THE SANITARY CHRONICLES OF St. Marylebone; BEING THE ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1904. 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, XXIV. lonOon : George Pulman Si Sons, Ltd., Printers, London and Wealdston k . PREFACE. The following report is the summary required by Statute of the Sanitary Administration during 1904. It gives in tabular form all essential facts as to the work of the Sanitary Officers and of the Public Health Committee with statistics of disease and mortality. The first of the series was issued in 1880, the present is therefore the twenty-fourth. Throughout the whole series the original form and arrangement has been maintained. No. 3, Upper Gloucester Place, W. February, 1905. CONTENTS. PAGE Meteorological Summary— March Quarter 7 June „ 7, 8 September „ 8 December „ 8 Births and Deaths— Deaths in extra Parochial Institutions 9, 10 Scarlet Fever 11 Diphtheria 11 Smallpox 11 Measles and Whooping Cough 12 Typhoid Fever 12 The Housing Area12, 13 Housing of the Working Classes Act 13 Prosecutions under the Public Health (London) Act 14 Practical Sanitary Work 15 Report of Miss Frances Baker 15, 16 Report of Mr. Richard Phillips 16,17 The Mortuary—Report of Mr. Ellis 17,24 Cleansing of Persons Act 18, 19 The Shelter House 19 Clerical Work of the Public Health Department 20 Disinfection 20, 21 The Sale of Food and Drugs Acts 21 Sanitary Legislation and important Legal Cases bearing on Public Health 22, 23 Regulations as to Drains, London School Board v. Fulham 22 County Council Bye-laws (Nokes v. Islington Borough Council) 22 Black Smoke (Lough v. Hopkins) 23 Destruction of Infected Clothing (Crolick v. Knottingley. Urban District Council) 23 The Margarine Act (Macnair v. Horon) 23 Copper in Peas (Firend v. Mapp; Hull v. Horsnell) 23 APPENDIX. Table I.—Report of Mortuary Keeper 24 „ II.—Sale of Food and Drugs Acts 25 „ III.—Table of New Cases of Infectious Sickness 26 ,, IV.—Causes of Death at the Middlesex, Queen Charlotte's, Samaritan Hospitals, etc 27 „ V.—Cause of and Ages at Death during 1904 in St. Marylebone 28 „ VI.—District Births and Deaths 29 Register of Sanitary Work 30-31 Index to Monthly Reports 32-33 Index to Annual Report 34 A REPORT OF THE METEOROLOGY, MORTALITY, AND SICKNESS OF ST. MARYLEBONE FOR THE YEAR 1904. By A. Wynter Blyth. METEOROLOGICAL SUMMARY. March Quarter. The first two weeks of January were practically sunless. During the rest of the month from 5 to 19 per cent, of bright sunshine was registered in Regent's Park. There was very little frost or fog ; the mean temperature was 50º. There were 20 rainy days giving a rainfall of 2 2 inches. Winds S.E. and S.W. February opened with two weeks of wet weather; altogether 15 rainy days were recorded with a rainfall of 2.84 inches. The winds were mostly westerly. During three out of the four weeks the temperature was mild and seasonable, but a cold spell sent the temperature down below freezing point in the last week. The mean temperature of the whole month was 40.0º. Sunshine varied from 6 to 14.4 per cent. The winds were mostly N.E. March was cooled by easterly and north-easterly winds, the mornings being mostly frosty. The mean temperature of the month was, however, 43.4°. There were 12 rainy days with a rainfall of 1.06 inch. During three out of the four weeks sunshine was almost absent. June Quarter. April was fairly sunny and of moderate temperature, the mean being 50.2º. There were 14 showery days, the total rainfall being 1.33 inch. Winds N.W. Frosts were absent. Sunshine varied from 24 to 40 per cent. May was a fine spring month with a mean temperature of 54º, the second week being particularly bright with a recorded 8 sunshine of 53 per cent. There were 10 rainy days, giving a rainfall of 16 inch. The winds were mostly S.W. June was sunny, with a recorded sunshine of from 30 to 44 per cent. The maximum temperature was 78º and the mean 61.2°. There were seven rainy days, giving a rainfall of only 0.84 inch. Winds W. and S.W. September Quarter. July—four out of the five weeks were warm and very bright, the sunshine ranging from 45 to 74 per cent., and the temperature attained a maximum of 84.0°, the mean temperature being 69°. The last week of July was stormy and unsettled, with thunder, lightning and heavy rain. There were nine rainy days giving a total rainfall of 1.91 inch. The prevailing winds were south-westerly. August was bright and summery, but the heat was not oppressive, the extreme ranges being from 48.5º to 87° and the mean 61.5°. There were 8 rainy days yielding a total rainfall of 0.83 inch. The winds were variable. Bright sunshine ranged from 41 to 68.4 per cent. September was also fairly fine. The temperature was between 40.5º and 71.6° with a mean of 57.0°. There were 12 rainy days giving a rainfall of 1.8l inch. The sunshine registered varied from 40 to 60 per cent. December Quarter. October.—The third and fourth weeks of October were more or less foggy. The temperature of the month was normal, the mean being 65.6°. There were 10 rainy days, the rainfall amounting to 1.27 inch. The winds were light and variable. The sunshine recorded during the fogless weeks, in Regent's Park, ranged from 11 to 28 %. November.—The November weather was variable, the first week being gloomy, the second wet, the third cool, the fourth cold and wintry, with a slight fall of snow. The temperature oscillated between 28° and 58°, the mean being 47.4°. On 11 days rain fell, giving a rainfall of 1.67 inch. Sunshine was generally deficient. December.—December was foggy, especially the last two weeks. There were altogether 12 foggy days, on at least 4 of which the fog was dense and general. The month was cool, most of the morning temperatures being from 1 to 3 degrees below zero; the mean temperature was 41.5°. On 15 days cold rain and slight snow fell, the rainfall being 174 inch. Bright sunshine was deficient, the sun being only transiently visible for a few days. 9 BIRTHS AND DEATHS. The number of births during the 53* weeks ending December 31st, 1904, when all the essential corrections have been made was 2,791. The number of deaths (corrected) of parishioners was 2,172. This gives a birth-rate, of 20.2; a death-rate of 16.0 per thousand. The birth and death-rates of the sub-districts during 1904 were as follows:— Birth-rate. Death-rate. All Souls 16.9 14.2 Rectory 15.8 12.8 St. Mary 22.8 16.4 Christ Church 26.8 18.8 St. John 19.0 16.7 The whole District 20.2 16.0 The following is a statement of the average birth and death rates for the five previous years:— Birth-rate. Death-rate. All Souls l6.3 14.3 Rectory 20.2 19.3 St. Mary 23.4 17.6 Christ Church 28.6 20.3 St. John 21.3 18.1 The whole District 21.8 17.7 The following table gives the distribution of the deaths dying in various extra-parochial institutions, all of which are included in the mortality statistics:— St. Marylebone Infirmary, Notting Hill 532 North-Western Fever Hospital 13 Western Fever Hospital 12 Northern Fever Hospital 1 St. Bartholomew's Hospital 5 St. Thomas's Hospital 2 Guy's Hospital 3 St. George's Hospital 4 University Hospital 24 Westminster Hospital 2 West London Hospital 1 Carried forward 599 * A year containing exactly 52 weeks would consist of 364 days, hence every few years it is necessary to make a year of 53 weeks. 10 Brought forward 599 King's College Hospital 2 Charing Cross Hospital 5 St. Mary's Hospital 55 National Hospital 1 Great Northern Hospital 1 North West London Hospital 1 Children's Hospital, Paddington 18 Children's Hospital, Great Ormonde Street 9 Children's Hospital, East London 1 French Hospital 4 Italian Hospital 2 Hospital for Women 2 Home Hospital,Fitzroy Square 4 Brompton Hospital 2 London Temperance Hospital 6 City of London Lying-in Hospital 1 Lying-in Hospital, Endell Street 1 Hanwell Asylum 17 Banstead Asylum 3 Caterham Asylum 2 Claybury Asylum 6 Darenth Asylum 1 Tooting Bee Asylum 3 Cane Hill Asylum 3 Bethlem Asylum 1 Friern Barnet Asylum 4 Colney Hatch Asylum 10 Leavesden Asylum 5 Hoxton House Asylum 1 Manor Asylum, Epsom 1 Middlesex Asylum 1 City of London Asylum 1 London County Asylum, Ilford 4 London County Asylum, Norwood 3 St. Luke's Home 2 St. James' Home, Stoke Newington 1 Royal Hospital for Incurables 1 Miller Hospital 1 Heart Hospital, Soho 1 St. Giles Workhouse 1 St. Pancras Infirmary 7 Central London Sick Asylum 3 Friedenheim 5 Various Homes and other addresses 19 Drowned in the Thames, the Serpentine, and canals 4 825 11 SCARLET FEVER. Scarlet Fever was, in comparison with former years, low; instead of from 400 to 800, only 296 cases were notified; of these, 10 died, giving a case mortality of 3.37 per cent. The number of cases calculated per 1,000 of the population was 2.21 per 1,000; since, however, the majority of cases occur in children below the age of 13 years, a better idea of its extent is to calculate the case rate per 1,000 of the population below the age of 13. This gives a case incidence of 18.2 per 1,000. The curve representing the number of cases week by week throughout the year (opposite page 19), shows that the seasonal distribution was about the same as in former years, that is, low during the winter and spring, and high in autumn. DIPHTHERIA. 112 cases of Diphtheria were notified; of these, 12 proved fatal, which is equal to a mortality of 107 per cent. of the cases notified; the previous year the case mortality was 13 per cent. A few of the notifications were confirmed by a bacteriological investigation at the Jenner Institute. The number of specimens derived from suspected throats sent for such bacteriological investigation was 9; of these, 5 proved the presence of the disease-producing bacillus, while in the remainder the bacillus could not be found. SMALL-POX. Only 6 cases were notified, and there was no extension. A most important advance seems to have been made during the past year in the more accurate knowledge of this malady by the discovery by Dr. Korte of the parasite of Small-pox, which has either eluded other investigators, or, when seen, its significance has not been appreciated. It is described as an amoeboid body of extreme delicacy, easily ruptured by drying or by pressure, hence, the ordinary processes used for rendering visible bacteria quite fail. Such amoeboid bodies have no definite form when living, for they are constantly changing their form. The amoeba contains a large number of minute spores. The amoeba of Chicken-pox is similar to that of Small-pox, but can be distinguished from it by certain re-actions to staining re-agents. If these interesting investigations are fully confirmed by subsequent independent observers, the consequences will be considerable and of direct advantage to the community. The obscure cases which often puzzle the most experienced medical men will be referred for scientific investigation to the microscopist and bacteriologist, and with more certainty than hitherto be identified. This in many instances will be of the greatest importance. 12 MEASLES AND WHOOPING-COUGH. Roth these infantile maladies prevailed during the year. There were 49 deaths from measles and 14 from whoopingcough. Since neither of these diseases are notifiable, the exact number of cases from whence the deaths are derived is unknown, but from the average case mortality it may be stated, with some confidence, that they represent not less than 980 cases of measles and 280 of whooping-cough. TYPHOID FEVER. N There were 49 cases of typhoid fever notified, 3 of which were fatal. So far as could be ascertained, the majority of these cases had contracted the malady outside the Borough. As the curve opposite page 19 shows, the number of cases was far below the average, and with the exception of a slight rise in August distributed throughout the year in a perfectly normal manner. THE HOUSING AREA. So many persons to the acre, or so many to the square mile, are familiar forms of statistical expression. Information of this kind respecting urban populations has a radical defect; its statement assumes that each human unit lives on the ground level— exists on a single plane—the statistics founded upon it are one dimensional, whereas the units of a city population, during a large portion of every twetaty-four hours, pass their existence in layers one over the other. Take two equal areas of urban habitations, the one covered by two-stdreyed cottages, the other by seven-storeyed dwellings—any comparison between the proportion of persons per acre is misleading. Obviously it would be of great utility to have some better form of mathematical expression of aggregation on areas so as to be able to compare the population of cities and townships built on diverse plans. The writer believes that a three dimensional valuation should be made by taking the area actually occupied by the houses and multiplying this area by an arbitrary number, expressing height according to the number of floors, which are, or may be used for habitation. This information should be supplemented by a statement of the open space area, and the area occupied by streets, forecourts, yards and so forth. As an example, the Borough of St. Marylebone has a total acreage of 1,427-8 acres (5,778,000 square metres) the open spaces, that is, Regent's Park, Primrose Hill, the Squares, the Churchyards, Lord's Cricket Ground, the Great Central Railway Clearance, and spaces of similar character occupy 515.65 acres 13 or thereabouts, totalling to 41.7% of the total area. There are in round numbers 14,000 houses varying in area from those in Harrow Street or Mitcham Street to the large houses in Portland Place. For our purpose the average area of the individual house may be taken as 65 square metres (699.7 square feet), which gives 17.1 % of the total area as occupied by houses. The area may therefore be thus divided:— Open spaces 41.7 per cent. Streets, yards, forecourts and gardens 41.3 „ Housing area 17.0 ,, The number to convert area into cube of the houses may be taken as three metres per floor, and the average number of floors throughout the district may be put at 4; multiplying the 65 square metres by 12 gives an average of 780 cubic metres per house, or 819 cubic metres (2,892 cubic feet) per head of the population. It is obvious, therefore, by taking the appropriate factor, the aggregation of population in a pioneer city of bungalows, or the many storeyed cities of the States, or cities like Paris, Vienna, and St. Petersburg can in this way be compared, which has hitherto not been done satisfactorily. Of course, exception can be taken to the details of the calculation which does not presume to be based on measurements of the greatest accuracy, and different opinions may be held on the hypothetical factor of 3 metres to a floor; but these objections will not touch the principle of the suggestion which is to substitute for the misleading one dimensional expression that of a three dimensional statement, supplemented by sub-division of the area as above exemplified. HOUSING OF THE WORKING CLASSES ACTS. The only case taken under the above Acts was that of 9, Gee's Court, which was closed as unfit for habitation. The owner subsequently executed considerable repairs and made it suitable for occupation. The John Street Dwellings by the close of the year were nearly complete, and the Housing Committee satisfactorily settled the scale of rents to be charged, with rules and conditions of occupation. The scheme was adopted by the Council. The Devonshire Place and Burne Street areas still remain to be dealt with. A variety of plans for their subsequent developments have been prepared under the direction of the Housing Committee, and definite results may be with some confidence expected in the ensuing year. 14 PROSECUTIONS UNDER THE PUBLIC HEALTH (LONDON) ACT. The proportion of summonses to the Council's orders issued continues to be very small. The owner of No. 12, North wick Terrace, was summoned for non-compliance with Sanitary Notices, but the work having been completed before hearing the summons was withdrawn. The occupier of a room in Capland Street kept it in so filthy a state, that other occupants of the house alleged the room was a nuisance, and that they suffered considerable annoyance. The Inspector was refused admittance and ultimately a Magistrate's order to enter was obtained. The occupier, before the order was executed, turned to and did a " spring cleaning," hence the nuisance was for the time indirectly abated. No. 13, King's Place, was ordered to be re-drained. The occupier failed to comply with the notices. A Magistrate's Order was therefore obtained ; this order was not complied with ; summonses were again taken out for closing the premises which ultimately were vacated. 119, Church Street, was found to be badly drained. The responsible person, a builder, was unable through poverty to execute the work, a summons was ultimately taken out and a Magistrate's Order obtained. The Order not being complied with, a summons was served for non-compliance and a fine inflicted. The fine not being paid the defendant went to prison for a short time. A third summons was then taken out to close the premises and a closing order obtained. The premises were not, however, closed, because the drainage works were in part executed. At the present moment, however, the ground landlord has stepped in and evicted the defendant. The case of 24, Townshend Cottages, was another curious case. The property is in Chancery and the tenants apparently have paid no rent for at least a twelve-month; they have also done no repairs or spent any money in respect of the premises, save to pay the rates by each subscribing a portion. The property has naturally fallen into an insanitary condition and a closing order was applied for and granted. The kitchens of 48, Linhope Street, were occupied illegally and after a long delay proceedings had to be taken. Before the hearing, however, the original notice was obeyed. Three first-class building firms were summoned for neglecting to deposit plans of drainage ; in two cases fines were inflicted, the third case was dismissed. The owners of 26-28, St. Anne's Terrace, were summoned for not executing drainage works; on receipt of the summons the work was pushed forward and completed. 15 PRACTICAL SANITARY WORK. A tabular statement is given of the work of each of the Sanitary Inspectors on pages 30-31. Complaints of sanitary defects were received and promptly attended to in 1,358 cases. The work of supervising new drainage works has been exceptionally heavy during the year, because so many new buildings are in course of construction. Two of the Inspectors, Mr. Richard Phillips and Miss Frances Baker, have special duties. Their reports of the year's work are as follows :— THE REPORT OF MISS F. BAKER. January, 1905. " I beg to report the following with reference to the work of the year 1904 :— Workshops on register at end of 1903 2,164 „ „ „ 1904 2,260 No. added during the year 303 No. of removals 207 Businesses represented by this No. 1,876 No. of re-inspections made 714 The work done on these premises represents various kinds of clothing and articles of dress, tailoring and dressmaking taking the lead. Only 6 cases of overcrowding have been detected, and these were chiefly owing to carelessness on the part of the person in charge of the room. The attention given to appliances and methods of heating the workrooms is much improved, and occupiers are realising that this is as essential as having adequate cubic space for their workers. 107 various complaints have been received, and the cases investigated; and at 128 premises cleansing and limewashing have been done. The defects of 26 sanitary accommodations have been remedied, besides which many other matters of insanitary condition have been rectified. Outworkers. No. resident in Borough at end of 1903 491 ,, „ „ ,, 1904 625 No. of removals during the year 88 No. received from other Boroughs 239 No. transferred 285 726 visits have been paid to Outworkers, and this number represents only those who work alone for London firms, not including those who have opened workrooms and employ other hands. The number of Laundries on the register is only 27, and owing to the fact that few premises in the Borough are suitable for this business, the number varies very slightly. 16 UNDERGROUND CONVENIENCES (FEMALE). The Women's Underground Conveniences have been under regular inspection. I have had no complaint to make to the Attendants with regard either to cleanliness of the premises or civility. The Conveniences appear to be almost entirely free from persons of objectionable character or habits." I am, Sir, Your obedient Servant, FRANCES A. BAKER, Inspector. THE REPORT OF MR. RICHARD PHILLIPS. " I beg to present a report of my work during the year 1904 :— FACTORIES AND WORKSHOPS. There are in the Borough 141 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, cleansing has been done and insanitary conditions remedied. All new workshops have been cubed up and registered in accordance with the Factory and Workshop Act, 1901. BAKEHOUSES. There are at the present time 86 in use ; of this number 11 are above or on ground level, and 75 are underground. Two Bakehouses above ground have been closed up during the year, and one underground has been demolished. SMOKE NUISANCES. The number of Smoke Nuisances detected or complained of during the year is 26. All premises where nuisances have occurred have been diligently watched and observations made. In consequence 3 Statutory Notices were served, and 16 Intimations sent out. TRADE NUISANCES. No complaints of trade nuisances have been received 17 UNDERGROUND CONVENIENCES (MALE). I have supervised the work at the Underground Conveniences, and constantly inspected them both day and night, on Sundays and all holidays. Some repairs and alterations have been done. I have always found the Conveniences were clean and well kept, and I am able to report satisfactorily on the work done by the Attendants, whose duties are chiefly arranged by me. PUBLIC URINALS. The 23 Public Urinals in the Borough which are situated above ground have been frequently inspected. All repairs have been attended to, and I have found the urinals well flushed and clean. HOTELS, RESTAURANTS, COFFEE SHOPS, AND DINING ROOMS. Of these I have made inspections of 211 premises, special attention being given to the kitchens and all places where food is stored or kept. The Lavatory accommodation has also had much of my attention. Appended is a statement of such of my work which admits of tabulation:— No. of visits made Workshops, &c. 629 Bakehouses 445 Restaurants, &c. 365 Smoke Nuisances 92 Underground Conveniences Daily Public Urinals Daily I am, Sir, Your obedient Servant, RICHARD PHILLIPS, Senior Inspector. THE MORTUARY. The report of the Mortuary keeper (Mr. Ellis) is to be found on page 24. It is interesting to observe that the number of bodies received during the past year was almost the same as in 1903, while the number of inquests in each of the years, 1903 and 1904, was absolutely identical. 