STMARY 7 THE SANITARY CHRONICLES of St. Marylebone; being the ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1902. 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. XXII. London: Printed by George Pulman & Sons, Ltd., 24-26, Thayer Street, Manchester Square, W. PREFACE. The following Report is a Summary of the Sanitary Administration of the Borough of St. Marylebone during 1902. It also gives in a tabular form all essential facts as to the work of the Sanitary Officers and Statistics of Disease and Mortality. The Annual Reports have been cast in the same form for more than twenty years, and for the sake of uniformity no alteration has been made in the arrangement of the present Report. No. 3, Upper Gloucester Place, W. February, 1903. A REPORT of the METEOROLOGY, MORTALITY, AND SICKNESS of ST. MARYLEBONE FOR THE YEAR 1902. By A. Wynter Blyth. METEOROLOGICAL SUMMARY. march quarter. January of 1902 was a moist month, deficient in sunshine, but with little fog or frost and no snow. The minimum temperature was 24.00; maximum, 55.0° mean 38.8°. The number of rainy days was 11, during which 1.38 inch of rain was recorded. February had more of a wintry character than January; some snow and rain fell on 5 days, but the falls were slight, the rainfall only measuring .40 inch. The temperature fell down to 20° with a maximum of 49.8° and a mean of 35.50. There was a fair amount of sunshine. The winds were mostly E. and N.E. The first week of March was wet, rain falling daily, and the rainfall measuring 0.85 inch. The remainder of the month was dry, with overcast skies. The minimum temperature was 30.0° ; maximum, 60.0°; mean 44.8°. 4 June Quarter. April was fairly bright but cool. The month was unusually dry, there being only 7 rainy days and a total rainfall of 0.44 inch. The minimum temperature was 300; maximum 60.0°; mean 44.8°. The winds were N. and N.E. May was cooler and moister than April. There were no less than 17 rainy days, with a total rainfall of 1.65 inch. The minimum temperature was 32.2°; maximum 67.8°; mean 48.2°. The winds were W. and S.W. June was also wet, having 16 rainy days and a total rainfall of 2.67 inches. The minimum temperature was 39.2°; maximum, 76.0°; mean, 53.00. September Quarter. July was unsettled but there was a good deal of sunshine, and taken as a whole the climate of the month was agreeable. The minimum temperature was 44.5°; maximum 84.5°; mean 66.00. Heavy showers of rain fell on 6 days, giving a rainfall of 1.57 inches. August was damp and unsettled. On no less than 19 days more or less rain fell, giving a rainfall for the month of 2.62 inches. The winds were mostly South-Westerly. September was an average month, but deficient in sunshine. The minimum temperature was 40.0°; maximum 71.50; mean 47.40. december quarter. October was a month of moderate temperature and small rainfall. There were 9 rainy days. Total rainfall, 0.91 inch. The minimum temperature was 35.00; maximum 60.0°; mean 50.0°. November was almost free from fog and fairly dry. There were only 5 rainy days, the total rainfall measuring 0.9 inch. December was for the first 2 weeks dry and cold, then afterwards warmer and moister. During the two frosty weeks the thermometer sank to 25 but the mean for the whole month was 43.6° with a maximum of 54.0°. There were 9 rainy days, during which 1.06 rain fell. The sky was usually overcast, hence but little sunshine was registered. 5 BIRTHS AND DEATHS. The number of births registered during the 53 weeks ending December 27th, 1902, when all the essential corrections have been made, was 2,960. The number of deaths (corrected) of parishioners was 2,458. This gives a birth-rate of 21.8; a death rate of 18.1 per thousand. The birth and death-rates of the sub-districts for 1902 were as follows:— Birth-rate. Death-rate. All Souls 15.8 13.9 Rectory 19.6 19.1 St. Mary 20.6 18.1 Christ Church 29.3 19.2 St. John 20.7 22.0 The following is a statement of the average birth and death-rates for the five previous years, 1896—1900. Birth-rate. Death-rate. All Souls 17.4 14.8 Rectory 21.2 21.2 St. Mary 24.2 18.7 Christ Church 25.3 18.8 St. John 27.6 21.0 The whole district 23.0 18.5 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 556 North Western Fever Hospital 36 North Eastern Fever Hospital 6 Western Fever Hospital 8 Grove Fever Hospital 1 South Wharf Shelter 1 Gore Farm Hospital 1 Long Reach Hospital 3 Hospital Ship, Atlas 12 Hospital Ship, Castalia 5 Small Pox Hospital, Kingsbury 1 London Fever Hospital 2 London Hospital 2 Carried forward 634 6 Brought forward 634 St. Mary's Hospital 59 King's College 2 University Hospital 10 Guy's Hospital 1 Charing Cross Hospital 2 St. Bartholomew's Hospital 3 St Thomas' Hospital 3 Westminster Hospital 1 St. George's Hospital 7 Royal Free Hospital 5 Middlesex Hospital 1 Great Northern Hospital 2 Children's Hospital, Paddington 12 Children's Hospital, Gt. Ormond Street 5 French Hospital 3 Italian Hospital 2 German Hospital 2 St. Pancras Infirmary 2 Chelsea Infirmary 1 Paddington Infirmary 1 ,, Workhouse 1 St. Giles' Workhouse 1 Hackney Infirmary 1 Salvation Army Maternity 1 Clapham Maternity 2 Lying-in Hospitul, Endell Street 2 Hospital for Women, Euston Road 1 London Temperance Hospital 3 Home Hospital, Fitzroy Square 1 Home Hospital, Hampstead 1 Royal Chest Hospital 1 Cancer Hospital 2 Homoeopathic Hospital 2 Brompton Hospital 4 St. Peter's Home, Kilburn 4 St. Joseph's Home 1 St. Luke's Home 1 Home for Aged Blind 3 Licensed Victuallers' Asylum 1 Hospital of God 1 Friedenheim 8 Hanwell Asylum 28 Leavesden Asylum 10 Banstead Asylum 7 Claybury Asylum 6 Colney Hatch Asylum 19 London County Asylum, Dartford 4 Hoxton House Asylum 4 In various Streets 14 892 7 SMALL POX. The epidemic of small pox began in June of the previous year, that is in 1901, and only slowly developed. 2 cases occurred in July and 13 in August. From August, 1901, until the second week in July, 1902, the Borough was never free entirely from cases of small pox, hence the epidemic lasted about 12 months. Local Distribution.—The number of small pox cases occurring during the period was 182, 124 of which belong to the year 1902, and the balance, 58, to the preceding year. The five sub-districts were unequally affected as follows:— Number of Cases. Attack rate per 10,000 of population. All Souls 53 15.0 Rectory 34 17.1 St. Mary 26 14.4 Christ Church 51 12.9 St. John 18 8.8 The whole district 182 13.6 If the proportion to population be considered, and not the actual numbers, then it will at once be seen the chief incidence of the epidemic fell upon All Souls, the Rectory and St. Mary, and that the district of St. John's Wood was but slightly affected. Case Mortality.—8 persons died of small pox in 1901 and 23 in 1902, therefore the total deaths were 31, which gives a case mortality of 17 per cent. The cases were distributed in 83 streets; generally only single cases occurred in the household affected; but in one tenement house 5 successive cases occurred; in a beer house, the upper part of which was let out as tenements there were also 5 cases; in both instances there was concealment for a few days of the malady. Class of Sufferers.—The sufferers were for the most part working people; a large number were derived from lodging houses. Only 12 persons were affected who might be considered to be in comfortable circumstances. The epidemic showed, indeed, more clearly than other epidemics, the great part played by the tramp and by the denizens of Common Lodging Houses in the dissemination 8 of smallpox throughout London. Not alone were there successive importations into the Metropolis by persons tramping into London, but the unfortunate, homeless, friendless condition of these people naturally led to difficulties in early diagnosis and control of their movements. In one case an unfortunate man who commonly slept at the Salvation Army Shelter, Burne Street, passed the day in a high state of fever on one of the seats in Regent's Park. Towards evening he became delirious, and wandered about all night, mostly in the neighbourhood of Covent Garden; ultimately he found his way to the St. Marylebone Casual Ward, and was certified to be suffering from smallpox. In another case a woman, who habitually slept in lodging houses and occasionally in doorways, was found to be suffering from smallpox, but dreading the enforced isolation, escaped from the Endell Street Infirmary before the arrival of the ambulance. Information was received on the evening of the following day that she had been seen in the neighbourhood of Rathbone Place. All that night the writer, with Mr. Gorniot and the Medical Officer of Health for the London County Council hunted for this woman throughout various lodging houses until daybreak without success; the day after she was handed over to a police constable but again escaped. Ultimately, after being four days at large in a dangerously infectious state, she was secured and conveyed to hospital. The amount of infection that this single case disseminated successfully will never be known, but the following extract from Dr. Shirley Murphy's report for 1901, throws some light upon a few of the cases:— "She was thus, while suffering from smallpox, a source of considerable danger to other persons during a period of four days and after the lapse of time corresponding with the incubation period of smallpox, ten women, who were inmates of common lodging houses in Parker Street. Kennedy Court, Stanhope Street, and Whitehouse Yard were attacked. At all these houses she was well known. At the same time three men in a neighbouring common lodging house in Vere Street and in Greville Street were attacked, and two men in Harmond Street, St. Pancras, were also attacked. Following these, and no doubt dependent on them, a series of cases occurred in common lodging houses in Fulwoods Rents and in Greville Street, Holborn, and a case in a common lodging house in Queen Street, Drury Lane"— A series of cases occurred at the Salvation Army Shelter in Burne Street, and there is little doubt if prompt action had not been taken the Borough would have suffered severely. 9 The writer at once had an interview with the Salvation Army authorities, and pressed upon them the immediate necessity of closing the doors to all who were not protected by a recent vaccination or a previous attack of smallpox, or who declined there and then re-vaccination. This the authorities consented to, and in a most businesslike way made suitable arrangements. Night after night, the Public Vaccinator attended until a late hour, and in a very short time the Salvation Army Shelter was rendered practically immune, and as a fact the notification of cases from the Shelter stopped. Instead of a source of danger, it became a centre from which issued persons immune to that particular contagium. Mistakes in Diagnosis.—The number of cases of smallpox given at the commencement of this account only includes true cases of smallpox, there were a large number of cases of mistaken diagnosis. Fortunately the Asylums Board have an excellent system by which the patients do not go at once to the Smallpox Hospitals, but are detained a short time at a sort of observation station from whence true cases are removed, doubtful cases detained for development, and obvious errors rectified by promptly returning cases to their homes. If the Public should insist that in every case an accurate diagnosis be made at the bedside the results from a preventive point of view would be unfortunate, for should the case turn out to be infectious, the longer unisolated the more likely the spread. The first symptoms of all eruptive fevers are similar, the first stage of most eruptions not typical, hence errors are bound to be made even by the most experienced. It is only justice to further state that in not a few of the so-called errors in diagnosis, the medical men were in doubt, and it was from a consideration of the dangers of infection spreading, that they resolved to certify "smallpox." It is satisfactory to learn that in none of the cases of erroneous diagnosis did any harm result. Vaccination.—The Borough was not adequately protected, even by primary vaccination, from smallpox, still less was there any large section of the community protected by re-vaccination. The best protected quarter in this respect was St. John's Wood, because of the former sharp outbreak in the year, and it is noticeable that St. John's Wood suffered during 1901-2 in only a trifling degree. The number of primary vaccinations in the Borough from October, 1901 to January, 1902, was, according to a return given to me by Mr. Frith, the Vaccination Officer, as follows:— 10 Primary Vaccinations. St. Marylebone Workhouse 96 St. Marylebone Infirmary 52 St. Marylebone Schools 21 Queen Charlotte's Hospital 674 Others 3,133 3,976 Re-vaccinations. St. Marylebone Workhouse Schools and Infirmary 881 Queen Charlotte's Hospital 167 By Public Vaccinator 10,514 11,562 To the 11,562 re-vaccinations must be added the revaccinations performed by private practitioners who are not compelled by law to make any return. There are, however, grounds for estimating within the same period the re-vaccinations by private practitioners as not less than 4,000. This brings the total primary vaccinations and the re-vaccinations up to 19,538 or 14.7 per cent. of the total population. Preventive Measures.—The measures taken to combat the epidemic in the Borough were the vaccinations and revaccinations as above; prompt removal to Hospital, irrespective of class or social position; the keeping under observation of contact cases until the incubation period had expired; continuous duty on the part of the sanitary officers from 9 a.m. until midnight; and very thorough disinfection; besides which, referees with special experience of smallpox were appointed to confer with medical practitioners in cases of doubtful character, and since experience had proved that the most frequent error took place with regard to chicken and smallpox, chickenpox was made a notifiable disease. SCARLET FEVER. The course of scarlet fever throughout the year is graphically delineated in the curve opposite page 18. There were 335 cases notified, 14 of which terminated fatally. This gives the low case mortality of a fraction over 4 per cent. Scarlet fever was about the average or a little below up to the last week in June. It was then above the average up to the second week of November, when it declined. Although more prevalent than usual in the months mentioned, yet the excess was not sufficiently marked to warrant the term "epidemic." 11 DIPHTHERIA. Diphtheria was more prevalent than usual during the latter part of January to the middle of February, and usually below the average throughout the rest of the year. There were 223 cases notified, 27 of which were fatal, equal to a case-mortality of 12 per cent. TYPHOID FEVER. From the latter end of June up to the first week in October, there were more cases than usual of typhoid fever. In all 95 cases were notified, of which 14 terminated fatally. This is equal to a case mortality of 14.7 per cent. DISINFECTION. The two disinfecting apparatuses, the one for the disinfection of articles presumably infected with fever contagion, the other for the sterilization of the for the most part verminous clothing of persons who use the cleansing baths, have been fully employed throughout the past year as the following table shows:— List of Articles disinfected during Beds Mattresses Bolsters Pillows Sheets Blankets Other Articles 1901 508 623 516 1,431 896 2.276 2,863 1902. 619 647 59° 1,585 1,289 2,007 3,474 The vans were used in 1901 618 times, in 1902, 617. CLEANSING OF PERSONS ACT. The cleansing baths established in 1898 under the Act of 1897 have been in continual use since March 2nd, 1898. From that time until December 31st, 1902, the number of baths given to males and females is no less than 19,888, or roughly speaking, 20,000. Of course this does not mean 20,000 different individuals for the same person may, and often does, come several times. In fact the deplorable state of personal neglect that certain of these people are in, renders it impossible for them to be thoroughly cleansed with one bath. The parasites which infest the skin can only be effectually got rid of by a number of successive cleansing operations. 12 It is most satisfactory to find that during the past year there has been a considerable increase in the number of females using the baths. The total approaches to nearly one for each working day. In 1900 there were only 28, in 1901, 135, in 1902, 278 women cleansed, hence the increase is progressive. The following tabular statements compiled by Miss Kilgallin who acts as general superintendent over the Shelter as well as the baths, shows, besides the total numbers, also the place from whence the applicant for baths was derived. CLEANSING OF PERSONS ACT, 1897. Baths, Grove Road, Marylebone. From January 1st to December 31st 1902. Males Females 4.250 278 Total 4,528 The addresses given of the applicants were as follows:— Males from Salvation Army Shelter Males from Lodging Houses in Parish Females from Shaftesbury Institute Females from private addresses owing to the epidemic of Small Pox 3.954 296 202 76 Total 4,528 THE ST. MARYLEBONE SHELTER. The St. Marylebone Shelter, established for the purpose of receiving during short periods persons temporarily evicted from their homes during disinfecting operations, has done excellent service during 1902. It was used 47 times, accommodating for various periods 89 adults and 61 children. It was also found in a iew instances advisable to detain in the shelter for some little time contact cases. 13 The periods during which these persons were detained and other particulars were as follows:— 1902. Day or Hours of Occupation. Disease. No. of Persons. Jan. 1st 6 hours Scarlet Fever.. 1 adult. Jan. 6th, 7th, 8th 50 hours Smallpox 2 adults 3 children. Jan. 8th 24 hours Smallpox 2 adults. Jan. 12th 60 hours Smallpox 2 adults, 1 child. Jan. 12 th 15 hours Smallpox 1 adult. Jan. 14th 24 hours Smallpox 2 adults, 6 children. Jan. 14th 65 hours Smallpox 1 adult, 2 children. Jan. 15th 24 hours Diphtheria 2 adults, 1 child. Jan. 15th and 16th 32 hours Smallpox 6 adults. Jan. 15th and 16th 14 hours Smallpox 1 adult, 5 children. Jan. 15th to 24th — Smallpox 2 children Jan. 17th to 18th 14 hours Smallpox 3 adults, 7 children. Jan. 21st 5 hours Scarlet Fever.. 1 adult. Jan. 15th to Feb. 1st 17 days Smallpox 2 children. Jan. 25th, 26th, 27th 36 hours Smallpox 1 adult. Jan. 25th, 26th, 27th 38 hours Smallpox 2 adults, 3 children. Jan. 27th and 28th 24 hours Smallpox 1 adult, 2 children. Jan. 30th, 31st, Feb 1st 36 hours Smallpox 1 adult. Jan. 31st, Feb. 1st 24 hours Smallpox 1 adult. Jan. 31st, Feb. 1st 28 hours 1 adult. Feb. 6th and 7th 24 hours Smallpox 2 adults, one child. Feb. 20th, 21st 24 hours Smallpox 3 adults, 1 child. Feb. 22nd and 23rd 10 hours 7 adults. Feb. 26th and 27th 19 hours Smallpox 3 adults. Mch. 2nd and 3rd 6 hours Smallpox 1 adult. Mch. 3rd and 4th 24 hours Smallpox 1 adult, 1 child. Mch. 5th 6 hours Smallpox 1 adult. Mch. 12th 6 hours Smallpox 1 adult. Mch. 13th and 14th 24 hours Smallpox 1 adult, 2 children. Mch. 14th and 15 th 24 hours Smallpox 3 adults.. 4 children. Mch. 17th, 18th, 19th, 20th 65 hours Smallpox 7 adults, 5 children. Mch. 22nd, 23rd, 24th 36 hours Smallpox 3 adults. Mch. 24th and 25th 24 hours Smallpox 2 adults. Mch. 25th, 26th, 27th 65 hours Smallpox 3 adults, 1 child. Mch. 25th and 26th 24 hours Smallpox 1 adult, 2 children. Mch. 27th 8 hours Smallpox 2 adults. Mch. 29th 3 hours Smallpox 1 adult. Mch. 30th and 31st 24 hours Smallpox 1 adult. Mch. 31st, Feb. 1st 2nd, 3rd 67 hours Smallpox 1 adult, 2 children. April 1 st and 2nd 12 hours Smallpox 1 adult. April 7th and 8th 15 hours Smallpox 1 adult, 3 children. April 12th, 13th, 14th, 15th 72 hours Smallpox 3 adults, 1 child. May 25th and 26th 24 hours Smallpox 2 adults, 1 child. June 3rd and 4th 24 hours Smallpox 4 adults. June 5th to 21st 17 days Smallpox 2 children. July 26th 2 hours Puerperal Fever 2 adults. July 28th and 29th 18 hours Smallpox 1 adult, 1 child. 14 CLERICAL WORK OF THE PUBLIC HEALTH DEPARTMENT. Mr. H. E. Curtis and Mr. W. J. Howe have performed during the year the clerical work of the Department in an efficient manner. They much appreciate the commodious and well-lighted rooms and the facilities for keeping in order the various documents and forms which the new offices possess. The meeting hour of the Committee being 5 p.m. and the press of work has necessitated long hours. An attempt has been made in the following statement to tabulate a portion of the clerical work admitting of this kind of numerical expression, but as may be expected it gives no adequate idea of the work performed. REGISTER OF CLERICAL WORK. 1901. 1902. Number of Notifications of Infectious Diseases entered in Register copied and sent to Metropolitan Asylums Board and Schools, receipt acknowledged and filed 1,113 1,722 Number of Complaints of Nuisances received, entered in Nuisance Register and filed 985 835 Number of letters despatched from Department 2,111 2,756 Number of Council orders issued 215 210 Number of Meetings of Public Health Committee prepared for, attended and Minutes drafted and written 24 25 Number of meetings of Public Health Sub-Committee's prepared for, attended, and Minutes drafted and written – 17 FACTORY AND WORKSHOPS ACTS. Mr. Richard Phillips and Miss Frances Baker are the Inspectors whose special duty is to see that the details of the Factory and Workshops Acts are properly carried out. Important additions to their duties have been made 15 during the latter part of the year in respect of the supervision of the Underground Conveniences. Mr. Richard Phillips has also special duties with regard to nuisances from smoke. Both these officers, the writer can testify, have their time fully occupied and their work has been done in an efficient manner. They have summarised the work in their respective departments during 1902, in the two following Reports:— Report of Mr. Richard Phillips. 3, Upper Gloucester Place, January 1st, 1903. Medical Officer of Health. Sir,—I beg to present to you a Report of my work during the year 1902. FACTORIES AND WORKSHOPS. There are in the Borough 115 registered workrooms which are occupied exclusively by men; the principal trades engaged in are tailoring and outfitting. These workshops have been regularly inspected, and where necessary, insanitary conditions have been remedied; many cleansing orders have been made, and certain drainage matters attended to. All new workshops have been measured, cubed up, and registered in the usual way; and I have assisted Miss O' Kell and Miss Baker in the measuring up of the large workrooms. BAKEHOUSES. The registered bakehouses in the Borough number 94; these have been repeatedly visited and reported upon. There are 12 bakehouses above ground level and 82 bakehouses under ground level. This number is 12 less than in 1901, but those 12 bakehouses were not baking in August, 1901, the time the new Act came into force, and therefore ceased to have the power of baking. SMOKE NUISANCES. The number of smoke nuisances detected or complained of during the year is 22. All places where nuisances have accrued are vigilantly watched, but a recurrence of the nuisance seldom takes place after due notice has been given. 16 TRADE NUISANCES. Complaints of trade nuisances have been received, and upon proof of the case, they have been abated in every instance. UNDERGROUND CONVENIENCES. There are three underground conveniences, namely, Marylebone Road, Portland Road, and Oxford Circus; and since the last Annual Report they have been placed under the control of the Public Health Department, and it is my duty to supervise the men employed as attendants, and to inspect any repairs necessary. This requires a daily or nightly visit; I have found the premises clean, and the attendants discharging their duties satisfactorily; and all repairs etc. brought to my notice have been reported and attended to forthwith. RESTAURANTS, DINING-ROOMS, AND COFFEE- SHOPS. In conformity with instructions from you I have inspected 149 restaurants, coffee-shops, and dining-rooms in the Borough, special attention having been given to the kitchens and to lavatory accommodation. I found 59 kitchens and 21 diningrooms required cleansing, and 8 W.C.s, very dirty with no water for flushing, 7 old pan closets with D traps in a bad state, and 7 W.C.s in direct communication with the kitchen. I also found a bed in one grill-room, and 5 coffee-shops without dustbins. There were 65 written intimations of nuisances served, and minor defects were corrected upon verbal attention being drawn to them; 30 Council orders were served with satisfactory results. Since these matters were looked into I have reinspected the premises and found them all clean and in good order. Appended is a statement of my work which admits of tabulation. No. of visits. Workshops, tailors, etc. 230 Bakehouses 276 Smoke Nuisances 162 Restaurants, Coffee and Dining-rooms 355 Underground Conveniences Daily I am, Sir, Yours obediently, RICHARD PHILLIPS, Inspector. 17 Report of Miss Frances Baker. 3, Upper Gloucester Place, January, 1903. Medical Officer of Health. Sir,—I herewith beg to submit to you a Report of the work done under the Factory and Workshops Act, during the year. Owing to the appointment of Miss O' Kell in March 1902, to Paddington, 9 out of the 12 month's work has been executed by me. Number of Workrooms on the Register at end of year 1901 1,682 Number of Workrooms added during the year 1902 315 Number of Workrooms removed during year 1902 196 Leaving a total on the Register of 1,801 Number of re-inspections made during year 1902 1,378 Number of businesses represented by workrooms 1,562 In addition to these workrooms there are the rooms occupied by outworkers, which represent various firms of dressmakers, furriers, outfitters, tailors, and upholsterers situate in several Metropolitan Boroughs; and they include besides the trades mentioned, gold-beaters, lace-cleaners, laundresses, silk-winders, marqueterie workers, etc. The lists of outworkers are received from the different firms in the Borough twice during the year, according to the provisions of the Factory and Workshop Acts; and they contain for the most part the names of families living in one to three rooms, with the foreign element much in evidence, and which shows itself not the least in a frequent disregard of all laws of cleanliness and health. Number of Outworkers on Register at close of year 1901 215 Number of Outworkers' names received during year 1902 909 Of which were transferred to other Boroughs 806 Number of removals during the year 1902 51 Leaving a total on the Register of 267 Number of Outworkers visited or re-inspected during the year 1902 489 There have been paid also to domestic workshops 42 visits, and 11 to factories. 18 NUISANCES ABATED. 85 intimations have been served, followed in 11 cases by Council Orders; but the amount of the work done is greatly in advance of the Notices served. The domestic cleaning of 32 premises has been done, also the walls and ceilings of 86 rooms; in 17 instances gas stoves have been properly ventilated, and the temperature of 19 workrooms improved. Attention has been drawn to 6 cases of overcrowding, but no repetition of the offence has been detected. The sanitary accommodation of 43 premises has been cleansed, besides which 13 additional ones have been placed; and there have been 32 general improvements made in sanitation. During the year 202 miscellaneous visits and inspections have been made, 142 visits to works in progress, and 87 complaints received followed by investigations. On one occasion a summons for the non-cleansing of workrooms was taken out by my predecessor, Miss O' Kell, with the result that a fine of £5 was enforced in addition to a payment of 10s. per day in default of the work being done. The underground conveniences for Women have been regularlv inspected. Having been placed under the control of the Public Health Department during the year, the work in connection therewith has very much increased, including also the supervision of the attendants, which has been placed almost entirely in my hands. Owing to various complaints received, I have found it necessary to visit them at all hours of the day and night, Sundays not excepted. The conveniences have always appeared to be clean and well attended to by those in charge. Where any improvements could be made they have been readily sanctioned by the Committee, and all repairs have been quickly carried out. I beg, Sir, to remain, Your obedient servant, FRANCES A. BAKER, Inspector. HOUSING OF THE WORKING CLASSES ACT. No new scheme under any of the divisions of the Act was initiated during the year. Nor is there much encouragement to put the Act again in force until the schemes already long ago represented have been dealt with. Nightingale still stands; Devonshire Place L.G. scheme and the larger one of Burne Street remain sub judice. What is really required is a clean sweep of the Housing of the Working Classes Acts, and legislation de novo, possibly on the lines of the Manchester 1902. