Ac 4353 STMARY 8 THE SANITARY CHRONICLES of St. Marylebone; being the ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1903. by ALEXANDER WYNTER BLYTH, Medical Officer of Health and Analyst of Food and Drugs for the Metropolitan Borough of St. Marylebone; Barrister-at-Law of Lincoln's Inn; Fellow of the Institute of Chemistry, &c., &c. VOL, XXIII. 88911 London: George Pulman & Sons, Ltd., Printers, Marylebone, Chiswick, and Harrow. CONTENTS. Meteorological Summary 7-8 Births and Deaths 9 General Health of District 11 Scarlet Fever 11 Diphtheria.11 Enteric Fever 11 Measles and Whooping Cough 12 The Healthiness of Artizans' Dwellings 12 Practical Sanitary Work 15 Factories and Workshops—Bakehouses 16 Smoke Nuisances 17 Trade Nuisances 17 Public Urinals 17 Restaurants and Dining-rooms 17 Miss Baker's Report 18 Nuisances Abatement 19 Underground Conveniences 19 Housing of the Working-Classes Act 19 Prosecutions under the Public Health Act 20 Mortuary and Coroner's Court 20 Cleansing of Persons Act 20 The Shelter 22 Disinfection 22 Clerical Work of the Public Health Department 23 Sale of Food and Drugs Acts 23 Sanitary Legislation, 1903 24 Sanitary Accommodation in Factories and Workshops 26 Tables 27-35 PREFACE. The following report is the usual summary as required by Statute of the Sanitary administration of the Borough of St. Marylebone during 1903. It gives in tabular form all essential facts as to the work of the Sanitary Office and the statistics of disease and mortality. The first of this series of reports was issued in 1880, the present is therefore the twenty-third. Throughout the whole series the original form and arrangement has been maintained. No. 3 Upper Gloucester Place, W. February, 1904 A REPORT of the METEOROLOGY, MORTALITY, AND SICKNESS of ST. MARYLEBONE FOE THE YEAR 1903. By A. Wynter Blyth. METEOROLOGICAL SUMMARY. March Quarter. January was mild, wet, and gloomy, with only one week of frost. Dense fogs were absent. On two days slight snow fell. The minimum temperature was 26.0°; the maximum, 52.0°; the mean 41.0°. The total rainfall amounted to 2.73 inches, this rain fell on 21 days. The sunshine registered in Regent's Park was but little more than 27 hours. February was fairly dry and mild. The minimum temperature was 30.0° ; maximum 58.0°; mean 45.1°. On eight days slight rain fell, amounting in all to 0.15 inch. The last week of February was stormy, the wind blowing from the S.W. and W.S.W. with hurricane force. The sunshine varied from 10 to 25%. March was characterised by strong westerly and South Westerly gales. Minimum temperature, 35.5°; maximum, 53.9°; mean 47.1°. There were 10 rainy days; the rainfall for the month was 3.82 inches. There was a fair amount of sunshine, from 13 to 29% being registered in Regent's Park. 8 June Quarter. April was bright and showery. Minimum temperature, 29.0°; maximum, 60.9°; mean 46.7°. On 16 days more or less rain fell, the total fall being 2.47 inches. The winds were for the most part N.W. and S.W. The sunshine varied from 18 to 55%. May was a somewhat wet month, 19 rainy days yielding 2.2 inches. Minimum temperature, 37.5°; maximum, 78.2°; mean 56.3°. Winds variable; sunshine from 8 to 58%. The rainfall for June was considerable; in eight days no less than 6.23 inches of rain falling. The minimum temperature was 40°; maximum, 85.0°; mean 59.0°. The sunshine varied from 16 to 59%. September Quarter. Although there were only 11 rainy days in the five July weeks, yet the total rainfall was heavy, viz., 5.4 inches. Minimum temperature, 45.0°; maximum, 86.0°; mean, 64.6°. The winds were variable but for the most part westerly. The sunshine registered varied from 25 to 75%. August was also an unusually wet month. There were 11 days of rain during four weeks, the total fall equalling 3.43 inches. Minimum temperature, 46.0°; maximum, 77.0°; mean 41.5°. Wind, S.W. Sunshine from 8 to 56%. September was a little drier. There were 6 rainy days in the first two weeks, giving a fall of 3.08 inches, while the last fortnight was rainless. The minimum temperature was 40.0°; maximum 81.0°; mean, 59.2. Winds, N.N.W. and N.E. Sunshine up to 45%. December Quarter. In October there were no less than 25 rainy days. The rainfall was not, however, great, considering the number of wet days, the fall amounting to 3.73 inches. Minimum temperature, 55.0°; maximum 68.0°; mean, 56.3°. Winds, S.W. Sunshine from 8 to 27%. November was free from fog. Minimum temperature, 34.2°; maximum, 55.0°; mean, 47.8°. 1.6 inch of rain fell in 10 days. Winds W. and N.W. Sunshine from 7 to 20%. December was fairly free from fog. There were 10 rainy days, giving a rainfall of 2.44 inches. There were a few frosty days, but no hard weather of any account and no snow. As usual sunshine was generally deficient. Under six hours of bright sunshine. being registered in Regent's Park. 9 BIRTHS AND DEATHS. The number of births during the 52 weeks ending December 26th, 1903, when all the essential corrections have been made, was 2,818. The number of deaths (corrected) of parishioners was 2,180. This gives a birth-rate of 21.2; a death rate of 16.4 per thousand. The birth and death-rates of the sub-districts for 1903 were as follows :— Birth-rate Death-rate. All Souls 17.1 13.5 Rectory 19.5 15.4 St. Mary 22.9 15.7 Christ Church 25.4 18.9 St. John 19.9 17.8 The whole district 21.2 16.4 The following is a statement of the average birth and death-rates for the five previous years. All Souls 16.5 14.6 Rectory 20.7 20.9 St. Mary 23.1 18.2 Christ Church 24.6 17.6 St. John .. 21.8 17.6 The whole district 21.9 17.9 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 528 North Western Fever Hospital 23 Western Fever Hospital 21 University Hospital 13 St. Mary's Hospital 41 St. Thomas's Hospital 6 St. George's Hospital 11 St. Bartholomew's Hospital 7 Westminster Hospital 2 Guy's Hospital 1 Charing Cross Hospital 2 National Hospital 2 Royal Free Hospital 2 French Hospital 6 Italian Hospital 2 German Hospital 1 Hostel of God 2 Carried forward 670 10 Brought forward 670 Hanwell Asylum 28 Leavesden 15 Colney Hatch Asylum 20 Cane Hill Asylum 1 Banstead Asylum 7 Camberwell House Asylum 1 Manor Asylum, Epsom 2 Hoxton Asylum 5 Tooting Bec Asylum 2 Darenth Asylum 6 Dartford Asylum 2 Caterham Asylum 2 Ilford Asylum 1 Claybury Asylum 7 Peckham House Asylum 1 Middlesex Asylum 1 Children's Hospital, Great Ormonde Street 8 Children's Hospital. Paddington 17 North Eastern Children's Hospital 1 Cancer Hospital 2 St. Pancras Workhouse 1 St. Pancras Infirmary 1 Paddington Workhouse 2 St. Joseph's Home 1 St. Anne's Home 1 St. Luke's Home 4 Holborn Infirmary 1 Clapham Maternity 1 West London Hospital 2 North-west London Hospital 1 Heart Hospital, Soho 1 Royal Chest Hospital 2 Mount Vernon Consumption Hospital 1 Brompton Hospital 2 St. Francis Hospital for Infants 2 Chelsea Infirmary 2 Paddington Infirmary 1 Islington Workhouse 1 St. Peter's Home 4 Kensington Infirmary 1 Grosvenor Hotel 1 Friedenheim 4 River Thames 1 Regent's Canal, Paddington 1 In the Streets 15 Total 853 II GENERAL HEALTH OF THE DISTRICT DURING 1903. Phenomenal as to rainfall, the year was also phenomenal as to low mortality and as to a high degree of general health. As shown in the succeeding paragraphs and tables the ordinary infectious diseases were for the most part below the average. Whether this was due to the constant washing of the atmosphere, or the washing away of masses of fermenting matter in drains and sewers, or the influence of excess of moisture on the slow and but little understood fermentation of the soil, or not to rainfall at all, but to the fairly uniform temperature, are matters of speculation difficult to decide. SCARLET FEVER. 410 cases of scarlet fever were notified ; of these 357 were removed to hospital. The case fatality was lower than that of the previous year (1902); it has indeed fallen to about 3.6%, hence the cases were as a rule mild. Scarlet fever, from the 2nd week in February up to the 2nd week in March was a little above the average. During two weeks in the middle of May scarlet fever was much above the average. During the rest of the year the number of cases were fewer than for the corresponding periods of the preceding five years. DIPHTHERIA. There were 205 cases of diphtheria notified, and of these 27 were fatal, giving a case mortality of 13%. Hence, diphtheria was three times as fatal as scarlet fever. In the majority of cases notified, the diagnosis has been confirmed by a bacteriological investigation of the throat. The comparatively high mortality of these cases also shows that the diagnosis was correct, and that but few cases of ordinary inflammatory affections of the throat have been erroneously described as diphtheritic. At the same time it is to be specially noted that diphtheria was less prevalent than in previous years. ENTERIC FEVER. Enteric or typhoid fever was generally below the normal, save for a sharp sudden rise in the latter end of September. There were 59 cases notified, of these 10 died, giving a case mortality of 17.5%. Most of these cases had contracted the malady from sources outside the Borough. 12 MEASLES AND WHOOPING COUGH. The only infectious diseases throughout the year which tended to become epidemic were measles and whooping cough. Neither of these diseases are notifiable, hence the only accurate knowledge obtained with regard to them is the record of deaths, and also the notices which the various school authorities send regularly to the Health Office. Since there were 32 deaths from measles and 57 from whooping cough, and the average case mortality is somewhere near 5%, it may be surmised that there were over 600 cases of measles, and 1,100 of whooping cough. THE HEALTHINESS OF ARTISANS' DWELLINGS. It has been advanced as an objection to the policy of building, or encouraging the building of, Artisans' Dwellings in this district, by an eminent member of the Council, that the death-rate of such dwellings is likely to be as high as in tenement streets. Since this question is of more than local interest. the writer has commenced the study of the question. There are now a large number of artisans' dwellings in the district, some of them extremely defective in original plan and unfortunately situated; others like Wharncliffe Gardens and Queen Street Buildings, on good sites, and in every way excellent. In the former case one would suspect that the objection has some basis, but in the latter there is no reason for believing that the conditions of housing are antagonistic to the highest degree of health and longevity. The buildings selected for the present purpose are Wharncliffe Gardens, situated high up in the residential neighbourhood of St. John's Wood, with ample light, pleasant views, and as good an atmosphere as can be obtained within four miles of Charing Cross, and a group of dwellings in Horace Street, which are unfortunate in being in the midst of a crowded locality and in point of planning and original construction and also in the wage earning capacity of the tenants, and their manner of living, somewhat different to Wharncliffe Gardens. WHARNCLIFFE GARDENS. The following figures have been supplied by the Superintendent of Wharncliffe Gardens in respect to the population of the dwellings :— 13 Rooms. adults. children.* total No. 1 Block 250 143 205 348 No. 2 „ 165 137 129 266 No. 3 „ 220 183 147 330 No. 4 „ 220 177 168 345 No. 5 „ 220 187 171 358 No. 6 „ 270 245 l6l 406 1,345 1,072 981 2,053 *The vague expression " children " includes ages up to 12. The deaths during four years 1899 to 1903 inclusive were as follows :— Small Pox 2 Measles 1 Scarlet Fever 1 Diphtheria 7 Diarrhoea 3 Phthisis, and other Tubercular Diseases 5 Cancer 1 Bronchitis, and other chest complaints 7 Premature birth 3 Heart Disease 3 Suicide 1 Other diseases 6 40 This is equivalent to a death-rate of 4.8, or just under 5 per thousand; the death-rate during the same period of the sub-district of St. John, varied from a minimum of about 18 to a maximum of 22 per thousand. The infectious diseases notified during the four years were as follows :— Wharncliffe Gardens Small Pox 8 Chicken Pox 7 Scarlet Fever 73 Typhoid Fever 3 Diphtheria 24 Croup 2 Erysipelas 1 118 This gives a zymotic rate of sickness per thousand living of 14.3 per thousand, the rate for the sub-district of St. John's during the same period being 11.8 or practically 12 per thousand. 14 HORACE STREET DWELLINGS. The Horace Street group of Artisans Dwellings are composed of :— Windsor Dwellings, Osborne Dwellings, Erin House, St. George's Dwellings, St. Mary's Dwellings, St. Michael's Dwellings. The number of families inhabiting these dwellings is 87. 33 of these occupy 1 room, 52 occupy 2 rooms, and 2 more than two rooms. The population, as taken by Mr. Andrews, the Inspector for the District, within a few days of the last day of the year was 355, 175 of whom were children. The deaths during four years, 1900 to 1903 inclusive, were as follows :— Whooping Cough 1 Diphtheria 2 Influenza 1 Phthisis and tubercular diseases 10 Bronchitis and other chest affections 9 Premature birth 1 Heart disease 1 Accidents 2 Other diseases 8 Total 35 This is equal to a death-rate of 24.5 per thousand per annum; the death rate of the, sub-district of St. Mary, in which the buildings are situated, varying in the same years from a minimum of 16 to a maximum of 19. The diseases notified during the four years were as follows :— Small Pox 1 Chicken Pox 1 Scarlet Fever 5 Diphtheria 11 Erysipelas 5 Total 23 This is equal to 16.1 per thousand of the population per annum, the similar rate for St. Mary's sub-district being for the same period only 7.4 per thousand. 15 In discussing these remarkable figures it must be remembered the figures cover but a short period, the reason for taking such a small period being that the returns for former years have in the confusion of removing to the present offices been mislaid. If a longer period had been taken it may be that Wharncliffe Gardens would not have had so low, the Horace Street Buildings so high, a rate. It must also be freely granted that Wharncliffe Gardens population is a selected one, the old and the weakly obviously do not exist there, and that the precise age constitution of the two populations is unknown. More than any other circumstance the "age constitution " influences death-rates. If a thousand individuals are taken, mainly composed of young persons from 10 to 15 years of age, a death-rate of under 4 per thousand would be quite normal. If on the other hand the thousand consisted of persons of 65 and above, a death rate of 100 to 200 per thousand would not require comment. Still, making every allowance for a probable favourable age constitution there is little doubt that Wharncliffe Gardens has enjoyed an exceptional freedom from fatal disease, more particularly, the rate for tubercular maladies is extremely low. It will be observed that on the other hand the Gardens have by no means been immune from infectious diseases, the rate being higher for zymotic sickness than that of the sub-district in which the buildings are situated. The Horace Street group of dwellings not only shows a higher death-rate than the sub-district, but a much higher zymotic sickness rate, and the figures for tuberculosis are high, tubercular affections accounting for about one-third of the total mortality. PRACTICAL SANITARY WORK, 1903. A tabular statement is given of the work of each of the Sanitary Inspectors at pages 34-35. Complaints of sanitary defects were received and promptly attended to in 869 cases. More than half the time of the Inspectors is taken up with the supervision of new, or the investigation of defective drains. An objection was raised by the County Council to the employment of Inspectors in the supervision of new drainage works, a duty which they have performed for many years, and for which their training and experience well qualifies them to fulfil, the ground of the objection was that the duties were not specifically mentioned in the Local Government Order, 16 and therefore the County Council could not repay the half of the salaries while such duties were performed. Subsequent correspondence with the Local Government Board showed how purely technical the objection was, the Board having no objection to the Inspectors acting as they have always done, provided the Inspectors were paid separately for such duties, the separate payment to be borne wholly by the local authority. Two of the Inspectors, Mr. Richard Phillips and Miss Frances Baker, have special duties with regard to the Factory Acts and the Public Conveniences. Their reports are as follows :— Report of Mr. Phillips. 3, Upper Gloucester Place, Marylebone Road, N.W. January, 1904. The Medical Officer of Health. Sir,—I beg to present to you a report of my work during the year 1903 :— FACTORIES AND WORKSHOPS. There are in the Borough 127 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, sanitary accommodation and drainage matters attended to. All new workshops have been measured, and registered in accordance with the Factory and Workshops Act, 1901. BAKEHOUSES. There are at the present time 96 bakehouses in the Borough, of this number 12 are overground, the remaining 84 are underground, and in accordance with Section 101 of the Factory and Workshops Act, 1901, no underground bakehouse could be used after the 1st January, 1904, for baking unless it had been certified by the Sanitary Authority. In consequence the whole of these bakehouses have been inspected, and in most cases a considerable amount of work has been carried out under my supervision before the certificate was granted. In 77 cases certificates have been granted by the Sanitary Authority. In the remaining 7 cases, no application has been made for a certificate owing to the fact that the leases of the premises expired very shortly, and the owners did not see their way to expend money on the structural and other alterations which were necessary. Consequently from the 1st January, 1904, they will cease to be used as bakehouses. 17 SMOKE NUISANCES. The number of smoke nuisances detected or complained of during the year is 13. All premises where nuisances have occurred are vigilantly watched, but a recurrence of the nuisance seldom takes place after an intimation of the nuisance has been given. TRADE NUISANCES. Complaints of trade nuisances have been received, and upon proof of the case, they have been abated in every instance. UNDERGROUND CONVENIENCES. I have supervised the work at the three underground conveniences, and constantly inspected them both day and night. Several repairs and alterations have been done ; I have found the premises well and cleanly kept, and am able to report satisfactorily on the work done by the Attendants, whose duties are chiefly arranged by me. PUBLIC URINALS. Since the last Annual Report, the 25 urinals situated in the Borough above ground have been placed under the control of the Public Health Department, and it is my duty to inspect the same for cleanliness and repairs, which require a daily visit ; also to supervise the men employed as flushers ; these I have found attentive to their duties. RESTAURANTS, DINING-ROOMS, AND COFFEE- SHOPS. I have inspected 163 restaurants, coffee-shops and diningrooms in the Borough, special attention being given to the kitchens and all places where food is stored. The lavatory accommodation has also had my attention. I found that 23 of the number required cleansing, and notices were served with satisfactory results. Appended is a statement of such of my work which admits of less tabulation :— No. of visits. Workshops, etc. 596 Bakehouses 456 Restaurants, etc. 405 Smoky Nuisances 98 Underground Conveniences Daily Public Urinals Daily I am, Sir, Your obedient Servant, RICHARD PHILLIPS, Senior Inspector. 18 REPORT OF MISS BAKER. Public Health Department, January, 1904. To the Medical Officer of Health. Sir,—I beg to present the report for the year ending 1903 :— Number of workshops on the Register at end of 1902 1,801 Do. at end of 1903 2,164 New ones added during the year 337 Removals 197 Number of businesses represented 1,770 Re-inspections made during the year 1,371 Of the new workshops added, 134 were received by notification from the Home Office; the remainder have been discovered on my periodical visits. The figures represent for the most part the trades of dressmaking and millinery, which are steadily increasing in numbers in spite of an already well filled district. The necessary repairs and cleansing are carried out without much delay, and only in a few cases has it been needful to watch any tendency to overcrowding, which, however, is not repeated. One of the chief points in visiting the workrooms in the winter months is to give a reminder that the temperature of the rooms must be kept at a reasonable height, a fact very apt to be overlooked when the girls are busily engaged during the colder weather, especially when the iron heaters are much in use; for it is often imagined that these stoves provide all the necessary heat. The outworkers employed on this district have almost doubled in number. They belong to the tailor's trade generally, and one observes a decided increase in the number of aliens employed. As a rule this means the establishment of more workshops, for it is seldom that a foreigner works alone or with members of his own family only; and in the ladies' tailoring this is especially the case. Number of Outworkers on the Register at end of year 1902 267 Do. at end of year 1903 491 Removals from the district 25 Names received during year from firms within district, received Februrary and August 1,734 Of which were transferred to other Boroughs 1,141 Received from other Boroughs 144 Re-inspections made during the year 423 35 Domestic Workshops in the district have also been visited. 19 NUISANCES ABATED. These, which number 138, principally concern the cleansing and repairing of the sanitary accommodation; next in importance come the ventilation of gas iron-heaters, the eleansing of c1sterns and the lime washing of workrooms. 78 various complaints have been received, followed by investigation, which in a few cases has proved there was no ground for complaint. UNDERGROUND CONVENIENCES. The women's conveniences have been regularly and frequently inspected both week-days and Sundays. They have always been found clean and well looked after. Having the supervision of the Attendants also I can report that they are civil in their manners and attentive to their duties. The recent adoption of special By-laws has ass1sted in keeping for the public generally better cleanliness and order in the lavatories. There are also several miscellaneous details of this department which have been attended to, which it is impossible to present in tabulated form. I am, Sir, Your obedient Servant, FRANCES A. BAKER Inspector. HOUSING OF THE WORKING CLASSES ACTS. No new scheme was carried through during the year. The opening of Queen Street Buildings and the commencement of clearing the Nightingale Street site, both on the Portman estate, mark however, progress with regard to the future of the d1strict. Devonshire Place still remains to swell the death-rate of the Chr1st Church D1strict. During the latter part of the year the members of the Housing Committee took a tour of inspection over the Burne Street area, and witnessed the squalor of some of the dwellings in that area, but neither of these schemes have made progress. In the meantime extensive changes are being brought about by the natural falling-in of long leases. This is particularly the case in St. John's Wood, where a number of the Howard de Walden leases have expired. In that d1strict a large block of artisans dwellings will be erected, in the highly residential d1strict of Grove End Road, a site, so far as health is concerned, quite unexceptionable. If no new scheme has been reported under the Act advantage has been taken of its 20 provisions to close up a good many dwellings. Bentinck Court and Williams Cottages (19 houses) were closed by Mag1strate's order under the Act. The same process was applied to No. 6, High Street, St. John's Wood, and to Nos. 6 and 11, Gees Court. PROSECUTIONS UNDER THE PUBLIC HEALTH ACT. In about 9 cases the Local Authority has been compelled to enforce the observance of the Law by legal proceedings. The owners of Nos. 4, Harrow Street, 69, Upper Berkeley Street, 34, Great Barlow Street, and 3 & 4, Wellington Place were summoned for neglecting to obey notices with regard to drainage or other sanitary matters. The owner of No. 107, Princess Street was summoned for not providing water to the premises ; the owner of 125, Great Portland Street was summoned for placing on the kerb an improper dust-bin, and an occupier of Montagu Mews was summoned for non-removal of manure. In most of the above cases, convictions and small penalties were obtained. THE MORTUARY AND CORONER'S COURT. The report of the Mortuary Keeper, Mr. Ellis, is to be found at page 27. The Mortuary continues to be of high utility. During the past year the Committee replaced the gas fittings by the electric light, the short roadway was taken up and laid down with asphalte, and the building was placed in communication with the general telephone system, all most desirable improvements, bringing the building and appliances up-to-date. THE CLEANSING OF PERSONS ACT. The Cleansing of Persons Act was passed in 1897, and the writer recommended the Vestry to put it into operation Accordingly, as an experiment, a single bath in Grove Road was fitted up, and was opened on the 2nd day of March. On the very first day there were no less than four applicants, and up to the last day of March, 148 persons had used the bath. Encouraged by this success various improvements were made in successive years, culminating in 1900 in the provision of baths for females, and a suitable building. As CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, AND TYPHOID FEVER DURING 1903 21 now constituted, the cleansing baths cons1st of 2 baths for males, and 2 baths for females. The water is heated by steam at a high temperature supplied by a Cornish boiler. The clothes, while the bathers are in the baths, are disinfected by a hot air apparatus. During 1903, as the following return compiled by Miss Kilgallin shows, no less than 6,170 separate baths were given. In a good proportion of cases, the bathers are found to be suffering from contagious skin diseases, and to be in a most offensive state generally. The disinfection of the clothing and bathing, not only is a protection to the public, but a great source of relief to the sufferers themselves. ST. MARYLEBONE BATHS, RICHMOND STREET, EDGWARE ROAD. CLEANSING OF PERSONS ACT, 1897. The addresses given of the applicants were as follows:— Males from Salvation Army Shelter 4,876 Males from Lodging Houses in Parish 639 Females from Shaftesbury Institute 400 Females from Private addresses 14 Females with no addresses 241 Total 6,170  Males. Females. Jan. 1-30 406 13 Feb. 2-21 358 1*5 (Closed 8 working days for New Baths). Mar. 4-31 416 27 April 1-30 364 31 May 1-30 359 31 I une 2-30 420 33 (Closed 2 working days for Boiler Inspecting). July 1-31 531 70 Aug. 1-31 576 7° Sept. 3-30 560 93 Oct. 1-30 534 107 (Closed 1½ working days for repairs). Nov. 2-30 492 87 Dec. 1-31 499 78 5,515 655 (Total number from 2nd March, 1898, to 31st December, 1903, 26,065). 