18 CLEANSING OF PERSONS ACT. The free baths established under the Cleansing Act, for the purpose of cleansing persons in so dirty a state that it is not desirable to admit them into the Public Baths of the district have been in full operation during the year. The comparative tabular statement shows a large increase in the number of males and especially in the number of females admitted. A great proportion of the female applicants are of the poorest class, and not a few are ill provided with underclothing. Owing to the kindness of one of the Councillors and others, small sums of money from time to time have been placed at the writer's disposal for the purpose of supplying some of the worst cases with necessary covering. Miss Kilgallin has performed this task with fairness. and discretion. It may as well be stated here, that chemises, stockings, petticoats, and shoes or boots in fair condition will be thankfully received by the Matron, for the purpose of replacing any similar articles of clothing which are not worth disinfecting, but rather should be destroyed, or for supplying such articles to those who are destitute of them, a similar remark applies to suitable articles of men's clothing. CLEANSING OF PERSONS' ACT, 1897. 1904. Males. Females. Total. Remarks. Jan. 1st to 31st 558 92 650 Closed ½ day for repairs Feb. 1 st to 29th 520 83 603 Closed ½ day sweeping flues. March 1st to 31st 610 94 704 April 5 th to 30th 520 105 625 Closed 3 days Easter holidays. May 2nd to 31st 488 110 598 Closed Whit Monday. June 1st to 30th 504 140 644 July 1st to 30th 646 144 790 August 2nd to 31st 731 171 902 Closed August Bank holiday. Sept. 1st to 30th 665 133 798 Oct. 1st to 31st 601 141 742 Closed ½ day sweeping flues. Nov. 1st to 30th 578 102 680 Dec. 1st to 31st 668 61 729 Closed 2 working days Christmas holidays. Totals 7089 1376 8465 CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, TYPHOID FEVER, AND SMALLPOX DURING THE YEAR 1904. >9 1903. Males. Females. Total. Remarks. Jan. 1st to 31st 406 '3 419 Feb. 2nd to 21st 358 15 373 Closed 8 working days, New Baths. March 4th to 31st 416 27 443 April 1st to 30th 364 31 395 Closed 3 days Easter. May 1st to 30th 359 31 390 June 1st to 30th 420 33 453 Closed 2 days Boiler cleaning. July 1st to 31st 531 70 601 August 1st to 31st 576 70 646 Sept. 1st to 30th 560 93 653 Oct. 1st to 30th 534 107 641 Closed 1 ½ working days repairs Nov. 2nd to 30th 492 87 579 Dec. 1st to 31st Totals 499 5515 78 655 1 577 6170 Closed 2 working days, Christmas holidays. The addresses of the applicants during 1904 were as follows:— Males from Salvation Army Shelter 5,089 Do. from Lodging Houses in the Borough 2,000 Females from private addresses 76 Females with no addresses 1,000 Females from Shaftesbury Institute 300 Total 8,465 THE SHELTER HOUSE, No. 27, Grove Road, N.W. The shelter was used 12 times during the year ending 31st December, 1904, accommodating for various periods 12 Adults and 6 Children. The following is a detailed statement of the Occupation:— 1904. Number of hours occupied. Reason of occupation. Number of persons. February 23rd 4 hours Scarlet Fever 1 Adult April 11th and 12th 14 hours Diphtheria 2 Adults, 1 Child June 25th and 26th 12 hours Diphtheria 3 Adults, 1 Child October 12th and 13th 12 hours Diphtheria 2 Adults, 2 Children October 26th and 27th 7 and 11 hours Diphtheria 2 Adults November 3rd and 4th 18 hours Skin Disease 1 Adult, 1 Child November 16th 4 hours *Catarrh Weakness 1 Adult *The woman was having one of the free baths, when she was taken faint, and was received into the Shelter until she was able to be removed to the Workhouse. 20 CLERICAL WORK OF THE PUBLIC HEALTH DEPARTMENT. Mr. H E. Curtis and Mr. W. J. Howe continue to discharge the duties .of Chief Clerk and Assistant Clerk in a most efficient manner. The Junior Clerk, Mr. Hodges, has improved his financial position by being transferred to the electricity department, and a successor has been appointed, Mr. H. A. James. The subjoined tabular statement of the work shows no signs of decrease, but, on the contrary, some slight augmentation. During the year the complete list of Index of Drainage Plans and Applications in the custody of the Department has at length been completed, and is being found daily both by the public and by the Department of the greatest use. REGISTER OF CLERICAL WORK. 1904. Number of Notifications of Infectious Disease, entered in Register, copied and sent to the Metropolitan Asylums Board and Schools, receipt acknowledged and filed 1,078 Number of complaints of Nuisances received, acknowledged, entered in Nuisance Register and filed 866.' Verbal complaints 492 1,358 Number of letters despatched from the Department 3,128 Number of Council Orders issued 200 Number of Meetings of Public Health Committee prepared for, attended, and Minutes drafted and prepared for Printer 24 Number of Meetings of Public Health SubCommittee prepared for, attended, and Reports drafted and written 54 Plans Registered and approved by Public Health Committee 381 DISINFECTION. Owing to the fact that infectious fevers were but little prevalent during the year, the amount of disinfection was generally less during 1904 than 1903. The disinfecting machine still continues in good order, a few minor repairs only having been necessary during the year. The boiler is regularly inspected by an officer of the Insurance Company, and his report presented to the Public Health Committee. 21 List of articles disinfected during 1903 1904 Beds 410 249 Mattresses 569 321 Bolsters 580 304 Pillows 1,333 854 Sheets 820 431 Blankets 1,697 M37 Sundries 3,078 1,766 The Vans were used 615 times in 1903; 437 times in 1904. THE SALE OF FOOD AND DRUGS ACTS. The work done under the Sale of Food and Drugs Acts is tabulated at page 25. Notwithstanding the change of districts from time to time and the constant employment of agents who cannot be known to the vendors, the figures for adulteration still continue at a low figure. The following is a list of the proceedings taken and the fines recovered:— Name. Address. Offence. Fine. Costs. James Bush, 25, Townshend Road, 19 per cent, added water to milk £10 12/6 Lionel Court, 9, Violet Hill, Milk 6.7 per cent, deficient in fat £2 12/6 Elizabeth Green, 32, Saville Street, Milk deficient in milk fat 6.7 per cent. 10/- 12/6 Wm. Smith, 19, Earl Street, Milk deficient in fat 16.6 per cent. £5 12/6 Ed. Taylor & Sons, 19 & 12, Earl Street, Milk deficient in milk fat 14.6 per cent. £2 - Elizabeth Small wood 74, Marylebone Lane Margarine sold as butter £2/5 12/6 £21/15 £3/2/6 In the case of a diluted whisky, alcoholic strength 30 degrees under proof, the solicitor considered that, owing to technical objections, proceedings could not be taken successfully. In the case of an adulterated milk, no summons was issued because the dilution was small. In another case of adulteration of milk, the case was dismissed, because the defendant proved a warranty from the farmer. 22 A sample of rum, brought by a private purchaser, could hardly be called of the nature and quality of the article demanded, because it was evidently derived from the dregs of a rum cask, and was full of dirt and debris. SANITARY LEGISLATION AND IMPORTANT LEGAL CASES BEARING ON PUBLIC HEALTH, 1904. No important legislation directly affecting the work of the Public Health Department took place during 1904. The following brief notes of important decisions may, however, be useful:— REGULATIONS AS TO DRAINS. The appeal case of the London School Board v. Fulham Borough Council clearly shows that if in a particular case the Local Authority require, under the Metropolitan Management Act of 1855, old drains to be taken up, such requirements can be enforced. In this case the School Board had submitted plans for the drainage of a school. The plans were passed with the express stipulation that a certain regulation made by the Fulham Local Authority, under the powers of the Metropolis Local Management Act, 1855, Sections 76, 83, was to be complied with. The regulation provided that all old drains were to be removed. The School Board, however, on making the new system of drainage, cut the old drains off and cleaned them, but did not remove them. Proceedings were taken before a magistrate, and a penalty imposed on the Board. The Board appealed, but the appeal was dismissed. COUNTY COUNCIL BY-LAWS. As apart of the history of the, year, the decisions of the High Court maybe mentioned in Nokes and another v. Islington Borough Council, and Styles v. Colinsky, under which certain by-laws compelling an owner to provide water closet accommodation in lodging houses in the proportion of one closet for every twelve adults, and also a by-law, made under Section 94, Public Health (London) Act, requiring premises to be cleansed in the month of April of each year, were held to be unreasonable, not on their merits, but mainly because no provision was made for giving notice to the party in default. It is not necessary to detail these cases because the London County Council took immediate steps to remedy the defect in the by-law, besides which there is ample statutory power to deal with deficient water closet accommodation and dirty premises irrespective of any by-law. 23 BLACK SMOKE. In the case of Tough v. Hopkins, it was decided that the funnel of a steamer is a chimney within Section 24 (b) of the Public Health (London) Act, 1891; and that where all that is required to prevent nuisance is careful stoking, it is unnecessary in a prohibition order under Section 5 to specify any works to be executed. DESTRUCTION OF INFECTED CLOTHING. The important appeal case of Crolick v. Knottingley Urban District Council (Knight's Loc. Gov. Rep. 1904, 1345) heard before Lord Alverstone, C.J., clearly shows that the power of destruction of infected clothing under the 121st Section of the Public Health Act, 1875, cannot be exercised by a Medical Officer of Health on his own initiative. A special resolution of the Authority is required in each case, and then only can the owner claim compensation from the Authority. In the Metropolitan Area, however, Section 60 of the Public Health (London) Act gives more extensive powers to the Medical Officer of Health, and therefore the decision does not precisely apply. THE MARGARINE ACT. A Metropolitan Police Magistrate dismissed a case in which the Local Authority prosecuted a seller of margarine under the labelling Section (Sec. 6). The margarine was taken from an unlabelled tub standing in full view of the customers. The Magistrate decided that having regard to the mode in which it was used, it being only used as a store for margarine, it was not a package within the meaning of Section 6 of the Margarine Act. The court decided, seeing the object of the Margarine Act, 1877, that the learned magistrate had arrived at a wrong conclusion, and that respondent should have been convicted (Macnair v. Horon.) COPPER IN PEAS. In the case of Firend v. Mapp it was decided that preserved peas coloured with copper sulphate (2.55 grains to the pound) a quantity insufficient to cause injury to health, were of the nature, quality, and substance demanded, and were therefore not adulterated under Section 6 of the Sale of Food and Drugs Acts. In the case of Hull v. Horsnell the analyst certified that a bottle of preserved peas contained copper equal to copper sulphate in the proportion of 187 per lb., and he stated in evidence that sulphate of copper is a substance injurious to health. The court sent the case back to the Magistrates with a direction that the finding that the added ingredient is in itself injurious to health is insufficient, it must be found that the article of food has been rendered injurious to health by such addition. 24 TABLE I. REPORT OF MORTUARY KEEPER. FOR THE YEAR 1904. Number of bodies received from January 1st to December 31st, 1904. Males. Females Males. Females. January 28 17 Forward Ill 92 February 15 11 July 18 13 March 11 . 18 August 23 13 April 20 13 September 12 14 October 14 18 May 24 19 November 20 14 June 13 14 December 23 23 111 92 221 187 Total 408 Number of Inquests held from January 1st to December 31st, 1904. January 14 Forward 81 February 11 July 13 March 11 August 21 September 11 April 17 October 16 May 17 November 19 June 11 December 23 81 184 Total 184 Infectious cases received. Diphtheria 4 25 TABLE II.—SALE OF FOOD AND DRUGS ACTS. Samples Analysed during the Year, 1901. Genuine. Adulterated. Total. dairy products Milk 238 7 215 Butter 73 2 75 Cream 6 — 6 Condensed Milk 9 — 9 Cheese 1 — 1 Margarine 9 — 9 alcoholic beverages— Whisky 38 1 39 Brandy 15 — 15 Cognac 1 — 1 Rum 11 — 11 Gin 12 — 12 non-alcoholic beverages— Tea 1 — 1 Coffee 14 — 14 Coffee and Chicory 2 — 2 Cocoa 6 — 6 condiments— Pepper 18 — 18 Mustard 17 — 17 Vinegar 8 — 8 Salt 2 — 2 Currie Powder 1 — 1 saccharine substances— Jam 17 — 17 Honey 6 — 6 Sugar 1 — 1 Golden Syrup 1 — 1 Sweets 16 — 16 TINNED & BOTTLED GOODS- Various tinned Foods 31 - 31 Beef Extract 1 — 1 Capers 2 — 2. drugs - Soda, carbonate 2 - 2 Magnesia, Citrate 1 — 1 Cream of Tartar 6 - 6 Olive Oil 5 - 5 Tincture of Ginger 1 - 1 miscellaneous- Cornflour 1 1 Lard 6 6 Beef dripping 1 — 1 Sauce 1 — 1 Glycerine 1 — 1 Ginger Wine 1 — 1 Beef Extract 1 - 1 Other 6 — 6 590 10 600 26 TABLE III .—TABLE OF POPULATION, BIRTHS, AND OP NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, in the Sanitary District of ST, MARYLEBONE, during 1904; 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 598 319 421 1058 395 2791 (d) Aged under 5 or over ft Under 5 5 upwards Under ft 1 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5upwards New Cases of Sickness in bach Locality COMING to the KNOWLEDGE OF the MEDICAL Officer of Health. Chicken pox 28 38 23 7 16 14 48 20 61 48 176 127 1. Smallpox .. .. .. 6 .. .. .. .. .. .. .. 6 2. Scarlatina 35 63 5 17 21 29 40 57 14 18 118 184 3. Diphtheria 9 16 4 11 10 10 15 16 11 10 49 63 4. Membranous Croup .. .. .. .. .. .. 1 .. 1 .. 2 .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 6 .. 7 .. 13 .. 16 1 6 1 43 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. 1 .. 1 .. .. .. 2 .. 4 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas 5 20 3 44 1 32 8 58 2 28 19 182 Number of such Cases Removed from their Homes in the several Localities fob Treatment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 30 42 5 9 8 19 33 50 13 13 89 133 3. Diphtheria 6 11 2 9 9 11 13 11 8 6 38 48 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 1 .. 3 .. 12 .. 9 .. .. 1 27 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 2 .. 38 .. 8 .. 14 1 8 1 7 27 TABLE IV.—Giving the Causes of Deaths during 1904, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John and 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 1 ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... Diphtheria ... ... ... ... ... ... Typhoid Fever 2 ... ... ... 2 ... Diarrhoea 1 ... ... 3 12 ... Erysipelas ... ... ... ... 2 ... Pneumonia and Pleurisy 25 ... ... ... 16 ... Pyaemia 2 ... 1 ... 1 ... Syphilis ... ... ... ... 14 ... Cancer 131 ... ... ... 42 2 Phthisis & Tuberculosis 30 ... 1 ... 105 16 Rheumatism ... ... ... ... 1 ... Apoplexy ... ... ... ... 13 ... Paralysis ... ... ... ... 26 ... Bronchitis 23 ... 4 7 112 ... Asthma ... ... ... ... 1 ... Peritonitis ... ... ... ... ... ... Disease of Brain ... ... ... ... ... ... „ Heart 27 3 4 11 35 ... „ Kidney ... ... ... ... 5 ... „ Liver 7 ... ... ... 6 ... „ Uterus ... ... ... ... ... ... ,, Ovary ... ... ... ... ... ... Parturition ... 5 ... ... ... ... Diabetes ... ... ... ... ... ... Fractures and Injuries 21 ... ... 1 15 ... Old Age ... ... ... ... 32 ... Low Vitality, Infants ... ... ... ... ... ... Premature Birth ... 13 ... 1 ... ... Other causes 129 23 7 23 92 5 Total *399 **44 ***17 46 532 †24 * Of the 399 deaths in the Middlesex Hospital, 297 were those of non-parishioners. ** 39 of the 44 deaths in Queen Charlotte's Hospital were those of non-parishioners. *** 12 of the 17 deaths in the Samaritan Hospital were those of non-parishioners. † 21 of the 24 deaths in the Hospital of St. John were non-parishioners. 28 TABLE V.—Causes of, and Ages at, Death during 1904 (53 weeks), in the Borough of St. Marylebone. CAUSES OF DEATH. Deaths in whole District at subjoined Ages. Deaths in Public Institutions (at all Ages). 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. Samaritan Hospital. Queen Charlotte's Hospital. Middlesex Hospital. Workhouse. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 49 11 35 2 1 .. .. 14 1 8 19 7 6 Scarlet Fever 10 .. 6 .. .. 1 .. 2 .. 3 3 2 6 Whooping Cough 14 4 10 .. .. .. 4 1 1 2 6 8 Diphtheria and Membranous Croup 12 2 5 .. 1 .. .. 3 1 2 4 2 6 Croup .. .. .. .. .. .. .. .. .. .. .. .. 2 Fever Typhus .. .. .. .. .. .. .. .. .. .. .. •• .. Enteric 3 .. 2 .. 1 .. .. .. .. 1 2 .. 5 Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza. 22 .. 1 .. .. 11 .. 2 6 4 5 5 .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhoea 105 80 14 .. .. 3 .. 19 9 14 52 11 19 Enteritis 17 7 10 .. .. .. .. 3 .. .. 14 .. 3 Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 8 1 .. .. .. .. 2 .. .. .. 2 1 1 Other Septic Diseases 20 3 .. 2 1 13 1 6 2 5 6 1 17 Phthisis 214 2 4 6 19 172 11 43 26 31 82 32 154 Other Tubercular Diseases 46 13 14 6 2 11 .. 12 6 12 14 2 32 Cancer, Malignant Disease 132 1 3 1 .. 73 54 27 17 26 38 24 171 Bronchitis 323 38 17 2 2 98 166 82 29 38 127 47 159 Pneumonia 132 29 32 3 3 41 21 30 14 19 46 23 52 Pleurisy 6 .. .. 1 1 1 3 2 1 2 .. 1 5 Other Diseases of Respiratory Organs 5 .. .. .. .. 2 3 1 1 .. 3 .. 3 Alcoholism Cirrhosis of Liver 34 .. .. .. .. 30 4 15 3 7 6 3 26 Venereal Diseases 20 16 3 .. .. 1 .. 3 2 3 8 4 11 Premature Birth 40 40 .. .. .. .. .. 10 3 7 16 4 14 Diseases and Accidents of Parturition 11 .. .. .. .. 11 .. 1 1 .. 7 .. 14 Heart Diseases 183 3 1 9 7 86 77 40 28 23 56 36 81 Accidents 63 9 7 2 4 14 17 17 4 6 14 12 34 Suicides 12 .. .. .. 1 8 3 2 1 3 4 2 12 All other causes 706 134 26 14 17 240 275 174 102 85 223 122 432 All causes 2172 393 190 55 60 819 655 512 258 302 753 347 1273 *Of these 372 were Non-Parishioners. 29 TABLE VI.—District Births and Deaths for the fifty-three weeks ending december 31st, 1904. Population in 1901. Births. Deaths. Males Fmls Males Fmls. All Souls 35,391 320 278 268 244 Rectory 19,849 162 157 142 116 St. Mary 18,099 214 207 147 155 Christ Church 39,536 534 524 427 326 St. John 20,426 206 189 175 172 Total 133,301 1436 1355 1159 1013 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 REGISTER OF SANITARY WORK Year ending 31st December, 1904. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. K. Lumley, Dust Inspector. Mr. R. Phillips Special Duties. Miss P. A. Baker. Total. Mr. J. Hodges, No. 1 District. Mr. A. Perry, 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. 409 489 378 471 401 2148 Tenements 477 117 460 350 368 3 1775 Underground Dwellings 155 15 224 68 196 648 Dairies, Milk Shops, Cow Houses 86 36 48 44 109 323 Slaughter Houses 24 35 5 15 2 81 Yards, Stables, and Mews 409 240 400 465 600 2114 Smoke Shafts 1 18 7 10 122 101 259 Offensive Trades and Effluvia Businesses 3 3 Refuse Receptacles 93 56 41 92 94 373 2 751 Enquiries re non-removal of refuse 65 50 70 57 86 2010 16 2354 Removal of Bodies to Mortuary 5 5 Visits to Works in Progress 2126 2735 1640 2790 1892 94 193 11470 Miscellaneous Inspections 1010 950 795 2265 1086 553 216 875 7750 UNWHOLFSOME FOOD:— Number of seizures made 2 3 1 6 INFECTIOUS DISEASE:- Cases Isolated 8 13 14 14 7 56 Cases removed to Hospital 95 24 136 74 106 435 Rooms Disinfected 167 41 154 195 235 792 NEW DRAINAGE:— Number of Plans Passed 46 72 68 108 76 6 376 New Pipe Drains (feet) 9764 1262 9000 10609 16222 174 58390 Houses where defects in existing Drainage have been detected and remedied 93 104 85 75 100 457 31 REGISTER OF SANITARY WORK Year ending 31st December, 1904 PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. K. Lumley, Dust Inspector. Mr. E. Lumley. Mr. R. Phillips, Special Duties. Miss P. 