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, TYPHOID FEVER & SMALLPOX DURING 1902, AS COMPARED WITH A FIVE YEARS' AVERAGE DECEMBER. 19 and Liverpool Local Acts, under which so much has been done and at a relatively less cost to the community than under the general Statute. PROSECUTIONS UNDER THE PUBLIC HEALTH (LONDON) ACT. Considering the number of notices and intimations under the Public Health (London) Act, the necessity for enforcing them by prosecutions are very few in number. For the most part sanitary notices have been executed promptly and without even questioning their justness. No. 3, Little Marylebone Street was found to be without a responsible owner. The drains were choked and there was no water supply. A magistrate's order was obtained for closing the premises. The house was fully occupied by various families. All except one family quickly removed without trouble. This family consisted of a man, his wife and six children. They stopped on, declaring that they could not find lodgings elsewhere. This no doubt was true, it is becoming more and more difficult for a working man with a young family of five or six to obtain any kind of lodging in the central districts. The case was obliged to be brought before the magistrate who ordered a penalty of 40s. a day from a certain date in February, the fine not to be enforced if the premises were vacated within 18 days. The family within the time stated removed from the premises which were then properly secured. No. 25, Harcourt Street was similarly found to be without a responsible owner ; the general sanitary state was bad and there was no water supply to the premises. A closing order was obtained. The house in Little Marylebone Street is still closed no owner having come forward. The house in Harcourt Street is at present undergoing considerable reparation in order to make suitable Club premises. The occupier of a house in Marylebone Lane was fined and prosecuted for the at first sight trivial offence of placing an improper receptacle on the kerb. The practice of putting the refuse collected daily from the leading streets in uncovered receptacles of all kinds and sizes has, however, been a constant source of nuisance. Not alone does the dust blow about the street, but to see slop buckets, old jugs, decaying hampers, egg boxes and so forth is an offence to the eye. 20 The owner of Nos. 10 and 13 Hereford Street was summoned for disobedience to a sanitary notice, the work being in progress at the time of hearing, the magistrate adjourned the case for 28 days, and ultimately the summons was withdrawn. The owner of 314, Edgware Road, was summoned for neglecting to supply suitable drainage. The ownership proved to be most complicated; leases, subleases and assignments were plentiful. Ultimately it was considered that the freeholder was responsible, and an order obtained against him with costs. The freeholder raised the technical objection that under the Act, he was not the "Owner" and appealed. On the advice of Counsel it appeared that there was some doubt as to whether the appellant was not technically right and the case was settled out of Court by the Council paying certain expenses. In the meantime the house in question has been effectually drained by one of the lessees. SALE OF FOOD AND DRUGS ACTS. The work under these Acts was interfered with during four or five weeks owing to the removal of the Laboratory from the Town Hall to the present address in consequence of which there was a slight diminution, in the number of samples analysed as compared with 1901. The figures for the two years being 1901, 646; 1902, 545. The tabulated statement of the analyses is to be found in Table II, page 23. Of the 545 samples 22 were reported adulterated. In most of the above, prosecutions were instituted and the vendors fined small sums, the minimum fine being £1, the maximum £5- The fines recovered under the Acts amounted to £41. The definite Standards fixed by the Board of Agriculture have worked well, they are not only decreasing the amount of adulteration but they render the conviction of offenders easier. SANITARY LEGISLATION, 1902. There has been no statute passed directly bearing upon sanitation, save "The Cremation Act, 1902, (2, Edward VII., c. 8). This Act makes all the provisions of the Burial Acts which refer to the provision of a burial ground, applicable also to the provision of crematoria, it also applies for similar purposes, the provisions of the Public Health (Interments) Act, 1879. 21 It further enacts that no crematorium shall be constructed nearer than 200 yards to any dwelling house except by consent in writing of the owner, lessee and occupier of such house, nor within 50 yards of any public highway nor in the consecrated part of the burial ground of any burial authority. The regulations as to the maintenance and inspection of the crematoria and all details as to the burning of the body, the disposal of the ashes and a variety of details are to be settled by the Secretary of State. The Secretary of State up to the present date has not issued any such regulations. 22 TABLE I. REPORT OF MORTUARY KEEPER. FOR THE YEAR 1902. Number of bodies received from January 1st to December 31st, 1902. Males. Females Males Females. January 22 19 Forward 114 113 February 26 24 July 18 18 March 17 24 August 23 9 April 15 12 September 14 21 October 19 21 May 13 17 November 15 16 June 21 17 December 19 25 114 113 222 223 Total 445 Number of Inquests from January 1st to December 31st, 1902. January 21 Forward 101 February 18 July 12 March 18 August 14 April 13 September 13 October 14 May 14 November 10 June 17 December 20 101 184 Total 184 Infectious cases received. Smallpox 1 Diphtheria 5 Typhoid 4 Measles 1 11 23 TABLE II.—SALE OF FOOD AND DRUGS ACT. Samples Analysed during 1902. Genuine. Adulterated. Total. DAIRY PRODUCTS— Milk 186 14 200 Butter 100 5 105 Margarine 18 1 19 Cheese 3 – 3 Lard 10 – 10 Cream 2 — 2 ALCOHOLIC BEVERAGES— Whisky 47 – 47 Brandy 11 2 13 Gin 20 – 20 Rum 3 – 3 Port Wine 6 – 6 Beer 12 – 12 Liqueurs 3 — 3 NON-ALCOHOLIC BEVERAGES— Coffee 8 – 8 Coffee and Chicory 3 – 3 Tea 2 – 2 Cocoa 1 — 1 CONDIMENTS— Pepper 11 – 11 Mustard 2 – 2 Sauce 6 – 6 Vinegar 1 – 1 TINNED GOODS 45 — 45 SACCHARINE SUBSTANCES— Honey 1 – 1 Sweets 4 – 4 Golden Syrup 5 – 5 Jam 1 – 1 Sugar 2 — 2 MISCELLANEOUS— Lime Juice 1 – 1 Essence of Lemon 1 – 1 Lemon Squash 3 – 3 Lemon Powders 1 – 1 Quinine 7 – 7 Glycerin 5 – 5 Tincture of Rhubard 2 – 2 Powdered Rhubarb 1 – 1 Spirits of Nitre 1 – 1 Salad Oil 2 – 2 Corn Flour 1 – 1 Peach Bitters 3 – 3 541 22 563 24 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 1902; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals Population at all ages. (b) Census 190 35,391 19,849 18,099 39,536 20,428 133,301 (c) Registered Births 570 396 381 1182 431 2960 (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 of Health. 1. Chicken Pox 51 55 49 3) 35 12 79 64 56 57 270 218 2. Smallpox .. 17 1 27 .. 20 2 41 .. 16 3 121 3. Scarlatina 21 22 12 38 9 27 12 33 48 110 105 230 4. Diphtheria 17 48 10 26 11 12 16 22 24 37 78 115 5. Membranous Croup .. .. .. .. .. .. .. .. 1 .. 1 Fevers. 6. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 7. Enteric or Typhoid 1 19 9 15 1 28 3 19 5 90 8. Continued .. .. .. .. .. .. .. .. .. .. .. .. 9. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 10. Puerperal .. 5 .. .. .. 1 .. 2 .. 1 .. 9 11. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 12. Erysipelas 1 28 .. 85 2 67 5 62 1 26 9 i68 Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospitals. 1. Smallpox .. 17 1 27 .. 20 2 41 .. 16 3 121 2. Scarlatina 18 59 10 39 7 24 10 35 41 86 86 243 3. Diphtheria 15 34 9 19 12 8 17 18 13 30 66 109 4. Membranous Croup .. .. .. .. .. .. .. .. 1 .. 1 .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid 1 12 .. 6 .. 10 1 21 2 14 4 63 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. 2 .. .. .. 1 .. .. .. 1 .. 4 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 3 .. 60 1 1 1 13 1 6 3 82 25 TABLE IV.—Giving the Causes of Deaths during the 53 Weeks ending December 27th, 1902, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John & Elizabeth, and the Marylebone Infirmary, Notting Hill, W. Middle- sex Hospital. Queen Charlotte's Hospital. Samaritan Hospital. Workhouse. Notting Hill Infirm'ry. Hospital of St. John & Elizabeth, Grove Road. Smallpox .. .. .. .. 1 .. Influenza 1 .. .. .. .. .. Scarlet Fever .. .. .. .. .. Diphtheria 6 .. .. .. .. .. Typhoid Fever 7 .. .. .. 1 .. Diarrhœa 5 .. .. 3 13 .. Ervsipelas 5 .. .. .. 7 .. Pneumonia and Pleurisy 31 1 .. 2 29 .. Pyaemia 1 .. .. .. 1 .. Syphilis .. .. .. .. 9 .. Cancer 150 .. 3 .. 27 5 Phthisis & Tuberculosis 25 .. .. 1 122 12 Rheumatism 1 .. .. .. 3 .. Apoplexy .. .. .. 1 7 .. Paralysis .. .. .. .. 26 .. Bronchitis 27 .. .. 10 111 5 Asthma .. .. .. 2 .. .. Peritonitis 3 1 .. .. 1 .. Disease of Brain .. .. .. .. .. .. ,, Heart 40 1 .. 6 48 4 ,, Kidney .. .. .. .. 2 .. ,, Liver 6 .. .. .. 5 .. „ Uterus .. .. 1 .. .. .. ,, Ovary .. .. .. .. .. .. Parturition .. .. .. .. .. .. Diabetes .. .. .. .. .. .. Fractures and Injuries 12 .. .. 3 10 .. Old Age .. .. .. .. 43 .. Low Vitality, Infants .. l .. .. .. .. Premature Birth 116 9 1 .. .. .. Other causes .. 13 5 26 90 8 Total *436 †26 ‡11 55 556 §34 * Of the 436 deaths in the Middlesex Hospital, 33 were those of non-parishioners. † The 21 of the 26 deaths in Queen Charlotte's Hospital were those of non-parishioners. ‡ 10 of the 11 deaths in the Samaritan Hospital were those of non-parishioners § 27 of the 34 deaths in St. John's Hospital were those of non-parishioners. 26 TABLE V.—Causes of, and Ages at, Death during 1902, 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 23 1 4 3 ... 14 1 4 5 5 5 4 19 Measles 36 26 50 10 ... ... ... 9 15 17 38 7 1 Scarlet Fever 14 2 9 2 ... 1 ... 2 3 1 2 6 11 Whooping Cough 16 5 11 ... ... ... ... 7 1 1 6 1 3 Diphtheria and Membranous Croup 27 2 15 7 2 1 ... 4 7 6 4 6 20 Croup 2 1 1 ... ... ... ... ... 1 ... 1 ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric 14 ... ... 1 5 8 ... 1 ... 1 9 3 13 Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza 35 4 1 ... 1 14 ... 6 ... 6 5 7 1 Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa 80 62 12 ... ... 4 ... 15 7 9 37 12 22 Enteritis 5 4 1 ... ... ... ... ... 1 2 2 ... 2 Puerperal fever 2 ... ... ... ... 2 ... ... 1 ... 1 ... 1 Erysipelas 7 3 ... ... ... 1 3 3 ... 2 1 1 4 Other Septic Diseases 23 1 ... 1 4 15 2 6 7 5 3 2 10 Phthisis 225 6 3 2 23 162 29 59 31 28 71 36 126 Other Tubercular Diseases 75 22 20 9 5 18 1 16 7 7 30 15 20 Cancer, Malignant Disease 146 ... ... ... ... 91 55 42 25 20 30 29 175 Bronchitis 345 39 24 5 6 98 173 72 74 48 105 46 116 Pneumonia 185 33 31 2 3 85 31 49 28 26 53 29 81 Pleurisy 6 ... ... 2 ... 4 ... ... 2 1 1 2 3 Other Diseases of Respiratory Organs 13 ... 2 ... ... 4 7 1 7 1 1 3 2 Alcoholism 45 ... ... ... 1 39 5 12 5 7 15 6 13 Cirrhosis of Liver Venereal Diseases 17 11 2 ... 1 3 ... 2 3 3 6 3 4 Premature Birth 52 52 ... ... ... ... ... 8 9 7 15 13 15 Diseases and Accidents of Parturition 9 ... ... ... 3 6 ... 4 1 ... 2 2 7 Heart Diseases 229 3 1 9 6 125 85 56 29 30 76 38 90 Accidents 69 23 6 4 4 19 13 6 6 4 36 17 28 Suicides 7 ... ... ... 2 4 1 3 1 2 ... 1 ... All other causes 701 134 31 7 20 253 256 116 100 95 220 170 302 All causes 2458 434 224 64 86 ... 679 503 387 334 775 459 *1089 * 392 of these deaths were Non-Parishioners. 27 TABLE VI..—District Births and Deaths for the fifty three weeks ending december 27th, 1902. Population in 1901. Births. Deaths. Males. Fmls. Males. Fmls All Souls 35,391 292 278 253 250 Rectory 19,849 191 205 194 193 St. Mary 18.099 195 186 167 167 Christ Church 39,536 592 590 419 356 St. John 20,426 217 214 219 240 Total 133,301 1487 1473 1252 1206 Note.—In the above the births and deaths have all been properly corrected, stranger have been eliminated, and extra-parochial deaths and others have been allotted to their proper sub-district. 28 REGISTER OF SANITARY WORK Year ending 31st December, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillips, Special Duties. Miss F. A. Baker. Total. 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. Public Health (London) Act. Inspections. Dwelling Houses, &c. 397 435 416 329 279 ... ... ... 98 4 1958 Tenements 538 132 503 524 343 ... ... ... ... ... 2040 Underground Dwellings 113 3 211 52 143 ... ... ... ... ... 522 Dairies, Milk Shops, Cow Houses 65 25 44 25 72 ... ... ... 11 1 243 Slaughter Houses 20 24 6 5 16 ... ... ... ... ... 71 Yards, Stables, and Mews 295 213 366 572 301 ... ... ... 10 3 1760 Smoke Shafts ... ... ... ... ... ... ... ... 57 7 64 Offensive Trades and Effluvia Businesses ... ... ... 2 ... ... ... ... 4 1 7 Refuse Receptacles 107 144 67 112 60 ... ... ... 2 7 499 Enquiries re non-removal of refuse 92 106 129 49 57 ... ... ... ... 12 445 Removal of Bodies to Mortuary 3 1 2 2 ... ... ... ... ... ... 8 Visits to Works in progress 2322 2384 2115 2439 1841 ... ... ... 280 176 11557 Miscellaneous Inspections 1638 1419 1285 1870 1274 ... ... ... 292 465 8243 UNWHOLESOME FOOD. Number of seizures made ... ... 2 2 ... ... ... ... ... ... 4 INFECTIOUS DISEASE:— Cases Isolated 12 18 9 8 6 ... ... ... ... ... 53 Cases Removed to Hospital 163 138 113 198 158 ... ... ... ... ... 770 Rooms Disinfected 310 235 167 347 302 ... ... ... ... ... 1361 NEW DRAINAGE Number of Plans Passed 89 73 60 104 106 ... ... ... 7 4 443 New Pipe Drains (feet) 12610 13321 4482 12311 14634 ... ... ... 30 ... 57388 Houses where defects in existing Drainage have been detected and remedied 101 102 108 71 89 ... ... ... 11 1 483 29 REGISTER OF SANITARY WORK Year ending 31st December. 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillips, Special Duties. / Miss F. A. Baker. Total 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. Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 449 127 576 Periodical Inspections:— ... ... ... ... ... ... ... ... 171 ... 171 Factories ... ... ... ... ... ... ... ... 48 18 66 Workshops ... ... 1 ... ... ... ... ... 654 1454 2109 Bakehouses 3 ... ... ... ... ... ... ... 464 15 482 Restaurants, &c. ... ... ... ... ... ... ... ... 427 3 430 Homeworkers' Premises ... ... ... ... ... ... ... ... 312 527 839 Domestic Workshops ... ... ... ... ... ... ... ... 206 39 245 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 127 109 122 89 107 ... ... ... ... 9 563 Correspondence, Legal Procedure, &c. Complaints received 109 100 176 199 179 ... ... ... 110 89 962 Letters and Intimations relating to Abatement of Nuisances 303 210 392 257 156 ... ... ... 95 170 1583 Statutory Notices Served 42 4 42 63 76 ... ... ... 34 8 269 Proceedings taken before Magistrates 6 ... ... 2 3 ... ... ... ... ... 11 (1) Under Public Health Act ... 1 5 1 ... ... ... ... ... ... 7 (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... 1 1 (3) „ Food & Drugs Act 2 4 4 3 8 ... ... ... ... ... 21 Reports made to Medical Officer of Health 429 335 342 619 593 ... ... ... 318 245 2881 30 INDEX TO MONTHLY REPORTS. A PAGE Age Distribution according to Censns of 1901 6, Table II. 10 Area, Houses and Population according to Census of 1901 Table II. 10 B Bakehouses underground 132 Baker, Miss Frances, Appointment of 37 Birth and Death Rate— January 3 February 22 March 36 April 51 May 60 June 73 July 88 August 99 September 99 October 120 November 30 Births and Deaths— January 2, Table XIII. 20 February 22, „ IV. 28 March 50, „ IV. 28 April 50, „ IV. 41 May 60, III. 66 June 72, „ V. 80 July 88, „ V. 95 August 98, „ III. 103 September 98, ,, IV. 104 October 120, „ III. 123 November 130, „ III. 135 Burne Street Area 63 c Callard, Annie, of 91, Salisbury Street, Prosecution of, for Margarine 37 Census, 1901 5, 7 Chickenpox, Notification of 121 Clanchy, of 51, Upper Berkeley Street, Prosecution of for Diluted Gin 37 Cohen, Abraham, of 14, Upper Rathbone Place, Prosecution of for Milk Adulteration 38 Conolly, Sarah, of 2, Union Street, Prosecution of for Milk Adulteration 48 D PAGE Death-rate, High 24 Deaths, Causes of and Ages at— January Table XII. 19 February „ V. 29 March „ V. 42 April „ V. 56 May „ V. 68 June „ VII. 81 July „ III. 91 August „ IX. 109 September „ X. 109 October „ V. 125 November „ V. 137 Devonshire Place Area 63 Duckett, David, Prosecution of for Milk Adulteration 38 E Edgware Road, No. 314. Prosecution of Owner under Public Health Acts 100 Evans, John, of 8, Christ Church Residences, Prosecution of, for Milk Adulteration 38 F Foreigners, Number of in Borough according to Census 7, Table V. 13 G Gardner, Mary, of 28, Bolsover Street, Prosecution of, for Milk Adulteration 38 Gowlett, John, of 113, Crawford Street, Prosecution of for Butter Adulteration 37 H Hall, John, of 75, Marylebone Lane, Prosecution of, for Milk Adulteration 38 Harcourt Street, No. 25, Prosecution of Owner under Public Health Acts 100 Hereford Street, Nos. 10 and 13, Prosecution of Owners under Public Health Acts 52 Housing of Working Classes Acts 62 31 INDEX TO MONTHLY REPORTS—continued. J page Jor.es. James, of 53, Charlbert. Street, Prosecution of, for Milk Adulteration 37 L Laboratory, Sale of Food and Drugs Acts, 37, 38, Table VI.. 43, 76, Table VIII , 82, 101, Table XII. 111 Little Marylebone Street, No. 3. Prosecution of Owner of under Public Health Acts 25 London County Council, General Powers Bill 75 Lunatics, Blind, &c., according to Census of 1901 7 M Marylebone Infirmary, Causes of Death— January Table XI. 18 February „ II. 27 March „ III. 60 April „ III. 54 May „ II. 65 June „ II. 77 July „ II. 31 August „ II. 102 September „ II. 102 October „ II. 102 November „ II. 134 Marylebone Lane, No. 124, Prosecution of Occupier as to Improper Dust Receptacle 63 Meteorology for— January 1 February 21 March 33 April 49 May 59 June 71 July 87 August 97 September 97 October 119 November 129 Middlesex Hospital, Causes of Death— January Table XI. 18 February „ XI. 17 March „ III. 40 April „ III. 54 May „ II. 65 June „ II. 77 July „ II. 91 August „ II. 102 September „ II. 102 October „ II. 122 November „ II. 134 N page Nightingale Street Area 62, 100 Notification of Infectious Disease — January Table IV. 136 February „ II. 26 March „ II. 49 April „ II. 53 May „ IV. 67 June „ IV. 79 July „ II. 91 August ,, VI. 105 September „ VII. 106 October „ IV. 124 November „ IV. 136 O Offices, New, for Public Health Department 52, 62, 90 O'Kell, Miss, Resignation of 24 P Pontifex, Richard, of No. 29, Upper Marylebone Street, Prosecution of for Milk Adulteration 76 Public Institutions of the Borough, Population of according to the Census 1901 Table IX. 16 Prosecutions under the Public Health Act 25, 52, 63, 100 Q Queen Charlotte's Hospital, Causes of Death— January Table XI. 18 February „ II. 27 March ,, III. 40 April „ III. 54 May „ II, 65 June „ II. 77 July „ II. 91 August „ II. 102 September „ II. 102 October II. 122 November „ II. 134 R Rowlands, Laura, of 14 Bell Street, Prosecution of, for Milk Adulteration 76 s Samaritan Hospital, Causes of Death in— January Table XI. 18 February „ II. 27 March „ III. 40 April „ III. 54 May „ II. 65 June „ II. 77 July „ II. 91 August „ II. 102 September „ II. 102 October „ II. 122 November „ II. 134 32 INDEX TO MONTHLY REPORTS—continued. page St. John and Elizabeth Hospital—Causes of Death— January Table XI. 18 February „ II. 27 March „ III. 40 April „ III. 54 May „ II. 65 June „ II. 77 July „ II. 91 August „ II. 102 September„ II. 102 October„ II. 122 November „ II. 134 Sanitary Work during— January 8, 9 February 30, 31 March 46, 47 April 57, 58 May 69, 70 June 84-86 July 95, 96 August 112, 113 September 114, 115 October 126, 127 November 138, 139 Servants, Number of according to the Census 7, Table VI. 14 Sex, Distribution of, in Borough according to the Census 5 Small-pox 3-5, 52, 62, 75, 90 Staines, Arthur, of 37, Barrow Hill Road, Prosecution of, for Milk Adulteration 37 T Tubercular Disease, Deaths from— January Table I. 3 February „ I. 23 March „ I. 36 April „ I. 51 PAGE May Table I. 61 June „ I. 74 July „ I. 89 August „ I. 99 September„ I. 99 October„ I. 121 November „ I. 131 w Wards, Population of according to the Census of 1901 Table III. 11 Williams, of 94, Devonshire Place, Prosecution of for Milk Adulteration 101 Workhouse, Causes of Death in— January Table XI. 18 February „ II. 27 March „ III. 40 April „ III. 54 May „ II. 65 June „ II. 77 July „ II. 91 August „ II. 102 September „ II. 102 October „ II. 122 November „ II. 134 z Zymotic Diseases, Deaths from, during— January Table I. 3 February „ I. 23 March „ I. 36 April „ I. 51 May „ I. 61 June „ I. 74 July I. 89 August „ I. 99 September „ I. 99 October „ I. 121 November „ I. 131 INDEX TO ANNUAL REPORT. A page Adulteration 20 All Souls Births and Deaths in, Table VI. 27 ' „ „ Birth and Death-rate of 6 „ „ Causes of Death in, Table V. 26 „ „ Infectious Diseases in, Table III. 24 „ „ Smallpox in 7 Andrews, D. J., Register of Sanitary Work 34, 35 B Baker, Miss Frances, Register of Sanitary Work 34, 35 Baker, Miss Frances, Report of Under Factory Acts 17, 18 Births and Deaths 5, Table VI 27 c Chickenpox, Notification of 10 Christ Church, Births & Deaths in, Table VI 27 „ „ Birth and Death-rate of 6 „ „ Causes of Death in, Table V 26 „ „ Infectious Diseases in, Table III. 24 Christ Church, Smallpox in 7 Cleansing of Persons Act 11, 12 Clerical Work of Sanitary Department 14 Closing Orders, 1902 19, 20 Coffee Shops 16 Cremation Act, 1902 20, 21 D Deaths, Extra-parochial 5, 6 Diagnosis, Mistakes in 9 Dining Rooms, Sanitary state of 16 Diphtheria 11 Disinfection 11 F Factory and Workshop Acts 14, 18 G Gorniot, T., Register of Sanitary Work Of 34, 35 H page Hodges, J., Register of Sanitary Work 34, 35 Housing of the Working Classes Act 18 K Kitchens, sanitary state of 16 M Meteorology 2, 4 Middlesex Hospital, Causes of Death in, Table VI. 25 Mortuary-Keeper, Report of, Table I. 22 N Notting Hill Infirmary, Causes of Death in, Table IV.25 P Perry, A., Register of Sanitary Work 34, 35 Phillips, Rd., „ „ 34, 35 „ Report of under Factory Acts 15, 17 Prosecutions under Public Health Act 19, 20 Q Queen Charlotte's Hospital, Causes of Death in, Table IV. 25 R Rectory, Births and Deaths in, Table VI. 27 „ Birth and Death, rate of 6 „ Causes of Death in, Table V. 26 „ Infectious Diseases in, Table III. 24 „ Smallpox in 7 Restaurants, sanitary state of 11 34 INDEX TO ANNUAL REPORT—continued. s PAGE St. John and Elizabeth, Hospital of, Causes of Death in, Table IV. 25 St. John, Births and Deaths in, Table VI. 27 ,, Birth and Death, rate of 6 „ Causes of Death in, Table V. 26 „ Infectious disease in, Table III. 24 „ Smallpox in 7 St. Mary, Births and Deaths in, Table VI. 27 „ Birth and Death, rate of 6 „ Causes of Death in, Table V. 26 „ Infectious Diseases in, Table III. 24 „ Smallpox in 7 Sale of Food and Drugs Acts, 20, Table II. 23 Salvation Army Shelter and Smallpox 8, 9 Samaritan Hospital, Causes of Death in, Table IV. 25 Sanitary Legislation, 1902 20 Scarlet Fever 10 Shelter, St. Marylebone 12, 13 Smallpox 7 Smoke Nuisances 15, 16 T PAGE Trade Nuisances 16 Tramps and Smallpox U Underground Conveniences 16, 18 V Vaccination 9, 10 w Workhouse, Causes of Death in, Table IV. 25 Y Yeo, W., Register of Sanitary Work 34, 35 THE SANITARY CHRONICLES of THE BOROUGH OF ST. MARYLEBONE DURING JANUARY, 1902. 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. XXII. Town Hall, St. Marylebone, February 8th, 1902. No. 1. The week ending December 28th, 1901, was overcast and sunless, with some fog. Minimum temperature, 26.0°; maximum, 45.5°; mean, 36.5°. On two days rain tell 0.61 inch. Winds, S.E. Mean barometer, 29.9 inches. The week ending January 4th, 1902, was wet; on five days rain falling to the total amount of 0.68 inch. Minimum temperature, 41.0°; maximum, 55.0°; mean, 45.3°. The winds were W. & W.S.W. Sunshine was deficient 35 hours being registered out of a possible 54.9. Mean barometer, 29.6 inches. The week ending January 11th was overcast, and on three days slight rain fell (0.07 inch). Minimum temperature, 39.2°; maximum, 52.5°; mean, 44.5°. Winds, S.W. & E.S.E. Sunshine, 4.7 hours out of a possible 56.2. Mean barometer, 30.2 inches. The week ending January 18th was rainless and cool. Minimum temperature, 24.0°; maximum, 48.5°: mean, 39.0. Winds, N.E. & N.W. Sunshine, 3.8 hours. Barometer, 30.3 inches. The week ending January 25th was also cool. On one day slight rain fell 0.02 inch. Minimum temperature, 29.9°; maximum, 52.0°; mean, 29.1°. Winds, W.S.W. Sunshine, 5.8 hours out of a possible 58.2. Mean barometer, 29.9 inches. 2 BIRTHS AND DEATHS. During the five weeks ending January 25th there have been registered 305 births and 249 deaths. These births and deaths are divided among the five sub-districts as set forth in Table XIII. Ninety-one of the deaths were extra-parochial as follows:— St. Marylebone Infirmary, Notting Hill 55 North-Western Fever Hospital 3 Western Fever Hospital 2 Hospital Ship "Atlas" 3 St. Mary's Hospital 3 Children's Hospital, Paddington 2 ,, „ Great Ormond Street 1 St. George's Hospital 1 University Hospital 1 Great Northern Hospital 1 French Hospital 1 Royal Hospital 1 London County Asylum, Dartford 1 Colney Hatch Asylum 3 Hanwell Asylum 2 Leavesden Asylum 1 St. Pancras Infirmary 1 St. Giles' Workhouse 1 55, Maida Yale 1 Gloucester Place, Paddington 1 Friedenheim 2 St. Luke's Home, Hampstead 1 Home Hospital, Hampstead 1 St. Peter's Home 1 Home for Aged Christian Blind 1 Total 91 The birth and death-rates, as deduced from the quarter's statistics, are as follows:— All Souls, birth-rate 16.4; death-rate 13.8. Rectory, birth-rate 21.0; death-rate 23.0. St. Mary, birth-rate 21.3; death-rate 21.9. Christ Church, birth-rate 33.0; death-rate 19.1. St. John, birth-rate 28.5; death-rate 24.4. The whole district, birth-rate 24.3; death-rate 19.4. DIAGRAM B. DIAGRAM showing the variations, month by month, in the average incidene of Small-pox mortality in London during the fifty years 1841-90, and the variations, month by month, in the average number of Smalt-pox patient admitted to the Metropolitan Asylum and Highgate Hospitals during the fifteen years 1876-90. A.—MEAN REGISTERED DEATHS FROM SMALL-POX. (50 years 1841-90.) The mean line represents an average weekly number of 17 deaths. B.—MEAN ADMISSIONS OF SMALL-POX PATIENTS TO THE METROPOLITAN ASYLUM AND HIGHGATE HOSPITALS. (15 years 1876-90.) The mean line represents an average weekly number of 57 admissions. 3 The average death-rates for five years (1895 to 1900) for the corresponding period were as follows All Souls, 15.8; Rectory, 26.6; St. Mary, 20.4; Christ Church, 19.0; St. John, 25.7; 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 25th, 1902, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 5 weeks ending Jan. 25th, 1902. Proportion of the deaths to 1,000 deaths from all causes. 5 weeks ending Jan. 21, 1902. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1900-1901. 1. Deaths from the chief Zymotic Diseases 20 80 1.51 2.27 2. Pulmonary, other than Phthisis 77 300 5.82 5.87 3. Tubercular 28 113 2.12 2.34 NOTES. 1, includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza, Whooping Cough, Erysipelas, Croup, Fever, and Diarrhœa. 