22 THE SHELTER. The Shelter, Grove Road, is practically a private house. It was, indeed, once the residence of the Surveyor, and has been plainly but comfortably furnished for the temporary housing of persons displaced from one or two roomed tenements during the operation of disinfection. Hence the number of times it is used varies according to the greater or less prevalence of infectious disease. 1903 was a year in which there was no considerable amount of notifiable maladies, hence it was only used 20 times, accommodating for various periods 15 adults and 15 children. 1903. Day or Hours of Occupation. Disease. No. of Persons. Jan. 3rd 4 hours Catarrh, weak ness* 1 adult. April 5 th, 6th, 7 th 50 hours Scarlet Fever 2 adults. May nth, :2th 12 hours Diphtheria 2 adults, 3 children. July t6th, 17th, 18th 36 hours Skin Disease 2 adults. Sept, 29th. 30th 24 hours Scarlet Fever 2 adults. Oct. 19th 2 hours Scarlet Fever 2 adults. Oct. 30th 3 hours Puerperal Fever 2 adults. Nov 2nd 12 hours Scarlet Fever 1 child. Nov. 2nd, 3rd 24 hours Scarlet Fever 1 adult, 1 child. Dec. 18 th, 19 th 24 hours Enteric Fever 1 adult, 4 children Dec. 20th, 21 st 24 hours Enteric Fever 1 adult, 2 children Dec. 31st 1 hour Enteric Fever 1 child. * The man was having one of the free baths when he was taken faint and received into the Shelter until he was able to be moved elsewhere. DISINFECTION. Owing to the moderate amount of infectious disease during 1903, disinfectant operations show a considerable decrease to that of 1902, as shown by the following comparative table:— L1st of Articles disinfected during 1902 1903 Beds 619 410 Mattresses 647 569 Bolsters 590 580 Pillows 1,585 1,333 Sheets 1,289 820 Blankets 2,007 1,697 Other Articles 3,474 3,078 The Vans were used 617 times in 1902; 615 times in 1903. 23 CLERICAL WORK OF THE PUBLIC HEALTH DEPARTMENT. Mr. H. E. Curtis and Mr. W. J. Howe continue to perform the clerical work of the department in a most efficient and creditable manner. Hodges, junior, has also ass1sted in this and various other ways. The work tends to increase year by year because fresh Acts of Parliament impose fresh duties, besides which a large amount of work is entailed in answering communications from other local authorities. Long and elaborate l1sts of questions on almost every conceivable sanitary subject pour in weekly from not only the Metropolitan local bodies but also from provincial towns, some of them quite remote. So far as possible these questions are answered, but to collate the information consumes much time. Only a portion of the clerical work admits of tabulation. The following statement may, however, give some idea of what has been done during 1903:— REG1stER OF CLERICAL WORK. 1903 Number of Notifications of Infectious Disease, entered in Reg1ster, copied and sent to the Metropolitan Asylums Board and Schools, receipt acknowledged and filed 981 Number of complaints of Nuisances received, entered in Nuisance Reg1ster and filed 755 Number of Letters despatched from the Department 2,007 Number of Council Orders issued 178 Number of Meetings of Public Health Committee prepared for, attended, and Minutes drafted 23 Number of Meetings of Public Health SubCommittee prepared for, attended, and Minutes drafted and written 58 Bakehouses, Certificates granted and despatched 77 Plans Reg1stered and approved by Public Health Committee 333 THE SALE OF FOOD AND DRUGS ACTS. As usual a large number of samples have been analysed under the Sale of Food and Drugs Acts. It is however, surprising how few have been found to be adulterated. The recent legislation with regard to the standardisation of milk and butter has acted beneficially. It is true that with regard to most articles for which a legal limit of quality is provided, 24 it is open to the vendor to reduce the article down to the legal limit and he can do so with impunity. In the writer's experience this is rarely done, the majority of persons finding in the long run that it pays better to sell an article of good quality than obtain a high profit for a short time and subsequently lose business. 221 samples of milk were analysed; a good percentage of these were taken on Sundays in the streets from itinerant barrows, yet with the exception of three, they were all up to standard, and most of them of quite high quality. Spirits have a statutory limit, the limit being an alcoholic strength of 35 degrees under proof for gin; 25 degrees under proof for the stronger spirits. 15 samples of gin were analysed, 67 of whisky, rum and brandy. The mean strength of the stronger spirits was 19 degrees under proof, while a sample of whisky and one of brandy was as strong as 4 degrees below proof. One sample of whisky was slightly below 25 degrees, and two samples of rum had been diluted just under the limit. Most of the gins were 32 degrees under proof. A careful search for arsenic has been made in most of the samples submitted; it has now been proved that small quantities of arsenic may be discovered with the improved processes available in a number of articles of food; for instance herrings, eggs, tinned tomatoes and substances which have no relationship to arsenical sulphuric acid, the cause of the mass poisoning in 1900 in the Midlands contain traces of arsenic. The writer has found small traces of arsenic in a few of the articles enumerated in Table II. In 11 samples of common salt, 8 were arsenic free, but 3 of the samples contained arsenic in the feeble proportion of .0024 grain per pound. The Commission on arsenical poisoning recommend that the limit of arsenical impurity should be one hundredth of a grain per lb. for solid foods, and one hundredth of a grain per gallon as regards liquids such as beer. The interest of finding arsenic in salt lies in the fact that it is used as a preservative for various meats and enters so largely into most articles of diet. SANITARY LEGISLATION, 1903. There was but little amendment or extension of the ex1sting Sanitary Law during the year, with the exception of the Housing of the Working Classes Act, which is considerably and beneficially amended by the Housing of the Working Classes Act, 1903. 25 The Secretary of State issued his Order during the year making detailed regulations respecting the maintenance and use of crematoria, and an important Order with regard to the Sanitary Conveniences in Factories and Workshops (extra, metropolitan) was also issued. The Housing of the Working Classes Act, 1903, Section 1, extends the period for the repayment of loans from 60 to 80 years. In connection with this the Local Government Board state in their circular letter on the new Act (September 22nd, 1903), that they propose in future as a general rule to allow the full term of 80 years for the repayment of money borrowed for the purchase of freehold land, and 60 years for the repayment of money borrowed for the erection of buildings under the Housing Acts. Section 3 imposes the obligation on Local Authorities. Companies, or other persons acquiring land under the Housing Acts on which there are working men's dwellings, occupied by 30 or more persons belonging to the working classes, not to enter on such dwellings until the Board have either approved of a housing scheme or decided that a scheme is not necessary. The same section applies a schedule which sets out in considerable detail, various provisions in relation to the making, enforcement and modification of such schemes. Section 4 enables the Local Government Board to order a scheme to be made; in case of failure to make such scheme, the order may be enforced by mandamus. Subsequent sections considerably simplify the procedure of putting the Act into force, and in particular enables a confirming Order of the Board to be effective in certain cases without confirmation by Parliament. Section 8 amends the law with regard to Closing Orders. Under the old Act notice had first to be given to place the premises in repair. In many cases it was well known that the notice would not be complied with. For example, a requisition to repair extensively a dilapidated house within six months of the termination of a lease is seldom obeyed. The Act now gives power, in cases in which the Local Authority thinks a notice cannot or will not be obeyed, to apply to a mag1strate and take out a summons for a closing order without giving the preliminary notice. When houses are demolished under the Act, and the sale of the materials fails to cover the cost of the demolition the balance can be recovered from the owner as a civil debt (section 9). 26 Section 10 gives a more speedy and efficacious way of recovery of possession of a house in respect of which a closing order has been made. New powers are given under Section 11 empowering the Council if they supply lodging houses, or if they supply housing accommodation, to provide and maintain in connection with such accommodation, shops, recreation grounds or other buildings or land, which, in the opinion of the Board might serve a beneficial purpose. An authority might, for instance build a block of artisan's dwellings, with shops underneath, or provide in connection with artisan's dwellings a plot of ground for use as a play-ground for children or as a drying ground for laundry purposes. Section 12 renders it impossible for landlords and tenants to agree to contract themselves out of the provisions of the principal Act, which enacts a condition is implied in letting a house or part of a house for habitation by the working classes that such house is at the commencement of the holding, fit for human habitation. SANITARY ACCOMMODATION IN FACTORIES AND WORKSHOPS. The Secretary of State has issued an order under Section 9 of the Factory and Workshop Act, 1901 (1 Ed. VII. c. 22), determining what is suitable and sufficient accommodation for persons in each sex in Factories and Workshops. The Order prescribes one sanitary convenience for every 25 males, and the same proportion for females, but there are provisions under which a less proportion is allowed in places employing 100 or more male workers. The Order does not apply to the Metropolis, but obviously it may be taken as a guide, the more especially as the order agrees with the general practice of the Metropolitan Sanitary Authorities. For many years it has been considered that with regard to workshops, insufficient sanitary accomodation means a less proportion than one convenience to 25 workers. 27 TABLE I. REPORT OF MORTUARY KEEPER. FOR THE YEAR 1903. Number of bodies received from January 1st to December 31st, 1903. Males. Females. Brought up Males. 105 Females. 98 January 21 17 July 15 11 February 17 16 August 13 8 March 17 17 September 19 17 April 21 19 October 16 19 May 15 17 November.. 14 17 June 14 12 December 24 29 105 98 206 199 Total 405 Number of Inquests held from January 1st to December 31st, 1903. January 16 July 6 February 13 August 11 March 15 September 17 April 19 October 14 May 15 November 14 June 13 December 31 • 91 93 Total 184 Infectious Cases received. Diphtheria 4 Enteric 1 Typhoid 1 Total 6 Number of bodies received January 1st, 1889, to December 31st, 1903 7,005 28 TABLE II.—SALE OF FOOD AND DRUGS ACTS. Samples Analysed during the Year 1903. Genuine. Adulterated Total. DAIRY PRODUCTS— Milk 218 3 221 Cream 2 — 2 Butter 87 87 Margarine 21 — 21 Lard 22 — 22 Cheese 3 — 3 ALCOHOLIC BEVERAGES— Whisky 46 — 46 Brandy 12 — 12 Gin 15 — 15 Rum 2 9 Port Wine 2 — 2 Cherry Whisky 1 — 1 Beer 1 — 1 NON-ALCOHOLIC BEVERAGES— Coffee 27 — 27 Coffee and Chicory 2 — 2 Tea 6 — 6 Cocoa and Chocolate 5 — 5 condiments— Salt 11 — 11 Sauce 1 — 1 Pepper 10 — 10 Mustard 6 — 6 Vinegar 2 — 2 Ginger 2 — 2 Curry Powder 2 — 2 SACCHARINE SUBSTANCES— Sweets 1 — 1 Jam 9 — 9 Honey 1 — 1 Sugar 2 — 2 Golden Syrup 2 — 2 TINNED GOODS- Condensed Milk 5 — 5 Peas 6 — 6 Sardines 6 — 6 Salmon 10 — 10 Pears 1 — 1 Pineapple 5 — 5 Apricots 1 — 1 Baked Beans 2 — 2 Tongue 1 — 1 Tomatoes 1 — 1 Lobster 2 — 2 Others 16 — 16 Carried forward 582 5 587 29 Sale of Food and Drugs Acts—continued. Brought forward Genuine. Adulterated. Total. 582 5 587 DRUGS— Bicarbonate of Soda 1 — 1 Citrate of Magnesia 2 — 2 Tincture of Rhubarb 1 — 1 Sweet Spirit of Nitre 1 — 1 Camphorated Oil 1 — 1 Quinine 1 — 1 Cough Mixture 1 — 1 MISCELLANEOUS— Olive Oil 4 — 4 Lemon Squash 2 — 2 Ginger Wine 2 — 2 Orange Wine 1 — 1 Fluid Beef 1 — 1 Flour 1 — 1 Beef Suet 1 — I Custard Powder 2 — 2 Cod Liver Oil 1 — 1 Pickles 3 — 3 Chutney 1 — 1 Force Food 1 — 1 Corn Flour 1 — 1 Pea Flour 1 — 1 Bottled Gooseberries 1 — 1 613 5 618 30 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 the year 1903; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals Pgpulation At all Ages. (b) Census 1901 35,391 19,849 18,099 39,536 20,426 133,301 (c) Registered Births 607 387 415 1003 406 2818 (d) Aged under 5 or over 5. Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 | 5 upwards Under 5 J 5 upwards Under 5 5 upwards New Cases op Sickness in bach Locality coming to the knowledge. op the medical Officer of Health. 1. Smallpox .. 1 .. .. .. .. .. .. .. .. .. 1 2. Scarlatina 28 56 16 46 11 32 51 70 34 66 140 270 3. Diphtheria 18 31 13 15 4 12 20 20 34 38 89 116 4. Membranous Croup .. .. .. 1 .. .. 2 .. 1 .. 4 .. Fevers. /6. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid 1 18 .. 5 .. 6 .. 10 1 18 2 57 7. Continued .. 2 .. .. .. .. .. .. .. 1 .. 3 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 0. Puerperal .. 1 .. .. .. 1 .. .. .. 1 .. 3 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas .. 22 5 69 1 20 2 58 2 14 10 183 Number of such Cases Removed from their Homes in the sbvebal Localities fob Tbeat- ment in Isolation Hospitals. 1. 3mallpox .. .. .. .. .. .. .. .. .. .. .. .. 2 Scarlatina 28 60 15 42 11 29 47 49 29 57 130 227 3. Diphtheria 17 29 11 13 3 6 19 19 26 26 76 93 4. Membranous Croup .. .. .. .. .. .. 1 .. .. .. 1 .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid 1 10 .. 2 .. .. .. 7 1 12 2 36 7. Continued .. .. .. .. .. .. .. .. .. 1 .. 1 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Fuerperal .. 1 .. .. .. .. .. .. .. .. .. 1 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 2 1 50 .. 6 .. 18 .. 6 1 82 31 TABLE IV.—Giving the Causes of Deaths during the fifty-two Weeks ending December 26th, 1903, 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 ... ... ... 1 1 ... Diarrhoea ... ... ... 6 9 ... Erysipelas 6 ... ... ... 6 1 Pneumonia and Pleurisy 16 ... ... 5 14 1 Pyaemia 2 ... 1 ... 2 ... Syphilis ... ... 1 ... 15 ... Cancer 127 ... ... 1 51 3 Phthisis & Tuberculosis 33 ... ... 7 115 14 Rheumatism ... ... ... ... ... ... Apoplexy ... ... ... 1 4 ... Paralysis ... ... ... ... 14 ... Bronchitis 19 ... ... 11 112 ... Asthma ... ... ... ... ... ... Peritonitis ... ... ... ... 1 ... Disease of Brain ... ... ... ... 1 ... Heart 25 ... ... 10 34 2 „ Kidney ... ... ... ... 1 ... ,, Liver 4 ... ... 3 5 1 „ Uterus ... ... ... ... ... ... Ovary ... ... ... ... ... ... Parturition ... 1 ... ... ... ... Diabetes ... ... ... ... ... ... Fractures and Injuries 14 ... ... 3 17 ... Old Age ... ... ... 2 15 ... Low Vitality, Infants ... ... ... ... ... ... Premature Birth 2 24 ... 8 6 ... Other causes 127 12 11 34 105 7 Total *376 †37 **13 87 528 ‡29 * Of the 376 deaths in the Middlesex Hospital, 309 were those of non-parishioners. † Of the 37 deaths in Queen Charlotte's Hospital 22 were those of non-parishioners. ** Six of the 13 deaths in the Samaritan Hospital were those of non-parishioners. ‡ Of the 29 deaths in St. John's Hospital 19 were those of non-parishioners. 32 TABLE V.—Causes of, and Ages at, Death daring 1903 in the Borough of St. Marylebone. CAUSES OF DEATH. Deaths in whole D1strict at subjoined Ages. Deaths in Localities (at all Ages). Deaths in Public Institutions. All ages. Under 1. 1 and under 5. 5 ami under 15. 15 and under 25. 25 and under 65. 65 and upwards. All Souls. Rectory. St. Mary. Chr1st Church. St. John. Smallpox .. .. .. .. • • .. .. .. .. .. .. .. .. Measles 32 13 18 1 .. .. .. 5 .. 1 19 7 5 Scarlet Fever 15 2 11 1 1 .. .. 2 1 .. 9 3 12 Whooping Cough 57 26 27 4 .. .. .. 9 6 5 23 14 9 Diphtheria and Membranous Croup 27 1 19 7 .. .. .. 5 2 .. 9 11 16 Croup 2 .. 2 .. .. .. .. .. .. .. 1 1 .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric 10 .. .. .. .. 10 .. 6 .. 1 2 1 5 Other continued 1 .. .. 1 .. .. .. .. .. .. 1 .. .. Epidemic Influenza 18 1 .. 1 .. 8 .. 3 .. 5 7 3 1 Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhoea 65 47 6 .. .. 5 .. 12 11 9 22 11 18 Enteritis 1 .. 1 .. .. .. .. .. .. .. .. 1 1 Puerperal Fever 2 .. .. .. .. 2 .. .. 1 .. 1 .. 1 Erysipelas 11 .. .. .. .. 5 6 4 .. 2 1 4 15 Other Septic Diseases 22 .. .. 3 1 18 .. 9 5 3 4 1 23 Phthisis 241 4 7 10 26 180 14 71 23 33 78 36 163 Other Tubercular Diseases 69 18 19 10 8 13 1 12 6 8 24 19 51 Cancer, Malignant Disease 163 .. 3 .. 1 98 61 40 29 31 31 32 178 Bronchitis 275 41 16 .. 1 73 141 50 53 40 106 26 143 Pneumonia 147 31 46 2 2 50 16 30 20 17 68 12 48 Pleurisy 3 .. .. 1 .. 2 .. 1 .. .. 2 •• 1 Other Diseases of Respiratory Organs 3 .. .. .. .. 1 2 1 .. •• 2 •• 1 Alcoholism Cirrhosis of Liver 37 .. .. .. .. 30 7 15 5 9 6 8 18 Venereal Diseases 13 9 1 .. .. 3 .. 3 2 1 5 2 11 Premature Birth 61 61 .. .. .. .. .. 18 10 5 20 8 31 Diseases and Accidents of Parturition 4 .. .. .. 1 3 .. 3 1 .. .. .. 18 Heart Diseases 174 4 .. .. 6 101 63 38 27 24 55 30 81 Accidents 83 13 7 6 7 28 22 17 12 12 34 8 42 Suicides 13 .. .. .. 3 10 .. 2 2 .. 8 3 8 All other causes 631 131 29 8 20 247 196 123 90 85 210 123 379 All causes 2180 402 212 55 79 887 545 479 306 285 746 364 *1279 * 918 of these were Non-Parishioners. 33 TABLE VI. — D1strict Births and Deaths for the 52 weeks ending December 26th, 1903. Population in 1891. Births. Deaths. Males. Fmls. Males. Fmls. All Souls 35,391 302 305 251 228 Rectory 19,849 200 187 162 144 St. Mary 18,099 211 204 132 153 Chr1st. Church 39.536 533 470 407 339 St. John 20,426 214 192 162 202 Total 133,301 146 0 1358 1114 1066 Note.—In the above the births and deaths hare been corrected, strangers have been eliminated, and extra-parochial deaths and others have been allotted to their proper sub-d1strict. 34 REGISTER OF SANITARY WORK Year ending December 31st, 1903. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. 11. Phillips, Special Duties. Miss F. A. Baker. Total. Mr. J. Hodges, No. 1 District. Mr. A. Perry, N<>. 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. 645 748 747 398 447 ... ... ... ... ... 2985 Tenements 638 193 587 745 489 ... ... ... ... ... 2652 Underground Dwellings 155 14 247 102 206 ... ... ... ... ... 724 Dairies, Milk Shops, Cow Houses 76 31 19 48 92 ... ... ... ... ... 266 Slaughter Houses 24 39 48 39 83 ... ... ... ... ... 233 Yards, Stables, and Mews 340 163 379 523 603 ... ... ... ... ... 2008 Smoke Shafts ... ... ... ... ... ... ... ... 24 ... 24 Offensive Trades and Effluvia Businesses ... ... 2 ... ... ... ... ... 5 ... 7 Refuse Receptacles 92 79 45 147 141 ... ... ... ... 19 563 Enquiries re non-removal of refuse 65 62 65 86 156 ... ... ... ... 26 460 Removal of Bodies to Mortuary 2 2 4 ... ... ... ... ... ... ... 8 Visits to Works in Progress 1828 2405 1585 2357 1817 ... ... ... 138 102 10232; Miscellaneous Inspections 1225 1280 910 2106 1284 ... ... ... 249 807 7861 UNWHOLESOME FOOD:— Number of seizures made ... 2 1 ... ... ... ... ... ... ... 3 INFECTIOUS DISEASE:— Cases Isolated 14 11 10 9 10 ... ... ... ... ... 54 Cases removed to Hospital 135 104 125 127 113 ... ... ... ... ... 604 Rooms Disinfected 227 191 154 204 239 ... ... ... ... ... 1015 NEW DRAINAGE Number of Plans Passed 66 86 45 123 108 ... ... ... 6 5 439 New Pipe Drains (feet) 8846 1207 3950 11146 17845 ... ... ... 374 200 54435 Houses where defects in existing Drainage have been detected and remedied 101 116 101 71 111 ... ... ... 2 ... 502 REG1stER OF SANITARY WORK Year ending December 31st, 1903. PUBLIC HEALTH DEPARTMENT. D1strict Inspectors. Mr. R. Phillips, Special Duties. Miss F. A. Baker. Total Mr. J. Hodges, No. 1 D1strict. Mr. A. Perry, No. 2 D1strict. Mr. D. J. Andrews No. 3 D1strict. Mr. T. Gorniot, No. 4 D1strict. Mr. W. Yeo, No. 5 D1strict. Factory and Workshop Aet. Enquiries as to Occupation ... ... ... ... ... ... ... ... 148 139 287 Periodical Inspections:— Factories ... ... ... ... ... ... ... ... 28 5 33 Workshops ... ... ... ... ... ... ... ... 625 1179 1804 Bakehouses ... ... ... ... ... ... ... ... 485 17 502 Restaurants, &c. ... ... ... ... ... ... ... ... 508 2 510 Homeworkers' Premises ... ... ... ... ... ... ... ... 159 682 841 Domestic Workshops ... ... ... ... ... ... ... ... 54 35 89 Food and Drugs Aet. ADULTERATION. Samples collected for Analysis 120 122 125 120 109 ... ... ... ... 25 621 Correspondence, Legal Procedure, &e. Complaints received 93 107 142 201 197 ... ... 53 76 869 Letters and Intimations relating to Abatement of Nuisances 228 190 257 327 252 ... ... ... 19 89 1362 Statutory Notices Served 56 37 34 76 106 ... ... ... 11 1 321 proceedings taken before Mag1strates ... ... 6 10 3 ... ... ... ... ... 19 (1) Under Public Health Act 1 2 5 3 ... ... ... ... ... ... 11 (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) ,, Food ft Drugs Act ... ... 1 ... 1 ... ... ... ... ... 2 (4) ,, Housing of the Working Classes Act ... 23 ... 1 ... ... ... ... ... ... 24 Reports made to Medical Officer of Health 385 310 348 635 706 ... ... ... 247 243 2874 36 INDEX TO MONTHLY REPORTS. B page Bakehouses 3,13 Bentinck Court and Williams' Cottages, Closing, of under the Housing Acts 106 Births and Deaths— January 2 February 12 March 22 April 36 May 46 June 58 July 72 August 84 September 84 October 104 November 116 Birth and Death rates per thousand of population— J anuary 2 February 12 March 23 April 37 May 47 June 59 July 72 August 85 September 85 October 104 November 116 By-laws as to Waterclosets 48-50 c Cleansing of Persons Act 3, 38 D Deaths, Causes of, for— January 7 February 18 March 30 April 42 May 54 June 67 July 79 August 95 September 96 October 112 November 122 Dustbins improper 14 G Gee's Court, Nos. 6, 9 and 11, Closing of, under the Housing Acts 48, 74, 87 Great Barlow Street, No. 34, prosecution of owner under Public Health Act 86 H page Harrow Street, prosecution of owner of No. 4, under Public Health Act 86 High Street, St. John's Wood, Closing of No. 11, under the Housing Acts 118 Hortin, Maria, prosecution of, for Milk Adulteration 61 Hospital of St. John and Elizabeth, Causes of Death in— January 4 February 15 March 28 April 40 May 52 June 66 July 76 August . 88 September 88 October 109 November 119 Housing of the Working Classes Acts 48, 74, 87, 106, 118 I Infectious disease, notifications of, for— J anuary 5 February 16 March 26 April 39 May 51 June 65 July 77 August 92 September 93 October 110 November 120 Measles and School closure 60 Measles, Local Government Board Order 24 Meteorology of the D1strict for— January 1 February . 12 March 21 April 35 May 45 June 57 July 71 August 83 September 83 October 103-104 November 115 37 INDEX TO MONTHLY REPORTS—continued. page liddlesex Hospital, Causes of Death in— January 4 February 15 March 28 April 40 May 52 June 66 July 76 August 88 September 88 October 109 November 119 ortuary, Electric Lighting and General Improvements in 3 ontagu Mews, W., prosecution of occupier for non-removal of manure 86 N ightingale Street Scheme, Provisional Order as to 107 P addington Street, prosecution of owner of No. 18, under the Public Health Act 87 omeroy v. Malvern D1strict Council 60 rincess Street, E.R., prosecution of owner of No. 107, under Public Health Act 118 posecutions under the Public Health Act 14, 86; 106, 118 Q aeen Charlotte's Hospital, Causes of Death in— J anuary 4 February 15 March 28 April 40 May 52 June 66 July 76 August 88 September 88 October 109 November 119 teen Street Dwellings, opening of 74 R im, adulterated 25 s le of Food and Drugs Acts, work under 25, 32, 61, 62, 87, 98, Maiylebone Infirmary, Notting Hill, Causes of Death in— January 4 February 15 March 28 page April 40 May 52 June 66 July 76 August 88 September 88 October 109 November 119 Samaritan Hospital, Causes of Death in— J anuary 4 February 16 March 28 April 40 May 52 June 66 July 76 August 88 September 88 October 109 November 119 Sanitary Work, Reg1ster of, for— J anuary 8-9 February 19-20 March 33-34 April 43-44 May 55-56 June 68-69 July . .80-81 August 99-100 September 101-102 October 113-114 November 123-124 Shelter, Grove Road 38 U Upper Berkeley Street, prosecution of owner of N0.69, the, under Public Health Act 80 V Ventilation of Bakehouses 14 w Wellington Place, prosecution of owner of Nos. 3 and 4, under Public Health Act 106 Williams' Cottages, Closing of, under the Housing Acts 106 Workhouse, Causes of Death in— January 4 February 15 March 28 April 40 May 52 June 66 July 76 August 88 September 88 October 109 November 119 38 INDEX TO ANNUAL KEPORT. page A Aliens, Increase of 18 All Souls Birth and Death-rate 9 ,, Causes of Death in, Table V 32 „ Infectious Sickness in, Table III. 30 Andrews, D. J., Reg1ster of Sanitary Work 34, 35 Arsenic in Food 24 Artizans' Dwellings 12 B Bakehouses 16 Baker, Miss, Reg1ster of Sanitary Work 34, 35 „ Report of 18 Bentinck Court and Williams' Cottages, Closing of 20 Births and Deaths, Table VI. 33 c Chr1st Church, Birth and Death-rate 9 ,, „ Causes of Death in, Table V. 32 „ ,, Infectious Sickness in, Table III 30 Cleansing of Persons Act 20 Clerical Work 23 Curtis, H. E., Work of 23 Coffee Shops, Inspection of 17 Conveniences, Women's 19 D Deaths, Causes of, Table V 32 Devonshire Place 19 Dining Rooms 17 Diphtheria 13 Disinfection 22 E Enteric Fever 11 Erin House 14 Extra-parochial Institutions in 9, 10 F Factories and Workshops 16 PAGE G Gee's-court, Closing of Nos. 6 and 11 203 Gorniot, T., Reg1ster of Sanitary Work 34, 353 Great Portland Street, Prosecution of Owner of No. 125 203 Great Barlow Street, Prosecution of Owner of No. 34 202 H Harrow Street, Prosecution of Owner of No. 4 202 Health of D1strict during 1903 11 High Street, St. John's Wood, Closing of No. 166 202 Hodges, J., Reg1ster of Sanitary Work 34, a Horace Street Dwellings, Death-rate and Sickness-rate of 14 Housing of the Working-Classes Act, 1903 24, 252 Howe, W. J., Clerical Work of 232 I Infectious Sickness, Table III. a K Kilgallin, Miss, Work of , 21 M Measles and Whooping-Cough 12 Meteorology of 1903 ??? Milk, Analysis of 24, 28 Montagu Mews, Prosecution of Occupier for Non-removal of Manure 20 Mortuary and Coroner's Court 20 N Nightingale Street Site 1 Nuisances Abated in Workshops 1 O Out-workers, Number of 1 39 INDEX TO ANNUAL REPORT—continued. P page Perry, A., Reg1ster of Sanitary Work 34, 35 Phillips, R., Reg1ster of Sanitary Work 34, 35 Report of 16 Prosecutions under the Public Health Act . 