cent., but were 3 per cent, or a little above. In other words, in 100 samples of milk 16 would have had to be certified as presumably adulterated by the abstraction of cream, and it would have to be left to the vendor to show that the milk had not been tampered with. BUTTER. Out of 21 samples of butter, four were found to be either margarine or mixtures of margarine and butter. Proceedings are pending with regard to three of these cases, therefore the details must be deferred to a future Report. COPPERED BEANS. A sample labelled "Macedoine de Legumes" was found to be greened with copper, the copper separated by galvanic action in a metallic form weighed 1.3 grain, equivalent to five grains per pound of crystallised copper sulphate. The sample was not divided according to the Act, so that no further action could be taken. Such an amount of copper can hardly be in accordance with the demand of the purchaser; as to whether it is injurious to health is a matter upon which medical opinion is equally divided. 8 TABLE 11.—TABLE OF POPULATION, BIRTHS, AND OF NEW CASES of INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, in the Sanitary District of ST. MARYLEBONE, during the March Quarter, 1901; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals Population at all Ages. (b) Census 1896 36,495 19,798 19,637 32,647 32,611 141,188 (c) Registered Births 42 99 119 317 115 792 (d) Aged under 5 or over 5 Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards | New Casks of Sickness in each Locality coming to the knowledge op the Medical Officer of Health. 1. Smallpox 2. Scarlatina 4 7 1 6 5 12 8 11 3 13 21 49 3. Diphtheria 7 8 1 .. 1 6 10 11 2 10 21 35 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. fbvbb8. 5.Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid 1 6 1 1 .. 2 .. 2 .. 1 2 12 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. - 11. Erysipelas .. 5 1 7 .. 5 .. 14 1 7 2 38 Number of such ()asks Removed from their I Homes in the several Localities fob Treatment in Isolation Hospital. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 4 7 1 5 5 10 8 8 3 10 21 40 3. Diphtheria 6 8 1 5 10 11 2 8 19 32 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. fevers. 5.Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid 1 6 1 1 .. 1 .. 2 .. 1 2 11 . 7. Continued .. .. .. •• .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 4 .. 9 3 .. 7 1 2 1 25 9 TABLE III.—Giving the Causes of Deaths during the 13 Weeks ending March 23rd, 1901, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital. Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill. Infirmary. Influenza ... ... ... ... ... Scarlet Fever ... ... ... ... ... Diphtheria ... ... ... ... ... Typhoid Fever 4 ... ... ... ... Diarrhœa 2 ... ... 1 1 Krysipelas ... ... ... ... ... Pneumonia and Pleurisy 12 2 ... 1 7 Pyaemia 1 ... ... ... ... Syphilis ... ... ... ... 2 Cancer 36 ... 3 ... 9 Phthisis and Tuberculosis 7 ... ... 3 32 Rheumatism ... ... ... 1 1 Apoplexy 2 ... ... 1 1 Paralvsis ... ... ... ... 5 Bronchitis 7 ... ... 1 23 Asthma ... ... ... 2 ... Peritonitis 2 ... ... ... ... Disease of Brain ... ... ... ... 5 „ Heart 5 ... ... 3 3 Kidney 5 I „ Liver 4 ... ... „ Uterus ... ... ... ... ... „ Ovary 1 ... ... ... ... Parturition ... 2 ... ... ... Diabetes ... ... ... ... ... Fractures and Injuries • 6 ... ... ... ... Old Age ... ... ... 2 10 Low Vitality, Infants ... 1 ... ... 2 Premature Birth ... 2 ... I 2 Other causes 19 5 1 2 13 Total *113 †l2 ‡4 18 117 * Of the 113 deaths in the Middlesex Hospital, 82 were those of non-parishioners, † Nine of the 12 deaths in Queen Charlotte's Hospital, were those of non-parishioners. ‡ The 4 deaths in the Samaritan Hospital were those of non-parishioners. 10 TABLE IV.—District Births and Deaths for the thirteen weeks ending march 23RD, 1901. All souls Population in 1896 Population in 1901. Births. Deaths. Males. Fmls. Males Fmls. 36.595 36,595 68 74 70 79 Rectory 19,798 19,798 53 46 37 59 St. Mary 19,637 19,637 62 57 47 42 Christ Church 32,547 32,547 172 145 93 94 St. John 32,611 33,011 50 65 50 42 Total 141,188 141,588 405 387 297 316 Note.—In the above the births and deaths have all been properly corrected, strangers have been eliminated, and extra-parochial deaths and others have been allotted to their proper sub-district. 11 TABLE V.—Causes of, and Ages at. Death during the thirteen weeks ending March 23rd, 1901, in the Borough of St. Marylebone. CAUSES OF DEATH. Deaths in whole District at subjoined Ages. Deaths in Localities (at all Ages). Deaths in Public Institutions. All ages. Under 1. 1 and under 5. 5 and under 15. . 15 and under 25. 25 and under 65. 65 and upwards. All Souls. Rectory. St. Mary. Christ Church. St. Johx. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever 3 .. 2 .. .. 1 .. •• 1 •• 2 •• •• Whooping Cough 16 5 11 •• •• •• •• 1 2 2 7 4 •• Diphtheria and Membranous Croup 6 •• 6 •• •• •• •• •• 2 1 2 1 •• Croup •• •• •• •• •• •• •• •• •• •• •• •• •• Fever Typhua •• •• •• •• •• •• •• •• •• •• •• •• •• Enteric 4 •• •• •• 1 3 •• 3 •• •• 1 •• 4 pother continued •• •• •• •• •• •• •• •• •• •• •• •• •• Epidemic Influenza 6 1 •• 1 •• 1 3 2 2 2 •• •• •• Cholera - - Plague •• •• •• •• •• •• •• •• •• •• •• •• •• Diarrhoea 2 2 •• •• •• •• •• 1 •• 1 •• •• 2 Enteritis 4 4 •• •• •• •• •• •• 1 1 2 •• •• Puerperal Fever 1 •• •• •• •• 1 •• •• I •• •• •• •• Eryaiplas •• •• •• •• •• •• •• •• •• •• •• •• •• Other Septic Diseates 4 •• 1 •• •• 2 1 2 2 •• •• •• Phthisis 79 •• •• •• 11 65 3 21 13 11 24 10 42 Other Tubercular Diseases 12 2 3 •• 2 4 1 6 1 1 2 2 •• Cancer, Malignant, 29 •• •• •• •• 17 12 14 4 2 7 2 49 Bronchitis 81 16 5 2 •• 23 35 12 13 16 85 3 31 Pneumonia 69 15 12 1 2 22 17 13 8 14 21 13 14 Pleurisy 1 •• •• •• •• •• 1 •• •• 1 •• •• •• Other Diseases of Kespiratory Organs 16 4 1 •• 2 5 4 4 5 3 2 2 1 Alcoholism Cirrhosis of Liver 14 •• •• •• •• 12 2 2 1 5 3 3 •• Venereal Diseases 4 4 •• •• •• •• •• 2 •• •• 1 1 •• Premature Birth 12 12 •• •• •• •• •• 2 2 1 6 1 •• Diseases and Accidents 4 •• •• •• 1 3 •• •• •• 1 1 2 •• Heart Diseases .. 54 •• •• 2 5 28 19 13 10 4 15 12 4 Accidents 14 6 •• •• •• 6 2 3 2 3 3 3 6 Suicides 4 •• •• •• •• 4 •• 4 •• •• •• •• •• All other causes.. 174 49 11 4 8 58 44 44 26 20 53 31 94 All causes .. 613 120 52 10 32 255 144 149 96 69 187 92 248 12 TABLE VI.—Sale of Food and Drugs Acts—Samples Analysed during the March Quarter, 1901. DAIRY PRODUCTS — Genuine. Adulterated. Total. Milk 53 2 55 Butter 17 4 21 Alcoholic Beverages Whisky 10 10 Brandy 3 3 Rum 1 1 Gin 2 2 Sloe Gin 1 1 Beer 54 54 NON-ALCOHOLIC BEVERAGES— Tea 2 2 Coffee 3 3 Cocoa 3 3 CONDIMENTS— Pepper 2 2 Mustard 2 2 Worcester Sauce 1 1 DRUGS— Quinine 1 1 Rhubarb Powder 1 1 Liquorice Powder 1 1 Sodic Bicarbonate 1 1 SACCHARINE SUBSTANCES— Sweets 4 4 Golden Syrup 2 2 Honey 5 5 Jam . 12 12 TINNED & BOTTLED GOODS— Condensed Milk 1 1 Apricots 1 1 Pineapple. 1 1 Sugar Corn 1 1 Baked Beans 1 1 Chicken and Tongue Paste 1 1 Bottled Peas 1 2 Bottled Beans 1 1 1 MISCELLANEOUS— Lard 1 1 Pea Flour 1 1 Desiccated Soup 1 1 192 7 199 REGISTER OF SANITARY WORK, Month ending 31st March, 1901. PUBLIC HEALTH DEPARTMENT. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. T. Gorniot, No. 3 District. Mr. D. J. Andrews, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell. Total. Number of Complaints received 8 9 • 24 • 29 16 2 15 103 Inspections. Of Dwelling Houses 34 36 30 35 37 — — 172 ,, Kitchens (separately occupied) 11 — 4 20 7 — — 42 „ Schools 1 1 1 — — — — 3 „ Houses registered under PublicHealth(London) Act, 1891 32 — 16 22 26 — — 96 „ Dairies and Cow-houses 2 1 1 — 5 — —- 9 „ Bakehouses 1 — — — — — — 1 „ Slaughterhouses 2 1 — — 1 — 4 „ Miscellaneous Inspections 82 82 190 150 68 304 364 1240 Notices issued for Abatement of Nuisances, etc 11 2 3 15 3 — — 34 Letters written relating to Abatement of Nuisances 21 13 12 i 15 11 — 25 97 Proceedings taken before Magistrates under Sanitary Acts — —j _ — — — — Reports made to Medical Officer of Health 28 32 45 30 47 4 6 192 Infectious Patients removed to Hospital 6 1 14 9 11 — — 41 Rooms Disinfected after Infectious Disease 11 4 23 19 — 66 New Pipe Drains (feet) | 1076 1230 907 j 790 1176 - - 5179 Houses where Defects in Drainage have been detected and remedied 7 4 6 9 5 — — 31 Unwholesome Food — Number of Seizures made — — *1 — 1 Food Adulteration. 'Samples collected for Analysis 17 24 17 15 31 — — 104 Proceedings taken before Magistrates — 1 — 1 — — 2 Removal of Bodies to Mortuary — — — 2 — — — 2 *1 box of Haddock Roes. 13 SANITARY CHRONICLES OF THE BOROUGH OF ST. MARYLEBONE DURING APRIL, 1901. BY ALEXANDER WYNTER BLYTH, Medical Officer of Health, and Analyst of Food and Drugs, for the Borough of St. Marylebone. PRINTED BY ORDER OF THE COUNCIL. Vol. XXI. Town Hall, St. Marylebone, May 4th, 1901. No. 4 The week ending March 30th was cold, and damp. Minimum temperature, 24°.2; maximum, 47°.5; mean, 34°.2. On three days rain or snow or sleet fell, giving a rainfall equal to 0.44 inch. The winds were Northerly and South-Westerly. Sunshine registered equal to 24 per cent. Mean barometer, 29.6 inches. The week ending April 6th was warmer. Minimum temperature, 31°.8; maximum, 83°.8; mean, 48°.0. On four days rain fell, 0.94 inch. Winds, WNW. Sunshine, 22.4 per cent. Mean barometer, 29.7 inches. The week ending April 13th was wet. Minimum temperature, 35o.0; maximum, 60°.0; mean, 48°.3. On seven days rain fell 0.84 inch. The winds were SW. Sunshine, 23.8 per cent. Mean barometer, 29.5 inches. The week ending April 20th was finer. Minimum temperature, 35°.5; maximum, 660.5; mean, 50°.7. On four days rain fell, 0.40 inch. Winds, WNW. Sunshine, 42.5 per cent. Mean barometer, 29.8 inches. The week ending April 27th was bright, warm and summer-like. Minimum temperature, 41°.0; maximum, 72o.0 ; mean, 59o.0. No rain fell. Sunshine, no less than 72.7 per cent. Winds, ESE. Mean barometer, 29.8 inches. Births and Deaths. During the five weeks ending April 27th, 1901, there have been registered 310 births and 211 deaths. These births and deaths are divided among the sub-districts as set forth in Table IV. Sixty-four of the deaths were extraparochial, as follows:— • St. Marylebone Infirmary, Notting Hill . 39 North-Western Fever Hospital 4 St. Mary's Hospital 7 Children's Hospital, Great Ormond Street 1 Children's Hospital, Paddington Street 2 Brompton Hospital 1 French Hospital 2 Camberwell House Asylum 1 Banstead Asylum 2 Colney Hatch Asylum 1 Darenth Asylum 1 St. Pancras Workhouse 1 St. Joseph's Home 1 Friedenheim 1 Total 64 The birth and death-rates, as deduced from the five weeks' statistics, are as follows:— All Souls, birth-rate 16.5: death-rate 11.3. Rectory, birth-rate 21.6; death-rate 17.5. St. Mary, birth-rate 26.5; death-rate 14.0. Christ Church, birth-rate 39.4; death-rate 22.8. St. John, birth-rate 9.9; death-rate 11.7. The whole district, birth-rate 22.8; death-rate 15.7. The average death-rates for five years (1895 to 1900) were as follows : — All Souls, 11.9; Rectory, 23.9; St. Mary, 20.1; Christ Church, 20.7; St. John, 18.9; the whole district, 19.1. 9 3 TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE FIVE WEEKS ENDING APRIL 27th, 1901, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES Total Deaths. 5 weeks ending Apl. 27th, 1901. Proportion of the deaths to 1,000 deaths from all causes. 5 weeks ending Apl.27,1901. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1895-1900. 1. Deaths from the chief Zymotic Diseases 18 85 1.32 2.65 2. Pulmonary, other than Phthisis 47 228 3.47 5.00 3. Tubercular 23 109 1.69 2.07 The following table gives, as usual, facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes: Census, 1901. The crude uncorrected totals of the enumerated population of the different districts have been published, from which it would seem that the population of St. Marylebone has sank to 133,329. In 1896 the population was estimated at 141,188. In round numbers, therefore, the population has decreased from 141,000 to 133,000, a decrease of 8,000. The calculated birth and death rates for the last two or three years are, therefore, too low by about 1 per 1,000. Taking, for instance, the death-rate of the Borough for the past five weeks, this, calculated on the old figures, gives 15.7 per 1,000; on the recent enumeration, 16.4. Until the official figures are published, however, showing the distribution of the population, the results cannot be properly used or discussed. Plague. The Health Officers for the various Ports continue to take the addresses of passengers arriving in this country from plague infected parts, and to forward the same to the various districts to which the passengers are bound. A considerable number of such passengers are supposed to have arrived in the Borough during the last five weeks, but in about ninety per cent, the addresses cannot be verified. It would thus appear that either the passenger knowingly gives a false address, or that circumstances occur altering his destination. If the Marylebone experience is any indication of what occurs generally, then the matter is one demanding legislation. It is obviously most important that in such a disease as plague all persons coming from an infected locality should be, for a week at all events, under the surveillance of the Sanitary Officers of any district in which they reside, and it should be incumbent on them to notifiy to the authorities their movements within the time of possible incubation. Such a course would not interfere with personal liberty, nor should it cause annoyance or inconvenience. 4 1901. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, AND TYPHOID FEVER DURING 1901, AS COMPARED WITH A FIVE YEARS' AVERAGE. APRIL. 45 5 Re-adjustment of the Sanitary Inspectors' Districts. The changes that have taken place in the Borough from the advent of the Great Central Railway and other causes have rendered imperative a re-adjustment of the districts of the Sanitary Inspectors. Therefore, the districts of Messrs. Yeo, Andrews, and Gorniot have been rearranged, Mr. Yeo's district will now be all east of Wimpole Street. Mr. Gorniot's the west side of Wimpole Street, on the east a line drawn through Old Quebec Street continued up through Montagu Street and Balcombe Street to Rossmore Road, the southern boundary being formed of Oxford Street, and the northern, Rossmore Road and Regent's Park, taking in also the Great Central Goods Depot. Mr. Andrew's district will be bounded on the east by the Milton Street line already mentioned, the west by the Edgware Road, the north by an irregular line running through Linton Street, Devonshire Street, Grove Road, up to Rossmore Road. Mr. Perry's and Mr. Hodges's districts remain as before. 48 6 TABLE II. —Giving the Causes of Deaths during the 5 Weeks ending April 27th, 1901, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital. Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill. Infirmary. Influenza ... ... ... ... ... Scarlet Fever ... ... ... ... ... Diphtheria ... ... ... ... ... Typhoid Fever ... ... ... ... ... Diarrhoea ... ... ... ... ... Erysipelas ... ... ... ... ... Pneumonia and Pleurisy 4 ... ... ... 