3, includes Phthisis, Scrofula, Rickets, and Tabes. Smallpox. Smallpox is still with us; should the outbreak follow the usual seasonal distribution, as shown graphically in the accompanying curves, it will decline during February and March to rise in April and attain a maximum in May. The number of cases of smallpox removed to hospital in the Borough from the 1st June, 1901, to the last day of January, 1902, was as follows:— 4 June, 1901 1 July 2 August 13 September 24 October 7 November 7 December 10 January, 1902 29 93 Nine of the 93 were unvaccinated children under 10 years of age, the rest were aged from 18 to 62. In only a few cases is there at present precise information as to the amount of protection the rest of the sufferers possessed in the way of vaccination, but even supposing they had all been thoroughly vaccinated in infancy, an 18 years old vaccination may be of value in modifying the character of the disease, but its protective value is small. On the other hand, no case has occurred in the district of a nature to shake the writer's absolute faith in the protective power of a recent re-vaccination, which has caused sufficient local action to show that the lymph has been absorbed. It would be highly desirable to know how far at the present time the inhabitants of the Borough have had the intelligence and will to take advantage of re-vaccination, or, in other words, to know what human material exists suitable for the cultivation of smallpox. We may at once exclude the population under 15 years of age ; the majority have been vaccinated in infancy, and the protection will have only worn itself out in a minority of the cases. All persons over 15, although they may have been well vaccinated in infancy, will be more or less liable to catch Smallpox, and these number 102,000. How many of these have been vaccinated? the numbers could be exactly told if all were re-vaccinated by the Public Vaccinator, but a large number are vaccinated by other practitioners, and hence no complete returns are available. From certain data it would appear the number may be anything between 16,000 and 50,000, the latter being a high 5 estimate, the former a low estimate. To alter the ordinary seasonal distribution, and to protect the Borough at once from all cases save imported cases, will require a farther re-vaccination of at least 50,000 adults. In proportion to its population, St. Marylebone is now better vaccinated than most of the Metropolis, the probability is, therefore, that a greater proportional number of unprotected persons are to be found in other districts, hence the epidemic will not be extinguished for want of material. THE CENSUS, 1901. The detailed statistical information concerning the population of the Metropolis and its various divisions and sub-divisions has been recently published as an official document and it will be useful to extract with comments the chief tables relative to the Borough. Table II. gives the population and inhabited houses both in 1901 and in 1891 for the Borough and for its five registration divisions, showing a considerable decrease in the population as a whole: the decrease being no less than 10,782 in the ten years, or over 1,000 a year. The decrease has been in every sub-district save that of St. John's Wood, in which locality there has been a slight increase. The causes are the general cause by which more and more the central parts of the Metropolis are utilised for business purposes, the suburbs for residential; each year as the Borough will become from the extension of buildings to the north and north-west more central, there will be a slow drifting from the area of high to those of lower rents, added to this the extensive changes wrought by the Great Central Railway, and the fact that during the decade a vast number of leases have fallen in and tenement streets have been converted into streets of a higher residential character. Distribution of Sex. The 1901 census gives the distribution of sex as 57,891 males and 75,410 females; this is in the proportion of 100 males to 130 females, in the former census the proportion was 100 males to 1.28 females, so that proportionately the sexes in Marylebone are even less equal than formerly. 6 Age Distribution. The age and sex distribution are important factors in interpreting birth and death rates. The natural death rate, for example, of children under 5 years of age is about 52 per 1000; of persons 85 and upwards 280 per 1000; while the natural death rate for persons between 20 and 35 is between 6 to 7 per 1000. Hence in a district containing a large barracks filled with young soldiers of the very best age, the mortality, quite irrespective of sanitary condition, may appear very low; in another district containing, say an orphan asylum crammed with very young children, and in addition to this a number of almshouses occupied by very old persons, the death rate may appear excessive and alarming, although it may be ouite a natural one. The age and sex distribution is set out elaborately in Table IV., but the chief facts as well as a comparative view of the age constitution in the former (1891) census is more conveniently shown by calculating the ages in groups per 1000 of the population:— 1891 1901 Under 5 years 93 83 5 to 15 162 143 15 to 25 216 216 25 to 40 262 279 40 and upwards 267 279 1000 1000 It is evident there is an alteration in the age constitution of the district, the proportion of children and young persons is less, of adults more, The Number of Foreigners in Marylebone. Table V. shows the number of foreigners of various countries resident in Marylebone. The majority of these are of German, French, Swiss, Italian, and American origin. It is interesting to observe that foreigners form 4 per cent. of the total London population, and also 4 per cent. of the Marylebone population. 7 Domestic Servants. A large number of domestic servants tends to lower the death rate, for the majority are of an age that only yields naturally from 6 to 7 deaths per 1000. In Marylebone there are 102,000 persons over 15 years of age, and of these 16 per cent. are in domestic service. (See Table VI.) Lunatics, Blind, &c. According to the census return (see Table VII) there are only 8 lunatics in the Borough. The writer would have thought there were more than this number. Indeed, with regard to the whole table, since those who become imbecile or deaf or blind within the district are afterwards received in various charitable institutions outside the district, the information is somewhat misleading. Tenements. Table VIII. is of great importance from the point of view of decently housing the people. The table shows that the total tenements of less than five rooms number 22,947, and that 15,603 of the population occupy either one or at the most two rooms, this is 11 per cent., or say 12 per cent, of the population. In 1891 14 per cent. of the population were housed in the same manner. In other words, the oue and two-roomed tenements have decreased. 8 REGISTER OF SANITARY WORK Month ending 31st January, 1902 PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell. Total. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. D. J. Anurews, No. 3 District. Mr. T. Gorniot, No. 4 District. Mr. W. Yeo, No. 5 District. Public Health (London) Act. Inspections. Dwelling Houses, &c 24 29 20 20 17 ... ... ... ... ... 110 Tenements 50 36 35 60 31 ... ... ... ... ... 212 Underground Dwellings 6 ... 18 4 3 ... ... ... ... ... 31 Dairies, Milk Shops, Cow Houses 9 1 ... 2 7 ... ... ... ... ... 19 Slaughter Houses 2 1 ... 1 3 ... ... ... ... ... 7 Yards, Stables, and Mews 38 42 36 40 26 ... ... ... ... ... 182 Smoke Shafts ... ... ... ... ... ... ... ... 3 ... 3 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... ... ... ... Refuse Receptacles 20 18 5 ... ... ... ... ... ... ... 43 Enquiries re non-removal of refuse 11 17 12 12 8 ... ... ... ... ... 60 Removal of Bodies to Mortuary ... ... 1 ... ... ... ... ... ... ... 1 Visits to Works in progress 135 146 140 150 141 ... ... ... 32 40 784 Miscellaneous Inspections 130 160 120 140 126 ... ... ... 51 12 739 UNWHOLESOME FOOD. Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE:— Cases Isolated ... ... ... ... ... ... ... ... ... ... ... Cases Removed to Hospital 15 5 13 31 19 ... ... ... ... ... 83 Rooms Disinfected 28 18 17 56 29 ... ... ... ... ... 148 NEW DRAINAGE:— Number of Plans Passed 6 3 3 5 7 ... ... ... 2 ... 26 New Pipe Drains (feet) 920 490 182 760 1642 ... ... ... ... ... 3994 Houses where defects in existing Drainage have been detected and remedied 6 9 4 5 7 ... ... ... 2 ... 33 9 REGISTER OF SANITARY WORK Month ending 31st January, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell. Total. 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. Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 49 20 69 Periodical Inspections:— Factories ... ... ... ... ... ... ... ... 3 3 6 Workshops ... ... ... ... ... ... ... ... 56 46 102 Bakehouses ... ... ... ... ... ... ... ... 10 ... 10 Restaurants, &c. ... ... ... ... ... ... ... ... 13 ... 13 Homeworkers' Premises ... ... ... ... ... ... ... ... 21 21 42 Domestic Workshops ... ... ... ... ... ... ... ... 18 7 25 Food and Drug's Act. ADULTERATION. Samples collected for Analysis 14 ... 21 7 1 ... ... ... ... ... 43 Correspondence, Legal Procedure, &c. Complaints received 17 18 20 16 19 ... ... ... 7 8 105 Letters and Intimations relating to Abatement of Nuisances 28 19 30 30 18 ... ... ... 5 32 162 Statutory Notices Served 6 3 7 3 5 ... ... ... 3 4 31 Proceedings taken before Magistrates ... ... ... ... ... ... ... ... ... ... ... (1) Under Public Health Act ... ... ... ... ... ... ... ... ... ... ... (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) „ Food & Drugs Act ... ... ... ... ... ... ... ... ... ... ... Reports made to Medical Officer of Health 54 42 45 70 61 ... ... ... 48 10 330 10 TABLE II.—Registration Districts of St. Marylebone. Area; Houses, and Population, 1891 and 1901; and Separate Occupiers, 1901. Registration Districts. Area in Statute Acres HOUSES. Families or Separate Occupiers. POPULATION. Inhabited. Uninhabited Inhabited. In Occupation. Not in Occupation. Building. Persons. Males. Females. Land and Inland Water. Inland Water only. 1891. 1901. 1901. 1891. 1901. 1891. 1901. 1891. 1901. St. Marylebone 1,472-8 25-5 15,496 13,536 762 702 132 31,623 144,083 133,301 63,151 57,891 80,932 75,410 1. All Souls 243.4 — 3,896 3,828 406 161 101 8.380 39,327 35,391 17,141 14,724 22,186 20,667 2. Rectory 117.8 — 1,956 1,673 121 65 6 4,272 20,502 19,849 8,603 7,955 11,899 11,894 3. St. Mary 106.1 — 2,064 1,955 87 156 2 4,803 19,239 18,099 8,213 7,623 11,026 10,476 4. Christ Ch. 600.7 25.5 4,589 3,584 78 151 19 9,250 45,191 39,536 21,343 19,281 23,848 20,255 6. St. John 404.8 — 2,991 3,001 70 169 4 4,918 19.824 20,426 7,851 8.308 11,973 12,118 11 TABLE III.—Metropolitan Borough of St. Marylebone, with its Constituent Civil Parish and Wards, Area, Houses, 1901, and Population, 1891 and 1901. METROPOLITAN BOROUGH. Area in Statute Acres. HOUSES. 1901. population. Uninhabited. | 1801. 1901. Inhabited. In Occupation. Not in Occupation. Building. Persons. Persons. Males. Females. St. Marylebone. 1472.8 13,536 762 702 132 144,083 133,301 57,891 75,410 Civil Parish St. Marylebone. (6:1-5) Wards: No. 1 Hamilton Terrace 1,402 25 73 1 ... 8,711 2,939 5,772 No. 2 St John's Wood Terrace 1,599 45 96 3 ... 11,715 5,369 6,346 No. 3 Church Street 2,248 56 32 18 ... 27,709 14,072 13,637 No. 4 Dorset Sq & Regent's Pk. 1,336 22 119 1 ... 11,827 5,209 6,618 N o. 5 Brjanston Square 1,955 87 156 2 ... 18,099 7,623 10,476 No. 6 Portman 1,673 121 65 6 ... 19,849 7,955 11,894 No. 7 Park Crescent ... 1,521 73 64 10 ... 15,559 6,442 9,117 No. 8 Langham 1,017 67 45 54 ... 11,210 4,417 6,793 No. 9 Cavendish 785 266 52 37 ... 8,622 3,865 4,757 12 TABLE IY.—Ages of Persons, Males and Females, in the Metropolitan Borough of St. Marylebone, 1901. Borough. All Ages. Under 1 yr. 1 2 3 4 Under 5 yrs. 5 10 13 St. Marylebone P. 133,301 2,475 2,208 2,129 2,195 2,036 11,043 9,630 5,572 1,831 M. 57,891 1,221 1,108 1,048 1,103 1,028 5,508 4,730 2,668 848 F. 75,410 1,254 1,100 1,081 1,092 1,008 5,535 4,900 2,904 983 Borough. 14 15 16 17 18 19 20 21 25 30 35 St. Marylebone 2,030 2,182 2,340 2,500 2,808 2,864 3,111 13,051 14,667 12,019 10,428 956 983 1,016 1,112 1,177 1,203 1,229 5,159 5,714 4,980 4,335 1,074 1,199 1,294 1,388 1,631 1,661 1,882 7,892 8,953 7,039 6,093 Borough. 40 45 50 55 60 65 70 75 80 85 90 95 100 & upwds. St. Marylebone ... 8,851 7,435 6,114 4,537 3,925 2,603 1,927 1,068 566 160 31 7 1 3,947 i,299 2,773 2,012 1,725 1,072 746 420 185 53 10 1 ... 4,904 1,136 3,341 2,525 2,200 1,531 1,181 648 381 107 21 6 1 13 TABLE V.—Country of Birth of Foreigners enumerated in the Borough of St. Marylebone. Males. Females EUROPE. Russia 151 115 Poland (Russian) 91 73 Sweden 70 39 Norway 15 17 Denmark 38 28 Holland 66 34 Belgium 77 88 France 473 671 Germany- 1,076 688 Austria 251 52 Hungary 40 10 Switzerland 220 150 Spain 28 12 Portugal 7 4 Italy 342 120 Greece 7 2 Servia, Boumania, and Bulgaria 15 4 Turkey .. 45 7 ASIA. China 19 4 Japan 8 1 Other Countries — 1 AFEICA. Egypt .. 1 — Other Countries 1 2 AMERICA. United States 173 180 Mexico 3 1 Other States of Central America 1 1 Argentine Republic 5 3 Brazil .. 1 2 Other States of South America 3 10 Countries not stated.. 10 4 3,237 2.323 5,560 14 TABLE VI.—Families or Separate Occupiers and Male and Female Domestic Indoor Servants* in the Borough of St. Marylebone with the Proportions per cent, of Domestic Servants to Families or Separate Occupiers. Metropolitan Borough. Families or Separate Occupiers. Domestic Indoor Servants.* Proportions per cent, of Domestic Indoor Servants to Families or Separate Occupiers. Total. Males. Females. Total. Males Females ST. MARYLEBONE 31,623 16,244 1,690 14.554 51.4 5.3 46.1 * Excluding those employed in Hotels, Lodging and Eating Houses. TABLE VII.—Persons returned as Blind, Deaf and Dumb, Deaf, Lunatic, Imbecile or Feeble-minded, or suffering from Combined Infirmities, in the Borough of St. Marylebone, 1901. Blind. °Deaf and Dumb. Deaf. Lunatic. Imbecile or feeble-minded Combined Infirmities. Metropolitan Borough. Total. From Childhood. Others. Total. i From Childhood. Others. Total. From- Childhood. Others. Total. From Childhood. Others. Total. From Childhood. Others. St. Marylebone 64 3 61 17 3 14 31 3 28 8 — 8 38 3 35 2 Note.—"These figures include persons returned simply as "Dumb." 15 TABLE VIII.—Total Tenements and Tenements of less than Five Rooms, distinguishing those occupied by various numbers of Persons, in the Metropolitan Borough of St. Marylebone, 1901. Metropolitan Borough. Rooms in tenement! Tenements of less than ttvo rooms. Persons per Tenement. 1 2 3 4 5 6 7 8 9 11 12 or more. St. Marylebone I S,312 3,641 2,619 1,140 582 234 72 16 5 3 ... ... Total Tenements, 31,623 2 8,246 785 1,980 1,747 1,415 1,020 685 366 170 55 19 4 ... 3 4,185 268 705 815 701 604 454 280 192 107 27 22 9 Tenements of less than live rooms, 22,947 4 2,204 90 320 357 370 305 277 167 146 86 54 20 12 16 TABLE IX.—Institutions. —Persons enumerated in Workhouse Establishments, in Hospitals and in Lunatic Asylums, in Prisons, and in Certified Reformatory and Industrial Schools in the Borough of St. Marylebone. Number of District and Sub-District. Registration District and Sub-District. Civil Parish. INSTITUTIONS. Special Inmates (Patients, Paupers, Lunatics, &c ) Officials and their Families. Persons. Males. Females. Persons. Males. Females. 6 St. Marylebone St. Marylebone 1 All Souls Middlesex Hospital 308 138 170 180 36 144 Ladies' Hospital, Harley Street 12 ... 12 19 1 18 All Saints'Hospital (Children's) 65 ... 65 35 ... 35 West End Hospital for Paraly- 36 15 21 17 1 16 National Orthopcedic Hospital 59 29 30 19 ... 19 London Throat Hospital 17 8 9 S ... 5 St. Elizabeth's Home 47 ... 47 20 ... 20 Medical and Surgical Home ... 5 2 3 12 1 11 Home for Incurables 16 ... 16 5 ... 5 Maurice Industrial School Girls' Home 25 ... 25 3 ... 3 2 Rectory ... Workhouse 1678 807 871 31 12 19 Casual Wards ... 95 65 30 4 1 3 Grotto Home for Working Boys 16 16 ... 3 1 2 3 St. Mary ... Samaritan Free Hospital 39 ... 39 34 1 33 Western Ophthalmic Hospital 7 2 5 3 ... 3 Queen Charlotte's Lying-in Hospital 97 28 69 42 4 38 Home for Consumptive Females 18 ... 18 4 ... 4 5 St. John ... Hospital of St. John and St. Elizabeth 50 ... 50 32 ... 32 Hospital for Epilepsy and Paralysis ... ... ... 2 ... 2 Home for Incurable Children 30 15 15 9 ... 9 Home of Rest, Finchley Road 20 1 19 7 ... 7 17 TABLE X,— 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, 1902; 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. 85,391 19,849 18,099 39.536 20,425 183,301 (c) Registered Births .. 58 41 37 124 47 305 (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 Sicknkss ik bach Lco.mty [ coming to thk knowlkdgb of this medical Offickk of Hkalth. 1. Chicken Pox 3 2 .. .. .. .. 2 1 1 1 1 4 2. Smallpox .. 8 .. 1 .. 3 .. 12 .. 5 .. 29 3. Scarlatina .. .1 8 .. 1 3 3 .. 2 1 3 . 5 17 4. Diphtheria .. .. 4 3 3 3 4 2 4 3 1 11 16 5. Membranous Croup.. .. .. .. .. .. .. .. ... .. .. .. .. .. Fbvebs. (6. Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. 7. Enteric or Typhoid .. 1 .. .. .. .. .. 2 .. 2 .. 5 8. Continued .. .. .. .. .. .. .. .. .. .. .. .. 9. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 10. Puerperal .. 2 .. .. .. .. .. .. .. .. .. 2 11. Cholera.. .. .. .. .. .. .. .. .. .. .. .. .. .. 12. Erysipelas .. .. 6 .. 5 2 .. .. 2 .. 2 2 15 Numbkr of such Casks Rkmovkd from thmr 1 Homks inthb sbvekal Locamtiks fob Treatment in Isolation Hospitals. i Smallpox .. 8 .. 1 .. .. .. 12 .. 5 .. 29 A Scarlatina .. 6 .. 1 2 3 .. 2 1 3 3 15 3. Diphtheria .. .. 1 3 3 4 2 2 3 3 1 12 10 f*. Membranous Croup.. .. .. .. .. .. .. .. .. .. .. .. .. .. Fbvebs. '5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 1 .. .. .. .. .. 2 .. 1 .. 4 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. S. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. \9. Puerperal .. 2 .. .. .. 1 .. .. .. 1 .. 4 10 . Cholera .. .. .. .. .. .. .. .. .. .. .. .. i" Erysipelas .. .. 1 .. .. 1 .. .. .. .. .. 1 4 18 TABLE XI.—Giving the Causes of Deaths during the 5 Weeks ending January 25th, 1902, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John & Elizabeth, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill. Infirmary. Hospital of St.John & Elizabeth Grove Rd. Smallpox ... ... ... ... 1 ... Influenza ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... Diphtheria ... ... ... ... ... ... Typhoid Fever 1 ... ... ... 1 ... Diarrhoea 1 ... ... ... ... ... Krvsinfilas ... ... ... ... 1 ... Pneumonia and Pleurisy 2 1 ... 1 3 ... Pvapmia 1 ... 1 ... ... ... Syphilis ... ... ... ... 1 ... CJanner 16 ... 2 ... 4 ... Phthisis &c Tuberculosis ... ... ... ... 8 3 Rheumatism 1 ... ... ... 1 ... Annnlexv ... ... ... ... 1 ... ... ... ... ... 4 ... Bronchitis 1 ... ... 1 10 ... Asthma ... ... ... ... ... ... Peritonitis 3 1 ... ... 1 ... Disfinsfi of Rrain ... ... 1 ... ... „ Heart 2 ... ... 1 7 ... Kidney ... ... ... ... ... ... „ Liver 2 ... ... ... 1 ... „ Uterus ... ... ... ... ... ... ,, Ovary ... ... ... ... ... ... Parturition ... ... ... ... ... ... nia.hfifcfis ... ... ... ... ... ... Fractures and Injuries 2 ... ... ... 2 ... Old Age ... ... ... ... 2 ... Low Vitality, Infants ... ... ... ... ... ••• Premature Birth ... ... ... ... ... ... Other causes 9 ... ... ... 7 1 Total *41 2 **3 4 55 6 * Of the 41 deaths in the Middlesex Hospital, 30 were those of non-parishioners. +The 3 deaths in the Samaritan Hospital were those of non-parishioners. Two of the 6 deaths in St. John's Hospital were those of non-parishioners. 19 TABLE Xir.—Causes of, and Ages at, Death during the 5 weeks ending January 25th, 1902, 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 Institution 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 4 ... 1 ... ... 3 ... ... 1 2 ... 1 4 Measles 5 2 2 1 ... ... ... ... 1 2 2 ... ... Scarlet Fever 2 1 1 ... ... ... ... ... ... 1 ... 1 4 Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria and Membranous Croup 3 ... 2 1 ... ... ... ... 1 ... 1 1 3 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric 2 ... ... ... ... ... .. 1 .. .. 1 .. 2 Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 1 1 .. .. .. .. .. .. 1 .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhoea 2 2 .. .. .. .. .. .. .. .. .. .. 1 Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 1 1 .. .. .. .. .. 1 .. .. .. .. .. Other Septic Diseases 4 .. .. .. .. 3 1 2 2 .. .. .. .. Phthisis 16 .. .. .. 1 13 2 4 2 .. 9 1 11 Other Tubercular Diseases 12 1 1 1 1 8 .. 1 5 .. 5 1 .. Cancer, Malignant Disease 15 .. .. .. .. 12 3 4 2 1 4 4 22 Bronchitis 47 4 2 .. 4 11 26 12 8 8 10 9 12 Pneumonia 16 4 1 .. .. 8 3 2 3 2 5 4 7 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases ot 1 .. 1 .. .. .. .. .. .. .. .. 1 .. Respiratory Organs Alcoholism Cirrhosis of Liver 8 .. .. .. .. 7 1 3 .. 2 2 1 .. Venereal Diseases 4 2 1 .. .. 1 .. .. 1 .. 1 2 .. Premature Birth 3 3 .. .. .. .. .. .. .. 1 2 .. .. Diseases and Accidents of Parturition 1 .. .. .. .. .. .. .. .. .. .. .. .. Heart Diseases 22 1 .. 2 .. 13 6 6 3 1 8 1 6 Accidents 8 4 .. .. .. 2 2 .. 3 .. 4 1 4 Suicides .. .. .. .. .. .. .. .. .. .. .. .. .. All other causes 72 11 3 1 5 34 18 11 11 14 18 18 45 All causes 249 37 15 6 12 117 62 47 41 38 72 48 126 20 TABLE XIII.—District Births and Deaths for the five weeks ending january 2oTH, 1902. All Souls Population in 1&01. Births. Deaths. Males. Fmls. Males Pmls. 35,391 25 31 24 23 Rectory 19,849 24 17 20 24 St. Mary 18,099 19 18 19 19 Christ Church 39,536 63 61 39 33 St. John 20,426 24 23 21 27 Total 133,301 155 150 123 126 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. THE SANITARY CHRONICLES OF THE BOROUGH OF ST. MARYLEBONE DURING FEBRUARY, 1902. 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. XXII. Town IIall, St. Marylebone, March 7th, 1902. No. 2. The week ending February 1st was cool but line. Minimum temperature, 28-5° ; maximum, 46'5° ; mean, SB'S0. Winds, "W.N.W. and N.E. On two days slight rain fell, 0-19 inch. Sunshine registered in Eegent's Park, 32'5 per cent. Mean barometer, 29-9 inches. The week ending February 8th was wintry. Minimum temperature, 30'0° ; maximum, 38'8° ; mean, 35'1°. "Winds, E.N.E. On three days rain or snow fell, 0* 11 inch. Sunshine received only lj hour. Mean barometer, 29'9 inches. The week ending February loth was cojd and wintry, and somewhat foggy. Minimum temperature, 22.0°; maximum, 39.2°; mean, 31.3°. "Winds, N.E. Sunshine registered 24.5 percent. Mean barometer, 29'8 inches. The week ending February 22nd was overcast and cold. Minimum temperature, 20.0° ; maximum, 49.8° ; mean, 39.5°. Winds, E. & N.E. On one day rain fell, 0.1 inch. Sunshine only 7.4 per cent. Moan barometer, 29.9 inches. 22 Births and Deaths. During the four weeks ending February 22nd there have been registered 232 births and 280 deaths. These births and deaths are divided among the five sub-districts as set forth in Table IV. Ninety-three of the deaths were extra-parochial as follows :— St. Marylebone Infirmary, Notting Hill 64 Hospital Ship " Atlas" 6 North Eastern Fever Hospital 2 North-Western Fever Hospital 3 Western Fever Hospital 1 St. Mary's Hospital 6 St. George's Hospital 1 Royal .Chest Hospital 1 Royal Hospital 1 Banstead Asylum 1 Hanwell Asylum 1 Licensed Victuallers' Asylum 1 St. Peter's Home 2 In the various streets 3 Total 93 The birth and death-rates, as deduced from the month's statistics, are as follows :— All Souls, birth-rate 16.5 ; death-rate 18.0. Rectory, birth-rate 29.3 ; death-rate 38.6. St. Mary, birth-rate 19.4; death-rate 29.4. Christ Church, birth-rate 31.9 ; death-rate 31.6. St. John, birth-rate 21.0; death-rate 22.0. The whole district, birth-rate 22.6; death-rate 27.3. The average death-rates for five years (1896 to 1901) for the corresponding period were as follows :—All Souls, 19.9 ; Rectory, 28.3 ; St. Mary, 23.9 ; Christ Church, 21.2; St. John, 2.0; the whole district, 22.4. 23 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 22nd, 1902, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 4 weeks ending Feb. 22nd, 1902. Proportion ofthedeaths to 1,000 deaths from all causes. 4 weeks ending Feb. 22,1902. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1900-1901. 1. Deaths from the chief Zymotic Diseases 45 161 4.39 2.17 2. Pulmonary, other than Phthisis 106 378 10.3 5.87 3. Tubercular 28 100 2.73 2.41 NOTES. 1. includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza,Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. 3, includes Phthisis, Scrofula, Rickets, and Tabes. 24 The High Death-Rate. The death-rate is much above the average ; this is due mainly to the deaths of old persons from chest affections, particularly bronchitis. The cold, impure air of February has directly caused no less than 82 deaths from bronchitis, 50 being persons aged over 65, added to this, influenza has been epidemic, and there has been a smart outbreak of measles, necessitating the closing of the infants' department of more than one school. Resignation of Miss O'Kell. Miss O'Kell has resigned simply because she has been able to command a slightly higher salary in Paddington. The increase is for the moment £10 per annum, hence as half the salary is contributed from the whole County, the Borough is losing the services of an invaluable officer for the sake of a £5 note. A matter much to be regretted. Smallpox. During the month there have been 26 cases of smallpox, no less than nine of these, or almost a third, were derived from the Salvation Army Barracks, Burne Street. The writer, therefore, had an interview, in company with the Medical Officer for the County of London, with the chief of this particular department, and suggested that none should be permitted to take any advantage of the shelter unless they were immunised by a recent re-vaccination, or were willing to be re-vaccinated. This was cheerfully assented to. Accordingly the Public Vaccinator has attended almost every night, with the gratifying result that over 600 adults in this institution have been re vaccinated ; others have been re-vaccinated previously, and there only remains a small residuum of unprotected persons, hence there is now no fear that the establishment in Burne Street will become a danger to the Borough. The same wise precaution has been adopted at the writer's suggestion by the authorities of Queen Charlotte's Hospital. A similar 25 regulation is in force in the various establishments of the Church Array. Nothing will more effectually arrest the spread of smallpox than this kind of mild compulsion. There have been 6 deaths from smallpox at the Hospital ships of parishioners, 3 of these were children from 2 to 14 years of age, not one of these had been protected by vaccination. One, it is true, is said to have been vaccinated, but the vaccination did not "take," the other three had been vaccinated in infancy, and as their ages ranged from 27 to 40 the protection had quite worn out. Prosecution under the Public Health (London) Act- No. 3, Little Marylebone Street, a house with neither drainage nor water supply, and without a responsible owner, was ordered to be closed by the Magistrate. A family consisting of man, wife, and six children, living on the first floor, continued their occupation, alleging that they could not find accommodation elsewhere. Thereupon a summons was taken out against the occupier. The Magistrate awarded a penalty of 40s. a day as from February 13tli, the fine not to be enforced if the premises were vacated by March 3rd. The premises were vacated before March 3rd, and the back and front of the premises properly secured by die Surveyor. These proceedings from first to last will have cost several pounds. No doubt a responsible owner will shortly come forward, and it is a question how far the owner can be equitably called upon to reimburse the local authority. 26 TABLE II.—TABLE OF POPULATION, BIBTH8, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, in the Sanitary District of ST. MARYLEBONE, daring February, 1902; classified according to Diseases, Ages, and Localities. (a) All Souls Rectorv St. Mary Christ Church Sr. John Totals 1 Population at all Ages. (6) Census 1901 85.391 19,849 18 099 39,536 30,423 133,301 (c) Registered Births 45 31 27 96 33 232 (<£) Aged under 5 or over 5 Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards j Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Nbw Cases of Sickness in bach Locality j coming TO the knowledge ok thb mkdical Okkickb ok Health. 1. Chicken Pox 2 10 3 .. 4 2 8 17 9 16 26 45 2. Smallpox .. 2 .. 6 .. 3 .. 13 .. 2 .. 26 3. Scarlatina 2 3 .. 4 1 2 1 9 1 5 5 23 4. Diphtheria 3 4 .. 1 .. 1 3 6 .. .. 6 12 5. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Freers. 6. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 7. Enteric or Typhoid .. .. .. .. .. 2 1 .. .. 2 1 4 8. Continued .. .. .. .. .. .. .. .. .. .. .. .. 9. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 10. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 11. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 12 Erysipelas .. 1 .. 3 .. .. 1 1 .. 5 1 10 Number of such Cases Removed from thkir Homes inthb skvkrat. Localities For Treatment in Isolation Hospitals. 