20 Prince's Street, Prosecution of Owner of No. 107 20 Q Queen Street Buildings 19 R Rectory, Birth and Death-rate of 9 „ Causes of Death in, Table V. 32 ,, Infectious Sickness in, Table III. 30 Restaurants, Inspection of 17 s St. George's Dwellings 14 St. John, Birth and Death-rate of 9 „ Causes of Death, Table V. 32 „ Infectious Sickness in, Table III 30 St. Mary, Birth and Death-rate of 9 „ Causes of Death in, Table V. 32 „ Infectious Sicknessin,Table III. 30 St. Mary's Dwellings 14 St Michael's Dwellings 14 Sale of Food and Drugs Acts, Table 11.24,28, 29 Salt, Arsenical 24 page Sanitary Accommodation in Factories 26 Sanitary Legislation 24 Sanitary Work, 1903 15, 16, 34, 35 Scarlet Fever 11 Shelter in Grove Road 22 Smoke Nuisance 17 Spirits, Analysis of 24 T Trade Nuisanccs 17 Typhoid Fever, see Enteric Fever u Underground Conveniences 17 Upper Berkeley Street, Prosecution of Owner of No. 69 20 Urinals, Public 17 w Wharncliffe Gardens, Death and Sickness, Rate of 13 Williams's Cottages, Closing of 20 Windsor Dwellings 14 Workshops 18 Y Yeo, W., Reg1ster of Sanitary Work of 34, 35 THE SANITARY CHRONICLES of the BOROUGH OF ST. MARYLEBONE DURING JANUARY, 1903. 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, February 5th, 1903. Vol. XXIII. No. 1. The week ending January 3rd was rainy, with bright intervals. Minimum temperature, 30.5°; maximum, 52.0°; mean, 41.2°. On six days rain fell up to 0.92 inch. The Winds were WNW. 8'3 hours of sunshine were reg1stered in Eegent's Park. Mean barometer, 29.l inches. The week ending January 10th was mild, wet and gloomy. Minimum temperature, 37.0°; maximum, 52.0°; mean, 44.4°. Rain fell every day total fall 1.0 inch. Winds WSW. Only 4 hours of sunshine were reg1stered. Mean barometer low, 29.7 inches. The week ending January 17th was bitterly cold owing to low temperatures and strong easterly winds. Minimum temperature, 26.0°; maximum, 40.0°; mean, 30.8°. Slight snow fell on two days (0.04 inch). Winds E and ENE. Sunshine about 3 and a-half hours. Mean barometer, 30.0 inches. The week ending January 24th was milder; a sudden thaw set in and sleet, falling on the frozen ground, became a coherent film of ice. Minimum temperature, 34.0°; maximum, 48.8°; mean, 41.8°. On three days rain fell (0.41 inch). Winds SE and SW. Sunshine reg1stered only 4 hours. Mean barometer 30.0° inches. The week ending January 31st was brighter and milder than the preceding four weeks. Minimum temperature, 38.8°; maximum, 51.5°; mean, 47.7°. On three days rain fell (0.36 inch). Winds SW and WSW. Sunshine reg1stered in Eegent's Park 8 hours. Mean barometer 30.0 inches. 2 Births and Deaths. During the five weeks ending January 31st there have been registered 292 births and 266 deaths. These births and deaths are divided among the five sub-districts as set forth in Table III. Seventy-nine of the deaths were extra-parochial, as follows :— St. Marylebone Infirmary, Notting Hill 53 North-Western Fever Hospital 2 St. Mary's Hospital 5 University Hospital 1 St. George's Hospital 1 Children's Hospital, Great Ormonde Street 1 „ Paddington 1 Cancer Hospital 1 Hanwell Asylum 1 Leavesden Asylum 7 Banstead Asylum 1 Manor Asylum, Epsom 1 Hostel of God 1 St. Pancras Workhouse 1 Clapham Maternity 1 In Street 1 Total 79 The birth and death-rates, as deduced from the five weeks' statistics, are as follows :— All Souls, birth-rate 17.3 ; death-rate 14.1. Kectory, birth-rate 22.0 ;] death-rate 19.4. St. Mary, birth-rate 17.8 ; death-rate 19.0. Christ Church, birth-rate 32.1 ; death-rate 25.0. St. John, birth-rate 19.3; death-rate 26.9. The whole district, birth-rate 22.8; death-rate 20.8. The average death-rates for five years (1897 to 1902) for the corresponding period were as follows :—All Souls, 16.4; Itectory, 26.2; St. Mary, 20.2; Christ Church, 19.5; St. John, 24.6; 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: 3 TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE FIVE WEEKS ENDING JANUARY 31ST, 1903, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FIIOM ALL CAUSES:— Total Deaths. - 5 weeks ending Jan. 31st, 1903. Proportion of thedeaths to 1,000 deaths from all causes. 5 weeks ending Jan. 31,1903. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1897-1902. 1. Deaths from the chief Zymotic Diseases 40 150 3.13 2.31 2. Pulmonary, other than Phthisis 74 278 5.77 6.15 3. Tubercular 33 124 2.58 2.27 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza,Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. The Health of the District. The rates for death and sickness during January have been average rates. It is always a month of high mortality mainly due to fatal chest affections. There has not been a single case of small pox, and other zymotic maladies have not been unduly prevalent. Bakehouses. An inspection of the S4 so called underground bakehouses has been made, and the results will be reported to the Public Health Committee at their next meeting. The Cleansing of Persons Act. During the month 406 males and 12 females took advantage of the cleansing baths, and had their clothes disinfected. The Mortuary. This handsome building will be now lit by the electric light, and also connected with the Telephone system. When 4 the connection is laid the Town Hall, the Baths and Washhouses, the Sanitary Offices and the Mortuary will all be in communication with each other. It was specially important to unite the Mortuary and Coroner's Court with the system, because each year a large number of cases of death occur which require instant removal to the Mortuary. TABLE II.—Giving the Canses of Deaths during the five Weeks ending January 31st, 1903, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John & Elizabeth, and the Marylebone Infirmary, Netting Hill, W. Middlesex Hospital Queen Charlotte's Sospital. Samaritan Hospital. Workhouse Notting Hill Infirmary. Hospital of St. John & Elizabeth, Grove Rd. Smallpox .. .. .. .. .. .. Influenza .. .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. Diphtheria .. .. .. .. .. .. Typhoid Fever .. .. .. .. .. .. Diarrhœa .. .. .. .. .. .. Erysipelas .. .. .. .. 2 .. Pneumonia and Pleurisy 3 .. .. 2 2 .. Pyæmia .. .. .. .. .. .. Syphilis .. .. 1 .. .. .. Cancer 10 .. .. .. 3 .. Phthisis & Tuberculosis 8 .. .. .. 12 1 Rheumatism .. .. .. .. .. .. Apoplexy .. .. .. .. .. .. Paralyasis .. .. .. .. 2 .. Bronchitis 1 .. .. .. 13 .. Asthma .. .. .. .. .. .. Peritonitis .. .. .. .. .. .. Disease of Brain .. .. .. .. .. .. ,, Heart 2 .. .. 2 7 .. ,, Kidney .. .. .. .. .. .. ,, Liver .. .. .. .. .. .. ,, Uterus .. .. .. .. .. .. „ Orary .. .. .. .. .. .. Parturition .. .. .. .. ..2 .. Diabetes .. .. .. .. .. .. Fractures and Injuries 3 .. .. .. .. .. Old Age .. .. .. .. .. .. Low Vitality, Infants .. .. .. .. .. .. Premature Birth .. .. .. .. .. ... Other causes 10 1 .. 3 10 1 Total *37 †1 **1 7 53 ‡2 * Of tlie 37 deaths in the Middlesex Hospital, 32 were those of non-parishioners, † The 1 death in Queen Charlotte's Hospital was that of an infant. † One of the 2 deaths in St. John's Hospital was that of a non-parishioner. ** The death in the Samaritan Hospital was that of a non-parishioner. 5 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. MAliYLEBONE, during January, 1903 ; 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 20,420 133,301 (c) Registered Births 59 42 31 122 38 292 (d) Aged under 5 or over 5 Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 6 upward- Under 5 5 upwards Under 5 5 upwards New Casks of Sickness in kach Locality coming to thk knowlkdgk op thk medical Ofpickr op Hkalth. 1. Chicken Pox 1 1 .. .. 1 1 1 1 1 .. 4 3 2. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 3. Scarlatina .. 3 1 1 .. 1 .. 3 5 3 10 11 4. Diphtheria 1 1 .. 2 .. 2 .. 2 2 .. .. 7 5 Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fkvkrs. 6. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 7. Enteric or Typhoid .. 2 .. .. .. 2 .. 1 .. 2 .. 7 8. Continued .. .. .. .. .. .. .. .. .. .. .. .. 9. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 10. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 11 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 12 Erysipelas. .. 1 .. 3 .. 2 .. 5 1 2 1 13 Numbkr op such Cases Removed prom their Homes in the skvkral Localitiks por Treamknt in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina .. 1 1 1 .. 1 4 3 5 2 10 8 3. Diphtheria 1 1 .. 2 .. 2 .. 2 1 .. 2 7 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 1 .. .. .. 2 .. .. .. 2 .. 5 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. 3 .. 1 .. 5 .. .. .. 9 6 TABLE IV.—District Births and Deaths for the five weeks ending january slst, 1903. Population in 1891. Births. Deaths. Males. Fmls. Males. Fnil All Souls 35; 91 37 22 26 22 Rectory 19.849 25 17 20 17 St. Marv 18,099 20 11 10 23 Christ Church 39.536 70 52 40 55 St. John 20,426 21 17 26 27 Total 133,301 173 119 122 144 Note.—In the above the births and deaths have all been properly corrected, strangers have been eliminated, and extra-p.irochial deaths and others have been allotted to their proper sab-district. - 7 TABLE V.—Causes of, and Ages at, Death during the 5 weeks ending January 7th, 1903, in the Borough of St. Marylebone. CAUSES Or 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 Ub 15 and under 25. 25 and under 65. 65 and upwards. All Souls. Rectory. St. Mary. Christ Church. St. John. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 2 2 .. .. .. .. .. 2 .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough 21 4 14 3 .. .. .. 1 4 3 5 8 .. Diphtheria and Membranous Croup 4 1 3 .. .. .. .. 2 .. .. 1 1 .. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric 2 .. .. .. .. 2 .. 1 .. .. 1 .. .. Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 6 1 .. .. .. 3 2 1 .. 1 3 1 .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 2 .. 1 .. .. .. 1 .. .. 1 .. 1 .. Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 3 .. .. .. .. 1 2 .. .. 2 .. 1 3 Other Septic Diseases. .. .. .. .. .. .. .. .. .. .. .. .. 3 Phthisis 24 .. 1 .. 1 20 2 3 1 6 8 6 10 Other Tubercular Diseases 0 2 5 1 .. I .. 1 1 .. 4 3 8 Cancer, Malignant, Disease 15 .. .. .. .. 11 4 5 .. 3 4 3 17 Bronchitis .. 46 5 3 .. .. 9 29 4 5 6 26 5 17 Pneumonia 28 6 7 1 1 9 4 4 7 2 10 5 8 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Respiratory Organs .. .. .. .. .. .. .. .. .. .. .. .. .. Alcoholism Cirrhosis of Liver 3 .. .. .. .. 1 2 .. 1 .. 2 .. .. Venereal Diseases .. .. .. .. .. .. .. .. .. .. .. .. Premature Birth 2 2 .. .. .. .. .. 1 .. .. .. 1 .. Diseases and Accidents .. .. .. .. .. .. .. .. .. .. .. .. .. Heart Diseases 21 .. .. .. .. 13 8 3 7 .. 5 6 12 Accidents 9 2 1 .. 1 1 4 3 2 1 3 .. 6 Suicides 1 .. .. .. .. 1 .. .. .. .. 1 .. 1 All other causes 68 18 4 1 1 26 18 17 9 8 22 12 30 All causes 266 43 39 • 6 4 98 76 48 37 33 95 53 119* *0f these 34 were non-parishioners. 8 REGISTER OF SANITARY WORK Month ending 31st January, 1903. 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. I nspections /Dwelling Houses, &c 53 47 60 39 45 ... ... ... ... ... 244 Tenements 48 6 50 60 41 ... ... ... ... ... 205 Underground Dwellings 11 4 25 12 18 ... ... ... ... ... 70 Dairies, Milk Shops, Cow Houses 7 2 ... 4 9 ... ... ... ... ... 22 Slaughter Houses 1 3 ... ... 3 ... ... ... ... ... 7 Yards, Stables, and Mews 22 16 25 30 32 ... ... ... ... ... 123 Smoke Shafts ... ... ... ... ... ... ... ... 3 ... 3 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... 1 ... 1 Refuse Receptacles 10 9 6 8 10 ... ... ... ... 2 45 Enquiries re non-removal of refuse 9 11 12 8 7 ... ... ... ... ... 47 Removal of Bodies to Mortuary ... ... ... ... ... ... ... ... ... ... ... Visits to Works in Progress 240 236 250 288 237 ... ... ... ... 19 1270 Miscellaneous Inspections 75 60 50 180 69 ... ... ... ... 70 504 UNWHOLESOME FOOD. Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE Cases Isolated 2 5 ... 1 1 ... ... ... ... ... 9 Cases removed to Hospital 5 8 9 9 3 ... ... ... ... ... 34 Rooms Disinfected 11 13 9 15 11 ... ... ... ... ... 59 NEW DRAINAGE Number of Plans Passed 8 6 7 18 3 ... ... ... ... 3 45 New Pipe Drains (feet) 856 730 500 650 1612 ... ... ... 8 80 4436 Houses where defects in existing Drainage have been detected and remedied 10 9 6 8 11 ... ... ... ... ... 44 9 REGISTER OF SANITARY WORK Month ending 31st January, 1903. 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. Gomiot, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. R. Phillips, Special Duties. Miss F. A. Baker Total. Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 20 5 25 Periodical Inspections:— Factories ... ... ... ... ... ... ... ... 3 2 5 Workshops ... ... ... ... ... ... ... ... 36 140 176 Bakehouses ... ... ... ... ... ... ... ... 78 ... 78 Restaurants, &c. ... ... ... ... ... ... ... ... 40 ... 40 Homeworkers' Premises ... ... ... ... ... ... ... ... 32 62 94 Domestic Workshops ... ... ... ... ... ... ... ... 12 4 16 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 7 ... 5 ... ... ... ... ... ... 19 31 Correspondence, Legal Procedure, &c. Complaints received 4 ... 13 14 11 ... ... ... 3 4 49 Letters and Intimations relating to Abatement of Nuisances 15 ... 23 28 21 ... ... ... 4 9 100 Statutory Notices Served 10 ... 6 12 11 ... ... ... 1 ... 40 Proceedings taken before Magistrates . ... ... ... 1 3 ... ... ... ... ... ... (1) Under Public Health Act ... ... ... ... ... ... ... ... ... ... ... (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) „ Food & Drugs Act ... ... ... ... ... ... ... ... ... ... ... Reports made to Medical Officer of Health 28 10 35 49 58 ... ... ... ... 20 200 •'. -.i THE SANITARY OHRONKLES OF THE BOROUGH OF ST. MARYLEBONE DURING FEBRUARY, 1903. 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. Town Hall, St. Mabylebone, Mabch 6th, 1903. Vol. XX No. 2. The week ending February 7th was cool and dull. Minimum temperature, 30.0°; maximum, 52.0°; mean, 43.8°. On two days rain and slight snow fell. Winds SW and WSW. About 13 hours of sunshine were registered in Regent's Park. Mean barometer, 29.8 inches. The week ending February 14th was dull and rainless. Minimum temperature, 37.0°; maximum, 56.0° ; mean, 48.7°. Only 10 hours out of a possible 67 were registered in Regent's Park. The winds were WNW. Mean barometer, 30 -2 inches. The week ending February 21st was much brighter than the preceding. Minimum temperature, 28.0°; maximum, 58.0°; mean, 42.9°. Sunshine 25%. On two days showers fell to the extent of .04 inch. Mean barometer, 30.1 inches. The week ending February 28th was one of storm. Minimum temperature, 36.2°; maximum, 55.0°; mean, 40.9°. On four days showers of hail and rain gave 0'7 inch of rainfall. On every day there were squalls of wind, but a gale of hurricane force blew on the 27th. The direction of the winds was SW and WSW. The sunshine amounted to 13 hours, equal to 17 % Mean barometer 29.6° inches. 12 Births and Deaths. During the four weeks ending February 28th there have been registered 254 births and 168 deaths. These births and deaths are divided among the five sub-districts as set forth in Table IV. Seventy-eight of the deaths were extra-parochial, as follows :— St. Marylebone Infirmary, Notting Hill 43 North-Western Fever Hospital 2 Western Fever Hospital 2 University Hospital 1 St. Thomas's Hospital 2 St. George's Hospital 1 Westminster Hospital 1 National Hospital 1 French Hospital 1 Hostel of God 1 Hanwell Asylum 2 Colney Hatch Asylum 4 Manor Asylum, Epsom 1 Hoxton House Asylum 1 Caterham Asylum 1 Claybury Asylum 2 Peckham House Asylum 1 In the Streets 1 Total 68 The birth and death-rates, as deduced from the four weeks' statistics, were as follows :— All Souls, birth-rate 19.1 ; death-rate 14.4. Rectory, birth-rate 19.6 ; death-rate 15.7. St. Mary, birth-rate 25.3 ; death-rate 15.8. Christ Church, birth-rate 32.9; death-rate 19.4, St. John, birth-rate 23.5; death-rate 15.3. The whole district, birth-rate 24.8; death-rate 16.4. The average death-rates for five years (1897 to 1902) for the corresponding period were as follows :—All Souls, 19.4; Rectory, 31.9; St. Mary, 24.6; Christ Church, 25.0 ; St. John, 20.7 ; the whole district, 23.6. The following table gives, as usual, facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes. 13 TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE FOUR WEEK. ENDING FEBRUARY 28th, 1903, FROM CERTAIN CLASSES OF DISEASI AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 4 weeks ending Feb. 28th, 1903. Proportion ofthe deaths to 1,000 deaths from all causes. 4 weeks ending Feb. 28,1903. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1897-1902. 1. Deaths from the chief Zymotic Diseases 19 113 1.86 2.81 2. Pulmonary, other than Phthisis 36 214 3.52 4.84 3. Tubercular 23 137 2.25 2.47 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. Chest affections generally have been below the average. A glance at the curve, opposite page 14 shows that scarlet fever is increasing, and above the average. Nevertheless, as regards fatal fevers, these have been below the average. This combination of causes gives a death-rate singularly low for the month. It has, indeed, been a most favourable winter for the very old and the very young—the two classes which suffer most from cold, fog, and damp. Bakehouses. All the bakehouses in the district which are technically underground have been inspected. Over fifty were found either first-class as to light, ventilation, and construction, or sufficiently good as to admit, with very little amendment, of being recommended for certification, and certificates to 14 these have been sanctioned. Some others remain which are under the consideration of the Public Health Committee. A few of them, having but one or two years' leases to run, will probably lapse, extensive structural alterations being required. In all those certified the ventilation was found to be good, the oven fires connected with long flues producing sufficient " head" to cause the outside air to press through every crevice. It must, however, be observed that on account of the cold draughts in bakehouses, the workers almost invariably stop up ventilating openings. The owner of a bakehouse may spend whatever money he pleases as to ventilation; he may carry up special flues, provide electric fans, and what not—to only discover that all appliances which can be easily got at have been bunged up with sacking or other obstructions. The writer found one particular bakehouse, which, of course, cannot under present conditions, be recommended for a certificate, quite exceptionally bad as regards ventilation. In this case the bread and pastry is baked by gas. Rows upon rows of gas burners heat various ovens, without any flue carrying off the fumes. In the centre of the room is, however, a large square ventilating shaft passing up through the roof. This shaft was of course at the time of visit found stuffed up by an old sack. Even after removal of the sack the carbonic acid gas in the air was found to be 22 per 10,000 (ordinary air being from 4 to 8 per 10,000). Besides this it contained traces of the poisonous carbon monoxide gas. Prosecution under the Public Health (London) Act. The considerable number of notices with regard to sanitary matters have been obeyed without trouble, save in one instance. The occupier of 125, Great Portland Street, was summoned before Mr. Plowden for placing an improper receptacle on the kerb. The magistrate dismissed the summons on the purely technical ground that no evidence was before him that a notice had been hung on the street lamps, in compliance with the Act. He, however, stated that the Dust Inspector could take out a fresh summons if he was prepared to produce such evidence. 15 TABLE II.—Giving the Causes of Deaths during the four Weeks ending February 28th, 1903, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John & Elizabeth, and the Marylebone Infirmary, Not ting 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 .. .. .. 2 1 .. Erysipelas .. .. .. .. .. .. Pneumonia and Pleurisy 2 .. .. 1 3 .. Pyæmia .. .. .. .. .. .. Syphilis .. .. .. .. .. .. Cancer 7 .. .. .. 4 .. Phthisis & Tuberculosis 4 .. .. .. 7 .. Rheumatism .. .. .. .. 1 .. Apoplexy .. .. .. .. .. .. Paralysis .. .. .. .. 3 Bronchitis 1 .. .. .. 11 .. Asthma .. .. .. .. .. .. Peritonitis .. .. .. .. .. .. Disease of Brain .. .. .. .. .. .. ,, Heart 1 .. .. .. 2 .. ,, Kidney .. .. .. .. .. .. „ Liver .. .. .. .. .. .. „ Uterus .. .. .. .. .. .. ,, Ovary .. .. .. .. .. .. Parturition .. .. .. .. .. .. Diabetes .. .. .. .. .. .. Fractures and Injuries 1 .. .. .. 2 .. Old Age .. .. .. .. 2 .. Low Vitality, Infants .. .. .. .. .. .. Premature Birth 1 4 .. .. .. .. Other causes 10 1 2 5 7 .. Total *27 †5 2 8 43 •• * Of the 27 deaths in the Middlesex Hospital, 25 were those of non-parishioners. † Four of the 5 deaths in Queen Charlotte's Hospital were those of non-parishioners; they were all infants. 16 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 February, 1903 ; 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 52 30 35 100 37 254 (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. 2. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 3. Scarlatina 2 4 2 5 1 1 2 11 1 7 8 28 4. Diphtheria 2 4 2 2 1 1 1 .. 2 3 8 10 5. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 6. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 7. Enteric or Typhoid .. 1 .. 1 .. 1 .. .. .. 3 .. 6 8. Continued .. .. .. .. .. .. .. .. .. .. .. .. 9. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 10. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 11 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 12 Erysipelas. .. 1 .. 10 .. .. .. 8 .. 1 .. 20 Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 2 3 .. 5 .. .. 2 7 1 7 8 23 3. Diphtheria 2 3 .. 2 .. 1 1 .. 1 3 4 9 4. Membranous .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. 1 .. .. .. .. .. .. .. 4 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puorperal .. .. .. .. .. .. .. .. .. .. .. .. 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas .. 1 .. 10 .. .. .. 4 .. .. •• 15 17 TABLE IV.—District Births and Deaths for the four weeks ending february 28th, 1903. Population in 1891. Births. Deaths. Mules. Fmls. Males. Fmlsp All Souls 35, 91 23 29 21 18 Rectory 19.849 12 18 8 16 St. Mary 18,099 22 13 13 9 Christ Church 39,536 58 42 29 30 St. John 20,426 23 14 4 20 Total 133,301 138 116 75 93 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. 18 TA RLE V.—Causes of, and Ages at, Death during the 4 weeks ending February 28th, 1903, 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 35. 25 and under 65. ! 65 and upwards. All Souls. Rectory. St. Mary. Christ Church. St. John. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 1 1 .. .. .. .. .. .. .. 1 .. .. . . Scarlet Fever 2 .. 2 .. .. .. .. .. .. .. 1 1 2 Whooping Cough 6 4 2 .. .. .. .. .. .. .. 6 .. .. Diphtheria and Membranous Croup 1 .. .. .. .. •• .. 1 .. .. .. .. 1 Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fkvkk Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric .. .. .. .. .. .. .. .. .. .. .. .. .. Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 2 .. .. .. •* 2 .. 1 .. .. .. 1 .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 7 6 .. .. .. .. .. 2 1 .. 4 .. 3 Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever.. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. Other Septic Diseases. 3 .. .. .. .. 3 .. .. 1 .. .. .. 2 Phthisis 19 2 .. 2 5 9 1 5 1 2 9 2 15 Other Tubercular Diseases 4 1 .. .. .. 1 .. 1 .. 1 .. 2 .. Cancer, Malignant Disease 13 .. .. .. .. 7 6 2 2 6 2 1 13 Bronchitis 28 7 3 .. .. 0 13 6 4 2 11 5 13 Pneumonia 8 1 1 .. .. 6 .. 2 2 1 3 .. 8 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Respiratory Organs .. .. .. .. .. .. .. .. .. .. .. .. .. Alcoholism Cirrhosis of Liver 2 .. .. .. .. .. .. .. 1 .. 1 .. 1 Venereal Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. Premature Birth 5 6 .. .. .. .. .. 3 1 1 .. .. 6 Diseases and Accidents of Parturition .. .. .. .. .. .. .. .. .. .. .. .. 1 Heart Diseases 12 1 .. .. 1 7 .. 1 2 .. 7 2 4 Accidents 6 1 1 .. 1 3 .. 2 .. 1 3 .. 3 .. .. .. .. .. .. .. .. .. .. .. .. .. All other causes 49 7 .. 1 .. 28 13 11 9 7 12 10 38 All causes 168 36 9 6 7 74 as 39 24 22 59 24 110* *29 of these were uon-parishioners. 19 REGISTER OF SANITARY WORK Month ending February 28th, 1903. PUBLIC HEALTH DEPARTMENT. District Inspectors. E. Lumley, Dust Inspector. Mr. 11. 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 48 53 45 19 39 ... ... ... ... ... 204 Tenements 38 35 32 27 ... ... ... ... ... 132 Underground Dwellings 14 20 10 15 ... ... ... ... ... 59 Dairies, Milk Shops, Cow Houses 2 1 2 6 7 ... ... ... ... ... 18 Slaughter Houses 2 3 ... 1 ... ... ... ... ... 6 Yards, Stables, and Mews 21 7 35 35 46 ... ... ... ... ... 144 Smoke Shafts ... ... ... ... ... ... ... ... ... ... ... Offensive Trades and Effluvia Businesses ... ... .... ... ... ... ... ... ... ... ... Refuse Receptacles 6 4 5 13 10 44 ... ... ... ... 82 Enquiries re non-removal of refuse 4 7 6 6 7 48 ... ... ... 3 81 Removal of Bodies to Mortuary ... ... ... ... ... ... ... ... ... ... ... Visits to Works in Progress 170 180 150 260 270 ... ... ... 59 13 1102 ^ Miscellaneous Inspections 52 86 45 180 91 150 ... ... 