4 Pyaemia ... ... ... ... ... Syphilis ... ... ... ... ... Cancer 16 ... 1 ... 3 Phthisis and Tuberculosis 5 1 ... 1 7 Rheumatism ... ... ... ... ... Apoplexy ... ... ... ... ... Paralysis ... ... ... ... 5 Bronchitis 1 ... ... ... 5 Asthma ... ... ... ... ... Peritonitis ... ... ... ... ... Disease of Brain ... ... ... ... ... „ Heart 1 ... ... 3 1 Kidney 1 ... ... ... 4 Liver 1 ... ... ... ... Uterus ... ... ... ... ... Ovary ... ... ... ... ... Parturition ... ... ... ... ... Diabetes ... ... ... ... ... Fractures and Injuries 3 ... ... ... ... Old Age ... ... ... ... 4 Low Vitalitv, Infants ... 2 ... ... ... Premature Birth ... ... ... ... ... Other causes 9 ... ... 2 6 Total *41 †3 ‡1 6 39 * Of the 41 deaths in the Middlesex Hospital, 34 were those of non-parishioners. f The 3 deaths in Queen Charlotte's Hospital, were those of non-parishioners, 2 of them were infants. f The death in the Samaritan Hospital was that of a non-parishioner. 47 7 TABLE III.—TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the lcnowledge of the Medical Officer of Health, in the Sanitary District of ST. MARTLEBONE, during April, 1901; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals Population at all Ages. (b) Census 1896 36,495 19,798 19,687 32,547 32,611 141,188 (c) Registered Births .. 60 42 49 129 30 310 (d) Aged under 5 orover 5 Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards New Cases of Sickness in each Locality coming to the knowledge of thb mbdical Offices of Health. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina .. 7 2 2 .. 2 6 7 3 6 11 24 3. Diphtheria 2 .. .. 1 2 3 3 3 1 5 8 12 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fbvbbs. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. .. .. 3 .. .. .. 3 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. 1 .. .. .. 1 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 4 .. 2 .. 4 .. 4 .. 4 .. 18 Numbbb of such Cases Removed from thbib Homes in the several Localities fob Tbeatmbnt in Isolation Hospital. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina .. 6 .. .. .. 1 .. 6 3 6 10 21 3. Diphtheria 2 .. .. .. 2 1 2 2 1 4 7 7 4. Membranous Croup. .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. .. .. 2 .. .. .. 2 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. \9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 1 .. 1 .. .. .. 2 .. 1 .. 5 48 8 TABLE IY.—District Births and Deaths for the five weeks ending April 27th, 1901. Population ill 1866. Births. Deaths. Males. Fmls Males Fmls. 36.595 «3 27 19 2?, Rectory 19.798 21 21 18 16 St. Mary 19,637 27 22 14 12 Christ Church 32,547 68 61 43 30 St. John 32,611 14 16 21 15 Total 141,188 163 147 115 95 Note.—In the above the births and deaths have all been properly corrected, strangers have been eliminated, and extra-parochial deaths and others have been allotted to their proper sub-district. 49 9 TABLE V.—Causes of, and Ages at, Death daring the five weeks ending April 27th, 1901, in the Borough of St. Marylebone. CAUSES OF DEATH. Deaths in whole District at subjoined Ages. Deaths in Localities (at all Ages). Deaths in Public Institutions. All ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. All Souls. Kectory. St. Mary. Christ Church. St. John. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever 1 .. 1 .. .. .. .. .. .. .. 1 .. .. Whooping Cough 11 7 4 .. .. .. .. .. 1 3 4 3 .. Diphtheria and Membranous Croup Croup 4 2 2 .. .. .. .. .. .. .. 3 1 .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric .. .. .. .. .. .. .. .. .. .. .. .. .. Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 2 .. 1 .. .. 1 .. .. .. .. 1 1 .. Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. Other Septic Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. Phthisis 14 .. .. 1 .. 11 2 4 4 1 1 4 14 Other Tubercular Diseases 9 2 .. .. .. 5 2 1 2 .. 4 2 .. Cancer, Malignant Disease 14 .. .. .. .. 7 7 5 2 2 3 2 20 Bronchitis 24 .. 3 .. .. 7 14 9 4 2 6 3 6 Pneumonia 23 8 .. 1 .. 13 1 5 5 5 8 .. 8 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Kespiratory Organs .. .. .. .. .. .. .. .. .. .. .. .. .. Alcoholism Cirrhosis of Liver 2 .. .. .. .. 1 1 .. 1 .. 1 .. .. Venereal Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. Premature Birth .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases and Accidents of Parturition 2 .. .. .. 2 .. .. .. .. 2 .. .. Heart Diseases 17 1 .. 1 .. 7 8 3 4 3 6 1 5 Accidents 6 1 .. .. .. 5 .. 1 2 1 1 1 7 Suicides 1 .. .. .. .. 1 .. 1 .. .. .. .. .. All other causes 81 23 5 1 4 25 23 13 9 9 32 18 30 All causes 211 44 16 4 6 83 58 42 34 26 73 36 90* * 37 of the 90 were not residents in the District. 50 10 REGISTER OF SANITARY WORK, Month ending 30th April, 1901. PUBLIC HEALTH DEPARTMENT. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. T. Gorniot, No. 3 District. Mr. D. J. Andrews, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell. Total. Number of Complaints received 18 9 20 22 20 3 2 94 Inspections. Of Dwelling Houses 45 32 30 43 35 38 — 223 „ Kitchens (separately occupied) 2 — 5 20 16 — — 43 „ Schools 1 1 — — 1 — — 3 „ Houses registered under PublicHealth(London) Act, 1891 35 12 22 19 — 88 „ Dairies and Cow-houses 2 1 1 — 3 — — 7 „ Bakehouses 1 — — — — 48 — 49 „ Slaughterhouses 3 — — — — — — 3 „ Miscellaneous Inspections 160 138 156 130 141 89 218 1032 Notices issued for Abatement of Nuisances, etc 6 3 4 4 5 — 1 23 Letters written relating to Abatement of Nuisances 21 10 13 27 11 2 8 92 Proceedings taken before Magistrates under Sanitary Acts. — — — — — — 1 Reports made to Medical Officer of Health 38 32 40 30 43 10 8 201 Infectious Patients removed to Hospital 15 3 14 9 4 — — 45 Rooms Disinfected after Infectious Disease 22 8 21 10 15 — — 76 New Pipe Drains (feet) 1260 1236 986 1344 1617 — — 6443 Houses where Defects in Drainage have been detected and remedied 8 8 7 16 5 44 Unwholesome Food — Number of Seizures made — — — — — Food Adulteration. 'Samples collected for Analysis 6 — 4 — — — — 10 Proceedings taken before Magistrates — 1 2 — — — — 3 Removal of Bodies to Mortuary — — — — — — — — THE SANITARY CHRONICLES of the BOROUGH OF ST. MARYLEBONE DURING MAY, 1901. BY ALEXANDER WYNTER BLYTH, Medical Officer of Health, and Analyst of Food and Drugs, for the Borough of St. Marylebone. PRINTED BY ORDER OF THE COUNCIL. Vol. XXI. Town Hall, St. Mabylebone, June 3bd, 1901. No. 5. The week ending May 4th was rainless. Minimum temperature, 34° ; maximum, 66°.7 ; mean, 53°.5. Winds, NE. Sunshine registered, 41.4 per cent. Mean barometer, 30 inches. The week ending May 11th was less bright and summer-like. Minimum temperature, 40.0° ; maximum, 50.2° ; mean, 48.9°. Winds WNYV. Rain fell on four days, 0.61 inch. Mean barometer, 29.6 inch. The week ending May 18th was rainless and exceptionally sunny. Minimum temperature, 37.5° ; maximum, 56.0°. Winds ENE. Sunshine registered 62.8 per cent. Mean barometer 30.2 inches. The week ending May 25th was also rainless and bright. Minimum temperature, 42.5° ; maximum, 76.0° ; mean, 60.3°. Winds ESE. Sunshine 62 per cent. Mean barometer 30.2 inches. The four weeks considered as a whole were exceptionally mild, dry and bright. 52 Births and Deaths. During the four weeks ending May 25th, 1901, there have been registered 250 births and 177 deaths. These births and deaths are divided among the five sub-districts as set forth in Table V. Eighty-one of the deaths were extraparochial, as follows:— St. Marylebone Infirmary, Notting Hill 56 North-Western Fever Hospital 1 Western Fever Hospital 2 Children's Hospital, Paddington 1 St. Mary's Hospital 3 St. Bartholomew's Hospital 1 London Fever Hospital 1 Brompton Hospital 1 Fountain Fever Hospital 1 Hanwell Asylum 3 Cane Hill Asylum 1 Banstead Asylum 1 Leavesden Asylum 1 St. Joseph's Home 2 Medical and Surgical Home, Fitzroy Square 1 St. Pancras Workhouse 1 St. Giles' Workhouse 1 In various streets 3 Total 81 The birth and death-rates, as deduced from the four weeks' statistics, are as follows :— All Souls, birth-rate 19.1; death-rate 15.2. Rectory, birth-rate 17.6 ; death-rate 14.4. St. Mary, birth-rate 33.0 ; death-rate 18.7. Christ Church, birth-rate 30.2; death-rate 16.1. St. John, birth-rate 19.; death-rate 23.. The whole district, birth-rate 24.4; death-rate 17.2. 53 The average death-rates for five years (1895 to 1900) for the corresponding period were as follows All Souls, 13.5 ; Keetory, 20.1 ; St. Mary, 18.2 ; Christ Church, 20.1; St. John, 22.4; the whole district, 18.5. The following table gives, as usual, facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes: TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE FOUR WEEKS ENDING MAY 25th, 1901, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 4 weeks ending May 25th, 1901. Proportion of the deaths to 1,000 deaths from all causes. 4 weeks ending May 25,1901. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1895-1900. 1. Deaths from the chief Zymotic Diseases 14 79 1.36 2.58 2. Pulmonary, other than Phthisis 33 186 3.21 3.66 3. Tubercular 15 85 1.46 1.88 NOTES. 1, includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza, Whooping Cough Erysipelas, Croup, Fever, and Diarrhoea. 3, includes Phthisis, Scrofula, Rickets, and Tabes. 54 The Census Returns. The Census returns, as compared with the Census of 1896, show the following facts :— A decrease in the district of All Souls of 1,201; a decrease in the district of St. Mary of 1,538 ; a decrease in the district of St. John of 12,185. On the other hand the Rectory shows an increase of 71, and the district of Christ Church an increase of 6,994. The net result for the whole district being that the population has decreased 7,859 from the enumerated figures of 1896, or about 9,000 from those of 1891. The explanation of the above figures is fairly obvious. In All Souls, denselypopulated streets, such as Union-street and Saville Street, have been pulled down and converted into residential flats. In this case there will not only be a decrease, but a change in the character of the population. In St. Mary's the termination of the leases on the Portman estate has resulted in the clearing of a large block of tenement property in Queen Street, Brown Street, Moore Street, and Seymour Place. Probably when the contemplated artisans' dwellings have been erected on the site, St. Mary's will, in great measure, recover its population. The enormous decrease in St. John's Wood is due to the Great Central Railway extension, as well as to the termination of leases. It is probable that during the next few years the population of this sub-district, will show a large increase, because various extensive building schemes are to be carried out. On the other hand, the notable increase of Christ Church is evidently due to the displaced population from the other districts finding homes within that already crowded locality. Cleansing of Persons Act. During four weeks of May there have been cleansed 323 persons, who at the same time have had their clothes disinfected. This number includes 10 females. 55 Report under the Housing of the Working Classes Act. The following Report has been submitted to the Council:— To the Mayor, Aldermen, and Councillors of the Metropolitan Borough of St. Marylebone. Gentlemen, In my Annual Report for 1883 (p. 124) will be found the following remarks :— " Devonshire Place, Lisson Grove, contributes to raise the death-rate of the Christ Church district. It is a sort of court with a paved yard ; its shape is that of a rectangle, one entrance being in Salisbury Street, the other in Devonshire Street. It consists of 26 houses, containing 273 inhabitants, thus averaging a little over 19 a house. The inhabitants are composed of general labourers, bricklayers' labourers, ostlers, hawkers, and others, with their wives and families, each family as a rule occupying one room. I have never found the sanitary state of the one side even reason ably good; sixteen of the houses have damp foundations; most of the drains are constructed of brick and are in a bad condition. The death rate is high, seven years of deaths yield an average rate of a little over 39 per thousand. Consumption in its various forms, maladies of the chest, and zymotic diseases are in excess." In January, 1884, I reported Nos. 2 to 17 under the Act then in force (Torrens' Act) as unfit for habitation. The Surveyor (Mr. Tomkins) was called upon under that Act to make a report. The Surveyor's Report, dated February 7th, 1884, enumerates the various structural defects, and concludes as follows :—" I am of opinion that the thorough repair of the roofs and gutters, the proper repair of the defective ceilings and floors, the repaving of those yards that need it, the substitution of 6-in. glazed stoneware drain pipes, properly laid, for the existing brick drains, the excavation of the ground under the floors in the ground floors, inserting air bricks back and front, the repair 56 or renewal of the water service where found defective, and the underpinning with a proper damp course of those walls where such is found necessary, with thorough cleansing and lime whitening, will render these houses fit for habitation. The various repairs were, more or less perfectly, carried out, but as will be shown, have had no marked influence on the high mortality, nor upon the sanitary state of the court. The history of Devonshire Place clearly shows that the evil lies deeper than can be touched by paving, cleansing, and whitewashing. A house-to-house inspectioa of Devonshire Place this year shows that 25 of the 26 houses are inhabited by 93 families, the number of rooms occupied being 131, which works out very little more than a room per family. In fact, Devonshire Place is essentially a locality in which the rule is that each room is occupied by a single family. The average death rate for the past five years has been 38 per thousand, the average zymotic rate, 8.93 per thousand, and the average rate from consumptive or tubercular maladies 6'71 per thousand, as compared with the following average figures for the whole district for the corresponding period :— Death rate, 21.1 ; zymotic rate, 2.61; tubercular rate, 2.15. I therefore deem it my duty to report under the Housing of the Working Classes Act, 1890, the small area shown in the accompanying plan comprising 26 houses in Devonshire Place, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, Devonshire Street, and Nos. 2, 4, 6, 8, Salisbury Street, as an unhealthy area and one which it is necessary to demolish and reconstruct and rearrange. I further submit that the area is too small to be dealt with under Part I. of the Housing of the W orking Classes Act. Section 39 of the said Act (b) states " Where it appears to the local authority that the closeness, narrowness, and bad arrangement or bad condition of any buildings, or the want of light, air ventilation, or any other sanitary defect in any buildings, is dangerous or prejudicial to the health of the inhabitants either of the said buildings or of the neighbouring buildings, and that the demolition or the recon- 1901, CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER. DIPHTHERIA, AND TYPHOID FEVER DURING 1901, AS COMPARED WITH A FIVE YEARS' AVERAGE. MAY. 57 struction and rearrangement of the said buildings, or of some of them is necessary to remedy the said evils and that the area comprising the buildings, and the yards, out-houses, and appurtenances thereof and the site thereof, is too small to be dealt with as an unhealthy area under Part I. of this Act, the local authority shall pass a resolution to the above effect and direct a scheme to be prepared for the improvement of the said area." The course, therefore, appears to be, that if after consideration the Council agree with the general tenor of this Report, a formal resolution under the Act will be necessary before a scheme is actually prepared. I am, your obedient Servant, * A. WYNTER BLYTH, Medical Officer of Health. The Town Hall, June Sth, 1901. 