1. Smallpox .. 2 .. 6 .. 3 .. 13 .. 2 .. 26 2. Scarlatina 2 3 .. 4 1 2 1 8 1 1 5 18 3. Diphtheria 3 2 .. .. .. .. 3 6 .. 2 6 10 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fkvkbs. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. 2 1 .. .. 1 1 3 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 . Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas .. .. .. 3 .. .. .. .. .. 2 .. .. 27 TABLE III.—Giving the Causes of Deaths during the 4 Weeks ending February 22nd, 1902, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John & Elizabeth, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital Queen Charlotte's Hospital Samaritan Hospital. Workhouse Notting Hill Infirmary. Hospital of St. John & Elizabeth Grove Rd. Smallpox ... ... ... ... ... ... Influenza ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... Diptheria ... ... ... ... ... ... Typhoid Fever ... ... ... ... ... ... Diarrhoea ... ... ... ... ... ... Erysipels ... ... ... ... ... ... Pneumonia ami Pleurisy 1 ... ... ... 4 ... Pyæmia ... ... ... ... ... syphillis ... ... ... ... ... ... Cancer 14 ... ... ... 3 ... Phthisis & Tuberculosis 2 ... ... 1 10 1 Rheumatism ... ... ... ... ... ... Apoplexy ... ... ... ... ... ... Paralysis ... ... ... ... 3 ... Bronchitis 5 ... ... 4 22 1 Asthma ... ... ... 2 ... ... Peritonitis ... ... ... ... ... ... Disease of Brain ... ... ... ... ... ... ,, Heart 1 ... ... ... 8 ... ,, Kidney ... ... ... ... 1 ... ,, Liver ... ... ... ... ... ... „ Uterus ... ... 1 ... ... ... ,, Ovary ... ... ... ... ... ... Parturition ... ... ... ... ... ... Diabetes ... ... ... ... ... ... Fractures and Injuries ... ... ... ... 2 ... Old Age ... ... ... ... 8 ... Low Vitality, Infants ... 1 ... ... ... ... Premature Birth ... 2 ... ... ... ... Other causes 10 1 1 1 3 ... Total j *33 4 2 8 64 2 * Of the 33 deaths in the Middlesex Hospital, 24 were those of non-parishioners, Three of the 4 deaths in Queen Charlotte's Hospital were those of non-parishioners One of the 2 deaths in the Samaritan Hospital were those of non-parishioners, The 2 deaths in St. John's Hospital were those of non-parishioners. 28 TABLE IV.—District Births and Deaths for the four weeks ending february 22nd, 1902. Population in 1901. Births. Deaths. Males. Fmls. Males |Fmls. 35,391 28 17 27 22 Rectory 19,849 14 17 25 34 st. Mary 18,099 12 15 20 21 Christ Church 39,530 43 53 53 42 St. John 20,426 15 18 17 19 Total 133,301 112 120 142 138 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 TABLE V.—Causes of, and Ages at, Death during the 4 weeks ending February 22nd, 1902, in the Borough of St. Marylebone. Deaths in whole District at subjoined Ages. Deaths in Localities (at all Ages). Deaths in Public Institutions.* CAUSES OF DEATH. 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. Rectoky. St. Mary. Christ Church. St. John. Smallpox 6 .. 1 2 .. 3 .. 2 1 1 2 .. 6 Measles 18 3 10 5 .. .. .. 2 .. 5 10 1 .. Scarlet Fever 1 .. .. 1 .. .. .. .. .. .. 1 .. 1 Whooping Cough 2 •• 2 .. .. .. .. 1 .. .. 1 .. .. Diphtheria and Membranous Croup 4 .. 1 3 .. .. .. .. 2 .. 1 1 3 Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric 2 .. .. .. .. .. .. .. .. .. 1 1 .. Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 11 .. .. .. .. .. .. .. 4 3 .. 2 .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. Diarrhoea .. .. .. .. .. .. .. .. .. .. .. .. .. Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 1 1 .. .. .. .. .. .. .. 1 .. .. .. Other Septic Diseases. 2 .. .. .. .. 2 .. .. 2 .. .. .. .. Phthisis 25 .. 1 .. .. 17 3 7 3 7 7 1 14 Other Tubercular Diseases 3 1 1 1 .. .. .. .. .. .. 2 1 .. Cancer, Malignant. Disease 7 .. .. .. .. 3 4 3 1 1 2 .. 17 Bronchitis 82 8 4 .. .. 20 50 12 25 11 21 10 32 Pneumonia 13 1 5 .. .. 6 1 1 1 3 8 .. 5 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Inspiratory Organs 4 .. .. .. .. 1 .. 1 2 .. .. 1 2 Alcoholism Cirrhosis of Liver 4 .. .. .. .. 4 .. .. 1 .. 3 .. .. Venereal Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. Premature Birth 6 6 .. .. .. .. .. 1 2 1 2 .. 2 Diseases and Accidents of Parturition .. .. .. .. .. .. .. .. .. .. .. .. .. Heart Diseases 29 .. .. 2 .. 12 15 6 5 2 0 7 9 Accidents 5 1 1 .. 1 .. 2 .. 1 .. 2 2 2 Suicides 1 .. .. .. .. 1 .. 1 .. .. .. .. .. All other causes 54 12 4 .. 1 14 23 10 9 6 20 9 20 All causes 280 35 30 14 7 87 107 49 59 41 95 30 113 * The deaths in Table III. are included in this column ; 27 out of the 113 were • on-parishioners. 30 REGISTER OF SANITARY WORK Month ending 28th February, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. J. Hodges No. 1 District. 1 .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. Public Health (London) Act. Inspections. Dwelling Houses, &c 30 28 25 23 26 ... ... ... 88 ... 220 Tenements 47 36 45 50 41 ... ... ... ... ... 219 Underground Dwellings 4 12 2 10 ... ... ... ... ... 28 Dairies, Milk Shops, Cow House? 4 2 2 3 5 ... ... ... ... ... 16 Slaughter Houses 1 1 ... ... 1 ... ... ... ... ... 3 Yards, Stables, and Mews 25 3 20 16 15 ... ... ... ... ... 79 Smoke Shafts ... ... ... ... ... ... ... ... 8 ... 8 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... 1 ... 1 Refuse Receptacles ... ... ... ... ... ... ... ... ... ... ... Enquiries re non-removal of refuse ... ... ... ... ... ... ... ... ... ... ... Removal of Bodies to Mortuary I 1 1 3 Visits to Works in progress 146 136 145 159 112 ... ... ... 27 15 740 Miscellaneous Inspections 110 82 50 120 96 ... ... 22 ... 480 UNWHOLESOME FOOD. Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE:— Cases Isolated 2 1 ... ... ... ... ... ... ... ... 3 Cases Removed to Hospital 16 3 17 20 19 ... ... ... ... ... 75 Rooms Disinfected 26 6 18 43 37 ... ... ... ... ... 130 NEW DRAINAGE :— Number of Plans Passed 5 3 5 7 7 ... ... ... 1 ... 28 New Pipe Drains (feet) 370 360 400 760 1062 ... ... ... ... ... 2952 Houses where defects in existing Drainage have been detected and remedied 7 6 8 4 9 ... ... ... 3 ... 37 31 REGISTER OF SANITARY WORK Month ending 28th February, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. 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. Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 30 8 38 Periodical Inspections:— Factories ... ... ... ... ... ... ... ... 4 ... 4 Workshops ... ... ... ... ... ... ... ... 61 45 106 Bakehouses ... ... ... ... ... ... ... 15 15 Restaurants, &c. ... ... ... ... ... ... ... ... 103 103 Homeworkers' Premises ... ... ... ... ... ... ... ... 20 20 Domestic Workshops ... ... ... ... ... ... ... ... 39 39 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 2 11 6 9 28 ... ... ... ... ... 56 Correspondence, Legal Procedure, &c. Complaints received 7 12 11 9 19 ... ... ... 26 9 93 Letters and Intimations relating to Abatement of Nuisances 21 18 32 14 20 ... ... ... 30 13 148 Statutory Notices Served 2 ... 2 4 4 ... ... ... 23 35 Proceedings taken before Magistrates ... ... ... 1 ... ... ... ... ... ... 1 (1) Under Public Health Act ... ... ... 1 ... ... ... ... ... ... 1 (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) „ Food & Drugs Act 1 ... 1 ... ... ... ... ... ... ... 2 Reports made to Medical Officer of Health 31 32 30 50 ... ... ... ... 25 10 184 THE SANITARY CHRONICLES 0F THE BOROUGH OF ST. MARYLEBONE DURING MARCH, 1902. Containing a Quarterly Summary of the Mortality Statistics for the °14 weeks ending March 29th, 1902, 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. Vol. XXII. Town Hall, St. Mabylebone, Apeil 5th, 1902. No. 3. The week ending March 1st was wet and overcast. Minimum temperature, 37.4° ; maximum, 51.8°; mean, 461c. On six days rain fell to the extent of 0*59 inch. Winds SE. or S. There was occasional fog. The Hinshine registered in Regent's Park amounted to only 3.75 hours out of a possible 74.3. During the same period 14.3 hours of sunshine were recorded at Greenwich. Mean barometer, 29.5 inches. The week ending March 8th was rainless. Minimum temperature, 30.0°: maximum, 52.0° ; mean, 43.4°. Winds, E. and NW., Some fog. In Regent's Park only 1.75 hour of sunshine was registered as against 8.3 hours registered at Greenwich out of a possible 77.3 hours. Mean barometer, 29.8 inches. * The year not being exactly 52 weeks, it is necessary every few years to add one week, otherwise the statistical weeks do not coincide with the ordinary weeks. 34 The week ending March loth was also rainless. Minimum temperature 36.0°; maximum, 55.0° ; mean, 47.6°. Winds, SSE. Sunshine registered in Regent's Park 14.6 hours, as compared with 19'4 hours registered at Greenwich out of a possible 80.8 hours. Mean barometer, 29.8 inches. The week ending March 22nd was a little brighter. Minimum temperature, 37.0° ; maximum, 60.0° ; mean, 42.4°. Winds, WSW. On one day rain fell, 0-26 inch. Sunshine registered in Eegent's Park 16 hours, as against 25.3 hours registered at Greenwich out of a possible 84.1 hours, Mean barometer, 296 inches. The week ending March 29th was similar in weather to the preceding ; minimum temperature 33.0; maximum 58.2;mean 46.6. On two days rain fell 0.18 inch. Winds SW. and WSW. 16.6 hours of sunshine were registered in Regent's Park, as compared with 22.6 hours at Greenwich out of a possible 871 hours. Mean barometer 29.6 inches. Health of the District. The death-rate for the quarter has been above the average ; this is due to mortality from small-pox, measles, influenza, and chest affections. The number of cases of small-pox from January to the end of March amount to 87 ; of these 16, or 18-3 per cent., have proved fatal. All the cases have been removed to hospital with great promptitude. The curve opposite page 40 shows that the course of the epidemic has been precisely that which was predicted. For the moment there is a lull, but the cases will certainly increase towards the end of this month. Births and Deaths. During the five weeks ending March 29th, 1902, there have been registered 287 births and 310 deaths : equal to a birth-rate of 22.4 per thousand, and a death-rate of 24.2 per thousand. The average death-rate for the corresponding period was 22.5 per thousand. 35 QUARTERLY SUMMARY. During the 14 weeks ending March 29th there have been registered 824 births and 839 deaths. These births and deaths are divided among the five sub-districts as set forth in Table VI. 262 of the deaths were extra-parochial, as follows: — St. Marylebone Infirmary, 163 North-Western Fever Hospital 8 North-Eastern Fever Hospital 2 Western Fever Hospital 5 South Wharf Shelter 1 Long Reach Hospital 1 Hospital Ship " Atlas " 11 ,, " Castalia " 2 Smallpox Hospital, Kingsbury 1 St. Mary's Hospital 12 Royal Free Hospital 1 St. George's Hospital 3 D niversity College Hospital 2 Great Northern Hospital 2 Royal Hospital 2 Royal Chest Hospital 1 French Hospital 1 Homeopathic Hospital 1 Hospital for Women, Euston Square 1 Cancer Hospital, Chelsea 1 Home Hospital, Fitzroy Square 1 „ Hampstead 1 Children's Hospital, Great Ormonde Street 3 „ Paddington 2 St. Luke's Home, Hampstead 1 St. Peter's Home.. 3 Home for aged Christian Blind 1 Friedenheim 2 Colney Hatch Asylum 2 Leavesden Asylum 4 Banstead Asylum 3 Hanwell Asylum 6 London County Asylum, Dartford 2 Licensed Victuallers' Asylum 1 St. Pancras Infirmary 1 St. Giles' Workhouse 1 Salvation Army Maternity Home 1 In various streets 6 Total 262 36 The birth and death-rates, as deduced from the month's statistics, are as follows:— All Souls, birth-rate 15.2 ; death-rate 16.4. Rectory, birth-rate 21.1; death-rate 31.2. St. Mary, birth-rate 27'9 ; death-rate 32.5. Christ Church, birth-rate 30 8 ; death-rate 24.5. St. John, birth-rate 34.6; death-rate 34.6. The whole district, birth-rate 23.0 ; death-rate 24.5. The average death-rates for five years (1896 to 1901) for the corresponding period were as follows :—All Souls, 18.0 ; Eectory, 26.0 ; St. Mary, 21.6 ; Christ Church, 20.4; St. John, 23.4; the whole district, 21.3. 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 FOURTEEN WEEKS ENDING MARCH 29th, 1902, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 14 weeks ending Mar. 29th, 1902. Proportion of the deaths to 1,000 deaths from all causes. 14 weeks ending Mar. 29,1902. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1896-1901. 1. Deaths from the chief Zymotic Diseases 130 155 3.60 2.2 2. Pulmonary, other than Phthisis 248 295 6.91 5.6 3. Tubercular 76 91 3.71 2.4 NOTES. 1, includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza,Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. 3, includes Phthisis, Scrofula, Rickets, and Tabes. 37 Appointment of Female Sanitary Inspector. In answer to an advertisement, sixteen applications for the post vacated by Miss O'Kell were received. One of these had not the necessary legal qualifications, reducing the number to fifteen. Five of the applicants appeared to the writer superior to the rest, and were selected for presentation to the Committee. Out of these five the Committee selected Miss Frances A. Baker, who has entered upon her duties. The Laboratory.—Sale of Food and Drugs Act (Table VI). A full list of the various articles of food, drink and drugs analysed during the quarterns to be found in Table VI, page 43. Out of 150 samples submitted by the Inspectors. 1 sample of gin, 7 samples of milk, 1 sample of butter, and 1 sample of margarine, formed the subject matter for prosecution as follows :— Herbert Clanchy, of 51, Upper Berkeley Street, was fined 40/- and 25/- costs, for selling gin 39.5 degrees under proof. Mrs. Annie Callard, of 91, Salisbury Street, was fined £1 and 2s. costs for exposing for sale margarine without a proper label. John Gowlett, of i 13, Crawford Street, was fined under the Sale of Food and Drugs Act and Margarine Act £3 10s., with 25s. costs, for selling butter adulterated with other fats. Arthur Staines, of 37, Barrow Hill Road, was fined £2, with 12s. 6d. costs, for selling milk diluted with 12.5 % water. James Jones, of 53, Charlbert Street, was fined £5, with 12s. 6d. costs, for selling milk diluted with 13.2 % water. 38 David Duckett, of 36, New Street, St. John's Wood, was fined £2, with 12s. 6d. costs, for selling milk diluted with 12 7 % water. Abraham Cohen, of 14, Upper Rathbone Place, was fined £1, with 14s. 6d. costs, for selling milk diluted with 12 6 % water. Sarah Conolley, of 2, Union Street, Middlesex Hospital, was fined £1, with 14s. 6d. costs, for selling milk diluted with 2 °/o water and deficient in fat 5 %. Mary Gardner, of 28, Bolsover Street, was fined £2, with 12s. 6d. costs, for selling milk deficient in milk fat 11 %. One sample of milk certified to be diluted with water is still sub judice. The following prosecution was based on a certificate issued the previous Quarter:— John Hall, of 75, Marylebone Lane, was fined £2, and 12s, 6d, costs, for selling milk diluted with 8½ % water. 39 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 March quarter, 1902; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church ! St. John Totals Population at all agk8. (6) Census 1901 35,391 19,849 18.099 39.536 20,425 133,301 (c) Registered Births 145 113 108 328 130 824 (d) Aged under 5 orover 5 Under 5 5 upwards Under 5 5 upwards ! Under 5 1 5 upwards j Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards New Casfs of Sickness in bach Locality com1no to the knowledge of the medical Offices of Health. /i. Chicken Pox 10 18 20 2 8 3 20 22 21 28 79 73 2. Smallpox .. 13 .. 15 .. 12 1 34 .. 12 1 86 3. Scarlatina 5 18 .. 6 5 7 2 11 2 9 14 51 4. Diphtheria 6 14 .. 8 3 6 6 12 5 1 23 41 5. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. Fevers. 6. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 7. Enteric or Typhoid .. 3 .. .. .. 2 1 5 .. 4 1 14 8. Continued '* .. .. .. .. .. .. .. .. .. .. .. 9. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 10. Puerperal .. 2 .. .. .. .. .. .. .. .. .. 2 11. Cholera.. .. .. .. .. .. .. .. .. .. .. .. .. .. \12. Erysipelas .. .. 8 .. .. 2 1 1 9 .. 8 3 42 Number of such Cases Removed from their home in the sevbbal localities fob tbeat- mbnt in Isolation Hospitals. 1. Smallpox .. 13 •• 15 •• 12 1 34 .. 12 1 86 2. Scarlatina 3 15 0 4 6 2 10 .. 5 12 42 3. Diphtheria 5 7 3 6 5 3 6 9 3 3 22 28 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fecer. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. Enteric or Typhoid .. 3 .. .. .. 2 1 5 .. 2 1 12 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. •• 9. Puerperal .. 2 .. .. .. .. .. .. .. .. 2 10 . Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 1 .. 10 1 .. 1 .. .. 2 2 13 40 TABLE III.— Giving the Causes of Deaths during the 14 Weeks ending March 29th, 1902, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John & Elizabeth, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill. Infirmary. Hospital of St John & Elizabeth, Grove Rd. Smallpox ... ... ... ... 1 ... Influenza 1 ... ... ... ... ... Scarlet Fever ... ... ... ... ... ...... Diphtheria 1 ... ......... ... ... ... Typhoid Fever 1 ... ... ... 1 ... Diarrhœa 1 ... ... ... ... ... Erysipelas 1 ... ... ... 2 ... Pneumonia and Pleurisy 11 1 ... 10 ... Pyœmia 1 ... 1 ... ... ... Syphilis ... ... ... ... 1 ... Cancer 39 ... 2 ... 9 1 Phthisis & Tuberculosis 7 ... ... 1 26 5 Rheumatism 1 ... ... ... 1 ... Apoplexy ... ... ... 1 1 ... Paralysis ... ... ... ... 7 ... Bronchitis 11 ... ... 8 42 1 Asthma ... ... ... 2 ... ... Peritonitis 3 1 ... ... 1 ... Disease of Brain ... ... ... 1 ... ... „ Heart 10 ... ... 2 19 2 „ Kidney ... ... ... ... 1 ... „ Liver 2 ... ... ... 1 ... „ Uterus ... ... 1 ... ... ... Ovary ... ... ... ... ... ... Parturition ... ... ... ... ... ... Diabetes ... ... ... ... ... ... Fractures and Injuries. 3 ... ... 1 7 ... Old Age ... ... ... ... 10 ... Low Vitality, Infants ... l ... ... ... ... Premature Birth 3 1 ... ... Other causes 26 1 1 6 23 1 Total *119 †7 ‡6 23 163 10 * Of the 119 deaths in the Middlesex Hospital, 88 were those of non-parishioners. † Four of the 7 deaths in Queen Charlotte's Hospital were those of non-parishioners. ‡ Five of the 6 deaths in the Samaritan Hospital were those of non-parishioners, ‡ Six of the 10 deaths in St. John's Hospital were those of non-parishioners. 1 902 . CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, TYPHOID FEVER, & SMALLPOX DURING 1902 AS COMPARED WITH A FIVE YEARS' AVERAGE. MARCH. 41 TABLE IV.—District Births and Deaths for the fourteen weeks ending* march 29th, 1902. Population in 1901. Births. Deaths. Males. Fmls. Males Fmls. 35.391 78 67 83 73 Rectory 19,849 57 56 74 93 St. Mary 18,099 57 51 61 65 Christ Church 39,530 156 172 138 122 St. John 20,426 63 67 59 71 Total 133,301 411 413 415 424 * The mortality statistics for this year will be calculated on 53 weeks, an extra week having every few years to be added. • 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. 42 TABLE V.— Causes of, and Ages at, Death during the 14 weeks ending March 29th, 1902, in the Borough of St. Marylebone. CAUSES OK DEATH. Deaths in whole District at subjoined Ages. Deaths in Localities (at all Ages). Deaths in Public Institutions.* All ages. Under 1. land under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. All Souls. Rectort. St. Mart. Christ Church. St. John. Smallpox 16 1 3 3 .. 9 .. 2 4 4 5 1 16 Measles 61 19 34 8 .. .. .. 4 9 15 31 2 .. Scarlet Fever 3 1 1 1 .. .. .. .. .. 1 1 1 3 Whooping Cough 3 1 2 .. .. .. .. 2 .. .. 1 .. .. Diphtheria and Membranous Croup 10 1 4 4 .. 1 .. 2 3 1 2 2 6 Croup 1 .. 1 .. .. .. .. .. .. .. 1 .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric 5 .. .. 1 1 3 .. 1 .. .. 3 1 3 Other continued . .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 24 3 .. .. .. 11 10 3 6 5 4 6 1 Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhoea 4 4 .. .. .. .. .. 1 .. 1 1 1 1 Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. 1 Erysipelas 3 .. .. .. .. .. 1 1 .. 2 .. .. 1 Other Septic Diseases.. 6 .. .. .. .. 5 1 2 4 .. .. .. .. Phthisis 55 1 1 .. 7 39 7 11 8 8 21 7 30 Other Tubercular Diseases 21 2 2 4 2 11 .. 5 5 1 7 3 1 Cancer, Malignant Disease 35 .. .. .. .. 22 13 7 7 8 8 0 48 Bronchitis 193 19 10 3 4 52 105 35 46 29 59 24 52 Pneumonia 48 7 12 1 .. 20 8 11 7 7 16 7 20 Pleurlay .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Inspiratory Organs 7 .. 1 •• .. 1 5 1 4 .. .. 2 2 Alcoholism Cirrhosis of Liver 16 .. .. .. 1 13 2 4 3 2 5 2 2 Venereal Diseases 4 2 1 .. .. 1 .. .. 1 .. 1 2 .. Premature Birth 16 16 .. .. .. .. .. 2 3 4 5 2 6 Diseases and Accidents of Parturition 2 .. .. •• 1 1 .. .. .. .. 1 1 •• Heart Diseases 77 2 .. 4 41 30 23 13 8 22 11 28 Accidents 21 8 1 2 1 3 6 1 4 .. 11 5 9 Suicides 2 .. .. .. .. 1 1 1 •• 1 .. .. .. All other causes 206 42 11 3 8 67 75 37 40 29 55 45 84 All causes 839 131 84 3 28 301 264 156 167 126 260 130 314 * 105 out of the 314 were ron-pariahioners. 43 TABLE VI.—Sale of Food and Drugs Act. — Samples analysed during March Quarter, 1902. Genuine. Adulterated. Total. Dairy Products : Milk 36 7 43 Butter 30 1 31 Margarine 9 1 10 Alcoholic Beverages : A Whisky 4 .. 4 Brandy 2 .. 2 Gin 2 1 3 Beer 5 .. 5 Vermouth 2 .. 2 Kumel 1 .. 1 Non-Alcoholic Beverages : Coffee 2 .. 2 Condiments: Pepper 3 .. 3 Mustard 1 .. 1 Vinegar 1 .. I Sauce 1 .. 1 Ketchup 1 .. 1 Drugs : Glycerine 1 .. 1 Saccharine Substances : Sweets 1 .. 1 Golden Syrup 3 .. 3 Jam 1 .. 1 Sugar 2 .. 2 Tinned and Bottled Goods : Condensed Milk 5 .. 5 Sardines 8 .. 8 Salmon 4 .. 4 Lobster 1 .. 1 Bloater Paste 2 .. 2 Anchovy Paste 1 .. 1 Veal and Ham Paste 1 .. 1 Rabbit 1 .. 1 Pineapple 2 .. 2 Peas, Tinned 1 .. 1 „ Bottled 1 .. 1 Miscellaneous : Corn-Flour 1 .. 1 Chutney 1 .. 1 Salad Oil 1 .. 1 Peach Bitters 3 .. 3 Total 141 10 151 44 REGISTER OF SANITARY WORK Month ending 31st March, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. J. Hodgss, 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. Public Health (London) Act. Inspections. Dwelling Houses, &c 26 29 30 28 22 ... ... ... 5 ... 140 Tenements 54 32 50 60 37 ... ... ... ... ... 233 Underground Dwellings 14 12 9 13 ... ... ... ... ... 48 Dairies, Milk Shops, Cow Houses 8 1 ... 1 5 ... ... ... ... ... 15 Slaughter Houses 1 2 ... ... 1 ... ... ... ... ... 4 Yards, Stables, and Mews 32 18 25 40 37 ... ... ... ... ... 152 Smoke Shafts ... ... ... ... ... ... ... ... 2 ... 2 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... ... ... ... Refuse Receptacles 20 36 6 10 9 ... ... ... ... ... 81 Enquiries re non-removal of refuse 10 13 12 ... 7 ... ... ... ... ... 42 Removal of Bodies to Mortuary 1 ... ... ... ... ... ... ... ... ... 1 Visits to Works in Progress 170 176 150 160 94 ... ... ... 39 30 819 Miscellaneous Inspections 162 150 120 180 146 ... ... ... ... 29 787 UNWHOLESOME FOOD. Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE Cases Isolated ... 1 1 1 ... ... ... ... ... ... 3 Cases removed to Hospital 15 1 5 30 17 ... ... ... ... ... 68 Rooms Disinfected 38 7 9 58 37 ... ... ... ... ... 149 NEW DRAINAGE Number of Plans Passed 6 5 4 5 9 ... ... ... ... ... 29 New Pipe Drains (feet) 1230 960 190 980 1642 ... ... ... ... ... 5002 Houses where defects in existing Drainage have been detected and remedied 8 9 7 6 5 ... ... ... ... ... 35 45 REGISTER OF SANITARY WORK Month ending 31st March, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. D. J. Andrews, No. 3 District. Mr. T. Gornot, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. R. Phillips, Spocial Duties. Miss L. M. O'Kell, Total. Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 76 15 91 Periodical Inspections: — Factories ... ... ... ... ... ... ... ... ... 3 3 Workshops ... ... ... ... ... ... ... ... 37 88 125 Bakehouses ... ... ... ... ... ... ... ... 29 ... 29 Restaurants, &c. ... ... ... ... ... ... ... ... 62 ... 62 Homeworkers' Premises ... ... ... ... ... ... ... ... 27 10 37 Domestic Workshops ... ... ... ... ... ... ... ... 20 3 2s Food and Drugs Act. ADULTERATION. Samples collected for Analysis 14 19 3 14 1 ... ... ... ... ... 51 Correspondence. Legal Procedure, &c. Complaints received 14 3 17 12 15 ... ... ... 31 18 110 Letters and Intimations relating to Abatement of Nuisances 28 15 30 25 13 ... ... ... 30 36 177 Statutory Notices Served . 6 ... 6 4 5 ... ... ... 5 4 30 Proceedings taken before Magistrates ... ... ... ... ... ... ... ... ... ... ... (1) Under Public Health Act ... ... ... ... ... ... ... ... ... ... ... (2) „ Factory &. Workshop Act ... ... ... ... ... ... ... ... ... 1 1 (3) „ Food & Drugs Act 3 2 4 ... ... ... ... ... 9 Reports made to Medical Officer of Health 56 30 30 70 64 ... ... ... 29 18 297 46 REGISTER OF SANITARY WORK Quarter ending 31st March, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. J. Hodges, No. 1 District. Mr. A. Perry, Wo. 2 District. Mr. D. J. Andrews, Ko. 3 District. Mr. T. G or mot, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell. Total. Public Health (London) Act. Inspections,. Dwelling Houses, &c 80 86 75 71 65 ... ... ... 93 ... 470 Tenements 151 104 130 170 109 ... ... ... ... ... 664 Underground Dwellings 21 42 15 26 ... ... ... ... ... 107 Dairies, Milk Shops, Cow Houses 21 4 2 6 17 ... ... ... ... ... 50 Slaughter Houses 4 4 ... 1 5 ... ... ... ... ... 14 Yards, Stables, and Mews 95 63 81 96 78 ... ... ... ... ... 113 Smoke Shafts ... ... ... ... ... ... ... ... 13 ... 13 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... 1 ... 1 Refuse Receptacles 40 54 11 10 9 ... ... ... ... ... 124 Enquiries re non-removal of refuse 21 30 24 12 15 ... ... ... ... ... 102 Removal of Bodies to Mortuary 2 ... 2 1 ... ... ... ... ... ... 5 Visits to Works in progress 451 458 435 469 317 ... ... ... 98 85 2343 Miscellaneous Inspections 402 392 290 440 368 ... ... ... 73 41 2006 UNWHOLESOME FOOD. Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE:— Cases Isolated 2 2 1 1 ... ... ... ... ... ... 6 Cases Removed to Hospital 46 9 35 81 55 ... ... ... ... ... 226 Rooms Disinfected 92 31 44 157 103 ... ... ... ... ... 427 NEW DRAINAGE :— Number of Plans Passed 17 11 12 17 23 ... ... ... 3 ... 83 New Pipe Drains (feet) 2520 1810 772 2500 4346 ... ... ... ... ... 11948 Houses where defects in existing Drainage have been detected and remedied 21 24 19 15 21 ... ... ... 5 ... 105 47 REGISTER OF SANITARY WORK Quarter ending 31st March, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. 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. 1 Mr. R. Phillips, Special Duties. Miss L. M. O'Kell, Total. Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 155 43 198 Periodical Inspections:— Factories ... ... ... ... ... ... ... ... 7 6 13 Workshops ... ... ... ... ... ... ... ... 154 179 333 Bakehouses ... ... ... ... ... ... ... ... 54 ... 54 Restaurants, &c. ... ... ... ... ... ... ... ... 178 ... 178 Homeworkers' Premises ... ... ... ... ... ... ... ... 68 31 99 Domestic Workshops ... ... ... ... ... ... ... ... 77 10 87 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 30 30 30 30 30 ... ... ... ... ... 150 Correspondence, Legal Procedure, &c. Complaints received 38 33 48 37 53 ... ... ... 64 35 308 Letters and Intimations relating to Abatement of Nuisances 77 52 92 69 51 ... ... ... 65 81 487 Statutory Notices Served 14 3 15 11 14 ... ... ... 31 8 96 Proceedings taken before Magistrates ... ... ... 1 ... ... ... ... ... ... 1 (1) Under Public Health Act ... ... ... 1 ... ... ... ... ... ... 1 (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... 1 1 (3) „ Food & Drugs Act 1 3 1 2 4 ... ... ... ... ... 11 Reports made to Medical Officer of Health 141 104 105 196 125 ... ... ... 102 38 811 THE SANITARY CHRONICLES of the BOROUGH OF ST. MARYLEBONE DURING APRIL, 1902. BY ALEX AND EE WYNTER BLYTH, Medical Officer of Health, and Analyst of Food and Drugs for the Borough of St. IVIarylebone. PRINTED BT ORDER OF THE COUNCIL. Vol. XXII. Town Hall, St. Maeylebone, May 8th, 1902. No. 4. The week ending April 5th was fairly fine and bright. Minimum temperature, 35.0° ; maximum, 60.5° ; mean, 46.9°. On two days rain fell (0.06 inch). The winds were SW. and NW. Sunshine, 20.1 per cent. Mean barometer, 29.7 inches. The week ending April 12th was cooled by easterly and north-easterly winds. Minimum temperature, 30.0° ; maximum, 52.0° ; mean, 43.4°. No rain fell. Sunshine, 8.5 per cent. Mean barometer, 29.8 inches. The week ending April 19th was also cool, but a little brighter. Minimum temperature, 35.0°; maximum, 67.0°; mean, 53.2°. On one day rain fell (0.1 inch). The winds were ESE. Sunshine, 17.0 per cent. Mean barometer, 29.7 inches. The week ending April 26th was unsettled, but fairly sunny. Minimum temperature, 39.5° ; maximum, 64.5° ; mean, 54.5°. On two days rain fell (0.14 inch). The winds were variable. Sunshine, 29.2 per cent. Mean barometer, 29.8 inches. 