76 67 747 UNWHOLESOME FOOD. ... ... ... ... ... ... ... ... ... ... ... Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE Cases Isolated ... 1 ... 1 2 ... ... ... ... ... 4 Cases removed to Hospital 16 8 9 10 11 ... ... ... ... ... 54 Rooms Disinfected 24 20 9 15 26 ... ... ... ... ... 94 NEW DRAIN AGE Number of Plans Passed 6 5 ... 8 5 ... ... ... 2 ... 26 New Pipe Drains (feet) 890 1036 325 1206 1468 ... ... ... 120 ... 5045 Houses where defects in existing Drainage have been detected and remedied 8 6 5 8 7 ... ... ... 1 ... 35 20 REGISTER OF SANITARY WORK Month ending February 28th, 1903. PUBLIC HEALTH DEPARTMENT. District Inspectors. E. Lumley, Dust Inspector. 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 ... ... ... ... ... ... ... ... 18 4 22 Periodical Inspections : — Factories ... ... ... ... ... ... ... ... ... 2 2 Workshops ... ... ... ... ... ... ... ... 89 148 237 Bakehouses ... ... ... ... ... ... ... ... 78 10 88 Restaurants, &c. ... ... ... ... ... ... ... ... 40 ... 40 Homeworkers' Premises ... ... ... ... ... ... ... ... 10 49 59 Domestic Workshops ... ... ... ... ... ... ... ... ... 2 2 Food and Drugs Act. f ADULTERATION. Samples collected for Analysis 13 19 15 ... 6 ... ... ... ... ... 53 Correspondence, Legal Procedure, &c. Complaints received 9 8 10 30 9 10 ... ... 5 8 89 Letters and Intimations relating to Abatement of Nuisances 25 13 20 36 27 30 ... ... 2 5 158 Statutory Notices Served 4 2 ... 10 7 ... ... ... ... ... 23 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 23 29 63 58 30 ... ... 33 20 288 THE SANITARY CMMCLES OF THE BOROUGH OF ST. MARYLEBONE DURING MARCH, 1903, Containing a Quarterly Summary of the Mortality Statjstlcs for the Quarter ending IVIarch 28th, 1903, 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. 3, Uppee Q-loucester Pia.ce, W., St. M.vrylebone, April 8th, L903. Vol. XXiy.m - No. 3. The week ending March 7th was stormy and wet. Minimum temperature, 35.0°; maximum, 54.0°; mean, 42.8°. On fiye days rain fell, total rainfall, l.22 inch. Strong westerly winds prevailed. Sunshine registered in Regent's Park equal to 13%. Mean barometer, 29.6 inches. The week ending March 14th was brighter and drier. Minimum temperature, 30.5°; maximum, 57.0° ; mean, 44.7°. On three days slight rain fell, 0.12 inch. The winds were westerly. Sunshine, 29. Mean barometer, 29.9 inches. The week ending March 21st was characterised by strong westerly and south-westerly gales. Minimum temperature, 35.4°; maximum, 55.8°; mean, 47.9°. On two days rain fell, 0.14 inch. Sunshine equal to 24.2%. Mean barometer, 29.9 inches. The week ending March 28th was also stormy. Minimum temperature, 38.0°; maximum, 67.0°; mean, 53.9°. Winds SW. Sunshine, 23.8%. Mean barometer, 29.5 inches. 22 Births and Deaths. Daring the four weeks ending March 28th there have been registered 229 births and 205 deaths; equal to a birth-rate of 22.4 per thousand, and a death-rate of 20.0 per thousand. QUARTERLY SUMMARY. During the March Quarter there have been registered 775 births and 639 d aths. 639 d aths. These births and deaths are divided among the five sub-districts as set forth in Table V L. 225 of the deaths were extra-parochial, as follows: — St. Marylebone Infirmary, Notting Hill 142 North-Western Fever Hospital 5 Western Fever Hospital 3 University Hospital 4 St. Mary's Hospital 10 St. Thomas's Hospital 2 St. George's Hospital 2 St. Bartholomew's Hospital 3 Westminster Hospital 1 Charing Cross Hospital 2 National Hospital 1 Royal Free Hospital 1 French Hospital 1 German Hospital 1 Hostel of God 2 Hanwell Asjlum 5 Leavesden Asylum 8 Colney Hatch Asylum 5 Banstead Asylum 2 Manor Asylum, Epsom 2 Horton Asylum 2 Hoxton House Asylum 1 Darenth Asylum 1 Caterham Asylum 2 Claybury Asylum 3 Beckham House Asylum 1 Children's Hospital, Great Ormonde Street 3 „ „ Paddington 2 Cancer Hospital 1 St. Pancras Workhouse 1 Paddington Workhouse 1 St. Anne's Home 1 Clapham Maternity 1 In the Streets 3 Total 225 23 The birth and death-rates, as deduced from the quarter statistics, are as follows:— All Souls, birth-rate 18.4; death-rate 14.9. Rectory, birth-rate 19.1; death-rate 17.3. St. Mary, birth-rate 21.0; death-rate 16.9. Christ Church, birth-rate 316; death-rate 23.5. St. John, birth-rate 21.1; death-rate 21.5. The whole district, birth-rate 23.3; death-rate 19.2. The average death-rates for five years (1897 to 1902) for the corresponding period were as follows:—All Souls, 18.1; Rectory, 28.7; St. Mary, 22.5; Christ Church, 22.6; St. John, 22.2; the whole district, 22.2. The following table gives, as usual, facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes. TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE THIRTEEN WEEKS ENDING MARCH 28TH, 1903, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 13 weeks ending Mar. 28th, 1903. Proportion of the deaths to 1.000 deaths from all causes, 13 weeks ending Mar. 28,1903. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1897-1902 1. Deaths from the chief Zymotic Diseases 83 139 2.53 2.76 2. Pulmonary, other than Phthisis 157 246 4.72 6.14 3. Tubercular 81 127 2.44 2.44 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza,Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. 24 Measles. An Order has recently been issued applying certain sections of the Public Health (London) Act to "Measles." Hitherto, although it is well known to be a most infectious malady, a child suffering from measles could be conveyed in a public conveyance, or could be sent to school, or exposed in any thoroughfare, and those in charge of the sufferer would not be liable to any penalty under the Sanitary Acts. Besides this disinfection would not be compulsory. From April 1st this is altered, and the law applicable to notifiable diseases will be applicable to measles. On the other hand there is no notification as to measles, nor is there any provision for Hospital accommodation. Information of the prevalence of the malady is only indirectly obtainable from the returns of school attendance and the Registrar's returns of deaths. The deaths from measles in the whole of London vary in different years from about 5 per 10,000 of all ages up to a little more than 8 per 10,000. Since, however, measles is essentially a disease of children it is better studied in relation to the child population. The deaths in 1901 in all London were equal to 37 per 10,000 children (under 5 years of age). St. Marylebone curiously enough has suffered very little from fatal measles in comparison with other London districts ; in a useful table compiled by the Medical Officer of Health for the County, it is there shown that St. Marylebone, Paddington, and Hampstead, have had a lower mortality from measles than 25 other Metropolitan districts. Measles varies much in virulence, and the relationship between the number of cases and the number of deaths is very different in different years. Probably for every 3 deaths at least 100 cases of sickness occur. In 1902 there were 86 deaths from measles in the Borough, and this would represent about 2,800 cases. 1902 was not an exceptional year as regards measles, it may, therefore, be confidently stated that from 2,000 to 6,000 cases occur annually. 25 Hence, if even the cases brought to notice incidentally through the channels already mentioned have to be visited, recorded, and the usual disinfecting operations put in force, it is obvious the present staff will not be able to cope with the work. It seems to the writer the best course would be to adopt the system in force in most of the Boroughs, and to relieve the present staff from the duty of disinfection, and appoint a special staff of disinfectors. If Hospital accommodation for bad cases had been provided. and then notification of measles adopted, there is little doubt much good would have been effected. Under present conditions without facilities for isolation and without notification, the results as regards controlling spread, will not be commensurate with the considerable pecuniary outlay involved. Hence the wisdom of making the Order is open to criticism, on the ground of its small utility—a half-hearted measure, expensive in its incidence, partial in its application and inefficacious to reduce the mortality or to control the spread of the disease. The Laboratory. Sale of Food and Drugs Acts. The usual large number of samples were analysed during the March quarter. It is satisfactory to note that the dairy produce, that is, milk and butter, was of good quality, and in no single instance below the standards laid down by the Board of Agriculture. Two samples of Rum had been reduced slightly below the statutory strength, and were certified accordingly. The remainder of the 177 samples call for no special notice. The complete list is tabulated at page 32. 26 TABLE 11.-TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, in the Sanitary District of ST. MARYLEBONE, during March 1903; 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.. 52 25 29 90 33 229 (d) Aged under 5 or over 5. Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards New Casks of Sickness in Each Locality coming to thk knowledge of the medical Offices of Health. 1. Chicken Pox .. .. .. .. .. .. .. .. .. .. .. .. 2 Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 3. Scarlatina 1 4 .. 4 1 2 3 2 7 11 12 23 4. Diphtheria .. 3 .. .. .. 1 .. 1 2 5 2 10 5. Membranous Croup .. .. .. .. 1 .. .. .. .. .. .. .. 1 6. Typhus .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 7. Enteric or Typhoid .. .. .. .. .. .. .. .. .. 1 .. 1 8. Continued .. .. .. .. .. .. .. .. .. .. .. .. 9. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 10. Puerperal .. 1 .. .. .. .. .. .. .. .. .. 1 11 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 12 Erysipelas .. .. 1 2 .. 1 .. 2 1 1 2 6 Number of such Cases Removed from theie Homes in the Several Localities for Treatment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 1 4 .. 2 1 2 2 2 4 10 8 20 3. Diphtheria .. 3 .. .. .. .. .. 1 2 4 2 8 4.. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. E.teric or Typhoid .. .. .. .. .. .. .. .. .. 1 .. 1 7, Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. 1 .. .. .. .. .. .. .. .. .. 1 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. . .. 1 .. .. .. .. .. 1 .. 2 MARCH, 1803. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA. AND TYPHOID FEVER DURING 1903 27 TABLE 111. — 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, 1903; 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 163 97 95 312 108 775 (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 ??? coming to the knowledge of the Medical Officer of Health. 1. Chicken Pox 1 1 .. .. 1 1 1 1 1 .. 4 3 2. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 8. Scarlatina 3 11 3 10 2 4 9 16 13 21 30 62 4. Diphtheria 3 8 2 4 1 4 1 3 6 8 13 27 5 Membranous Croup .. .. .. 1 .. .. .. .. .. .. .. 1 Fbvebs. 6. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 7. Enteric or Typhoid .. 3 .. 1 .. .. .. 1 .. 6 .. 14 8. Continued .. .. .. .. .. .. .. .. .. .. .. .. 9. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 10. Puerperal .. 1 .. .. .. .. .. .. .. .. .. 1 11 Cholera .. .. .. .. .. .. .. .. .. .. .. .. \ 12 Erysipelas. .. 2 1 15 .. .. .. 15 2 4 3 39 ??? Homes in the several Localities foe Treatment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 3 8 3 8 .. 4 8 12 10 19 26 51 3. Diphtheria 3 7 .. 4 .. 3 1 3 4 7 8 24 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 6. Enteric or Typhoid .. 1 .. 1 .. 3 .. .. .. 5 .. 10 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. S. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. 1 .. .. .. .. .. .. .. .. .. 1 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 1 .. 14 .. 1 .. 9 .. 1 .. 26 28 TABLE IV.—Giving the Causes of Deaths during March Quarter, 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 .. .. .. 3 4 .. Erysipelas .. .. .. .. 2 1 Pneumonia and Pleurisy 5 .. .. 3 5 .. Pyæmia .. .. .. .. 1 .. Syphilis .. .. 1 .. 1 .. Cancer 27 .. .. .. 9 .. Phthisis & Tuberculosis 12 .. .. .. 31 2 Rheumatism .. .. .. .. .. .. Apoplexy .. .. .. .. .. .. Paralysis .. .. .. .. 6 .. Bronchitis 4 .. .. 1 39 .. Asthma .. .. .. .. .. .. Peritonitis .. .. .. .. .. .. Disease of Brain .. .. .. .. .. .. „ Heart 4 .. .. 3 .. 1 „ Kidney .. .. .. .. .. .. „ Liver .. .. .. 1 .. .. „ Uterus .. .. .. .. .. .. „ Ovary .. .. .. .. .. .. Parturition .. 1 .. .. .. .. Diabetes .. .. .. .. .. .. Fractures and Injuries 5 .. .. .. 6 .. Old Age .. .. .. .. 4 .. Low Vitality, Infants .. .. .. .. .. .. Premature Birth 2 6 .. .. .. .. Other causes 25 2 2 11 24 2 Total *84 †9 **3 22 142 ‡6 * Of the 84 deaths in the Middlesex Hospital, 63 were those of non-parishioners. † Eight of the 9 deaths in Queen Charlotte's Hospital were those of infants, and nonparishioners. ‡ Four of the 6 deaths in St. John's Hospital were those of non-parishioners. ** Two of the 3 deaths in the Samaritan Hospital were those of non-parishioners. 29 TABLE V, — District Births and Deaths for the four weeks ending march 27th, 1903. Population in 1891. Births. Deaths. Males. Fmls. Males. Fmls. All Souls 35,391 19 33 23 22 Rectory 19,849 7 18 10 15 St. Mary 18,099 18 11 9 12 Christ Church 39.536 42 48 39 42 St. John 20,426 16 17 10 23 Total 133,301 102 127 91 114 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 march 27th, 1903. Population in 1901. Births. Deaths. Males. Fmls. Males Fmls. All Souls 35,391 79 84 70 62 Rectory 19,849 44 53 38 48 St. Mary 18,099 60 35 33 43 Christ Church 39,536 170 142 108 127 St. John 20,426 60 48 40 70 Total 133,301 413 362 289 350 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. 30 TABLE YII.— Causes of, and Ages at, Death during the 4 weeks ending March 28tb, 1903, 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 2 1 1 .. .. .. .. 1 .. .. 1 .. .. Scarlet Fever 1 .. 1 .. .. .. .. .. .. .. 1 .. 1 Whooping Cough 12 7 5 .. .. .. .. 3 .. 7 2 3 Diphtheria and Membranous Croup 1 .. .. 1 .. .. .. .. 1 .. .. .. .. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric .. .. .. .. .. .. .. .. .. .. .. .. .. Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 1 .. 1 .. .. .. .. .. .. .. 1 .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 6 4 1 .. .. 1 .. 3 1 .. 1 1 5 Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 3 .. .. .. .. 2 1 .. .. .. 1 .. 3 Other Septic Diseases 6 .. .. .. .. 6 .. 4 1 .. 1 7 Phthisis 18 .. 1 .. 1 15 1 6 2 2 6 2 10 Other Tubercular 7 1 2 1 1 2 .. 1 1 .. 4 1 14 Cancer, Malignant Disease 14 .. .. .. .. 9 5 5 2 2 3 2 2 Bronchitis 31 4 2 .. .. 11 14 4 6 5 13 3 18 Pneumonia 14 3 2 .. .. 6 3 2 1 2 8 1 5 Pleurisy 2 .. .. .. .. 2 .. 1 .. .. 1 .. 1 Other Diseases of 1 .. .. .. .. .. 1 .. .. .. 1 .. 1 Alcoholism Cirrhosis of Liver .. .. .. .. .. 1 1 1 .. .. .. 1 1 Venereal Diseases 1 1 .. .. .. .. .. .. .. .. 1 .. 1 Premature Birth 11 11 .. .. .. .. .. 3 1 1 5 1 4 Diseases and Accidents .. .. .. .. .. .. .. .. .. .. .. .. 1 Heart Diseases 17 .. .. .. .. 9 8 6 3 1 6 1 6 Accidents 6 1 1 .. 1 2 1 1 1 .. 4 .. 3 Suicides 3 .. .. .. 1 2 .. .. 1 .. 2 .. 2 All other causes 46 9 4 .. 2 13 18 4 4 8 15 15 23 All causes 205 42 20 3 6 81 53 15 25 21 81 33 111* *22 of these were non-parishioners. 31 TABLE VIII.—Causes of, and Ages at, Death during the 13 weeks ending March 28th, 1903, 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 4 1 ... ... ... ... 3 ... 1 1 ... ... Scarlet Fever 3 ... 3 ... ... ... ... ... ... ... 2 1 3 Whooping Cough 39 15 21 3 ... ... ... 4 4 3 18 10 4 Diphtheria and 6 1 3 2 ... ... ... 3 1 ... 1 1 1 branous Croup Croup ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric 2 ... ... ... ... 2 ... 1 ... ... 1 ... ... Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenea 9 1 ... 1 ... 5 2 2 ... 1 3 3 1 Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea 15 10 2 ... ... 2 1 5 2 1 5 2 10 Enteritis ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal fever ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 6 ... ... ... ... 3 3 ... ... 2 1 3 6 Other Septic Diseases 9 ... ... ... ... 9 ... 6 2 ... 1 ... 12 Phthisis 61 2 2 2 7 44 4 14 4 10 23 10 35 Other Tubercular 20 4 7 4 1 4 ... 3 2 1 8 6 22 Diseases Cancer, Malignant 42 ... ... ... ... 27 15 12 4 11 9 6 32 Disease Bronchitis 105 16 8 ... ... 25 56 14 15 13 50 13 48 Pneumonia 50 10 10 1 1 21 7 8 10 5 21 6 21 Pleurisy 2 ... ... ... ... 2 ... 1 ... ... 1 ... 1 Other Diseases of Respiratory Organs 1 ... ... ... ... ... 1 ... ... ... 1 ... 1 Alcoholism Cirrhosis of Liver 7 ... ... ... ... 3 4 1 2 ... 3 1 2 Venereal Diseases 1 1 ... ... ... ... ... 1 1 Premature Birth 18 18 ... ... ... ... ... 7 2 2 5 2 10 Diseases and Accidents ... ... ... ... ... ... ... ... ... ... ... ... 2 of Parturition Heart Diseases 50 1 ... ... 1 29 19 10 12 1 18 9 22 Accidents 21 4 3 ... 3 6 5 6 3 2 10 ... 12 Suicides 4 ... ... ... 1 3 ... ... 1 ... 3 ... 3 All other causes 103 34 8 2 3 67 49 32 22 23 49 37 91 All causes 039 121 68 15 17 252 166 132 86 76 235 110 340* *86 of these were Non-Parishioners. 32 TABLE IX.—SALE OF FOOD AND DRUGS ACT. Samples Analysed during March Quarter, 1903. Genuine. Adulterated. Total. DAIRY PRODUCTS— Milk 61 — 61 Batter 30 — 30 Margarine 4 — 4 Lard 9 — 9 ALCOHOLIC BEVERAGES— Whisky 10 — 10 Brandy 2 — 2 Gin 2 — 2 Rum — 2 2 Port Wine 2 — 2 Cherry Whisky 1 — 1 NON-ALCOHOLIC BEVERAGES— Coffee 8 — 8 Coffee and Chicory 1 — 1 Tea 2 — 2 Cocoa 1 — 1 condiments— Pepper 4 4 Mustard 2 — 2 Vinegar 1 — 1 SACCHARINE SUBSTANCES— Jam 2 — 2 Honey 1 — 1 TINNED GOODS- Condensed Milk 2 — 2 Peas 3 — 3 Sardines 3 — 3 Salmon 1 — 1 Pines 2 — 2 Apricots 1 — 1 Baked Beans 1 — 1 Tongue 1 — I drugs— Bicarbonate of Soda 1 — 1 Glycerine 1 — 1 Tincture of Rhubarb 1 — 1 Sweet Spirit of Nitre 1 — 1 Camphorated Oil 1 — 1 MISCELLANEOUS— Olive Oil 2 — 2 Lemon Squash 1 — 1 Ginger Wine 2 — 2 Orange Wine 1 — 1 Fluid Beef 1 — 1 Flour 1 — 1 Custard Powder 1 — 1 Cod Liver Oil 1 — 1 Pickles 3 — 3 175 2 177 33 REGISTER OF SANITARY WORK Month ending March 31st, 1903. PUBLIC HEALTH DEPARTMENT. District Inspectors. E. Lumley, Dust Inspector. 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. Publie Health (London) Act. Inspections. Dwelling Houses, &c 84 86 95 26 21 ... ... ... ... ... 312 Tenements 60 ... 45 11 19 ... ... ... ... ... 135 Underground Dwellings 12 3 20 10 13 ... ... ... ... ... 58 Dairies, Milk Shops, Cow Houses 11 9 ... 16 10 ... ... ... ... ... 46 Slaughter Houses 3 3 ... ... 1 ... ... ... ... ... 7 Yards, Stables, and Mews 21 13 45 17 38 ... ... ... ... ... 134 Smoke Shafts ... ... ... ... ... ... ... ... 2 ... 2 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... 1 ... 1 Refuse Receptacles 6 6 ... 3 4 40 ... ... ... ... 59 Enquiries re non-removal of refuse 4 2 5 4 3 100 ... ... ... 2 120 Removal of Bodies to Mortuary ... ... ... ... ... ... ... ... ... ... ... Visits to Works in Progress 150 130 160 113 94 ... ... ... ... 10 657 Miscellaneous Inspections 164 185 150 196 136 150 ... ... ... 82 1063 UNWHOLESOME FOOD. Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE Cases Isolated 3 ... 1 ... 2 ... ... ... ... ... 6 Cases removed to Hospital 13 9 7 4 9 ... ... ... ... ... 42 Rooms Disinfected 22 20 9 6 19 ... ... ... ... ... 76 NEW DRAINAGE Number of Plans Passed 4 7 5 14 12 ... ... ... 2 2 46 New Pipe Drains (feet) 864 896 250 390 1670 ... ... ... 120 120 4310 Houses where defects in existing Drainage have been detected and remedied 8 7 9 ... 5 ... ... ... ... ... 29 34 REGISTER OF SANITARY WORK Month ending March 31st, 1903. PUBLIC HEALTH DEPARTMENT. District Inspectors. E. Lnmlev, Dust Inspector. 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 ... ... ... ... ... ... ... ... 30 8 38 Periodical Inspections: — Factories ... ... ... ... ... ... ... ... 4 ... 4 Workshops ... ... ... ... ... ... ... ... 49 68 115 Bakehouses ... ... ... ... ... ... ... ... 43 ... 43 Restaurants, &c. ... ... ... ... ... ... ... ... 50 ... 50 Homeworkers' Premises ... ... ... ... ... ... ... ... 10 24 34 Domestic Workshops ... ... ... ... ... ... ... ... 5 2 7 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 10 13 15 30 19 ... ... ... ... 5 92 Correspondence, Legal Procedure. &e. Complaints received 8 13 15 16 16 16 ... ... 6 5 95 Letters and Intimations relating to Abatement of Nuisances 22 18 30 21 26 25 ... ... 2 9 153 Statutory Notices Served 4 2 5 3 5 ... ... ... 1 1 21 Proceedings taken before Magistrates ... ... ... ... ... ... ... ... ... ... ... (1) Under Public Health Act ... ... ... ... ... ... ... ... ... ... ... (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) „ Food & Drugs Act ... ... ... ... ... ... ... ... ... ... ... Reports made to Medical Officer of Health 33 30 31 54 67 ... ... ... 28 10 253 THE SANITARY CHRONICLES of the BOROUGH OF ST. MARYLEBONE DURING APRIL, 1903, 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. XXIII. 3, Upper Gloucester Place, W., Mat 8th, 1903. No. 4 The week ending April 4th was wet. Minimum temperature, 33.5°; maximum, 55.0°; mean, 47.7°. On seven consecutive days rain fell, giving a total of 0.84 inch. Winds, WSW. and W. Sunshine registered in Eegent's Park equal to 16.9%. Mean barometer, 29.7 inches. The week ending April 11th was fine and dry. Minimum temperature, 35.5°; maximum, 55.0°; mean, 48.3. On one day slight rain fell, 0.06 inch. Winds, WSW. and NE. Sunshine, 17.7%. Mean barometer, 30.1 inches. The week ending April 18th was also fairly dry and bright. Minimum temperature, 29.0°; maximum, 50.0°; mean, 42.0°. On two days slight rain fell, 0.07 inch. Winds, NNW. Sunshine, 54.7%. Mean barometer, 30.0 inches. The week ending April 25th was rainless. Minimum temperature, 30.0°; maximum, 58.0Q; mean, 45.3%Cool ENE winds prevailed. Sunshine, 25.5%. Mean barometer, 29.6 inches. The week ending May 2nd was unsettled and wet. Minimum temperature, 41.0°; maximum, 60.9°: mean 50.6°.On six days rain fell, giving a total rainfall of l.57 inches. Winds, SE. and SW. Sunshine, 24.3%. Mean barometer, 29.3 inches. 36 Births and Deaths. During the five weeks ending May 2nd there have been registered 269 births and 201 deaths. These births and deaths are divided among the five sub-districts as set forth in Table IV. 90 of the deaths were extraparochial, as follow:— St. Marylebone Infirmary, Netting Hill 62 Western Fever Hospital 2 St. Mary's Hospital 4 Children's Hospital, Paddington 3 „ „ Great Ormond Street 1 Guy's Hospital 1 University Hospital 1 French Hospital 1 North-West London Hospital 1 National Hospital 1 Eoyal Chest Hospital 1 Claybury Asylum 1 Banstead Asylum 1 Hanwell Asylum 3 Leavesden Asylum 2 Chelsea Infirmary 2 Islington "Workhouse 1 St. Peter's Home 1 In the Streets ■ 1 Total 90 37 The birth and death-rates, as deduced from the five weeks' statistics, are as follows :— All Souls, birth-rate 16.2; death-rate 14.4. Rectory, birth-rate 15.2; deatii-rate 12.0. St. Mary, birth-rate 31.6: death-rate 13.8. Christ Church, birth-rate 26.6; death-rate 13.8. St. John, birth-rate 14.8; death-rate 17.3. The whole district, birth-rate 21.3; death-rate 15.7. The average death-rates for five years (1898 to 1902) for the corresponding period were as follows:—All Souls, 14.3; Rectory, 21.9; St. Mary, 17.9; Christ Church, 18.9; St. John, 20.2; the whole district, 18.2. 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 2nd, 1903, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES Total Deaths. 5 weeks ending May 2nd, 1903. Proportion of the deaths to 1,000 deaths from all causes. 5 weeks ending May 2,1903. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1898-1902. 1. Deaths from the chief Zymotic Diseases 9 45 0.70 2.24 2. Pulmonary, other than Phthisis 39 195 3.04 3.79 3. Tubercular 32 160 2.50 1.97 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza,Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. 38 Health of the District. The general death rate for April has been much lower than usual. This is in the main owing to the very low mortality from scarlet fever and diphtheria with other zymotic diseases. The average mortality from infectious diseases for April is a little over 2 per 1,000 of population, this, during the past live weeks has fallen to 7 per 1,000. The Shelter, Grove Road. The Shelter has been re-papered, re-painted, the ceilings white-washed, and the interior generally decorated. A necessary work after the small pox epidemic, besides which the place for some years has had nothing done to it save the usual cleansing operations. Last year it was almost continuously occupied from January to the beginning of August, by families turned out of their rooms temporarily to enable the Officers to properly disinfect. Since August up to the present, it has been used very little. Infectious fevers generally having been but little prevalent. The Baths, Grove Road. The Cleansing Baths continue to be used and are doing good work. It is gratifying to observe that the number of females taking advantage of the cleansing facilities have much increased, the returns for the month being Males - 364 Females - 31 Total 395 APRIL, 1903. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, AND TYPHOID FEVER DURING 1903 ■ 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 April, 1903; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals Population at all Ages. (b) Ceusus 1901 35,391 19,849 18,099 39,536 20,426 133,301 (c) Registered Births.. 55 29 55 101 29 269 (d) Aged under 5 or over 5. Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards New Cases op Sickkkss iw bach Locality coming to the Knowledg of the medical Officer of Health. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 3 6 3 7 .. 2 1 4 .. 7 11 26 3. Diphtheria .. 4 1 2 .. 1 .. 4 .. 3 1 14 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 1 .. 1 .. .. .. 1 .. 1 .. .. 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas .. 4 .. 5 .. 3 .. .. .. 1 .. 13 Number of such Cases Removed from their Homes in the several Localities foe Treat- 1 ment in Isolation Hospitals. .. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2 Scarlatina .. 6 3 5 .. 1 1 4 .. 7 11 23 3. Diphtheria .. .. 4 1 2 .. .. .. 4 .. 1 1 11 h " Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. 15. Typhus .. .. .. .. .. •• .. .. .. .. .. .. Fevers. Enteric or Typhoid .. 1 .. 1 .. .. .. 1 .. .. .. 3 7. Continued .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 \ Erysipelas .. .. .. .. 5 • 1 .. .. .. .. .. 6 40 TABLE III.—Giving the Causes of Deaths during April, 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 1 .. Erysipelas .. .. .. .. .. .. Pneumonia and Pleurisy 1 .. .. .. 