58 TABLE II.—Causes of, and Ages at, Death during the four weeks ending May 25th, 1901, in the Borough of St. Marylebone. CAUSES OF DEATH. Deaths in whole District at subjoined Ages. Deaths in Localities (at all Ages). Deaths in Public Institutions, All ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. All Souls. Rectory. St. Mary. Christ Churcm. St. John. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 2 .. 2 .. .. .. .. 1 .. .. .. .. .. Scarlet Fever 1 .. 1 .. .. .. .. .. .. .. 1 .. .. Whooping Cough 5 2 3 .. .. .. .. 1 1 1 .. .. .. Diphtheria and Membranous Croup 2 .. 1 1 .. .. .. .. .. 1 .. 1 .. Croup 1 .. 1 .. .. .. .. .. .. .. 1 .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric .. .. .. .. .. .. .. .. .. .. .. .. .. Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhoea 2 2 .. .. .. .. .. 2 .. .. .. .. 1 Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 1 .. .. .. .. .. 1 1 .. .. .. .. 1 Other Septic Diseases.. .. .. .. .. .. .. .. .. .. .. .. .. .. Phthisis 15 2 .. 1 2 10 .. 2 1 2 2 4 12 Other Tubercular Diseases 1 .. .. •• 1 .. .. .. .. .. .. .. .. Cancer, Malignant Disease 12 .. .. .. .. 10 2 9 3 1 1 2 11 Bronchitis 9 .. .. .. .. 1 5 3 2 2 4 1 4 Pneumonia 22 5 5 .. 1 10 1 3 3 2 8 5 4 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Respiratory Organs 2 .. .. .. .. 2 .. 1 3 1 .. 1 .. Alcoholism Cirrhosis of Liver 1 .. .. .. .. 1 .. .. .. .. 1 .. .. Venereal Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. Premature Birth 3 3 .. .. .. .. .. .. 1 1 2 .. .. Diseases and Accidents 1 .. .. .. .. 1 .. 1 .. 1 .. .. .. Heart Diseases 16 1 .. .. 1 5 9 1 .. 3 9 5 .. Accidents 4 .. .. 1 .. 1 2 1 .. .. 1 2 3 Suicides 2 .. .. .. .. 2 .. .. .. 2 .. .. .. All other causes 75 16 3 1 3 25 27 17 8 9 19 16 47 All causes 177 31 16 4 8 71 47 43 22 26 49 37 83 59 TABLE III.—TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, in the Sanitary District of ST. MARYLEBONE, during May, 1901; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals Population at all AOBS. (b) Census 1901 35,394 19,869 18,099 39,541 20,426 133,329 (c) Registered Births 51 27 46 92 31 250 (d) Aged under 5 orover 5 Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards New Cases of Sickness in bach Locality coming to thb knowledge of thb medical Offices of Hbalth. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina .. 3 .. 2 2 10 3 5 6 8 11 28 3. Diphtheria 2 5 1 .. 2 7 .. 7 3 2 8 21 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fbvbbs. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 2 .. .. .. .. .. .. .. 1 .. 3 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. 1 .. .. .. .. .. .. .. .. .. 1 10. Cholera. .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 5 .. 3 .. 2 1 6 .. 5 1 21 Number of such Cases Rknovbd fbom their Homes in thb sbtbbal Localities fob Tbbatment in Isolation Hospital. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina .. 2 .. 2 1 8 .. 5 5 5 9 22 5. Diphtheria . 2 4 1 .. 1 5 .. 6 3 1 7 16 4. Membranous Croup. .. .. .. .. .. .. .. .. .. .. .. .. Fbvbbs. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 1 .. .. .. .. .. .. .. 1 .. 2 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 2 .. 2 .. .. .. 1 .. .. .. 5 60 TABLE IV.— Giving the Causes of Deaths during the 4 Weeks ending May 25th, 1901, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital. Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill. Infirmary. Influenza ... ... ... ... ... Scarlet Fever ... ... ... ... ... Diphtheria ... ... ... ... ... Typhoid Fever ... ... ... ... ... Diarrhoea ... ... ... ... 1 Erysipelas ... ... ... ... 1 Pneumonia and Pleurisy 1 ... ... ... 4 Pyæmia 1 ... ... ... ... Syphills 1 1 ... ... ... Cancer 6 ... ... ... 5 Phthisis and Tuberculosis 1 ... ... ... 12 Rheumatism ... ... ... ... ... Apoplexy 1 ... ... ... 2 Paralysis ... ... ... ... 3 Bronchitis 1 1 ... ... 2 Asthma ... ... ... ... ... Peritonitis ... ... ... 1 ... Disease of Brain ... ... ... ... ... „ Heart 3 ... ... ... 5 „ Kidney l ... ... ... 6 „ Liver ... ... ... ... 1 ,, Uterus ... ... ... ... ... „ Ovary ... ... ... ... ... Parturition ... ... ... ... ... Diabetes ... ... ... ... ... Fractures and Injuries ... ... ... ... 2 Old Age ... ... ... ... 7 Low Vitality, Infants ... ... ... ... ... Premature Birth ... 1 ... ... ... Other causes 4 ... 1 ... 5 Total *21 †3 ‡2 1 56 * Of the 21 deaths in the Middlesex Hospital, 9 were those of non-parishioners, †Two of the 3 deaths in Queen Charlotte's Hospital, were those of non-parishioners. ‡ The 2 deaths in the Samaritan Hospital were those of non-parishioners. 61 TABLE V.—District Births and Deaths for the four weeks ending MAY 25TH, 1901. Population in ltOl Births. Deaths. Males. Fmls. Males Fmls. All Souls 35,394 22 32 ?,1 22 Rectorv 19,869 13 14 14 8 St. Mary 18,099 27 19 10 16 Christ Church 39,541 51 41 23 26 St. John 20,426 15 16 23 14 Total 133,329 128 122 91 86 Note.—In the above the births and deaths have all been properly corrected, strangers have been eliminated, and extra-parochial deaths and others have been allotted to their proper sub-district. 62 REGISTER OF SANITARY WORK, Month ending 31st May. 1901. PUBLIC HEALTH DEPARTMENT. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. T. Gorniot, No. 3 District. Mr. D. J. Andrews, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell. Total Number of Complaints received 12 16 14 16 15 3 8 84 Inspections. 'Of Dwelling Houses 36 23 20 25 27 — — 131 „ Kitchens (separately occupied) 2 — — 20 14 — — 36 „ Schools 1 1 1 — 1 — — 4 „ Houses registered under PublicHealth(London) Act, 1891 30 — 10 22 25 — — 87 „ Dairies and Cow-houses 8 1 1 16 5 — — 26 „ Bakehouses 1 — — — — 40 — 41 „ Slaughterhouses 2 — — — 1 — — 3 „ Miscellaneous Inspections 160 147 145 150 137 220 320 1279 Notices issued for Abatement of Nuisances, etc 4 3 1 1 7 — 16 Letters written relating to Abatement of Nuisances 16 10 12 15 13 1 15 82 Proceedings taken before Magistrates under Sanitary Acts. — — — — — — — — Reports made to Medical Officer of Health 36 36 40 31 43 — 7 193 Infectious Patients removed to Hospital 16 7 2 23 5 — — 53 Rooms Disinfected after Infectious Disease 22 14 4 27 11 — — 78 New Pipe Drains (feet) 950 1230 890 669 1132 — — 4871 Houses where Defects in Drainage have been detected and remedied 7 3 4 9 3 — — 26 Unwholesome Food — Number of Seizures made — — — — — — — — Food Adulteration. Samples collected for Analysis 11 17 17 16 23 — — 84 Proceedings taken before Magistrates — — — — — — — — Removal of Bodies to Mortuary — — — — — — — — THE SANITARY CHMICMS OF THE BOROUGH OF ST. MARYLEBONE DURING JUNE, 1901. Containing a Quarterly Summary of the Mortality Statistics for the Quarter ending June 22nd, 1901, and the Quarterly Statement of Analytical Work done under the Sale of Food and Drugs Act, &c. BY ALEXANDER WYNTER BLYTH, Medical Officer of Health, and Analyst of Food and Drugs, for the Borough of St. Marylebone. PRINTED BY ORDER OP THE COUNCIL. Vol. XXI. Town Hall, St. Mabylebone, July 6th, 1901. No. 6. The week ending June 1st was dry and fine. Minimum temperature, 44.0°; maximum, 82.8°; mean, 65.00. Winds, light and variable. On one day rain fell 0.01 inch. Sunshine, 41.0 per cent. Mean barometer, 29.8 inches. The week ending June 8th was fine and rainless. Minimum temperature, 56.0° ; maximum, 72.0° ; mean, 63.1°. Winds, variable. Sunshine, 48 per cent. Mean barometer, 30.1 inches. The week ending June 15th was sunny and generally fine. Minimum temperature, 41.5° ; maximum, 80.0° ; mean, 60.4°. On two days slight rain fell, 0.1 inch. Winds WNW. Sunshine, 45.6 per cent. Mean barometer, 29.8 inches. The week ending June 22nd had similar weather to the preceding. Minimum temperature, 40.0° ; maximum, 75.5° ; mean, 60.8°. On two days slight rain fell, 0.04 inch. Mean barometer 30.0 inches. 64 Births and Deaths. During the four weeks ending June 22nd, 1901, there have been registered 231 births and 151 deaths; equal to a birth-rate of 22.5 per thousand, a death-rate of 14.7 per thousand. The average death-rate for the five previous years was 18.1 per thousand. QUARTERLY SUMMARY. During the quarter ending June 22nd, there have been registered 791 births and 539 deaths. These births and deaths are distributed among the five sub-districts as set forth in Table VI. Two hundred and eighteen of the deaths were extra-parochial, as follows :— St. Marylebone Infirmary, Notting Hill 134 Northern Fever Hospital 1 North-Western Fever Hospital 6 Western Fever Hospital 3 Fountain Fever Hospital 1 London Fever Hospital 1 St. Mary's Hospital 21 St. Bartholomew's Hospital 1 U niversity College Hospital 2 Charing Cross Hospital 1 Children's Hospital, Paddington 4 Children's Hospital, Great Ormonde Street 1 Brompton Hospital 4 French Hospital 3 Camberwell House Asylum 1 Leavesden Asylum 3 Banstead Asylum 3 Colney Hatch Asylum 2 Cane Hill Asylum 1 Darenth Asylum 1 Hanwell Asylum 5 City Infirmary 1 St. Pancras Infirmary 1 St. Pancras Workhouse 3 St. Giles Infirmary 1 Poplar Workhouse 1 Private Hospital, Warrington Lodge 1 St. Anne's House 1 St. Joseph's Home 3 St. Luke's Home 1 Medical and Surgical Home, Fitzroy Square 1 Friedenheim 1 In various streets 4 Total 218 65 The birth and death-rates, as deduced from the thirteen weeks' statistics, are as follows :— All Souls, birth-rate 17.2; death-rate 13.6. Rectory, birth-rate 21.3 ; death-rate 15.5 St. Mary, birth-rate 29.6 ; death-rate 17.0. Christ Church, birth-rate 31.3; death-rate 21.5. St. John, birth-rate 17.6; death-rate 19.0. The whole district, birth-rate 23.7; death-rate 16.2. The average death-rates for five years (1895 to 1900) for the corresponding Quarter were as follows : —A.11 Souls, 13.9 ; Rectory, 22.0 ; St. Mary, 19.2 ; Christ Church, 19.2; St. John, 21.8; the whole district, 18.6. The following table gives, as usual, facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes: TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE 13 WEEKS ENDING JUNE 22nd, 1901, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 13 weeks ending June 22nd, 1901. Proportion ofthedeaths to 1,000 deaths from all causes. 13 weeks ending June 22,1901. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1895-1900. 1. Deaths from the chief Zymotic Diseases 51 94 1.53 2.40 2. Pulmonary, other than Phthisis 100 185 3.00 4.06 3. Tubercular 65 121 2.70 2.05 NOTES. 1, includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza, Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. 3, includes Phthisis, Scrofula, Rickets, and Tabes. 66 Small-Pox. The district in common with the whole Metropolis continues to be free from anything like an epidemic of smallpox, notwithstanding its prevalence during the past three months in various large centres. An imported case did occur, however, under the following circumstances :— A young American developed, at one of the hotels in the neighbourhood of ChariDg Cross, a feverish attack, and a few pimples made their appearance ; the medical man in attendance considered the case one of chicken pox, caught apparently in Paris. The patient was removed to a house in the borough, to be nursed by an experienced nurse. This nurse, a woman of 30 years of age, had premonitory symptoms of a serious illness on June loth, and died of a malignant form of small-pox on the 20th. The inference naturally is that, with regard to the American, a mistake of diagnosis was made. The writer, as far as possible, investigated the matter, and found that the first case, if small-pox, must have been of an extremely mild type, and one of those cases not perhaps easy to distinguish from the milder disease, " chicken pox." The young American left this country for New York on the 17th June having perfectly recovered. With regard to the nurse who so tragically in the exercise of her duties succumbed. The body, alter having been treated by the undertaker with a powerful disinfectant, was removed to the mortuary, and all necessary disinfection was done by the sanitary staff. The Public Vaccinator attended at once the case was notified and re-vaccinated all the persons who had been in contact with the deceased. The latent or incubation period of small-pox is about fourteen days. Seventeen days having now elapsed it is improbable that there will be any spread. Devonshire Place, Lisson Grove. The report of the Housing Committee having been adopted by the Council to the effect that a representation should be made to the London County Council under Part I. of the Housing of the Working Classes Acts, such representation has been made. 67 Conference on the Housing of the Working Classes Act, Part III. The London County Council have, in common with the Metropolitan Boroughs, powers and duties under Part III. of the Housing of the Working Classes Act. That is to say, both local and central authorities can purchase land and build cottages or lodging-houses ; in the one case the expense falling on the locality, in the other on the whole administrative area. The London County Council, therefore, wisely convened a conference of representatives of the various boroughs in order, if possible, to define the various spheres of action and to prevent, as far as possible, overlapping. The Council appointed three representatives, the Rev. H. Russell Wakefield, Mr. J. Boyton, and the writer, and the conference duly took place. The results were not encouraging ; no general agreement having been come to of any value ; a second meeting will probably take place in October. It is the writer's personal opinion that it would be more useful if the London County Council provided for the wants of the Metropolis under Part III. of theHousingof theWorking Classes Act, and that the Borough Councils did not individually put Part III. in force. The reason for this opinion is that it is impracticable for anyborough after acquiring land or premises to confine its use under Part III. to its own district. For example, suppose this Borough acquire an estate in, say, St. John's Wood, or Kilburn, or Willesden, and erect thereon suitable dwellings, it would not in practice be possible to accept only Marylebone workers as tenants : the actual tenants would be drawn from