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. VV. Yeo. No. 5 District. Factory and Workshop Act. Enquiries as to Occupation 209 128 337 Periodical Inspections:— Factories 83 3 86 Workshops 678 891 1569 Bakehouses 475 475 Restaurants, &c. 400 400 Homeworkers' Premises 105 727 832 Domestic Workshops 21 2 23 Food and Drugs Act. ADULTERATION Samples collected for Analysis 135 118 113 110 114 590 Correspondence, Legal Procedure, &c. Complaints received 127 113 136 128 154 541 69 90 1358 Letters and Intimations relating to Abatement of Nuisances 297 202 334 355 222 199 22 155 1786 Statutory Notices Served 53 12 37 22 83 8 7 222 Proceedings taken before Magistrates 2 1 1 4 (1) Under Public Health Act 7 6 1 1 14 (2) „ Factory & Workshop Act (3) „ Food & Drugs Act 2 3 5 Reports made to Medical Officer of Health 408 351 359 617 642 243 252 109 2981 32 INDEX TO MONTHLY REPORTS B PAGE Back Land Houses in Glasgow 82 Baltic Street tenements (balance sheet) Glasgow 81 Berners Street—Appeal with regard to a by-law to the London County Council 123 Births and Deaths— January 2 February 12 March 22 April 48 May 50 June 62 July 76 August 91 September October 112 November 120 Birth and Death-rates- January 2 February 12 March 23 April 39 May 50 June 63 July 76 August 91 September October 112 November 120 Bush, James, prosecution of, for adulterated milk 25 Bywater, J. and A., prosecution of, for neglect to deposit plans 64 By-laws—Appeal to the London County Council 52, 123 c Capland Street, Magistrate's order to enter a house in 40 Church Street, No. 11, prosecution of owner under the Public Health Act 92 Court, Lionel, prosecution of, for milk adulteration 64 D Deaths, Causes of— January 8 February 18 March 31, 32 April 44 May 57 PAGE June 67 June Quarter 72 July 85 August 102 September 103 September quarter 104 October 117 November 127 Diarrhoea, summer 92 G Garages, nuisance from 41 Gees Court, No. 9 proceedings under the Housing of the Working Classes Act 40, 65 Green. Elizabeth, proceedings against for milk adulteration 64 Glasgow Congress, report on 77, 93 Glasgow Family House 79 „ Model Lodging Houses 79 H Haghill tenements (Glasgow), balance sheet of 81 Housing of the Working Classes Act 40 I Improvement Act (Glasgow) 80 Infectious Disease, Notifications for— January 5 February 10 March 26, 27 April 45 May 55 June 69, 70 July 83 August 99 September 100, 101 October 115 November 124 J James Street, Nos. 26, 28 —Appeal to London County Council against the application of a by-law 52 K King's Place, No. 13, proceedings under the Public Health (London) Act against owner 25,41, 52 33 INDEX TO MONTHLY REPORTS-continued. L PAGE Linhope Street, No. 48, prosecution of owner with regard to illegal occupation of kitchens 65 IV) Matthews, Messrs., prosecution of, for neglect to deposit plans 65 Meteorology for January 1 February 11 March 21 April 37, 38 May 49 June 61, 62 July 75, 76 August 89 September 90 October Ill November 119 Milk, adulterated 25 „ depots 92 „ „ dirty -4 Motor Garages, nuisance from 41 Middlesex Hospital, causes of death in— January 6 February 15 March 28 April 42 May 54 June 71 July 84 August September 96 October 114 November 125 P Public Health Act, prosecutions under 25, 40, 41, 64, 65, 92 Q Queen Charlotte's Hospital, causes of death in— January 6 February 15 March 28 April 42 May 54 June 71 July 84 August September October 114 November 125 s St. John Hospital of, causes of death in— January 6 February 15 March 28 April 42 May 45 June 71 PAGE July 84 August September 96 October 114 November 125 St. Marylebone Infirmary, Notting Hill, causes of death in— January 6 February 15 March 28 April 42 May 54 June 71 July 84 August September 96 October 114 November 125 Sale of Food and Drugs Acts 25,64,95 Samaritan Hospital, causes of death in— January 6 February 15 March 28 April 42 May 54 June 71 July 84 August September 96 October 114 November 125 Sanitary Work, register of— January 9, 10 February 19, 20 March 34, 35 April 40, 47 May 58, 59 June 73, 74 July 85 ,88 August 106, 107 September 107, 108 October 118, 119 November 128, 129 Small Pox 25 T Townshend Cottages, prosecution of owner under Public Health (London) Act 25 w Women, free sanitary conveniences for 14 Workhouses, causes of death in— January 6 February 15 March 28 April 42 May 54 June 71 July 84 August September 96 October 114 November 125 34 INDEX TO REPORT. A Page All Souls, births and deaths in, Table VI. 29 ,, birth and death-rate of 9 „ causes of death, Table V. 28 „ notification of infectious disease in, Table III 26 Andrews, D. J., register of sanitary work 30, 31 Area housing 12,13 B Bakehouse 16 Baker, Miss Frances, register of sanitary work 30, 31 „ report of 15 Births and deaths, Table VI 9, 29 Burne Street area 13 Bush, James, prosecution of for milk adulteration 21 c Capland Street, obstruction by occupier of a room in 14 Christ Church,births and deaths, Table VI. 29 „ birth and death-rate of 9 „ causes of death in, Table V. 28 „ notification of infectious disease in. Table III 26 Church Street, No. 119, prosecution of owner of 14 Cleansing of Persons Act 18 Clerical work 20 Coffee shops, inspection of 17 Copper in peas 23 Court, Lionel, prosecution of for milk adulteration 21 Crolick v. Knottingley Urban District Council 23 Curtis, H. E., clerical work of 20 D Deaths, ages at and causes of, Table V 28 Devonshire Place area 13 Dining rooms, inspection of 17 Diphtheria 11 Disinfection 20, 21 Dust inspections 30 E Extra-parochial institutions, deaths in 9-10 F page Factories and workshops 16 Firend v. Mapp 23 Gee's Court, No. 9, closing 13 Gorniot, T., register of sanitary work of 30, 31 Green, Eliz., prosecution of, for milk adulteration 21 H Hodges, J., register of sanitary work of 30, 31 Hotels, inspection of 17 Housing area 12, 13 Housing of the Working Classes Acts 13 Howe, W. J., clerical work of 20 Hull v. Horsnell 23 I Infectious Diseases notified 26 Inquests in 1904, Table I 24 J James, H. A., appointment of 20 John Street Dwellings 13 K King's Place, No. 13, prosecution of occupier of 14 L Laundries 15 Linhope Street, No. 48, illegal occupation of kitchens14 Lumley, E., register of inspections 30 M Macnair v. Horon 23 Margarine Act 23 Measles and Whooping Cough 12 Meteorological Summary 7,8 Middlesex Hospital, causes of death in, Table IV 27 Mortuary, The 17 Mortuary Keeper's Report, Table I. 24 35 INDEX TO ANNUAL REPORT—continued. N PAGE Northwick Terrace, No. 12, prosecution of owner of 14 Nokes v. Borough of Islington 22 Notification of Infectious Diseases 26 o Open Spaces of the District 12 Outworkers 15 P Perry, A., register of sanitary work 30, 31 Phillips, R. „ 30,31 Practical Sanitary Work 15 Q Queen Charlotte's Hospital, causes of death in, Table IV 27 R Rectory, births and deaths in, Table VI. 29 „ birth and death-rate of 9 „ causes of death in, Table V 28 „ notification of infectious diseases in, Table III 26 Rum, adulterated 22 s St. Ann's Terrace, Nos. 26-28, prosecution of owner of 14 St. John, births and deaths in, Table VI. 29 birth and death-rate of 9 „ causes of death in, Table V 28 „ notification of infectious diseasesin, Table III 26 St. John and Elizabeth Hospital, causes of death in, Table IV 27 St. Mary, births and deaths in, Table VI. 29 „ birth and death-rate of 9 PAGE St. Mary, causes of death in, Table V. 28 „ notification of infectious diseases in, Table III. 26 St. Marylebone Infirmary, causes of death in, Table IV. 27 Sale of Food and Drugs Acts, Table II. .. 21, 25 Samaritan Hospital, causes of death in, Table IV 27 Sanitary legislation. 22 Scarlet fever 11 Shelter house 19 Smallpox 11 Smallwood, Elizabeth, prosecution of, for milk adulteration 21 Smith, William, prosecution of, for milk adulteration 21 Smoke, black 23 Smoke nuisances 16,17 Styles v. Colinsky 22 T Taylor, Ed., and Sons, prosecution of, for milk adulteration 21 Tough v. Hopkins 23 Townshend cottages, No. 24, closing of.. 14 Trade nuisances 16 Typhoid fever 12 U Underground Conveniences 16,17 Urinals, public 17 w Whiskey, diluted . 21 Workhouse, causes of death in, Table IV. 27 Workshops 15 Y Yeo, W., register of sanitary work of 30,31 THE SANITARY CHRONICLES OF THE BOROUGH OF ST. MARYLEBONE DURING JANUARY, 1904, BY ALEXANDER WYNTER BLYTH, Medical Officer of Health, and Analyst of Food and Drugs for the Borough of St. Marylebone. Public Health Department, 3, Uppee Q-loucestise Place, St. Mabylebone, Februaey 5th, 1904. Vol. XXIV. No. 1. The week ending January 2nd was gloomy and sunless. On three days rain fell to the amount of 0.19 inch. The minimum temperature was 27.5º; maximum 38.5º; mean, 34.0º. Winds, S.B. Barometer, 29.9 inches. The week ending January 9th was also practically sunless, only 23 minutes of bright sunshine being registered in Regents Park. On five days rain fell to the extent of 0.24inch. Minimum temperature, 330°; maximum, 47.0°; mean, 4T3º. Winds S.W. and S.E. Mean barometer 29.9 inches. The week ending January 16th was brighter the sunshine being 18.8 per cent. of the possible. On live days rain fell to the extent of 0.66 inch. Winds N.W. and S.W. Minimum temperature, 33.0°; maximum, 54.5°; mean, 43.lº. Mean barometer, 29.6 inches. The week ending January 23rd was drier than the preceding weeks, rain only falling on three days to the extent of .22 inch. The sunshine equalled l3.5 per cent. of the possible. Winds N.E. and W.N.W. Mean barometer, 30.3 inches. The week ending January 30th was one of heavy rain, 0.9 or nearly an inch of rain falling in 4 days. Minimum temperature, 30.0º; maximum, 51.0°; mean, 42.1° Winds S.E. and S.W. Sunshine only 3.2 hours equal to 5.2 per cent. Mean barometer 29.8 inches. 2 Births and Deaths. During the five weeks ending January 30th there have been registered 274 births and 263 deaths. These births and deaths are divided among the five sub-dislricts as set forth in Table III, Ninety-five of the deaths were extra-parochial, as follows:— St. Marylebone Infirmary, Hotting Hill 62 North-Western Fever Hospital 3 "Western Fever Hospital 1 St. George's Hospital 1 St. Bartholomew's Hospital 1 French Hospital 1 Italian Hospital 1 St. Mary's Hospital 5 National Hospital 1 Children's Hospital, Great Ormond Street 1 Childrens Hospital, Paddington 1 London Temperance Hospital 1 University Hospital 4 King's College Hospital 1 Central London Sick Asylum 1 Claybury Asylum 2 Colney Hatch Asylum 2 Leayesden Asylum 1 Banstead Asylum 1 St. Luke's Hume 1 St. James' Home, Stoke Newington 1 River Thames 1 In the Streets 1 Total 95 The birth and death-rates, as deduced from the five weeks' statistics, are as follows:— All Souls, birth-rate 19.7; death-rate 19.7. Rectory, birth-rate 16.2; death-rate 17.3. St. Mary, birth-rate 21.8; death-rate 21.8. Christ Church, birth-rate 27.1; death-rate 20.3. St. John, birth-rate 17.8; death-rate 24.4. The whole district, birth-rate 21.0; death-rate 20.5. The average death-rates for five years (1898 to 1903) for the corresponding period were as follows :—All Souls, 15.7; Rectory, 2.V2; St. Mary, 19.1; Christ Church, 2.3; St. John, 232; the whole district, 20.5. 8 The following table gives, as usual, facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes: TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE five WEEKS ENDING JANUARY 30TH, 1904, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 5 weeks ending Jan. 30th, 1904. Proportion of the deaths to 1.000 deaths from all causes. 5 weeks ending Jan. 30, 1904. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1898-l903. 1. Deaths from the chief Zymotic Diseases 37 141 2.88 2.49 2. Pulmonary, other than Phthisis 69 224 3.38 5.81 3. Tubercular 31 117 2.42 2.41 notes. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza,Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. 4 The General Health of the District. The mild, damp January has had no injurious effect on the death rate, which is exactly the average of the past five years. Epidemics were absent. Chest affections less prevalent than usual. Dirty Milk. A Report on this subject by the Medical Officer of Health for Islington is now before the Public Health Committee. It is a fact that a large portion of the milk supply of the Metropolis derived from the country is distinctly dirty. There are model dairy farms in which the udder of each cow is carefully cleansed before milking and the hands of the milkers are also washed, but in a large number these essential precautions are either not done at all, or in a perfunctory manner. No small portion of town milk is drawn from the cow at about 4 a.m. It is not every farm labourer that on a chilly winter morning, in dark, miserable weather, will spend a quarter of an hour cleaning himself at the pump, and then devote five minutes extra to each cow, the more especially as trains have to be caught and there may be but a scanty margin of time to allow for various contingencies. The Dairies and Milkshops Order enforces general cleanliness in dairies and places where cows are kept, but it seems to be enforced by only a few Local Authorities. In any case it is a difficult matter to enforce cleanliness by Act of Parliament. In the writer's opinion the most practical way to deal with the question would be to fix, after due enquiry, a standard for the amount of dirt in milk, the standard, of course, based on clean commercial milk. It is an absolute impossibility to obtain milk quite free from dust or dirt, but it is not difficult to put into circulation milk which has a very small quantity of impurities derived from the dust of the cowshed and the hair and skin of the animal. JANUARY, 1904. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, AND TYPHOID FEVER DURING 1904. 5 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 January, 1904; 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 39,536 20,426 133,301 (c) Registered Births 67 31 38 103 35 274 (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 up ward s. New Casks of Sickness in each Locality coming to the knowledge of the medical Officer of Health. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 2 4 1 .. 2 3 2 2 .. 4 7 13 8. Diphtheria .. 3 .. 1 .. 2 .. .. .. 1 .. 7 4. Membranous Croup .. .. .. .. .. .. .. .. 1 .. 1 .. Fevers. 15. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. 1 .. 2 1 .. 1 3 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. 1 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas. .. 1 .. 1 .. .. .. 3 .. .. .. 10 Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 1 4 1 .. 2 3 2 2 .. 2 6 11 3. Diphtheria .. 3 .. 1 .. 1 .. .. .. .. .. 5 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. 1 .. 2 1 .. 1 3 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. 1 .. 1 .. 1 .. .. .. .. 6 TABLE III.—Giving the Causes of Deaths during January, 1904, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John and 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 Rever .. .. .. .. .. .. Diphtheria .. .. .. .. .. .. Typhoid Fever .. .. .. .. .. .. Diarrhoea .. .. .. .. 2 .. Erysipelas .. .. .. .. .. .. Pneumonia and Pleurisy .. .. .. .. 1 .. Pyaemia .. .. .. .. .. .. Syphilis .. .. .. .. 1 .. Cancer 13 .. .. .. 7 .. Phthisis & Tuberculosis 3 .. .. .. 14 .. Rheumatism .. .. .. .. .. .. Apoplexy .. .. .. .. .. .. Paralysis .. .. .. .. 1 .. Bronchitis .. .. .. 3 18 .. Asthma .. .. .. .. .. .. Peritonitis .. .. .. .. .. .. Disease of Brain .. .. .. .. .. .. „ Heart .. .. .. .. 5 .. „ Kidney .. .. .. .. 2 .. „ Liver .. .. .. .. .. .. „ Uterus .. .. .. .. .. .. „ Ovary .. .. .. .. .. .. Parturition .. .. .. .. .. .. Diabetes .. .. .. .. .. .. Fractures and Injuries .. .. .. .. .. .. Old Age .. .. .. .. 2 .. Low Vitality, Infants .. .. .. .. .. .. Premature Birth .. .. .. .. .. .. Other causes 19 4 .. 8 9 .. Total *45 †5 .. 13 62 ‡2 * Of the 46 deaths in the Middlesex Hospital, 31 were those of non-parishioners. † Four of the 5 deaths in Queen Charlotte's Hospital were those of non-parishioners. ‡ The two deaths in St. John's Hospital were those of non-parishioners. 7 TABLE IV.—District Births and Deaths for the five weeks endino january l 10th, 1904. Population in 1891. Births. Deaths. Males. Fmls. Males Fmls. All Souls 35,391 34 33 35 32 Rectory 19,849 14 17 17 16 St. Mary 18,099 24 14 16 22 Christ Church 39,530 46 57 43 34 St. John 20,426 17 18 24 24 Total 133,301 135 139 135 128 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. 8 TABLE V.—Causes of, and Ages at, Death during the 5 weeks ending January 30th, 1904, 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 17 .. 10 1 1 .. .. 2 .. .. .. 6 3 Scarlet Fever 1 .. .. .. .. 1 .. 1 .. .. .. .. .. Whooping Cough 3 .. 8 .. .. .. .. .. 1 .. .. 2 1 Diphtheria and Membranous Croup 1 .. .. .. 1 .. .. .. .. .. 1 .. l Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric 1 ... ... ... ... 1 ... ... ... ... 1 ... 1 Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza 7 ... ... ... ... 3 ... ... 2 ... ... 1 ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea 7 3 1 ... ... 1 ... 3 2 ... 1 1 3 Enteritis ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal fever ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... Other Septic Diseases 2 ... ... ... ... 2 ... ... 1 ... ... 1 1 Phthisis 25 ... ... 1 2 21 ... 3 4 8 ... 5 15 Other Tubercular Diseases 6 ... ... 1 ... 3 ... 4 ... 1 1 ... 5 Cancer, Malignant Disease 16 ... ... ... ... 10 6 2 1 5 4 4 11 Bronchitis 54 ... 1 ... ... 18 28 13 3 11 ... 11 24 Pneumonia 13 ... 4 ... ... 5 1 5 ... 1 5 2 3 Pleurisy ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Respiratory Organs 2 ... ... ... ... ... 2 ... ... ... 2 ... 1 Alcoholism Cirrhosis of Liver 4 ... ... ... ... 3 1 3 1 ... ... ... 3 Venereal Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 8 ... ... ... ... ... ... 1 ... 1 1 ... ... Diseases and Accidents of Parturition ... ... ... ... ... ... ... ... ... ... ... ... 1 Heart Diseases 21 ... ... 8 ... 14 4 6 1 1 8 5 12 Accidents 6 ... ... 1 ... 1 3 3 1 ... 1 1 5 Suicides ... ... ... ... ... ... ... ... ... ... ... ... ... All other causes 74 16 2 2 2 28 24 21 16 9 19 9 53 All causes 263 40 21 9 6 111 76 67 33 38 77 48 *113 *Of these 37 were Non-Parishioners. 9 REGISTER OF SANITARY WORK Month ending 31st January, 1904. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. E. Lumley, Dust Inspector. Mr. R. Phillips, Special Duties. Miss P. 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. Inspection*. Dwelling Houses, &c. 37 48 35 20 29 ... ... ... ... ... 169 Tenements 73 36 75 43 47 ... ... ... ... 3 277 Underground Dwellings 12 ... 20 ... 10 ... ... ... ... ... 42 Dairies, Milk Shops, Cow Houses 10 3 1 1 3 ... ... ... ... ... 18 Slaughter Houses 2 2 0 0 2 ... ... ... ... ... 8 Yards, Stables, and Mews 34 10 30 33 41 ... ... ... ... ... 148 Smoke Shafts ... ... ... ... ... ... ... ... 2 ... ... Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... ... ... ... Refuse Receptacles 11 6 5 4 9 ... 36 Enquiries re non-removal of refuse 10 8 10 3 7 ... 38 Removal of Bodies to Mortuary . ... ... ... ... ... ... ... ... ... ... ... Visits to Works in progress 131 160 120 120 147 ... ... ... ... 3 681 Miscellaneous Inspections 42 36 35 140 103 ... ... ... 20 78 454 UNWHOLESOME FOOD. ... ... ... ... ... ... ... ... ... ... ... Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE:— Cases Isolated. ... 1 2 ... ... ... ... ... ... ... 4 Cases Removed to Hospital 6 2 10 4 7 ... ... ... ... ... 29 Rooms Disinfected 12 5 11 6 15 ... ... ... ... ... 49 NEW DRAINAGE :— Number of Plans Passed 2 3 3 11 7 ... ... ... 2 ... 28 New Pipe Drains (feet) 300 456 320 560 974 ... ... ... 85 ... 2695 Houses where defects in existing Drainnge have been detected and remedied 6 4 6 4 7 ... ... ... ... ... 26 10 REGISTER OF SANITARY WORK Month ending 31st January, 1904. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. K.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. Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 18 4 22 Periodical Inspections:— Factories ... ... ... ... ... ... ... ... 5 1 6 Workshops ... ... ... ... ... ... ... ... 89 63 152 Bakehouses ... ... ... ... ... ... ... ... 59 ... 59 Restaurants,&c. ... ... ... ... ... ... ... ... 40 ... 40 Homeworkers' Premises ... ... ... ... ... ... ... ... 5 28 33 Domestic Workshops ... ... ... ... ... ... ... ... 8 ... 8 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 12 ... 15 0 1 ... ... ... ... ... 28 Correspondence, Legal Procedure, &c. Complaints received 7 11 10 9 ... ... ... ... 9 8 54 Letters and Intimations relating to Abatement of Nuisances 18 15 19 29 22 ... ... ... 3 3 109 Statutory Notices Served 4 ... 2 2 5 ... ... ... 2 ... 15 Proceedings taken before Magistrates ... 1 ... ... ... ... ... ... ... .. 1 (1) Under Public Health Act ... ... 1 ... ... ... ... ... ... ... 1 (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) „ Food & Drugs Act ... ... ... ... ... ... ... ... ... ... ... Reports made to Medical Officer of Health 32 34 30 50 ... ... ... ... 29 8 183 THE SANITARY CHRONICLES OF THE BOROUGH OF ST.MARYLEBONE DURING FEBRUARY, 1904, 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, Upper Gloucester Place, W.,March 6th, 1904. Vol. XXIV. No. 2. The week ending February 6th was of a moderate temperature the lowest being 33.0°; highest, 48.0°; mean, 41.8. On three days, rain fell to the total amount of 1.12 inch. The winds were N.W. and S.W. Sunshine in Regent's Park (under ten hours) was equal to 13.8 per cent. of the possible. Mean barometer 29.3 inches. The week ending February 13th was wet, rain falling on six days out of the seven to the total amount of 1.24 inch. Minimum temperature, 33.2° maximum, 49.8°; mean, 43.3°. Winds S.W. Sunshine 12.4 per cent. Mean barometer (low) 29.1 inches. The week ending February 20th was drier and cooler. Minimum temperature, 30.0° ; maximum, 52.8° ; mean, 40.2o. Slight rains fell on four days to the amount of 0.43 inch. Winds, W.N.W. and N.W. Sunshine 14.4 per cent. Mean barometer, 29.3 inches. The week ending February 27th was unseasonably cold. Minimum temperature, 29.8° ; maximum, 53.0°; mean, 39.3°. There were only two days of rain. The rainfall being .05 inch. The winds N.E. and S.E. and the sunshine only 6 per cent. Mean barometer 29.9 inches. The month was therefore unusually wet. More or less rain fell on 15 days, the total rainfall equalling 2.83 inches. 12 Births and Deaths. During the four weeks ending February 27th there have been registered 203 births and 180 deaths. These births and deaths are divided among the five sub-districts as set forth in Table IV. Eighty of the deaths were extra parochial, as follows:— St. Marylebone Infirmary, Notting Hill 44 North-West Fever Hospital 2 St. Bartholomew's Hospital 1 Guy's Hospital 1 University Hospital 1 Charing Cross Hospital 1 St. Mary's Hospital 8 Great Northern Hospital 1 North-West London Hospital 1 Brompton Hospital 1 Hanwell Asylum 5 Banstead Asylum 1 Caterham Asylum 2 Claybury Asylum 1 Bethlem Hospital 1 Colney Hatch Asylum 2 Leavesden Asylum 1 Miller Hospital 1 Children's Hospital, Great Ormond Street 1 Children's Hospital, Paddington 2 St. Giles' Workhouse 1 In the Streets 1 Total 80 The birth and death-rates, as deduced from the four weeks' statistics, were as follows:— All Souls, birth-rate 13.2; death-rate 15.1. Rectory, birth-rate 10.5 ; death-rate 16.4. St. Mary, birth-rate 22.8 ; death-rate 15.8. Christ Church, birth-rate 25.3; death-rate 19.7. St. John, birth-rate 26.7; death-rate 20.3. The whole district, birth-rate 19.8; death-rate 17.5. The average death-rates for five years (1897 to 1902) for the corresponding period were as follows:—All Souls, 17.6; Rectory, 33.4; St. Mary, 20.1; Christ Church, 25.0; St. John. 18.7 ; the whole district, 21.3. 