1 .. Pyæmia l .. .. .. .. .. Syphilis .. .. .. .. .. .. Cancer 15 .. .. .. .. .. Phthisis & Tuberculosis 1 .. .. .. 18 .. Rheumatism .. .. .. .. .. .. Apoplexy .. .. .. .. .. .. Paralysis .. .. .. .. 1 .. Bronchitis .. .. .. .. 17 .. Asthma .. .. .. .. .. .. Peritonitis .. .. .. .. 1 .. Disease of Brain .. .. .. .. .. .. Heart 3 .. .. .. .. .. ,, Kidney .. .. .. .. 1 .. „ Liver 1 .. .. .. 1 .. „ Uterus .. .. .. .. .. .. „ Ovary .. .. .. .. .. .. Parturition .. .. .. .. .. .. Diabetes .. .. .. .. .. .. Fractures and Injuries 1 .. .. .. .. .. Old Age .. .. .. .. .. .. Low Vitality, Infants .. .. .. .. .. .. Premature Birth .. 3 .. .. .. .. Other causes 11 2 1 2 3 1 Total *34 †5 **3 5 62 ‡4 * Of the 34 deaths in the Middlesex Hospital,,27 were those of non-parishioners, † The deaths in Queen Charlotte's Hospital were non-parishioners, ‡The deaths in St. John's Hospital were those of non-parishioners. ** The 3 deaths in the Samaritan Hospital were those of non-parishioners. 41 TABLE IV. — District Births and Deaths for the five weeks ending may 2nd, 1903. Population in 1891. Births. Deaths. Males. Fmls. Males. Fmls. All Souls 35,391 24 31 22 26 Rectory 19,849 19 10 14 9 St. Mary 18,099 26 29 15 9 Christ Church 39,536 50 51 42 30 20,426 16 13 15 19 Total 133,301 135 134 108 93 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 5 weeks ending May 2nd, 1903, in the Borough of St. Marylebone. CAUSES OF DEATH. Deaths in whole District at subjoined Ages. Deaths in Localities Cat all Ages). Deaths in Public Institutions. All ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. All Souls. Rectory. St. Mary. Christ Church. St. John. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever 1 .. 1 .. .. .. .. .. .. .. .. 1 1 Whooping Cough 5 2 2 1 .. .. .. 1 1 .. 2 1 1 Diphtheria and Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric .. .. .. .. .. .. .. .. .. .. .. .. .. Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 1 .. .. .. .. 1 .. .. .. .. 1 .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 2 .. .. .. .. 1 1 1 .. .. .. 1 1 Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. Other Septic Diseases 2 .. .. 1 .. 1 .. .. 1 .. .. 1 3 Phthisis 27 2 1 2 2 18 2 13 .. 2 9 3 22 Other Tubercular 5 4 .. 1 .. .. .. 1 .. 1 3 .. 4 Cancer, Malignant 26 .. .. .. .. 10 16 4 5 10 2 5 19 Bronchitis 26 8 2 .. .. 4 12 7 5 3 10 1 11 Pneumonia 13 4 4 .. 1 3 1 3 .. .. 10 .. 2 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Respiratory Organs .. .. .. .. .. .. .. .. .. .. .. .. .. Alcoholism Cirrhosis of Liver 4 .. .. .. .. 3 1 1 .. .. .. 3 4 Venereal Diseases 2 2 .. .. .. .. .. 1 .. .. 1 .. 1 Premature Birth 3 3 .. .. .. .. .. .. 1 .. 1 1 4 Diseases and Accidents of Parturition .. .. .. .. .. .. .. .. .. .. .. .. 8 Heart Diseases 18 .. .. .. .. 11 7 4 1 1 8 4 6 Accidents 7 1 .. 1 .. 3 2 2 1 1 2 1 3 Suicides .. .. .. .. .. .. .. .. .. .. .. .. .. All other causes 59 15 3 .. 1 23 17 10 8 6 23 12 33 All causes 201 41 13 6 4 78 59 48 23 24 72 34 123* *37 of these were non-parishioners. 43 REGISTER OF SANITARY WORK Month ending April 30th, 1903. PUBLIC HEALTH DEPARTMENT. District Inspectors. B. Lumley, Dust Inspector. 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. 1 District. Mr. W. Yeo, No. 5 District. ' Public Health (London) Act. Inspections. /Dwelling Houses, &c. 48 86 45 39 31 ... ... ... ... ... 249 Tenements 34 ... 35 43 30 ... ... ... ... ... 142 Underground Dwellings 12 ... 30 9 17 ... ... ... ... ... 68 Dairies, Milk Shops, Cow Houses 10 3 6 4 12 ... ... ... ... ... 35 Slaughter Houses 2 2 ... ... 1 ... ... ... ... ... 5 Yards, Stables, and Mews 12 9 50 40 67 ... ... ... ... ... 178 Smoke Shafts ... ... ... ... ... ... ... ... ... ... ... Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... ... ... ... Refuse Receptacles 4 3 ... 10 7 ... ... 30 ... 3 57 Enquiries re non-removal of refuse ... ... ... 10 5 ... ... 200 ... 2 217 Removal of Bodies to Mortuary ... ... 2 ... ... ... ... ... ... ... 2 Visits to Works in Progress 150 486 110 280 207 ... ... ... ... 8 1241 Miscellaneous Inspections 160 102 120 240 168 ... ... 125 ... 44 959 UNWHOLESOME FOOD:— Number of seizures made . ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE:— Cases Isolated 1 ... 2 ... 1 ... ... ... ... ... 4 Cases removed to Hospital 9 4 6 15 12 ... ... ... ... ... 46 Rooms Disinfected 20 9 9 23 21 ... ... ... ... ... 82 NEW DRAINAGE :— Number of Plans Passed 5 6 4 8 9 ... ... ... ... ... 32 New Pipe Drains (feet) 560 786 450 1200 2118 ... ... ... 10 ... 5124 Houses where defects in existing Drainage have been detected and remedied 8 7 5 9 13 ... ... ... 1 ... 43 44 REGISTER OF SANITARY WORK Month ending April 30th, 1903. PUBLIC HEALTH DEPARTMENT. District Inspectors. E. Lumlev, Dust Inspector. 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 .. .. .. .. .. .. .. .. 18 15 33 Periodical Inspections : — Factories .. .. .. .. .. .. .. .. 3 .. 3 Workshops .. .. .. .. .. .. .. .. 33 95 128 Bakehouses .. .. .. .. .. .. .. .. 29 1 30 Restaurants, & c. .. .. .. .. .. .. .. .. 48 .. 48 Homeworkers' Premises .. .. .. .. .. .. .. .. 18 46 64 Domestic Workshops .. .. .. .. .. .. .. .. 10 2 12 Food and Drugs Aet. ADULTERATION. Samples collected for Analysis 22 17 17 .. 12 .. .. .. .. .. 68 Correspondence, Legal Procedure, &c. Complaints received 3 7 8 16 28 .. .. 30 3 6 101 Letters and Intimations relating to Abatement of Nuisances 12 12 14 34 26 .. .. 25 6 3 132 Statutory Notices Served 4 4 1 11 12 .. .. .. .. .. 32 Proceedings taken before Magistrates .. .. .. .. .. .. .. .. .. .. .. (1) Under Public Health Act .. .. .. .. .. .. .. .. .. .. .. (2) „ Factory & Workshop Act .. .. .. .. .. .. .. .. .. .. .. (3) „ Food & Drugs Act .. .. .. .. .. .. .. .. .. .. .. Reports made to Medical Officer of Health 38 32 30 63 74 .. .. 35 28 16 316 THE SANITARY CHRONICLES OF THE BOROUGH OF ST. MARYLEBONE DURING MAY, 1903, 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. XXI11. 3, Upper Gloucester Place, W., June 6th, 1903. No. 5 The week ending May 9th was cool and wet. Minimum temperature, 40.0° ; maximum, 64.0°; mean, 52.6°. On five days rain fell, giving the high rainfall of 2.13 inches. The winds were SW. and SSE. Sunshine was deficient, being just under 8°/° of the possible. Mean barometer 29.6 inches. The week ending May ]6th was finer than the preceding. Minimum temperature, 37.5° ; maximum, 61.50 ; mean, 51.68. On three days rain fell, 0.33 inch. Sunshine, 20°/o. Winds variable. Mean barometer 29.8 inches. The week ending May 23rd was bright and fairly warm. Minimum temperature, 38.5° ; maximum, 78.2° ; mean, 58.18. On three days thunder showers yielded 0.51 inch, of rain. Sunshine in Eegent's Park was equal to 49.7°/o. Winds, SSW. and NNW. Mean barometer 29.9 inches. The week ending May 30th was warm and summerlike. Minimum temperature, 40.5° ; maximum, 78.0° ; mean, 62.9°. Winds NE. and SE. On two days thunder storms yielded 0.24 inch of rain. Sunshine in Eegent's Park 64.8 hours equal to 57.7°/0. Mean barometer 30.0 inches. 46 Births and Deaths. During the four weeks ending May 30th there have been registered 234 births and 157 deaths. These births and deaths are divided among the five sub-districts as set forth in Table IV. 63 of the deaths were extraparochial, as follow:— St. Marylebone Infirmary, Notting Hill 35 North-Western Fever Hospital 6 St. Mary's Hospital 9 Children's Hospital, Paddington 2 St. Bartholomew's Hospital 1 Colney Hatch Asylum 4 Banstead Asylum 1 Hanwell Asylum 2 Middlesex Asylum 1 In the Streets 2 Total 63 47 The birth and death-rates, as deduced from the five weeks' statistics, are as follows : — All Souls, birth-rate 19.8 ; death-rate 13.6. Rectory, birth-rate 21.6 ; death-rate 11.8. St. Mary, birth-rate 28.7: death-rate 16.5. Christ Church, birth-rate 23.7 ; death-rate 17.4. St. John, birth-rate 22.2 ; death-rate 16.5. The whole district, birth-rate 22.9 ; death-rate 15.3. The average death-rates for five years (1898 to 1902) for the corresponding period were as follows :—All Souls, 13.7 ; ltectory, 16.7 ; St. Mary, 19.0 ; Christ Church, 19.7; St. John, 21.3; 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 30th, 1903, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 4 weeks ending May 30th, 1903. Proportion ofthedeaths to 1,000 deaths from all causes. 4 weeks ending May 30,1903. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1898-1902. 1. Deaths from the chief Zymotic 21 134 2-05 2-07 2. Pulmonary, other than Phthisis 30 191 2-93 3-83 3. Tubercular 25 159 2-42 1-82 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza,Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. 3. Includes Phthisis, Sorofula, Rickets, and Tabes. 48 Health of the District. The weather of the four weeks has been favourable to human life. The rate of deaths from chest affections has been much below the average. Generally speaking, with the exception of a short burst of scarlet fever and diptheria during the second and third weeks, there has not been so healthy a May for several years. Housing of the Working Classes Act, 1890. No. 6, Gees Court having been allowed to fall into a deplorable state of dilapidation has been reported on under the above Act, and a closing order obtained- The writer regrets that there does not appear any present likelihood of the whole Court being opened up as a street improvement. There can be little doubt that if the entrance at either end were widened, the Common Lodging Houses and tenement dwellings the Court contains would be replaced by first-class business premises of high rateable value, the increased assessment of which would go far to pay the cost of such improvement. Appeal to the London County Council as to the interpretation of a Bye-law. Under Section 39 (1) of the Public Health (London) Act, a bye-law of the London County Council enacts, inter alia, that " Every person who shall hereafter construct a watercloset in connection with a building shall construct such watercloset in such a position that, in the case of a watercloset, one of its sides at the least shall be an external wall, which external wall shall abut immediately upon the street or upon a yard or garden or open space of not less than one hundred square feet of superficial area measured horizontally at a point below the level of the floor of such closet." Some new mansions in Glentworth Street have been built with closets having external walls, which external walls abut upon spaces of about 60 square feet, if the word 49 " abut" is taken in its usual sense. The word is derived from the French abouter, the primitive meaning of which is " to join end to end," that is, strictly speaking, nothing can be said " to abut" unless it is at right angles, or directly opposite. The architect, however, contended that since the 60 square feet was continuous with a much larger open space than the 60 immediately opposite the external wall, the bye-law was complied with. The Public Health Committee on viewing the premises did not consider this contention valid, and declined to pass the deposited plans. An appeal was lodged with the County Council against this decision, and the matter was argued. The Appeal Committee of the London County Council have decided that the appeal should be allowed ; at the same time the Chairman intimated that it was necessary to alter the bye-law, and to prescribe a minimum width for the space in question. An application by the Appellants for costs was refused. It is, therefore, quite obvious that since from this decision there is, under the statute, no appeal, the bye-law with regard to space, until a minimum width is prescribed, is absolutely inoperative, for if in the construction of the word " abut" the Committee have adopted any principle at all, that principle must be that any space which is horizontally continuous 'abuts;" in other words, with regard to an isolated house, the front space abuts on the sides and back, because the spaces are continuous— a manifest absurdity. It is probably unfair to seek for logical principles, with regard to the decision of a Court, of the constitution of the Appeal Committee of the London County Council; such a Court naturally enough looks at all the surrounding circumstances ; in this particular case, the buildings were up, and it would have been a greater punishment to the owner than the offence deserved to have to pull them down and rebuild. On the other hand, the Public Health Committee of this borough had absolutely no choice than to refuse to pass plans which they conscientiously believed did not comply with bye-laws in reference to new and important blocks of 50 buildings, the more especially since it would have been easy to have planned the structure in such a way that no embarrassing questions could have arisen. Bye-laws with regard to Basement Closets. Under the same section of the Public Health (London) Act, tlier ■ is a bye-law prohibiting the construction of a watercloset below the surface of the ground unless it has an area or open space "measuring at least forty superficial feet in extent, and having a distance across of not less than five feet, and not covered in otherwise than by a grating or railing." This bye-law may be unobjectionable as applied to new buildings, but it is unreasonable as applied to old and existing buildings. If carried out with strictness it would absolutely prevent desirable improvements, such, for example, as the removal of a watercloset from the centre of a dwelling to an area, which, although not strictly complying with the bye-law, would afford a more suitable and sanitary position. In a recent case the London County Council complained that a certain workshop had insufficient sanitary accommodation. The premises are so constructed that it is impossible to comply with the Statute and with the bye-law. The owner has given more accommodation ; accommodation in compliance with the Statute, not in compliance with the bye-law. The County Council now write complaining of the local authority permitting the erection of the convenience. The proposed new lavatory accommodation at the Town Hall is absolutely in contravention of the bye-law in question. No improvement in that direction is possible if the bye-law is to be observed The writer's consistent advice to the local authority has been that, in all such instances, the bye-law is mischievous and should be ignored, and that an excellent case can be made for defence on the ground of the bye-law being unreasonable. MAY, 1903. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA. AND TYPHOID FEVER DURING 1903 51 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 Mag, 1903; classified according to Diseases, Ages, and Localities. a) All Souls Rectory St. Mary Christ Church St. JOKK Totals pvl at all Age- (b) Census 1901 35,391 19.849 18,099 39,536 20,426 133,301 (c) Registered Births 54 33 40 72 35 231 (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 knowledgh of the medical Officer op Health. / 1 Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 2 1 2 8 1 8 9 10 3 7 17 34 3. Diphtheria .. 1 1 3 2 1 1 .. 2 3 5 8 .. 4. Membranous C roup .. .. .. .. .. .. .. .. 1 .. 1 .. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 6. ' Enteric or Typhoid .. .. .. .. .. 1 .. .. .. 1 .. 2 7 Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. 1 .. .. .. .. .. .. .. .. .. 1 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 \ Erysipelas .. 1 2 10 1 .. .. 6 .. .. 3 17 Number of such Cases Removed from their Homes in thk several Localities for Treat. ment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2 Scarlatina 2 1 2 8 1 6 8 7 2 4 15 26 3. Diphtheria 1 1 3 2 1 .. .. 2 2 1 7 6 4 Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. 1 .. .. .. .. .. 1 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8 Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9 Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 \ Erysipelas .. .. 1 7 .. .. .. 1 .. .. 1 8 52 TABLE III— Giving the Causes of Deaths during May, 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 ETospital. Samaritan Hospital. Workhouse Notting Hill Infirmary. Hospital of St. John & Elizabeth Grove Rd. Smallpox .. .. .. .. .. .. Influenza .. .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. Diphtheria 1 .. .. .. .. .. Typhoid Fever .. .. .. .. .. .. Diarrhœa .. .. .. .. 1 .. Erysipelas .. .. .. .. 1 .. Pneumonia and Pleurisy .. .. .. .. .. .. Pyæmia .. .. .. .. .. .. Syphilis .. .. .. .. .. .. Cancer .. .. .. .. 4 .. Phthisis & Tuberculosis 5 .. .. .. 12 .. Rheumatism .. .. .. .. .. .. Apoplexy .. .. .. .. .. .. Paralysis .. .. .. .. 1 .. Bronchitis 5 .. .. .. 9 .. Asthma .. .. .. .. .. .. Peritonitis .. .. .. .. .. .. Disease of Brain .. .. .. .. .. .. „ Heart 2 .. .. 1 3 .. ,, Kidney .. .. .. .. .. .. ,, Liver 1 .. .. .. .. .. „ Uterus .. .. .. .. .. .. ,, Ovary .. .. .. .. .. .. Parturition .. .. .. .. .. .. Diabetes .. .. .. .. .. .. Fractures and Injuries. .. .. .. .. .. .. Old Age .. .. .. .. 2 .. Low Vitality, Infants .. .. .. .. .. .. Premature Birth .. 2 .. .. .. .. Other causes 12 .. 3 4 2 .. Total *35 †2 **3 5 35 .. * Of the 35 deaths in the Middlesex Hospital, 31 were those of non-parishioners, † The 2 deaths in Queen Charlotte's Hospital were infants, non-parishioners. ** The 3 deaths in the Samaritan Hospital were those of non-parishioners. 53 TABLE IV. — District Births and Deaths for the four weeks ending may 30th, 1903. Population in 1891. Births. Deaths. Males. Fmls. Males. Fmls. All Souls 35,391 31 20 19 18 Rectory 19,849 16 17 10 8 St. Mary 18,099 19 21 10 13 Christ. Church 39.536 32 40 27 26 St. John 20,426 17 18 12 14 Total 133,301 118 116 78 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. 54 TABLE V.—Causes of, and Ages at, Death during the 4 weeks ending May 30th, 1903, 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. Small pox .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 2 2 .. .. .. .. .. 2 .. .. .. .. .. Scarlet Fever 3 .. 3 .. .. .. .. .. .. .. 3 .. 3 Whooping Cough 3 3 .. .. .. .. .. 1 .. .. 1 .. 1 Diphtheria and Membranous Croup 5 .. 3 .. .. .. .. .. 1 .. 2 .. 3 Croup .. .. .. .. .. .. .. .. .. .. .. .. .. FkvkR Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric .. .. .. .. .. .. .. .. .. .. .. .. .. Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 1 .. .. .. .. .. 1 .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 6 1 1 .. .. 2 2 .. .. .. .. .. 1 Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. 1 1 .. .. .. .. 1 Other Septic Diseases.. .. .. .. .. .. .. .. .. .. .. .. .. .. Phthisis 19 .. .. 2 .. 15 2 8 2 2 5 2 12 Other Tubercular Diseases 6 .. 1 1 .. 1 1 1 .. 1 4 .. 3 Cancer, Malignant, Disease 9 .. 1 .. .. 5 3 1 .. 1 3 4 5 Bronchitis 24 2 .. .. .. 9 13 5 4 5 9 1 15 Pneumonia 6 1 3 .. .. 2 .. 1 .. 2 .. 1 1 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Respiratory Organs .. .. .. .. .. .. .. .. .. .. .. .. .. Alcoholism Cirrhosis of Liver 2 .. .. .. .. 1 1 1 1 .. .. .. .. Venereal Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. Premature Birth 1 1 .. .. .. .. .. 1 .. .. .. .. 2 Diseases and Accidents of parturition 1 .. .. .. .. 1 .. 1 .. .. .. .. .. Heart Diseases 13 .. .. .. .. 8 5 4 2 4 2 1 7 Accidents 6 .. .. .. 2 4 .. 1 .. 1 2 2 2 Suicides 2 .. .. .. .. 2 .. 1 .. .. .. 1 .. All other causes 47 11 4 .. 1 16 15 8. 8 6 16 9 35 All causes 157 22 16 5 4 66 41 37 18 23 53 26 91 *37 of these were non-parishioners. 55 REGISTER OF SANITARY WORK Month ending May 31st, 1903. PUBLIC HEALTH DEPARTMENT. District Inspectors. E. Lumley, Dust Inspector. Mr. R. Phillips, Special Duties. Miss F. A. Baker. Total. Mr. J. Hodges, No. 1 District. Mr. A. Perry, N<«. 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 46 48 55 25 41 .. .. .. .. .. 215 Tenements 52 30 45 160 91 .. .. .. .. .. 378 Underground Dwellings 12 .. 25 4 15 .. .. .. .. .. 56 Dairies, Milk Shops, Cow Houses 4 3 3 1 9 .. .. .. .. .. 20 Slaughter Houses 2 2 .. .. 1 .. .. .. .. .. 5 Yards, Stables, and Mews 30 9 55 160 88 .. .. .. .. .. 342 Smoke Shafts .. .. .. .. .. .. .. .. 1 .. 1 Offensive Trades and Effluvia Businesses .. .. .. .. .. .. .. .. 1 .. 1 Refuse Receptacles 8 7 5 12 11 .. .. .. .. 1 44 Enquiries re non-removal of refuse 5 6 6 4 7 .. .. .. .. 3 31 Removal of Bodies to Mortuary .. .. .. .. .. .. .. .. .. .. .. Visits to Works in Progress 160 163 150 140 167 .. .. .. .. 3 783 Miscellaneous Inspections 180 190 130 220 189 .. .. .. .. 75 984 UNWHOLESOME FOOD:— Number of seizures made .. .. .. .. .. .. .. .. .. .. .. INFECTIOUS DISEASE Cases Isolated 1 1 3 1 .. .. .. .. .. .. 6 Cases removed to Hospital 12 8 19 22 6 .. .. .. .. .. 67 Rooms Disinfected 22 20 24 35 14 .. .. .. .. .. 115 NEW DRAINAGE Number of Plans Passed 8 9 7 15 7 .. .. .. .. .. 46 New Pipe Drains (feet) 960 1320 280 1760 1220 .. .. .. .. .. 5540 Houses where defects in existing Drainage have been detected and remedied 10 12 9 5 15 .. .. .. .. .. 51 56 REGISTER OF SANITARY WORK Month ending May 31st, 1903. PUBLIC HEALTH DEPARTMENT. District Inspectors. E. Lumlev, Dust Inspector. 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 .. .. .. .. .. .. .. .. 10 20 30 Periodical Inspections: — Factories .. .. .. .. .. .. .. .. 2 .. 2 Workshops .. .. .. .. .. .. .. .. 53 144 197 Bakehouses .. .. .. .. .. .. .. .. 21 2 23 Restaurants, &c. .. .. .. .. .. .. .. .. 56 2 58 Homeworkers' Premises .. .. .. .. .. .. .. .. 5 51 56 Domestic Workshops .. .. .. .. .. .. .. .. 10 4 14 Food and Drugs Act. ADULTERATION. Samples collected for Analysis .. .. 1 26 8 .. .. .. .. .. 35 Correspondence, Legal Procedure, &c. . Complaints received 14 15 7 15 24 .. .. .. .. 4 79 Letters and Intimations relating to Abatement of Nuisances 24 20 22 30 37 .. .. .. 2 5 140 Statutory Notices Served 4 3 4 9 11 .. .. .. .. .. 31 Proceedings taken before Magistrates .. .. 1 1 .. .. .. .. .. .. 2 (1) Under Public Health Act .. .. .. .. .. .. .. .. .. .. .. (2) „ Factory & Workshop Act .. .. .. .. .. .. .. .. .. .. .. (3) „ Food & Drugs Act .. .. 1 .. 1 .. .. .. .. .. 2 Reports made to Medical Officer of Health 38 30 31 70 87 .. .. .. .. 10 266 THE SANITARY CHRONICLES OF THE v'/ BOROUGH OF ST. MARYLEBONE DURING JUNE, 1903, Y+V"~"~ •' Containing a Quarterly Summary of the Mortality Statisttcs for the Quarter ending June 27th, 1903, 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 BT ORDER OF THE COUNCIL. Vol. XXII. 3, Uppeu Gloucester Place, W., July 10th, 1903. No. 6. The week ending June 6th was a bright summer week. Minimum temperature, 44.08 ; maximum, 85.08; mean, 58.2°. On one day slight rain fell 0.05 inch. Winds easterly, Sunshine 58.6°/0. Mean barometer 30 inches. The week ending June 13th was wet and overcast. Minimum temperature, 40.08 ; maximum, 54.8° ; mean, 56.38. On three days rain fell, 1.94 inch. Sunshine, 16%,. Winds ENE. Mean barometer 29.9 inches. The week ending June 20th was one of quite exceptional heavy rain. The rain fell each day and almost continuously to the large amount of 4.24 inches. Winds SE. and NE. Sunshine 14.7%,. Mean barometer (low) 29.6 inches. The week ending June 27th was bright, warm and rainless. Minimum temperature, 45.08; maximum, 85.08 ; mean, 63.98. Winds SW. and SE. Sunshine, 45°/0. Mean barometer 30.1 inches. 58 Births and Deaths. Daring the four weeks ending June 27th there have been registered 241 births and 157 deaths. These births and deaths are divided among the five sub-districts as set forth in Table IV. The birth-rate for the month is therefore 23.5; the death-rate 15.3 per thousand. Quarterly Summary. During the quarter ending June 27th there have been registered 744 births and 515 deaths. These births and deaths are divided among the five sub-districts as set forth in Table V. 228 of the deaths were extra-parochial, as follow : — St. Marylebone Infirmary, Notting Hill 142 Western Fever Hospital 3 North-Western Fever Hospital 7 St. Mary's Hospital 17 Children's Hospital, Paddington 7 „ Great Ormonde Street 2 Guy's Hospital 1 St. Bartholomew's Hospital 2 University Hospital 1 St. George's Hospital 3 French Hospital 1 Italian Hospital 1 West London Hospital 1 North-West London Hospital 1 National Hospital 1 Heart Hospital, Soho 1 Royal Chest Hospital 1 St. Francis Hospital for Infants 1 Colney Hatch Asylum 8 Olaybury Asylum 1 Banstead Asylum 3 Darenth Asylum 2 Hanwell Asylum 7 Leavesden Asylum 4 Middlesex Asylum 1 Chelsea Infirmary 2 Islington Workhouse 1 Paddington Infirmary 1 St. Peter's Home 1 In the Streets 4 Total 228 59 The birth and death-rates, as deduced from the thirteen weeks' statistics, are as follows :— All Souls, birth-rate 18.8 ; death-rate 14.5. Rectory, birth-rate 19.1 ; death-rate 13.9. St. Mary, birth-rate 28.7: death-rate 15.0. Christ Church, birth-rate 25.4 : death-rate 17.1. St. John, birth-rate 20.0 ; death-rate 15.9. The whole district, birth-rate 22.4; death-rate 15.8. The average death-rates for five years (1898 to 1902) for the corresponding period were as follows :—All Souls, 13.0 ; Rectory, 19-9 ; St. Mary, 17.5; Christ Church, 19-0; St. John, 19.3; the whole district, 17.6. The following table gives, as usual, facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes. TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE THIRTEEN WEEKS ENDING JUNE 27TH, 1903, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES Total Deaths. 13 weeks ending June 27th, 1903. Proportion ofthedeaths to 1,000 deaths from all causes. 13 weeks ending June 27,1903. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1898-1902 1. Deaths from the chief Zymotic Diseases 41 80 1.23 2.13 2. Pulmonary, other than Phthisis 92 179 2.63 3.65 3. Tubercular 83 161 2.50 2.10 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria., Influenza, Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. 3. Includes Phthisis, Scrofula, Kickets, and Tabes. 