50 The week ending May 3rd was bright with variable weather. Minimum temperature, 33.9° ; maximum, 57.3° ; mean, 48.3°. On three days rain fell (0.51 inch). Winds, WNW. and WSW. Sunshine, 42.8 per cent. Mean barometer, 29.5 inches. Births and Deaths. During the five weeks ending May 3rd there have been registered 270 births and 191 deaths. These births and deaths are divided among the five sub-districts as set forth in Table IV. 77 of the deaths were extra-parochial, as follows: — St. Marylebone Infirmary, Notting Hill 49 North-Western Fever Hospital 2 Western Fever Hospital 1 North-Eastern Fever Hospital 2 Gore Farm Hospital 1 Long Reach Hospital 2 Hospital Ship "Castalia" 1 London Fever Hospital 1 St. Mary's Hospital 5 University College Hospital 2 French Hospital 1 German Hospital 1 Hanwell Asylum 3 Banstead Asylum 1 Colney Hatch Asylum 3 Friedenheim 2 Total 77 51 The birth and death-rates, as deduced from the five weeks' statistics, are as follows:— All Souls, birth-rate 18.8 ; death-rate 13.5. Rectory, birth-rate 14.7 ; death-rate 13.6. St. Mary, birth-rate 16.1; death-rate 13.2. Christ Church, birth-rate 32 7 ; death-rate 15.4. St. John, birth-rate 13.7; death-rate 19.3. The whole district, birth-rate 21.1; death-rate 14.9. The average death-rates for five years (1896 to 1901) for the corresponding period were as follows :—All Souls, 14.8 ; Rectory, 22.6 ; St. Mary, 18.6 ; Christ Church, 18.7; St. John, 22.1; the whole district, 19.0. 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 MAY 3rd, 1902, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 5 weeks ending May 3rd, 1902. Proportion of thedeaths to 1,000 deaths from all causes. 5 weeks ending May 3,1902. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1900-1901. 1. Deaths from the chief Zymotic 29 152 2.26 2.20 2. Pulmonary, other than Phthisis 34 178 2.65 5.12 37 194 2.88 2.12 NOTES. 1, includes Smallpox Measles, Scarlet Fever, Diphtheria, Influenza,Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. 3, includes Phthisis, Scrofula, Rickets, and Tabes. 52 Smallpox. Contrary to all precedent the outbreak of smallpox, instead of increasing towards the month of May, shows decided indications of abatement. During the five weeks ending April 3rd there have only been notified 10 cases within the Borough, of these 10 cases one properly belongs to another district; the patient walking in from Notting Hill with the eruption out on him. Prosecution under the Public Health (London) Act. No. 25, Harcourt Street, having apparently no responsible owner, was closed by Magistrate's Order. The premises were in a general insanitary state, and the water supply had been cut off. Housing of the Public Health Department. The Town Hall has long been too small for the immense amount of public business there transacted. The writer some time ago recommended that partial relief would be given, by the transference of the Sanitary Department to a separate building, and this suggestion has at length found favour with the Council on the recommendation of the Housing Committee. A rent of £120 is the maximum fixed by the Finance Committee. Hence, the choice of premises, considering that they must be in a central situation, is limited. The writer has recommended what appears to be a convenient house in situation and size to the Housing Committee, and negotiations are in progress. It is to be hoped that the move will be accomplished before the long vacation. 1 902. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, TYPHOID FEVER, & SMALLPOX DURING 1902, AS COMPARED WITH A FIVE YEARS' AVERAGE. APRIL. 53 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 April, 1902; 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 35,391 19,849 18,099 39,536 20,426 133,301 (c) Registered Births 64 28 28 123 27 270 (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 of Health. /1. Chicken Pox 7 6 9 1 2 2 2 3 7 2 27 14 2. Smallpox .. 2 .. 2 .. 1 .. 3 .. 2 .. 10 3. Scarlatina 2 3 2 3 .. 2 2 1 1 2 7 11 4. Diphtheria 1 2 1 2 .. 1 1 .. 4 3 7 8 5. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fbvers. 6. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 7. Enteric or Typhoid .. 1 .. 1 .. .. .. .. 1 .. 1 4 8. Continued .. .. .. .. .. .. .. .. .. .. .. .. 9. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 10. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 11. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 12 Erysipelas .. 1 .. 8 .. 1 .. 2 1 6 1 18 Number of such Cases Removed from thbir Homes in the several Localities for Treatment in Isolation Hospitals. 1. Smallpox .. 2 .. 2 .. 1 .. 3 .. 2 .. 10 2. Scarlatina .. 3 1 3 .. .. 2 1 .. 1 3 8 3. Diphtheria 1 1 1 1 .. 1 1 .. 2 3 5 6 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fbvers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. 1 .. .. .. 2 1 .. 1 3 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 . Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas .. .. .. 6 .. .. .. .. 1 1 1 7 54 TABLE III.—Giving the Causes of Deaths during the 5 Weeks ending May 3rd, 1902, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John & Elizabeth, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill. Infirmary. Hospital of St. John & Elizabeth, Grove Rd. Smallpox ... ... ... ... ... ... Influenza ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... Diphtheria ... ... ... ... ... ... Typhoid Fever ... ... ... ... ... ... Diarrhoea ... ... ... ... 1 ... Erysipelas ... ... ... ... 1 ... Pneumonia and Pleurisy 2 ... ... ... 4 ... Pyaemia ... ... ... ... ... ... Syphilis ... ... ... ... 1 ... Cancer 13 ... ... ... 1 1 Phthisis & Tuberculosis 1 ... ... ... 22 2 Rheumatism ... ... ... ... ... ... Apoplexy ... ... ... ... ... ... Paralysis ... ... ... ... 3 ... Bronchitis 3 ... ... 1 8 2 Asthma ... ... ... ... ... ... Peritonitis ... ... ... ... ... ... Disease of Brain ... ... ... ... ... ... „ Heart 3 ... ... 1 1 ... „ Kidney ... ... ... ... ... ... ,, Liver ... ... ... ... ... ... Uterus ... ... ... ... ... ... „ Ovary ... ... ... ... ... ... Parturition ... ... ... ... ... ... Diabetes ... ... ... ... ... ... Fractures and Iniuries 1 ... ... ... 1 ... Old Age ... ... ... ... 2 ... Low Vitality, Infants ... ... ... ... ... ... Premature Birth ... 1 ... ... ... ... Other causes 5 1 2 1 4 1 Total *28 ++ ++ 2 ‡2 3 49 ‡6 * Of the 28 deaths in the Middlesex Hospital, 24 were those of non-parishioners. ‡ The 2 deaths in the Samaritan Hospital were those of non-parishioners. ‡‡ The 2 deaths in Queen Charlotte's Hospital were those of infants, one was the child of a non-parishioner. ‡‡ The 6 deaths in St. John's Hospital were those of non-parishioners. 55 TABLE IV.—District Births and Deaths for the five weeks ending may 3RD, 1902. Population in 1501. Births. Deaths. Males. Fmls. Males Fmls. All Souls 35,391 34 30 26 20 Rectory 19,849 11 17 15 11 St. Mary 18,099 16 12 14 9 Christ Church 39,536 59 64 35 23 St. John 20,426 16 11 24 14 Total 133,301 136 134 114 77 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. 56 TABLE V.—Causes of, and Ages at, Death during the 5 weeks ending May 3rd, 1902, 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 4 .. .. .. .. 4 .. 1 .. 1 .. 2 .. Measles 13 2 10 1 .. .. .. .. 4 2 5 2 .. Scarlet Fever 3 .. 2 .. .. 1 .. 2 1 .. .. .. .. Whooping Cough 1 1 .. .. .. .. .. .. .. 1 .. .. .. Diphtheria and branous Croup 1 .. .. .. 1 .. .. .. .. .. 1 .. .. Croup 1 1 .. .. .. .. .. .. 1 .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric .. .. .. .. .. .. .. .. .. .. .. .. .. Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 2 .. .. .. .. .. .. .. 1 .. .. 1 .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 2 2 .. .. .. .. .. .. .. .. 1 1 1 Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 1 1 .. .. .. .. .. .. .. .. .. 1 1 Other Septic Diseases 1 1 .. .. .. 2 .. .. .. .. 1 .. .. Phthisis 31 .. .. .. .. 17 14 10 4 .. 11 6 25 Other Tubercular Diseases 6 2 .. 2 1 1 .. 2 .. 1 3 .. .. Cancer, Malignant Disease 11 .. .. .. .. 6 5 7 .. 1 2 1 15 Bronchitis 18 1 1 .. .. 8 8 2 7 3 4 2 14 Pneumonia 13 2 2 1 .. 5 3 3 1 5 .. 1 6 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Respiratory Organs 3 .. 1 .. .. 1 1 .. 2 .. 1 .. .. Alcoholism Cirrhosis of Liver 1 .. .. .. .. 1 .. .. .. .. 1 .. .. Venereal Diseases 1 1 .. .. .. .. .. .. .. .. 1 .. 1 Premature Birth 7 7 .. .. .. .. .. 1 .. 2 2 2 l Diseases and Accidents of Parturition .. .. .. .. .. .. .. .. .. .. .. .. .. Heart Diseases 19 .. .. .. .. 10 9 7 1 4 2 5 5 Accidents 5 2 .. .. .. 3 .. .. .. .. 4 1 2 Suicides .. .. .. .. .. .. .. .. .. .. .. .. .. All other causes 47 12 3 .. .. 16 16 11 4 3 16 13 19 All causes 191 35 19 4 2 74 57 44 26 23 58 38 90 * The deaths in Table III. are included in this column; 63 out of the 90 were non-parishioners. 57 REGISTER OF SANITARY WORK Month ending 30th April, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell. Total. 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. o District. Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 39 40 79 Periodical Inspections:— 95 95 Factories ... ... ... ... ... ... ... ... 7 3 10 Workshops ... ... 1 ... ... ... ... ... 73 45 119 Bakehouses 1 ... ... ... ... ... ... ... 29 ... 30 Restaurants, &c. ... ... ... ... ... ... ... ... 63 1 64 Homeworkers' Premises ... ... ... ... ... ... ... ... 25 18 43 Domestic Workshops ... ... ... ... ... ... ... ... 18 3 21 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 13 17 21 13 23 ... ... ... ... ... 87 Correspondence, Legal Procedure, &c. Complaints received 3 6 10 14 11 ... ... ... 3 7 54 Letters and Intimations relating to Abatement of Nuisances 10 13 12 18 14 ... ... ... 4 18 89 Statutory Notices Served ... ... ... 7 7 ... ... ... ... ... 14 Proceedings taken before Magistrates ... ... ... ... ... ... ... ... ... ... ... (1) Under Public Health Act ... ... 1 ... ... ... ... ... ... ... 1 (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) „ Food & Drugs Act ... ... ... ... ... ... ... ... ... ... ... Reports made to Medical Officer of Health 34 36 30 46 47 25 28 241 58 REGISTER OF SANITARY WORK Month ending 30th April, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell. Total. Mr. J. Hodgss, 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. Publie Health (London) Act. Inspections. Dwelling Houses, &c. 55 54 56 40 ... ... ... ... ... ... 205 Tenements 40 ... 26 20 ... ... ... ... ... ... 92 Underground Dwellings 10 ... 12 ... ... ... ... ... ... ... 22 Dairies, Milk Shops, Cow Houses 4 1 1 4 ... ... ... ... ... ... 10 Slaughter Houses 1 2 ... 1 ... ... ... ... ... ... 4 Yards, Stables, and Mews 12 3 30 20 ... ... ... ... ... ... 65 Smoke Shafts ... ... ... ... ... ... ... ... 3 ... 3 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... ... ... ... Refuse Receptacles 11 13 9 20 ... ... ... ... ... ... 53 Enquiries re non-removal of refuse 8 10 12 6 ... ... ... ... ... ... 36 Removal of Bodies to Mortuary 1 ... ... ... ... ... ... ... ... ... 1 Visits to Works in Progress 170 160 151 120 ... ... ... ... 39 15 654 Miscellaneous Inspections 220 132 110 140 ... ... ... ... 27 80 709 UNWHOLESOME FOOD. Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE Cases Isolated ... 2 ... ... ... ... ... ... ... ... 2 Cases removed to Hospital 8 5 7 10 ... ... ... ... ... ... 30 Rooms Disinfected 14 ... 12 18 ... ... ... ... ... ... 44 NEW DRAINAGE:— Number of Plans Passed 6 4 7 12 ... ... ... ... ... 1 30 New Pipe Drains (feet) 870 680 250 1209 ... ... ... ... ... ... 3009 Houses where defects in existing Drainage have been detected and remedied 10 8 9 10 ... ... ... ... ... ... 37 THE SANITARY CHRONICLES OF THE BOROUGH OF ST. MARYLEBONE DURING MAY, 1902. 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. XXII. Town Hall, St. Marylebone, June 7th, 1902. No. 5. The week ending May 10th was cool and rainy. Minimum temperature, 33.0°; maximum, 56.0°; mean, 45.5°. On four days rain fell (0.25 inch). Winds, NE. Sunshine, 34.6 per cent.; mean barometer, 30.1 inches. The week ending May 17th was also cool and wet. Minimum temperature, 32.2°; maximum, 57.0°; mean, 46.1°. On six days rain fell, the total rainfall being 0.65 inch. Winds, SW. Sunshine registered in Regent's Park, 21.9 per cent. of the possible. Mean barometer, 29.7 inches. The week ending May 24th was a little warmer, but still cool and damp. Minimum temperature, 38.5°; maximum, 67.8°; mean, 53.0°. On four days rain fell (0.24 inch). Winds, NNW and SW. Sunshine 31.4 per cent. Mean barometer, 30.0 inches. The week ending May 31st was warmer and brighter. Minimum temperature, 46.5°; maximum, 70.0°; mean, 61.9°. On three days rain fell (0.4 inch). Winds, westerly. Sunshine in Regent's Park, 50 hours, or 44.4 per cent. Mean barometer, 29.9 inches. 60 Births and Deaths. During the four weeks ending May 31st there have been registered 217 births and 165 deaths. These births and deaths are divided among the five sub-districts as set forth in Table III. 67 of the deaths were extra-parochial, as follows :— St. Marylebone Infirmary, Notting Hill 39 St. Mary's Hospital 7 Hospital Ship "Atlas" 1 North-West Fever Hospital 1 University Hospital 3 Homœopathic Hospital 1 Brompton Hospital 2 French Hospital 1 King's College Hospital 1 Hanwell Asylum 3 Leavesden Asylum 1 Clay bury Asylum 2 Colney Hatch Asylum 1 Banstead Asylum 1 Hoxton House Asylum 1 St. Joseph's Home 1 In the street (St. Pancras) 1 Total 67 The birth and death-rates, as deduced from the five weeks' statistics, are as follows:— All Souls, birth-rate 18.4; death-rate 12.1. Rectory, birth-rate 24.2; death-rate 16.4. St. Mary, birth-rate 17.9; death-rate 15.1. Christ Church, birth-rate 23.3; death-rate 18.0. St. John, birth-rate 22.3; death-rate 20.4. The whole district, birth-rate 21.2; death-rate 16.1. 61 The average death-rates for five years (1896 to 1901) for the corresponding period were as follows:—All Souls, 13.9; Rectory, 17.2; St. Mary, 18.5; Christ Church, 19.6; St. John, 21.6; the whole district, 17.9. 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 31ST, 1902, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 4 weeks ending May 31st, 1902. Proportion of the deaths to 1,000 deaths from all causes. 4 weeks ending May 31,1902. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1896-1901. 1. Deaths from the chief Zymotic Diseases 9 54 0.88 2.13 2. Pulmonary, other than Phthisis 53 321 517 5.76 3. Tubercular 23 139 2.24 1.27 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza,Whooping Cough, Erysipelas, Croup, Fever, and Diarrhœa. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. 62 Health of the District. The health of the district during the past four weeks has been quite exceptional. It is true there have been 15 cases of smallpox, but this, considering the anticipated seasonal increase in May, is quite an insignificant number; had the outbreak pursued its usual course, the number might well have been 10 times 15, i.e., 150. The deaths from all infectious diseases are only 9, giving a zymotic death-rate of 8 per 10,000, the number for the corresponding period of a five years' average being at the rate of 21 per 10,000. The average general death rate for May is about 18 per 1,000; this month it is but 16. No. 3, Upper Gloucester Place. In a month or two the Public Health Department will have removed to temporary premises at the above address. The writer believes that, standing at the edge of one of the main arteries of the borough, the situation will be more convenient to the inhabitants than Marylebone Lane. At all events, the offices can be reached by any resident within 15 minutes. The omnibus routes and the Underground Railway also give ample facilities of cheap and speedy access for those in other parts of the metropolis who have business with the Public Health Department. Housing of the Working Classes Acts. Nightingale Street Scheme.—As far back as 1898, the writer presented a Report on the condition of Nightingale Street. Successive steps, by the Sanitary Committee of the Old Vestry and the Committees of the present Council, culminated in the London County Council preparing a scheme under Part I. of the Housing Act, an inquiry by the Home Secretary, and a Provisional Order which received the sanction of Parliament; nevertheless the houses deteriorated in structure still stand, and a recent attempt to close, under Part II., six houses, has for the moment failed, the cases being dismissed by the Stipendiary Magistrate under a pure technicality. 63 The delay in carrying out any improvement under the Acts is simply intolerable; the delay being mainly due to the complicated procedure as well as to the difficulty of interpretation of the statute. Burne Street area.—The Burne Street area is a second example of delay, this was duly reported under Part I. of the Housing Act to the London County Council in 1900, but the Housing Committee of the Council has not yet even taken it into consideration. Devonshire Place area.—A third example is the Devonshire Place area, reported to the County Council in 1901. That Council has adopted the Report of the Housing Committee, to the effect that, as to whether it shall be dealt with under Part I. by the London County Council, or under Part II. by the Borough Council, is to be determined by the Secretary of State, the County Council suggesting the latter course. It appears to take, in practice, a year or two to get a scheme considered, and after all formalities have been completed a scheme adopted, and an area ordered to be cleared and built upon, the clearing and building exhausts an equally long period. As things stand, it is quite exceptional for a scheme to be carried out from first to last within five years. In the writer's opinion the Housing of the Working Classes Acts should be entirely repealed and legislation of a simpler character substituted, based upon the large experience of the inefficient, tedious, and expensive nature of the existing statutes. Prosecutions under the Public Health (London) Act. The occupier of premises in Marylebone Lane was prosecuted and fined a nominal sum for not providing under bye-law 18 a proper receptacle "constructed of metal and provided with one or more suitable handles and cover." This is not such a trivial offence as it may at first sight seem. In streets where the kerb collection is in force, 64 should occupiers be permitted to place any kind of pail, old egg box, hamper, or basket on the kerb, the effect is, in addition to the slovenly appearance of so various a collection, the refuse is more liable to blow about the street, to escape on to the pavement, and to cause generally a nuisance, increasing the expense of scavenging and making an otherwise clean street dirty ; hence the Public Health Committee are determined to enforce proper receptacles, and the dust inspector has received orders to follow up by summons all persons who after due notice fail to provide and maintain such receptacles. 1902. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, TYPHOID FEVER, & SMALLPOX DURING 1902, AS COMPARED WITH A FIVE YEARS' AVERAGE. MAY. 65 TABLE II.—Giving the Causes of Deaths during the 4 Weeks ending May 31st, 1902, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John & Elizabeth, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill. Infirmary. Hospital of St. John & Elizabeth, Grove Rd. Smallpox ... ... ... ... ... ... Influenza ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... Diphtheria ... ... ... ... ... ... Typhoid Fever ... ... ... ... ... ... Diarrhœa ... ... ... ... 2 ... Erysipelas ... ... ... ... ... ... Pneumonia and Pleurisy 5 ... ... ... 3 ... Pyaemia ... ... ... ... ... ... Syphilis ... ... ... ... 1 ... Cancer 8 ... ... ... 1 ... Phthisis & Tuberculosis 2 ... ... ... 6 1 Rheumatism ... ... ... ... ... ... Apoplexy ... ... ... ... 1 ... Paralysis ... ... ... ... ... ... Bronchitis ... ... ... ... 10 ... Asthma ... ... ... ... ... ... Peritonitis ... ... ... ... ... ... Disease of Brain ... ... ... ... ... ... „ Heart 3 ... ... ... 7 ... „ Kidney ... ... ... ... ... ... ,, Liver ... ... ... ... ... ... ,,Uterus ... ... ... ... ... ... „ Ovary ... ... ... ... ... ... Parturition ... ... ... ... ... ... Diabetes ... ... ... ... ... ... Fractures and Injuries ... ... ... ... 1 ... Old Age ... ... ... ... 2 ... Low Vitality, Infants ... ... ... ... ... ... Premature Birth ... 3 ... ... ... ... Other causes 9 1 ... 1 5 ... Total *28 ‡‡4 ‡l 2 39 ‡‡l * Of the 28 deaths in the Middlesex Hospital, 21 were those of non-parishioners. ‡ The 1 death in the Samaritan Hospital was that of a non-parishioners. ‡‡ The 4 deaths in Queen Charlotte's Hospital were those of infants, all nonparishioners. ‡‡ The 1 death in St. John's Hospital was that of a non-parishioner. 66 TABLE III.—District Births and Deaths for the four weeks ending may 31 st, 1902. Population in 1901. Births. Deaths. Males. Fmls. Males Fmls. All Souls 35,391 23 27 15 18 Rectory 19,849 21 16 12 13 St. Mary 18,099 12 13 10 11 Christ Church 39,536 36 34 31 23 St. John 20,426 16 19 18 14 Total 133,301 108 109 86 79 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. 67 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 Mag, 1902; 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 35,391 19,849 18,099 39.536 20,426 133,301 (c) Registered Births 50 37 25 70 35 217 (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 bach Locality coming to the knowledge of the Medical Officer of Health. 1. Chicken Pox 6 8 .. .. 1 •• 1 3 4 2 12 13 2. Smallpox .. .. 1 7 .. 4 1 .. .. 2 2 13 3. Scarlatina 2 9 .. 1 1 1 2 1 2 7 7 19 4. Diphtheria .. 5 .. 3 .. .. .. .. 1 .. 1 8 5. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 6. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 7. Enteric or Typhoid .. 3 .. .. .. .. .. .. .. .. .. 3 8. Continued .. .. .. .. .. .. .. .. .. .. .. .. 9. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 10. Puerperal .. 1 .. .. .. .. .. .. .. .. .. 1 11. Cholera. .. .. .. .. .. .. .. .. .. .. .. .. 12. Erysipelas .. 1 .. 8 .. 1 .. 6 .. .. .. 16 Number of such Cases Removed from their Homes in tihe several Localities for Treatment in Isolation Hospitals. ' 1. Smallpox .. .. 1 7 .. 4 1 .. .. 2 2 13 2. Scarlatina 2 7 .. 1 1 1 1 1 .. 2 4 12 3. Diphtheria .. 1 .. 2 .. .. .. .. .. .. .. 3 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fbvf.ks. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. .. .. .. .. .. .. .. 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. 7 .. .. .. 1 .. .. .. 8 68 TABLE V.—Causes of, and Ages at, Death during the 4 weeks ending May 31st, 1902, 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 .. .. .. 1 Measles 3 3 .. .. .. .. .. .. 2 .. 1 .. .. Scarlet Fever 1 1 .. .. .. .. .. .. .. .. 1 .. 1 Whooping Cough .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria and Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric .. .. .. .. .. .. .. .. .. .. .. .. .. Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 1 .. .. .. .. 1 .. .. .. 1 .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 3 1 2 .. .. .. .. 2 .. .. 1 .. 2 Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. Other Septic Diseases 1 .. .. .. .. .. .. .. .. .. .. 1 .. Phthisis 16 2 .. .. 1 12 1 3 5 3 4 1 9 Other Tubercular Diseases 7 2 2 1 1 1 .. 1 .. 2 4 .. .. Cancer, Malignant Disease 14 .. .. .. .. 9 5 6 1 .. 1 6 10 Bronchitis 19 1 2 •• .. 7 9 4 5 3 5 2 11 Pneumonia 23 5 2 .. 1 12 3 3 5 4 5 6 19 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Respiratory Organs 1 .. .. .. .. .. 1 .. .. 1 .. .. .. Alcoholism Cirrhosis of Liver 1 .. .. .. •• 1 .. 1 .. .. .. .. .. Venereal Diseases 2 2 .. .. .. .. .. .. .. .. 2 .. 1 Premature Birth 3 3 .. .. .. .. .. 1 .. .. 2 .. 3 Diseases and Accidents of Parturition .. .. .. .. .. .. .. .. .. .. .. .. .. Heart Diseases 19 .. .. .. 1 12 6 4 2 .. 9 4 10 Accidents 7 2 2 .. .. 1 2 .. .. 1 5 1 1 Suicides .. .. .. .. .. .. .. .. .. .. .. .. .. All other causes 43 13 1 .. 2 19 8 8 4 6 14 11 7 All causes 1.5 35 12 1 6 76 35 33 25 21 54 32 75 69 REGISTER OF SANITARY WORK Month ending 31st May, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell. Total. 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. Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 15 7 22 Periodical Inspections:— Factories ... ... ... ... ... ... ... ... 1 1 2 Workshops ... ... ... ... ... ... ... ... 59 180 239 Bakehouses ... ... ... ... ... ... ... 26 2 28 Restaurants, &c. ... ... ... ... ... ... ... ... 39 ... 39 Homeworkers' Premises ... ... ... ... ... ... ... ... 20 12 32 Domestic Workshops ... ... ... ... ... ... ... ... 5 3 8 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 17 9 9 ... ... ... ... ... ... 4 39 Correspondence, Legal Procedure, &c. Complaints received 9 5 14 12 14 ... ... ... 10 9 73 Letters and Intimations relating to Abatement of Nuisances 43 16 42 21 ... ... ... ... 5 13 140 Statutory Notices Served 8 ... 7 4 9 ... ... ... ... ... 28 Proceedings taken before Magistrates ... ... ... ... ... ... ... ... ... ... ... (1) Under Public Health Act ... ... ... ... ... ... ... ... ... ... ... (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) ,, Food & Drugs Act ... 1 2 ... 1 ... ... ... ... ... 4 Reports made to Medical Officer of Health 48 30 35 56 47 ... ... ... 30 28 272 70 REGISTER OF SANITARY WORK Month ending 31st May, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell. Total. Mr. J. Hodgss, 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. Public Health (London) Act. Inspections. Dwelling Houses, &c. 47 56 50 40 43 ... ... .. ... ... 236 Tenements 50 ... 30 63 27 ... ... ... ... ... 170 Underground Dwellings 20 ... 25 5 21 ... ... ... ... ... 71 Dairies, Milk Shops, Cow Houses 6 2 3 2 5 ... ... ... ... ... 18 Slaughter Houses 1 2 ... 1 1 ... ... ... ... ... 5 Yards, Stables, and Mews 18 18 30 60 26 ... ... ... ... 2 154 Smoke Shafts ... ... ... ... ... ... ... ... 4 ... 4 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... ... ... ... Refuse Receptacles 5 13 6 20 5 ... ... ... ... ... 49 Enquiries re non-removal of refuse 8 9 12 ... 7 ... ... ... ... ... 36 Removal of Bodies to Mortuary ... ... ... ... ... ... ... ... ... ... ... Visits to Works in Progress 141 162 150 180 97 ... ... ... 35 12 777 Miscellaneous Inspections 54 63 50 60 69 ... ... ... 20 27 343 UNWHOLESOME FOOD. Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE:- Cases Isolated ... ... ... ... 2 ... ... ... ... ... 2 Cases removed to Hospital 11 9 8 6 11 ... ... ... ... ... 45 Rooms Disinfected 24 18 16 12 26 ... ... ... ... ... 96 NEW DRAINAGE:- Number of Plans Passed 7 11 5 12 13 ... ... ... ... ... 48 New Pipe Drains (feet) 954 1720 352 560 1648 ... ... ... ... ... 5234 Houses where defects in existing Drainage have been detected and remedied 11 12 10 5 9 ... ... ... ... ... 47 THE SANITARY CHRONICLES of THE BOROUGH OF ST. MARYLEBONE DURING JUNE, 1902. Containing a Quarterly Summary of the Mortality Statistics for the Quarter ending June 28th, 1902, 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. Vol. XXII. Town Hall, St. Marylebone, July 5th, 1902. No. 6. The week ending June 7th was wet and unpleasant. Minimum temperature, 50.0°; maximum, 76.0°; mean, 59.8°. On six days 1.05 inch rain fell. The winds were WSW and WNW; the sunshine, 23.8 per cent. Mean barometer, 29.8 inches. The week ending June 14th was also wet and cool. Minimum temperature, 39.2°; maximum, 60.0°; mean, 52.5°; On four days rain fell (1.28 inch). "Winds variable. Sunshine, 14.3 per cent. Mean barometer, 29.6 inches. The week ending June 21st showed but a slight improvement. Minimum temperature, 45.0°; maximum, 71.5°; mean, 58.0°. Winds, N and SE. On three days rain fell (0.30 inch). Sunshine only 18.5 per cent. Mean barometer, 29.6 inches. 