13 The following table gives, as usual, facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes : TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE FOUR WEEKS ENDING FEBRUARY 27TH, 1904, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 4 weeks ending Feb. 27th, 1904. Proportion of the deaths to 1,000 deaths from all causes. 4 weeks ending Feb. 27, 1904. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1898-1903. 1. Deaths from the chief Zymotic Diseases 16 89 1.57 2.50 2. Pulmonary, other than Phthisis 42 233 4.10 6.32 3. Tubercular 18 100 1.76 2.45 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza, Whooping Cough Erysipelas, Croup, Fever, and Diarrhœa. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. 14 Health of the District. The death rates continue abnormally low, and there fore satisfactory. The season, although most uncomfortably wet, has been mild, owing to this the mortality from chest complaints, which is usually at this time of year about 6 per thousand has sunk to 4, the rate for tubercle is also nearly 1 per thousand lower than usual. Seasonal influences afford, however, no explanation of the small incidence of the infectious or notifiable diseases, all of which are remarkably low. Free Sanitary Conveniences for Women. In this district, in the Metropolis generally, and in all large cities there is a considerable roving population of the poorest class of women. These women, driven by urgent and natural necessity, foul various dark corners, badly-lit archways, and secluded spots generally. The only practical abatement and remedy for such continual nuisances is the construction of free conveniences for women, with proper supervision and public notices in the chief thoroughfares denoting their position. The writer is satisfied that the main bulk of these persons have no definite place of abode, hence it is a question whether the establishment and maintenance of such places should not be undertaken by the Central rather than the Local Authorities. At almost each meeting of the Public Health Committee nuisances are reported of the nature referred to, and the Committee have hitherto been unable to deal with the matter effectually. FEBRUARY, 1904. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, AND TYPHOID FEVER DURING 1904. 15 TABLE II.—Giving the Causes of Deaths during the four Weeks ending February 27th, 1904, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John and Elizabeth, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill Infirmary. Hospital of St. John & Elizabeth Grove Rd. Smallpox .. .. .. .. .. .. Influenza .. .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. Diphtheria .. .. .. .. .. .. Typhoid Fever .. .. .. .. .. Diarrhœa .. .. .. .. 2 .. Erysipelas .. .. .. .. .. .. Pneumonia and Pleurisy 1 1 Pyæmia .. .. .. .. .. .. Syphilis .. .. .. .. 4 .. Cancer 9 .. .. .. 7 .. Phthisis & Tuberculosis 3 .. .. .. 3 .. Rheumatism .. .. .. .. 1 .. Apoplexy .. .. .. .. 2 .. Paralysis .. .. .. .. .. .. Bronchitis 5 .. .. 1 7 .. Asthma .. .. .. .. .. .. Peritonitis .. .. .. .. 1 .. Disease of Brain .. .. .. .. .. .. „ Heart 1 .. .. 1 5 .. „ Kidney .. .. .. .. 3 .. „ Liver .. .. .. .. .. .. „ Uterus .. .. .. .. .. .. „ Ovary .. .. .. .. .. .. Parturition .. .. .. .. .. .. Diabetes .. .. .. .. .. .. Fractures and Injuries .. .. .. .. 2 .. Old Age .. .. .. .. 3 .. Low Vitality, Infants .. .. .. .. .. .. Premature Birth .. .. .. 1 .. .. Other causes 7 3 .. 4 3 .. Total *26 †3 .. 7 44 .. * Of the 26 deaths in the Middlesex Hospital, 21 were those of non-parishioners, † The 3 deaths in Queen Charlotte's Hospital were 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, 1904; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Total* Population at all ages. (b) Census 1901 35,391 19,849 18,099 39,536 20,426 133,301 (c) Registered Births 36 16 32 77 42 203 (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 upward* New Cases of sickness in each locality coming to the knowledge of the medical officer of Health. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 1 2 .. 1 4 6 .. 2 1 1 6 12 3. Diphtheria .. 2 .. .. .. .. 1 2 1 1 2 5 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. .. .. .. .. .. .. .. 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8.Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. 1 .. 1 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas. .. 3 .. 2 .. .. 3 6 .. .. 3 11 Number of such Cases Removed from there Homes in the several localities for ment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina .. 2 .. .. .. 1 .. 2 1 1 1 6 3. Diphtheria .. 1 .. .. .. .. 1 2 .. .. 1 3 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. .. .. .. .. .. .. .. 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 2 .. 1 .. 2 .. 1 •• .. .. 6 17 TABLE IV.—District Births and Deaths for the four weeks ending February 27th, 1904. Population in 1891. Births. Deaths. Males. Fmls. Males Fmls. Ail Souls 35,391 20 16 21 20 Rectory 19,849 6 10 15 10 St. Mary 18,099 17 15 11 11 Christ Church 39,536 34 43 27 33 St. John 20,426 25 17 18 14 Total 133,301 102 101 92 88 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 TABLE V.—Causes of, and Ages at, Death during the 4 weeks ending February 27th, 1904, 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 ... ... ... 1 ... 1 2 ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough 2 1 1 ... ... ... ... ... ... ... ... 2 ... Diphtheria and Membranous Croup 2 1 ... 1 ... ... ... 1 ... ... ... 1 1 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric 1 ... ... 1 ... ... ... ... ... 1 ... ... 1 Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza 3 ... ... ... ... 3 ... 1 1 ... ... 1 ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa 3 1 ... ... ... ... 2 2 ... ... ... 1 2 Enteritis 1 1 ... ... ... ... ... ... ... ... 1 ... ... Puerperal fever ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... Other Septic Diseases ... 5 1 1 3 3 1 2 Phthisis 13 3 8 2 3 1 " 7 2 12 Other Tubercular Diseases 4 ... 3 ... ... 1 ... ... 1 1 2 ... 3 Cancer, Malignant Disease 14 ... ... ... ... 10 4 4 ... 1 7 2 20 Bronchitis 29 2 ... ... ... 12 15 8 2 4 11 4 14 Pneumonia 11 2 2 ... ... 5 2 2 3 ... 3 3 4 Pleurisy 2 ... ... 1 1 ... ... ... ... 2 ... ... ... Other Diseases of Respiratory Organs ... ... ... ... ... ... ... ... ... ... ... ... ... Alcoholism Cirrhosis of Liver 3 ... ... ... ... 1 2 2 ... 1 ... ... 2 Venereal Diseases 4 8 1 ... ... ... ... 1 ... ... 2 1 5 Premature Birth 5 5 ... ... ... ... ... ... 1 ... 2 2 ... Diseases and Accidents of Parturition 1 ... ... ... ... 1 ... 1 ... ... ... ... 5 Heart Diseases 12 1 ... 1 ... 5 5 ... 3 2 4 3 4 Accidents 6 ... ... ... 1 3 2 2 ... 2 2 ... 1 Suicides ... ... ... ... ... ... ... ... ... ... ... ... ... All other causes 55 10 1 1 1 17 25 10 13 6 16 10 38 All causes 180 28 11 7 6 69 59 41 25 22 60 32 *114 *26 of the 114 deaths were Non-Parishioners. 19 REGISTER OF SANITARY WORK Month ending 29th February, 1904. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. E.Lumley, Dust, Inspector. Mr. R.Phillips, Speoial 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. 26 29 25 30 31 ... ... ... ... ... 141 Tenements 42 ... 35 28 29 ... ... ... ... ... 134 Underground Dwellings 18 ... 20 5 16 ... ... ... ... ... 59 Dairies, Milk Shops, Cow Houses 8 3 1 2 16 ... ... ... ... ... 30 Slaughter Houses 2 3 ... ... 1 ... ... ... ... ... 6 Yards, Stables, and Mews 31 10 30 25 43 ... ... ... ... ... 139 Smoke Shafts ... ... ... ... ... ... ... ... 4 ... 4 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... ... ... ... Refuse Receptacles 8 4 ... 4 3 ... ... 45 ... ... 64 Enquiries re non-removal of refuse 4 3 5 3 9 ... ... 250 ... 2 276 Removal of Bodies to Mortuary ... ... ... ... ... ... ... ... ... ... ... Visits to Works in progress 135 196 130 260 141 ... ... ... ... 6 868 Miscellaneous Inspections 84 92 85 150 91 ... ... 65 20 78 629 NWHOLESOME FOOD. Number of seizures made ... ... ... ... ... ... ... ... ... ... ... NFECTIOUS DISEASE:— Cases Isolated ... ... ... ... ... ... ... ... ... ... ... Cases Removed to Hospital 2 1 14 1 3 ... ... ... ... ... 21 Rooms Disinfected 10 1 14 4 16 ... ... ... ... ... 45 NEW DRAINAGE:— Number of Plans Passed 5 4 3 8 5 ... ... ... 2 ... 27 New Pipe Drains (feet) 520 860 530 860 1312 ... ... ... 89 ... 4171 Houses where defects in existing Drainage have been detected and remedied 6 7 5 6 9 ... ... ... ... ... 33 20 REGISTER OF SANITARY WORK Month ending 29th February, 1904. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. 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. 4 District. Mr. W.Yeo, No. 5 District. Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 29 10 39 Periodical Inspections :— Factories ... ... ... ... ... ... ... ... 4 ... 4 Workshops ... ... ... ... ... ... ... ... 73 17 90 Bakehouses ... ... ... ... ... ... ... ... 69 ... 69 Restaurants, &c. ... ... ... ... ... ... ... ... 30 ... 30 Homeworkers' Premises ... ... ... ... ... ... ... ... 5 117 122 Domestic Workshops ... ... ... ... ... ... ... ... 7 ... 7 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 18 23 5 ... 22 ... ... ... ... ... 74 Correspondence, Legal Procedure, &c. Complaints received 11 22 6 8 10 ... ... 40 4 3 104 Letters and Intimations relating to Abatement of Nuisances 34 30 32 25 26 ... ... 12 3 10 172 Statutory Notices Served 1 2 3 2 7 ... ... ... 1 ... 19 Proceedings taken before Magistrates ... 1 ... ... ... ... ... ... ... ... ... (1) Under Public Health Act ... ... ... ... ... ... ... ... ... ... ... (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) „ Food & Drugs Act ... ... ... ... ... ... ... ... ... ... ... Reports made to Medical Officer of Health 32 36 30 50 47 ... ... 15 28 12 256 THE SANITARY CHRONICLES of the BOROUGH OF ST. MARYLEBONE DURING MARCH, 1904, Containing a Quarterly Summary of the Mortality Statistics for the Quarter ending March 26th, 1904, 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, Upper Gloucester Place, W., April 11th, 1904. Vol. XXIV. No. 3 The week ending March 5th was a cold week. Minimum temperature, 27.5°; maximum, 40.0° ; mean, 34.4°. On four days rain, snow, or sleet fell to the amount of 0.53 inch. Sunshine scarcely 4 per cent. Wind easterly. Barometer 29.9 inches. The week ending March 12th had similar weather, but slightly warmer. Minimum temperature, 30.0° ; maximum, 58.0°; mean, 52.0°. On four days rain fell, the total fall measuring 0.28 inch. Winds E. and N.E. Sunshine registered in Regent's Park was equal to 22.9 hours, or nearly 29 per cent. Mean barometer 29.8 inches. The week ending March 19th was fairly dry, only one shower of rain falling (0.03 inch). Minimum temperature, 26.5°; maximnm, 51.0° ; mean, 43.1°. Winds N.E. and W.S.W. Sunshine only 10 per cent. Mean barometer 29.7 inches. The week ending March 26th was warmer than the three preceding weeks. Minimum temperature, 32.5°; maximum, 53.0°; mean, 44.9°. On three days slight rain fell (0.22 inch). Winds N.N.W. and N.E. Sunshine 8 per cent. Mean barometer 30.0 inches. 22 Births and Deaths. During the four weeks ending March 26th there have been registered 197 births and 212 deaths—equal to a birth-rate of 19.2 and a death-rate of 20 7 per thousand. The mean death-rate for the corresponding period during the last five years is 22.6 per thousand. Quarterly Summary. During the March Quarter there have been registered 674 births and 655 deaths. These births and deaths are divided among the five subdistricts as set forth in Table VI. 255 of the deaths were extra-parochial, as follows:— St. Marylebone Infirmary, Notting Hill 154 North-West Fever Hospital 5 Western Fever Hospital 1 St. Bartholomew's Hospital 3 St. Thomas' Hospital 1 Guy's Hospital 1 St. George's Hospital 1 University Hospital 6 Kings' College Hospital 1 Charing Cross Hospital 1 St. Mary's Hospital 17 National Hospital 1 Great Northern Hospital 2 French Hospital 1 Italian Hospital 1 North-West London Hospital 1 Brompton Hospital 1 Hanwell Asylum 11 Banstead Asylum 2 Tooting Bee Asylum 1 Caterham Asylum 2 Claybury Asylum 5 Bethlem Hospital 1 Colney Hatch Asylum 5 Manor Asylum, Epsom 1 Leavesden Asylum 3 St. Luke's House 2 St. James' Home, Stoke Newington 1 Miller Hospital 1 London Temperance Hospital 2 Children's Hospital, Great Ormond Street 3 Children's Hospital, Paddington 6 St. Giles' Workhouse 1 St. Pancras Infirmary 1 Central London Sick Asylum 1 " The Best," Clapton 1 Freidenheim 3 River Thames 1 In the Streets 3 Total 255 23 The birth and death-rates, as deduced from the thirteen weeks' statistics were as follows :— All Souls, birth-rate 16.9; death-rate 18.4. Rectory, birth-rate 14.9 ; death-rate 16.7. St. Mary, birth-rate 21.2 : death-rate 20.8. Christ Church, birth-rate 26.4 : death-rate 21.1 St. John, birth-rate 18.2 ; death-rate 20.7. The whole district, birth-rate 20.3; death-rate 19.7. The average death-rates for five years (1898 to 1903) for the corresponding period were as follows:—All Souls, 13.6; Rectory, 27.0; St. Mary, 20.6; Christ Church, 24.1; St. John. 20.4; the whole district, 21.4. 24 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 26TH, 1904, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 13 weeks ending Mar. 26th, 1904. Proportion of the deaths to 1,000 deaths from all causes. 13 weeks ending Mar. 26,1904. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1898-1903. 1. Deaths from the chief Zymotic Diseases 67 102 2.05 2.69 2. Pulmonary, other than Phthisis 171 261 5.14 5.87 3. Tubercular 80 122 2.40 2.72 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza, Whooping Cough, Erysipelas, Croup, Fever, and Diarrhœa. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. 25 Smallpox. Smallpox has appeared among the denizens of Common Lodging Houses and Workhouses in the Metropolis. In this district there have been but two cases up to date and it is improbable that there will be any considerable extension. The experience of many years clearly shows that a community, save under exceptional circumstances is reasonably safe from epidemic, unless there is a large increase of cases in April, the maximum of epidemicity falling in the month of May. Prosecutions under the Public Health Act. The owner of 13, King Street, was proceeded against for failing to carry out a notice to drain the premises and a Magistrate's order obtained. Subsequently the defendant was arrested and imprisoned for non-payment of rates, and the enforcement of the order has to await his release. The owner of 39, Townshend Road, was summoned for failure to comply with a notice to re-drain the premises. The Magistrate adjourned the case for the work to be done. Sale of Food and Drugs Act. The usual large number of samples were taken during the quarter, as set forth in detail in Table IX. Of the 153 samples, four were certified to be adulterated, three of the samples were milk, one sample was butter. The latter contained a small percentage of water above the limit and it was thought, under the circumstances, sufficient to acquaint the trader with the fact and to warn him to cease selling an article slightly below standard, the same course was taken with one of the samples of milk. In another case in which the milk was certified to be diluted with 8 percent. of water, the legal adviser discovered a flaw in the procedure of taking the sample and the case was not further proceeded with, but the vendor will be watched and other samples taken from time to time. James Bush, of 25, Townshend Road, was fined £10 and £3 3s. costs for selling milk diluted with 19 per cent. of water. 26 TABLE II.–TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, in the Sanitary District of ST. MARYLEBONE, during March, 1904 : classified accordinq 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 47 27 26 81 16 197 (d) Aged under 5 or over 5 Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5. 5 upwards. New Cases of sickness in each locality coming to the knowledge of the medical officer of Health. 1. Smallpox .. .. .. 2 .. .. .. .. .. .. .. 2 2. Scarlatina 3 4 .. 1 .. .. 1 3 .. 3 5 11 3. Diphtheria .. 2 .. .. .. .. .. 1 1 .. 1 3 4. Membranous Croup .. .. .. .. .. .. 1 .. .. .. 1 .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. .. .. 1 .. .. .. 1 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. 1 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas. .. 1 .. 4 .. 1 .. 6 .. 1 .. 13 Number of such Cases Removed from there Homes in the several localities for ment in Isolation Hospitals. 1. Smallpox .. .. .. 2 .. .. .. .. .. .. .. 2 2. Scarlatina 2 3 1 1 .. .. .. 1 .. 3 3 8 3. Diphtheria .. .. .. .. .. .. .. .. 1 .. 1 .. 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. FEVERS. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. .. .. .. .. .. .. .. 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. 4 .. .. .. 1 .. 1 .. 6 27 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 March Quarter, 1904; 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 150 74 96 261 93 674 (d) Aged under 5 or over 5 Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards. New Cases of sickness in each locality coming to the knowledge of the medical officer of Health. 1. Smallpox .. .. .. 2 .. .. .. .. .. .. .. 2 2. Scarlatina 6 10 1 2 7 9 3 7 1 8 18 36 3. Diphtheria .. 7 .. 1 .. 2 1 3 2 2 3 15 4. Membranous Croup .. .. .. .. .. .. 1 .. 1 .. 2 .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. 1 .. 3 1 .. 1 4 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. 1 .. .. .. .. .. 2 .. 3 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 5 .. 7 .. 6 3 15 .. 1 3 34 Number of such Cases Removed from there Homes in the several localities for ment in Isolation Hospitals. 1. Smallpox .. .. .. 2 .. .. .. .. .. .. .. 2 2. Scarlatina 3 9 2 1 2 4 2 5 1 6 10 25 3. Diphtheria .. 4 .. 1 •• 1 1 2 1 .. 2 8 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. 1 .. 2 1 .. 1 3 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 2 .. 6 .. 3 .. 3 .. 1 .. 15 28 TABLE IV.—Giving the Causes of Deaths during the March Quarter, 1904, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John and 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 4 .. Erysipelas .. .. .. .. .. .. Pneumonia and Pleurisy 3 .. .. .. 4 .. Pyaemia .. .. .. .. .. .. Syphilis .. .. .. .. 7 .. Cancer 29 .. .. .. 16 .. Phthisis & Tuberculosis 8 .. .. .. 30 .. Rheumatism .. .. .. .. 1 .. Apoplexy .. .. .. .. 3 .. Paralysis .. .. .. .. 4 .. Bronchitis 12 .. .. .. 39 .. Asthma .. .. .. .. .. .. Peritonitis .. .. .. .. 1 .. Disease of Brain .. .. .. .. .. .. „ Heart 8 .. .. 3 11 .. „ Kidney .. .. .. 3 11 .. „ Liver 1 .. .. .. .. .. „ Uterus .. .. .. .. .. .. „ Ovary .. .. .. .. .. .. Parturition .. 3 .. .. .. .. Diabetes .. .. .. .. .. .. Fractures and Injuries. 4 .. .. .. 2 .. Old Age .. .. .. .. 10 .. Low Vitality, Infants . .. .. .. .. .. .. Premature Birth .. 1 .. 1 .. .. Other causes 35 9 .. 12 17 1 Total *100 †13 .. 23 154 ‡5 * Of the 100 deaths in the Middlesex Hospital, 71 were those of non-parishioners, † Twelve of the 13 deaths in Queen Charlotte's Hospital were non-parishioners. ‡ The 5 deaths in St. John's Hospital were those of non-parishioners. MARCH, 1904. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, AND TYPHOID FEVER, AND SMALLPOX DURING 1904. 29 TABLE V.—District Births and Deaths for the four weeks ending march 20th, 1904. Population in 1891. Births. Deaths. Males. Fmls. Males. Fmls. All Souls 35,391 22 25 33 22 Rectory 19,849 12 15 9 16 St. Mary 18,099 14 12 19 15 Christ Church 39,536 40 41 44 28 St. John 20,426 6 10 13 13 Total 133,301 94 103 118 94 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 VI.—District Births and Deaths for the thirteen weeks ending march 25th, 1904. Population in 1891. Births. Deaths. Males. Fmls. Males Fmls. All Souls 35,391 76 74 89 74 Rectory 19,849 32 42 41 42 St. Mary 18,099 55 41 46 48 Christ Church 39,536 120 141 114 95 St. John 20,426 48 45 55 51 Total 133,301 331 343 345 310 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. 31 TABLE VII.—Causes of, and Ages at, Death during the 4 week ending March 26th, 1904. 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 6 2 4 ... ... ... ... 1 1 ... ... ... ... Scarlet Fever 1 ... 1 ... ... ... ... 1 ... ... ... ... 1 Whooping Cough 1 1 1 Diphtheria and Membranous Croup 1 ... ... ... ... ... ... 1 ... ... ... ... 1 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric ... ... ... ... ... ... ... ... ... ... ... ... ... Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza 3 ... ... ... ... 1 2 ... 1 1 ... 1 ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa 2 1 1 ... ... ... ... ... ... 1 ... 1 1 Enteritis ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal fever ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... Other Septic Diseases 1 ... ... ... ... ... 1 ... ... 1 ... ... ... Phthisis 26 ... 1 2 ... 21 2 7 5 4 9 1 16 Other Tubercular Diseases 6 2 1 2 ... 1 ... 2 1 2 1 ... 4 Cancer, Malignant Disease 10 ... ... ... ... 8 2 1 1 2 3 3 11 Bronchitis 40 4 6 1 ... 12 17 9 7 5 16 3 25 Pneumonia 20 2 7 1 1 3 6 6 1 3 7 3 5 Pleurisy ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Respiratory Organs ... ... ... ... ... ... ... ... ... ... ... ... ... Alcoholism Cirrhosis of Liver 1 ... ... ... ... 1 ... 1 ... ... ... ... ... Venereal Diseases 2 1 1 ... ... ... ... ... ... ... 