60 Health of the District. The health of the District continues to be excellent. Both infectious diseases and pulmonary maladies are lower than during any corresponding period during the past five years. Interpretation of By-laws. With regard to the writer's observations (Sanitary Chronicles for May, 1903) as to the impossibility of enforcing strictly certain by-laws of the London County Council in old buildings, the more particularly in the central parts of the Metropolis, the judgment of the Court of Appeal in Pomeroy and another v. Malvern Urban District Council (Times Law Report July 6th) deserve quotation. The appellants had been convicted at the instance of the Malvern Authority of a breach of a building by-law under circumstances in which it was unreasonable to enforce the by-law. The Lord Chief Justice pointed out that it might in certain cases be very hard to apply a by-law such as the one in question in all its strictness. Mr. Justice Channell, in concurring, said that by-laws ought not to be criticised too adversely, but ought to be left to persons to administer properly. It was impossible to make them to suit every case. That being so, one was accustomed to assume that if a case occurred where the by-law became wholly unreasonable, either the Local Authority would be reasonable in taking proceedings, or. if not, the magistrates would exercise the discretion, which was given tlieni by the Summary Jurisdiction Act of 1879. School Closure on Account of Measles. The Annual Report of Dr. Kerr, the Medical Officer of the School Board for London, has just been issued, and contains, among other things, a valuable investigation as to Measles in reference to School closure, which will form a guide to the practical dealing with the question in this and other districts. Measles is a fatal disease of infant life, and a great proportion of children suffer during the early 61 years of their lives from an attack of measles, which makes them immune from a second attack. An inquiry with regard to the Woolwich Schools show how large a proportion of infants attending school have thus been rendered immune. It, therefore, appears common sense that if measles breaks out in a school an inquiry should be made of the parents of the children, and from the information thus obtained the pupils be divided into two groups, the one of children which have had measles, and therefore if exposed to infection are not likely to suffer, the other group children who have not had measles, and therefore constitute the combustible material. In the Infant School at Woolwich, which formed the subject of investigation, seven classes showed varying conditions of possible receptivity from 7 to 29 per cent. In the most favourable class, for instance, out of 58 pupils, 54 were protected, 4 were not protected ; in the least favourable class 42 were protected, 17 were unprotected. Under such conditions it would seem wisest to simply prohibit the unprotected children from coming to the school; thus interfering but little with instruction and preventing the necessity of school closure. The closing of schools is now a more serious thing than formerly, since the Authorities have, in the writer's opinion, most unwisely abolished the grants paid under Article 101 to Schools closed by order of a Sanitary Authority. The Laboratory—Sale of Food and Drugs Acts. During the past three months there have been analysed, under the Sale of Food and Drugs Acts, 152 samples of food, drink, and drugs, a full list of which is printed on page (52 Table II. Of the 152 samples, only two were found to be adulterated. The two samples in question were samples of milk : Maria Horton, of 44, Richmond Street, was convicted of selling milk diluted with at least 10 per cent, of water. The defendant was fined 20s. with 12s. 6d. costs. John Gowlett, of 113, Crawford Street, was fined £4 and 12s. 6d. costs for selling milk deficient to the extent of 16.7 per cent, of milk fat. The same vendor had been fined for butter adulteration in March, 1902. 62 The small amount of adulteration in milk during the quarter is noteworthy, the more so since special efforts were made by the staff to ascertain the quality of the milk sold; each of the Inspectors, for example, took a number of samples on Sunday in the street under conditions which rendered the substitution of milk specially prepared for an inspector to that actually under sale impossible. TABLE II.—SALE OF FOOD AND DRUGS ACT. Samples Analysed during June Quarter, 1903. Genuine. Adulterated. Total. DAIRY PRODUCTS— Milk 63 2 65 Butter 29 — 29 Margarine 14 — 14 Cheese 11 — 11 ALCOHOLIC BEVERAGES— Whisky 6 — 6 Brandy 1 — i Gin 4 — 4 Rum 1 — 1 Beer 1 — 1 NON-ALCOHOLIC BEVERAGES— Coffee 6 — 6 CONDIMENTS— Pepper 3 — 3 Ginger 7 — 7 SACCHARINE SUBSTANCES— Sugar 2 — 2 TINNED GOODS- Condensed Milk 1 1 Lobster 1 — 1 150 2 152 JUNE. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, AND TYPHOID FEVER DURING 1903 63 TABLE III.— Causes of, and Ages at, Death during the 4 weeks ending June 27th, 1903, 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 tinder 15. 15 and under 25. 25 and under 65. 65 and upwards. All Souls. Rectory. St. Mary. Christ Church. St. John. Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 2 1 1 .. .. .. .. .. .. .. .. 2 .. Scarlet Fever 1 .. 1 .. .. .. .. 1 .. .. .. .. .. Whooping Cough 2 .. 2 .. .. .. .. .. .. 1 .. 1 .. Diphtheria and Membranous Croup 1 .. 1 .. .. .. .. .. .. .. .. 1 .. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric .. .. .. .. .. .. .. .. .. .. .. .. .. Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 2 .. .. .. .. 1 1 1 .. 1 .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 2 2 .. .. .. .. .. .. 2 .. .. .. .. Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 1 .. .. .. .. .. 1 1 .. .. .. .. 1 Other Septic Diseases 1 .. .. .. .. 1 .. 1 .. .. .. .. 2 Phthisis 21 .. 2 1 7 10 1 9 4 3 2 3 17 Other Tubercular Diseases 5 .. 1 1 2 1 .. 2 1 1 .. 1 5 Cancer, Malignant Disease 17 .. .. .. .. 12 5 8 3 1 1 4 21 Bronchitis 11 2 .. .. .. 2 7 1 4 1 5 .. 10 Pneumonia 12 1 5 .. .. 4 2 4 3 .. 5 .. 2 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Respiratory Organs .. .. .. .. .. .. .. .. .. .. .. .. .. Alcoholism Cirrhosis of Liver 2 .. .. .. .. 2 .. 1 .. 1 .. .. 2 Venereal Diseases 1 1 .. .. .. .. .. .. .. .. 1 .. 1 Premature Birth 5 5 .. .. .. .. .. 3 1 .. .. 1 3 Diseases and Accidents of Parturition 1 .. .. .. .. 1 .. 1 .. .. .. .. 1 Heart Diseases 10 1 .. .. 2 4 3 1 .. 5 3 1 6 Accidents 8 2 .. 1 .. 1 4 2 1 1 3 1 5 Suicides .. .. .. .. .. .. .. .. .. .. .. .. .. All other causes 52 9 3 1 1 24 14 7 9 6 24 6 39 All causes 157 24 16 4 12 63 38 43 28 21 44 21 115 •37 of these were non-parishioners. 64 TABLE IV. — District Births and Deaths for the four weeks ending june 27th, 1903. Population in 1891 Births. Deaths. Males. Fmls. Males. Fmls. All Souls 35,391 31 26 26 17 Rectory 19,849 15 18 18 10 St. Mary 18 099 19 16 10 11 Christ Church 39,536 48 30 23 21 St. John 20,426 18 20 11 10 Total 133,301 131 110 88 69 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 sab-district. TABLE V.—District Births and Deaths for the thirteen weeks ending june 27th, 1903. Population in 1901. Births. Deaths. Males. Fmls. Males. Fmls. All Souls 35,391 89 77 67 61 Rectory 19,849 50 45 42 27 St. Mary 18,099 64 66 35 33 Christ Church 39,536 130 121 92 77 St. John 20,426 51 51 38 43 Total 133,301 384 360 274 241 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. 65 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 the June quarter, 1903; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals At All Ages. (b) Census 1901 35,391 19,849 18,099 39,536 20,426 133,301 (c) Registered Births 166 95 130 251 102 744 (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. / 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 13 13 8 19 3 11 14 17 10 19 48 79 3. Diphtheria 3 7 4 5 1 2 1 7 5 9 14 30 4. Membranous Croup .. .. .. .. .. .. .. .. 1 .. 1 .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 2 .. 2 .. 2 .. 1 .. 2 .. 9 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. 1 .. .. .. .. .. .. .. .. .. 1 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 10 3 25 1 5 1 11 .. 2 5 53 Number of such Cases Removed from their Homes in the several Localities for ment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 13 12 8 17 3 8 12 14 8 15 44 66 3. Diphtheria 3 7 5 5 1 .. 1 7 2 2 12 21 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 1 .. .. .. 1 .. 1 .. .. .. .. 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 1 1 20 .. 2 .. 2 .. 1 1 26 66 TABLE VII.—Giving the Causes of Deaths during the June quarter, 1903, 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 k Elizabeth Grove Rd. Smallpox .. .. .. .. .. .. Influenza .. .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. Diphtheria 1 .. .. .. .. .. Typhoid Fever .. .. .. .. .. .. Diarrhœa .. .. .. 1 2 .. Erysipelas .. .. .. .. 2 .. Pneumonia and Pleurisy 4 .. .. 1 1 .. Pyæmia 1 .. .. .. .. .. Syphilis .. .. .. .. 4 .. Cancer 37 .. .. .. 19 .. Phthisis & Tuberculosis 10 .. .. .. 42 1 Rheumatism .. .. .. .. .. .. Apoplexy .. .. .. 1 2 .. Paralysis .. .. .. .. 3 .. Bronchitis 6 .. .. .. 32 .. Asthma .. .. .. .. .. .. Peritonitis .. .. .. .. 1 .. Disease of Brain .. .. .. .. 1 .. „ Heart 6 .. .. 3 13 1 „ Kidney .. .. .. .. 1 .. „ Liver 2 .. .. .. 2 1 „ Uterus .. .. .. .. .. .. ,, Ovary .. .. .. .. .. .. Parturition .. .. .. .. .. .. Diabetes .. .. .. .. .. .. Fractures and Injuries .. .. .. .. .. .. Old Age .. .. .. .. 6 .. Low Vitality, Infants .. .. .. .. .. .. Premature Birth .. 8 .. .. .. .. Other causes 35 3 6 6 11 1 Total *102 †11 **6 12 142 ***4 * Of the 102 deaths in the Middlesex Hospital, 85 were those of non-parishioners, † The 11 deaths in Queen Charlotte's Hospital were those of non-parishioners. ** The 6 deaths in the Samaritan Hospital were those of non-parishioners. *** The deaths in St. John's Hospital were those of non-parishioners. 67 TABLE VIII.—Causes of, and Ages at, Death during the 13 weeks ending June 27th, 1903, 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 4 3 1 ... ... ... ... 2 ... ... ... 2 ... Scarlet Fever 5 ... 5 ... ... ... ... 1 ... ... 3 1 4 Whooping Cough 10 5 4 1 ... ... ... 2 1 2 3 2 2 Diphtheria and Membranous Croup 6 ... 4 2 ... ... ... ... 1 ... 2 3 3 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric ... ... ... ... ... ... ... ... ... ... ... ... ... Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza 4 ... ... ... ... 2 ... 1 ... 1 2 ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea 10 3 1 ... ... 3 ... 1 2 ... 3 4 2 Enteritis ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal fever ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 2 ... ... ... ... ... ... 2 ... ... ... ... 2 Other Sept c Diseases 3 ... ... 1 ... ... ... 1 1 ... ... 1 5 Phthisis 67 2 3 5 9 43 5 30 6 7 16 8 51 Other Tubercular Diseases 16 5 2 3 3 2 1 4 1 3 7 1 12 Cancer, Malignant Disease 52 ... 1 ... ... 27 24 13 8 12 6 13 45 Bronchitis 61 12 2 ... ... 15 32 13 13 9 24 2 36 Pneumonia 31 6 12 ... 1 9 3 8 3 2 17 1 5 Pleurisy ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Respiratory Organs ... ... ... ... ... ... ... ... ... ... ... ... ... Alcoholism Cirrhosis of Liver 8 ... ... ... ... 6 2 3 1 1 ... 3 6 Venereal Diseases 3 3 ... ... ... ... ... 1 ... ... 2 ... 2 Premature Birth 9 9 ... ... ... ... ... 4 2 ... 1 2 9 Diseases and Accidents of Parturition 2 ... ... ... ... 2 ... 2 ... ... ... ... 9 Heart Diseases 41 1 ... ... 2 23 15 9 3 10 13 6 19 Accidents 21 3 ... 2 2 8 6 5 2 3 7 4 10 Suicides 2 ... ... ... ... 2 ... 1 ... ... ... 1 ... All other causes 158 35 10 1 3 63 46 25 25 18 63 27 110 All causes 515 87 45 15 20 207 141 128 69 68 169 81 332* *180 of these were Non-Parishioners. 68 REGISTER OF SANITARY WORK Month ending June 30th, 1903. 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 38 46 35 20 41 ... ... ... ... ... 180 Tenements 48 9 50 60 37 ... ... ... ... ... 204 Underground Dwellings 12 3 20 12 21 ... ... ... ... ... 68 Dairies, Milk Shops, Cow Houses 4 2 1 2 9 ... ... ... ... ... 18 Slaughter Houses 2 3 ... ... 2 ... ... ... ... ... 7 Yards, Stables, and Mews 24 12 26 40 57 ... ... ... ... ... 159 Smoke Shafts ... ... ... ... ... ... ... ... 2 ... 2 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... 1 ... 1 Refuse Receptacles 16 13 5 23 16 ... ... ... ... 2 75 Enquiries re non-removal of refuse 10 9 6 12 21 ... ... ... ... 1 59 Removal of Bodies to Mortuary ... ... ... ... ... ... ... ... ... ... ... Visits to Works in Progress 180 193 120 186 161 ... ... ... ... 4 844 Miscellaneous Inspections 162 170 150 220 140 ... ... ... ... 61 903 UNWHOLESOME FOOD:- Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE:— Cases Isolated ... ... 1 2 ... ... ... ... ... ... 3 Cases removed to Hospital 6 7 8 11 18 ... ... ... ... ... 50 Rooms Disinfected 11 14 11 19 27 ... ... ... ... ... 82 new drainage :— Number of Plans Passed 6 6 5 9 7 ... ... ... 2 ... 35 New Pipe Drains (feet) 1120 1350 225 1200 1624 ... ... ... 86 ... 5605 Houses where defects in existing Drainage have been detected and remedied 8 10 7 8 9 ... ... ... ... ... 42 69 REGISTER OF SANITARY WORK Month ending June 30th, 1903. 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 ... ... ... ... ... ... ... ... 10 12 22 Periodical Inspections:— Factories ... ... ... ... ... ... ... ... 3 ... 3 Workshops ... ... ... ... ... ... ... ... 76 180 256 Bakehouses ... ... ... ... ... ... ... ... 42 2 44 Restaurants, &c. ... ... ... ... ... ... ... ... 53 ... 53 Homeworkers' Premises ... ... ... ... ... ... ... ... 12 44 56 Domestic Workshops ... ... ... ... ... ... ... ... 15 4 19 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 8 13 12 4 12 ... ... ... ... ... 49 Correspondence, Legal Procedure, &c. Complaints received 6 7 8 17 11 ... ... ... 4 13 66 Letters and Intimations relating to Abatement of Nuisances 22 19 32 28 19 ... ... ... 3 14 137 Statutory Notices Served 6 7 1 4 9 ... ... ... ... ... 27 Proceedings taken before Magistrates ... ... 4 5 ... ... ... ... ... ... 9 (1) Under Public Health Act ... ... 3 2 ... ... ... ... ... ... 5 (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) „ Food & Drugs Act ... ... ... ... ... ... ... ... ... ... ... Reports made to Medical Officer of Health 36 30 23 50 41 ... ... ... 42 10 237 THE SANITARY CHRONICLES OF THE BOROUGH OF ST. MARYLEBONE DURING JULY, 1903, BY ALEXANDER WYNTER BLYTH, Medical Officer of Health, and Analyst of Food and Drugs for the Borough of St. Marylebone. PRINTED BY ORDER OP THE COUNCIL. Vol. XXIII. 3, Upper Gloucester Place, W., Aug. 7th, 1903. No. 7. The week ending July 4th was rainless. Minimum temperature, 54.0° ; maximum, 85.0°; mean, 69.2°. The winds were variable. The sunshine registered in Regent's Park amounted to 849 hours out of a possible 115.5. Mean barometer 30.0 inches. The week ending July 11th was also rainless and fairly bright; minimum temperature, 45.0°; maximum, 86.0°; mean, 68.7. The winds were NW. and SW. Sunshine in Regent's Park, 60.8 hours. Mean barometer 30.0 inches. The week ending July 18th was unsettled. Minimum temperature, 47.5°; maximum, 75.5; mean, 63.4°. On two days there were heavy thunder showers and rainfall amounting to 2.12 inches. The winds were variable. Sunshine, 29.5 hours. Mean barometer (low) 29.8 inches. The week ending July 25th was also unsettled. Minimum temperature, 48.0 ; maximum, 72.0° ; mean, 62.9°. On three days rain fell, the total fall being 1.21 inch. Winds, NW. and SW. Sunshine, 27.9 hours. Mean barometer 29.9 inches. The week ending August 1st was wet. Minimum temperature, 52.0° maximum, 68.0° ; mean, 59.2. Rain fell during 6 days, giving a total fall of 2.07 inches. Winds, NW. and SW. Sunshine, 28.9 hours. Mean barometer, 29.7 inches. 72 Births and Deaths. During the five weeks ending August 1st there have been registered 245 births and 136 deaths. These births and deaths are divided among the five sub-districts as set forth in Table IV. Forty-seven of the deaths were extra-parochial, as follow:— St. Marylebone Infirmary, Notting Hill 25 North-Western Fever Hospital 2 Western Fever Hospital 1 St. Mary's Hospital 2 St. George's Hospital 1 St. Thomas' Hospital 1 Children's Hospital, Paddington 2 „ Great Ormonde Street 1 French Hospital 1 Banstead asylum 1 Hanwell Asylum 2 Colney Hatch Asylum 3 Darenth Asvlum 1 Paddington Workhouse 1 St. Pancras Infirmary 1 River Thames 1 In the Streets 1 Total 47 The birth and death-rates, as deduced from the five weeks' statistics, are as follows:— All Souls, birth-rate 13.2 ; death-rate 9.7. Rectory, birth-rate 17.3 ; death-rate 12.6. St. Mary, birth-rate 21.8; death-rate 12.6. Christ Church, birth-rate 23.4 ; death-rate 8.9. St. John, birth-rate 20.4 ; death-rate 11.7. The whole district, birth-rate 19.0; death-rate 10.6. 73 The average death-rates for five years (1898 to 1902) for the corresponding period were as follows :—All Souls, 12.2 ; Rectory, 14.9 ; St. Mary, 16.4 ; Christ Church, 17.0; St. John, 17.8; the whole district, 15.5. The following table gives, as usual, facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes. TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE FIVE WEEK ENDING AUG. 1st, 1903, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 5 weeks ending Aug. 1st, 1903. Proportion of the deaths to 1,000 deaths from all causes. 5 weeks ending Aug. 1, 1903. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1898-1902. 1. Deaths frOm the chief Zymotic 17 123 1.26 2.90 2. Pulmonary, other than Phthisis 23 169 1.74 2.48 3. Tubercular 16 117 1.21 1.82 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza,Whooping Cough, Erysipelas, Croup, Fever, and Diarrhœa. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. 74 Health of the District. Once more the death-rate is so low as to be phenomenal. The average death-rate for the month of July is usually low, something about 15 per thousand, but the past July death-rate does not attain 11 per thousand. This is mainly to be attributed to the favourable temperatures, to the absence of diarrhoea and to the general decline of infectious maladies. Prosecution under the Housing of the Working Classes Act. Proceedings before the Magistrate have been commenced for the purpose of closing No. 11, Gees Court as unfit for habitation. The owner, having undertaken to clear the premises of the tenants and to execute as soon as practicable the necessary works, the hearing of the summons has been adjourned six weeks. Housing of the Working Classes. The fine series of Artisans' Buildings, erected by Lord Portman in Queen Street, is a most important advance in the solution of the difficult problem of housing at reasonable rates the classes which earn by their labour a moderate weekly wage. The buildings consist of four blocks, and contain 176 tenements, as follows:— One-roomed tenements 74 Two-roomed tenements 78 Three-roomed tenements 23 There is one four-roomed tenement, the fourth room being used as an office. 75 The maximum and minimum rents of the different tenements., including rates and taxes, are as follows:— Weekly rents. One-roomed tenements 2s. 9d. to 4s. Two-roomed tenements 5s. 5d. ,, 7s. 4d. Three-roomed tenements 8s. 0d. „ 9s. 7d. The average size of the one-roomed tenements is 165 square feet of floor space and a cube of 1402. This would permit of occupation by three adults, or, say, man, wife and two young children. In one respect the buildings differ from most modern dwellings of the same class in having no dust shoot. The tenants will have to carry down their household refuse to receptacles fixed in the yards. Dust shoots are a fertile source of nuisance, and it will be interesting to see how far this new system will be successful. Another advantage of the new buildings is that the gates will be shut early, and although the bona fide tenants can of course gain admission at all hours, yet the occupation of the stairs by tramps and other persons at night will be effectually prevented. 76 TABLE II.—Giving the Causes of Deaths during July, 1903, 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 .. .. .. .. .. .. Darrhœa .. .. .. .. .. .. Erysipelas 5 .. .. .. 1 .. Pneumonia and Pleurisy 2 .. .. .. 1 .. Pyœmia .. .. 1 .. .. .. Syphilis 1 .. .. .. .. .. Cancer 13 .. .. .. 3 .. Phthisis & Tuberculosis .. .. .. .. 6 2 Rheumatism .. .. .. .. .. .. Apoplexy .. .. .. .. .. .. Paralysis .. .. .. .. .. .. Bronchitis 1 .. .. .. 6 .. Asthma .. .. .. .. .. .. Peritonitis .. .. .. .. .. .. Disease of Brain .. .. .. .. .. .. ,, Heart 5 .. .. .. 1 .. „ Kidney .. .. .. .. .. .. „ Liver .. .. .. 1 .. .. ,, Uterus .. .. .. .. .. .. ,, Ovary .. .. .. .. .. .. Parturition .. .. .. .. .. .. Diabetes .. .. .. .. .. .. Fractures and Injuries. 2 .. .. .. 1 .. Old Age .. .. .. .. 1 .. Low Vitality, Infants .. .. .. .. .. .. Premature Birth .. 3 .. 1 .. .. Other causes 11 1 2 1 5 1 Total *40 †4 **3 3 25 ***3 * Of the 40 deaths in the Middlesex Hospital, 36 were those of non-parishioners. † Three of the 4 deaths in Queen Charlotte's Hospital were those of non-parishioners. ** The 3 deaths in the Samaritan Hospital were those of non-parishioners. *** Two of the 3 deaths in St. John's Hospital were those of non-parishioners. JULY. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA. AND TYPHOID FEVER DURING 1903 77 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 July 1903; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals At all Ages. (b) Census 1901 35,391 19.849 18,099 39,536 20,426 133,301 (c) Registered Births 45 33 38 89 40 245 (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 of Sickness in bach Locality coming to the knowledge of the Medical Officer op Health. 1 Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 5 8 .. 2 .. 4 7 6 1 1 13 21 3. Diphtheria 3 .. .. .. .. 1 2 2 2 3 7 6 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid 1 2 .. .. .. .. .. .. 1 4 2 6 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 4 .. 4 .. .. .. 3 .. 2 .. 13 Number of such Cases Removed from their Homes in the several Localities for ment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. Scarlatina 5 7 .. 2 .. 5 6 5 1 1 12 20 3. Diphtheria 2 .. .. .. .. 1 2 2 2 3 6 6 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid 1 1 .. .. .. .. .. .. 1 2 2 3 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. 4 .. .. .. 2 .. 1 .. 7 78 TABLE IV. — District Births and Deaths for the five weeks ending august 1st, 1903. Population in 1891. Births. Deaths. Males. Fmls. Males. Fmls. All Souls 35,391 20 25 21 12 Rectory 19,849 14 19 11 13 St. Mary 18,099 18 20 11 11 Christ Church 39,536 48 41 21 13 St. John 20,426 20 20 11 12 Total 133,301 120 125 75 61 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. 79 TABLE V.—Causes of, and Ages at, Death during the 5 weeks ending August 1st, 1903, 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 2 .. .. 1 1 .. .. .. 1 .. .. 1 2 Whooping Cough 4 4 .. .. .. .. .. 2 .. .. 1 1 1 Diphtheria and Membranous Croup 1 .. 1 .. .. .. .. .. .. .. .. 1 1 Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric 1 .. .. .. .. 1 .. 1 .. .. .. .. 1 Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 2 .. .. .. .. 1 1 .. .. 1 1 .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 5 3 2 .. .. .. .. 1 .. 1 3 .. 1 Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 2 .. .. .. .. 1 1 1 .. .. .. 1 6 Other Septic Diseases 4 .. .. 1 .. 3 .. 1 1 1 1 .. 1 Phthisis 14 .. .. 1 2 9 2 4 2 1 5 9 Other Tubercular Diseases 2 .. 1 ... .. .. .. .. .. .. .. .. .. Cancer, Malignant Disease 10 .. .. .. .. 8 2 3 3 2 1 1 17 Bronchitis 9 .. 1 .. .. 1 7 1 2 2 2 8 Pneumonia 13 3 .. .. 8 .. 5 2 2 3 1 6 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Respiratory Organs 1 .. .. .. .. .. 1 1 .. .. .. .. .. Alcoholism Cirrhosis of Liver 4 .. .. .. .. 4 .. 1 1 1 .. 1 1 Venereal Diseases 1 .. .. .. .. 1 .. 1 .. .. .. .. 1 Premature Birth 10 10 .. .. .. .. .. 3 2 1 3 1 4 Diseases and Accidents of Parturition 1 .. .. .. .. 1 .. 1 .. .. .. .. .. Heart Disease 11 .. .. .. .. 8 3 1 3 3 .. 4 9 Accidents 5 1 .. .. .. 3 1 1 .. 2 2 .. 3 Suicides 1 .. .. .. .. 1 .. .. .. .. 1 .. 1 All other causes 33 9 2 .. 1 11 10 5 7 5 11 5 27 All causes 136 30 10 3 4 61 28 33 24 22 34 23 *99 *54 of these were non-parishioners. 80 REGISTER OF SANITARY WORK Month ending July 31st, 1903. PUBLIC HEALTH DEPARTMENT. District Inspectors. E. Lumley, Dust Inspector. Mr. R. Phillips, Special Duties. Miss F. A. Baker. Total. M r. 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 38 36 30 40 32 … … … … … 176 Tenements 40 … 20 58 19 … … … … … 137 Underground Dwellings 8 2 10 4 21 … … … … … 45 Dairies, Milk Shops, Cow Houses 6 3 … 2 3 … … … … 14 Slaughter Houses 2 2 … … 1 … … … … … 5 Yards, Stables, and Mews 18 15 12 23 79 … … … … … 147 Smoke Shafts … … … … … … … … 5 … 5 Offensive Trades and Effluvia Businesses … … … … … … … … … … … Refuse Receptacles 8 12 2 20 32 … 60 … … 4 138 Enquiries re non-removal of refuse 4 6 … 2 67 … 180 … … 2 261 Removal of Bodies to Mortuary 1 … 1 … … … … … … … 2 Visits to Works in Progress 120 196 25 245 47 … … … … 10 643 Miscellaneous Inspections 175 186 25 180 94 … 35 … … 72 767 UNWHOLESOME FOOD Number of seizures made … 1 … … … … … … … … 1 INFECTIOUS DISEASE Cases Isolated … … … 1 … … … … … … 1 Cases removed to Hospital 11 10 6 8 17 … … … … … 52 Rooms Disinfected 18 19 8 14 29 … … … … … 88 NEW DRAINAGE Number of Plans Passed 8 9 4 16 11 … … … … … 48 New Pipe Drains (feet) 976 856 250 780 1670 … … … … … 4532 Houses where defects in existing Drainage have been detected and remedied 8 10 7 5 11 … … … … … 41 81 REGISTER OF SANITARY WORK Month ending July 31st, 1903. PUBLIC HEALTH DEPARTMENT. District Inspectors. E. Lumley, Dust Inspector. 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 … … … … … … … … 7 12 19 Periodical Inspections Factories … … … … … … … … 2 … 2 Workshops … … … … … … … … 43 72 115 Bakehouses … … … … … … … … 21 … 21 Restaurants, &c. … … … … … … … … 39 … 39 Homeworkers' Premises … … … … … … … … 26 135 161 Domestic Workshops … … … … … … … … 2 5 7 Food and Drugs Act. ADULTERATION. Samples collected for Analysis … … 4 13 12 … … … … … 29 Correspondence, Legal Procedure, &c. Complaints received 11 13 16 12 23 … … … 2 6 83 Letters and Intimations relating to Abatement of Nuisances 25 19 22 30 9 … 28 … … 18 151 Statutory Notices Served 4 5 1 4 16 … … … … … 30 Proceedings taken before Magistrates … … 1 2 … … … … … … 3 (1) Under Public Health Act … … 1 1 … … … … … … 2 „ Housing Working Classes Act … … … 1 … … … … … … 1 (2) „ Factory & Workshop Act … … … … … … … … … … … (3) ,, Food & Drugs Act … … … … … … … … … … … Reports made to Medical Officer of Health 25 28 13 60 71 … 40 … 29 12 278 THE SANITARY CHRONICLES of the BOROUGH OF ST. MARYLEBONE DURING AUGUST AND SEPTEMBER, 1903, Containing a Quarterly Summary of the Mortality Statistics for the Quarter ending September 26th, 1903, and the Quarterly Statement of Analytical Work done under the Sale of Food and Drugs Act, &c. Vol. XXIV . 3, Upper Gloucester Place, October. 