72 The week ending June 28th was one of perfect summer. Minimum temperature, 50.5°; maximum, 80.5°; mean, 69.4°. No rain fell. Winds, SE and E. Sunshine registered in Begent's Park, 77.9 hours, equal to 67.l per cent. Mean barometer, 30.1 inches. Births and Deaths. During the four weeks ending June 28th there have been registered 210 births and 160 deaths; equal to a birth-rate of 20.5 per thousand, a death-rate of 15.6 per thousand. The average death-rate for the corresponding period during the five previous years was 17.1 per thousand. Quarterly Summary. During the quarter ending June 28th there have been registered 688 births and 516 deaths. These births and deaths are distributed among the five sub-districts as set forth in Table VI. Two hundred and one of the deaths were extra-parochial, as follows:— St. Marylebone Infirmary, Notting Hill 124 North-Western Fever Hospital 6 Western Fever Hospital 1 North-Eastern Eever Hospital 3 Gore Farm Hospital 1 Long Eeach Hospital 2 Hospital Ship "Atlas" 1 „ „ "Castalia" 3 London Fever Hospital 1 London Hospital 1 St. Mary's Hospital 15 Children's Hospital, Paddington 1 King's College Hospital 1 University College Hospital 6 St. Thomas' Hospital 1 Cancer Hospital, Chelsea 1 French Hospital 2 170 73 Brought forward 170 Italian Hospital 1 German Hospital 1 Royal Free Hospital 1 Homoeopathic Hospital 1 Brompton Hospital 2 St. Peter's Home, Kilburn 1 St. Joseph's Home 1 Hanwell Asylum 8 Leavesden Asylum 1 Banstead Asylum 2 Claybury Asylum 2 Colney Hatch Asylum 4 Hoxton House Asylum 1 Friedenheim 2 In various streets 3 Total 201 The birth and death-rates, as deduced from the thirteen weeks' statistics, were as follows:— All Souls, birth-rate 17.3; death-rate 14.4. Rectory, birth-rate 19.1; death-rate 14.7. St. Mary, birth-rate 16.1; death-rate 13.5. Christ Church, birth-rate 28.5; death-rate 15.6. St. John, birth-rate 16.6; death-rate 20.7. The whole district, birth-rate 20.6; death-rate 15.5. The average death-rates for five years (1896 to 1901) for the corresponding period were as follows:—All Souls, 13.8; Rectory, 21.0; St. Mary, 18.4; Christ Church, 18.9; St. John, 20.6; the whole district, 17.3. 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: 74 TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE THIRTEEN WEEKS ENDING JUNE 28th, 1902, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 13 weeks ending June 28th, 1902. Proportion of the deaths to 1,000 deaths from all causes. 13 weeks ending June 28,1902. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1896-1901. 1. Deaths from the chief Zymotic Diseases 52 101 1.56 1.44 2. Pulmonary, other than Phthisis 99 192 2.97 3.83 3. Tubercular 79 153 1.62 2.07 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza, Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. 75 Health of the District. Small-pox has for the time practically died out. On the other hand, there has been an unusual burst of scarlet fever during the latter part of June ; there has also been a rise above the normal of typhoid fever. No direct connection between milk or water supply can be established. In a few of the cases of typhoid there is some evidence of being derived from eating shell-fish or oysters, but in others the history is too vague and indefinite to justify conclusions. In other respects, the past three months have been fairly healthy; the general death-rate, as well as that from pulmonary and tubercular diseases, being well below the average. London County Council (General Powers) Bill. This Bill, now before the House of Lords, seeks, among other things, to empower the officers of the London County Council to inspect any dairy in any place in or out of London from whence milk supposed to have caused illness is derived. The Boroughs of Paddington, of Lambeth, of Hampstead, of Islington, of St. Pancras, the County Councils of Middlesex and of Herts, the Metropolitan Branch of the Society of Medical Officers of Health, all petition against these powers being granted. To the mind of the writer the powers of each County Council, whether the County Council of London or that of any of the provinces, should be confined to the functions of a Local Government Board, and many functions now exercised by the Local Government Board might be usefully transferred. But when matters of detail are in question, such as the inspection of dairies, of common lodging houses, the provision of facilities of escape from fire, and so forth, all such matters can be done more economically and more efficiently by the officers of the various local sanitary authorities. It is therefore much to 76 be regretted that the London Council constantly in their policy depart from this great and essential principle of referring all details to local authorities, and evince a desire to initiate and carry out themselves the most minute detail with regard to sanitary inspection; which means an enormous duplication of officers, and consequent quite unnecessary expense. It is for the above reasons that the writer heartily approves of the opposition to the Bill by the authorities named. The Laboratory (Sale of Food and Drugs Acts). The work done under the Sale of Food and Drugs Acts is presented in a tabular form (page 82); from the table it will be seen that 155 samples of various articles of food and drink have been analysed, and that out of these,—four samples of milk and two samples of butter were certified to be adulterated. Prosecutions have been initiated as follows:— Laura Rowlands, of 14, Bell Street, was fined £2 with costs for selling milk diluted with 20 per cent. water. John Evans, of 8 Christ Church residences, was fined £1 and costs for selling milk deficient in milk fat, to the extent of 13 per cent. Richard Pontifex, of No. 29, Upper Marylebone Street, was fined £3 with costs for selling milk deficient in milk fat to the extent of 16 per cent. A sample of butter was certified to contain 20 per cent. of water. The sample having been taken a few days before the regulations fixing the limit of water at 16 per cent, had come into force, no prosecution took place. Other prosecutions are pending. 77 TABLE 11.—Giving the Causes of Deaths during the 13 Weeks ending June 28th, 1902, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John & Elizabeth, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill. Infirmary. Hospital of St. John & Elizabeth, Grove Rd. Smallpox ... ... ... ... ... ... Influenza ... ... ... ... ... ... Scarlet Fever ...... ... ... ... ... ... Diphtheria ... ... ... ... ... ... Typhoid Fever ... ... ... ... ... ... Diarrhoea ... ... ... 1 4 ... Erysipelas ... ... ... ... 1 ... Pneumonia and Pleurisy 7 ... ... 1 11 ... Pyaemia ... ... ... ... ... ... Syphilis ... ... ... ... 4 ... Cancer 34 ... 1 ... 4 3 Phthisis & Tuberculosis 3 ... ... ... 33 2 Rheumatism ... ... ... ... ... ... Apoplexy ... ... ... ... 1 ... Paralysis ... ... ... ... 3 ... Bronchitis 4 ... ... 1 25 2 Asthma ... ... ... ... ... ... Peritonitis ... ... ... ... ... ... Disease of Brain ... ... ... ... ... ... „ Heart 11 ... ... 1 12 ... „ Kidney ... ... ... ... 1 ... ,, Liver ... ... ... ... 2 ... „ Uterus ... ... ... ... ... ... „ Ovary ... ... ... ... ... ... Parturition ... ... ... ... ... ... Diabetes ... ... ... ... ... ... Fractures and Injuries. 3 ... ... 1 2 ... Old Age ... ... ... 6 ... Low Vitality, Infants ... ... ... ... ... ... Premature Birth 4 ... ... ... ... Other causes 25 4 3 5 15 2 Total *87 ‡‡8 ‡4 10 124 ‡‡9 * Of the 87 deaths in the Middlesex Hospital, 65 were those of non-parishioners. ‡‡ The 8 deaths in Queen Charlotte's Hospital were those of infants; seven were the children of non-parishioners. ‡ The 4 deaths in the Samaritan Hospital were those of non-parishioners. †† Seven of the 9 deaths in St. John's Hospital were those of non-parishioners. 78 TABLE III.—TABLE OF POPULATION, BIRTH, 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, 1902; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church Sr. John Totals Population at all Ages. (b) Census 1901 35,391 19,849 18,090 39.536 20,425. 133,301 (c) Registered Births 39 30 20 98 23 210 (d) Aged under 5 or over 5 Under 5 5 upwards Under o 5 upwards Under 5 5 upwards Under 5 j 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 of Health. 1. Chicken Pox 8 12 3 2 6 2 3 9 .. 3 20 28 2. Smallpox .. 1 .. 3 .. 3 .. 4 .. .. .. 11 3. Scarlatina 1 7 .. .. .. 4 1 5 8 10 11 26 4. Diphtheria .. .. 2 4 1 1 1 1 1 2 5 8 5. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. Fevers. 6. Typhus .. .. .. .. .. .. .. .. .. .. .. 7. Enteric or Typhoid .. 2 .. 2 .. 3 .. 6 .. 3 .. 16 8. Continued .. .. .. .. .. .. .. .. .. .. .. .. 9. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 10. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 11. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 12. Erysipelas .. 4 .. 9 .. 2 2 10 .. 3 2 18 . Number of such Cases Removed from their Homes in the several Localities fob Treatment in Isolation Hospitals. 1. Smallpox .. 1 .. 3 .. 3 .. 4 .. .. .. 11 2. Scarlatina .. 4 .. 1 4 .. 4 7 8 8 20 3. Diphtheria .. .. 1 2 1 1 .. 1 .. 1 3 5 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 2 .. 1 .. .. .. 6 .. 2 .. 11 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. •• .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 . Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas .. .. .. 6 .. .. .. 1 .. 2 .. 9 1903. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, TYPHOID FEVER, & SMALLPOX DURING 1902, AS COMPARED WITH A FIVE YEARS' AVERAGE. JUNE. 79 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 June Quarter, 1902; 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 19,849 18,099 39,536 20,426 133,801 (c) Registered Births 153 95 73 291 85 697 (d) Aged under 5 or over 5. Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 up words Under 5 5 upwards Under 5 5 upwards New Cases op Sickness in each Locality coming to the knowledge of the medical Officer of Health. 1. Chicken Pox 21 26 12 3 9 4 6 15 11 7 59 55 2 Smallpox .. 3 1 12 .. 8 1 7 .. 4 2 34 3. Scarlatina 5 19 2 4 2 7 .. 7 11 19 25 56 4. Diphtheria 1 7 3 9 1 2 .. 1 6 5 13 24 5. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. Fevers. 6. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 7. Enteric or Typhoid .. 6 .. 3 .. 3 .. 8 1 3 1 23 8. Continued .. .. .. .. .. .. .. .. .. .. .. .. 9. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 10. Puerperal .. 1 .. .. .. .. .. .. .. .. .. 1 11 Cholera. .. .. .. .. .. .. .. .. .. .. .. .. 12 . Erysipelas .. 6 .. 25 .. 4 2 18 1 9 3 62 Number of such Cases Removed from their . Homes in the several Localities for Treatment in Isolation Hospitals. 1 Smallpox .. 3 1 12 .. 8 1 7 4 2 34 2 Scarlatina 2 14 2 8 1 5 3 6 7 11 15 44 3 Diphtheria 1 2 2 5 1 2 1 2 4 8 14 4 Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 2 .. 2 .. .. .. 6 1 2 1 12 7, Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 . Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas .. .. .. 19 .. .. .. 2 1 3 1 24 80 TABLE V.—District Births and Deaths for the four weeks ending june 28TH, 1902. Population in 1901 Births. Deaths. Males. Fmls. Males Fmls. 35,391 22 17 20 23 Rectory 19,849 12 18 8 14 St. Mary 18,099 12 8 6 11 Christ Church 39,536 46 52 22 20 St. John 20,426 15 8 14 22 Total 133,301 107 103 70 90 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 thirteen weeks ending June 28th, 1902. Population in 1901. Births. Deaths. Males. Fmls. Males. Fmls. All souls 35,391 79 74 61 61 Rectory 19,849 44 51 35 38 St. Mary 18,099 40 33 30 31 Christ Church 39,536 132 150 88 66 St. John 20,426 47 38 56 50 Total 133,301 342 346 270 246 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. 81 TABLE VII.—Causes of, and Ages at, Death during the 13 weeks ending June 28th, 1902, 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 7 .. 1 .. .. 5 1 2 1 1 .. 3 3 Measles 19 5 13 1 .. .. 2 6 2 7 2 .. Scarlet Fever 6 1 3 1 .. 1 .. 2 1 .. 1 2 3 Whooping Cough 2 1 1 .. .. .. .. 1 .. 1 .. .. .. Diphtheria and Membranous Croup 4 1 1 1 1 .. .. .. 2 1 1 .. 3 Croup 1 1 .. .. .. .. .. .. 1 .... .. .. .. Fever 'Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric .. .. .. .. .. .. .. .. .. .. .. .. .. Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 4 .. .. .. .. 2 2 .. 2 1 .. 1 .. Cholera .. .. .. .. .. .. .. .. .. .... .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhoea 8 6 2 .. .. .. .. 3 .. .. 4 1 5 Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 1 1 .. .. .. .. .. .. .. .. .. 1 1 Other Septic Diseases 3 1 .. .. .. 2 .. .. .. .. 1 2 .. Phthisis 59 .. .. .. 4 38 15 13 11 3 18 9 39 Other Tubercular Diseases 20 7 5 .. 3 2 .. 5 .. 3 11 1 1 Cancer, Malignant Disease 43 .. .. .. .. 25 18 18 3 3 7 12 41 Bronchitis 47 2 4 .. .. 19 22 11 16 6 9 5 32 Pneumonia 44 8 4 1 .. 23 7 11 8 9 9 7 26 Pleurisy 4 .. 1 .. 3 .. .. 1 .. 1 2 1 Other Diseases of Respiratory Organs 4 .. 1 .. .. 2 1 .. 2 1 1 .. .. Alcoholism Cirrhosis of Liver 7 .. .. .. .. 7 .. 2 .. 1 2 2 .. Venereal Diseases 6 5 .. .. 1 .. .. 1 .. 2 3 .. 4 Premature Birth 13 13 .. .. .. .. .. 2 1 2 5 3 4 Diseases and Accidents of Parturition 1 .. .. •• 1 1 .. .. .. .. .. Heart Diseases 58 .. .. 3 32 23 15 4 7 19 13 24 Accidents 21 6 3 .. 1 7 4 2 1 3 10 5 9 Suicides .. .. .. .. .. .. .. .. .. .. .. .. .. All other causes 131 33 5 1 2 51 42 26 13 15 45 35 57 All causes 516 93 43 9 16 220 135 122 73 61 154 106 253 82 TABLE VIII.—SALE OF FOOD AND DRUGS ACT. Samples Analysed during June Quarter 1902. Genuine. Adulterated. Total. DAIRY PRODUCTS- Milk 64 4 68 Butter 29 2 31 Margarine 6 - 6 Cheese 1 - 1 Lard 2 — 2 ALCOHOLIC BEVERAGES— Whisky 15 - 15 Brandy 4 — 4 Gin 6 - 6 Beer 7 - 7 Port Wine 3 — 3 NON-ALCOHOLIC BEVERAGES— Coffee 1 - 1 CONDIMENTS— Vinegar 1 - 1 Sauce 1 — 1 TINNED GOODS— Salmon 3 - 3 Sardines 2 — 2 SACCHARINE SUBSTANCES— Honey 1 — 1 MISCELLANEOUS— Corn Flour 1 - 1 Chutney 1 - 1 Essence of Lemon 1 - 1 149 6 155 83 REGISTER OF SANITARY WORK Month ending 30th June, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell. Total. Mr. J. Hodgss, 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. Public Health (London) Act. Inspections. Dwelling Houses, &c 18 19 15 20 17 ... ... ... ... ... 89 Tenements 43 16 35 56 29 ... ... ... ... ... 179 Underground Dwellings 7 3 25 4 13 ...... ... ... ... ... 52 Dairies, Milk Shops, Cow Houses 5 1 12 2 3 ... ... ... ... ... 23 Slaughter Houses 2 2 ... 1 1 ... ... ... ... ... 6 Yards, Stables, and Mews 32 26 40 35 29 ... ... ... ... ... 162 Smoke Shafts ... ... ... ... ... ... ... ... 4 ... 4 Offensive Trades and Effluvia Businesses Refuse Receptacles 5 9 6 ... 4 ... ... ... ... ... 24 Enquiries re non-removal of refuse 6 7 12 ... 3 ... ... ... ... ... 28 Removal of Bodies to Mortuary ... ... ... 1 ... ... ... ... ... ... 1 Visits to Works in Progress 190 186 150 210 174 ... ... ... ... 6 946 Miscellaneous Inspections 150 132 120 180 98 ... ... ... ... 22 702 UNWHOLESOME FOOD. Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE Cases Isolated 1 1 3 1 1 ... ... ... ...... ... 7 Cases removed to Hospital 12 19 16 16 8 ... ... ... ... ... 71 Rooms Disinfected 24 28 22 28 26 ... ... ... ... ... 128 NEW DRAINAGE Number of Plans Passed 8 5 6 12 11 ... ... ... ... ... 42 New Pipe Drains (feet) 1360 1702 250 1200 1616 ... ... ... ... ... 6158 Houses where defects in existing Drainage have been detected and remedied 8 10 6 7 9 ... ... ... ... ... 40 84 REGISTER OF SANITARY WORK Month ending 30th June, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell. Total. 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 Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 18 6 24 Periodical Inspections:— Factories ... ... ... ... ... ... ... ... 3 2 5 Workshops ... ... ... ... ... ... ... ... 51 283 334 Bakehouses ... ... ... ... ... ... ... ... 39 ... 39 Restaurants, &c. ... ... ... ... ... ... ... ... 51 1 55 Homeworkers' Premises 10 66 76 Domestic Workshops ... ... ... ... ... ... ... ... 20 4 24 Food and Drugs Act. ADULTERATION. Samples collected for Analysis ... 7 2 ... ... ... ... ... ... ... 9 Correspondence, Legal Procedure, &c. Complaints received 7 5 8 13 15 ... ... ... 5 8 61 Letters and Intimations relating to Abatement of Nuisances 25 23 29 22 27 ... ... ... 7 7 140 Statutory Notices Served 4 ... 1 2 9 ... ... ... 1 ... 17 Proceedings taken before Magistrates 6 ... ... ... ... ... ... ... ... ... 6 (1) Under Public Health Act ... 1 ... ... ... ... ... ... ... ... 1 (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) „ Food & Drugs Act ... ... ... ... ... ... ... ... ... ... ... Reports made to Medical Officer of Health 12 ... 30 55 76 ... ... ... 36 22 261 85 REGISTER OF. SANITARY WORK Quarter ending 30th June, 1902 PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillip*. Special Duties. Miss L. M. O'Kell. Total. 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. Public Health (London) Act. Inspections. Dwelling Houses, &c 120 129 121 100 60 ... ... ... ... ... 530 Tenements 139 16 91 139 56 ... ... ... ... ... 441 Underground Dwellings 37 3 62 9 34 ... ... ... ... ... 145 Dairies, Milk Shops, Cow House.- 15 4 16 8 8 ... ... ... ... ... 51 Slaughter Houses 4 6 ... 3 2 ... ... ... ... ... 15 Yards, Stables, and Mews 62 47 100 115 55 ... ... ... ... 2 381 Smoke Shafts ... ... ... ... ... ... ... ... 11 ... 11 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... ... ... ... Refuse Receptacles 21 35 21 40 9 ... ... ... ... ... 126 Enquiries re non-removal of refuse 22 26 36 6 10 ... ... ... ... ... 100 Removal of Bodies to Mortuary 1 ... ... 1 ... ... ... ... ... ... 2 Visits to Works in progress 501 508 150 510 271 ... ... ... 74 33 2377 Miscellaneous Inspections 424 327 280 380 167 ... ... ... 47 129 1754 UNWHOLESOME FOOD. Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE:— Cases Isolated 1 3 3 1 3 ... ... ... ... ... 11 Cases Removed to Hospital 31 33 31 32 19 ... ... ... ... ... 146 Rooms Disinfected 62 46 50 58 52 ... ... ... ... ... 268 NEW DRAINAGE:— Number of Plans Passed 21 20 18 36 24 ... ... ... ... 1 120 New Pipe Drains (feet) 3184 4102 852 2969 3294 ... ... ... ... ... 14401 Houses where defects in existing Drainage have been detected and remedied 29 30 25 22 18 ... ... ... ... ... 124 86 REGISTER OF SANITARY WORK Quarter ending June 30th, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell, Total. 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. \V. Yeo, No. 5 District. Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 72 53 125 Periodical Inspections:— 95 ... 95 Factories ... ... ... ... ... ... ... ... 11 6 17 Workshops ... ... 1 ... ... ... ... ... 183 508 092 Bakehouses 1 ... ... ... ... ... ... ... 94 2 97 Restaurants, &c. ... ... ... ... ... ... ... ... 156 2 158 Homeworkers' Premises ... ... ... ... ... ... ... ... 55 96 151 Domestic Workshops ... ... ... ... ... ... ... ... 43 10 53 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 30 33 32 13 23 ... ... ... ... 4 135 Correspondence, Legal Procedure, &c. Complaints received 19 16 32 39 40 ... ... ... 18 24 188 Letters and Intimations relating to Abatement of Nuisances 78 52 83 61 41 ... ... ... 16 38 369 Statutory Notices Served 12 ... 8 13 25 ... ... ... 1 ... 59 Proceedings taken before Magistrates 6 ... ... ... ... ... ... ... ... ... 6 (1) Under Public Health Act ... 1 1 ... ... ... ... ... ... ... 2 (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) „ Food & Drugs Act ... 1 2 ... 1 ... ... ... ... ... 4 Reports made to Medical Officer of Health 124 66 95 157 170 ... ... ... 91 78 781 THE SANITARY CHRONICLES of the BOROUGH OF ST. MARYLEBONE DURING JULY, 1902. Public Health Department, 3, Upper Gloucester Place, St. Marylebone, August 9th, 1902. Vol. XXII. No. 7. The week ending July 5th was one of unsettled weather. Minimum temperature, 47.0°; maximum, 81.2°; mean, 65.0°. Winds E and SW On three days rain fell (1.24 inch); sunshine, 42.25 hours. Mean barometer, 30.0 inches. The week ending July 12th was one of pleasant summer warmth. Minimum temperature, 44.5°; maximum, 83.0°; mean, 67.3°. On two days rain fell (0.24 inch). Winds variable. Sunshine registered in Regent's Park, 54 hours. Mean barometer, 30.0 inches. The week ending July 19th was bright and rainless. Minimum temperature, 46.0°; maximum, 84.5°; mean, 68.4°. Winds, NW. Sunshine 67.5 hours. Mean barometer, 300 inches. The week ending July 26th was cooled by easterly winds. Minimum temperature, 50.0°; maximum, 71.2°; mean, 60.1°. On one day rain fell (0.09 inch). Sunshine, 1ST hours. Mean barometer, 29.8 inches. The week ending August 2nd was also cool. Minimum temperature, 49.4°; maximum, 68.8°; mean, 58.1°. Sunshine registered, 40 hours. On two days slight rain fell (0.14 inch). Winds, WSW. Mean barometer, 29.9 inches. 88 Births and Deaths. During the five weeks ending August 2nd there have been registered 294 births and 179 deaths. These births and deaths are divided among the five sub-districts as set forth in Table IV Eighty-three of the deaths were -parochial, as follows:— St. Marylebone Infirmary, Notting Hill 54 North-Eastern Fever Hospital 1 North-Western Fever Hospital 6 St. Mary's Hospital 4 St. George's Hospital 1 Charing Cross Hospital 2 Children's Hospital, Great Ormond Street 1 Hostel of God 1 Clapham Maternity 2 Hanwell Asylum 6 Colney Hatch Asylum 4 The Serpentine 1 Total 83 The birth and death-rates, as deduced from the month's statistics, are as follows:— All Souls, birth-rate 19.7; death-rate 10.3. Rectory, birth-rate 19.5; death-rate 8.7. St. Mary, birth-rate 22.4; dentil-rate 15.5. Christ Church, birth-rate 28.4; death-rate 14.7. St. John, birth-rate 20.9; death-rate 20.4. The whole district, birth-rate 22.9; death-rate 14.0. The average death-rates for five years (1896 to 1901) for the corresponding period were as follows:—All Souls, 13.1; Rectory, 15.7; St. Mary, 13.7; Christ Church, 16.4; St. John, 20.2; the whole district, 16.3, 89 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 AUGUST 2nd, 1902, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 5 weeks ending Aug 2nd, 1902. Proportion of the deaths to 1,000 deaths from all causes. 5 weeks ending Aug. 2,1902. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1896-1901. 1. Deaths from the chief Zymotic Diseases 28 156 2.18 3.02 2. Pulmonary, other than Phthisis 30 168 2.34 2.47 3. Tubercular 25 140 1.95 1.76 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza,Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. 90 The Temporary Offices of the Public Health Department. As indicated on the first page, the business of the Public Health Department will now be carried on at No. 3, Upper Gloucester Place. For the first time during the writer's long period of office, there is suitable accommodation for the increasing mass of papers, reports, correspondence, and records. Although the offices are confessedly temporary, no one with any knowledge of public business can for a moment doubt but that it will be many years before municipal offices will be built and ready for occupa" tion. The construction of a new Town Hall is eminently a matter of contention; there will be honest differences of opinion as to the best possible site, as to the kind of building, and as to the cost of both; there can, however, hardly be any room for dispute that such offices are urgently needed. It was only when the position of affairs became intolerable that the Council consented to separate for a time the Public Health Department from the old Town Hall, and thus give a transient relief and some little better accommodation to the other departments. The Health of the District during July. Small-pox has for the time definitely died out. The unusually moderate temperatures have had the direct effect of reducing the infantile diarrhoea, that usually causes a good many deaths in hot July months, to insignificant limits. On the other hand, one district of the Borough has suffered from scarlatina and throat affections to a far greater extent than usual. The whole death-rate is, however, more than two per thousand lower than the average. 1902. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, TYPHOID FEVER, & SMALLPOX DURING 1902, AS COMPARED WITH A FIVE YEARS' AVERAGE- JULY. 91 TABLE 11.—Giving the Causes of Deaths during the 5 Weeks ending August 2nd, 1902, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John & Elizabeth, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Nothing Hill, infirmary Hospital of St. John & Elizabeth, Grove ltd. Smallpox ... ... Influenza ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... Diphtheria 2 ... ... ... ... ... Typhoid Fever ... ... ... ... ... ... Diarrhoea ... ... ... ... 2 ... Erysipelas 1 ... ... ... 2 ... Pneumonia and Pleurisy 5 ... ... ... 2 ... Pyaemia ... ... ... ... ... ... Syphilis ... ... ... ... 1 .. Cancer 16 ... ... ... 2 ... Phthisis & Tuberculosis 3 ... ... ... 14 1 Rheumatism ... ... ... ... 1 ... Apoplexy ... ... ... ... ... ... Paralysis ... ... ... ... 3 ... Bronchitis 2 ... ... ... 13 l Asthma ... ... ... ... ... ... Peritonitis ... ... ... ... ... ... Disease of Brain ... ... ... ... ... ... „ Heart 3 1 ... ... 3 1 „ Kidney ... ... ... ... ... ... „ Liver ... ... ... ... ... ... „ Uterus ... ... ... ... ... ... „ Ovary ... ... ... ... ... ... Parturition ... ... ... ... ... ... Diabetes ... ... ... ... ... ... Fractures and Injuries 1 ... ... ... ... ... Old Age ... ... ... ... 5 ... Low Vitality, Infants ... ... ... ... ... ... Premature Birth ... ... ... ... ... ... Other causes 9 1 ... 3 6 ... Total *42 †2 ... 5 54 ‡3 92 TABLE III.—Causes of, and Ages at, Death during the 5 weeks ending August 2nd, 1902, 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. .... .. .. .. .. .. .. .. .. .. .. .. .. Measles 3 .. 2 1 .. .. .. .. .. .. .. 3 .. Scarlet Fever 1 .. 1 .. .. .. .. .. .. .... .. 1 1 Whooping Cough 1 1 .. .. .. .. .. .. .. .. 1 .. .. Diphtheria and Membranous Croup 4 .. 3 1 .. .. .. .. .. 2 .. 2 4 Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric 3 .. .. .. 2 1 .. .. .. .. 3 .. 2 Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhoea 10 8 1 .. .. 1 .. 1 2 1 4 2 2 Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 1 .. .. .. .. 1 .. .. .. .. 1 .. .. Erysipelas 2 .. .. .. .. 1 1 1 .. .. 1 .. 1 Other Septic Diseases 3 .. .. .. 1 2 .. 1 1 1 .. .. 2 Phthisis 17 .. .. 1 1 14 1 5 3 3 3 3 2 Other Tubercular Diseases 8 .. 4 .. .. 1 .. 1 1 .. 4 2 .. Cancer, Malignant 11 .. .. .. .. 8 3 2 1 3 2 3 17 Bronchitis 20 2 .. .. .. 7 11 7 6 1 4 2 2 Pneumonia 10 1 .. .. 1 7 1 4 .. 2 1 3 5 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Respiratory Organs .. .. .. .. .. .. .. .. .. .. .. .. .. Alcoholism Cirrhosis of Liver 4 .. .. .. .. 4 .. 1 1 1 1 .. 2 Venereal Diseases 1 1 .. .. .. .. .. .. .. 1 .. .. .. Premature Birth 4 4 .. •• .. .. .. 1 .. 1 1 1 .. Diseases and Accidents 1 .. .. .. .. 1 .. 1 .. .. .. .. .. Heart Diseases 14 .. .. 1 .. 8 5 1 3 9 1 5 Accidents 6 4 .. .. 1 1 .. 1 .. 4 1 1 Suicides 2 .. .. .. .. 2 .. 1 1 .. .. .. .. All other causes 53 6 3 .. 4 10 22 8 4 8 17 16 9 All causes 179 20 14 4 10 78 44 35 21 27 56 40 55 93 TABLE TV.—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, 1902; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals Population at all Ages. 1 (3) Census 1901 36,'495 19.798 19,637 32,547 32,611 141,188 (c) Registered Births 67 38 39 108 42 294 (d) Aged under 5 or over 5. Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 up words Under 5 5 upwards Under 5 5 upwards New Casks of Sickness in each Locality coming to the knowledge of the medical Officer of Health. 1. Chicken Pox 7 4 . . 3 2 1 5 5 1 8 15 21 2. Smallpox . . 1 . . 1 . . . . . . . . . . . . . . 2 3. Scarlatina . . 5 1 3 1 3 . . 1 6 24 8 36 4. Diphtheria 2 4 1 5 3 1 4 2 2 6 12 18 5. Membranous Croup . . . . . . . . . . . . . . . . . . . . . . . . Fevers. 6. Typhus . . . . . . . . . . . . . . . . . . . . . . . . 7. Enteric or Typhoid 1 3 . . 1 . . 1 . . 4 . . 3 1 12 8. Continued . . . . . . . . . . . . . . . . . . . . . . . . 9. Relapsing . . . . . . . . . . . . . . . . . . . . . . . . 10. Puerperal . . . . . . . . . . 1 . . 1 . . . . . . 2 11 Cholera . . . . . . . . . . . . . . . . . . . . . . . . 12 Erysipelas . . 2 . . 5 . . . . . . 4 . . 1 . . 12 | Number of such Cases Removed from their 1 Homes in the several Localities for Treatment in Isolation Hospitals. 1 Smallpox . . 1 . . 1 . . . . . . . . . . . . . . 2 2. Scarlatina . . 2 1 3 1 3 . . 1 . . 19 7 28 3. Diphtheria 1 4 1 4 3 . . 4 2 . . 5 10 15 1. Membranous Croup . . . . . . . . . . . . . . . . . . . . . . . . Fevers. 5. Typhus . . . . . . . . . . . . . . . . . . . . . . . . 6. Enteric or Typhoid 1 2 . . . . . . 1 . . 3 . . 3 1 9 7. Continued . . . . . . . . . . . . . . . . . . . . . . . . 8. Relapsing . . . . . . . . . . . . . . . . . . . . . . . . 9. Puerperal . . . . . . . . . . . . . . . . . . . . . . . . 10 Cholera . . . . . . . . . . . . . . . . . . . . . . . . 11 Erysipelas . . 1 . . 3 . . . . . . 1 . . . . . . 5 94 TABLE V.—District Births and Deaths for the five weeks ending august 2nd, 1902. Population in 1901. Births. Deaths. Males. Fmls. Males Fmls. All Souls 35,391 33 34 IB 20 Rectory 19,849 18 20 16 5 St. Mary 18,099 20 19 13 14 Christ Church 39,536 59 49 28 28 St. John 20,426 21 21 20 20 Total 133,301 151 143 92 87 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. 95 REGISTER OF SANITARY WORK Month ending 31st July, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. H. Phillips, Special Duties. Miss F. A. Baker. Total. 