every part of the metropolis, because the working classes, according to the conditions of employment, are constantly flitting from district to district. Of course, it is not to be denied that such action on the part of this Borough would assist in solving a great problem ; but it is a problem that cannot, with any justness, be solved by schemes supported and initiated by local funds, the more especially since the boroughs, supposing they do much in this direction individually, will not only have to bear the whole expense and responsibility of their own schemes, but also pay their 68 quota to the schemes of the London County Council. These remarks are, of course, made upon the assumption that Part III. cannot be put in force by local authorities in such a way as to be self-supporting; and it is the writer's belief that to build houses under present conditions for the lowest paid labour—the class that is most distressed for want of suitable habitation—cannot be made remunerative. By-Laws as to Houses Let in Lodgings. Weatherett v. Cantlay. This appeal case heard before a full court in the King's Bench Division is important, seeing the large number of Artisans' Dwellings in this district, and merits special notice. In 1899, the Vestry of St George-the-Martyr directed a certain block of Artisans' Dwellings to be registered under the By-laws with respect to houses let in lodgings. The owner (Cantlay) contended that the buildings did not come within the By-laws, and refused to give the necessary information for the purpose of registration. The Vestry summoned the owner before the Stipendiary. The Stipendiary decided against the Vestry. The Vestry, now become a Borough Council, appealed. The results of the appeal upheld the Magistrate's decision. The following being the judgment of the Lord Chief Justice :— The Lord Chief Justice: "I think, now this case has been argued out, that there really is no difficulty in it. I do not think that any of the cases on the meaning of the word ' house ' for the purpose of particular statutes help us. I think we have really to look to see what the object of this legislation was, and then construe the words with reference to the object of the legislation. By Sub-section A of Section 94 of the Public Health (London) Act, 1891 : ' Every sanitary authority shall make and enforce such By-laws as are requisite for the following matters, that is to say :—(a) For fixing the number of persons who may occupy a house or part of a house which is let in lodgings.' I think the object of this legislation was to control the number of people who should occupy a tenement which may fairly be described as a separate house, and that is shewn by the words ' part of a 69 house which is let in lodgings.' Speaking for myself, I do not draw any distinction between the words ' let in lodgings ' or ' occupied by members of more than one family,' except that one state of facts may bring it within one set of words and another state of facts may bring it within the other, but whether the lodgings are furnished or unfurnished for the purpose of this section seems to me to make no difference. I think I must find in order to bring it within the section either a house which is itself let in lodgings or a part of a house which is let in lodgings. " It is said when you come to deal with the facts of this case that you are to look at the whole structure, and regard the whole building of bricks and mortar as one house, and then if you find it sub divided inside it is a house which is, or a part of which is, let in lodgings. I do not call attention to the extraordinary results of that argument, except for the purpose of trying to see why the legislature should have put in those limiting words ; but one cannot help seeing that if Mr. Macmorran's view is right there might be some very large structure of absolutely residential flats, and if any one of them was let in lodgings, the whole of them must come in for the purpose of this. Further than that, I cannot help thinking that there is a good deal in the view, that, although the legislature might have imposed a limit to the value in every case, either lodgings let at a certain rent or houses occupied by members of more than one family, or a house, that is to say a separate tenement, let at a certain rent, yet still, when you find these general words, you would expect to find them applicable to a given subject matter, and not to a subject matter limited by some pecuniary standard. " I think when you look at the facts of this case this building is a collection of houses for the purpose of this section. There is no front door. There is a common passage and common staircases. On these common passages and common staircases open a number of front doors, which may be locked, and the tenements are separately occupied by the tenants of the houses. If any one of those is let in lodgings, or if a room is occupied by members of more than one family, then the particular landlord of that particular house would come within the terms of the section. 70 "In my opinion it is going too far to say that the whole structure of bricks and mortar is a house, or part of a house, let in lodgings or occupied by members of more than one family, simply because there are separate tenements and separate occupations under the circumstances stated in this case." I think, therefore, the judgment of the Magistrate was quite right.—Appeal dismissed with costs. 20tli May, 1901. The Laboratory—Sale of Food and Drugs Acts. One hundred and fifty-one samples of food, drink, or drugs have been analysed during the past quarter: of these a sample of milk was found diluted with water to the extent of 20 per cent.; the vendor, Elizabeth Watts, of 37, Dorset Street, was prosecuted and fined £1 and costs. The full list of the various articles analysed will be found at page 76. 1901. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, AND TYPHOID FEVER DURING 1901, AS COMPARED WITH A FIVE YEARS' AVERAGE. JUNE. NOTES: • • • • ■ Scarlet Fever. ■ Diphtheria. Typhoid Fever. X x x *x x Average of Scarlet Fever during 5 years ending 1900 * x x- x -x x „ Diphtheria * * * * *- * .. .. Typhoid Fever 71 TABLE II.—Giving the Causes of Deaths during the 13 Weeks ending June 22nd, 1901, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital. Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill. Infirmary. Influenza ... ... ... ... ... Scarlet Fever ... ... ... ... ... Diphtheria ... ... ... ... ... Typhoid Fever ... ... ... ... 1 Diarrhœa 1 ... ... ... 1 Erysipelas ... ... ... ... 2 Pneumonia and Pleurisy 6 ... ... ... 8 Pyæmia 1 ... ... ... ... Syphilis 2 1 ... ... 2 Cancer 34 ... ... ... 8 Phthisis and Tuberculosis 8 1 ... ... 28 Rheumatism ... ... ... ... ... Apoplexy 1 ... ... ... 5 Paralysis ... ... ... ... 12 Bronchitis 3 1 ... ... 12 Asthma ... ... ... ... ... Peritonitis 1 ... ... ... 3 Disease of Brain ... ... ... ... 3 " Heart 4 ... ... ... 9 " Kidney 3 ... ... ... 11 " Liver 1 ... ... ... 1 " Uterus 1 ... ... ... ... " Ovary ... ... ... ... ... Parturition ... 1 ... ... ... Diabetes ... ... ... ... ... Fractures and Injuries 7 ... ... ... 2 Old Age ... ... ... ... 14 Low Vitality, Infants ... 2 ... 3 ... Premature Birth ... 1 ... ... ... Other causes 19 1 1 2 12 Total *92 +8 *3 10 134 Of the 92 deaths in the Middlesex Hospital, 68 were those of non-parishioners, Seven of the 8 deaths in Queen Charlotte's Hospital were those of non-parishioners. The 3 deaths in the Samaritan Hospital were those of non-parishioners. 72 TABLE III.—TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, in the Sanitary District of ST. MARYLEBONE, during June, 1901; classified according to Diseases, Ages, and Localities. a) All Souls Rectory St. Mary Christ Church St. John Totals Population at all Ages. (b) Census 1901 35,394 19,869 18,099 39,541 20,426 133,329 (c) Registered Births 38 37 39 88 29 231 (d) Aged under 5 or over 5 Under 5 5 upwards Under ft 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards New Gases of Sickness in each Locality coming to the knowledge op the Medical Office of Health. 1. Smallpox .. .. .. .. .. 1 .. .. .. .. .. 1 2. Scarlatina 1 5 .. 1 1 6 .. 5 1 2 8 19 3. Diphtheria 2 5 .. 2 4 1 .. 6 1 3 10 17 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fbvbbs. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 4 .. .. .. .. .. 1 .. 1 .. 6 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas .. 3 •• 4 1 2 5 15 Number op such Cases Removed prom their Homes in the several Localities for Treatment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 1 4 1 .. 1 4 2 5 1 6 13 3. Diphtheria 2 4 .. 2 4 1 3 3 1 2 10 12 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 4 .. .. .. .. .. 1 .. 1 .. 6 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 . Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas .. 1 .. 1 .. .. .. 1 .. .. .. 3 73 TABLE IV.— TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Office of Health, in the Sanitary District of ST. MARYLEBONE, during Jun quarter, 1901 ; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals Population at all age . (b) Census 1901 35,391 19.869 18,099 39,541 20,426 133,329 (c) Registered Births.. 152 106 131 309 90 791 (d) Aged under 5 or over 5. Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 up words j Under 5 5 upwards Under 5 5 upwards New Cases of Sickness in each Locality coming to the KNOWLEDGE of the medical Officer of Health. 1 Smallpox .. .. .. .. .. 1 .. .. .. .. .. 1 2. Scarlatina 1 15 3 .. 3 18 13 17 10 16 30 71 3. Diphtheria 6 10 1 .. 8 11 6 16 5 10 26 50 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 6 .. .. .. .. .. 4 .. .. .. 12 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. 1 .. .. .. .. .. 1 .. .. .. 2 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 13 .. 9 .. 7 1 12 .. 14 .. 54 Number of such Casks Removed from their Homes in the several Localities for Treatment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2 Scarlatina 1 12 3 4 2 13 10 16 9 11 25 66 3. Diphtheria 6 8 1 2 7 7 5 .. 5 .. 21 35 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 5 .. .. .. .. .. .. .. .. .. 10 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas .. 4 .. 2 .. .. .. 4 .. 1 .. 11 74 TABLE V.—District Births and Deaths for the four weeks ending JUNE 22ND, 1901. All Souls Population in 1901 Births. Deaths. Males. Fmls. Males Fmls. 35,394 24 14 17 18 Reetory 19,809 17 20 12 9 St. Mary 18,099 20 19 14 10 Christ Church 39.541 41 47 27 21 St. John 20,426 17 12 7 16 Total 133,329 119 112 77 74 Note.—In the above the births and deaths have all been properly corrected, strangers have been eliminated, and extra-parochial deaths and others have been allotted to their proper sub-district. TABLE vi.—District Births and Deaths for the 13 weeks ending june 22ND, 1901. Population in 1901. Births. Deaths. .Males. Fmls. Males. Fmls. All Souls 35,394 79 73 57 63 Rectory 19,869 51 55 44 33 St. Mary 18,099 74 60 38 38 Christ Church 39,541 160 149 93 76 St. John 20,426 46 44 51 46 Total 133,329 410 381 283 256 Note.—In the above the births and deaths have all been properly corrected, strangers have been eliminated, and extra-parochial deaths and others have been allotted to their proper sub-district. 75 TABLE VII.—Causes of, and Ages at, Death during the 13 weeks ending June 22nd, 1901, in the Borough of St. Marylebone. CAUSES OF DEATH. Deaths in whole District at subjoined Ages. Deaths in Localities (at all Ages). Deaths in Public Institutions. All ages. Under 1. 1 and under 5. 5 and under 15 and under 25. 25 and under 65. 65 and upwards. All Souls. Rectory. St. Mary. Christ Church. St. John. Smallpox 1 .. .. .. .. 1 .. .. .. 1 .. .. .. Measles 2 .. 1 .. 1 .. .. 2 .. .. .. .. .. Scarlet Fever 4 .. 4 .. .. .. .. .. .. .. 4 .. .. Whooping Cough 19 12 7 .. .. .. .. 4 2 5 5 3 .. Diphtheria and Membranous Croup 9 4 4 1 .. .. .. 1 .. 2 4 2 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric 1 .. .. .. .. 1 .. .. .. .. 1 .. .. Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 2 1 .. .. .. 1 .. 1 .. .. 1 .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhoea 9 6 2 .. .. 1 .. 5 .. .. 3 1 2 Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 4 .. .. .. .. 2 2 3 .. .. 1 .. 2 Other Septic Diseases 1 .. .. .. .. 1 .. 1 .. .. .. .. .. Phthisis 44 .. .. 1 5 35 3 11 9 6 8 10 38 Other Tubercular 21 4 5 2 .. 8 2 9 2 1 5 4 .. Cancer, Malignant 34 .. .. .. 1 19 14 12 7 5 6 4 43 Bronchitis 51 4 8 .. .. 16 23 13 8 5 19 6 16 Pneumonia 47 11 4 .. 2 24 4 7 11 10 14 5 14 Pleurisy 2 .. .. .. .. 2 .. 1 .. .. .. 1 .. Other Diseases of Respiratory Organs .. .. .. .. .. .. .. .. .. .. .. .. .. Alcoholism Cirrhosis of Liver 5 .. .. .. .. 4 1 1 1 1 .. 1 .. Venereal Diseases 3 2 .. .. .. 1 .. 1 .. .. 1 1 3 Premature Birth 6 6 .. .. .. .. .. 1 1 .. 4 .. 1 Diseases and Accidents of Parturition 7 .. .. .. 2 4 1 2 1 .. 2 2 1 Heart Diseases 55 2 .. 1 2 23 27 6 9 12 16 12 .. Accidents 14 1 .. 1 .. 12 .. 3 2 4 4 1 9 Suicides 2 .. .. .. .. 2 .. 1 .. 1 .. .. .. All other causes 196 42 9 3 12 58 72 35 24 23 70 14 118 All causes 539 95 41 11 25 215 149 120 77 76 169 97 247 * 37 of the 90 were not residents in the District. 76 TABLE VIII.—Sale of Food and Drugs Acts—Samples Analysed during the June Quarter, 1901. Genuine. Adulterated. Total. DAIRY PRODUCTS- Milk 69 1 70 Butter 20 20 Margarine 6 6 ALCOHOLIC BEVERAGES— Whisky 10 10 Brandy 2 2 Rum 2 2 Gin 4 4 Port Wine 1 1 NON-ALCOHOLIC BEVERAGES— Coffee 5 5 CONDIMENTS— Mustard 2 2 DRUGS— Liquorice Powder 1 1 Quinine and Orange Wine 1 1 SACCHARINE SUBSTANCES— Sweets 4 4 Golden Syrup 1 1 Jam 2 2 Lemon Syrup 3 3 TINNED & BOTTLED GOODS- Pineapples 1 1 Apples 2 2 Apricots 1 1 Tomatoes 1 1 Salmon 3 3 Sardines 1 1 Bloater Paste 2 2 MISCELLANEOUS— Essence of Ginger 1 1 Vinegar 2 2 Salad Oil 3 3 150 1 151 77 REGISTER OF SANITARY WORK, Month ending 30th June, 1901. PUBLIC HEALTH DEPARTMENT. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. T. Gorniot, No. 3 District. Mr. D. J. Andrews, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell. Total. Number of Complaints received 7 11 17 18 13 3 6 75 Inspections. Of Dwelling Houses 36 32 35 30 28 39 — 200 „ Kitchens (separately occupied) 6 — 3 25 17 — — 51 „ Schools 1 1 — — 1 — — 3 „ Houses registered under Public Health( London) Act, 1891 34 12 22 32 — 100 „ Dairies and Cow-houses 2 1 1 — 3 — — 7 „ Bakehouses 1 — — 1 4 49 — 55 „ Slaughterhouses . 3 — — — — — — 3 „ Miscellaneous Inspections 180 162 185 150 177 126 213 1193 Notices issued for Abatement of Nuisances, etc 5 1 7 11 9 — 5 38 Letters written relating to Abatement of Nuisances 20 23 27 31 3 18 122 Proceedings taken before Magistrates under Sanitary Acts — — — — — — — — Reports made to Medical Officer of Health 45 36 42 30 51 10 6 220 Infectious Patients removed to Hospital 9 1 7 16 9 — — 42 Rooms Disinfected after Infectious Disease 16 3 12 20 17 — — 68 New Pipe Drains (feet) 1270 986 870 664 1146 — — 4936 Houses where Defects in Drainage have been detected and remedied 6 3 4 10 5 — _ 28 Unwholesome Food—Number of Seizures made 2' — — 2 Food Adulteration. Samples collected for Analysis 19 14 11 14 6 — — 64 Proceedings taken before Magistrates — — 1 — — — — 1 Removal of Bodies to Mortuary — — — 1 — — — 1 *70 cases Canadian apples from 92 Seymour Place (6 tins in each case) 420 tins. 7 baskets of strawberries from 7, Hanway Street. 