1 1 1 Premature Birth 5 5 ... ... ... ... ... 3 ... 1 ... 1 1 Diseases and Accidents of Parturition 2 ... ... ... ... 1 1 ... 1 1 ... ... 5 Heart Diseases 8 1 ... ... ... 3 4 ... 1 4 1 ... 4 Accidents 4 ... ... ... 1 3 ... 4 ... ... ... ... ... Suicides ... ... ... ... ... ... ... ... ... ... ... ... ... All other causes 73 12 6 1 3 23 28 18 6 9 30 10 41 All causes 212 31 28 8 5 77 63 55 25 34 72 26 *116 *Of these deaths 27 were Non-Parishioners. 32 TABLE VIII.—Causes of, and Ages at, Death during the 13 weeks ending March 26th, 1904, 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 27 7 17 2 1 .. .. 4 1 1 15 6 3 Scarlet Fever 2 .. 1 .. .. 1 .. 2 .. .. .. .. 1 Whooping Cough 6 2 4 .. .. .. .. 1 1 .. .. 4 2 Diphtheria and Membranous Croup 4 1 .. 2 1 .. .. 2 .. .. 1 1 2 Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric 2 .. .. 1 .. 1 .. .. .. 1 1 .. 2 Other continued . .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza . 13 .. .. .. .. 7 6 1 4 2 3 3 .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 12 5 2 .. .. 1 4 5 2 1 1 3 6 Enteritis 1 1 .. .. .. .. .. .. .. .. 1 .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. Other Septic Diseases 8 1 .. 1 .. 5 1 3 1 2 1 1 3 Phthisis 64 .. 1 3 5 50 5 13 10 12 21 8 43 Other Tubercular Diseases 16 4 4 3 .. 5 .. 6 2 4 4 .. 12 Cancer, Malignant Disease 40 .. .. .. .. 28 12 7 2 8 14 9 42 Bronchitis 123 13 7 1 .. 42 60 30 12 20 43 18 63 Pneumonia 44 7 13 1 1 13 9 13 4 4 15 8 12 Pleurisy 2 .. .. 1 1 .. .. .. .. 2 .. .. .. Other Diseases of Respiratory Organs 2 .. .. .. .. .. 2 .. .. .. 2 .. 1 Alcoholism Cirrhosis of Liver 8 .. .. .. .. 5 3 6 1 1 .. .. 5 Venereal Diseases 6 4 2 .. .. .. .. 1 .. .. 3 2 6 Premature Birth 13 13 .. .. .. .. .. 4 1 .. 3 3 1 Diseases and Accidents of Parturition 3 .. .. .. .. 3 .. 1 1 1 .. .. 11 Heart Diseases 41 2 .. 4 .. 22 13 6 5 7 13 10 20 Accidents 16 1 .. 1 2 7 5 9 1 2 3 1 6 Suicides .. .. .. .. .. .. .. .. .. .. .. .. .. All other causes 202 38 9 4 6 67 73 49 35 24 60 29 12 All causes 655 99 60 24 17 25 198 163 83 94 209 106 373 *Of these 90 were Non-Parishioners. 33 TABLE IX.—SALE OF FOOD AND DRUGS ACTS. Samples Analysed during March Quarter, 1904. Genuine. Adulterated. Total. DAIRY PRODUCTS— Milk 65 3 68 Butter 13 1 14 Cream 2 — 2 Margarine 3 — 3 ALCOHOLIC BEVERAGES— Whisky 5 - 5 Brandy 2 - 2 Rum 2 — 2 Gin 3 - 3 NON-ALCOHOLIC BEVERAGES— Coffee 8 — 8 Coffee and Chicory 2 — 2 Cocoa 2 - 2 CONDIMENTS— Pepper 8 - 8 Mustard 6 — 6 Vinegar 5 - 5 Salt 1 — 1 Currie Powder 1 — 1 SACCHARINE SUBSTANCES— Jam 8 - 3 Sugar 1 — 1 Sweets 3 — 3 TINNED GOODS— Condensed Milk 4 — 4 Sardines 1 - 1 Salmon 1 — 1 Bloater Paste 1 — 1 Tinned Peas 1 - 1 DRUGS— Bicarbonate of Soda 1 — 1 MISCELLANEOUS— Olive Oil 2 — 2 Beef Dripping 1 — 1 Sauce 1 — 1 Jelly 1 - 1 149 4 153 34 REGISTER OF SANITARY WORK Month ending 31st March, 1904. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. K. 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. Public- Health (London) Act. Inspections. Dwelling Houses, See 37 39 35 40 43 ... ... ... ... ... 194 Tenements 46 ... 45 76 37 ... ... ... ... ... 204 Underground Dwellings 11 3 25 3 19 ... ... ... ... ... 61 Dairies, Milk Shops, Cow Houses 6 3 1 4 10 ... ... ... ... ... 24 Slaughter Houses 2 4 ... ... 1 ... ... ... ... ... 7 Yards, Stables, and Mews 42 32 40 60 64 ... ... ... ... ... 238 Smoke Shafts ... ... ... ... ... ... ... ... 4 ... 4 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... ... ... ... Refuse Receptacles 10 8 ... 8 9 ... ... 20 ... ... 55 Enquiries re non-removal of refuse 8 5 6 6 7 ... ... 250 ... 3 285 Removal of Bodies to Mortuary ... ... ... ... ... ... ... ... ... ... ... Visits to Works in progress 162 192 150 190 174 ... ... ... ... 28 896 Miscellaneous Inspections 96 84 95 280 88 ... ... 90 ... 79 812 UNWHOLESOME FOOD. Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE:— Cases Isolated ... ... ... 3 2 ... ... ... ... ... 5 Cases Removed to Hospital 4 ... 5 4 5 ... ... ... ... ... 18 Booms Disinfected 10 ... 5 12 11 ... ... ... ... ... 38 NEW DRAINAGE:— Number of Plans Passed 2 4 6 9 ... ... ... ... ... ... 21 New Pipe Drains (feet) 460 850 650 980 1264 ... ... ... ... ... 4204 Houses where defects in existing Drainage have been detected and remedied 5 7 6 4 5 ... ... ... ... ... 27 35 REGISTER OF SANITARY WORK Month ending 31st March, 1904. 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. 5 District. Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 20 18 38 Periodical Inspections:— Factories ... ... ... ... ... ... ... ... 2 ... 2 Workshops ... ... ... ... ... ... ... ... 49 120 169 Bakehouses ... ... ... ... ... ... ... ... 20 ... 20 Restaurants,&c.. ... ... ... ... ... ... ... ... 10 ... 10 Homeworkers' Premises ... ... ... ... ... ... ... ... 30 95 125 Domestic Workshops ... ... ... ... ... ... ... ... ... 1 1 Food and Drugs Aet ADULTERATION. Samples collected for Analysis 9 7 10 24 ... ... ... ... ... ... 50 Correspondence, Legal Procedure, &c. Complaints received 6 ... 8 12 8 ... ... 59 5 15 113 Letters and Intimations relating to Abatement of Nuisances 28 ... 25 35 12 ... ... 10 3 15 128 Statutory Notices Served 2 3 2 ... 7 ... ... ... 1 ... 15 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 32 34 31 56 47 ... ... 15 25 12 252 THE SANITARY CHRONICLES of the BOROUGH OF ST. MARYLEBONE DURING APRIL, 1904 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. XXIV. 3, Upper Gloucester Place, W., May 9th, 1904. No.4 The week ending April 2nd was one of moderate temperatures and variable winds. Minimum temperature, 33.5°; maximum, 52.5°; mean, 43.8°. On three days rain fell to the amount of 0.83 inch. The sunshine in Regent's Park was equal to 24 per cent. of the possible. Mean barometer 29.9 inches. The week ending April 9th was showery. Minimum temperature, 38.0°; maximum, 63.5°; mean, 50.1°. Winds N.W. and W.N.W. Sunshine equal to 34 per cent. Rain fell on five days ; the total rainfall equalling 0.33 inch. Mean barometer 29.8 inches. The week ending April 16th was a fine spring week. Minimum temperature, 36.8° ; maximum, 65.5° ; mean, 51.8°. On two days rain fell 0.32 inch. Winds W.N.W. and N.W. Sunshine 33 per cent. Mean barometer 29.6 inches. 38 The week ending April 23rd was a bright dry week. Minimum temperature, 37.2°; maximum, 66.0°; mean, 52.6°. On one day only rain fell 0.12 inch. Winds N.E. and S.W. Sunshine 40 per cent. of the possibleMean barometer 29.9 inches. The week ending April 30th was also fine. Minimum temperature 40.0° ; maximum, 62.0° ; mean, 52.9°. On three days slight showers yielded 0.03 inch of rain. The winds W.S.W. and W.N.W. Sunshine 28.5 per cent. Mean barometer 29.9 inches. Births and Deaths. During the five weeks ending April 30th there have been registered 297 births and 189 deaths. These births and deaths are divided among the five sub-districts as set forth in Table IV, 59 of the deaths were extra-parochial, as follows:- St. Marylebone Infirmary, Notting Hill 35 North-West Fever Hospital 4 St. Mary's Hospital 6 Guy's Hospital 1 University College Hospital 1 St. Bartholomew's Hospital 1 Hospital for women, Soho 1 St. Pancras Infirmary 1 Central London Sick Asylum 1 Bellevue, Haverstock Hill 1 City of London Asylum 1 Middlesex Asylum 1 Han well Asylum 2 Claybury Asylum 1 Leavesden Asylum 1 In the Serpentine 1 Total 59 39 The birth and death-rates, as deduced from the five weeks' statistics, are as follows:— All Souls, birth-rate 18.8; death-rate 14.1. Rectory, birth-rate 15.7 ; death-rate 12.8. St. Mary, birth-rate 27.0; death-rate 16.1. Christ Church, birth-rate 27.9 ; death-rate 15.3. St. John, birth-rate 25.4 ; death-rate 16.3. The whole district, birth-rate 23.2; death-rate 14.7. The average death-rates for five years (1899 to 1903) for the corresponding period were as follows:—All Souls, 13.8; Rectory, 17.7; St Mary, 16.5; Christ Church, 19.5; St. John. 17.5; the whole district, 16.8. The following table gives, as usual, facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes : TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE FIVE WEEKS ENDING APRIL 30TH, 1904, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES Total Deaths. 5 weeks ending April 30th, 1904. Proportion of the deaths to 1,000 deaths from all causes. 5 weeks ending Apr. 30, 1904. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1897-1903. 1. Deaths from the chief Zymotic Diseases 21 111 1.64 1.72 2. Pulmonary, other than Phthisis 40 211 3.12 3.92 3. Tubercular 25 132 1.95 2.23 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza, Whooping Cough, Erysipelas, Croup, Fever, and Diarrhœa. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. 40 General Health of the District. The general health of the district, mainly owing to the bright mild weather of April, continues excellent. So far the few cases of smallpox have been confined to the Workhouse, to the class which recent events have shown is a potent factor in all epidemics in disseminating the malady. The risk of spreading is however much minimised when the patients are attacked in an institution like the Workhouse, under strict observation and discipline; it is gratifying to note that as yet not a single case has been notified from the Salvation Army Shelter or from the numerous Common Lodging Houses in the district. Report under the Housing of the Working Classes Act. No. 9, Gee's Court has been reported as unfit for habitation, and a summons taken out for the purpose of closing the premises. The back and front walls are in a bad state, woodwork throughout old and decayed, windows broken, drains defective and the whole place in a state of utter neglect. Probably nothing short of re-building will put the premises in a proper and fit state for habitation. Legal Proceedings under the Public Health (London) Act. It is seldom that a Magistrate's Order has to be obtained to enter premises. A complaint was laid that the occupier of a certain room in Capland Street kept her room in a filthy, even disgusting, condition. She refused to allow the Inspector to view the same, and recourse had to be made to a magistrate. An order was granted, but in the meantime the lady had done a considerable amount of spring cleaning, and by the time the Inspector gained 41 access, there was not much fault to be found. A good result therefore was obtained quicker than if there had been no preliminary opposition. No. 13, King's Place* was again before the magistrate; the Order of the Court not having been obeyed, the magistrate ordered the house to be closed until the necessary sanitary works of drainage, &c., had been properly carried out. Nuisance from Garages and Motor Cars. The Public Health Committee will shortly have to consider the important question of how to deal with the serious complaints of nuisance incidental to the Motor Car industry. There are several garages in the district in which cars are stored, charged with petrol, cleaned, repaired, and the engines started to see that each cylinder beats in proper time and that all is in order; during this operation, more especially if the crank chamber is full of oil, or if the engine is dirty, there is considerable smell, and more or less noise. In one case the occupiers of adjoining premises have laid a formal complaint by petition, and there is not the slightest doubt that there is nuisance—nuisance that is inseparable from the industry, and one difficult to deal with without seriously interfering with a growing and important trade. It is the writer's opinion that all garages of the kind should have a special shed or room in which to start the engines; any architect could design by means of double walls a practically noise-proof shed ; there would also have to be a flue with good draught carrying the waste gases away to the height of the highest chimneys in the neighbourhood. This means a considerable expenditure of money, but when any person establishes a new, noisy, and intermittently offensive business in densely populous localities, he must either spend money in minimising any nuisance incidental to the business, or run the risk of having his business entirely prohibited. ♦Erroneously described in last month's Chronicles as King Street. 42 TABLE III.—Giving the Causes of Deaths during April, 1904, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John and 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 .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. Pneumonia and Pleurisy 4 .. .. .. .. .. Pyæmia .. .. .. .. 1 .. Syphilis .. .. .. .. .. .. Cancer 11 .. .. .. 1 .. Phthisis & Tuberculosis 2 .. .. .. 8 2 Rheumatism .. .. .. .. .. .. Apoplexy .. .. .. .. 1 .. Paralysis .. .. .. .. 2 .. Bronchitis l .. .. .. 8 .. Asthma .. .. .. .. .. .. Peritonitis .. .. .. .. .. .. Disease of Brain .. .. .. .. .. .. ,, Heart .. .. .. 1 1 .. „ Kidney .. .. .. .. .. .. „ Liver 1 .. .. .. .. .. „ Uterus .. .. .. .. .. .. „ Ovary .. .. .. .. .. .. Parturition .. .. .. .. .. .. Diabetes .. .. .. .. .. .. Fractures and Injuries. l .. .. .. .. .. Old Age .. .. .. .. 5 .. Low Vitality, Infants .. .. .. .. .. .. Premature Birth .. .. .. .. .. .. Other causes 16 .. 1 2 8 1 Total *39 .. **1 4 35 †3 * Of the 39 deaths in the Middlesex Hospital, 27 were those of non-parishioners. ** The death in the Samaritan Hospital was that of a non-parishioner. †Of the three deaths in the Hospital of St. John two were non-parishioners. APRIL, 1904. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, AND TYPHOID FEVER, AND SMALLPOX DURING 1904. 43 TABLE V.—District Births and Deaths for the five weeks ending April 30th, 1904. Population in 1891. Births. Deaths. Males. Fmls. Males. Fmls. All Souls 35,391 31 33 24 24 Rectory 19,849 16 14 15 8 St. Mary 18,099 23 24 16 12 Christ Church 39,536 56 50 38 20 St. John 20,426 20 30 12 20 Total 133,301 146 151 105 84 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. 44 TABLE V.—Causes of, and Ages at, Death during the 5 weeks ending April 30th, 1904, 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 12 1 11 ... ... ... 4 ... 6 1 1 1 Scarlet Fever 2 ... ... 2 ... ... ... ... ... 1 1 ... 2 Whooping Cough 3 ... 3 ... ... ... ... 1 ... ... ... 2 2 Diphtheria and Membranous Croup 1 ... 1 ... ... ... ... ... ... ... ... ... 1 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric ... ... ... ... ... ... ... ... ... ... ... ... ... Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza 2 ... 1 ... ... ... 1 ... 1 1 ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa ... ... ... ... ... ... ... ... ... ... ... ... ... Enteritis 1 1 ... ... ... ... ... ... ... ... 1 ... ... Puerperal fever ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... Other Septic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... Phthisis 21 ... ... ... 2 22 ... 6 4 4 8 2 12 Other Tubercular Diseases 1 ... ... ... ... 1 ... ... ... ... ... 1 3 Cancer, Malignant Disease 5 ... ... ... ... 2 3 3 ... 1 ... 1 10 Bronchitis 25 4 1 ... ... 11 9 6 2 4 11 2 11 Pneumonia 15 3 2 1 ... 7 2 3 2 1 6 3 4 Pleurisy ... ... ... ... ... ... ... ... ... ... ... ... 2 Other Diseases of Respiratory Organs ... ... ... ... ... ... ... ... ... ... ... ... ... Alcoholism Cirrhosis of Liver 2 ... ... ... ... 1 1 ... ... 1 1 ... 2 Venereal Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 3 3 ... ... ... ... ... ... ... 1 2 ... ... Diseases and Accidents of Parturition ... ... ... ... ... ... ... ... ... ... ... ... ... Heart Diseases 22 ... ... ... 1 13 8 6 3 2 3 8 6 Accidents 5 1 1 ... ... 1 2 2 ... ... 1 2 2 Suicides 2 ... ... ... ... 2 ... 1 ... ... 1 ... 2 All other causes 64 11 2 2 3 19 27 16 11 5 22 10 42 All causes 189 24 22 5 6 79 53 48 23 28 58 32 *102 *30 of these were Non-Parishioners. 45 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 April, 1904; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals Population at all ages (b) Census 1901 35,391 19,849 18,099 39,536 20,426 133,301 (c) Registered Births 64 30 47 106 50 297 (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 kach Locality coming to the knowledge of the medical Officer of Health. Chicken pox 9 2 8 2 1 4 1 2 12 10 31 20 1.Smallpox .. .. .. 4 .. .. .. .. .. .. .. 4 2.Scarlatina 4 6 .. 2 .. 5 1 4 1 .. 6 17 3.Diphtheria .. .. .. .. 2 .. 1 .. 2 2 5 2 4.Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5.Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6.Enteric or Typhoid .. .. .. .. .. 1 .. 1 .. 1 .. 3 7.Continued .. .. .. .. .. .. .. .. .. .. .. .. 8.Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10.Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11.Erysipelas. 3 .. .. 1 .. 2 .. 7 .. 1 3 11 Number of such Cases Removed from their Homes in the several Localities for Trbatment in Isolation Hospitals. 1. Smallpox .. .. .. 4 .. .. .. .. .. .. .. 4 2.Scarlatina 4 4 .. 1 .. 5 .. 3 1 .. 5 13 3. Diphtheria .. .. .. .. 2 .. 1 .. 2 2 5 2 4.Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5.Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. 1 .. .. .. l .. 2 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puorperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. .. .. 1 .. 3 .. 1 .. 5 46 REGISTER OF SANITARY WORK Month ending 30th April, 1904. 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. 5 District. Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 30 9 39 Periodical Inspections:— ... ... ... ... ... ... ... ... ... ... ... Factories ... ... ... ... ... ... ... ... 4 ... 4 Workshops ... ... ... ... ... ... ... ... 95 101 196 Bakehouses ... ... ... ... ... ... ... ... 20 ... 20 Restaurants,&c. ... ... ... ... ... ... ... ... 39 ... 39 Homeworkers' Premises ... ... ... ... ... ... ... ... 12 32 44 Domestic Workshops ... ... ... ... ... ... ... ... ... ... ... Food and Drugs Act. ADULTERATION. Samples collected for Analysis ... 12 18 11 6 ... ... ... ... ... 47 Correspondence, Legal Procedure, &c. Complaints received 5 6 8 6 11 ... ... 136 7 8 187 Letters and Intimations relating to Abatement of Nuisances 31 26 34 43 15 ... ... 10 11 8 178 Statutory Notices Served 2 2 ... ... 5 ... ... ... 1 ... 10 Proceedings taken before Magistrates ... ... ... ... ... ... ... ... ... ... ... (1) Under Public Health Act 1 1 ... ... ... ... ... ... ... ... 2 (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) ,, Food & Drugs Act ... ... ... ... ... ... ... ... ... ... ... Reports made to Medical Officer of Health 38 37 36 55 67 ... ... 25 30 8 296 47 REGISTER OF SANITARY WORK Month ending 30th April, 1904. 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. Gormiot, No. 4 District. Mr. W. Yeo, No. 5 District. Public Health (London) Act. Inspections. Dwelling Houses, &c 42 36 45 35 38 ... ... ... ... ... 186 Tenements 30 29 35 16 28 ... ... ... ... ... 138 Underground Dwellings 10 9 15 8 16 ... ... ... ... ... 58 Dairies, Milk Shops, Cow Houses 6 3 2 5 9 ... ... ... ... ... 25 Slaughter Houses 2 2 ... ... 1 ... ... ... ... ... 5 Yards, Stables, and Mews 37 39 35 46 49 ... ... ... 2 ... 208 Smoke Shafts ... ... ... ... ... ... ... ... 4 ... 4 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... 1 ... 1 Refuse Receptacles 4 2 ... 3 ... ... 18 ... 2 ... 29 Enquiries re non-removal of refuse 3 4 5 3 4 ... 350 ... ... 3 372 Removal of Bodies to Mortuary ... ... ... ... ... ... ... ... ... ... ... Visits to Works in progress 170 193 160 220 149 ... ... ... ... 5 897 Miscellaneous Inspections \ 84 71 60 180 79 ... ... ... ... 63 537 UNWHOLESOME FOOD. Number of seizures made ... ... ... 1 ... ... ... ... ... ... 1 INFECTIOUS DISEASE:— Cases Isolated 2 9 ... 1 ... ... ... ... ... ... 12 Cases Removed to Hospital 6 2 10 5 9 ... ... ... ... ... 32 Rooms Disinfected 11 6 12 8 17 ... ... ... ... ... 54 NEW DRAINAGE Number of Plans Passed 4 7 8 14 10 ... ... ... 2 ... 45 New Pipe Drains (feet) 600 546 500 890 1614 ... ... ... ... ... 4150 Houses where defects in existing Drainage have been detected and remedied 1 8 6 6 7 ... ... ... ... ... 34 '. THE SANITARY CHRONICLES OF THE BOROUGH OF ST. MARYLEBONE DURING MAY,1904. BY ALEXANDER WYNTER BLYTH, Medical Officer of Heatlh, and Analyst of Food and Drugs for the Borough of St.Marylebone. PRINTED BY ORDER OF THE COUNCIL. Vol. XXIV. 3, Upper Gloucester Place, W., June 4th, 1904. No. The week ending May 7th was a fairly fine spring week. Minimum temperature, 47.5°; maximum, 62.5°; mean, 51.8°. On three days rain fell, giving a total fall of 0.51 inch. Winds W.S.W. Sunshine 37 per cent. Mean barometer 29.8 inches. The week ending May 14th was overcast, with variable and S.W. winds. Minimum temperature, 37.2°; maximum, 69.5°; mean, 52.9°. On two days rain fell to the extent of 0.34 inch. Mean barometer 30.0 inches. The week ending May 21st was a remarkably bright summer-like week. Minimum temperature, 43.1°; maximum, 72.6°; mean, 56.4°. Winds light and variable. Showers of rain fell on one day only, yielding 0.34 inch. Sunshine over 58 hours, which is equal to 53 per cent. Mean barometer 29.9 inches. The week ending May 28th was cloudy and unsettled. Minimum temperature, 50.0°; maximum, 74.0°; mean, 59.0°. On four days rain fell the total fall being equal to 0.41 inch. Winds variable. Sunshine only 9 per cent. Mean barometer 29.8 inches. 50 Births and Deaths. During the four weeks ending May 28th there have been registered 210 births and 147 deaths. These births and deaths are divided among the five sub-districts as set forth in Table IV, Fifty-seven of the deaths were extra-parochial, as follows:— St. Marylebone Infirmary,Notting Hill 32 North-West Fever Hospital 2 Western Fever Hospital 1 St. Mary's Hospital 3 St. George's Hospital 1 Children's Hospital, Paddington 4 University College Hospital 4 Central London Sick Asylum 1 French Hospital 1 Home Hospital, Fitzroy Square 1 Hanwell Asylum 2 Cane Hill Asylum 1 Darenth Asylum 1 Banstead Asylum 1 Butchers' Institution, Fulham 1 Royal Chest Hospital 1 Total 57 The birth and death-rates, as deduced from the four weeks' statistics, are as follows:— All Souls, birth-rate 15.1; death-rate 12.1. Rectory, birth-rate 17.0 ; death-rate 14.4. St. Mary, birth-rate 17.9 ; death-rate 14.4. Christ Church, birth-rate 29.3 ; death-rate 13.5 St. John, birth-rate 18.4 ; death-rate 19.7. The whole district, birth-rate 20.5 ; death-rate 14.4. The average death-rates for five years (1899 to 1903) for the corresponding period were as follows:—All Souls, 13.1; Rectory, 17.2; St. Mary, 17.4; Christ Church, 18.8 ; St. John, 19.9 ; the whole district, 17.0. 