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. Public Health (London) Act. Inspections. Dwelling Houses, &c 36 34 26 25 26 ... ... ... 5 ... 152 Tenements 40 ... 36 43 11 ... ... ... ... ... 130 Underground Dwellings 6 ... 10 8 7 ... ... ... ... ... 31 Dairies, Milk Shops, Cow Houses 2 1 5 4 3 ... ... ... 11 ... 26 Slaughter Houses 2 2 ... 1 ... ... ... ... ... ... 5 Yards, Stables, and Mews 21 19 20 40 17 ... ... ... 10 ... 127 Smoke Shafts ... ... ... ... ... ... ... ... 15 ... 15 Offensive Trades and Effluvia Businesses ... ... ... 2 ... ... ... ... ... ... 2 Refuse Receptacles 10 13 6 10 3 ... ... ... ... ... 42 Enquiries re non-removal of refuse 4 5 3 8 2 ... ... ... ... 3 25 Removal of Bodies to Mortuary ... ... ... ... ... ... ... ... ... ... ... Visits to Works in Progress 180 192 50 240 196 ... ... ... 31 13 902 Miscellaneous Inspections 96 76 50 90 113 ... ... ... 27 49 501 UNWHOLESOME FOOD. Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE Cases Isolated 2 3 3 1 ... ... ... ... ... ... 9 Cases removed to Hospital 25 27 9 21 10 ... ... ... ... ... 92 Rooms Disinfected 38 48 10 42 19 ... ... ... ... ... 157 NEW DRAINAGE Number of Plans Passed 8 7 2 12 13 ... ... ... ... ... 42 New Pipe Drains (feet) 1360 1328 150 1206 1426 ... ... ... ... ... 5470 Houses where defects in existing Drainage have been detected and remedied 8 9 6 8 7 ... ... ... 5 ... 43 96 REGISTER OF SANITARY WORK Month ending 31st July, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillips, Special Duties. Miss F. A. Baker. Total. 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 Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... ... 11 11 Periodical Inspections Factories ... ... ... ... ... ... ... ... ... ... ... Workshops ... ... ... ... ... ... ... ... 35 303 338 Bakehouses 1 ... ... ... ... ... ... ... 17 ... 18 Restaurants, &c. ... ... ... ... ... ... ... ... 20 ... 20 Homeworkers' Premises ... ... ... ... ... ... ... ... 9 83 92 Domestic Workshops ... ... ... ... ... ... ... ... ... 8 8 Food and Drugs Act. ADULTERATION. Samples collected for Analysis ... ... ... 2 ... ... ... ... ... ... 2 Correspondence, Legal Procedure, &c. Complaints received 13 8 26 30 26 ... ... ... 7 10 120 Letters and Intimations relating to Abatement of Nuisances 21 15 22 36 9 ... ... ... 5 13 121 Statutory Notices Served ... ... 2 6 7 ... ... ... 15 Proceedings taken before Magistrates ... ... ... ... ... ... ... ... ... ... ... (1) Under Public Health Act ... ... ... ... ... ... ... ... ... ... ... (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) „ Food & Drugs Act ... ... ... ... ... ... ... ... ... ... ... Reports made to Medical Officer of Health 32 30 9 63 66 ... ... ... 24 28 342 THE SANITARY CHRONICLES OF THE BOROUGH OF ST. MARYLEBONE DURING AUGUST AND SEPTEMBER, 1902. Containing a Quarterly Summary of the Mortality Statistics for the Quarter ending September 27th, 1902, and the Quarterly Statement of Analytical Work done under the Sale of Food and Drugs Act, &c. Vol. XXII. 3, Upper Gloucester Place, October 8th, 1902. No. 8. The week ending August 9th was rainy and cool. Minimum temperature, 59.0°; maximum, 71.0°; mean, 60.3°. On six days rain fell (069 inch). Winds WSW and SE. Sunshine, l3.8 per cent. Mean barometer, 29.8 inches. The week ending August 16th was cool and unsettled. Minimum temperature, 44.0°; maximum, 75 0°; mean, 61.4°. Winds NW. On three days rain fell (0.10 inch). Sunshine 27'5 per cent. Mean barometer, 29.8 inches. The week ending August 23rd was wet. Minimum temperature, 48.0°; maximum, 72.5°; mean, 62.5°. Winds, SW. On live days rain fell (1.61 inch). Sunshine 27.2 per cent. Mean barometer, 29.8 inches. The week ending August 30th was brighter and more seasonable. Minimum temperature, 50.0°; maximum, 77.0°; mean, 63.8°. Winds SSE. Sunshine, 40.8 per cent. On three days slight rain fell (0.02 inch) Mean barometer, 29.8 inches. The week ending September 6th was a moderately fine week. Minimum temperature, 50.o°; maximum, 71.5°; mean, 63.8°. Winds, SE and SW. On three days slight rain fell (0.59 inch). Sunshine 29.6 per cent. Mean barometer 29.8 inches. 98 The week ending September 13th was fine but cool. Minimum temperature, 40.0°; maximum, 69.0°; mean, 58.7°. On two days rain fell (0.17 inch). Sunshine, 30.8 per cent. Mean barometer, 29.9 inches. The week ending September 20th was dull and cool. Minimum temperature, 40.0°; maximum, 64.0°; mean, 58.4°. On one day rain fell (0.8 inch). Sunshine, 23.4 per cent. Mean barometer, 28.9 inches. The week ending September 27th was much brighter and liner than the preceding. Minimum temperature, 42.0°; maximum, 73.0°; mean, 59.0°. On one day only rain fell (0.02 inch). The winds were southeasterly. Sunshine, 39.3 per cent. Mean barometer, 30.2 inches. Quarterly Summary. During the thirteen weeks ending September there have been registered 725 births and 488 deaths. These births and deaths are divided among the live sub-districts as set forth in Tables Y. and XI. Two hundred and seven of the deaths were extra-parochial, as follows:— St. Marylebone Infirmary, Notting Hill 131 North-Eastern Fever Hospital 1 North-Western Fever Hospital 14 Grove Fever Hospital 1 St. Mary's Hospital 15 St. Thomas' Hospital 2 St. George's Hospital 1 Charing Cross Hospital 2 King's College Hospital 1 St. Bartholomew's Hospital 1 Brompton Hospital 2 Children's Hospital, Great Ormond Street 1 ,, „ Paddington 6 Clapham Maternity 2 Lying-in-Hospital, Endell Street 1 Hostel of God 1 Hanwell Asylum 10 Banstead Asylum 1 Colney Hatch Asylum 7 99 Leavesden Asylum 3 Chelsea Infirmary 1 Friedenheim 1 The Serpentine 1 In the Street, Paddington 1 Total 207 The birth and death-rates, as deduced from the month's statistics, are as follows:— All Souls, birth-rate 17.9 ; death-rate 11.7. Rectory, birth-rate 23.6 ; death-rate 16.2. St. Mary, birth-rate 21.2 : death-rate 12.8. Christ Church, birth-rate 27.1; death-rate 10.0. St. John, birth-rate 21.7; death-rate 20.8. The whole district, birth-rate 21.8; death-rate 14.7. The average death-rates for five years (1896 to 1901) for the corresponding period were as follows:—All Souls, 15.2; Rectory, 18.1; St. Mary, 19.3; Christ Church, 20.4; St. John, 22.3; the w hole district, 18.9. 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 27TH, 1002, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 13 weeks ending Sept. 27th, 1902. Proportion of the deaths to 1,000 deaths from all causes. 13 weeks ending Sept. 27,1902. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1896-1901. 1. Deaths from the chief Zymotic Diseases 78 159 2.20 4.0 2. Pulmonary, other than Phthisis 61 133 2.47 2.1 3. Tubercular 55 112 1.65 2.0 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza,Whooping Cough, Erysipelas, Croup, Fever, and Diarrhœa. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. 100 Health of the District. The mortality of the past three months has been unusually low. This is mainly clue to a decided fall in deaths from diarrhoea and from zymotic diseases generally, as compared with former years. Small-pox was practically absent, and there are grounds for hope that there will be no recurrence of the epidemic. On the other hand, the, cool, wet, dull summer appears to have been favourable for inflammatory diseases of the intestines, and also for typhoid fever. Scarlet fever is shown by the curve opposite page 107 to be on the increase, being far above the average, and still rising. Nightingale Street. The Notices of the London County Council requiring the inhabitants to vacate the premises have now expired. For the time the London County Council stand in the technical position of "owners," and from a reliable source of information the writer understands that the officers of that (Council are empowered to close as soon as practicable the worst houses, and to make a few others temporarily habitable while the work of reconstruction goes on. The writer has had an opportunity of seeing the plans for the new Nightingale Street buildings. These, when constructed, will add yet another block of Artizans' Dwellings to the district, and at least house, under favourable conditions, as great a number of persons as those who have been displaced by the scheme. Prosecutions under the Public Health (London) Act. The owner of Ncs. 10 and 13, Hereford Street, was summoned for disobedience of a sanitary notice ; but as the work was in progress at the time of hearing, the Magistrate adjourned the case for 28 days. The owner of No. 314, Edgware Road, was summoned for neglecting to provide suitable drainage for the premises. An order was 101 made against the freeholder, with £2 4s. 6d. costs. The freeholder disputes he is the "owner" within the meaning of the Public Health Act, and has appealed to the Sessions. The Laboratory—Sale of Food and Drugs Act. Work in the Laboratory during the quarter has necessarily been much interfered with, owing to the removal from the Town Hall and the necessary delay caused by fitting up new premises. The Laboratory is, however, now in good order, and the usual number of samples per quarter will be analysed. Notwithstanding the inconvenience alluded to, 98 samples were analysed, a full list of which is to be found in Table XII, page 111. Mr. Williams, of 94, Devonshire Street, Lisson Grove, was fined 40s., with costs, for selling milk certified to be diluted with 13 per cent. of water. 102 TABLE II.—Giving the Causes of Deaths during the 13 Weeks ending September 27th, 1902, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John & Elizabeth, and the Marylebone Infirmary, Notting Hill, \V. Middlesex Hospital Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill. Infirmary. Hospital of St. John & Elizabeth, Grove Rd. Smallpox ... ... ... ... ... ... Influenza ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... Diphtheria 3 ... ... ... ... ... Typhoid Fever 5 ... ... ... ... ... Diarrhœa 4 ... ... 2 8 ... Erysipelas 1 ... ... ... 3 ... Pneumonia and Pleurisy 7 ... ... ... 3 ... Pyaemia ... ... ... ... ... ... Syphilis ... ... ... ... 1 ... Cancer 38 ... ... ... 8 ... Phthisis & Tuberculosis 7 ... ... ... 31 2 Rheumatism ... ... ... ... 2 ... Apoplexy ... ... ... ... ... ... Paralysis ... ... ... ... 3 ... Bronchitis ... ... ... ... 21 2 Asthma ... ... ... ... ... ... Peritonitis ... ... ... ... ... ... Disease of Brain ... ... ... ... ... ... „ Heart ... ... ... ... 8 1 „ Kidney ... ... ... ... ... ... „ Liver ... ... ... ... 2 ... „ Uterus ... ... ... ... ... ... „ Ovary ... ... ... ... ... ... Parturition ... ... ... ... Diabetes ... ... ... ... ... ... Fractures and Injuries ... ... ... ... 1 ... Old Age ... ... ... ... 17 ... Low Vitality, Infants ... ... ... ... ... ... Premature Birth ... 1 ... ... ... ... Other causes 38 2 ... 3 23 ... Total *120 †4 ... 7 131 ‡5 * Of the 120 deaths in the Middlesex Hospital, 98 were those of non-parishioners, † The 4 deaths in Queen Charlotte's Hospital were those of non-parishioners. ‡ Four of the 5 deaths in St. John's Hospital were those of non-parishioners. TABLE III.—District Births and Deaths for the four weeks ending august 30th, 1902. Population in ROI. Births. Deaths. Males. Fmls. Males Fmls. All Souls 35,391 16 28 20 16 Rectory 19,849 13 17 12 9 St. Mary 18,099 14 11 11 8 Christ Church 39,530 32 44 22 20 St. John 20,426 16 24 14 17 Total 133,301 91 124 79 70 Note.—In the above the births and deaths hare all been properly corrected, strangers have been eliminated, and extra-parochial deaths and others have been allotted to their proper sub-district. 104 TABLE IV.—District Births and Deaths for the four weeks ending September 27th, 1902. Population in 1891. Births. Deaths. Males. Fmls. Males. Fmls. All Souls 35,3 91 26 21 19 14 Rectory 19,849 12 13 13 9 St. Mary 18,099 14 18 8 4 Christ Church 39,536 47 37 31 29 St. John 20,426 16 13 21 12 Total 133,301 115 102 92 68 Note.—Iu 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 V.—District Births and Deaths for the THIRTEEN weeks ending September 27TH, 1902. Population in 1901. Births. Deaths. Males. Fmls. Males. Fmls. All Souls 35,391 75 83 54 50 Rectory 19,849 43 50 41 23 St. Mary 18.099 48 48 32 26 Christ Church 39,536 138 130 81 77 St. John 20,426 53 58 55 49 Total 133,301 357 369 263 225 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. 105 TABLE VI.— 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 August 1902; 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 35,391 19,849 18,099 39,536 20,426 133,301 (C) Registered Births 44 30 25 76 10 215 (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 j Under 5 5 upwards New Cases of Sickness in kach Locality coming to the knowledge of the medical Officer of Health. 1. Chicken Pox 3 2 1 2 4 1 10 6 5 3 23 14 2. Smallpox . . . . . . . . . . . . . . . . . . . . . . . . 3. Scarlatina 4 6 . . . . . . 1 . . 2 9 17 13 31 4. Diphtheria . . 8 . . . . . . 2 . . . . 2 4 2 14 5. Membranous Croup . . . . . . . . . . . . . . . . . . . . . . . . Fevers. 6. Typhus . . . . . . . . . . . . . . . . . . . . . . . . 7. Enteric or Typhoid . . 1 . . . . . . 1 . . 5 1 1 1 8 8. Continued . . . . . . . . . . . . . . . . . . . . . . . . 9. Relapsing . . . . . . . . . . . . . . . . . . . . . . . . 10. Puerperal . . . . . . . . . . . . . . . . . . 1 . . 1 11. Cholera . . . . . . . . . . . . . . . . . . . . . . . . 12. Erysipelas . . 1 . . 3 . . 1 . . 5 . . 3 2 13 Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospitals. 1 Smallpox . . . . . . . . . . . . . . . . . . . . . . . . 2 Scarlatina 3 6 . . 4 . . 1 . . 2 . . 15 12 28 3. Diphtheria . . 7 . . . . . . 1 . . . . 1 3 1 11 4. Membranous Croup . . . . . . . . . . . . . . . . . . . . . . . . Fevers. 5. Typhus . . . . . . . . . . . . . . . . . . . . . . . . 6. Enteric or Typhoid . . . . . . . . . . 1 . . 4 . . 1 . . 6 7. Continued . . . . . . . . . . . . . . . . . . . . . . . . 8. Relapsing . . . . . . . . . . . . . . . . . . . . . . . . 9. Puerperal . . . . . . . . . . . . . . . . . . 1 . . 1 10 Cholera . . . . . . . . . . . . . . . . . . . . . . . . 11 Erysipelas . . . . . . 1 . . . . . . 2 . . . . . . 3 106 TABLE VII.—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, 1902; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals Population at all Ages. (6) Census 1901 35,391 19,849 18.099 39,536 20,423 133,301 (c) Registered Births 47 25 132 84 29 217 (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 upwards New Casks of Sickness in bach Locality coming to thb knowledge of the Medical Office of Health. 1. Chicken Pox 2 1 . . 2 8 2 10 1 8 4 28 10 2. Smallpox . . . . . . . . . . . . . . . . . . . . . . . . 3. Scarlatina 3 9 . . 5 1 4 2 4 8 16 15 38 4. Diphtheria 4 4 . . 1 2 1 1 1 1 8 7 5. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 6. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 7. Enteric or Typhoid .. .. .. .. .. 4 .. 2 .. 3 .. 9 8. Continued .. .. .. .. .. .. .. .. .. .. .. .. 9. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 10. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 11. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 12 Erysipelas .. 4 .. 8 .. 1 .. 5 .. .. 1 Number of such Cases Removed from their homes in the several localities for treatment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2 Scarlatina 3 9 .. 4 .. 4 2 4 5 14 12 35 3. Diphtheria 4 4 .. 1 .. .. 1 1 1 1 8 67 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. (6). Enteric or Typhoid .. .. .. .. .. 3 .. 1 .. .. .. 7 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 . Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas .. 1 .. 5 .. .. .. .. .. 1 .. 7 TABLE VIII —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, 1902 ; 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 35,391 19,849 18,099 39,536 20,426 133,301 (c) Registered Births 158 93 96 268 111 726 (d) Aged under 5 or over 5 Under 5 5 upwards Under 5 5 upwards Under 6 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 of Health. Chicken Pox . 12 7 1 7 14 4 25 12 14 15 66 45 1 Smallpox .. 1 .. .. .. .. .. .. .. .. .. 1 2. Scarlatina 7 20 2 13 2 8 2 7 23 57 36 105 3. Diphtheria 6 16 1 6 5 3 5 3 5 11 22 39 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 15. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid 1 4 .. 1 .. 6 .. 11 1 8 2 30 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. 1 .. 1 .. 1 .. 3 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas. 1 7 .. 16 .. 2 2 14 .. 6 3 45 Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospitals. 1.. Smallpox .. 1 .. .. .. .. .. .. .. .. .. 1 2. Scarlatina 6 17 2 11 2 8 2 7 19 18 31 91 3. Diphtheria 5 15 1 5 5 1 5 3 3 9 19 33 1 Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus . .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid 1 2 .. .. .. 5 .. 8 .. 7 1 22 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. \9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas .. 2 .. 9 .. .. .. 3 .. 1 .. 15 107 108 TABLE IX.—Causes of, and Ages at, Death during the 4 weeks ending August 30th, 1902, 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 1 .. 1 .. .. .. .. 1 .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. •• .. .. .. .. .. .. .. .. .. .. Diphtheria and Membranous Croup 1 .. 1 .. .. .. .. .. 1 .. .. .. 1 Group .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric 3 .. .. .. 1 2 .. .. .. .. 2 1 4 Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhoea 16 11 3 .. .. 2 .. 2 3 .. 7 4 3 Enteritis 1 1 .. .. .. .. .. .. .. .. 1 .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. Other Septic Diseases.. 7 .. .. .. 2 3 .. 1 1 4 1 .. 4 Phthisis 13 1 .. .. 2 10 .. 6 2 1 2 2 4 Other Tubercular Diseases 3 2 1 .. .. .. .. 1 .. 1 .. 1 2 Cancer, Malignant Disease 12 .. .. .. .. 7 5 4 2 1 4 1 14 Bronchitis 10 4 2 .. .. 1 2 1 2 1 3 3 8 Pneumonia 8 2 1 .. .. 2 3 4 2 .. .. 2 4 Pleurisy 1 .. .. .. •• .. .. .. .. 1 .. .. 1 Other Diseases of Respiratory Organs .. .. .. .. •• .. .. .. .. .. .. .. .. Alcoholism Cirrhosis of Liver 5 .. .. .. .. 4 1 3 .. .. 2 .. .. Venereal Diseases 1 .. .. .. .. 1 .. .. 1 .. .. .. .. Premature Birth 2 2 .. .. .. .. .. 1 .. .. .. 1 1 Diseases and Accidents of Parturition 2 .. .. .. .. 2 .. .. .. .. 1 1 1 Heart Diseases 8 .. .. 1 .. 3 4 2 .. 3 3 .. 3 Accidents 5 1 .. 1 .. 1 2 .. 1 .. 2 2 3 Suicides .. .. .. .. .. .. .. .. .. .. .. .. .. All other causes 60 11 .. .. 1 13 25 10 6 6 15 13 2 All cause 119 35 9 6 6 51 43 36 21 19 42 31 81 109 TABLE X.—Causes of, and Ages at, Death during the 4 weeks ending September 27th. 1902, in the Borough of St. Marylebone. S 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 1 1 ... ... ... ... ... 1 ... ... ... ... 1 Scarlet Fever 1 ... 1 ... ... ... ... ... 1 ... ... ... 1 Whooping Cough 1 ... 1 ... ... ... ... 1 ... ... ... ... 1 Diphtheria and Membranous Croup 1 ... 1 ... ... ... ... 1 ... ... ... ... 1 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric 1 ... ... ... ... 1 ... ... ... ... ... 1 ...- Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza 1 ... 1 ... ... ... ... ... 1 ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea 23 20 3 ... ... ... ... 4 1 4 12 2 7 Enteritis 1 ... 1 ... ... ... ... ... 1 ... ... ... ... Puerperal fever ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 1 ... ... ... ... ... 1 1 ... ... ... ... 1 Other Septic Diseases . ... ... ... ... ... ... ... ... ... ... ... ... ... Phthisis 18 1 ... ... ... 15 2 4 2 2 6 4 13 Other Tubercular Diseases 6 1 5 ... ... ... ... ... ... ... 3 3 2 Cancer, Malignant Disease 13 ... ... ... ... 11 2 3 5 ... 2 3 13 Bronchitis 8 ... 1 ... ... 0 1 4 ... ... 3 1 3 Pneumonia 8 1 1 ... ... 5 1 3 ... ... 4 1 4 Pleurisy ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Respiratory Organs ... ... ... ... ... ... ... ... ... ... ... ... ... Alcoholism Cirrhosis of Liver 4 ... ... ... ... 4 ... 1 ... ... 2 1 3 Venereal Diseases 2 1 ... ... ... 1 ... 1 1 ... ... ... ... Premature Birth 4 4 ... ... ... ... ... 1 ... ... 3 ... ... Diseases and Accidents of Parurition 2 ... ... ... 1 1 ... 1 1 ... ... ... 3 Heart Diseases 9 ... ... ... ... 7 2 ... 4 ... 4 1 4 Accidents 3 ... ... ... ... 2 ... 1 ... ... 1 1 3 Suicides 1 ... ... ... 1 ... ... ... ... 1 ... ... ... All other causes 51 12 2 1 ... 23 13 6 6 5 20 15 25 All causes 160 41 17 2 2 76 22 33 22 12 60 33 87 110 TABLE XI.—Causes of, and Ages at, Death during the quarter ending September 27th, 1902, 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 5 1 3 1 ... ... ... 2 ... ... ... 3 1 Scarlet Fever 2 ... 2 ... ... ... ... ... 1 ... ... 1 2 Whooping Cough 2 1 1 ... ... ... ... 1 ... ... 1 ... 1 Diphtheria and Membranous Croup 6 ... 5 1 ... ... ... 1 1 2 ... 2 6 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... | Enteric 7 ... ... ... 3 4 ... ... ... ... 5 2 8 Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza 1 ... 1 ... ... ... ... ... 1 ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague Diarrhoea ... 49 ... 39 7 ... ... ... ... ... ... ... 7 6 5 23 8 12 Enteritis 2 1 1 ... ... ... ... ... 1 1 ... ... ... Puerperal fever 1 ... ... ... ... 1 ... ... ... ... 1 ... ... Erysipelas 3 ... ... ... ... 1 2 2 ... ... 1 ... 2 Other Septic Diseases 10 ... ... 1 3 5 1 2 2 5 1 ... 6 Phthisis 48 2 ... 1 3 39 3 15 7 6 11 9 19 Other Tubercular Diseases 17 6 10 ... ... 1 ... 2 1 1 7 6 4 Cancer, Malignant Disease 36 ... ... ... ... 26 10 9 8 4 8 7 44 Bronchitis 38 6 3 1 ... 14 14 12 8 2 10 6 13 Pneumonia 26 4 2 ... 1 14 5 11 2 2 5 6 13 Pleurisy 1 ... ... 1 ... ... ... ... ... 1 ... ... 1 Other Diseases of Respiratory Organs ... ... ... ... ... ... ... ... ... ... ... ... ... Alcoholism Cirrhosis of Liver 13 ... ... ... ... 12 1 5 1 1 5 1 5 Venereal Diseases 4 2 ... ... ... 2 ... 1 2 1 ... ... ... Premature Birth 10 10 ... ... ... ... ... 3 ... 1 4 2 1 Diseases and Accidents of Parturition 5 ... ... ... 1 4 ... 2 1 ... 1 1 4 Heart Diseases 31 ... ... 2 18 11 2 5 6 16 2 12 Accidents 14 5 ... 2 1 4 2 2 1 ... 7 4 7 Suicides 3 ... ... ... 1 2 ... 1 1 1 ... ... ... All other causes 154 28 5 1 5 55 60 24 15 19 52 44 62 All causes 488 105 40 11 18 205 109 104 64 58 158 104 223 111 TABLE XII.—SALE OF FOOD AND DRUGS ACT. Samples Analysed during September Quarter 1902. Genuine. Adulterated. Total. DAIRY PRODUCTS— Milk 21 1 22 Butter 11 — 11 Margarine 1 — 1 Cheese 2 2 Lard 2 2 Cream 2 — 2 ALCOHOLIC BEVERAGES— Whisky 18 18 Brandy 2 2 Gin 10 — 10 Rum 2 2 Port Wine 1 — 1 NON-ALCOHOLIC BEVERAGES— Coffee 4 — 4 Coffee and Chicory 1 1 Tea 1 — 1 CONDIMENTS— Pepper 2 — 2 Sauce 2 — 2 TINNED GOODS— Kipper Paste 1 1 Condensed Milk 2 — 2 Salmon 2 — 2 Sardines 2 — 2 Pines 2 — 2 Apricots 1 — 1 SACCHARINE SUBSTANCES— Chocolates 1 — 1 MISCELLANEOUS— Lime Juice 1 — 1 Lemon Squash 2 — 2 Lemon Powders 1 — 1 97 1 98 112 REGISTER OF SANITARY WORK Month ending 31st August, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. K. Phillips, Special Duties. Miss F. A. Baker. Total. Mr . J. Hodges No. 1 Dirt riot. 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. Public Health (London) Act. Inspections. Dwelling Houses, &c 33 26 37 35 17 ... ... ... ... ... 148 Tenements 48 50 29 21 ... ... ... ... ... 148 Underground Dwellings 10 15 4 7 ... ... ... ... ... 36 Dairies, Milk Shops, Cow Houses 2 1 1 1 3 ... ... ... ... ... 8 Slaughter Houses 2 2 ... ... 1 ... ... ... ... ... 5 Yards, Stables, and Mews 20 13 35 26 15 ... ... ... ... ... 109 Smoke Shafts ... ... ... ... ... ... ... ... ... 2 2 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... ... 1 1 Refuse Receptacles 8 9 5 15 7 ... ... ... ... ... 44 Enquiries re non-removal of refuse 16 13 20 5 11 ... ... ... ... ... 65 Removal of Bodies to Mortuary ... ... ... ... ... ... ... ... ... ... ... Visits to Works in Progress 220 39 150 230 26 ... ... ... ... 7 672 Miscellaneous Inspections 130 50 120 140 49 ... ... ... 30 3 522 UNWHOLESOME FOOD. Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE Cases Isolated ... 4 3 2 1 1 ... ... ... ... ... 11 Cases removed to Hospital 25 16 6 8 19 ... ... ... ... ... 74 Rooms Disinfected 57 30 23 12 30 ... ... ... ... ... 152 NEW DRAINAGE Number of Plans Passed 12 6 12 9 7 ... ... ... ... ... 46 New Pipe Drains (feet) 976 843 1368 980 764 ... ... ... ... ... 4931 Houses where defects in existing Drainage have been detected and remedied 7 6 12 4 3 ... ... ... ... ... 32 113 REGISTER OF SANITARY WORK Month ending 31st August, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. 1 Mr. R. Phillips, Special Duties. Miss F. A. Baker. Total. 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 Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 43 ... 43 Periodical Inspections: — Factories ... ... ... ... ... ... ... ... 2 ... 2 Workshops ... ... ... ... ... ... ... ... 29 16 45 Bakehouses ... ... ... ... ... ... ... ... 10 ... 10 Restaurants, &c. ... ... ... ... ... ... ... ... 15 ... 15 Homeworkers' Premises ... ... ... ... ... ... ... ... 19 41 60 Domestic Workshops ... ... ... ... ... ... ... ... 10 ... 10 Food and Drugs Act. ADULTERATION. Samples collected for Analysis ... ... 7 ... ... ... ... ... ... ... 7 Correspondence, Legal Procedure. &c- Complaints received 5 9 13 23 19 ... ... ... 5 3 77 Letters and Intimations relating to Abatement of Nuisances 24 10 35 19 7 ... ... ... 2 5 102 Statutory Notices Served 4 ... ... 1 5 ... ... ... ... ... 10 Proceedings taken before Magistrates ... ... ... ... ... ... ... ... ... ... ... (1) Under Public Health Act ... ... 3 ... ... ... ... ... ... ... 3 (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) ,, Food & Drugs Act ... ... ... ... ... ... ... ... ... ... ... Reports made to Medical Officer of Health 21 18 12 35 26 ... ... ... ... 10 122 114 REGISTER OF SANITARY WORK Month ending 30th September, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillips, Special Duties. Miss F. A. Baker. Total. 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, Public Health (London) Act. Inspections. Dwelling Houses, &c 8 36 37 6 34 ... ... ... ... ... 121 Tenements 20 ... 50 10 36 ... ... ... ... ... 116 Underground Dwellings ... ... 15 ... 19 ... ... ... ... ... 34 Dairies, Milk Shops, Cow Houses 2 1 3 1 5 ... ... ... ... 1 13 Slaughter Houses 2 3 3 ... 2 ... ... ... ... ... 10 Yards, Stables, and Mews 12 8 35 30 29 ... ... ... ... ... 114 Smoke Shafts ... ... ... ... ... ... ... ... 4 2 6 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... 2 1 3 Refuse Receptacles 4 13 6 3 9 ... ... ... 2 1 38 Enquiries re non-removal of refuse ... 5 12 ... 4 ... ... ... ... 2 23 Removal of Bodies to Mortuary ... ... ... ... ... ... ... ... ... ... ... Visits to Works in Progress 140 320 250 120 312 ... ... ... ... 3 1174 Miscellaneous Inspections 108 116 150 110 132 ... ... ... 36 45 697 UNWHOLESOME FOOD. Number of seizures made ... ... ... 1 ... ... ... ... ... ... 1 INFECTIOUS DISEASE Cases Isolated ... ... 1 ... ... ... ... ... ... ... ... 1 Cases removed to Hospital 3 24 14 6 20 ... ... ... ... ... 67 Rooms Disinfected 8 32 14 7 34 ... ... ... ... ... 95 NEW DRAINAGE Number of Plans Passed 8 10 6 4 13 ... ... ... ... ... 41 New Pipe Drains (feet) 750 1026 450 96 1146 ... ... ... ... ... 3468 Houses where defects in existing Drainage have been detected and remedied 9 8 20 ... 11 ... ... ... ... ... 48 115 REGISTER OF SANITARY WORK Month ending 30th September, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillips, Special Duties. Miss F. A. Baker. Total. 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 Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 49 4 53 Periodical Inspections: — Factories ... ... ... ... ... ... ... ... 10 3 13 Workshops ... ... ... ... ... ... ... ... 73 54 127 Bakehouses ... ... ... ... ... ... ... ... 20 ... 20 Restaurants, &c. ... ... ... ... ... ... ... ... 15 1 16 Homeworkers' Premises ... ... ... ... ... ... ... ... 39 12 51 Domestic Workshops ... ... ... ... ... ... ... ... 19 5 24 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 6 15 23 14 24 ... ... ... ... ... 82 Correspondence, Legal Procedure, &e. Complaints received 10 12 13 6 16 ... ... ... 4 2 63 Letters and Intimations relating to Abatement of Nuisances 25 32 30 5 19 ... ... ... ... 7 118 Statutory Notices Served ... ... 3 ... 7 ... ... ... ... ... 10 Proceedings taken before Magistrates ... ... ... ... ... ... ... ... ... ... ... (1) Under Public Health Act ... ... 1 ... ... ... ... ... ... ... 1 (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) „ Food & Drugs Act ... ... 1 ... ... ... ... ... ... ... 1 Reports made to Medical Officer of Health 10 26 30 12 51 ... ... ... 29 26 184 116 REGISTER OF SANITARY WORK Quarter ending 30th September, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell. Total. 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. Public Health (London) Act. ...Inspections. Dwelling Houses, &c. 77 96 100 66 77 ... ... ... 