78 REGISTER OF SANITARY WORK, Quarter ending 30th June, 1901. PUBLIC HEALTH DEPARTMENT. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. T. Gorniot, No. 3 District. Mr. D. J. Andrews No. 4 District. Mr. W. Yeo, No. 5 District. Mr. K. Phillips, Special Duties. Miss L. M. O'Kell Total. Number of Complaints received 37 36 51 56 48 0 10 247 Inspections. Of Dwelling Houses 117 87 85 98 101 77 ... 565 „ Kitchens (separately occupied) 10 ... 8 65 47 ... ... 130 „ Schools 3 „ 3 1 ... 3 ... ... 10 ,, Houses registered under PublicHealth( London) Act, 1891 99 ... 34 66 76 ... ... 275 „ Dairies and Cow-houses 7 ... 3 18 11 ... ... 40 „ Bakehouses 3 ... ... 1 4 137 ... 145 „ Slaughterhouses 8 ... ... ... 1 ... ... 9 „ Miscellaneous Inspections 500 447 486 430 455 435 751 3504 Notices issued for Abatement of Nuisances 15 7 12 16 21 ... 6 77 Letters written relating to Abatement of Nuisances ... 57 20 48 69 55 3 41 293 Proceedings taken before Magistrates under Sanitary Acts ... ... ... ... ... ... ... ... Reports made to Medical Officer of Health 119 104 122 91 137 20 21 614 Infectious Patients removed to Hospital 40 11 23 48 18 ... ... 140 Rooms Disinfected after Infectious Disease 60 25 37 57 43 ... ... 222 New Pipe Drains (feet) 3480 3152 2746 2077 3895 ... ... 16250 Houses where defects in Drainage have been detected and remedied 21 14 15 35 13 ... ... 98 Unwholesome Food — Number of Seizures made ... ... ... 2 ... ... ... 2 Food Adulteration. Samples collected for Analysis 36 31 32 30 29 ... ... 158 Proceedings taken before Magistrates ... 1 3 ... ... ... ... 4 Removal of Bodies to Mortuary ... ... ... 1 ... ... ... 1 THE SANITARY CHRONICLES of the BOROUGH OF ST. MARYLEBONE DURING JULY, 1901. Vol. XXI. Town Hall, St. Marylebone, August 1901. No. 7. The week ending June 29th was one of moderate temperatures and variable winds. Minimum temperature, 48.0°; maximum, 76.0° ; mean, 61.5°. The sunshine registered in Regents Park was equal to 61 per cent. of the possible. Mean barometer, 30.0 inches. The week ending July 6th was warm and summery. Minimum temperature, 55.0°; maximum, 82.5°; mean, 67.0°. On one day rain fell (0.20 inch). Sunshine, 35.4 per cent. The winds were E and NE. Mean barometer, 29'8 inches. The week ending July 13th was bright, warm, and rainless. Minimum temperature, 50.0° ; maximum, 84.0°; mean, 70.2°. Light easterly airs prevailed. The sunshine registered was equal to 42 per cent. Mean barometer, 30.0 inches. The week ending July 20th was tropical in its character. Minimum temperature, 53.0°; maximum, 86.8°; mean, 74.4°. Light easterly airs. Sunshine, 66'1 per cent. Mean barometer, 30'1 inches. The week ending July 27th was one of considerable atmospheric disturbance. Minimum temperature, 52.0°; maximum, 86.0°; mean, 64.4°. A violent storm, with thunder and lightning, burst on the 25th, over two inches of rain falling in a short time; there were two other rainy days, bringing up the total rainfall for the week to the high figure of 3.74 inches. Sunshine, 28.4 per cent. Mean barometer, 29.7 inches. 80 Births and Deaths. During the five weeks, ending July 27th, there have been registered 269 births and 215 deaths. These births and deaths are divided among the five sub-districts as set forth in Table V. Eighty-two of the deaths were extra-parochial, as follows :— St. Marylebone Infirmary, Notting Hill 52 North-Western Fever Hospital 5 Western Fever Hospital 1 St. Mary's Hospital 5 Children's Hospital, Paddington 3 U niversity College Hospital 4 St. Bartholomew's Hospital 1 Brompton Hospital 1 City of London Chest Hospital 1 Lying-in Hospital, Endell Street 1 St. Pelagia's Creche 1 Hanwell Asylum 5 Leavesden Asylum 1 In the streets 1 Total 82 The birth and death-rates, as deduced from the five weeks' statistics, are as follows :— All Souls, birth-rate 14.7; death-rate 14.1. Rectory, birth-rate 25.l; death-rate 12.3. St. Mary, birth-rate 25.3 ; death-rate 18.4. Christ Church, birth-rate 21.8; death-rate 17.6. St. John, birth-rate 22.4; death-rate 22.4. The whole district, birth-rate 21.0; death-rate 16.8. The average death.rates for five years (1895 to 1900) for the corresponding period were as follows :—All Souls, 14.1; Fectory, 17.3 ; St. Mary, 17.8; Christ Church, 17.8; St. John, 21.3; the whole district, 17.8. 81 The following table gives, as usual, facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes: TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE 5 WEEKS ENDING JULY 27th, 1901, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES Total Deaths. 5 weeks ending July 27th, 1901. Proportion of the deaths to 1,000 deaths from all causes. 5 weeks ending July 27,1901. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1895-1900. 1. Deaths from the chief Zymotic Diseases 47 219 4.58 3.12 2. Pulmonary, other than Phthisis 32 149 3.12 2.46 3. Tubercular 32 149 3.12 1.67 NOTES. 1, includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza, Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. 3, includes Phthisis, Scrofula, Rickets, and Tabes. 82 General Health of the District. It will be seen on reference to the curve on the opposite page that scarlet fever was somewhat above the average in the first week of July and that in the third week of July there was a well-marked rise in the prevalence of typhoid fever. The most serious rise was that however of diphtheria; the excess of cases above the average has not been confined to this district, but has been pretty general throughout the Metropolis and therefore depends upon some widespread favouring cause. It may have some connection with the dry and hot weather. Cleansing of Persons Act. The number of males who took advantage of the Act during the five weeks of July amounted to 464, the number of females to 5, giving a total of 469. Factory and Workshops Act. PROSECUTION FOR OVERCROWDING. Various notices and verbal warnings having been of no avail, Madame Derry, of 36, York Place, was prosecuted for disregarding the order of the Council and fined 40s. and costs. In the season there is a great temptation to overcrowd the dressmaking establishments of the Borough, necessitating frequent supervision. X 9 O 1 . CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, AND TYPHOID FEVER DURING 1901, AS COMPARED VITH A FIVE YEARS' AVERAGE. JULY. NOTES: Scarlet Fever Diphtheria. it o i ■ t » Typhoid Fever. x y x X x x Average of Scarlet Fever during 5 years ending 1900 v- x *••• x- x x .. .. Diphtheria -x- * * * •• Typhoid Fever 83 TABLE II.—Giving the Causes of Deaths during the 5 Weeks ending July 27th, 1901, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital. Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill Infirmary. Influenza ... ... ... ... ... Scarlet Fever ... ... ... ... ... Diphtheria ... ... ... ... ... Typhoid Fever ... ... ... ... Diarrhoea ... ... ... ... 1 Erysipelas ... ... ... ... Pneumonia and Pleurisy 3 ... ... ... 5 Pysemia ... ... ... ... ... Syphilis ... ... ... ... ... Cancer 13 ... ... ... 6 Phthisis and Tuberculosis 4 ... ... ... 13 Rheumatism ... ... ... ... ... Apoplexy ... ... ... ... Paralvsis ... ... ... ... 2 Bronchitis 1 ... ... ... 7 Asthma ... ... ... ... ... Peritonitis 5 ... ... ... ... Disease of Brain ... ... ... 1 ... „ Heart 1 ... ... 2 7 ,, Kidney I ... ... ... ... „ Liver 1 ... ... ... 1 „ Uterus ... ... ... ... ... „ Ovarv ... ... ... ... ... Parturition ... 1 ... ... ... Diabetes ... ... ... ... ... Fractures and Injuries ... ... ... ... 1 Old Age ... ... ... ... 5 Low Vitalitv, Infants ... 1 ... ... ... Premature Birth ... 1 ... ... ... Other causes 6 ... ... ... 4 Total *35 +3 ... 4 52 * Of the 35 deaths in the Middlesex Hospital, 26 were those of non-parishioners. + The 8 deaths in Queen Charlotte's Hospital were those of non-parishioners, 2 of them were infants. 84 TABLE III.—Causes of, and Ages at, Death during the 5 weeks ending July 27th, 1901, in the Borough of St. Marylebone. CAUSES OF DEATH. Deaths in whole District at subjoined Ages. Deaths in Localities (at all Ages). Deaths in Public Institutions. All ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. All Souls. Rectory. St. Mary. Christ Church. St. John. Smallpox 1 .. .. .. .. 1 .. .. .. 1 .. .. .. Measles 4 1 3 .. .. .. .. 4 .. .. .. .. .. Scarlet Fever 1 .. 1 .. .. .. .. .. .. .. .. .. .. Whooping Cough 2 .. 1 .. .. .. .. .. .. .. 1 1 .. Diphtheria and Membranous Croup 4 .. 4 .. .. .. .. .. .. .. 2 1 .. Crop .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric .. .. .. .. .. .. .. .. .. .. 1 .. .. Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhoea 34 31 3 .. .. .. .. .. 4 .. 17 .. .. Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. Other Septic Diseases 3 .. .. .. .. 2 .. 1 1 .. .. 1 .. Phthisis 26 1 .. .. .. 23 1 7 .. 5 6 8 17 Other Tubercular 6 1 3 .. .. 2 .. 1 .. 2 2 1 .. Cancer, Malignant Disease 20 .. .. .. .. 16 4 9 1 4 1 5 19 Bronchitis 16 2 .. .. .. 5 9 4 4 3 3 2 7 Pneumonia 16 2 2 .. .. 7 3 3 1 2 9 1 5 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Respiratory Organs .. .. .. .. .. .. .. .. .. .. .. .. .. Alcoholism Cirrhosis of Liver 7 .. .. .. .. 7 .. 2 1 .. 3 1 .. Venereal Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. Premature Birth 4 4 .. .. .. .. .. 2 .. 1 1 .. .. Diseases and Accidents of Parturition .. .. .. .. .. .. .. .. .. .. .. .. .. Heart Diseases 24 .. .. .. .. 13 .. 2 3 4 8 .. 7 Accidents 2 .. 1 .. 1 .. .. .. .. 1 .. 1 1 Suicides .. .. .. .. .. .. .. .. .. .. .. .. .. All other causes 44 7 1 1 1 17 17 10 9 3 13 9 37 All causes 215 50 19 4 6 93 43 48 24 32 67 44 94 85 TABLE IV.—TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, in the Sanitary District of ST. MARYLEBONE, during July, 1901; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals Population at all Agks. (b) Census 1901 36.495 19,798 19,637 32,547 32,611 141,188 (c) Registered Births 50 48 44 83 44 269 (d) Aged under 5 or over 5 Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 ' 5 upwards New Cases of Sickness in each Locality coming to the knowledge of the medical Officer op Health. 1. Smallpox .. 1 .. .. .. 1 .. .. .. .. .. 2 2. Scarlatina 2 2 .. 4 3 4 1 14 3 5 9 29 3. Diphtheria 1 4 1 1 5 4 4 4 3 2 14 15 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 2 .. .. .. .. .. .. .. .. .. 11 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas .. 1 2 11 .. 2 .. 6 1 .. 3 20 Number of such Cases Removed prom their Homes in the several Localities fob Treatment in Isolation Hospitals. 1. Smallpox .. 1 .. .. .. 1 .. .. .. .. .. 2 2. Scarlatina 2 2 .. .. 3 3 1 11 3 .. 9 24 3. Diphtheria 1 2 .. .. .6 2 4 3 1 .. 11 9 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. .. .. 5 .. 2 .. 7 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. 4 .. .. .. .. .. .. .. 4 86 TABLE Y.—District Births and Deaths fok the five weeks ending JULY 27TH, 1901. Population in 1901. Birtbs. Deaths. Males. Fmlfi. Males Fmls. All Souls 35.394 24 26 31 17 Rectory 19,809 24 24 9 15 St. Mary 18,099 20 94 13 19 Christ Church 39.541 40 43 33 34 St. John 20,426 25 19 24 20 Total 133,329 133 136 110 105 Note.—In the above the births and deaths have all been properly corrected, strangers have been eliminated, and extra-parochial deaths and others have been allotted to their proper sub-district. 87 REGISTER OF SANITARY WORK, Month ending 31st July, 1901. PUBLIC HEALTH DEPARTMENT. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. T. Gorniot, No. 3 District. Mr. D. J. Andrews, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell. Total. Number of Complaints received 10 12 14 25 20 6 4 91 Inspections. Of Dwelling Houses 40 39 20 45 29 35 — 208 ,, Kitchens (separately occupied) 4 — 2 20 5 — — 31 „ Schools 1 2 1 — 2 — — 6 „ Houses registered under Public Health( London) Act, 1891 30 — — 22 21 1 74 ., Dairies and Cow-houses 2 1 1 - 5 — — 9 „ Bakehouses — — — — 1 43 — 44 „ Slaughterhouses 2 — — — 1 — — 3 „ Miscellaneous Inspections 187 192 140 150 171 184 241 1265 Notices issued for Abatement of Nuisances, etc. 6 3 4 8 9 — 2 32 Letters written relating to Abatement of Nuisances 32 24 15 50 21 3 36 181 Proceedings taken before Magistrates under Sanitary Acts — — — 3 3 Reports made to Medical Officer of Health 36 32 40 35 49 15 12 219 Infectious Patients removed to Hospital 13 1 6 30 17 — 67 Rooms Disinfected after Infectious Disease 24 3 12 36 31 — 106 New Pipe Drains (feet) 1240 986 850 942 1614 — — 5632 Houses where Defects in Drainage have been detected and remedied 8 7 6 11 5 — 6 43 Unwholesome Food — Number of Seizures made — — — Food Adulteration. Samples collected for Analysis 7 8 30 20 8 — 73 Proceedings taken before Magistrates — — — — Removal of Bodies to Mortuary 1 — — — — — 1 I . THE SANITARY CHRONICLES of the BOROUGH OF ST. MARYLEBONE DURING AUGUST AND SEPTEMBER, 1901. Containing a quarterly Summary of the MortaLity Statistics for the Quarter ending September 22nd, 1901, and the Quarterly Statement of Analytical work done under the Sale of Food and Drugs Acts, &c. Vol. XXI. Town Hall, St. Marylebone, October 3rd, 1901. No. 8. The week ending Aueust 3rd was rainless with moderate temperatures. Minimum temperature, 51.0°; maximum, 80.0°; mean, 68.4°. Wind, light N.E. Sunshine 50 per cent. Mean barometer, 30T inches. The week ending August 10th was warm, rainless, and summery. Minimum temperature, 51.5°; maximum, 97.0° ; mean, 68.1°. Winds westerly. Sunshine, 44.7 per cent. Mean barometer, 29.8 inches. The week ending August 17th was less settled. Minimum temperature, 50.0°; maximum, 71.2°; mean, 64.4°. On two days rain fell, 0.26 inch. Winds variable. Barometer, 29.0 inches. The week ending August 24th was fine and rainless. Minimum temperature, 50.5°; maximum, 81.0°; mean, 68.0°. Winds E. & E.S.E. Sunshine, 69.6 per cent. Barometer, 30.2 inches. The week ending August 31st was unsettled. Minimum temperature45.0° ; maximum, 82.5°; mean, 59T°. On two days rain fell, 0.59 inch. Wind, W.N.W. Sunshine, 39T percent. Mean barometer, 29 8 inches. The week ending September 7th was cooler and fairly dry. Minimum temperature, 45.0° ; maximum, 69.5° ; mean, 60 0. On one day rain fell, 0.28 inch. Winds, N. & S.E. Sunshine, 51.3 per cent. Mean barometer, 29.9 inches. The week ending September 14th was similar in weather to the preceding. Minimum temperature, 51.0°; maximum, 75.2°; mean, G2.3°. On one day rain fell, 0.37 inch. Sunshine, 16.8 per cent. Mean barometer, 29.6 inches. The week ending September 21st was unsettled. Minimum temperature, 50.0°; maximum, 66.5°: mean, 59.0°. On two days rain fell, 0.47 inch. AVinds, W.N.W. & S.E. Sunshine, 16.7 per cent. Mean barometer, 29.6 inches. 