14th, 1903. No. 8. The week ending August 8th was fairly dry and fine. Minimum temperature, 47.0° ; maximum, 77.0°; mean, 64.6°. Winds, S.W. On one day only rain fell (0.31 inch). Sunshine in Regent's Park equal to 55.5 per cent. of the possible. Mean barometer 29.9 inches. The week ending August 15th was unsettled and wet. Minimum temperature, 47.0°; maximum, 72.2°; mean, 60.9. Winds, S.W. and S.E. On three days rain fell to the amount of 1.3 inch. The sunshine was about 38 per cent. Mean barometer (low) 29.6 inches. The week ending August 22nd was also wet. Minimum temperature, 49.2°; maximum, 69.2; mean, 61.1°. Winds, S.W. and N.E. On four days rain fell (0.39 inch). The sunshine was equal to 46 per cent. Mean barometer 29.7 inches. The week ending August 29th was unsettled, rainy and with much electrical disturbance. Minimum temperature, 46.2°; maximum, 69.0°; mean, 59.4°. Winds, S.W. and W.N.W. On three days rain fell (1.43 inch). Mean barometer 29.9 inches. The week ending September 5th was similar in weather to the preceding week, that is, unsettled, thundery and wet. Minimum temperature, 51.5°; maximum, 81.0° ; mean, 66.0°. Winds, S.W. and W.N.W. On three days rain fell (2.37 inches). Sunshine, 44.6 per cent. Mean barometer, 29'9 inches. The week ending September 12th was still unsettled. Minimum temperature, 40.0°; maximum, 67.0; mean, 55.3. Winds, N.NW. On three days rain fell (0.71 inches). Mean barometer, 29.8 inches. The week ending September 19th was rainless. Minimum temperature, 40.0° ; maximum, 64.5° ; mean, 55.0. Winds, N.N.E. and S.S.E Sunshine, 44 per cent. Mean barometer, 30.0 inches. 84 The week ending September 26th was also fine. Minimum temperature, 52.0°; maximum, 67.5; mean, 60.7. Sunshine, 23 per cent. Mean barometer, 30.0 inches. During the eight weeks under consideration the temperature was unusually low, rain frequent, only three weeks really fine, the other five more or less unsettled. Quarterly Summary. During the thirteen weeks ending September 26th there have been registered 653 births and 449 deaths These births and deaths are divided among the iive sub-districts as set forth in Tables V and XI. One hundred and eighty-five of the deaths were extra-parochial, as follow:— St. Marylebone Infirmary, Notting Hill 114 North-Western Hospital 3 Western Hospital 7 Children's Hospital, Paddington 4 „ Great Ormond Street 1 St. Mary's Hospital 7 St. Thomas' Hospital 2 University Hospital 3 St. G-eorge's Hospital 4 Brompton Hospital 2 French Hospital 2 Italian Hospital 1 Cancer Hospital 1 Hanwell Asylum 7 Colney Hatch Asylum 3 C.C. Asylum, Darenth 3 „ Dartford 1 „ Ilford 1 Banstead asylum 1 Claybury Asylum 1 Leavesden Asylum 1 Cane Hill Asylum 1 Tooting Beck 2 Camberwell House Asylum 1 Friedenheim 1 St. Francis Hospital 1 St. Pancras Infirmary 1 Holborn Infirmary 1 Paddington Workhouse 1 St. Lukes Home 2 Regent's Canal, Paddington 1 River Thames 1 In the Streets Total 3 185 85 Births and Deaths. The birth and death-rates, as deduced from the three months' statistics, are as follows :— All Souls, birth-rate 14.1; death-rate 13.9. Rectory, birth-rate 19.4 death-rate 12.1. St. Mary, birth-rate 22.3: death-rate 14.4. Christ Church, birth-rate 23.7 : death-rate 14.4, St. John, birth-rate 18.8; death-rate 15.9. The whole district, birth-rate 19.6; death-rate 13.5. The average death-rates for five years (1897 to 1902) for the corresponding period were as follows :—All Souls, 13.2 ; Rectory, 15.6 ; St. Mary, 16.9 ; Christ Church, 18.7 ; St. John, 18.8; the whole district, 16.5. The following table gives, as usual, facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes. TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE THIRTEEN WEEKS ENDING SEPT. 26th, 1903, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 13weeks ending Sept. 26th, 1903. Proportion ofthedeaths to 1,000 deaths from all causes. 13 weeks ending Sept. 26,1903. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1897-1902. 1. Deaths from the chief Zymotic Diseases 55 178 1.65 3.69 2. Pulmonary, other than Phthisis 56 181 1.68 2.07 3. Tubercular 70 226 2.10 1.89 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza,Whooping Cough, Erysipelas, Croup, Fever, and Diarrhœa. 3. Includes Phthisis, Scrofula, Rickets, and Tabes, 8(5 The Health of the District during the Quarter. The cool, damp, unsettled summer, however disagree" able from the view of personal comfort, has been favourable to human life. Small-pox absent, scarlet fever below the average, diphtheria and typhoid also below, save during the last fortnight, diarrhoea lower than for a long period, and the general death-rate only 13.5 per cent. Taking the decade 1893-1902 inclusive, diarrhoea accounted for 1,018 deaths, Avhich averages about 102 per annum, the maximum of 180 being reached in 1899, the minimum of 42 in 1894. This diarrhoeal mortality as a rule is restricted to the September quarter, and since the diarrhoeal deaths have been only 25 ; 1903 bids fair to be a record year, and will probably show a figure below that of 1894. Prosecutions under the Public Health Acts. The occupier of stables in Montagu Mews North, was fined £5 and costs for not removing periodically the manure from Wyndham Mews. The owner of 4, Harrow Street was summoned for neglecting to obey a notice of the Sanitary Authority, but the work being finished between the summons and the hearing thereof, the summons was withdrawn. The owner of 69, Upper Berkely Street was summoned for failure to comply with a notice of the Sanitary Authority. Ultimately, after more than one adjournment, the summons was withdrawn on the work being done and payment of solicitor's costs. The owner of 34, Great Barlow Street neglected to redrain the premises. A magistrate's order was obtained to do the work in 28 days, and a penalty inflicted Avith costs. The magistrate's order was not obeyed nor was the penalty or costs forthcoming ; a fresh summons was issued for disobedience of the magistrate's order; this was heard 87 on October 2nd, when the magistrate allowed the defendant a further time of 6 weeks. The defendant was arrested on leaving the Police Court and, at the present time, is said to be in prison for non-payment of rates. The owner of 18, Paddington Street was summoned for letting kitchens illegally. The magistrate gave time for the rooms to be vacated, stating that in default the full penalty would be enforced. The order was obeyed. Prosecution under the Housing of the Working Classes Act. The owner of No. 6, Gees Court was summoned under the above Act, and a closing order obtained. Certain tenants did not obey the order, hence it was necessary to summon these tenants for disobedience of the magistrate's order. The premises are now closed. The Laboratory—Sale of Food and Drugs Act. 150 samples of various foods and drugs (see Table XII) have been examined, but not a single certificate of adulteration has been given. A sample of coffee, it is true, had a small admixture of chicory, and a sample of milk might have been certified to contain some 2 per cent. of water. There were, however, doubts in each case as to Wilful adulteration. The present blank record is particularly satisfactory with regard to dairy produce, as a great proportion of the samples were collected in the streets on Sunday—a day which used to be specially selected by a certain class of milk-sellers for operating on the milk, believing that they could do so with impunity. 88 TABLE II.—Giving the Causes of Deaths during the September quarter, 1903, 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 6 .. .. .. 2 .. Pneumonia and Pleurisy 2 .. .. .. 6 .. Pysemia .. .. 1 .. .. .. Syphilis 1 .. .. .. 1 .. Cancer 35 .. .. .. 11 .. Phthisis & Tuberculosis 4 .. .. .. 33 3 Rheumatism .. .. .. .. .. .. Apoplexy .. .. .. .. .. .. Paralysis .. .. .. .. 4 .. Bronchitis 2 .. .. .. 15 .. Asthma .. .. .. .. .. .. Peritonitis .. .. .. .. ,.., .. Disease of Brain .. .. .. .. .. .. „ Heart 12 .. .. .. 7 .. „ Kidney .. .. .. .. .. .. „ Liver 1 .. .. 1 3 .. ,, Uterus .. .. .. .. .. .. ,, Ovary .. .. .. .. .. .. Parturition .. .. .. .. .. .. Diabetes .. .. .. .. .. .. Fractures and Injuries 6 .. .. .. 6 .. Old Age .. .. .. .. 1 .. Low Vitality, Infants .. .. .. .. .. .. Premature Birth .. 6 .. 1 .. .. Other causes 43 5 2 3 23 1 Total *112 †11 **3 5 114 ***4 *Of the 112 deaths in the Middlesex Hospital, 88 were those of non-parishioners. †Seven of the 11 deaths in Queen Charlotte's Hospital were those of non-parishioners. **The 3 deaths in the Samaritan Hospital were those of non-parishioners. ***Three of the 4 deaths in St. John's Hospital were those of non-parishioners. 89 TABLE III — District Births and Deaths for the four weeks ending august 29th, 1903. Population in 1891. Births. Deaths. Males. Fmls. Males. Fmls All Souls 35,391 23 21 18 13 Rectory 19,849 18 20 4 8 St. Mary 18,099 12 17 12 7 Christ Church 39,536 42 29 35 16 St. John 20,426 20 14 10 16 Total 133,301 115 101 79 60 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. 90 TABLE IV.—District Births and Deaths for the four weeks ending september 26th, 1903. Population in 1901. Births. Deaths. Males. Fml8. Males. Fmls. All Souls 35,391 15 21 17 20 Rectory 19,849 9 16 16 8 St. Mary 18,099 17 17 13 11 Christ church 39,536 39 36 38 19 St. John 20,426 12 10 13 19 Total 133,301 92 100 97 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. 91 TABLE V.—District Births and Deaths for the thirteen weeks ending september 26TH, 1903. Population in 1891. Births. Deaths. Males. Fmls. Males Fmls. All Souls 35,391 58 67 56 45 Rectory 19,849 41 55 31 29 St. Mary 18,099 47 54 36 29 Christ Church 39,536 129 106 94 48 St. John 20,426 52 44 34 47 Total 133,301 327 326 251 198 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. 92 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, 1903; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mart Christ Church St. John Totals Population at all ages. (b) Census 1901 36,495 19,798 19,637 32,547 32,611 141,188 (c) Registered Births 44 38 29 71 31 216 (d) Aged under 5 or over 5 Under 6 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards New Casks of Sickness in each Locality coming to the knowledge op the medical Officer op HEALTH. 1. small pox .. .. .. .. .. .. .. .. .. .. .. .. 2. scarlatina 1 4 1 4 1 4 9 7 7 4 19 23 3. Diphtheria 5 1 1 .. .. 2 1 6 1 14 8 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. 1 .. .. .. .. .. .. 1 7. Continued .. .. .. .. .. .. .. 1 .. 1 .. 2 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas. .. .. .. 2 .. 2 .. 11 .. 1 .. 16 Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospitals. 1. small pox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 1 4 1 4 1 4 9 6 7 4 19 22 3. Diphtheria 5 4 1 1 .. .. 2 1 5 1 13 7 4. Membranous .. .. .. .. .. .. .. .. .. .. .. .. fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. 1 .. .. .. .. .. .. .. 1 7. Continued .. .. .. .. .. .. .. .. .. 1 .. 1 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. 2 .. 1 .. 4 ..•• 1 •• 8 AUGUST AND SEPTEMBER. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, AND TYPHOID FEVER DURING 1903 93 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, 1903; 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 18,099 39,536 20,425 133,301 (c) Registered Births 36 25 34 75 22 192 (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 op Sickness in each Locality coming to the knowledge op the medical Officer op Health. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 1 7 1 2 .. 4 4 9 2 5 8 27 3. Diphtheria 1 3 3 3 1 2 6 1 7 7 18 16 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 4 .. .. .. 1 .. 4 .. 4 .. 13 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. .9. Puer .. .. .. .. .. .. .. .. .. 1 .. 1 10. Cholera .. .. .. .. .... .. .. .. .. .. .. .. 11. Erysipelas .. 1 1 3 .. 2 .. 7 .. 4 1 17 Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 1 7 1 2 .. 4 4 9 2 5 27 3. Diphtheria 1 3 3 4 1 1 6 1 5 7 16 16 4.. Membranous Croup .. .. .. .. .. .. .. .. .. •• .. •• fevers. 5. Typhus .. .. .. .. .. .. ..•• .. .. .. .. .. 6'. Enteric or Typhoid .. 5 .. .. .. 1 .. 2 .... 1 •• 9 7. Continued .. .. .. .. .. .. .. .. .. •..• •• .. 8. Relapsing .. .. .. .. .. .. .... .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. ..•• .. .. .. .. .. 10. Cholera .. .. .. .. .. .. ..•• .. .. .. .. .. 11. Erysipelas .. .. 1 2 .. .. ..•• 1 .. 1 1 4 94 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 SI1. MARYLEBONE, during the September Quarter, 1903; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary CHRIST church St. John Totals At all Ages. (b) Census 1901 35,391 19,849 18,099 39,536 20,426 133,301 (c) Registered Births 125 96 101 235 96 653 (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 op Sickness in each Locality coming to the knowledge op the medical Offices of Health. / 1 - Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 7 19 2 8 1 12 20 22 10 10 40 71 3. Diphtheria 9 8 4 4 1 3 10 4 15 11 39 30 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid 1 6 .. 1 .. 1 .. 4 1 8 2 20 7. Continued .. .. .. .. .. .. .. 1 .. 1 .. 2 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 0. Puerperal .. .. .. .. .. .. .. .. .. 1 .. 1 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. 5 1 9 .. 4 .. 21 .. 7 1 46 Number of such cases Removed from their Homes in the several Localities for Treatment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 7 18 2 8 1 12 19 20 10 10 39 68 3. Diphtheria 8 7 4 4 1 2 10 4 12 11 35 28 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 6. Enteric or Typhoid 1 6 .. 1 .. 1 .. 2 1 3 2 13 7. Continued .. .. .. .. .. .. .. .. .. 1 .. 1 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. 1 .. 1 .. 7 .. 3 .. 12 95 TABLE IX.—Causes of, and Ages at, Death during the 4 weeks ending August 29th, 1903, 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 1 .. 1 .. .. .. .. .. .. .. 1 .. 1 Whooping Cough .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria and Membranous Croup 2 .. 2 .. .. .. 1 .. .. .. 1 .. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric .. .. .. .. .. .. .. .. .. .. .. .. .. i Other continued 1 .. .. 1 .. .. .. .. .. .. 1 .. .. Epidemic Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 10 10 .. .. .. .. .. 2 .. 2 5 1 1 Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 1 .. .. .. .. 1 .. 1 .. .. .. .. 1 Other Septic Diseases 1 .. .. 1 .. .. .. .. .. 1 .. .. 1 Phthisis 20 .. 1 .. 1 15 3 5 1 5 5 4 17 Other Tubercular Diseases 5 1 3 .. .. 1 .. 1 .. .. 3 I .. Cancer, Malignant Disease 13 .. •• .. .. 9 4 1 3 2 3 4 22 Bronchitis 5 .. .. .. .. 2 3 .. 2 .. 2 1 3 Pneumonia 7 1 1 1 .. 3 1 .. 2 1 4 .. ??? Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Respiratory Organs .. .. .. .. .. .. .. .. .. .. .. .. .. Alcoholism Cirrhosis of Liver 4 .. .. .. .. 4 .. 1 .. .. 2 I 4 Venereal Diseases 1 1 .. .. .. .. .. .. .. 1 .. .. Premature Birth 5 5 .. .. .. .. .. 1 1 .. 3 .. 1 Diseases and Accidents of Parturition .. .. .. .. .. .. .. .. .. .. .. .. .. Heart Diseases 13 .. .. .. .. 6 7 2 1 1 5 4 9 Accidents 5 1 .. 2 .. 1 1 1 1 .. 2 1 6 Suicides 1 .. .. .. .. 1 .. 1 .. ..- •• .. 1 All other causes 43 9 3 2 5 18 6 14 1 7 13 8 32 All causes 139 28 11 8 6 61 25 31 12 19 51 26 *103 "Of these, 28 were Non-Parishioners. 96 TABLE X.—Causes of, and Ages at, Death during the 4 weeks ending September 27th, 1903, 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. 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 2 ... 2 ... ... ... ... ... ... ... 2 ... 2 Scarlet Fever 1 1 ... ... ... ... ... 1 ... ... ... ... 1 Whooping Cough 2 1 1 ... ... ... ... 1 ... ... 1 ... 1 Diphtheria and Membranous Croup 4 ... 4 ... ... ... ... ... ... ... 3 1 4 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric 1 ... ... ... ... 1 ... 1 ... ... ... ... 1 Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa 10 8 1 ... ... ... 1 1 1 2 3 3 1 Enteritis 1 1 ... ... ... ... ... ... ... ... ... 1 ... Puerperal fever 1 ... ... ... ... 1 ... ... ... ... 1 ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... Other Septic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... Phthisis 23 ... 1 1 2 19 ... 5 3 3 10 2 18 Other Tubercular Diseases 6 1 3 1 1 ... ... 2 ... 2 1 1 4 Cancer, Malignant Disease 11 ... ... ... ... 5 6 3 ... 1 4 3 15 Bronchitis 13 ... ... ... ... 3 10 3 4 2 3 1 10 Pneumonia 8 2 4 ... ... 2 ... 3 1 2 2 ... 4 Pleurisy ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Respiratory Organs ... ... ... ... ... ... ... ... ... ... ... ... ... Alcoholism Cirrhosis of Liver 3 ... ... ... ... 3 ... 2 ... ... ... 1 1 Venereal Diseases 1 ... 1 ... ... ... ... 1 ... ... ... ... ... Premature Birth 1 1 ... ... ... ... ... ... ... ... ... 1 3 Diseases and Accidents of Parturition 1 ... ... ... ??? ... ... ... 1 ... ... ... ... Heart Diseases 19 ... ... ... 1 13 5 2 1 5 5 6 12 Accidents 13 1 2 2 ... 6 2 2 4 1 6 ... 4 Suicides ... ... ... ... ... ... ... ... ... ... ... ... ... All other causes 53 6 ... 2 3 23 19 10 9 6 16 12 36 All causes 174 22 19 6 8 76 43 37 24 24 57 32 117* *30 of these were Non-Parishioners. 97 TABLE XI.—Causes of, and Ages at, Death during the 13 weeks ending September 26th, 1903, 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 3 .. 2 1 .. .. .. .. .. .. 3 •• 2 Scarlet Fever 4 1 1 1 1 .. .. 1 1 .. 1 1 4 Whooping Cough 6 5 1 .. .. .. .. 3 .. .. 2 1 2 Diphtheria and Membranous Croup 7 .. 7 .. .. .. .. 1 .. .. 3 3 5 Croup .. .. .. .. .. .. .. .. .. .. .. .. .. FEVER Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric 2 .. .. .. .. 2 .. 2 .. .. .. .. 2 Other continued 1 .. .. 1 .. .. .. .. .. .. 1 .. .. Epidemic Influenza 2 .. .. .. ... 1 1 .. .. 1 1 .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 25 21 3 .. .. .. 1 4 1 5 11 4 3 Enteritis 1 .. 1 .. .. .. .. .. .. .. .. 1 .. Puerperal Fever 1 .. .. .. .. 1 .. .. .. .. 1 .. .. Erysipelas 3 .. .. .. .. 2 1 2 .. .. .. 1 7 Other Septic Diseases 5 .. .. 2 .. 3 .. 1 1 2 1 .. 2 Phthisis 57 .. 2 2 5 43 5 14 6 9 20 8 44 Other Tubercular Diseases 13 3 7 1 1 1 .. 3 .. 2 4 4 4 Cancer, Malignant Disease 34 .. .. .. .. 22 12 7 6 5 8 8 54 Bronchitis 27 .. 1 .. .. 6 20 4 8 4 7 4 21 Pneumonia 28 5 8 1 .. 13 1 8 5 5 9 1 ??? Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Respiratory Organs 1 .. .. .. .. .. 1 1 .. .. .. .. .. Alcoholism Cirrhosis of Liver 11 .. .. .. .. 11 .. 4 1 1 2 3 6 Venereal Diseases 3 1 1 .. .. 1 .. 2 .. .. 1 .. 1 Premature Birth 16 16 .. .. .. .. .. 4 3 1 6 2 8 Diseases and Accidents of Parturition 2 .. .. .. 1 1 .. 1 1 .. .. .. .. Heart Diseases 43 .. .. .. 1 27 15 5 5 9 10 ??? 30 Accidents 23 3 2 4 .. 10 4 4 5 3 10 1 13 Suicides 2 .. .. .. .. 2 .. 1 .. .. 1 .. 2 All other causes 129 24 5 4 9 52 35 29 17 18 40 25 95 All causes 449 79 41 17 18 198 96 101 60 65 142 81 *309 *112 of these were Non-Parishioners. 98 TABLE XII.—SALE OF FOOD AND DRUGS ACT Samples Analysed during September Quarter, 1903. DAIRY PRODUCTS— Genuine. Adulterated. Total. Milk 42 — 42 Butter 15 — 15 Margarine 1 — 1 Cheese 1 1 Lard 2 — 2 ALCOHOLIC BEVERAGES— Whisky 16 — 16 Brandy 5 — 5 Rum 3 — 3 Gin 3 — 3 NON-ALCOHOLIC BEVERAGES— Tea 2 — 2 Coffee 9 — 9 Coffee and Chicory 1 — 1 CONDIMENTS— Mustard 3 — 3 Pepper 2 — 2 Curry Powder 1 — 1 Vinegar 1 — 1 Sauce 1 — 1 SACCHARINE SUBSTANCES— Jam 5 — 5 Sweets 1 — 1 TINNED GOODS- Condensed Milk 1 — 1 Pineapple 3 — 3 Tomatoes 1 — 1 Salmon 8 — 8 Pears 1 — 1 Potted Meat 4 — 4 Bloater Paste 2 — 2 Sardines 2 — 2 Mackerel 1 — 1 Baked Beans 1 — 1 Peas 2 — 2 DRUGS— Quinine 1 — 1 Citrate of Magnesia 2 — 2 MISCELLANEOUS— Custard Powder 1 — 1 Force Food 1 — 1 Corn Floor 1 — 1 Ginger 1 — 1 Olive Oil 1 — 1 Lemon Squash 1 — 1 Bottled Gooseberries 1 — 1 150 — 150 99 REGISTER OF SANITARY WORK Month ending 31st August, 1903. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. It. 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. 36 28 75 23 35 ... ... ... ... ... 197 Tenements 38 30 35 62 19 ... ... ... ... ... 184 Underground Dwellings 11 ... 25 5 18 ... ... ... ... ... 59 Dairies, Milk Shops, Cow Houses 8 1 ... 1 12 ... ... ... ... 22 Slaughter Houses 2 1 ... ... 2 ... ... ... ... ... 5 Yards, Stables, and Mews 32 28 25 53 49 ... ... ... ... ... 187 Smoke Shafts ... ... ... ... ... ... ... ... ... ... ... Offensive Trades and Effluvia Businesses ... ... 1 ... ... ... ... ... ... ... 1 Refuse Receptacles 6 8 3 16 14 ... ... ... ... ... 47 Enquiries re non-removal of refuse 7 5 6 12 8 ... ... ... ... 3 41 Removal of Bodies to Mortuary ... ... ... ... ... ... ... ... ... ... ... Visits to Works in Progress 120 103 95 125 108 ... ... ... 23 7 581 Miscellaneous Inspections 43 38 35 115 46 ... ... ... 49 59 385 UNWHOLESOME FOOD:— Number of seizures made ... 1 ... ... ... ... ... ... ... ... 1 INFECTIOUS DISEASE:— Cases Isolated 1 ... ... ... ... ... ... ... ... ... 1 Cases removed to Hospital 17 14 11 8 12 ... ... ... ... ... 62 Rooms Disinfected 24 21 12 12 26 ... ... ... ... ... 95 NEW DRAINAGE:— N umber of Plans Passed 6 11 3 14 16 ... ... ... ... 50 New Pipe Drains (feet) 940 1290 320 1350 1624 ... ... ... ... ... 5524 Houses where defects in existing Drainage have been detected and remedied 11 13 10 8 12 ... ... ... ... ... 54 100 REGISTER OF SANITARY WORK Month ending 31st August, 1903. 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 ... ... ... ... ... ... ... 4 2 6 Periodical Inspections:— Factories ... ... ... ... ... ... ... ... 1 ... 1 Workshops ... ... ... ... ... ... ... ... 29 5 34 Bakehouses ... ... ... ... ... ... ... ... 30 ... 30 Restaurants, &c. ... ... ... ... ... ... ... ... 49 ... 49 Homeworkers' Premises ... ... ... ... ... ... ... ... 10 42 52 Domestic Workshops ... ... ... ... ... ... ... ... ... 3 3 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 24 6 18 ... ... ... ... ... ... ... 48 Correspondence, Legal Procedure, &c. Complaints received 8 9 12 21 19 ... ... ... 10 4 83 Letters and Intimations relating to Abatement of Nuisances 26 23 24 35 21 ... ... ... ... 4 133 Statutory Notices Served 6 5 2 8 14 ... ... ... ... ... 35 Proceedings taken before Magistrates ... ... ... ... ... ... ... ... ... ... ... (1) Under Public Health Act ... ... ... ... ... ... ... ... ... ... ... (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) ,, Food & Drugs Act ... ... ... ... ... ... ... ... ... ... ... Reports made to Medical Officer of Health 41 32 35 60 52 ... ... ... 10 7 237 101 REGISTER OF SANITARY WORK Month ending 30th September, 1903. PUBLIC HEALTH DEPARTMENT. Mr. J. Hodges, No. 1 District. District Inspectors. 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 F. A. Baker. Total. Public Health (London) Act. Inspections. Dwelling Houses, &c. 76 86 95 12 26 ... ... ... ... ... 295 Tenements 38 32 45 9 18 ... ... ... ... ... 142 Underground Dwellings 6 ... 10 1 8 ... ... ... ... ... 25 Dairies, Milk Shops, Cow House 8 1 2 1 7 ... ... ... ... ... 19 Slaughter Houses 2 4 3 ... ... ... ... ... ... ... 9 Yards, Stables, and Mews 28 9 30 15 29 ... ... ... ... ... 111 Smoke Shafts ... ... ... ... ... ... ... ... ... ... ... Offensive Trades and Effluvia Businesses ... ... 1 ... ... ... ... ... ... ... 1 Refuse Receptacles 6 4 3 5 9 ... ... ... ... ... 27 Enquiries re non-removal of refuse 4 3 9 0 7 ... ... ... ... 5 28 Removal of Bodies to Mortuary ... ... 1 ... ... ... ... ... ... ... 1 Visits to Works in progress 118 136 120 50 69 ... ... ... 15 2 510 Miscellaneous Inspections 34 48 45 60 42 ... ...... ... 29 38 296 UNWHOLESOME FOOD. Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE:— Cases Isolated 2 1 ... ... ... ... ... ... ... ... 3 Cases Removed to Hospital 18 15 13 12 21 ... ... ... ... ... 79 Rooms Disinfected 26 21 20 31 11 ... ... ... ... ... 109 NEW DRAINAGE:— Number of Plans Passed 4 6 6 6 7 ... ... ... ... ... 29 New Pipe Drains (feet) 250 986 300 200 846 ... ... ... 30 ... 2582 Houses where defects in existing Drainage have been detected and remedied 7 9 9 2 7 ... ... ... ... ... 34 102 REGISTER OF SANITARY WORK Month ending 30th September. 1903. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillips, Special Duties. Miss P. A. Baker, Total Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. i 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 ... ... ... ... ... ... ... ... 2 7 9 Periodical Inspections:— Factories ... ... ... ... ... ... ... ... ... ... ... Workshops ... ... ... ... ... ... ... ... 9 6 15 Bakehouses ... ... ... ... ... ... ... ... 15 ... 15 Restaurants, &c. ... ... ... ... ... ... ... ... 29 ... 29 Homeworkers' Premises ... ... ... ... ... ... ... ... ... 57 57 Domestic Workshops. ... ... ... ... ... ... ... ... ... 2 2 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 6 24 8 17 18 ... ... ... ... ... 73 Correspondence, Legal Procedure, &c. Complaints received 6 9 11 9 10 ... ... ... 3 2 50 Letters and Intimations relating to Abatement of Nuisances 11 10 12 7 14 ... ... ... ... 4 58 Statutory Notices Served 2 ??? 4 1 8 ... ... ... ... ... 16 Proceedings taken before Magistrates ... ... ... ... ... ... ... ... ... ... ... (1) Under Public Health Act ... ... ... ... ... ... ... ... ... ... ... (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) „ Food & Drugs Act ... ... ... ... ... ... ... ... ... ... ... Reports made to Medical Officer of Health 28 32 30 20 37 ... ... ... 12 9 168 SANITARY CHRONICLES OF THE BOROUGH OF ST. MARYLEBONE DURING OCTOBER, 1903, 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. XXIII. 3, Upper Gloucester Place, W., Nov. 6th, 1903. No. 9. The week ending October 3rd was the first of a series of wet weeks. Minimum temperature, 52.00; maximum, 68.0°; mean, 61.7° Wind, S.W. Rain fell on four days up to 0.59 inch. Sunshine registered in Regent's Park equal to 26 per cent. of the possible. Mean barometer 29.8 inches. The week ending October 10th was a wet week. Minimum temperature, 39.00; maximum, 64.0°; mean, 53.5°. Winds, S.W. and N.W. On five days rain fell (1.29 inch). Sunshine, 18.7 percent. Mean barometer 29.6 inches. The week ending October 17th was similar to the preceding—a wet week. Minimum temperature, 43.5°; maximum, 61.50; mean, 53.5°. Winds, W.S.W. Rain fell for five days to the amount of 1.85 inches. Sunshine, 27.4 per cent. Mean barometer 29.5 inches. The week ending October 24th was wet and gloomy. Minimum temperature, 37.20; maximum, 55.0°; mean, 50.9°. On four days rain fell (0.71 inch). Winds, S.S.W. Only six hours of sunshine recorded throughout the week. Mean barometer (low) 29.4 inches. 