5 ... 416 Tenements 108 ... 136 82 68 ... ... ... ... ... 394 Underground Dwellings 16 ... 40 12 33 ... ... ... ... ... 101 Dairies, Milk Shops, Cow Houses 6 3 9 6 11 ... ... ... 11 1 47 Slaughter Houses 6 7 3 1 3 ... ... ... ... ... 20 Yards, Stables, and Mews 53 40 90 96 51 ... ... ... 10 ... 340 Smoke Shafts ... ... ... ... ... ... ... ... 21 2 23 Offensive Trades and Effluvia Businesses ... ... ... 2 ... ... ... ... 2 1 5 Refuse Receptacles 22 35 17 28 19 ... ... ... 2 1 124 Enquiries re non-removal of refuse 20 23 35 13 17 ... ... ... ... 5 113 Removal of Bodies to Mortuary ... ... ... ... ... ... ... ... ... ... ... Visits to Works in progress 540 551 450 590 534 ... ... ... 60 23 2748 Miscellaneous Inspections 334 242 320 340 294 ... ... ... 93 97 1720 UNWHOLESOME FOOD. Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE:- Cases Isolated 6 7 5 2 1 ... ... ... ... ... 21 Cases Removed to Hospital 53 67 29 35 49 ... ... ... ... ... 233 Rooms Disinfected 103 110 47 61 83 ... ... ... ... ... 404 NEW DRAINAGE:- Number of Plans Passed 28 23 20 25 33 ... ... ... ... ... 129 New Pipe Drains (feet) 3086 3197 1968 2282 3336 ... ... ... ... ... 13869 Houses where defects in existing Drainage have been detected and remedied 24 23 38 12 21 ... ... ... 5 ... 123 117 REGISTER OF SANITARY WORK Quarter ending September 30tii, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillips, Special Duties. Miss L. M. O'Kell, Total. 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. Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 92 15 107 Periodical Inspections:— Factories ... ... ... ... ... ... ... ... 12 3 15 Workshops ... ... ... ... ... ... ... ... 137 373 510 Bakehouses 1 ... ... ... ... ... ... ... 47 ... 48 Restaurants, &c. ... ... ... ... ... ... ... ... 50 1 51 Homeworkers' Premises ... ... ... ... ... ... ... ... 67 136 203 Domestic Workshops ... ... ... ... ... ... ... ... 29 13 42 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 6 15 30 16 24 ... ... ... ... ... 91 Correspondence, Legal Procedure, &c. Complaints received 28 20 52 59 61 ... ... ... 16 15 260 Letters and Intimations relating to Abatement of Nuisances 70 57 87 60 35 ... ... ... 7 25 341 Statutory Notices Served 4 ... 5 7 19 ... ... ... ... ... 35 Proceedings taken before Magistrates ... ... ... ... ... ... ... ... ... ... ... (1) Under Public Health Act ... ... 4 ... ... ... ... ... ... ... 4 (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) „ Food & Drugs Act ... ... 1 ... ... ... ... ... ... ... 1 Reports made to Medical Officer of Health 63 74 51 110 143 ... ... ... 53 64 558 ' . THE SANITARY CHRONICLES OF THE BOROUGH OF ST. MARYLEBONE DURING OF OCTOBER, 1902. BY ALEXANDER WYNTER BLYTH, Medical Officer of Health, and Analyst of Food and Drugs for the Borough of St. Marylebone. Public Health Department, 3, Upper Gloucester" Place, St. Marylebone, November 7th, 1902. Vol. XXIlI No. 9. The week ending October 4th was dull and of moderate temperature. Lowest temperature, 41-0°; mean, 43.4o; highest, 59.0°. On three days rain fell 0.11 inch Winds ???NE. Sunshine 1.6 per cent. Mean barometer, 300 inches. The week ending October 11th was almost rainless. Minimum temperature, 44.8°; maximum, 57.5°; mean, 53.8°. On one day rain fell 0.07 inch. Winds ENE and NNE. Sunshine only 6 per cent. Mean barometer, 29.6 inches. The week ending October 18th was brighter. Minimum temperature, 40.5o; maximum, 60.5°; mean, 52.3°. On two days rain fell 0.55 inch. Winds SW and WNW. Sunshine 24 per cent. Mean barometer, 29.7 inches. The week ending October 25tH was dull and unsettled. Minimum temperature, 350°; maximum, 59.0°; mean, 51.8O. On three days rain fell 0.18 inch. Winds westerly. Mean barometer, 30.1 inches. The week ending November 1st was dry and dull, with some fog. Minimum temperature, 35.0°; maximum, 57.7°; mean, 49.9°. On two days slight rain fell 0.06 inch. Sunshine, 15 percent. Winds variable. Mean barometer, 29.9 inches. 120 Births and Deaths. During the five weeks ending November 1st there have been registered 271 births and 231 deaths. These births and deaths are divided among the five sub-districts as set forth in Table III. Seventy-eight of the deaths were extra-parochial, as follows :— St. Marylebone Infirmary, Notting Hill 43 North-Western Fever Hospital 5 London Fever Hospital 1 Guy's Hospital 1 University Hospital 1 Children's Hospital, Paddington 2 Paddington Infirmary 1 „ Workhouse 1 St. Mary's Hospital 6 Lying-in-Hospital, Endell Street 1 Italian Hospital 1 London Temperance Hospital 1 Friedenheim 2 Middlesex Asylum 1 Claybury Asylum 4 Hanwell Asylum 2 Hoxton House Asylum 1 Dartford County Asylum 2 Colney Hatch Asylum 1 In Streets 1 Total 78 The birth and death-rates, as deduced from the month's statistics, are as follows :— All Souls, birth-rate 12.3; death-rate 15.3. Rectory, birth-rate 20.4; death-rate 12.6. St. Mary, birth-rate 23.6; death-rate 21.3. Christ Church, birth-rate 30.0 ; death-rate 20.8. St. John, birth-rate 17.8; death-rate 19.9. The whole district, birth-rate 21.1; death-rate 18.0. The average death-rates for five years (1896 to 1901) for the corresponding period were as follows:—All Souls, 12.3 ; Rectory, 16.2; St. Mary, 13.1; Christ Church, 15.7; St. John, 16.8; the whole district, 14.7. 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: 121 TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE FIVE WEEKS ENDING NOVEMBER 1st, 1902, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 5 weeks ending Nov. 1st, 1902. Proportion of the deaths to 1,000 deaths from all causes. 5 weeks ending Nov. 1,1902. Rate per 1,000 of the population. Mean rate per 1,001 population for corresponding period 1896-1901. 1. Deaths from the chief Zymotic Diseases 26 114 2.02 2.12 2. Pulmonary, other than Phthisis 51 222 3.98 2.55 3. Tubercular 26 114 2.02 1.91 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza, Whooping Cough Erysipelas, Croup, Fever, and Diarrhoea. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. Health of the District. Zymotic diseases generally have diminished; scarletfever in particular (see curve opposite page 122,) which during September threatened to become epidemic, has nowdecreased below the average. Small-pox is still absent. A single case which was reported and sent to Hospital turned out to be Chicken Pox. Notification of Chicken Pox. A communication was sent from the Borough Council on the recommendation of the Public Health Committee, suggesting that the compulsory notification of Chicken Pox was no longer necessary, seeing that the epidemic of Smallpox had subsided. The London County Council have, however, not acceded to this suggestion, but have extended the period for the notification of Chicken Pox for a further period of two months. 122 . TABLE II.— Giving the Causes of Deaths during the five Weeks ending November 1st, 1902, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John & Elizabeth, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill. Infirmary. Hospital of St. John & Elizabeth, Grove Rd. Smallpox ... ... ... ... ... ... Influenza ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... Diphtheria 1 ... ... ... ... ... Typhoid Fever ... ... ... ... ... ... Diarrhœa ... ... ... ... 1 ... Erysipelas 3 ... ... ... 1 ... Pneumonia and Pleurisv 2 ... ... ... 1 ... Pyaemia ... ... ... ... ... ... Syphilis ... ... ... ... ... ... Cancer 9 ... ... ... 3 ... Phthisis & Tuberculosis 1 ... ... ... 6 ... Rheumatism ... ... ... ... ... ... Apoplexy ... ... ... ... 1 ... Paralysis ... ... ... ... 4 ... Bronchitis 1 ... ... ... 5 ... Asthma ... ... ... ... ... ... Peritonitis ... ... ... ... ... ... Disease of Brain ... ... ... ... ... ... ,, Heart ... ... ... 1 3 ... „ Kidney ... ... ... ... ... ... „ Liver ... ... ... ... ... ... „ Uterus ... ... ... ... ... ... „ Ovary ... ... ... ... ... ... Parturition ... ... ... ... ... ... Diabetes ... ... ... ... ... ... Fractures and Injuries.. l ... ... ... ... ... Old Age ... ... ... ... 5 ... Low Vitality, Infants ... ... ... ... ... ... Premature Birth ... ... ... ... ... ... Other causes 10 2 1 5 13 1 Total *31 †3 **1 6 43 ‡3 * Of the 31 deaths in the Middlesex Hospital, 24 were those of non-parishioners. †The 3 deaths in Queen Charlotte's Hospital were those of non-parishioners; 2 were Infants. ‡The 3 deaths in St. John's Hospital were those of non-parishioners. ** The death in the Samaritan Hospital was one of a non-parishioner. 1902. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, TYPHOID FEVER & SMALLPOX DURING 1902, AS COMPARED WITH A FIVE YEARS' AVERAGE. OCTOBER. 123 TABLE iii.— District Births and Deaths for the five weeks ending november 1ST, 1902. Population in 1901. Births. Deaths. Males. Fmls. Males Fmls. Ail Souls 35,391 20 22 24 28 Rectory 19,849 19 20 15 9 St. Mary 18,099 18 28 15 22 Christ Church 39,536 62 52 38 41 St. John 20,426 21 14 9 30 Total 133,301 140 131 101 130 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. 124 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 October 1902; 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 19,849 18,099 39,536 20,426 133,301 (c) Registered Births 42 39 41 114 35 271 (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 bach Locality coming to the knowledge of the medical Officer of Health. Chicken Pox 1 3 2 1 1 1 5 5 5 4 14 14 2. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 3. Scarlatina 4 4 4 5 .. .. 2 6 7 12 17 27 4. Diphtheria 2 3 .. .. 2 .. 1 4 4 11 9 18 5. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 6. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 7. Enteric or Typhoid .. 1 .. 2 .. 3 .. .. 1 2 1 10 8. Continued .. .. .. .. .. .. .. .. .. .. .. .. 9. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 10. Puerperal .. 1 .. .. .. .. .. .. .. .. .. 1 11. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 12. Erysipelas .. 3 .. 6 .. 1 .. 8 .. .. .. 18 Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 4 4 4 5 .. .. 2 6 7 11 17 26 3. Diphtheria . 2 3 .. .. 1 1 1 3 4 9 8 16 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 1 .. 2 .. 3 .. 1 1 1 1 8 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. 5 .. .. .. .. .. .. .. 5 125 TABLE V.— Causes of, and Ages at, Death during the 5 weeks ending November 1st, 1902, 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 tinder 65. 65 and upwards. All Souls. Rectory. St. Mary. Christ Church. St. John. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever 3 .. 3 .. .. .. .. .. 1 .. .. 2 3 Whooping Cough 2 .. 2 .. .. .. .. .. .. .. 1 1 .. Diphtheria and Membranous Croup 3 .. 3 .. .. .. .. 1 .. 2 .. .. 3 Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric 2 .. .. .. .. 1 .. .. .. .. 1 .. 1 Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 2 1 .. .. 1 .. .. 1 1 .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 12 7 3 .. .. 1 .. 2 .. 2 6 2 4 Enteritis 2 2 .. .. .. .. .. .. .. .. 2 .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. Other Septic Diseases 3 .. .. .. .. 3 .. 1 1 .. 1 .. 1 Phthisis 19 .. 1 .. 5 11 2 .. .. .. 5 2 7 Other Tubercular Diseases 7 3 2 ???1 .. 1 .. 1 .. .. 3 3 4 Cancer, Malignant, Disease 16 .. .. .. .. 10 6 6 .. .. 2 2 14 Bronchitis 20 2 3 1 .. 5 9 1 1 8 6 .. 7 Pneumonia 28 4 5 .. 1 16 2 9 2 .3 11 3 11 Pleurisy 1 .. .. .. .. 1 .. .. 1 .. .. .. 1 Other Diseases of Respiratory Organs 2 .. .. .. .. 1 1 .. 1 .. .. 1 .. Alcoholism Cirrhosis of Liver 1 .. .. .. .. 1 .. .. .. .. .. 1 .. Venereal Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. Premature Birth 6 6 .. .. .. .. .. .. 3 .. .. .. 1 Diseases and Accidents .. .. .. .. .. .. .. .. .. .. .. .. .. Heart Diseases 22 1 .. .. .. 13 7 6 2 3 8 3 10 Accidents 4 3 .. .. .. 1 .. .. .. .. 2 2 1 Suicides 1 .. .. .. 1 .. .. 1 .. .. .. .. .. All other causes 75 13 2 1 2 29 28 12 6 12 31 14 47 All causes 231 42 24 4 11 94 56 52 24 37 79 39 115 126 REGISTER OF SANITARY WORK Month ending 31st October, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. It. Phillips, Special Duties. Miss F. A. Baker. Total. Mr. J. Hodgss, 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. Public Health (London) Act Inspections. Dwelling Houses, &c 35 38 45 33 26 ... ... ... ... ... 177 Tenements 54 12 56 60 41 ... ... ... ... ... 223 Underground Dwellings 12 ... 25 8 14 ... ... ... ... ... 59 Dairies, Milk Shops, Cow Houses 6 7 6 1 5 ... ... ... ... ... 25 Slaughter Houses 2 3 3 ... 3 ... ... ... ... ... 11 Yards, Stables, and Mews 30 21 25 45 39 ... ... ... ... 1 161 Smoke Shafts ... ... ... ... ... ... ... ... 3 2 5 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... 1 ... 1 Refuse Receptacles 10 6 7 8 9 ... ... ... ... 1 4! Enquiries re non-removal of refuse 6 5 12 5 3 ... ... ... ... 2 33 Removal of Bodies to Mortuary ... 1 ... ... ... ... ... ... ... ... 1 Visits to Works in Progress 250 272 230 280 267 ... ... ... 38 11 1348 Miscellaneous Inspections 206 186 175 250 184 ... ... ... 40 70 1111 UNWHOLESOME FOOD. Number of seizures made ... ... 2 2 ... ... ... ... ... ... INFECTIOUS DISEASE:— Cases Isolated 1 2 ... 1 1 ... ... ... ... ... 5 Cases removed to Hospital 19 16 7 19 11 ... ... ... ... ... 72 Rooms Disinfected 26 25 10 24 19 ... ... ... ... ... 104 NEW DRAINAGE :— Number of Plans Passed 7 6 3 6 7 ... ... ... ... 1 30 New Pipe Drains (feet) 980 964 250 970 1266 ... ... ... 30 ... 4460 Houses where defects in existing Drainage have been detected and remedied 9 9 10 8 7 ... ... ... 1 1 45 127 REGISTER OF SANITARY WORK Month ending 31st October, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillips, Special Duties. Miss F. A. Baker. Total. 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 Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 76 4 80 Periodical Inspections: — Factories ... ... ... ... ... ... ... ... 9 1 10 Workshops ... ... ... ... ... ... ... ... 86 102 188 Bakehouses ... ... ... ... ... ... ... ... 65 3 68 Restaurants, &c. ... ... ... ... ... ... ... ... 5 ... 5 Home workers' Premises ... ... ... ... ... ... ... ... 63 85 148 Domestic Workshops ... ... ... ... ... ... ... ... 10 2 12 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 25 9 15 13 ... ... ... ... ... ... 62 Correspondence, Legal Procedure. &c. Complaints received 6 5 15 16 8 ... ... ... 4 5 59 Letters and Intimations relating to Abatement of Nuisances 30 15 33 25 14 ... ... ... 3 14 134 Statutory Notices Served ... ... ... 9 ... ... ... ... 1 ... 10 Proceedings taken before Magistrates ... ... ... ... ... ... ... ... ... ... ... (1) Under Public Health Act ... ... ... ... ... ... ... ... ... ... ... (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) „ Food & Drugs Act ... ... ... ... ... ... ... ... ... ... ... Reports made to Medical Officer of Health 32 30 30 56 49 ... ... ... 23 26 246 THE SANITARY CHRONICLES OF THE BOROUGH OF ST. MARYLEBONE DURING NOVEMBER, 1902. BY ALEXANDER WYNTER BLYTH, Medical Officer of Health, and Analyst of Food and Drugs for the Borough of St. Marylebone. Public Health Department, 3, Upper Gloucester Place, St. Marylebone, December 5th, 1902. Vol. XXIII. No. 10. The week ending November 8th was fairly dry and somewhat foggy. Minimum temperature, 40-0°; maximum, 58.5o; mean, 50.9o. Winds ESE and SSW. On two days slight rain fell (0.15 inch.) Sunshine 12.75 hours out of a possible 66 hours. Mean barometer, 29.7 inches. The week ending November 15th was dry and overcast, but fairly free from fog. Minimum temperature, 36.0°; maximum, 54.5o; mean. 49.1o. Winds SE. On one day only slight rain fell (0.02 inch.) Sunshine registered in Regent's Park only 8.9 hours. Mean barometer, 29.9 inches. The week ending November 22nd was dry and cold. Minimum temperature, 29.0°; maximum, 46.0°; mean, 38.2°. Winds E and NE. On one day slight rain fell (0.02 inch.) Sunshine only 5.5 hours out of a possible 60.7. Mean barometer, 30.1 inches. The week ending November 29th was overcast and wet. Minimum temperature, 36.5°; maximum, 50.8°; mean, 47.8°. Winds SE and SW. On five days rain fell (0.83 inch.) Sunshine only 14 hour. Mean barometer, 29.4 inches. 130 Births and Deaths. During the four weeks ending November 29th there have been registered 246 births and 184 deaths. These births and deaths are divided among the five sub-districts as set forth in Table III. Sixty-five of the deaths were extra-parochial, as follows :— . St. Marylebone Infirmary, Notting Hill 44 St. Mary's Hospital 8 St. George's Hospital 2 University Hospital 1 St. Bartholomew's Hospital 2 Westminster Hospital 1 Royal Free Hospital 1 Children's Hospital, Paddington 1 London Temperance Hospital 1 London Hospital 1 Hoxton House Asylum 1 In Streets 2 Total 65 The birth and death-rates, as deduced from the month's statistics, are as follows :— All Souls, birth-rate 16.9; death-rate 10.6. Rectory, birth-rate 17.7; death-rate 18.3. St. Mary, birth-rate 22.3: death-rate 17.9. Christ Church, birth-rate 36.5: death-rate 20.7. St. John, birth-rate 22.3; death-rate 24.8. The whole district, birth-rate 24.0; death-rate 17.9. The average death-rates for five years (1896 to 1901) for the corresponding period were as follows:—All Souls, 13.0; Rectory, 21.6; St. Mary, 18.6; Christ Church, 16.5; St. John, 18.9; the whole district, 17.0. 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: 131 TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE FOUR WEEKS ENDING NOVEMBER 29TH, 1902, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 4 weeks ending Nov. 29th, 1902. Proportion of the deaths to 1,000 deaths from all causes. 4 weeks ending Nov. 29, 1902. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1896-1901. 1. Deaths from the chief Zymotic Diseases 8 43 0.78 1.59 2. Pulmonary, other than Phthisis 40 217 3.90 3.90 3. Tubercular 29 157 2.83 2.11 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza,Whooping Cough Erysipelas, Croup, Fever, and Diarrhœa. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. Health of the District. The curve opposite page 134 shows that with the exception of a local burst of scarlet fever in the second week of November, zymotic diseases generally have been below the average. The mortality from zymotic diseases has been remarkably low; it may be also noted that during the past five years the mortality from this cause in November, has progressively diminished; in 1897 there were 28 deaths; in 1898, 22; in 1899, 15; in 1900, 16; in 1901, 9; while the present November only yields 8. The district still keeps free from smallpox, and it may be now predicted with more confidence, that there is not likely to be a recurrence of the malady in an epidemic form during 1903. 132 Underground Bakehouses. The Factory and Workshop Act of 1901, requires that after January 1st, 1904, no Underground Bakehouse shall be used unless certified by the Borough Council that it is suitable as regards— 1. Construction 2. Light 3. Ventilation 4. In all other respects. The question of bakehouses and inhabited kitchens has been somewhat prejudiced by the misleading use of the word "underground;" the common meaning of the term is obviously "subterranean" like sewers, mines, tube railways, or catacombs, whereas the Statute by the term "Underground" simply means basements, similar to the majority of London kitchens, the floor of which is more than three feet below the level of the adjacent footway. Although it is more than 12 months before the special enactments come into force, yet it is not only a matter of convenience, but of justice to the various bakers of the Borough to decide as soon as practicable what, if any, bakehouses are unfit to certify, and if any are unfit whether structural alterations can be made so as to bring them up to the standard of those which may be permitted to continue. This important matter was discussed at a recent meeting of the Health Committee, and the Committee adopted the writer's suggestion that the underground bakehouses should be specially inspected during the first quarter of 1903, and that each case should be considered on its merits. The bakehouses in Marylebone are decreasing; 12 bakehouses were not in use on August 17th, 1901. and, by Statute, an underground bakehouse not in use at that date can no o nger be used as a bakehouse. 133 In about two years the leases of a good many oldfashioned bakehouses fall in and the premises will be pulled down and re-built; these bakehouses will also disappear. At the present moment there are 94 bakehouses, 12 being above ground and 82 below the level of the street. Hence the majority of the bakers in the Borough will be affected by the provisions of the Statute. 134 TABLE II.— Giving the Causes of Deaths during the four Weeks ending November 29th, 1902, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John & Elizabeth, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill. Infirmary. Hospital of St. John & Elizabeth, Grove Rd. Smallpox ... ... ... ... ... ... Influenza ... ... ... ... ... ... Scarlet lever ... ... ... ... ... ... Diphtheria ... ... ... ... ... ... Typhoid Fever 1 ... ... ... ... ... Diarrhœa ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... Pneumonia and Pleurisy 3 ... ... ... ... ... Pyaemia ... ... ... ... ... ... Syphilis ... ... ... ... 2 ... Cancer 18 ... ... ... 1 ... Phthisis & Tuberculosis 3 ... ... ... 16 1 Rheumatism ... ... ... ... ... ... Apoplexy ... ... ... ... ... ... Paralysis ... ... ... ... 4 ... Bronchitis 1 ... ... ... 8 ... Asthma ... ... ... ... ... ... Peritonitis ... ... ... ... ... ... Disease of Brain ... ... ... ... ... ... ,, Heart 4 ... ... ... 3 1 „ Kidney ... ... ... ... ... ... „ Liver 2 ... ... ... ... ... „ Uterus ... ... ... ... ... ... „ Ovary ... ... ... ... ... ... Parturition ... ... ... ... ... ... Diabetes ... ... ... ... ... ... Fractures and Injuries 1 ... ... ... ... ... Old Age ... ... ... ... ... ... Low Vitalitv, Infants ... ... ... ... ... ... Premature Birth ... ... ... ... ... ... Other causes 5 2 ... 5 10 2 Total *38 †2 — 5 44 ‡4 * Of the 38 deaths in the Middlesex Hospital, 32 were those of non-parishioners. † The 2 deaths in Queen Charlotte's Hospital were infants of non-parishioners. ‡ The 4 deaths in St. John's Hospital were those of non-parishioners. 1902 . CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, TYPHOID FEVER & SMALLPOX DURING 1902, AS COMPARED WITH A FIVE YEARS' AVERAGE NOVEMBER. 135 TABLE III.—District Births and Deaths for the four weeks ending november 29TH, 1902. Population in 1901. Births. Deaths. Males. Fmls. Males Fmls. All Souls 35,391 24 21 12 17 Rectorv 19,849 14 13 15 13 St. Mary 18,099 15 16 17 8 Christ Church 39,530 54 54 39 24 St. John 20,426 17 18 19 20 Total 133,301 124 122 102 82 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. 136 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 November, 1902; 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 19,849 18,099 39,536 20,426 133,301 (c) Registered Births. 45 27 31 108 35 246 (d) Aged under 5 or over 5. Under 5 | 5 upwards j Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards i Under 5 \ 5 upwards J Nkw Casks of Sickness in each Locality coming to tub knowledge. op the medical Officer of Health. 1. Chicken Pox . 1 .. 4 7 1 1 11 4 2 .. 19 12 2. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 3. Scarlatina 3 7 2 7 .. 4 1 4 4 5 10 27 4. Diphtheria . 2 3 2 1 .. .. 1 1 2 3 7 1 8 5. Membranous Croup .. .. .. .. .. .. .. .. 1 .. 1 .. Fevers. 6. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 7. Enteric or Typhoid .. 1 .. 2 .. 1 .. 2 .. 1 .. 7 8. Continued .. .. .. .. .. .. .. .. .. .. .. .. 9. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 10. Puerneral .. .. .. .. .. .. .. .. .. .. .. .. 11. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 12. Erysipelas .. 2 .. 8 .. 2 .. 6 .. 3 .. 21 Number of such Cases Removed from their I Homes in the several Localities for Treatmf.nt in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 3 5 2 7 .. 4 1 4 4 5 10 25 3. Diphtheria 2 3 2 1 .. .. 1 1 .. 1 5 6 4. Membranous Croup .. .. .. .. .. .. .. .. 1 .. 1 .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 1 .. 2 .. .. .. 1 .. 1 .. .. 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. 6 .. .. .. 1 .. .. .. 7 137 TABLE V.—Causes of, and Ages at, Death during the 4 weeks ending November 29th, 1902, 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 .. .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough 1 .. .. 1 .. .. .. .. .. .. 1 .. .. Diphtheria and Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric .. .. .. .. .. .. .. .. .. .. .. .. 1 Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 2 .. .. .. .. .. 2 .. 1 .. 1 .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa. 3 2 .. .. .. .. .. .. .. 1 .. .. .. Enteritis 1 1 .. .. .. .. .. .. .. 1 .. .. 2 Puerperal Fever 1 .. .. .. .. .. .. .. 1 .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. Other Septic Diseases .. .. .. .. .. .. .. .. .. .. .. .. 2 Phthisis 24 .. .. .. .. 22 .. 4 2 4 9 5 20 Other Tubercular Diseases 5 2 .. .. .. 1 .. 2 1 1 1 .. 4 Cancer, Malignant Disease 9 .. .. .. .. 4 .. 1 .. 1 2 3 25 Bronchitis 28 9 .. .. .. 5 12 5 1 3 15 4 3 Pneumonia 12 5 .. .. .. 3 2 4 1 2 5 .. 3 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Respiratory Organs .. .. .. .. .. .. .. .. .. .. .. .. .. Alcoholism Cirrhosis of Liver 3 .. .. .. .. 1 .. .. 1 1 .. 1 3 Venereal Diseases 2 1 1 .. .. .. .. .. .. .. 1 1 .. Premature Birth 4 4 .. .. .. .. .. 1 .. .. 1 .. 2 Diseases and Accidents 1 .. .. .. 1 .. .. 1 .. .. .. .. 3 Heart Diseases 18 .. .. .. 14 4 3 .. 1 5 6 10 Accidents 7 1 2 .. .. 2 1 .. .. 1 5 1 5 Suicides 1 .. .. .. .. 1 .. .. .. .. .. 1 .. All other causes 62 10 6 .. 1 20 25 6 13 9 17 17 24 All causes 184 35 15 1 5 74 54 29 28 25 63 39 107 138 REGISTER OF SANITARY WORK Month ending 30th November, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. K. Phillips, Special Duties. Miss F. A. Baker. Total. Mr . J. Hodgss, 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. Public Health (London) Act Inspections. /Dwelling Houses &c. 40 38 35 30 22 ... ... ... ... 4 169 Tenements 36 ... 45 23 31 ... ... ... ... ... 135 Underground Dwellings 12 ... 21 6 17 ... ... ... ... ... 56 Dairies, Milk Shops, Cow Houses 10 6 6 2 12 ... ... ... ... ... 36 Slaughter Houses 2 1 ... ... 1 ... ... ... ... ... 4 Yards, Stables, and Mews 20 12 30 40 47 ... ... ... ... ... 149 Smoke Shafts ... ... ... ... ... ... ... ... 7 3 10 Offensive Trades and Effluvia Businesses ... ... .... ... ... ... ... ... ... ... ... Refuse Receptacles 8 7 6 14 11 ... ... ... ... 3 49 Enquiries re non-removal of refuse 11 13 12 8 5 ... ... ... ... 2 51 Removal of Bodies to Mortuary ... ... ... ... ... ... ... ... ... ... ... Visits to Works in Progress 260 263 250 320 211 ... ... ... 10 16 1330 Miscellaneous Inspections 140 136 120 220 135 ... ... ... 39 74 864 UNWHOLESOME FOOD. Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE Cases Isolated ... 1 ... 2 1 ... ... ... ... ... 4 Cases removed to Hospital 4 9 7 20 12 ... ... ... ... ... 52 Rooms Disinfected 11 17 12 33 22 ... ... ... ... ... 95 NEW DRAINAGE Number of Hans Passed 6 6 4 7 10 ... ... ... 2 ... 35 New Pipe Drains (feet) 980 1328 340 920 1126 ... ... ... ... ... 4694 Houses where defects in existing Drainage have been detected and remedied 8 11 9 7 13 ... ... ... ... ... 48 139 REGISTER OF SANITARY WORK Month ending 30th November, 1902. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillips, Special Duties. Miss F. A. Baker. Total. 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. Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 25 5 30 76 ... 76 Periodical Inspections:— Factories ... ... ... ... ... ... ... ... 4 2 6 Workshops ... ... ... ... ... ... ... ... 53 142 195 Bakehouses ... ... ... ... ... ... ... ... 108 6 114 Restaurants, &c. ... ... ... ... ... ... ... ... 18 ... 18 Homeworkers' Premises ... ... ... ... ... ... ... ... . 30 95 125 Domestic Workshops ... ... ... ... ... ... ... ... 12 3 15 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 36 20 15 14 20 ... ... ... ... ... 105 Correspondence, Legal Procedure &c. Complaints received 10 10 12 3G 6 ... ... ... 7 7 88 Letters and Intimations relating to Abatement of Nuisances 7 13 53 28 ... ... ... ... 4 8 113 Statutory Notices Served 4 1 1 9 9 ... ... ... 1 ... 25 Proceedings taken before Magistrates ... ... ... ... ... ... ... ... ... ... ... (1) Under Public Health Act ... ... ... ... ... ... ... ... ... ... ... (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) ,, Food St Drugs Act ... ... ... ... ... ... ... ... ... ... ... Reports made to Medical Officer of Health 33 31 30 45 47 ... ... ... 34 9 229