90 Births and Deaths. AUGUST. During the four weeks ending August 27th, there have been registered 217 births and 167 deaths—equal to a birth-rate of 21.1 ; a death-rate of 16.3 per thousand. The average death-rate for the corresponding month during the five years 1894-9 was 19-2. SEPTEMBER. During the four weeks ending September 21st there have been registered 243 births and 159 deaths, equal to a birth-rate of 23.7 ; a death-rate of 15.5 per thousand. The average death-rate for the corresponding mouth during the five years 1894-9 was 18.2. QUARTERLY SUMMARY. Dnring the thirteen weeks ending September 22nd there have been registered 729 births and 541 deaths. These births and deaths are divided among the five sub-districts as set forth in Tables III. and V. 176 of the deaths were extra-parochial, as follows:— St. Marylebone Infirmary, Notting Hill . 108 North-Western Fever Hospital 8 Western Fever Hospital 3 South-Eastern Fever Hospital 1 South-Western Fever Hospital 1 North-Eastern Fever Hospital 1 Hospital Ship "Atlas" 3 Hospital Ship "Castalia" 1 St. Mary's Hospital 8 Children's Hospital, Paddington 5 Children's Hospital, Great Ormond Street 1 St. Thomas' Hospital 1 King's Cross Hospital 1 University College Hospital 4 St. Bartholomew's Hospital 1 Brompton Hospital 1 Italian Hospital 2 Royal Chest Hospital 1 City of London Chest Hospital 1 City of London Hospital 1 Lying-in Hospital, Endell Street 1 German Hospital ] London City Asylum, Dartford 1 Hanwell Asylum 9 Leavesden Asylum 3 Darenth Asylum 1 Colney Hatch Asylum 1 Claybury Asylum 2 Friedenheim 1 St. Pelagia's Creche 1 H.M. Prison Holloway 1 In the streets 1 Total 176 91 The birth and death-rates, as deduced from the quarter's statistics are as follows:— All Souls, birth-rate 15.3; death-rate 15.6. Rectory, birth-rate 19.1 ; death-rate 12.3. St. Mary, birth-rate 22.3 ; death-rate 15.5. Christ Church, birth-rate 26.3; death-rate 16.5. St. John, birth-rate 25.1; death-rate 21.5. The whole district, birth-rate 21.9; death-rate 16.2. The average death-rates for five years (1895 to 1900) for the corresponding quarter were as follows All Souls, 14.5 ; Rectory, 18.8 ; St. Mary, 17.8; Christ Church, 18.6; St. John, 23.6; the whole district, 18.3. The following table gives, as usual, facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes: TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE THIRTEEN WEEKS ENDING SEPTEMBER 21st, 1901, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 13 weeks ending Sept. 21st, 1901. Proportion of the deaths to 1,000 deaths from all causes. 13 weeks ending Sept.21,1901. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1899-1900. 1. Deaths from the chief Zymotic Diseases 134 247 4.02 3.94 2. Pulmonary, other than Phthisis 64 118 1.92 2.23 3. Tubercular 67 124 2.01 1.99 NOTES. 1, includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza, Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. 3, includes Phthisis, Scrofula, Rickets, and Tabes. 92 Smallpox. As early as June 20th infection from Paris was imported into the Borough by a young gentleman. His disease was supposed to be an ordinary case of chicken-pox. The nurse who attended him sickened and rapidly died of a malignant form of smallpox. So far as can be ascertained there was no farther extension from these cases of the disease. The next cases were in the early part of July. E.K., a clerk, was taken ill on July 9th, and E.K., a female servant, on July 12th. They both lived in different parts of the Borough, but had both been employed at a house in the Paddington district from whence a case of smallpox was removed July 6th. Hence since the usual period of incubation is about a fortnight; these cases were derived from some common source of infection. Again preventive measures were successful, and from these cases no subsequent case, so far as is known, was derived. The district was now free from smallpox eighteen days, but on the 24th of August up to the present date, a series of notifications of smallpox have been received, the infection apparently for the most part being derived from a group of cases which occurred in the neighbouring district of St. Pancras, and are reported to be caused through some undiscovered cases of smallpox which had been erroneously diagnosed as chicken-pox. These, with the exception of three of the more recent, have all occurred south of the Marylebone Road; there has not been a case in the St. John's Wood district. It must also be particularly noted that there has been no case in the various millinery and drapery establishments or in the business houses. The three cases north of the Marylebone Road occurred a week ago in a densely populated quarter, and naturally cause some anxiety. Preventive Measures. Directly each case has been notified a telegram or telephonic message has been forwarded to the Asylums Board, and the case removed with all the rapidity and comfort characteristic of Asylum Board management. It may be mentioned that one case was even removed at 2 a.m., the 93 diagnosis having been arrived at after midnight. On removal of the patient the room or rooms have been at once fumigated, and all things liable to retain infection disinfected by superheated steam or, if extremely foul, dirty, or old, destroyed. The Vaccination Officer and the Public Vaccinator have been at once communicated with by telephone or special messenger. They have attendeed at the house, and have been extremely successful in re-vaccinating "contact" cases. During the operation of disinfection the majority of those who have been in contact with the patient have been persuaded to take advantage of the shelter, have had a cleansing bath, and their wearing apparel disinfected. 3,000 circulars have been sent to employers of labour in the district suggesting the propriety of calling the attention of their workers to the immunity conferred by re-vaccination, and in the majority of instances there has been a favourable and practical response. The Guardians quite early took a sensible view of their responsibilities, and granted the Public Vaccinator proper facilities to perform his duties. The writer addressed a letter to the School Board for London, requesting permission to cause an investigation to be made as to the degree of immunity the scholars might possess. After some time a special meeting of the School Board was held and permission granted for this investigation, but coupled with conditions that almost entirely nullified its practical use. In effect, resistance to the examination was suggested to the parents. Even the names and addresses of those who declined vaccination were not allowed to be taken and the Public Vaccinator was not permitted to vaccinate children who desired vaccination then and there, but must track them to their homes. On account of the three cases north of Marylebone Road and also because a large number of persons who have been hop-picking have recently returned to the Borough, it has been considered a wise precaution to make arrangements for the officers of the Sanitary staff to be on duty in relays from 9 a.m. up to 11.30 p.m., and these arrangements have been communicated to all Medical men in the Borough. 94 The general course of the outbreak may be gathered from the curve opposite page 96. Scarlet Fever and Diphtheria. The notifiable infectious diseases generally have been above the average. The amount above the average of scarlet fever and diphtheria can be gathered from a glance at the curves on page 96. Added to greater prevalence there has been diminished hospital accommodation. On the suggestion of the Local Government Board one of the Asylum Board Hospitals has been kept apart in readiness for the reception of possible cases of plague. At the same time the Gore Hospital, hitherto receiving scarlet fever cases, is now being prepared to receive smallpox. Owing to these circumstances the resources of the Board have been taxed to the utmost limit, and at one time it looked as if many urgent cases would have to be retained at home. In only two or three cases has there been a slight delay so far as this borough is concerned. At the present moment there is not a single case remaining which is not either effectually isolated in hospital or at home. The Laboratory—Sale of Food and Drugs Acts. During the quarter there have been 151 samples of various articles of Food, Drink, and Drugs analysed, as detailed in table VI. Eight samples of milk were adulterated, and the following prosecutions instituted:— Thomas Thomas, of 41, Great Barlow Street, was summoned for selling milk diluted with 8.5 per cent. of water, and fined 20s. and 12s. 6d. costs. Mrs. Shanly, of Princes Pavilion, Regent's Park, was fined £3 and 12s. 6d. costs for selling milk deficient in milk fat 13 per cent. Elizabeth Neville, of 3, Glentworth Street, was fined 40s. and costs for selling milk diluted with 40.5 per cent. of water. 95 John Ward, of 48, Upper Rathbone Place, was fined the same amount for selling milk diluted with 11 per cent. of water. Two summonses were taken out against a Buckinghamshire farmer for sending milk, diluted in each case with a considerable quantity of water, consigned to a vendor in the district. The summonses were dismissed because it was shown that the milk had been consigned to a certain person and then forwarded on to St. Marylebone. In other words the milk did not come direct from the farmer. 96 TABLE II.—Giving the Causes of Deaths during the 13 Weeks ending September 21st, 1901, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital. Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill Infirmary. Influenza ... ... ... ... ... Scarlet Fever ... ... ... ... ... Diphtheria ... ... ... ... 1 Typhoid Fever 3 ... ... ... 1 Diarrhoea ... ... ... ... 3 Erysipelas ... ... ... ... ... Pneumonia and Pleurisy 8 1 ... ... 6 Pysemia 1 ... ... ... ... Syphilis ... ... ... ... 1 Cancer 28 ... ... ... 8 Phthisis and Tuberculosis 9 ... ... ... 24 Rheumatism ... ... ... ... ... Apoplexy ... 1 ... ... ... Paralysis ... ... ... ... 5 Bronchitis 2 ... ... ... 16 Asthma ... ... ... ... 1 Peritonitis 8 ... ... ... ... Disease of Brain ... ... ... 2 ... „ Heart 7 ... ... 3 16 ,, Kidney 4 ... ... ... ... ,, Liver 3 ... ... ... 1 „ Uterus ... ... ... ... ... „ Ovary 1 ... ... ... ... Parturition ... 2 ... ... ... Diabetes ... ... ... ... ... Fractures and Injuries 3 ... ... ... 2 Old Age ... ... ... ... 7 Low Vitality, Infants ... 1 ... 1 ... Premature Birth ... 2 ... ... ... Other causes 15 ... ... I 16 Total *92 †7 ... 8 108 * Of the 92 deaths in the Middlesex Hospital, 73 were those of non-parishioners. f The 7 deaths in Queen Charlotte's Hospital were those of non-parishioners, 5 of them were infants. 1 9 O 1 . CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, TYPHOID FEVER, & SMALLPOX DURING 1901, AS COMPARED WITH A FIVE YEARS' AVERAGE. AUGUST AIMD SEPTEMBER. 97 TABLE III.—Causes of, and Ages at, Death during the 13 weeks ending September 21st, 1901, in the Borough of St. Marylebone. CAUSES OP DEATH. Deaths in whole District at subjoined Ages. Deaths in Localities (at all Ages). Deaths in Public Institutions, All ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. All Souls. Rectory. St. Mary. Christ Church. St. John. Smallpox 5 .. .. 1 .. 4 .. 1 2 1 1 .. .. Measles 6 1 5 .. .. .. .. 4 .. .. 2 .. .. Scarlet Fever 3 .. 2 1 .. .. .. .. .. 1 .. 2 .. Whooping Cough 5 3 2 .. .. .. .. 1 .. .. 2 2 .. Diphtheria and Membranous Croup 10 .. 8 2 .. .. .. 1 1 1 3 4 1 Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric 3 .. .. .. 2 1 .. 1 .. .. 1 1 4 Other continued .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhoea 98 87 7 .. .. 2 2 14 8 9 53 14 3 Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 1 .. .. .. .. 1 .. .. .. .. 1 .. .. Other Septic Diseases.. 6 .. .. 1 1 3 1 2 1 1 .. 2 1 Phthisis 51 1 .. .. 2 44 2 17 3 7 13 11 33 Other Tubercular Diseases 16 4 7 1 .. 4 .. 3 2 2 7 2 .. Cancer, Malignant Disease 36 .. .. .. .. 28 8 14 2 10 1 9 36 Bronchitis 36 3 .. .. 1 14 18 11 5 4 8 8 19 Pneumonia 21 4 3 .. 3 11 3 5 2 3 12 2 15 Pleurisy 2 .. .. .. .. 2 .. .. 2 .. .. .. .. Other Diseases of Respiratory Organs 2 .. .. .. .. 2 .. 1 .. .. .. 1 .. Alcoholism 15 .. .. .. .. 13 2 7 1 .. 4 3 .. Cirrhosis of Liver Venereal Diseases 2 1 .. .. .. 1 .. .. 1 1 .. .. 1 Premature Birth 9 9 .. .. .. .. .. 4 .. 1 1 3 2 Diseases and Accidents of Parturition 2 .. .. .. .. 2 .. 1 .. 1 .. .. 2 Heart Diseases 65 .. .. 8 3 34 20 12 10 10 19 11 26 Accidents 10 1 1 .. 2 4 2 2 .. 4 2 2 5 Suicides 1 .. .. .. .. 1 .. .. .. .. .. 1 .. All other causes 133 27 2 2 4 58 40 26 21 14 43 29 67 All causes 511 141 37 18 18 229 93 127 61 70 173 110 215 98 TABLE IV.—TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, in the Sanitary District of ST. MARYLEBONE, during September Quarter, 1901; classified according to Diseases, Ages, and Localities. a All Souls Rectory St. Mary Christ Church Sr. John Totals Population at all AGKS. (6) Census 1901 36,495 19,798 19,637 32,547 32,611 141,188 (c) Registered Births .. 135 90 116 260 128 729 (d) Aged under 5 orover 5 Under 5 5. upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards New Casks of Sickness in bach Locality coming to thk knowledge of the medical Officer of Health. 1. Smallpox .. 32 .. 4 .. 4 .. 3 .. .. .. 43 2. Scarlatina 6 17 2 7 6 11 10 27 10 15 34 77 3. Diphtheria 3 16 3 4 6 7 8 11 9 7 29 45 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 4 .. .. .. .. .. 9 .. 11 .. 24 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. 1 .. .. .. •• .. .. .. .. .. 1 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 5 2 24 .. 3 .. 9 2 9 4 50 Number of such Casks Removed from their homes in the sevearal localities fob treat- ment in Isolation Hospitals. 1. Smallpox .. 32 .. 4 .. 4 .. 3 .. .. .. 43 2. Scarlatina 6 14 .. .. 6 9 8 23 10 14 32 65 3. Diphtheria .. 3 10 2 1 6 3 7 10 7 6 25 30 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fbvbbs. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 1 .. .. .. •• .. 8 .. 7 .. 16 7. Continued .. .. .. .. .. •• .. .. .. •• .. •• 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. •• .. .. 10. Cholera .. •• .. .. .. •• .. .. .. .. .. .. 11. Erysipelas .. .. .. 11 .. .. .. .. .. 2 .. 13 99 TABLE V.—District Births and Deaths for the thirteen weeks ending september 21ST, 1901. Population in 1901. Bulbs. Deaths. Males Fmls. Males Fmls. All Souls 35,394 68 67 70 57 Rectory 19,869 47 43 30 31 St. Mary 18,099 61 55 34 36 Christ Church 39,541 121 139 96 77 St. John 20,426 69 59 62 48 Total 133,329 366 363 292 249 Note.—In the above the births and deaths have all been properly corrected, strangers have been eliminated, and extra-parochial deaths and others have been allotted to their proper sub-district. 100 TABLE VI.—Sale of Food and Drugs Act.—Samples analysed during the year ending 30th September, 1901. Genuine. Adulterated. Total. Dairy Products: Milk 41 8 49 Butter 10 .. 10 Margarine 5 .. 5 Cream 2 .. 2 Condiments: Mustard 4 .. 4 Pepper 1 .. 1 Vinegar 1 .. 1 Curry Powder 1 .. 1 Capers Spirits: 1 .. l Gin 4 .. 4 Whisky 14 .. 14 Brandy 4 .. 4 Rum 1 .. 1 Beverages: Tea 6 .. 6 Coffee 1 .. 1 Drugs: Tartaric Acid 1 .. 1 Carbonate of Soda 1 .. 1 Miscellaneous: Ketchup 2 .. 2 Corn-Flour 1 .. 1 Jam 6 .. 6 Sweets 3 .. 3 Port Wine 1 .. 1 Lard 2 .. 