51 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 26th, 1904, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 4 weeks ending May 28th, 1904. Proportion of the deaths to 1,000 deaths from all causes. 4 weeks ending May 28,1904. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1897-1903. 1. Deaths from the chief Zymotic Diseases 8 54 0.78 1.52 2. Pulmonary, other than Phthisis 29 197 2.83 3.74 3. Tubercular 19 129 1.86 2.05 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza, Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. 52 General Health of the District. The general health of the district continues to be excellent. The few cases of small-pox which occurred in the Workhouse the previous month have not spread further and the chief infectious diseases are well below the average. There has been on the other hand a slight outbreak of chicken-pox, 55 cases of that mild non-fatal disease having been notified during the last four weeks. No. 13, King's Place. No. 13, King's Place was again before the Magistrate, the occupier not having obeyed the Magistrates Order to close the premises. The Magistrate inflicted a penalty of £5 with £3 costs and a continuing penalty of £1 per day, The penalty not having been paid and the officer of the Court reporting that there were no goods the defendant was committed to prison. The case, therefore, shows how defective the law is with regard to the closing of admittedly insanitary premises. After a month of legal proceedings and expenditure of public money the notices of the Local Authority have not been attended to, the premises are still occupied and the ratepayers have to contribute to support the wrongdoer in jail. Appeal to London County Council under Public Health (London) Act, 1891, Section 41. It is the statutory duty of every Local Authority in the Metropolis to enforce By-laws made under Section 41 as to the construction of closets. Plans were submitted to the Public Health Committee with regard to 26 and 28, James Street, proposing to construct closets below the surface of the ground, and showing an open area more than 40 square feet in extent, but less than 5 feet across. The By-law expressly provides that a new closet in a basement must be approached "directly from 53 an area or other open space available for purposes of ventilation measuring at least 40 superficial feet in extent and having a distance across of not less than 5 feet, and not covered in otherwise than by a grating or railing." The Public Health Committee being bound by the strict terms of the By-law, had no alternative but to decline to pass the plans. Thereupon the owners appealed to the County Council under Section 41 of the Public Health (London) Act, which provides— "That any person aggrieved by any notice or act of a Sanitary Authority under this section (i.e. Section 41) in relation to any water closet .... may appeal to the London County Council, whose decision shall be final." The appeal was heard by a Committee of the London County Council on the 17th May, with the result that the appeal was dismissed. If this case is to be taken as a precedent, it would appear that the County Council will not support any deviation from the strict letter of the By-law with regard to new constructions. 54 TABLE II.—Giving the Causes of Deaths during May, 1904, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John and 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 1 .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. Diphtheria .. .. .. .. .. .. Typhoid Fever .. .. .. .. .. .. Diarrhosa .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. Pneumonia and Pleurisy 1 .. .. .. 1 .. Pyæmia .. .. .. .. .. .. Syphilis .. .. .. .. .. .. Cancer 11 .. .. .. 5 1 Phthisis & Tuberculosis 3 .. .. .. 4 1 Rheumatism Apoplexy .. .. .. .. 1 .. Paralysis .. .. .. .. .. .. Bronchitis .. .. .. .. 10 .. Asthma .. .. .. .. .. .. Peritonitis .. .. .. .. .. .. Disease of Brain .. .. .. .. .. .. Heart 1 .. .. 3 3 .. Kidney .. .. .. .. .. .. ,, Liver .. .. .. .. 1 .. ,, Uterus .. .. .. .. .. .. „ Ovary .. .. .. .. .. .. Parturition .. .. .. .. .. .. Diabetes .. .. .. .. .. .. Fractures and Injuries .. .. .. .. 1 .. Old Age .. .. .. .. 3 .. Low Vitality, Infants .. .. .. .. .. .. Premature Birth .. 6 .. .. .. .. Other causes 12 5 1 2 3 .. Total *34 †11 **1 5 32 ***2 * Of the 34 deaths in the Middlesex Hospital, 30 were those of non-parishioners, † Ten of the 11 deaths in Queen Charlotte's Hospital were those of non-parishioners. ** The 1 death in the Samaritan Hospital was that of a non-parishioner. *** The 2 deaths in St. John's Hospital were those of non-parishioners. MAY, 1904. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, TYPHOID FEVER, AND SMALLPOX DURING 1904. 55 TABLE III. - TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, in the Sanitary District of ST. MARYLEBONE, during May, 1904; 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 . 41 26 25 89 29 210 (d) Aged under 5 or over 5 Under 5 5 upwards| Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 (5 upwards) New Casks of Sickness in each Locality coming to the knowledge of the medical Officer of Health. Chicken pox 1 12 5 1 5 3 10 4 6 8 27 28 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 3 6 .. 1 .. 1 3 .. .. 1 8 9 3. Diphtheria .. .. 1 .. .. 1 2 2 3 .. 6 3 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 1 .. .. .. 1 .. .. .. 3 .. 7 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas. .. 2 .. 2 .. .. .. .. .. 1 .. 12 Number of suck Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 3 .. .. 1 .. 1 .. .. .. 1 7 9 3. Diphtheria .. .. .. .. .. 1 .. .. 1 .. 3 3 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. 1 .. 2 .. 1 .. 4 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puoreperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. 1 .. .. .. 2 .. .. .. 3 56 TABLE IV.—District Births and Deaths for the four weeks ending may 28th, 1904. Population in 1891. Births. Deaths. Males. Fmls. Males Fmls. All Souls 35,391 20 21 17 16 Rectory 19,849 11 15 13 9 St. Mary 18,099 12 13 10 10 Christ Church 39,536 45 44 30 11 St. John 20,426 15 14 19 12 Total 133,301 103 107 89 58 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. 57 TABLE V.—Causes of, and Ages at, Death during the 4 weeks ending May 28th, 1904, 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 6 3 2 ... ... ... ... 4 ... 1 ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria and Membranous Croup 1 ... 1 ... ... ... ... ... ... ... ... 1 1 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric ... ... ... ... ... ... ... ... ... ... ... ... ... Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa 2 2 ... ... ... ... ... ... ... ... 2 ... ... Enteritis ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal fever ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... Other Septic Diseases 2 1 ... ... 1 ... ... 1 1 ... ... ... 2 Phthisis 16 1 1 1 4 8 ... 2 ... 3 4 6 10 Other Tubercular Diseases 4 ... 2 ... 1 1 ... 2 ... ... 2 ... 2 Cancer, Malignant Disease 16 ... ... ... ... 9 7 1 3 3 7 2 18 Bronchitis 18 2 2 ... ... 6 8 8 ... 4 5 1 9 Pneumonia 10 2 2 ... 1 4 1 ... ... 1 4 5 2 Pleurisy 1 ... ... ... ... ... 1 ... 1 ... ... ... ... Other Diseuses of Respiratory Organs ... ... ... ... ... ... ...... ... ... ... ... ... ... Alcoholism Cirrhosis of Liver 2 ... ... ... ... 2 ... 1 ... 1 ... ... 2 Venereal Diseases 1 1 ... ... ... ... ... 1 ... ... ... ... ... Premature Birth 4 4 ... ... ... ... ... 2 1 ... 1 ... 6 Diseases and Accidents of Parturition ... ... ... ... ... ... ... ... ... ... ... ... ... Heart Diseases 12 ... ... ... 2 5 5 1 4 ... 3 4 8 Accidents 5 1 2 ... ... ... 2 ... ... 2 2 1 7 Suicides 1 ... ... ... 1 ... ... ... ... 1 ... ... 1 All other causes 48 6 5 ... 2 18 17 10 12 4 11 11 37 All causes 147 23 17 1 12 63 41 33 22 20 41 31 *105 *42 of these were Non-Parishioners. 58 REGISTER OF SANITARY WORK Month ending 31st May, 1904. 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. Yen, No. 5 District. Public Health (London) Act. Inspections. Dwelling Houses, &c 56 83 48 30 51 ... ... ... ... ... 268 Tenements . 52 50 40 48 ... ... ... ... ... 190 Underground Dwellings 12 3 25 3 19 ... ... ... ... ... 62 Dairies, Milk Shops, Cow Houses 6 3 3 5 16 ... ... ... ... ... 33 Slaughter Houses 2 2 ... ... 1 ... ... ... ... ... 5 Yards, Stables, and Mews 46 54 45 40 68 ... ... ... ... ... 253 Smoke Shafts ... ... ... ... ... ... ... ... 6 ... 6 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... 1 ... 1 Refuse Receptacles 6 3 ... 5 9 ... ... 20 ... ... 43 Enquiries re non-removal of refuse 4 2 5 4 7 ... ... 250 ... ... 272 Removal of Bodies to Mortuary .. ... ... ... ... ... ... ... ... ... ... ... Visits to Works in progress 230 240 200 250 183 ... ... ... ... 21 1124 Miscellaneous Inspections 96 89 85 240 77 ... ... ... ... 74 664 UNWHOLESOME FOOD. Number of seizures made ... ... ... ... 1 ... ... ... ... ... 1 INFECTIOUS DISEASE:— Cases Isolated. ... 2 3 ... ... ... ... ... ... ... 5 Cases Removed to Hospital 4 4 10 5 9 ... ... ... ... ... 32 Rooms Disinfected 8 6 10 15 27 66 NEW DRAINAGE :— Number of Plans Passed 6 7 3 11 5 ... ... ... ... ... 32 New Pipe Drains (feet) 760 836 650 740 1264 ... ... ... ... ... 4250 Houses where defects in existing Drainage have been detected and remedied 10 8 9 4 5 ... ... ... ... ... 36 59 REGISTER OF SANITARY WORK Month ending 31st May, 1904. 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. o District. Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 4 16 20 Periodical Inspections: — Factories ... ... ... ... ... ... ... ... 49 ... 49 Workshops ... ... ... ... ... ... ... ... 43 110 153 Bakehouses ... ... ... ... ... ... ... ... 29 ... 29 Restaurants, &c. ... ... ... ... ... ... ... ... 56 ... 56 Homeworkers' Premises ... ... ... ... ... ... ... ... ... 78 78 Domestic Workshops ... ... ... ... ... ... ... ... .... 1 1 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 30 18 8 14 ... ... ... ... ... 70 Correspondence, Legal Procedure, &e. Complaints received 11 4 11 10 14 ... ... 35 ... 9 100 Letters and Intimations relating to Abatement of Nuisances 16 13 15 20 15 ... ... 15 ... 20 114 Statutory Notices Served 3 2 2 3 5 ... ... ... ... 3 18 Proceedings taken before Magistrates ... ... ... 1 ... ... ... ... ... ... 1 (1) Under Public Health Act ... ... ... 1 ... ... ... ... ... 1 (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) ,, Food & Drugs Act 1 ... ... ... ... ... ... ... ... ... 1 Reports made to Medical Officer of Health 32 31 31 60 67 ... ... 25 ... 12 258 THE SANITARY CHRONICLES of the BOROUGH OF ST. MARYLEBONE DURING JUNE, 1904, Containing a Quarterly Summary of the Mortality Statistics for the Quarter ending June 25th, 1904, 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. IVIarylebone. PRINTED BY ORDER OF THE COUNCIL. Vol. XXV. 3, Upper Gloucester Place, W., July 10th, 1904. No. 6 The week ending June 4th was unsettled but of pleasant temperatures, minimum 43-0°; maximum, 61-50; mean 57-2°. On four days rain fell, the total fall measuring 0'54 inch. Winds variable. Sunshine 30 per cent. of the possible. Mean barometer 29.9 inches. The week ending June 11th was dry oright, and of pleasant temperatures, minimum temperature 47.5°; maximum, 71.8°; mean, 59.8°. Winds easterly. On one day only rain fell to the extent of 0.12 inch. Sunshine 34.6 per cent. Mean barometer 29.9 inches. The week ending June 18th was bright, warm, and unsettled, minimum temperature, 50.00.; maximum, 70.5°; mean, 61.9°. Winds S. and S.W. Sunshine 33.3 per cent On three days rain fell (0.30 inch). Mean barometer 29.9 inches. 62 The week ending June 25th was dry, bright, and warm, minimum temperature, 46.0°; maximum, 78.0°; mean, 61.9°. Winds W. and N.W. Sunshine 44.1 per cent. Mean barometer 30.0 inches. Births and Deaths. During the four weeks ending June 25th there have been registered 207 births and 142 deaths. These births and deaths are divided among the five sub-districts as set forth in Table IV. The birth rate for the month was therefore 20.2; the death rate 13.9 per thousand. Quarterly Summary. During the quarter ending June 25th there have been registered 714 births and 478 deaths. These births and deaths are divided among the five sub-districts, as set forth in Table V. 179 of the deaths were extra-parochial, as follows:— St. Marylebone Infirmary, Notting Hill 112 North-Western Fever Hospital 6 Western Fever Hospital 2 St. Mary's Hospital 13 Guy's Hospital 1 King's College Hospital 1 University Hospital 8 Charing Cross Hospital 1 St. Bartholomew's Hospital 1 St. George's Hospital 1 Hospital for Women 2 St. Pancras Infirmary 1 French Hospital 1 Central London Sick Asylum 2 Bellevue, Tavistock Hill 1 City of London Lying-in Hospital 1 City of London Asylum 1 Middlesex Asylum 1 Colney Hatch Asylum 1 Hanwell Asylum 5 Banstead Asylum 1 Claybury Asylum 1 Cane Hill Asylum 1 Leavesden Asylum 1 Darenth Asylum 1 In the Serpentine 1 Children's Hospital, Paddington 6 Children's Hospital, Great Ormonde Street 1 Home Hospital, Fitzroy Square 2 Royal Chest Hospital 1 Butchers' Institute, Fulham 1 Total 179 63 Health of the District. The health of the district continues exceptionally good. The infectious diseases generally have been well below the average, the only exception to this statement being a curious burst of scarlet fever during the first week in June ; prompt isolation of the cases, however, appeared to check farther spread, and the malady rapidly went down below normal. See Chart opposite page (58. The birth and death-rates, as deduced from the quarter's statistics, are as follows:— All Souls, birth-rate 18.4; death-rate 12.8. Rectory, birth-rate 15.5; death-rate 12.8. St. Mary, birth-rate 22.3: death-rate 13.7. Christ Church, birth-rate 26.7: death-rate 16.5 St. John, birth-rate 21.3; death-rate 17.2. The whole district, birth-rate 2l.5; death-rate 14.4. The average death-rates for five years (1899 to 1903) for the corresponding period were as follows:—All Souls, 13.9; Rectory, 18.0; St. Mary, 17.2; Christ Church, 16.0; St. John. 23.1; the whole district, 17.0. The following table gives, as usual, facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes: TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE THIRTEEN WEEKS ENDING JUNE 25TH, 1904, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 13 weeks ending June 25th, 1904. Proportion of the deaths to 1,000 deaths from all causes. 13 weeks ending June 25,1904. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1897-1903. 1. Deaths from the chief Zymotic Diseases 35 73 1.05 1.70 2. Pulmonary, other than Phthisis 93 194 2.79 3.33 3. Tubercular 04 134 1.92 2.22 NOTES. 1. Includes Smallpox, Measles, Scarlet l ever, Diphtheria, Influenza, Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. 64 Sale of Food and Drugs Acts. As set out in detail in Table II there have been 145 samples analysed under the Sale of Food and Drugs Acts; of this number two samples of milk and one sample of whisky were certified to be adulterated. Lionel Court, of 9, Violet Hill, was fined £2 with 12s. 6d. costs for selling milk deficient in milk fat to the extent of at least 67 per cent. Elizabeth Green, of 32, Saville Street, W., was fined 10s. and 12s. (3d. costs for selling milk deficient in milk fat to the extent of at least 6 7 per cent. With regard to the sample of unduly diluted whisky, the advice of the Solicitor was not to proceed farther because the Vendor was found to have a notice in the bar to the effect that all spirits were diluted. All the other samples were of fair commercial quality. Prosecutions under the Public Health (London) Act. Every builder before erecting a new building is bound under penalty to deposit plans showing the drainage and sanitary appliances. This is a wise and excellent regulation made alike in the interests of the owners and of the builders, and it is most important that the bye-law should be strictly enforced, for it is easier to prevent a person constructing something irregular when he gives you notice of his intention, than to alter premises and fittings once they are erected. It is astonishing that one or two well-known building firms have from inattention ignored the regulation and laid themselves open to legal proceedings. Messrs. J. & A. Bywater were summoned for not depositing plans with regard to a new building on the site of No. 21, Nottingham Street, and fined £1 and £1 3s. costs. 65 Messrs. Matthews, of 78, Charlotte Street, were convicted of a similar offence, and fined £1 and £1 3s. costs. Another large firm was summoned for a similar offence, but the case was dismissed from a purely technical flaw. It is to be hoped that these prosecutions will be noted by all those engaged in the building trade and that no further trouble will arise. The owner of 48, Linhope Street was summoned for allowing illegal occupation of the kitchens. Before the hearing the kitchens had been vacated; it also appeared that there was a defect in the serving of the summons, therefore the Magistrate dismissed the same. The Magistrate made an order for the closing of 9, Gee's Court May 13th; four tenants neglected to obey the order. Summonses were therefore taken out for disobedience of the order, with the result that the defendants were ordered to vacate the room within ten days, or pay a fine of £2 each with 6s. costs. The premises are now vacated. 66 TABLE II.—SALE OF FOOD AND DRUGS ACTS. Samples Analysed during June Quarter, 1904. Genuine. Adulterated. Total. DAIRY PRODUCTS— Milk 66 2 68 Butter 14 - 14 Margarine i — 4 Cream 2 - 2 Cheese 1 - 1 ALCOHOLIC BEVERAGES— Whisky 6 1 7 Brandy 2 — 2 Gin 2 — 2 Rum 2 - 2 Cognac Spirit 1 — i NON-ALCOHOLIC BEVERAGES— Coffee 3 - 3 Cocoa 1 — 1 CONDIMENTS— Pepper 3 — 3 Mustard 5 — 5 Vinegar 2 — 2 SACCHARINE SUBSTANCES— Jam 6 — 6 Honey 1 — 1 TINNED GOODS- Condensed Milk 2 — 2 Sardines 1 1 Salmon 1 — 1 Chicken, Ham, and Tongue 1 — 1 Herrings' Roes 1 — 1 Beans 1 — 1 Peas 1 - 1 DRUGS— Cream of Tartar 6 — 6 Carbonate of Soda 1 — 1 Citrate of Magnesia 1 — 1 MISCELLANEOUS - Olive Oil 1 — 1 Lime Juice 1 — 1 Lemon Squash 1 — 1 Extract of Beef 1 — 1 Brunak (Imitation Coffee) 1 — 1 142 3 145 Peas—contained Copper Sulphate, *656 grains per lb. Beans— „ „ „ *432 „ „ „ One of tlie Samples of Cream, contained '125 per cent. Boric Acid, Jar was labelled that the Cream contained a small quantity of Boric Acid (-25 per cent, allowed). Cream of Tartar—No Lead or Arsenic found in Samples. No metals found in samples of Sardines, Salmon, Chicken, Ham, and Tongue, Herrings' Roes. No Preservatives or Artificial Colouring matter found in the samples of Milk. 67 TABLE III.—Causes of, and Ages at, Death during the 4 weeks ending June 25th, 1904, in the Borough of St. Marylebone. CAUSES OK DEATH. Deaths in whole District at subjoined Ages. Deaths in Localities (at all Ages). Deaths in Public Institutions. All ages. Under 1. 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 .. 2 .. .. .. .. .. .. .. 2 .. 2 Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria and Membranous Croup 1 .. 1 .. .. .. .. .. .. .. 1 .. .. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric 1 .. .. 1 .. .. .. .. .. .. 1 .. 1 Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. holera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhoea. 2 1 .. .. .. 1 .. .. .. .. 1 1 .. Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. Other Septic Diseases.. .. .. .. .. .. .. .. .. .. .. .. .. .. Phthisis 19 1 1 1 2 11 3 4 2 1 11 1 16 Other Tubercular Diseases 1 1 .. .. .. .. .. .. .. 1 .. .. .. Cancer, Malignant Disease 10 .. .. .. .. 5 5 3 1 2 2 2 4 Bronchitis 14 .. 1 .. .. 4 9 3 3 .. 3 5 14 Pneumonia 9 4 2 .. .. 1 2 2 1 2 3 1 5 Pleurisy 1 .. .. .. .. 1 .. 1 .. .. .. .. 2 Other Diseases ot Respiratory Organs .. .. .. .. .. .. .. .. .. .. .. .. .. Alcoholism Cirrhosis of Liver 3 .. .. .. .. 3 .. 1 .. 1 .. 1 .. Venereal Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. Premature Birth 1 .. .. .. .. .. .. .. .. 1 .. .. .. Diseases and Accidents of Parturition 1 .. .. .. .. 1 .. .. .. .. 1 .. .. Heart Diseases 16 .. .. 1 1 7 7 5 2 2 5 2 8 Accidents.. 1 .. .. .. .. .. 1 .. .. .. 1 .. .. Suicides 2 .. .. .. .. 2 .. .. .. .. 1 1 1 All other causes 58 9 1 2 1 19 26 13 8 4 22 11 36 All causes 142 17 8 5 4 55 53 32 17 14 54 25 *79 *37 of these were Non-Parishioners. 68 TABLE IV.—District Births and Deaths for the four weeks ending JUNE 25th, 1904. Population in 1891. Births. Deaths. Males. Fmls. Males Fmls. All Souls . 35,391 34 24 17 15 Rectory 19,849 14 7 9 8 St. Mary 18,099 12 17 6 8 Christ Church 39,536 37 32 28 26 St. John 20,426 17 13 12 13 Total 133,301 114 93 72 70 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 V.—District Births and Deaths for the thirteen weeks ending june 25th, 1904 . Population in 1891. Births. Deaths. Males. Fmls. Males Fmls. All Souls 35,391 85 78 58 55 Rectory 19,849 41 36 37 25 St. Mary 18,099 47 54 32 30 Christ Church 39,536 138 126 96 57 St. John 20,426 52 57 43 45 Total 133,301 363 351 266 212 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. JUNE, 1904. 69 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 June, 1904; classified according to Diseases. Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals Population at all ages. (6) Census 1901 35,391 19,849 18,099 39,536 20,420 133,301 (c) Registered Births 58 21 29 69 30 207 (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. Chicken pox 8 11 7 2 5 2 9 6 13 35 28 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 2 4 .. 2 2 4 10 6 3 .. 17 16 3. Diphtheria 4 .. 2 1 .. 1 3 2 .. .. 9 4 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 1 .. .. .. .. .. .. .. .. .. 