104 The week ending October 31st was, like the previous four weeks— wet. Minimum temperature, 39.2°; maximum, 58.0°; mean, 52.8°. Winds, S.W. Rain fell each day save one (1.19 inch). Sunshine 20.7 per cent. Mean barometer 29.4 inches. Hence no less than 24 out of 35 were days of rain, the rainfall in this district reaching the total figure of 5.63 inches—a greater rainfall than has been experienced within living memory during the corresponding period. Births and Deaths. During the five weeks ending October 31st there have been registered 261 births and 183 deaths These births and deaths are divided among the five sub-districts as set forth in Table IV, Sixty of the deaths were extra-parochial, as follow:— St. Marylebone Infirmary, Notting Hill 40 Children's Hospital, Paddington 3 „ Great Ormond Street 1 North-Eastern Children's Hospital 1 Western Fever Hospital 3 North-Western Fever Hospital 1 St. Mary's Hospital 2 St. George's Hospital 1 St. Thomas' Hospital 2 St. Bartholomew's Hospital 1 University Hospital 1 Friedenheim 1 French Hospital 1 Hanwell Asylum 1 In the Streets 1 Total 60 The birth and death-rates, as deduced from the five weeks' statistics, are as follows:— All Souls, birth-rate 16.4; death-rate 12.6. Rectory, birth-rate 23.0 death-rate 16.2. St. Mary, birth-rate 17.8; death-rate 12.6. Christ Church, birth-rate 21.8; death-rate 16.6. St. John, birth-rate 23.9; death-rate 12.2. The whole district, birth-rate 20.4; death-rate 14.3. 105 The average death-rates for five years (1898 to 1902) for the corresponding period were as follows All Souls, 13.1; Rectory, 14.7; St. Mary, 15.1; Christ Church, 17.4; St. John, 16.3; the whole district, 15.3. 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 FIVE WEEKS ENDING OCTOBER 31ST, 1903, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 5 weeks ending Oct. 31st, 1903. Proportion ofthedeaths to 1,000 deaths from all causes. 5 weeks ending Oct. 31,1903. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1898-1902. 1. Deaths from the chief Zymotic Diseases 19 103 1.48 2.20 2. Pulmonary, other than Phthisis 31 169 2.42 2.75 3. Tubercular 27 145 2.11 2.05 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza,Whooping Cough, Erysipelas, Croup, Fever, and Diarrhœa. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. 106 Health of the District for October. The death-rate is about the average. The ordinary infectious diseases, as shown by the curve, have been generally below the average. A single case of modified extremely mild smallpox was notified, under circumstances which are not favourable to its farther extension. Prosecution under the Public Health (London) Act. The owner of Nos. 3 and 4, Wellington Place was summoned for not obeying a notice requiring new drains throughout the premises. The case was adjourned for three weeks for the work to be done. Housing of the Working Classes Act. Bentinck Court and Williams Cottages are situated in a rectangular court approached through an archway out of Henry Street, St. John's Wood, and also by a narrow passage from Upper William Street. The number of houses in Bentinck Court is 15, in Williams Cottages 4, the latter used to be separated from the court by a partition, this, however, became dilapidated, was destroyed by the occupants and not re-constructed. All the houses are tworoomed houses, and therefore each house is only large enough for a single family. The long lease expired about two years ago, a building contract for a lease has been granted by the freeholders (the Howard de Walden Estate) but no lease has been actually entered into, As usual, with tenement property, at the end of a lease, the structure generally of these cottages has deteriorated so that they are no longer fit for habitation. After waiting for signs of closing the court and demolition of the houses, the writer felt compelled to make an official representation, and the Public Health Committee ordered 107 summonses to be taken out for "closing orders." Closing orders were granted by Sir Albert de Rutzen, and in a short time this picturesque but insanitary court will be a thing of the past. The Nightingale Street Scheme. The greater portion of the Nightingale Street area has now been cleared, the general plan of the buildings to be erected is prepared, and the work of construction will shortly be commenced. It may be well to state that the action of Lord Portman is taken by virtue of a "Provisional Order," which is as much an Act of Parliament as any one of the general Statutes. The chief powers and duties under this Order are as follows:—"5. The existing buildings constituting the "Improvement area shall be taken down and removed, and "new dwellings upon the said lands or on some part "or parts thereof shall be erected by the Viscount Portman "as may be determined from time to time in that behalf by "the (London County) Council, with the approval of one of "His Majesty's Secretaries of State. The new dwellings "shall be constructed in such manner as to position, eleva"tion, size, design, and extent of accommodation as the "(London County) Council, with such approval as aforesaid, "shall prescribe or approve, and to their satisfaction, so as "to afford in the aggregate suitable accommodation for not "less than five hundred and seventy-six persons of the "working classes. "Such dwellings shall be furnished with such water"closets, sinks, water supply, and other proper sanitary "arrangements as the Council shall prescribe and to their "satisfaction. Such of the lands constituting the Improve"ment area as shall not be required for the purpose of "providing accommodation as aforesaid for five hundred "and seventy-six persons of the working classes may be "formed or laid out as an open space or recreation ground 108 "for the use of the residents in the new dwellings to be "erected by the said Viscount Portman. Viscount Portman "shall carry this scheme into execution in accordance with "and subject to the provisions of the Housing of the "Working Classes Act, 1890, and this scheme, and subject "to such modifications therein or additions thereto as may "be prescribed and made under the authority of the said "Act. "(6. The following street shall bo stopped up and "form part of the Improvement area—viz., the whole of "Nightingale Street." The last section of the Order, abolishing Nightingale Street, will render alterations of the existing Nightingale Street sewer a necessity; the sewer not only receives Nightingale Street sewage, but also that of the Board School and some six houses in Capland Street. If the sewer should have to be removed, provision must be made by the Local Authority for the drainage of the houses now draining into the sewer and not included in the scheme. OCTOBER, 1903 CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA. AND TYPHOID FEVER DURING 1903 109 TABLE II.—Giving the Causes of Deaths during October, 1903, 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 .. .. .. 1 .. .. Erysipelas .. .. .. .. .. .. Pneumonia and Pleurisy .. •• .. 1 1 .. Pyæmia .. .. .. .. .. .. Syphilis .. .. .. .. .. .. Cancer 15 .. .. .. 4 2 Phthisis & Tuberculosis 4 .. .. .. 11 1 Rheumatism .. .. .. .. .. .. Apoplexy .. .. .. .. .. .. Paralysis .. .. .. .. 1 .. Bronchitis 1 .. .. •• 10 .. Asthma .. .. .. .. .. .. Peritonitis .. .. .. .. .. .. Disease of Brain .. .. .. .. .. .. „ Heart .. .. .. .. 2 .. „ Kidney .. .. .. .. .. .. „ Liver 1 .. .. .. .. .. „ Uterus .. .. .. .. .. .. „ Ovary .. .. .. .. .. .. Parturition .. .. .. .. .. .. Diabetes .. .. .. .. .. .. Fractures and Injuries 3 .. .. .. 2 .. Old Age .. .. .. .. 4 .. Low Vitality, Infants .. .. .. .. .. .. Premature Birth .. 2 .. .. .. .. Other causes 7 1 1 .. 5 3 Total *34 †3 **1 2 40 ***6 * Of the 34 deaths in the Middlesex Hospital, 29 were those of non-parishioners, f One of the three deaths in Queen Charlotte's Hospital was that of a non-parishioner. ** The death in the Samaritan Hospital was that of a non-parishioner. *** Three of the 6 deaths in St. John's Hospital were those of non-parishioners. 110 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 October, 1903 ; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals Population at all agks. ' (b) Census 1901 35,391 19,849 18,099 39,636 20,426 133,301 (c) Registered Births 56 41 31 83 47 261 (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 fach Locality coming to the knowlkdge of the medical Officer of Health. 1. Smallpox .. 1 .. .. .. .. .. .. .. .. .. 1 2. Scarlatina 2 .. 1 1 .. 3 3 9 .. 5 6 24 3. Diphtheria 1 1 1 .. .. .. 2 4 3 4 7 9 4. Membranous Croup .. .. .. .. .. .. 1 .. .. .. 1 .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 1 .. .. .. .. .. 1 .. 2 .. 4 7. Continued .. 1 .. .. .. .. .. .. .. .. .. 1 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. 1 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas. .. .. .. 16 .. .. .. 6 .. .. .. 25 Number if such Cases Removed from thier Homes in the several localities fob treat- ment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. scarlatina 2 5 1 1 .. .. 3 7 .. 4 6 20 3. Diphtheria 1 1 1 .. .. .. 2 4 3 3 7 8 4. Membranous .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. .. .. 1 .. .. .. 1 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. 13 .. .. .. .. .. .. .. 13 TABLE IV.—District Births and Deaths for the thirteen weeks ending october 31ST, 1903. Population in 1891. Births. Deaths. Males. Fmls. Males Fmls. All Souls 35.391 28 28 27 16 Rectory 19,849 26 18 18 13 St. Mary 18,099 16 15 9 13 Christ Church 39,530 44 39 34 29 St. John 20,426 25 22 12 12 Total 133,301 139 122 100 83 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. 112 TABLE V.—Causes of, and Ages at, Death during the 5 weeks ending October 31st, 1903, 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. and upwards. All Souls. Rectory. St. Mary. Christ Church. St. John. Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 3 ... 3 ... ... ... ... ... ... ... 3 ... ... Scarlet Fever 1 ... 1 ... ... ... ... ... ... ... 1 ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria and Membranous Croup 3 ... ... ... ... ... ... 1 ... ... 1 ... 2 Croup 2 ... ... ... ... ... ... ... ... ... 1 ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric 1 ... ... ... ... 1 ... 1 ... ... ... ... 1 Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea 9 9 ... ... ... ... ... 2 4 ... 3 ... 2 Enteritis ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal fever 1 ... ... ... ... 1 ... ... 1 ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... Other Septic Diseases 3 ... ... ... 1 2 ... ... 1 ... 2 ... 1 Phthisis 20 ... ... 1 18 ... 5 1 3 6 5 11 Other Tubercular Diseases 7 2 2 ... 1 2 ... 1 1 1 2 2 2 Cancer, Malignant Disease 12 ... 1 ... ... 8 3 2 5 ... 4 1 21 Bronchitis 20 2 2 ... ... 5 11 5 4 4 7 ... 9 Pneumonia 11 6 3 ... ... 1 1 4 ... 2 1 4 5 Pleurisy ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Respiratory Organs ... ... ... ... ... ... ... ... ... ... ... ... ... Alcoholism Cirrhosis of Liver 5 ... ... ... ... 5 ... 4 1 ... ... ... 2 Venereal Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 8 8 ... ... ... ... ... 1 1 ... 5 1 2 Diseases and Accidents of Parturition ... ... ... ... ... ... ... ... ... ... ... ... 4 Heart Diseases 14 ... ... ... 1 7 6 7 2 ... 4 1 3 Accidents 7 1 ... ... 2 2 2 2 1 2 2 ... 2 Suicides 1 ... ... ... ... 1 ... ... ... ... 1 ... ... All other causes 55 10 2 ... 2 16 25 8 9 10 20 8 17 All causes 183 38 17 3 8 69 48 43 31 22 63 24 84* *31 of these were Non-Parishioners. 113 REGISTER OF SANITARY WORK Month ending 31st October, 1903. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. R. Phillips, Special Duties. Miss F. A. Baker. Total. M r. 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 72 76 92 49 37 ... ... ... ... ... 326 Tenements 54 32 42 60 41 ... ... ... ... ... 229 Underground Dwellings 21 ... 30 12 17 ... ... ... ... ... 80 Dairies, Milk Shops, Cow Houses 6 3 2 3 3 ... ... ... ... ... 17 Slaughter Houses 2 4 ... ... 1 ... ... ... ... ... 7 Yards, Stables, and Mews 44 36 41 70 77 ... ... ... ... ... 268 Smoke Shafts ... ... ... ... ... ... ... ... 5 ... 5 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... 2 ... 2 Refuse Receptacles 8 6 5 10 14 ... ... ... ... 3 46 Enquiries re non-removal of refuse 6 7 5 7 6 ... ... ... ... 2 33 Removal of Bodies to Mortuary ... ... ... ... ... ... ... ... ... ... ... Visits to Works in Progress 160 286 150 270 196 ... ... ... 2 5 1069 Miscellaneous Inspections 52 84 50 180 162 ... ... ... 39 82 649 UNWHOLESOME FOOD:— Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE Cases Isolated 1 1 ... 1 3 ... ... ... ... ... 6 Cases removed to Hospital 10 7 14 6 8 ... ... ... ... ... 45 Rooms Disinfected 17 10 18 10 17 ... ... ... ... ... 72 NEW DRAINAGE Number of Plans Passed 1 4 2 3 5 ... ... ... ... ... 15 New Pipe Drains (feet) 320 1360 250 560 1246 ... ... ... ... ... 3736 Houses where defects in existing Drainage have been detected and remedied 8 15 12 6 9 ... ... ... ... ... 50 114 REGISTER OF SANITARY WORK Month ending 31st October. 1903. 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 ... ... ... ... ... ... ... ... 3 16 19 Periodical Inspections Factories ... ... .. ... ... ... ... ... 2 1 3 Workshops ... ... ... ... ... ... ... ... 49 74 123 Bakehouses ... ... ... ... ... ... ... ... 20 ... 20 Restaurants, &c. ... ... ... ... ... ... ... ... 56 ... 56 Homeworkers' Premises ... ... ... ... ... ... ... ... 3 80 83 Domestic Workshops ... ... ... ... ... ... ... ... ... 5 5 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 9 ... 16 ... 9 ... ... ... ... ... 34 Correspondence, Legal Procedure, &e. Complaints received 6 11 14 18 15 ... ... ... 4 17 85 Letters and Intimations relating to Abatement of Nuisances 24 28 26 30 27 ... ... ... ... 7 142 Statutory Notices Served 4 2 6 2 5 ... ... ... ... ... 19 Proceedings taken before Magistrates ... ... ... ... ... ... ... ... ... ... ... (1) Under Public Health Act ... 2 ... ... ... ... ... ... ... ... 2 (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) „ Food & Drugs Act ... .. ... ... ... ... ... ... ... ... ... (4) „ Housing of the Working Classes Act ... 19 ... ... ... ... ... ... ... ... 19 Reports made to Medical Officer of Health 22 30 31 40 64 ... ... ... 28 11 226 THE SANITARY CHRONICLES OF THE BOROUGH OF ST. MARYLEBONE DURING NOVEMBER, 1903, 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. Mabylebone, Decembeb 5th, 1903. Vol. XXIV.III No. 10. The week ending November 7th was fine with moderate temperatures Minimum temperature, 36.58; maximum, 55.0°; mean, 53.0°. The winds, E.S.E. and N.N.E. On one day rain fell to the amount of 0.24 inch. The sunshine registered in Regent's Park amounted to 12 01 hours or about 18-9 per cent, of the possible. Mean barometer 30.1 inches. The week ending November 14th was also a week of moderate temperatures. Minimum temperature, 40.0° ; maximum, 55.0° ; mean, 49.88. On three days rain fell (0.18 inch). The winds were W.S.W. The sky was generally overcast and only 7'2 per cent. of sunshine was received. Mean barometer 30.1 inches. The week ending November 21st. was cool, fairly dry. and fine. Minimum temperature, 342°; maximum, 54.2°; mean, 42.6°. Winds, N.N.W. On two days slight rain fell (0.06 inch). The sunshine amounted to 20 per cent. Mean barometer 29.9 inches. The week ending November 28th was wet and stormy. Minimum temperature, 39.0°; maximum. 52.5°; mean, 45.8°. Winds, westerly, Rain fell on four days to the extent of 1.12 inch. Sunshine 10.8 per cent. Mean barometer 29.9 inches. The characters of the November weather were somewhat unusual. There was generally a considerable amount of wind. Fogs and frosts were absent and during the last week much rain fell. 116 Births and Deaths. During the four weeks ending November 28th there have been registered 207 births and 150 deaths. These births and deaths are divided among the five sub-districts as set forth in Table IV. Fifty-four of the deaths were extra-parochial, as follow:— St. Marylebone Infirmary, Notting Hill 30 North-Western Fever Hospital 2 Western Fever Hospital 2 St. Mary's Hospital 3 Royal Chest Hospital 1 Colney Hatch Asylum 1 Hoxton Asylum 1 Banstead Asylum 1 Hanwell Asjlum 4 Leavesden Asylum 2 Friedenheim 1 University Hospital 2 Children's Hospital, Great Ormond Street 1 St. Luke's Home 1 In the Streets 2 Total 54 The birth and death-rates, as deduced from the four weeks' statistics, are as follows:— All Souls, birth-rate 18.8; death-rate 9.5. Rectory, birth-rate 15.1 ; death-rate 17.7. St. Mary, birth-rate 233; death-rate 12.9. Christ Church, birth-rate 23 0 ; death-rate 17.1. St. John, birth-rate 18.4 ; death-rate 17.2. The whole district, birth-rate 20.2; death-rate 14.7. The average death-rates for five years (1897 to 1902) for the corresponding period were as follows :—All Souls, 14.3; Rectory, 19.7 ; St. Mary, 19.6 ; Christ Church, 19.2 ; St. John, 17.3; the whole district, 17.6. 117 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 NOVEMBER 28TH, 1903, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES Total Deaths. 4 weeks ending Nov. 28th, 1903. Proportion ofthedeaths to 1,000 deaths from all causes. 4 weeks ending Nov. 28,1903. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1897-1902. 1. Deaths from the chief Zymotic Diseases 13 87 1.30 1.46 2. Pulmonary, other than Phthisis 30 200 2.93 3.89 3. Tubercular 25 167 2.44 2.26 NOTES. I. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza,Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. 118 The Health of the District during November. The moderate temperature and for the most part clear atmosphere of November, 1903, decreased the amount of chest maladies materially and thus lowered the average death rate. Small-pox still continues absent although there have been cases in several other districts in the Metropolitan area. The only zymotic disease that shows an excess above the mean is diphtheria. Prosecution under the Public Health Act. The owner of 107, Princess Street, Edgware Road, was summoned for neglecting to provide the house with a water supply. The Magistrate made an order to close the premises with 23s. costs. Housing of the Working Classes Act. The writer has made a report under the Housing of the Working Classes Act, with reference to No. 11, High Street, St. John's Wood, which has become so dilapidated as to be unfit for human habitation. The Public Health Committee ordered the necessary notices to be served. This house with several others on the Howard de Walden Estate are to be pulled down and no doubt improved premises will be ultimately built in their place. For some reason or other, however, the schemes are delayed in execution and the condemned houses go from bad to worse. Even the best built houses after a few years require an annual expenditure to maintain them in repair, much more houses of 70 and 100 years old. NOVEMBER, 1903. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA. AND TYPHOID FEVER DURING 1903 119 TABLE 11.—Giving the Causes of Deaths during the four weeks ending November 28th, 1903, 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 Hospita Queen Charlotte's Hospita] Samaritan Hospital. Workhous Notting Hill Infirmary Hospital of St. John k Elizabeth Grove Rd Smallpox .. .. .. .. .. .. Influenza .. .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. Diphtheria .. .. .. .. .. .. Typhoid Fever .. .. .. .. 1 .. Diarrhoea .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. Pneumonia and Pleurisy 1 .. .. .. .. .. Pyaemia .. .. .. .. .. .. Syphilis .. .. .. .. .. .. Cancer 4 .. .. .. 1 .. Phthisis & Tuberculosis 3 .. .. .. 7 4 Rheumatism .. .. .. .. .. .. Apoplexy .. .. .. .. .. .. Paralysis .. .. .. .. .. .. Bronchitis 2 .. .. .. 6 .. Asthma .. .. .. .. .. .. Peritonitis .. .. .. .. .. .. Disease of Brain .. .. .. .. .. .. „ Heart 3 .. .. .. 4 .. „ Kidney .. .. .. .. .. .. „ Liver .. .. .. .. 1 .. „ Uterus .. .. .. .. .. .. „ Ovary .. .. .. .. .. .. Parturition .. .. .. .. .. .. Diabetes .. .. .. .. .. .. Fractures and Injuries. .. .. .. .. 2 .. Old Age .. .. .. .. 2 .. Low Vitality, Infants .. .. .. .. .. .. Premature Birth .. 1 .. .. .. .. Other causes 11 .. .. 2 6 .. Total *24 †l .. 2 30 ‡4 * Of the 24 deaths in the Middlesex Hospital, 17 were those of non-parishioners, t The one death in Queen Charlotte's Hospital was that of an infant non-parishioner. } The four deaths in St. John's Hospital were those of non-pariihioners. 120 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 November, 1903 ; 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 36,391 19,849 18,099 39,636 20,426 183,801 (c) Registered Births 91 23 34 70 29 207 (d) Aged under 5 or over 6 Under 6 5 upwards | Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 6 upwards Under 5 ; 5 upwards 1 New Cases of Sickness in each Locality coming to the knowlkdge of the Medical Officer of Health. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 2 2 1 5 .. .. 2 5 1 8 6 20 8. Diphtheria 2 4 1 1 1 2 4 1 3 6 11 14 4. Membranous Croup .. .. .. .. .. .. 1 .. .. .. 1 .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 2 .. 1 .. .. .. 3 .. .. .. 6 7. Continued .. 1 .. .. .. .. .. .. .. .. .. 1 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas. .. 3 .. 4 .. 3 1 3 .. 1 1 14 Number such Cases Removed from their Homes in the several Localities foe Treatment. in Isolation Hospitals. l. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 2 2 1 5 .. .. 2 6 1 6 6 18 3. Diphtheria 2 4 1 .. .. 1 4 1 3 3 11 9 4. Membranous Croup .. .. .. .. .. .. 1 .. .. .. 1 .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. .. .. 3 .. .. .. 3 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puorperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. 2 .. 1 .. .. .. 1 .. 4 121 TABLE iv.—District Births and Deaths for the four weeks ending november 28TH, 1903. Population in 1891. Births. Deaths. Males. Fmla. Males Fmls. All Souls 35.391 27 24 11 15 Rectory 19,849 17 6 14 13 St. Marv 18,099 13 3 15 Christ Church 39,530 36 34 37 15 St. John 20,426 15 14 17 10 Total 133,301 108 99 82 68 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. 122 TABLE V.—Causes of, and Ages at, Death during the 4 weeks ending November 28th, 1903, 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 4 1 3 ... ... ... ... ... ... ... 3 ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough 1 1 ... ... ... ... ... ... 1 ... ... ... ... Diphtheria and Membranous Croup 3 ... 3 ... ... ... ... ... ... ... 1 2 3 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric 2 ... ... ... ... 2 ... 1 ... ... 1 ... 1 Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa 3 2 ... ... ... ... 1 ... ... 2 ... ... ... Enteritis ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal fever ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... Other Septic Diseases 2 ... ... ... ... 2 ... 1 ... 1 ... ... 1 Phthisis 16 ... ... ... 2 14 ... 2 5 2 6 1 8 Other Tubercular Diseases 9 2 ... ... 2 3 ... ... 2 ... 2 5 7 Cancer, Malignant Disease 11 ... 1 ... ... 6 4 1 2 2 3 3 7 Bronchitis 15 4 ... ... 1 4 6 4 2 3 5 1 7 Pneumonia 15 2 8 ... ... 2 3 1 1 1 12 ... 1 Pleurisy ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Respiratory Organs ... ... ... ... ... ... ... ... ... ... ... ... ... Alcoholism Cirrhosis of Liver 3 ... ... ... ... 2 1 1 ... 1 ... I 1 Venereal Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 1 1 ... ... ... ... ... ... ... ... 1 ... 1 Diseases and Accidents of Parturition ... ... ... ... ... ... ... ... ... ... ... ... 3 Heart Diseases 13 ... ... ... ... 8 4 3 ... 3 2 ... 3 Accidents 4 ... 2 ... ... 1 1 ... ... ... 2 2 2 Suicides 1 ... ... ... ... 1 ... ... ... ... ... 1 1 All other causes 47 11 2 1 2 19 12 12 8 3 14 10 30 All causes 150 24 19 3 8 64 32 26 27 18 62 27 *76 *21 of these were Non-Parishioners. 123 REGISTER OF SANITARY" WORK Month ending 30th November, 1903. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. E. Lumley, Dust Inspector. 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. 6 District. Public Health (London) Act. Inspections. Dwelling Houses, &c 61 96 75 56 48 ... ... ... ... ... 339 Tenements 42 ... 35 60 41 ... ... ... ... ... 178 Underground Dwellings 22 2 20 15 26 ... ... ... ... ... 85 Dairies, Milk Shops, Cow Houses 8 2 2 4 5 ... ... ... ... ... 21 Slaughter Houses 52 9 45 39 68 ... ... ... ... ... 213 Yards, Stables, and Mews ... ... ... ... ... ... ... ... 3 ... 3 Smoke Shafts ... ... ... ... ... ... ... ... ... ... ... Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... ... ... ... Refuse Receptacles 8 4 6 12 3 ... ... 40 ... ... 73 Enquiries re non-removal of refuse 6 3 5 6 7 ... ... 120 ... 3 150 Removal of Bodies to Mortuary ... 1 ... ... ... ... ... ... ... ... 1 Visits to Works in progress 164 178 160 280 174 ... ... ... 39 19 1014 Miscellaneous Inspections 86 93 75 175 81 ... ... 60 56 70 696 UNWHOLESOME FOOD. Number of seizures made ... ... 1 ... ... ... ... ... ... ... I INFECTIOUS DISEASE:— Cases Isolated 2 2 2 2 ... ... ... ... ... ... 8 Cases Removed to Hospital 9 11 13 16 7 ... ... ... ... ... 56 Rooms Disinfected 18 19 15 25 19 ... ... ... ... ... 96 NEW DRAINAGE Number of Plans Passed 6 6 5 7 7 ... ... ... ... ... 31 New Pipe Drains (feet) 750 896 450 870 1641 ... ... ... ... ... 4607 Houses where defects in existing Drainage have been detected and remedied 7 9 10 7 5 ... ... ... ... ... 38 124 REGISTER OF SANITARY WORK Month ending 30th November, 1903. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. E. Lumley, Dust Inspector, ' Mr. R. Phillips, Special Duties. Miss F. A. Baker. Total. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. ilr. D. J. Andrews, No. 3 District. Mr. T. Gorniot, No. 4 District. Mr. W. Yeo, No. "5 District Factory and Workshop Act. C. Enquiries as to Occupation ... ... ... ... ... ... ... ... 20 28 48 Periodical Inspections Factories ... ... ... ... ... ... ... ... 1 ... 1 Workshops ... ... ... ... ... ... ... ... 110 125 235 Bakehouses ... ... ... ... ... ... ... ... 49 ... 49 Restaurants, &c. ... ... ... ... ... ... ... ... 28 ... 28 Homeworkers' Premises ... ... ... ... ... ... ... ... 30 57 87 Domestic Workshops ... ... ... ... ... ... ... ... ... 2 2 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 18 24 14 30 13 ... ... ... ... ... Correspondence, Legal Procedure, &c. Complaints received 12 10 12 16 18 ... ... 32 7 2 109 Letters and Intimations relating to Abatement of Nuisances 12 16 21 29 11 ... ... 8 ... 8 105 Statutory Notices Served 4 4 3 6 7 ... ... ... ... ... 23 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 ... 30 56 49 ... ... 20 15 5 209 Housing Working Classes Act ... 2 ... ... ... ... ... ... ... ... 2