2 Pickles 1 .. 1 Tinned and Bottled Foods 21 .. 21 Custard Powder 1 .. 1 Honey 1 .. 1 Gingerbread 1 .. 1 Lime Juice 2 .. 2 Lemon Quash 3 .. 3 Total 143 8 151 101 REGISTER OF SANITARY WORK, Month ending 31st August, 1901. SANITARY DEPARTMENT. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. T. Gorniot, No. 3 District. Mr. D. J. Andrews, No 4 District. Mr. W. Yeo, No. 5 District. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell Total. Number of Complaints received 10 6 16 17 12 6 20 87 Inspections Of Dwelling Houses 36 23 23 35 31 ... ... 148 „ Kitchens (separately occupied) 4 ... ... 20 11 ... ... 35 „ Schools 1 1 ... 1 3 ... ... 6 „ Houses registered under Public Health (London) Act, 1891 24 ... 11 22 32 ... ... 89 „ Dairies and Cow-houses 2 1 1 1 7 ... ... 12 „ Bakehouses ... ... ... ... 1 ... ... 1 „ Slaughterhouses 2 2 9 ... 3 ... ... 16 „ Miscellaneous Inspections 160 123 120 150 174 184 164 1075 Notices issued for Abatement of Nuisances, etc. 4 2 ... ... 9 ... ... 15 Letters written relating to Abatement of Nuisances 18 20 20 23 21 3 17 122 Proceedings taken before Magistrates under Sanitary Acts ... 1 ... ... ... ... ... 1 Reports made to Medical Officer of Health 22 32 40 20 49 15 6 184 Infectious Patients removed to Hospital 16 2 10 19 11 ... ... 58 Rooms Disinfected after Infectious Disease 25 6 19 32 26 ... ... 108 New Pipe Drains (feet) 1280 830 860 640 1226 ... ... 4836 Houses where defects in Drainage have been detected and remedied 7 2 ... 3 17 ... ... 29 Unwholesome Food—Number of Seizures made ... ... 1 ... ... ... ... 1 Food Adulteration. Samples collected for Analysis 19 17 ... 10 19 ... ... 65 Proceedings taken before Magistrates 1 ... ... ... 2 ... ... 3 Removal of Bodies to Mortuary ... ... ... ... ... ... ... 102 REGISTER OF SANITARY WORK Month ending 30th September, 1901. PUBLIC HEALTH DEPARTMENT. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. T. Gorniot, No. 3 District. Mr. D. J. Andrews, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell. Total. Number of Complaints received 5 5 30 13 6 4 5 68 Inspections. Of Dwelling Houses 15 16 40 25 4 ... ... 100 ,, Kitchens (separately occupied) ... ... 2 10 4 ... ... 16 „ Schools ... 1 1 ... 1 ... ... 3 „ Houses registered under PublicHealth(London) Act, 1891 16 ... 12 10 9 1 48 „ Dairies and Cow-houses 2 1 1 2 2 ... ... 8 „ Bakehouses ... ... ... ... ... 43 ... 43 „ Slaughterhouses 2 2 6 3 2 ... ... 15 „ Miscellaneous Inspections 125 96 230 100 26 176 83 836 Notices issued for Abatement of Nuisances, etc. 3 2 5 2 5 ... 1 18 Letters written relating to Abatement of Nuisances 12 13 31 15 11 ... 15 97 Proceedings taken before Magistrates under Sanitary Acts ... ... ... ... ... ... ... ... Reports made to Medical Officer of Health 18 30 60 20 36 15 8 187 Infectious Patients removed to Hospital 9 15 16 16 6 ... ... 61 Rooms Disinfected after Infectious Disease 14 32 130 29 13 ... ... 218 New Pipe Drains (feet) 560 380 1760 324 226 ... ... 3250 Houses where Defects in Drainage have been detected and remedied 4 3 6 3 2 ... ... 18 Unwholesome Food—Number of Seizures made ... ... ... ... ... ... ... ... Food Adulteration. ''Samples collected for Analysis 4 ... ... ... ... ... ... 4 Proceedings taken before Magistrates ... ... 3 ... ... ... ... 3 Removal of Bodies to Mortuary ... ... ... ... ... ... ... ... 103 REGISTER OF SANITARY WORK, Quarter ending 30tii September, 1901. PUBLIC HEALTH DEPARTMENT. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. T. Gorniot, No. 3 District. Mr. D. J. Andrews No. 4 District. Mr. W. Yeo, No. 5 District. Mr. R. Phillips, Special Duties. Miss L. M. O'Kel!. Total. Number of Complaints received 25 23 60 55 38 16 29 246 Inspections. Of Dwelling Houses 91 78 83 105 64 35 ... 456 „ Kitchens (separately occupied) 8 ... 4 50 20 ... ... 82 „ Schools 2 4 2 1 6 ... ... 15 „ Houses registered under PublicHealth(London) Act, 1891 70 ... 23 54 62 ... 2 211 „ Dairies and Cow-houses 6 3 3 3 14 ... ... 29 ,, Bakehouses ... ... ... ... 2 86 ... 88 „ Slaughterhouses 6 4 15 3 6 ... ... 34 „ Miscellaneous Inspections 472 411 490 400 371 544 488 3176 Notices issued for Abatement of Nuisances 13 7 9 10 23 ... 3 65 Letters written relating to Abatement of Nuisances 62 57 66 88 53 6 68 400 Proceedings taken before Magistrates under Sanitary Acts .. 1 ... ... ... ... 3 4 Reports made to Medical Officer of Health 76 94 140 75 134 45 26 590 Infectious Patients removed to Hospital 38 18 32 65 33 ... ... 186 Rooms Disinfected after Infectious Disease 63 41 161 97 70 ... ... 432 New Pipe Drains (feet) 3080 2196 3470 1906 3066 ... ... 13718 Houses where defects in Drainage have been detected and remedied 19 12 12 17 24 ... 6 90 Unwholesome Food—Number of Seizures made ... ... 1 ... ... ... ... 1 Food Adulteration Samples collected for Analysis 30 25 30 30 27 ... ... 142 Proceedings taken before Magistrates 1 ... 3 ... 2 ... ... 6 Removal of Bodies to Mortuary 1 ... ... ... ... ... ... 1 THE SANITARY CHROICLES OF THE BOROUGH OF ST. MARYLEBONE DURING OCTOBER, 1901. BY ALEXANDER WYNTER BLYTH, Medical Officer of Health, and Analyst of Food and Drug for the Borough of St. Marylebone. PRINTED BY ORDER OF THE COUNCIL. Vol. XXI. Town Hall, St. Mabylebone, November 7th, 1901. No. 9. The week ending September 28th was fine and dry. Minimum temperature, 45.0°; maximum, 73.0° ; mean, 60.80. Winds, S.E. & N.W. Sunshine, 19.l°/. Mean barometer, 29.8 inches. The week ending October 5th was less settled. Minimum temperature, 41.0°; maximum, 73.0°; mean, 58.1°. On two days rain fell (0.5 inch). Winds, S.W. Sunshine, 17.9°/0. Mean barometer, 29.9 inches. The week ending October 12th was bright and sunny. Minimum temperature, 39.0°; maximum, 61.0° ; mean, 51.8°. On two days rain fell (0.06 inch). Variable winds. Sunshine, 23.3°/°. Barometer, 29.7 inches. The week ending October 19th was generally overcast. Minimum temperature, 42.5° ; maximum, 62.4° ; mean, 52.7°. On two days rain fell (0.20 inch.) Winds, E. & S.E. Fogs threatened. Sunshine, 13.2°/°. Mean barometer, 29.8 inches. The week ending October 26th was dull, overcast and inclined to fog. Minimum temperature, 33.5° ; maximum, 56.0° ; mean, 47.8°, Winds, S.W. and S.E. On two days rain fell (0.11 inch). Sunshine, 11.4°/°. Mean barometer, 29.8 inches. 106 BIRTHS AND DEATHS. During the five weeks ending October 26th there have been registered 300 births and 167 deaths. These births and deaths are divided among the five sub-districts as set forth in Table V. Sixty-five of the deaths were extra-parochial as follows:— St. Marylebone Infirmary, Notting Hill 34 North-Western Fever Hospital 2 Western Fever Hospital 1 Hospital Ship " Castalia " 1 London Fever Hospital 1 St. Mary's Hospital Children's Hospital, Paddington 8 3 German Hospital University College Hospital 2 Charing Cross Hospital 1 Colney Hatch Asylum 2 Claybury Asylum 1 Leavesden Asylum 1 Hoxton House Asylum 1 Banstead Asylum 1 Hanwell Asylum 1 St. Pelagia's Creche 1 St. Joseph's Home 1 In the streets 2 Total 65 The birth and death-rates, as deduced from the four weeks' statistics, are as follows :— 107 The average death-rates for five years (1895 to 1900) for the corresponding period were as follows:— All Souls, 12.5 ; Rectory, 17.2 ; St. Mary, 13.3; Christ Church, 15.3; St. John, 19.9; the whole district, 15.5. The following table gives, as usual, facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes: TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE FIVE WEEKS ENDING OCTOBER 26TH, 1901, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES Total Deaths. 5 weeks ending Oct. 26th, 1901. Proportion of the deaths to 1,000 deaths from all causes. 5 weeks ending Oct. 26, 1901. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1895-1900. 1. Deaths from the chief Zymotic Diseases 18 108 1.40 2.16 2. Pulmonary, other than Phthisis 29 173 2.26 2.73 3. Tubercular 29 173 2.26 1.88 NOTES. 1, includes Smallpox. Measles, Scarlet Fever, Diphtheria, Influenza, Whooping Cough Erysipelas, Croup, Fever, and Diarrhoea. 3, includes Phthisis, Scrofula, Rickets, and Tabes. 108 Smallpox. During the month there have only been seven cases of smallpox notified, the seven cases occurring in various parts of the Borough, and on notification promptly removed. The greatest danger to the Metropolis is, without doubt, the wandering cases of the malady. For example, one poor woman, who was in the habit of sleeping in open doorways, disused basements, and common lodging houses, is known to have wandered for three days and nights, between the eastern portion of the Borough and the central districts, in a most infectious state. The following is a brief history of another case:— C. E., aged 19, felt ill on the 16th October, but continued his employment, which consisted in delivering handbills from house to house. On the 17th he consulted a medical man at a certain dispensary in this Borough; the medical man apparently did not recognise the disease. During the rest of the day he lay in his grandmother's small back room in St. John's Wood. At 7 p.m. he went for the night to the Salvation Army Shelter, where he regularly slept. On the 18th he was probably delirious some part of the time, and his exact movements are uncertain, but he appears to have walked the streets in the neighbourhood of Covent Garden all night until the early morning. He then made his way to Regent's Park, and . passed the whole day on one of the seats. On the evening of the 19th he presented himself at the Salvation Army Shelter, and was noticed to have an eruption on his face. It had really appeared on the 17th, possibly even earlier; this time he was not admitted, but sent to the Casual Ward, seen by a medical man, and promptly removed to hospital. A relative of the patient saw him at St. John's Wood on the 17th, and was attacked a fortnight afterwards, and has been removed to hospital from another district. In that portion of the Metropolis in which the patient was delivering handbills, it is also to be observed that there was an outburst of smallpox around the 29th and 30th of the month, which would agree with the incubation period of seed dropped into people's letter boxes on the 16th. Hence, the inference that some of these infections were derived from C. E. 1 9 O 1 . CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, TYPHOID FEVER & SMALLPOX DURING 1901, AS COMPARED WITH A FIVE YEARS' AVERAGE. OCTOBER 109 Bubonic Plague. In the report for August and September (Sanitary Chronicle 1900, p. 96), 191)0, the writer recorded the fact of plague having broken out in Glasgow ; and now for the second time after the interval of a year, undoubted cases of plague have occurred not only in Glasgow, but in Liverpool. The introduction of plague into this Borough, or into any part of the Metropolis is, therefore, not impossible and if there is any reasonable precaution that can be adopted, it should be immediately put into force. The careful investigations of a number of observers have now established the important fact that the propagation of plague is intimately connected with the presence of rats; so much so, that it may be confidently asserted that in any locality free from rats, the plague is not likely to spread to any great extent. Infected garments, infected food, infected dust and even actual contact with the sick playing a subordinate part. Unfortunately, at the present time, owing to the extensive demolition of houses and the breaking up of old drains or the disuse of the same, rats swarm in certain portions of the district, the exits from the sewers being extremely numerous. Besides this in the 30 miles or so of old Westminster sewers, there are a vast number of imperfect brick connections and old disused drains, all affording facilities for rats to multiply, burrow, and make their way into houses. The writer, therefore, brought this subject lately before the Public Health Committee, suggesting the appointment of a sufficient staff of properly qualified men to make a systematic inspection of the sewers, sealing up as they go all rat-runs and disused drains, and reporting faulty connections. The Public Health Committee unanimously approved the report and passed a resolution referring the same to the Works Committee under the jurisdiction of which Committee are all matters relating to the sewers. Scarlet Fever and Diphtheria. It will be seen by a reference to the curve on the opposite page, that both scarlet fever and diphtheria are below the average for the corresponding five weeks of previous years. 110 TABLE II.—TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, in the Sanitary District of ST. MARYLEBONE, during October, 1901; classified according to Diseases, Ages, and Localities. (a) All Souls RectorY St. Maky • Christ Church St. John Totals Population at all Ages. (b) Census 1901 35,394 19,869 18,099 39,541 20,423 133,329 (c) Registered Births 54 27 46 92 31 250 (d) Aged under 5 or over 5 Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards New Casks of Sickness in each Locality coming to thk knowlkdge of the Medical Officer of Health. 1. Smallpox .. 1 .. 3 .. 1 .. 2 .. .. .. 7 2. Scarlatina 3 9 .. 5 .. 5 1 12 2 10 6 41 3. Diphtheria .. 1 .. .. 1 4 3 3 7 7 12 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. 5. Typhus .. .. .. .. .. .. .. .. .. .. •• .. Fevers. 6. Enteric or Typhoid .. 6 .. .. .. 3 1 1 .. 4 1 14 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 1 • • 5 .. 1 1 10 .. 3 1 20 Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospitals. 1. Smallpox .. 1 .. 3 .. 1 .. 2 .. .. .. 7 2. Scarlatina 3 9 .. 5 .. 5 1 10 1 8 5 37 3. Diphtheria .. 1 .. .. 1 .. 2 2 2 6 5 9 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 6. Enteric or Typhoid .. 1 .. .. .. 1 1 2 .. 2 1 6 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. .. .. .. 1 1 .. .. 1 1 111 TABLE III.— Giving the,Causes of Deaths during the 5 Weeks ending October 26th, 1901. at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital. Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill. Infirmary. Influenza ... ... ... ... ... Scarlet Fever ... ... ... ... ... Diphtheria 1 ... ... ... ... Typhoid Fever 1 ... ... ... ... Diarrhæa ... ... ... ... ... Erysipelas ... ... ... ... ... Pneumonia and Pleurisy 1 ... ... ... 1 Pyæmia ... ... ... ... ... Syphilis ... 1 ... ... ... Cancer 8 ... ... ... 2 Phthisis and Tuberculosis 6 ... ... ... 14 Rheumatism ... ... ... ... ... Apoplexy ... ... ... ... ... Paralysis ... ... ... ... 2 Bronchitis ... ... ... 1 7 Asthma ... ... ... ... ... Peritonitis 1 ... ... ... ... Disease of Brain ... ... ... ... ... „ Heart 3 ... ... ... 5 „ Kidney 1 ... ... ... ... „ Liver 2 ... ... ... ... „ Uterus ... ... ... ... ... „ Ovary ... ... ... ... ... Parturition ... ... ... ... ... Diabetes ... ... ... ... ... Fractures and Injuries 1 ... ... ... 1 Old Age ... ... ... ... ... Low Vitality, Infants ... 1 ... ... ... Premature Birth ... 4 ... ... ... Other causes 4 ... ... ... 2 Total *29 +6 i 34 * Of the 29 deaths in the Middlesex Hospital, 27 were those of non-parishioners. t The 6 deaths in Queen Charlotte's Hospital were those of infants of non-parishioners. 