1 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas. .. 1 .. 3 .. 6 .. 3 .. 1 .. 14 Number of such Cases Removed from their Homes ih the several Localities for Treatment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. scarlatina 2 3 .. .. 1 2 8 5 3 .. 14 10 3. Diphtheria 4 .. 2 1 .. 1 1 1 .. .. 7 3 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus . .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. .. .. .. .. .. .. .. 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholem .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. 2 .. 1 .. 2 .. .. .. 5 70 TABLE VII.—TABLE OF POPULATION, BIETHS, AND OF NEW OASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, in the Sanitary District of ST, MARYLEBONE, during the June Quarter, 1904; 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 20,426 133,361 (c) Registered Births 163 77 101 264 109 714 (d) Aged under 5 orover 5 Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards New Cases of Sickness in each Locality coming to the knowledge of the medical Officer of Health. Chicken pox 18 25 20 5 11 9 20 6 24 31 93 76 1. Smallpox .. .. .. 4 .. .. .. .. .. .. .. 4 2. Scarlatina 9 16 .. 5 4 10 14 10 4 1 31 42 3. Diphtheria 4 .. 3 1 2 2 6 4 5 2 20 9 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 2 .. .. .. 2 .. 3 .. 4 .. 11 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas 3 3 .. 6 .. 8 .. 17 .. 3 3 37 Number of such Cases Removed from their Homes ih the several Localities for Treatment in Isolation Hospitals.. 1. Smallpox .. .. .. 4 .. .. .. .. .. .. .. 4 2. Scarlatina 9 13 .. 2 8 8 10 8 4 1 26 32 3. Diphtheria 4 .. 2 1 2 2 4 3 3 2 15 8 4. Membranous Croup. .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. 6'. Enteric or Typhoid .. .. .. .. .. 2 .. 2 .. 2 .. 6 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. lirysipelas .. .. .. 3 .. 2 .. 7 .. 1 .. 13 71 TABLE VIII.—Giving the Causes of Deaths during the June quarter, 1904, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John and Elizabeth, and the Marylebone Infirmary, Notting Hill, W. Middle- sex Hospital. Queen Charlotte's Hospital. Samaritan Hospital. Workhouse. Notting Hill Infirm'ry. Hospital of St. John & Elizabeth, Grove Road. Smallpox .. .. .. .. .. .. Influenza l .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. Diphtheria .. .. .. .. .. .. Typhoid Fever .. .. .. .. 1 .. Diarrhœa .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. Pneumonia and Pleurisy 9 .. .. .. 4 .. Pyæmia .. .. .. .. l .. Syphilis .. .. .. .. .. .. Cancer 23 .. .. .. 6 1 Phthisis & Tuberculosis 5 .. .. .. 24 3 Rheumatism .. .. .. .. .. .. Apoplexy .. .. .. .. 2 .. Paralysis .. .. .. .. 6 .. Bronchitis 6 .. .. 2 22 .. Asthma .. .. .. .. .. .. Peritonitis .. .. .. .. .. .. Disease of Brain .. .. .. .. .. .. Heart 5 .. .. 6 7 .. ,, Kidney .. .. .. .. .. .. ,. Liver 2 .. .. .. 1 .. „ Uterus .. .. .. .. .. .. „ Ovary .. .. .. .. .. .. Parturition .. .. .. .. .. .. Diabetes .. .. .. .. .. .. Fractures and Injuries 6 .. .. .. 1 .. Old Age .. .. .. .. 9 .. Low Vitality, Infants .. .. .. .. .. .. Premature Birth .. 6 .. .. .. .. Other causes 36 5 2 5 28 l Total *93 †11 **2 13 112 ***5 * Of the 93 deaths in the Middlesex Hospital, 75 were those of non-parishioners, †Ten of the 11 deaths in Queen Charlotte's Hospital were those of non-parishioners ** The 2 deaths in the Samaritan Hospital were those of non-parishioners. *** Of the 5 deaths in St. John's Hospital four were those of non-parishioners. 72 TABLE IX.—Causes of, and Ages at, Death during the 13 weeks ending June 25th, 1904, 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 19 4 15 ... ... ... ... 8 ... 7 3 1 3 Scarlet Fever 2 ... ... 2 ... ... ... ... ... 1 1 ... 2 Whooping Cough 3 ... 3 ... ... ... ... 1 ... ... ... 2 2 Diphtheria and Membranous Croup 3 ... 3 ... ... ... ... ... ... I 1 1 2 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric 1 ... ... 1 ... ... ... ... ... ... 1 ... 1 Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza 2 ... 1 ... ... ... 1 ... 1 1 ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea 4 3 ... ... ... 1 ... ... ... ... 3 1 ... Enteritis 1 1 ... ... ... ... ... ... ... ... 1 ... ... Puerperal fever ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... Other Septic Diseases 2 1 ... ... 1 ... ... 1 1 ... ... ... 2 Phthisis 58 2 2 2 8 41 3 12 6 8 23 9 38 Other Tubercular Diseases 6 1 2 ... 1 2 ... 2 ... 1 2 1 5 Cancer, Malignant Disease 31 ... ... ... ... 16 15 7 4 6 9 5 32 Bronchitis 57 6 4 ... ... 21 26 17 5 8 19 8 34 Pneumonia 34 9 6 1 1 12 5 5 3 4 13 9 11 Pleurisy 2 ... ... ... ... 1 1 1 1 ... ... ... 4 Other Diseases of Respiratory Organs ... ... ... ... ... ... ... ... ... ... ... ... ... Alcoholism Cirrhosis of Liver 7 ... ... ... ... 6 1 2 ... 3 1 1 4 Venereal Diseases 1 1 ... ... ... ... ... 1 ... ... ... ... ... Premature Birth 8 8 ... ... ... ... ... 2 1 2 3 ... 6 Diseases and Accidents of Parturition 1 ... ... ... ... 1 ... ... ... ... 1 ... ... Heart Diseases 50 ... ... 1 4 25 20 12 9 4 11 14 20 Accidents 11 2 3 ... ... 1 5 2 ... 2 4 3 9 Suicides 5 ... ... ... 1 4 ... 1 ... 1 2 1 4 All other causes 170 26 8 4 6 56 70 39 31 13 55 32 115 All causes 478 64 47 11 22 187 147 113 62 62 153 88 *294 *91 of these were Non-Parishioners. 73 REGISTER OF SANITARY WORK Month ending 30th June, 1904. 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. 5 District. Public Health (London) Act. Inspections. Dwelling Houses, &c. 25 36 20 130 41 ... ... ... ... ... 252 Tenements 50 15 25 25 37 ... ... ... ... ... 152 Underground Dwellings 6 ... 12 8 19 ... ... ... ... ... 45 Dairies, Milk Shops, Cow Houses 8 3 ... 4 7 ... ... ... ... ... 22 Slaughter Houses 2 2 ... ... 1 ... ... ... ... ... 5 Yards, Stables, and Mews 37 13 35 36 64 ... ... ... ... ... 185 Smoke Shafts ... ... ... ... ... ... ... ... 7 ... 7 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... 1 ... 1 Refuse Receptacles 4 5 3 8 14 20 ... ... ... ... 54 Enquiries re non-removal of refuse 3 4 5 8 7 30 ... ... ... 2 59 Removal of Bodies to Mortuary 1 ... ... ... ... ... ... ... ... ... 1 Visits to Works in progress 170 326 150 280 174 ... ... ... 49 39 1188 Miscellaneous Inspections 42 37 35 250 106 ... ... ... ... 81 551 UNWHOLESOME FOOD. Number of seizures made . ... ... 1 1 ... ... ... ... ... ... 2 INFECTIOUS DISK A HE:— Cases Isolated. 1 ... 3 3 1 ... ... ... ... ... 8 Cases Removed to Hospital 15 2 8 9 10 ... ... ... ... ... 44 Rooms Disinfected 25 3 10 29 16 ... ... ... ... ... 83 NEW DRAINAGE Number of Plans Passed 8 15 10 13 11 ... ... ... ... ... 57 New Pipe Drains (feet) 1060 1365 350 1720 1642 ... ... ... ... ... 6137 Houses where defects in existing Drainage have been detected and remedied 6 8 5 8 9 ... ... ... ... ... 36 74 REGISTER OF SANITARY WORK Month ending 30th June, 1904. 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..). Andrews, No. 3 District. Mr. T. Gorniot, No. 4 District. Mr. W. Yeo, No. 5 District. Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 28 21 49 Periodical Inspections: — Factories ... ... ... ... ... ... ... ... 3 ... 3 Workshops ... ... ... ... ... ... ... ... 49 125 174 Bakehouses ... ... ... ... ... ... ... ... 20 ... 20 Restaurants, &c. ... ... ... ... ... ... ... ... 36 ... 36 Homeworkers' Premises ... ... ... ... ... ... ... ... 5 85 90 Domestic Workshops. ... ... ... ... ... ... ... ... 3 ... 3 Food and Drugs Act. Adulteration. Samples collected for Analysis ... ... 4 19 8 ... ... ... ... ... 31 Correspondence, Legal Procedure, &c. Complaints received 14 9 12 14 24 ... ... 52 7 8 140 Letters and Intimations relating to Abatement of Nuisances 18 10 20 29 7 ... ... 22 ... 32 138 Statutory Notices Served 4 ... 2 6 8 ... ... ... ... 2 22 Proceedings taken before Magistrates ... ... ... ... 1 ... ... ... ... ... 1 (1) Under Public Health Act ... ... ... ... ... ... ... ... ... ... ... (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) „ Food & Drugs Act ... ... ... 1 ... ... ... ... ... ... 1 Reports made to Medical Officer of Health 26 ... 25 65 94 ... ... 26 18 8 262 THE SANITARY CHRONICLES OF THE BOROUGH OF ST. MARYLEBONE DURING JULY, 1904, BY ALEXANDER WINTER BLYTH, Medical Officer of Health, and Analyst of Food and Drugs for the Borough of St. Marylebone. PRINTED BY ORDER OF THE COUNCIL. Vol. XXIV. 3, Upper Gloucester Place, W., Aug. 10th, 1904. No. 7 The week ending July 2nd was dry, bright and warm. Minimum temperature, 47.0°; maximum, 75.0°; mean, 63.9°. On one day only a little rain fell (0.03 inch). Winds variable. Sunshine registered in Regent's Park, 68.4 hours, equal to 59.2 %. Mean barometer, 29.9 inches. The week ending July 9th was similar in weather to the preceding. Minimum temperature, 50.0°; maximum, 81.0°; mean, 67.5°. On one day rain fell (0.10 inch). Winds westerly. Sunshine, 45.3 %. Mean barometer, 30.0 inches. The week ending July 16th was very warm, the mean temperature being no less than 72.3°, with minimum and maximum of 67.0° and 84.0°. On one day only rain fell (0.02 inch). Winds S.W. and S.E. Sunshine in Eegent's Park, 74%. Mean barometer, 30.0 inches. The week ending July 23rd was almost equal in heat to the previous week, the mean temperature being 71.4°, the minimum 55.0°; the maximum, 89.0°. A slight shower of rain fell (0.02 inch). Winds S.W. and S.E. Sunshine, 65.8%. Mean barometer, 30.0 inches. 76 The week ending July 30th was unsettled, cooler, and moister. Minimum temperature, 54.0°; maximum, 79.5°; mean, 53.2°. On fire days rain, mostly accompanied with thunder and lightning, fell to the extent of l.74 inch. Sunshine, 25 %. Mean barometer, 29.8 inches. Births and Deaths. During the five weeks ending July 30th there have been registered 259 births and 157 deaths. These births and deaths are divided among the five sub-districts, as set forth in Table IV. 52 of the deaths were extra-parochial, as follows:— St. Marylebone Infirmary, Notting Hill 36 Western Fever Hospital 2 Charing Cross Hospital 1 University Hospital 1 St. Mary's Hospital 5 Children's Hospital, Paddington 1 Colney Hatch Asylum 1 St. Thomas' Home 1 St. Pancras Workhouse 1 St. Pancras Infirmary 1 Rowton House, Hammersmith 1 In the Street 1 Total 52 The birth and death-rates, as deduced from the five weeks' statistics, are as follows: — All Souls, birth-rate 13.8; death-rate 9.7. Rectory, birth-rate 19.4 ; death-rate 8.9. St. Mary, birth-rate 25.3: death-rate 14.9. Christ Church, birth-rate 25.8: death-rate 15.3. St. John, birth-rate 16.4; death-rate 11.7. The whole district, birth-rate 20.2; death-rate 12.3. The average death-rates for five years (1898 to 1902) for the corresponding period were as follows:—All Souls, 12.8; Rectory, 14 2; St. Mary, 15.4; Christ Church, 15.8; St. John. 16.5; the whole district, 14.6. 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; 77 SHOWING THE COMPARATIVE MORTALITY DURING THE FIVE WEEKS ENDING JULY 30th, 1904, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 5weeks ending July 30th, 1904. Proportion of the deaths to 1,000 deaths from all causes. 5 weeks ending July 30,1904. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1899-1903. 1. Deaths from the chief Zymotic Diseases 29 185 2.26 3.87 2. Pulmonary, other than Phthisis 18 115 1.40 4.20 3. Tubercular 13 83 1.01 2.72 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. The brilliant hot summer weather has had the usual effect of increasing adult health generally ; chest diseases, the infectious fevers, and tubercular affections all being inhibited or benefited by the disinfecting and germicidal action of the sun, aided by the abundant ventilation of constant open windows. On the other hand fatal diarrhoea has appeared among infants; the fact that the fatal cases occur in the greatest proportion in the poorest and dirtiest localities shows the intimate connection of infantile diarrhoea with hygienic conditions. Report of the St. Marylebone delegate to the Sanitary Congress—Glasgow, 1904. The appointment of a delegate or delegates to a Congress is of small utility unless a report be furnished to the authority represented embodying observations of practical results achieved in the locality visited, or of any suggestions as to administration derived from papers or discussions. 78 Different municipalities have different methods in the expenditure of public money in the interests of general health and some get much more value for the money than others. There is so much to be learned from Glasgow of utility to this Borough that no apology is necessary in laying stress in this report on what has been done and what is doing in Glasgow. Housing of the Working Classes—Clearing of Insanitary Areas. It is certain Glasgow could not have carried out large and important clearing and re-housing schemes under an Act so obscure in phraseology, so complicated in procedure, and so expensive in operation as the Housing of the Working Classes Act, 1890; a simpler, more economical and concise instrument was acquired so long ago as 1866 in the Glasgow Improvement Act. Under this Act a City Improvement Trust was established, with a borrowing power of £1,250,000, afterwards increased to £1,500,000 for the purpose of clearing certain large areas, re-building with wider streets, and also for establishing a Public Park. It is instructive to those in this Borough who hold such decided opinions on the taxation of ground values, that the assessments to meet this large expenditure fell wholly on the occupiers, and that when an attempt was made in 1892 to shift a portion of the burden on to the owners, Parliament refused to sanction such an arrangement. Armed with the extensive powers of the Act, the Trustees bought large quantities of land in the different scheduled parts of the City and cleared them of dilapidated and insanitary dwellings. The Trustees started with the idea they would be able to sell such cleared areas to private persons under agreement to build certain types of habitations, at a price which would largely recoup the ratepayers for the initial expense. This idea was only partially realised; the disastrous commercial crisis of 1878 culminating in the failure of the City of Glasgow Bank, produced a complete collapse in the property market, which for a long time arrested and interfered with the full development of the schemes. 79 Within the scheduled areas existed a number of common lodging houses described as promiscuously overcrowded, the haunts of vice, filth and immorality—these were replaced by seven model lodging houses, which were studied by Lord Rowton and served him as types of construction for his famous and successful London venture. The seven houses accommodate nightly 2,400 persons at charges of from 3½d. to 6d. per night. They are so like the Rowton houses that they need not be further described. The total cost of the seven houses including sites and equipment has been £109,343, after writing off for depreciation £19,966 ; the return for the year 1903 was £5 8s. 3¼d. per cent. A peculiar institution to Glasgow is the " Family Home " situated in St. Andrew Street; the cost of which was £17,600, designed for deserving widows and widowers having one or more young children with no one to look after them ; now, however, it is restricted entirely to widowers. The house contains 160 single plainly furnished bedrooms, each capable of accommodating one adult and three children—a common dining room and kitchen, with gas fires and steam cooking boilers; a nursery, recreation rooms, baths, and lavatories. The building is lighted by the electric light and warmed by a hot water installation. The rent of each bedroom is 5s 6d. per week, meals are cooked and supplied at almost cost price, and the children are boarded at an average of 1s. 7d. per week each. A superintendent, nurses, and servants form the staff. Children under school age are attended by the nurses—the elder children go to school. The expenses, therefore, of a widower left with three young children, his wages being, say, 25s. per week, would total up somewhat as follows ;—- s. d. Rent of furnished room 5 6 Expense of food for the three children 4 9 His own food, say 6 0 16 3 This leaves 8s. 9d. per week for clothes, club subscription, literature, tobacco, beer, amusements; no large sum, but with strict economy and self control sufficient. 80 It is stated there is a small loss on the "Family Home" scheme. The number of houses erected or re-constructed under the powers of the 1866 Act and subsequent Improvement Acts are as follows:— 1 Tenement Houses. 2 Tenement Houses. 3 Tenement Houses. Larger. Houses. Total New erections 474 1,042 197 11 1,724 Old properties re-constructed 94 92 82 268 568 1,134 279 11 1,992 The total population housed is given as 11,500. The rents charged for the One apartment houses are from 1/8 to 3/5 per week. Two „ „ „ 2/7 „ 5/5 Three , „ „ 4/9 „ 8/0 These are lower rents than the rents in Marylebone for the same class of property. The financial result of the schemes is set forth as follows:— Total amount of Assessment from 1866—1897, when it ceased £597,003 0 11 Nett free assets over liabilities, May 31st, 1903 £28,616 17 10 Total cost to ratepayers £568,386 3 1 For this they have obtained (1.) The Alexandra Park, a fine park of 104 acres. (2.) 98,929 square yards of ground applied in the formation of 30 new streets, and in the improvement of 26 existing streets. (3.) Various other public works. The great problem in St. Marylebone and in the Metropolis generally, is that of housing the poorest classes. JULY, 1904. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, TYPHOID FEVER, AND SMALLPOX DURING 1904. 81 Glasgow has to a certain extent, aided it must be confessed by exceptional local circumstances, solved the question. The Trustees under an Improvement Act of 1897, acquired at "very moderate prices" 25 acres of vacant ground, the larger portion of which is in the northern part of the city, the smaller in the eastern part (Baltic Street and Haghill). By the end of 1902 the latter portion had been covered with houses of low rental, the rents averaging £5 per annum for a one-apartment house, £8 per annum, for a two-apartment house, exclusive of taxes. For the former no one is accepted as tenant whose earnings are above 22s. per week ; for the £8 house tenants are only accepted whose earnings are below 26s. per week. The blocks, two in number, are each four storeys high, and each contain 112 one-room tenements and 145 tworoom tenements. The cost of these buildings was as follows: Haghill Tenements. Site £1,503 12 0 Buildings 15,798 2 4 £17,301 14 4 Baltic Street Tenements. Site €1,044 2 6 Buildings 10,465 8 1 £11,509 10 7 The balance-sheet for a year of one of these blocks is given as follows :— Haghill Labourers' Dwellings. Yeah ending 31st Mat, 1902. Rental. Outlays. Percentage of Rental. £ s. d. £ s. d. Tear 1901-1902 1,099 3 0 Management 44 17 1 4.08 28.25 Repairs 79 15 9 7.25 Rates and Taxes, £329 7 11 Less recovered from tenants 187 14 9 132 13 2 12.07 Insurance 7 13 6 .71 Miscellaneous .. ... 6 16 1 .61 Caretaker (Wages and house rent) 33 9 3 3.04 Irrecoverable arrears 5 8 8 .49 Sinking Fund 288 6 8 26.24 73.81 Interest on £17,000, at £3 1 6 per cent. 522 15 0 47.57 Deficiency 22 12 2 -2.06 £1,121 15 2 1,121 15 2 100.0 82 The deficiency of 2 per cent. on rental value will, in a few years disappear, as the sinking fund accumulates. It will be observed that the improvements have not been effected under the general powers of the statut es but under the special powers of Local Acts. In one important direction Glasgow has made use, however, of the Housing of the Working Classes Acts. In bygone years houses in Glasgow were built and streets formed having a good space at the back of each house—but owing to the demand for buildings and absence of a proper building Act, owners have been allowed to build on these "back lands," covering such open spaces with structures effectually blocking out light and air, and leaving between each building only narrow passages, the receptacle of dust, garbage and filth. The Corporation have utilised the sections of the Housing of the Working Classes Act, 1890, which are applicable to obstructive buildings and demolished and cleared a number of the "back land" houses. In the Borough of St. Marylebone a somewhat similar condition of things prevails. The back yards of hundreds of houses have been either entirely built over, or cottages have been formed in the rear, obstructing the light and air of the principal or parent building. It may be possible to follow the example of Glasgow in many of such cases. (To be continued.) 83 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 July, 1904 ; classified according to Diseases, Ages, and Localities. (a) All Souls Rector St. Mary Christ Church St. John Totals Population at all ages- (6) Census 1901 35,391 19,849 18,099 39,&36 20,426 133,301 (c) Registered Births 47 37 44 98 33 259 (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. Chicken pox 5 5 3 .. 1 .. 15 1 14 10 38 16 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 3 4 .. .. 3 1 4 3 1 2 13 10 3. Diphtheria .. 3 .. 1 1 1 2 .. 2 1 5 6 4 Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. 1 .. .. .. .. .. .. .. 1 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas. .. 1 2 10 .. 2 1 7 1 3 4 23 Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2 Scarlatina 2 4 1 .. 2 1 3 3 1 2 9 10 3. Diphtheria .. 3 .. 1 1 1 2 .. 2 1 5 6 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. .. .. .. .. .. .. .. 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. 10 .. 1 .. .. .. .. .. 11 84 *Of the 38 deaths in the Middlesex Hospital, 32 were those of non-parishioners. †The 5 deaths in Queen Charlotte's Hospital were those of non-parishioners. ‡One of the 3 deaths in St. John's Hospital was that of a non-parishioner. **The 1 death in the Samaritan Hospital was that of a non-parishioner. TABLE III.—Giving the Causes of Deaths during Jul}', 1904, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John and 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 1 .. .. .. .. .. Diarrhoea .. .. .. .. 