112 TABLE IV.—Causes or, and Ages at, Death during the 5 weeks ending October 26th, 1901, in the Borough of St. Marylebone. CAUSES OF DEATH. Deaths in whole District at subjoined Ages. Deaths in Localities (at all Ages). Deaths in Public Institutions. All ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25." 25 and under 65. 65 and upwards. All Souls. Rectory. St. Mary. Christ Church. St. John. Smallpox 1 .. .. 1 .. .. .. .. .. .. 1 .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever 3 1 1 .. .. 1 .. 1 .. .. 2 .. .. Whooping Cough .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria and Membranous Croup 4 .. 4 .. .. .. .. .. .. .. 2 2 1 Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric .. .. .. .. .. .. .. .. .. .. .. .. 1 Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza .. 1 .. .. .. .. 1 .. .. .. .. 1 .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 8 5 3 .. .. .. .. 4 .. 1 3 .. .. Enteritis 1 .. .. .. .. 1 .. 1 .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. Other Septic Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. Phthisis 22 .. .. .. 19 1 10 .. 4 6 2 20 Other Tubercular Diseases 7 1 2 1 .. 3 .. .. 4 .. 1 2 .. Cancer, Malignant, Disease 9 .. .. .. .. 2 7 1 2 2 3 1 10 Bronchitis 20 6 1 .. .. 6 7 6 1 3 6 4 8 Pneumonia 8 4 1 1 .. 2 .. 1 .. .. 6 1 2 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Respiratory Organs 1 .. .. .. .. 1 .. .. .. 1 .. .. .. Alcoholism Cirrhosis of Liver 4 .. .. .. .. 4 .. .. 2 .. 1 1 .. Venereal Diseases 2 2 .. .. .. .. .. .. .. 1 .. 1 1 Premature Birth 4 4 .. .. .. .. .. .. 1 .. 3 .. .. Diseases and Accidents of Parturition 1 .. .. .. .. 1 .. 1 .. .. .. .. .. Heart Diseases 20 1 .. .. .. 13 6 4 2 1 8 5 8 Accidents 6 3 2 .. .. .. 1 2 .. 1 2 1 2 Suicides 4 .. .. .. .. 4 .. 1 1 .. 2 .. .. All other causes 41 9 2 .. 2 16 12 8 5 5 14 9 37 All causes 167 36 16 3 4 74 34 40 18 19 61 29 70 33 of the 70 deaths were those of non-parishioners. 113 TABLE V.—District Births and Deaths for the five weeks ending october 26th, 1901. All Souls Population in 1901. Births. Deaths. Males. Fmls. Males Fmls. 35,394 25 39 20 20 Rectory 19,809 14 20 14 4 St. Mary 18,099 23 21 8 11 Christ Church 39,541 60 64 36 25 St. John Total 20,426 21 13 17 12 133,329 143 157 95 72 Note.—In the above the births and deaths have all been properly corrected, strangers have been eliminated, and extra-parochial deaths and others have been allotted to their proper sub-district. 114 REGISTER OF SANITARY WORK, Month ending 31st October, 1901. PUBLIC HEALTH DEPARTMENT. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. T. Gorniot, No. 3 District. Mr. D. J. Andrews, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell. Total. Number of Complaints received 7 11 16 20 20 1 8 83 Inspections Of Dwelling Houses 30 25 20 35 13 ... ... 123 „ Kitchens (separately occupied) 10 15 ... 20 13 ... ... 58 „ Schools 1 2 2 ... 2 ... ... 7 „ Houses registered under Public Health (London) Act, 1891 25 ... ... 15 21 ... ... 61 „ Dairies and Cow-houses 2 1 2 1 5 ... ... 11 „ Bakehouses ... ... ... ... ... 40 ... 40 „ Slaughterhouses 2 2 1 1 1 ... ... 7 „ Miscellaneous Inspections 225 230 260 150 147 175 223 1410 Notices issued for Abatement of Nuisances, etc 8 7 5 8 9 ... 7 44 Letters written relating to Abatement of Nuisances 24 16 18 53 15 3 23 152 Proceedings taken before Magistrates under Sanitary Acts ... ... ... ... ... ... ... ... Reports made to Medical Officer of Health 41 36 56 31 59 29 14 266 Infectious Patients removed to Hospital 10 12 18 21 15 ... ... 76 Rooms Disinfected after Infectious Disease 16 28 35 22 25 ... ... 126 New Pipe Drains (feet) 1570 1960 1609 606 1712 ... ... 7457 Hou ses where defects in Drainage have been detected and remedied 8 11 6 9 5 ... ... 39 Unwholesome Food—Number of Seizures made ... ... ... ... ... ... ... ... Food Adulteration. Samples collected for Analysis 12 10 10 26 22 ... ... 80 Proceedings taken before Magistrates ... ... ... ... ... ... ... ... Removal of Bodies to Mortuary 1 ... ... ... ... ... ... 1 THE SANITARY CHRONICLES OF THE BOROUGH OF ST. MARYLEBONE DURING NOVEMBER, 1901. BY ALEXANDER WYNTER BLYTH, Medical Officer of Health, and Analyst of Food and Drugs for the Borough of St. Marylebone, PRINTED BY ORDER OF THE COUNCIL. Vol. XXI. Town Hail, St. Marylebone, December 7th, 1901. No. 10. The week ending November 2nd was rainless and fairly sunny. Minimum temperature, 33.0° ; maximum, 59.0° ; mean, 49.5°. Winds, E. & S.E. Sunshine registered in Regent's Park, 21.6 hours. Mean barometer, 30.l inches. The week ending November 9th was rainless and dark, with a succession of dense fogs. Minimum temperature, 29.5° ; maximum, 56.0° ; mean, 40.9°. Mean barometer, 30.1 inches. The week ending November 16th was a little brighter. Minimum temperature, 25.5° ; maximum, 54.5° ; mean, 43.3°. N.E. winds. On one day thick fog. Rainless. Mean barometer, 29.5 inches. The week ending November 23rd was less dry and fairly clear. Minimum temperature, 23.5 ; maximum, 53.0° ; mean, 39.4°. On two days slight rain fell 0.22 inch. Winds S.E. and N.E. Mean barometer, 29.9 inches. Sunshine, 5.4 hours. 116 BIRTHS AND DEATHS. During the four weeks ending November 23rd there have been registered 241 births and 160 deaths. These births and deaths are divided among the five sub-districts as set forth in Table V. Fifty-seven of the deaths were extra-parochial as follows :— St. Marylebone Infirmary, Notting Hill 31 North-Western Fever Hospital 2 Western Fever Hospital 2 St. Mary's Hospital 2 London Hospital 1 University College Hospital 1 St. Bartholomew's Hospital 1 Brompton Hospital 1 Belgrave Hospital 1 Hanwell Asylum 1 Leavesden Asylum 2 Dartford Asylum 2 Claybury Asylum 3 Caterham Asylum 1 Cane Hill Asylum 3 Royal Free Hospital 1 St. Pancras Infirmary 1 Paddington Infirmary 1 Total 57 The birth and death-rates, as deduced from the four weeks' statistics, are as follows :— All Souls, birth-rate 17.9 ; deat h-rate 12.1. Rectory, birth-rate 22.9 ; death-rate 16.3. St. Mary, birth-rate 22.3 ; death-rate 15.8. Christ Church, birth-rate 31.2 ; death-rate 17.1. St. John, birth-rate 19.1; death-rate 17.8. The whole district, birth-rate 18.8; death-rate 15.6. The average death-rates for five years (1895 to 1900) for the corresponding period were as follows :—All Souls, 15.3 ; Rectory, 23.7 ; St. Mary, 16.7 ; Christ Church, 16.9; St. John, 21.2; the whole district, 18.3. The following table gives, as usual, facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes: 117 TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE FOUR WEEKS ENDING NOVEMBER 23RD, 1901, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. — 4 weeks ending Nov. 23rd, 1901. Proportion of the deaths to 1,000 deaths from all causes. 4 weeks ending Nov. 23, 1901. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1895-1900, 1. Deaths from the chief Zymotic Diseases 9 56 0.88 1.78 2. P ulmonary, other than Phthisis 53 331 5.17 4.12 3. Tubercular 20 125 1.95 2.22 NOTES. 1, includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza, Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. 3, includes Phthisis, Scrofula, Rickets, and Tabes. The Health of the District. The general death rate for the month is lower than the average of five years, while the deaths from chest complaints are decidedly in excess ; this may be fairly attributed to the influence of the November fogs, which were unusually frequent, and particularly irritating to the respiratory organs. Infectious notifiable diseases in the latter part of the month declined. There were seven cases of small-pox notified and promptly removed. With regard to the latter disease it is satisfactory to again note, that as yet cases have not appeared in any of the trade or business establishments in the Borough, and therefore it ought not to disturb in any way the considerable increased commercial activity that naturally and normally takes place at this season of the year, for it is obvious that seven scattered cases of small-pox, promptly diagnosed and promptly isolated in hospital out of a population of over 130,000, are incidents that need cause no alarm. On the other hand, the writer has not felt justified in relaxing a single precaution; the night and day duty being still continued. 118 TABLE II.—TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical 0fficer of Health, in the Sanitary District of ST. MARYLEBONE, during November, 1901; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals Population at all Ages. (b) Census 1901 35,394 19,869 18,099 39.541 20,425 133,329 (c) Registered Births 50 35 31 95 30 241 (d) Aged under 5 or over 5 Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 j 5 upwards Under 5 5 upwards 1 New Cases of Sickness in each Locality coming to the knowledge of thb medical Officeb of Health. 1. Smallpox .. 4 .. .. .. .. .. 2 .. 1 .. 7 2. Scarlatina 2 4 2 1 3 8 5 7 4 8 16 28 3. Diphtheria 1 4 .. 1 1 1 1 3 2 4 5 13 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 6. Enteric or Typhoid .. 3 .. 1 .. 1 .. 2 .. 1 .. 8 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 2 .. 5 .. 1 .. 3 .. .. .. 11 Number of such Cases Removed from their Homes in the several Localities fob Tbeatment in Isolation Hospitals. 1. Smallpox .. 4 .. .. .. .. .. 2 .. 1 .. 7 2. Scarlatina 2 4 2 1 3 8 5 4 3 6 15 23 3. Diphtheria 1 2 .. 1 1 .. 1 3 1 2 4 8 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 6. Enteric or Typhoid .. 2 .. .. .. 1 .. 2 .. 1 .. 6 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. .. .. .. .. 2 .. .. .. 2 1 9 0 1 . CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, TYPHOID FEVER, & SMALLPOX DURING 1901, AS COMPARED WITH A FIVE YEARS' AVERAGE- NOVEMBER 119 TABLE III.—Causes of, and Ages at, Death during the 4 weeks ending November 23rd, 1901, in the Borough of St. Marylebone. CAUSES OF DEATH. Deaths in whole District at subjoined Ages. Deaths in Localities (at all Ages). Deaths in Public Institutions, All ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. All Souls. ' Rectory. St. Mary. Christ Church. St. John. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever 3 .. 2 .. .. 1 .. 1 .. 1 1 .. .. Whooping Cough .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria and Membranous Croup 2 .. 2 .. .. .. .. .. .. 1 1 .. .. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric 1 .. .. .. .. 1 .. 1 .. .. .. .. .. Other Continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 1 1 .. .. .. .. .. .. .. 1 .. .. 1 Enteritis 1 .. 1 .. .. .. .. 1 .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 1 .. .. .. .. 1 .. .. .. .. .. 1 .. Other Septic Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. Phthisis 13 .. .. .. 3 10 .. 3 4 .. 5 1 9 Other Tubercular Diseases 7 2 1 .. .. 4 .. 1 .. 2 3 1 .. Cancer, Malignant. Disease 14 .. .. .. .. 12 2 8 .. 1 2 3 17 Bronchitis 40 3 1 .. 1 23 12 7 11 4 13 5 17 Pneumonia 12 6 3 .. 1 2 .. 4 .. 1 5 2 3 Pleurisy 1 .. .. .. .. 1 .. .. .. .. 1 .. .. Other Diseases of Respiratory Organs .. .. .. .. .. .. .. .. .. .. .. .. .. Alcoholism Cirrhosis of Liver 5 .. .. .. .. 5 .. .. .. 2 2 1 .. Venereal Diseases 2 2 .. .. .. .. .. 2 .. .. .. .. .. Premature Birth 1 1 .. .. .. .. .. .. 1 .. .. .. .. Diseases and Accidents of Parturition .. .. .. .. .. .. .. .. .. .. .. .. .. Heart Diseases 11 .. .. .. .. 3 8 2 3 2 2 2 3 Accidents 3 1 .. .. .. 2 .. .. .. .. 2 1 .. Suicides .. .. .. .. .. .. .. .. .. .. .. .. .. All other causes 42 10 1 2 .. 17 12 3 6 7 15 11 21 All causes 160 26 11 2 5 82 34 33 25 22 52 28 71 120 TABLE IV.—Giving the Causes of Deaths during the 4 Weeks ending November 23rd, 1901, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital. Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill. Infirmary. Influenza ... ... ... ... ... Scarlet Fever ... ... ... ... ... Diphtheria ... ... ... ... ... Typhoid Fever ... ... ... ... ... Diarrhœa 1 ... ... ... ... Erysipelas ... ... ... ... ... Pneumonia and Pleurisy 3 ... ... ... 1 Pyaemia ... ... ... ... Syphilis ... ... ... ... ... Cancer 13 ... ... ... 4 Phthisis and Tuberculosis 2 ... ... ... 7 Rheumatism ... ... ... ... ... Apoplexy ... ... ... ... ... Paralysis ... ... ... ... 1 Bronchitis ... ... ... 5 12 Asthma ... ... ... ... ... Peritonitis 2 ... ... ... ... Disease of Brain ‡ ... ... ... ... „ Heart 1 ... ... 1 1 „ Kidney ... ... ... ... „ Liver ... ... ... ... 1 „ Uterus ... ... 2 ... ... „ Ovary ... ... ... ... ... Parturition ... ... ... ... ... Diabetes ... ... ... ... ... Fractures and Injuries ... ... ... 1 2 Old Age ... ... ... ... ... Low Vitality, Infants ... 1 ... ... ... Premature Birth ... ... ... ... ... Other causes 7 1 ... ... 2 Total *29 †2 ‡2 7 31 * Of the 29 deaths in the Middlesex Hospital, 20 were those of non-parishioners. † The 2 deaths in Queen Charlotte's Hospital were those of infants of non-parishioners ‡ The 2 deaths in the Samaritan Hospital were those of non-parishioners. 121 TABLE V.—District Births and Deaths for the four weeks ending november 23rd, 1901. All Souls Population in 1901. Biiths. Deaths. Males. Fmla. Males Fmla. 35,394 28 22 14 19 Rectory 19,869 16 19 13 12 St. Mary 18,099 16 15 12 10 Christ Church 39,541 45 50 20 32 St. John 20,426 11 19 10 18 133,329 116 125 69 91 Total Note.—In the above the births and deaths have all been properly corrected, strangers have been eliminated, and extra-parochial deaths and others have been allotted to their proper sub-district. REGISTER OF SANTARY WOR K, Month ending 3th November, 1901 PUBLIC HEALTH DEPARTMENT. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. T. Gorniot, No. 3 District. Mr. D. J. Andrews, No 4 District, Mr. W. Yeo, No. 5 District. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell. Total. Number of Complaints received 10 2 14 7 14 4 14 65 Inspections Of Dwelling Houses 38 20 26 35 29 ... ... 148 „ Kitchens (separately occupied) 8 ... ... 12 15 ... ... 35 „ Schools ... 2 ... ... 2 ... ... 4 „ Houses registered under Public Health (London) Act, 1891 30 ... 10 12 31 ... ... 83 „ Dairies and Cow-houses 2 1 3 ... 5 ... ... 11 „ Bakehouses ... ... ... ... ... 103 ... 103 „ Slaughterhouses 2 2 ... ... 2 ... ... 6 „ Miscellaneous Inspections 160 160 170 150 173 84 296 1193 Notices issued for Abatement of Nuisances, etc 8 1 3 4 9 ... 4 29 Letters written relating to Abatement of Nuisances 16 13 14 15 19 ... 35 113 Proceedings taken before Magistrates under Sanitary Acts 1 ... ... ... 1 ... ... 2 Reports made to Medical Officer of Health 34 36 50 30 64 ... 12 226 Infectious Patients removed to Hospital 7 6 21 20 16 ... ... 70 Rooms Disinfected after Infectious Disease 22 15 40 21 21 ... ... 119 New Pipe Drains (feet) 960 1820 760 594 1748 ... ... 5882 Houses where defects in Drainage have been detected and remedied 10 7 6 8 3 ... ... 34 Unwholesome Food—Number of Seizures made ... ... ... ... ... ... ... ... Food Adulteration. Samples collected for Analysis 6 7 18 6 4 ... ... 41 Proceedings taken before Magistrates ... ... ... ... ... ... ... ... Removal of Bodies to Mortuary ... ... ... ... ... ... ... ...