2 .. Erysipelas .. .. .. .. 1 .. Pneumonia and Pleurisy 2 .. .. .. .. .. Pyaemia .. .. 1 .. .. .. Syphilis .. .. .. .. 1 .. Cancer 18 .. .. .. 1 .. Phthisis & Tuberculosis 3 .. .. .. 3 1 Rheumatism .. .. .. .. .. .. Apoplexy .. .. .. .. .. .. Paralysis .. .. .. .. 3 .. Bronchitis 1 .. .. .. 6 .. Asthma .. .. .. .. .. .. Peritonitis .. .. .. .. .. .. Disease of Brain .. .. .. .. .. .. ,, Heart .. .. .. .. 4 .. ,, Kidney .. .. .. .. .. .. „ Liver .. .. .. .. 1 .. „ Uterus .. .. .. .. .. .. „ Ovary .. .. .. .. . . .. Parturition .. 1 .. .. .. .. Diabetes .. .. .. .. .. .. Fractures and Injuries 1 .. .. .. .. .. Old Age .. .. .. .. 3 .. Low Vitality, Infants .. .. .. .. .. .. Premature Birth .. 2 .. .. .. .. Other causes 12 2 .. 4 11 1 Total *38 †5 **1 4 36 ‡3 85 TABLE IV.—Causes of, and Ages at, Death during the 5 weeks ending July 30th, 1904, 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 .. 3 .. .. .. .. 2 .. .. 1 .. 1 Scarlet Fever 2 .. 2 .. .. .. .. .. .. .. 1 .. 2 Whooping Cough 1 .. 1 .. .. .. .. 1 .. .. .. .. .. Diphtheria and Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric .. .. .. .. .. .. .. .. .. .. .. .. 1 Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 23 19 4 .. .. .. .. 5 1 2 14 1 2 Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. Other Septic Diseases .. .. .. .. .. .. .. .. .. .. .. .. 1 Phthisis 9 .. .. .. .. 9 .. 3 .. .. 3 2 8 Other Tubercular Diseases. 4 1 2 .. .. 1 .. .. .. 2 1 1 2 Cancer, Malignant 5 1 3 .. .. 1 .. .. 1 3 1 .. 15 Bronchitis 11 .. 1 .. .. 3 6 5 1 .. 2 2 6 Pneumonia 7 3 .. .. .. 3 .. 1 1 2 2 1 5 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Respiratory Organs .. .. .. .. .. .. .. .. .. .. .. .. .. Alcoholism Cirrhosis of Liver 7 .. .. .. .. 7 .. 2 1 2 2 .. 2 Venereal Diseases 2 2 .. .. .. .. .. .. 2 .. .. .. 1 Premature Birth 8 3 .. .. .. .. .. 1 .. .. 2 .. 2 Diseases and Accidents .. .. .. .. .. .. .. .. .. .. .. .. 1 Heart Diseases 16 .. .. .. 1 10 5 1 2 .. 11 2 3 Accidents 2 .. .. .. .. 2 .. 1 .. .. .. 1 1 Suicides 2 .. .. .. .. 1 1 .. 1 .. .. 1 4 All other causes 60 10 3 1 2 27 17 11 6 13 18 12 33 All causes 157 39 19 2 4 64 29 33 17 26 58 23 *90 *39 of these were Non-Parishioners. 86 TABLE V.—District Births and Deaths for the five weeks ending july 30th, 1904. Population in 1891. Births. Deaths. Males. Fmls. Males. Fmls All Souls 35,391 26 21 21 12 Rectory 19,849 18 19 9 8 St. Mary 18.099 17 27 14 12 Christ Church 39,536 60 38 31 27 St. John 20,426 19 14 10 13 Total 133,301 140 119 85 72 Note.—In the above the births and deaths have all been properly corrected, strangers have been eliminated, and extra-parochial deaths and others have been allotted to their proper sub-district. 87 REGISTER OF SANITARY WORK Month ending 31st July, 1904. 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. 5 District Factory and Workshop Act Enquiries as to Occupation ... ... ... ... ... ... ... ... 10 5 15 Periodical Inspections:— Factories ... ... ... ... ... ... ... ... 1 ... 1 Workshops ... ... ... ... ... ... ... ... 49 121 170 Bakehouses ... ... ... ... ... ... ... ... 35 ... 35 Restaurants, &c. ... ... ... ... ... ... ... ... 27 ... 27 Homeworkers' Premises ... ... ... ... ... ... ... ... 5 61 66 Domestic Workshops ... ... ... ... ... ... ... ... ... ... ... Food and Drugs Act. ADULTERATION. Samples collected for Analysis 6 4 6 6 ... ... ... ... ... ... 22 Correspondence, Legal Procedure, &e. ... ... ... ... 1 ... ... ... ... ... 1 Complaints received 18 11 17 8 15 40 ... ... 2 3 114 Letters and Intimations relating to Abatement of Nuisances 25 21 26 30 14 20 ... ... ... 6 142 Statutory Notices Served 6 2 ... 5 15 ... ... ... 2 ... 30 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 48 30 15 56 76 25 ... ... 25 6 281 88 REGISTER OF SANITARY WORK Month ending 31st July, 1904. 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. PerryNo. 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 32 38 25 30 31 ... ... ... ... ... 156 Tenements 34 13 29 25 29 ... ... ... ... ... 130 Underground Dwellings 10 ... 12 8 21 ... ... ... ... ... 51 Dairies, Milk Shops, Cow Houses 3 3 ... 5 5 ... ... ... ... ... 16 Slaughter Houses 2 3 ... ... 1 ... ... ... ... ... 6 Yards, Stables, and Mews 30 13 35 40 79 ... ... ... ... ... 197 Smoke Shafts ... 1 ... ... ... ... ... ... 39 ... 40 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... ... ... ... Refuse Receptacles 7 9 6 9 9 50 ... ... ... ... 90 Enquiries re non-removal of refuse 6 4 5 5 7 ... ... ... ... 2 29 Removal of Bodies to Mortuary 1 ... ... ... ... ... ... ... ... ... 1 Visits to Works in progress 230 240 50 310 204 ... ... ... ... 28 1062 Miscellaneous Inspections 220 236 75 270 216 65 ... ... 65 88 1235 UNWHOLESOME FOOD. Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE:— Cases Isolated ... ... ... ... ... ... ... ... ... ... ... Cases Removed to Hospital 11 5 8 6 6 ... ... ... ... ... 36 Rooms Disinfected 18 7 18 30 17 ... ... ... ... ... 90 NEW DRAINAGE Number of Plans Passed 6 8 9 7 6 ... ... ... ... ... 36 New Pipe Drains (feet) 970 1320 1500 760 1174 ... ... ... ... ... 5724 Houses where defects in existing Drainage have been detected and remedied 12 9 12 9 9 ... ... ... ... ... 51 THE SANITARY CHRONICLES BOROUGH OF ST MARYLEBONE DURING AUGUST AND SEPTEMBER, 1904. Containing a Quarterly Summary of the Mortality Statistics for the Quarter ending September 24th, 1904, and the Quarterly Statement of Analytical Work done under the Sale of Food and Drugs Act, &c. Vol. XXIV. 3, Upper Glodcester Place, October 14th, 1904. No. 8. The week ending August 6th was fine and warm. Minimum temperature, 53.0°; maximum, 87.0°; mean, 68.0°. On two days there were slight showers, the rainfall only measuring 0.08 inch. Winds S.W Sunshine 63.4%. Mean barometer, 29.9 inches. The week ending August 13th was similar in weather, but slightly cooler. Minimum temperature, 49.8°; maximum, 75.0°; mean, 61.0°. On one day only slight rain fell (0.06 inch). Winds N. and W.S.W. Sunshine, 59.6 %. Mean barometer 29.9 inches. The week ending August 20th was cooler than the preceding two weeks. Minimum temperature 45.5°; maximum 75.0°; mean 59.5°. On two days rain fell, the rainfall measuring 0.47 inch. Sunshine 38%. Winds W.S.W. Mean barometer, 29.9 inches. The week ending August 27th was cool, owing to N. and N.E. winds. Minimum temperature 43.5°; maximum 72.7°; mean 57.6° On three days slight rain fell (0.22 inch). Sunshine, 41.3%. Mean barometer, 29.9 inches. The week ending September 3rd was moist, with variable winds. Minimum temperature, 49.5°; maximum, 81.9°; mean, 61.0°. On three days heavy showers fell, giving a rainfall of 1.01 inch. Sunshine, 40.9%. Mean barometer, 29.8 inches. 90 The week ending September 10th was finer than the preceding. Minimum temperature 42.2°; maximum 71.6°; mean 57.0° On three days rain fell (0'36 inch). Wind S.W. Sunshine 44.8%. Mean barometer 29.9 inches. The week ending September 17th was of moderate temperatures, the minimum being 41.0°; maximum 71.4°; mean 56.4°. Winds variable. On three days slight rain fell (0.24 inch). Sunshine 41.0%. Mean barometer 29.8 inches. The week ending September 24th was cooler, owing to N. and N.E. winds. Minimum temperature 40.5°; maximum 64.1°; mean 53.6°. On three days slight rain fell (0.20 inch). Sunshine 60%. Barometer 29.9 inches. Quarterly Summary. During the thirteen weeks ending September 27th there have been registered 680 births and 479 deaths. These births and deaths are' divided among the five sub-districts, as set forth in Tables V. and XL. One hundred and seventy-five of the deaths were extra-parochial, as follow:— St. Marylebone Infirmary, Notting Hill 119 Western Fever Hospital 5 St. Mary's Hospital 14 University College Hospital 4 St. Thomas' Hospital 1 Charing Cross Hospital 1 London Temperance Hospital 2 Children's Hospital, Paddington 2 Children's Hospital, Great Ormond Street 1 Children's Hospital, East London 1 Heart Hospital, Soho 1 Colney Hatch Asylum 4 Tooting Beck Asylum 2 Leavesden Asylum 1 Hoxton House Asylum 1 London County Asylum, Ilford 1 London County Asylum, Norwood1 Friern Barnet Asylum 1 Rowton House, Hammersmith1 St. Pancras Infirmary 3 St. Pancras Workhouse 1 St. Thomas' Home 1 The Nest, Upper Clapton 1 Paddington Canal 1 Public Baths, Finchley Road 1 In the Streets 4 Total 175 91 Births and Deaths. The birth and death-rates, as deduced from the three months' statistics, are as follows :— All Souls, birth-rate 15.3; death-rate 12.0. Rectory, birth-rate 21.6 ; death-rate 8.5. St. Mary, birth-rate 24.1 : death-rate 17.2. Christ Church, birth-rate 26.3 ; death-rate 16.5. St. John, birth-rate 18.0 ; death-rate 12.9. The whole district, birth-rate 20.4; death-rate 14.4. The average death-rates for five years (1898 to 1903) for the corresponding period were as follows:- All Souls, 12.8; Rectory, 14.3; St. Mary, 15.9; Christ Church, 18.6; St. John, 17.6; the whole district, 15.8. The following table gives, as usual, facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes : TABLE I. SHOWING THE COMPARATIVE; MORTALITY DURING THE THIRTEEN WEEKS ENDING SEPT. 24th, 1904, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 13 weeks ending Sept. 24th, 1904. Proportion of the deaths to 1,000 deaths from ail causes. 13 weeks ending Sept. 24,1904. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1898-1903. I. Deaths from the chief Zymotic Diseases 105 219 3.17 3.62 2. Pulmonary, other than Phthisis 54 113 1.62 1.90 3. Tubercular 49 102 1.47 1.95 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza, Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. 92 Health of the District. The health of the district has been exceptionally good throughout the past quarter. Seldom has there prevailed climatic conditions so favourable to good health, for although the sunshine has been unusually abundant, there has been no prolonged wave of hot weather. The chief factor raising or lowering the general mortality in the summer months is the prevalence or absence of infantile diarrhoea. Nearly 30 deaths of young infants occurred during the quarter from this cause, but the number is still below the average. Prosecutions under the Public Health (London) Act. The case of 119, Church-street was again before the Magistrate, and Joseph Andrews, the owner, again stated he was without means to do the work; thereupon the Magistrate sent him to prison, for disobedience of the order, for three weeks. The case is profoundly unsatisfactory, and shows something entirely wrong in procedure; a house is ordered to be drained, the owner cannot pay the money to have it done, and the final remedy is that he obtains board and lodging at the expense of the community, the house remaining as before. REPORT OF THE DELEGATE TO THE GLASGOW HEALTH CONGRESS. (Continued from Page 82.) Depots for the Supply of clean sterilised Milk for hand-fed Infants. It is beyond dispute that much of the fatal infantile diarrhoea of infants is caused by dirty, or sour, or impure milk. The Corporation of Glasgow is grappling in a practical manner with this subject by sterilising milk on a large scale. 93 The milk is first cleansed of dirt by an adaptation of an Alpha-Laval separator. It is then bottled into 7-oz. bottles by an ingenious automatic arrangement, allowing a large number of bottles to be filled simultaneously : the bottles are stoppered, put into galvanized iron baskets, each containing nine bottles, and conveyed to the steriliser, an apparatus which can sterilise 860 bottles in these baskets at one charge. After remaining twenty minutes at a temperature just under boiling water, the steam is replaced by a spray of cold water, the steriliser is opened, and the trolleys bearing the trays of bottles run into a refrigerator, from whence, after forty minutes, they are conveyed to the sale room. The prices are as follows:— Nine 7-oz. bottles, one part with two parts water, suitable for infants under 3 months old 2d. Nine 7-oz. bottles, one part milk and one part water, suitable for infants from 3 months to 6 months old 2½d. Nine 7-oz. bottles, two parts with one part water, for infants from 6 to 8 months old 3d. Several other corporate bodies outside the Metropolis are now provided with similar depots, notably Liverpool; the Liverpool depot, instead of selling milk diluted with water according to the age of the infant, aims at imitating human milk by suitable additions of water, cream, sugar, and salt. The system was initiated in 1901, so that Liverpool has two years' experience of the system. The Medical Officer of Health for Liverpool, in his last annual report, states : "The fact stands out that of 4,453 infants coming very promiscuously to the depot at varied ages and in conditions of health below the average, the mortality was 78 per 1,000, as against 100 for the whole city;" In the more crowded parts of Marylebone the mortality of hand-fed infants is excessive, and if there is a reasonable prospect of reducing this mortality by following the examples of Glasgow, of Liverpool, of Ashton-under-Lyne, 94 of Battersea, and other places, then it is obviously the duty of a Health Authority to consider seriously the question of establishing a depot.* In applying to the firm of engineers who arranged the plant for the Glasgow depot, prices of the apparatus on various scales, large and small, were submitted. The following is the cost of the plant for an installation of moderate size:— Specification for Municipal Milk Depot: 100 to 500 Children. Vertical steam boiler, mounted, including injector £34 0 0 2 sterilisers, capacity about 400 bottles each, for steam 35 0 0 1 "Ross Jones" automatic bottle filler on iron stand and stays 38 0 0 1 steam turbine bottle washer—2 brushes 7 0 0 1 galvanized iron tank for ditto 6 10 0 1 Gerber tester 3 10 0 50 gross bottles 46 15 0 450 wire baskets, 9 bottles each 21 17 6 50 „ ,, large 10 0 0 1 galvanised iron soak tank 10 0 0 1 mixing tank, gauged 2 5 0 1 patent strainer 2 0 0 Measures and other necessary tins 9 5 O £226 2 6 Not including fittings. For Depot such as established at Ashton-under-Lyne. To this estimate must be added the cost of fitting and the cost of altering premises so as to be adapted for the process, and other expenses, bringing the probable total cost to something like £800, but if the experience of other places is a guide, the maintenance, including interest of money, rent, rates, wages and cost of distribution would be met by the profit on sales and not fall on the rates. It may be reasonably asked, Why not rather trust to private enterprise than start a new form of *Apparently there are no statutory powers enabling Metropolitan districts to establish such depots, therefore these would first have to be acquired. 95 municipal trading? The answer to this is that the aim o private persons would naturally be commercial, whereas the aim of a Health Authority would be to reduce infantile mortality by obtaining the cleanest kinds of milk from properly supervised farms, and only to make a sufficient profit to render the scheme self-supporting. Your delegate has in the above report made no allusion to the work of the Congress itself. There were many excellent addresses, papers, and good discussions, but his at tention was directed rather to matters which either are or may become burning practical questions affecting the Borough of St. Marylebone, and he trusts he has collected information of some value. The Laboratory—Sale of Food and Drugs Act, The samples taken during the quarter are detailed in Table XII. Of the 151 samples, not a single one justified the issue of a certificate of adulteration. The low amount of adulteration in Marylebone has been commented upon ; it must, however, be remembered that adulteration in the Metropolis generally is low; that a large number of samples are taken every year; that those who formerly occupied a fairly long black list have been harassed by frequent sampling aud have left the district in consequence. It must also be borne in mind that the Sale of Food and Drugs Acts permit high-class milks to be watered down to the borders of the statutory limit, and to be also deprived of cream to a certain definite extent. Of the 57 milks examined, there were several just on the border line. One milk was found to contain a little borax; this was not sufficient to preserve it effectually nor sufficient to support a certificate in the hot weather of July. The majority of the milks were of firstclass quality. There have been a few prosecutions in certain districts as to brandy lately, but there still exists a good deal of difference of opinion as to what the standard should be for brandy. The six samples examined this quarter all contained the amount of ether and higher alcohols which have been found in genuine brandy, but could not be called of the highest quality. A large number of the other samples consist of articles rarely wilfully adulterated, but were specially examined for metals and injurious substances. 96 TABLE II.— Giving the Causes of Deaths during the September quarter, 1904, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John and Elizabeth, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill Infirmary. Hospital of St. John 4c Elizabeth Grove Rd. S0mallpox .. .. .. .. .. .. Influenza .. .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. Typhoid Fever 2 .. .. .. .. .. Diarrhoea 1 .. .. 1 6 .. Erysipelas .. .. .. .. 2 .. Pneumonia and Pleurisy 5 .. .. .. .. .. Pyæemia .. .. 1 .. .. .. .. .. .. .. 4 .. Cancer 35 .. .. .. 8 .. Phthisis & Tuberculosis 9 .. .. .. 24 .. Rheumatism .. .. .. - .. .. Apoplexy .. .. .. .. 3 .. .. .. .. .. 5 .. 2 .. .. .. 16 .. .. .. .. .. .. .. Peritonitis .. .. .. .. .. .. .. .. .. .. .. .. 3 1 .. 2 12 .. .. .. .. .. .. .. 4 .. .. .. 2 .. .. .. .. .. .. .. Ovary .. .. .. .. .. .. Parturition .. 1 .. .. .. .. Diabetes .. .. .. .. .. .. Fractures and Injuries. 7 .. .. 1 8 .. Old Age .. .. .. .. .. .. Low Vitality, Infants .. .. .. .. .. .. Premature Birth .. 3 .. .. .. .. Other causes 24 4 1 6 29 .. Total *92 †9 **2 10 119 ‡6 * Of the 92 deaths in the Middlesex Hospital, 61 were those of non-parishioners, † Seven of the 9 deaths in Queen Charlotte's Hospital were those of non-parishioners. ** The deaths in the Samaritan Hospital were those of non-parishioners. ‡ Four of the six deaths in the Hospital of St. John were non-parishioners 97 TABLE III — district Births and Deaths for the four weeks ending august 24th, 1904. Population in 1891. Births. Deaths. Males. Fmls. Males. Fmls. All Souls 35,391 20 26 25 19 Rectory 19,849 14 10 9 3 St. Mary 18.099 18 13 17 14 Chrits Church 39,536 49 44 38 41 St. John 20,426 15 8 11 15 Total 133,301 116 101 100 92 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 IV.— District Births and Deaths for the four weeks ending september 24th, 1904. Population in 1891. Births. Deaths. Males. Fmla. Males. Fmls. All Souls 35,391 27 16 15 14 Rectory 19.849 8 14 7 6 St. Mary 18,099 20 14 10 11 Christ Church 39.536 36 33 30 20 St. John 20,426 19 17 11 6 Total 133,301 110 94 73 57 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. 98 TABLE V.— District Births and Deaths for the thirteen weeks ending september 24th, 1904. Population in 1891. Births. Deaths. Males. Fmls. Males Fmls. All Souls 35.391 73 63 61 47 Rectory 19,849 40 43 2.5 17 St. Mary 18.099 55 54 41 37 Christ Church 39,536 145 115 99 88 St. John 20,426 53 39 32 34 Total 133,301 366 314 258 221 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. AUGUST-SEPTEMBER, 1904. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, TYPHOID FEVER, AND SMALLPOX DURING 1904. 99 TABLE VI.— TABLE OF POPULATION, BIRTHS, AND OF NEW OASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, in the Sanitary District of ST. MARYLEBONE, during August, 1904; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary ! Christ Church Sr. John | Totals Population at all Ages. (6) Census 1901 35,391 19,849 18,099 39,536 20,426 133,301 (c) Registered Births 46 24 31 93 23 217 (d) Aged under 5 or over 5 Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards New Casks of Sickness in Each Locality coming to the knowledge of the medical Officer of Health. Chicken pox 2 3 .. .. 3 .. 6 6 9 1 20 10 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 4 7 .. 2 6 2 2 10 1 .. 13 21 3. Diphtheria 2 2 .. .. .. 1 .. 3 .. .. 2 6 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. 2 .. 5 .. 1 .. 8 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 6 .. 4 .. 7 1 3 .. •• 1 20 SUMliKK of such casks removed from their riombs in thb sbvbkal localitibs fob treatment in Isolation Hospitals. 1 Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 4 7 .. 2 6 2 2 10 1 .. 13 21 3. Diphtheria 1 1 .. .. .. 1 .. 1 .. .. 1 3 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. 2 .. 4 .. .. .. 6 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 Cholera .. .. .. .. .. .. .. .. .. .. •• .. 11 Erysipelas .. .. .. 2 .. 1 .. •• .. •• .. 3 100 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, 1904; classified according to Diseases, Ages, and Localities. (a) All Souls Rector 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 43 22 34 69 36 204 (c) Registered Births (d) Aped under 5 or over 5 Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 npwards Under 5 5 upwards New Casks of Sickness in kaoh Locality coming to the knowledge of the medical Offickb of Hkalth. Chickenpox .. 1 .. .. .. 1 3 2 10 2 13 6 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 3 5 .. 1 2 1 5 8 .. 1 11 16 8. Diphtheria 1 .. .. 1 1 3 3 2 .. 1 5 7 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 1 .. 2 .. 2 .. 3 .. .. .. 8 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 Chollera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas. 1 .. .. 1 1 2 2 5 .. 9 5 17 Number of bucu Cases Removed from their I Homes ih the several Localities for Treatmbni in Isolation Hospitals. 1 Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 2 5 .. .. 2 1 5 7 .. 1 10 14 3. Diphtheria 1 .. .. 1 1 3 3 2 .. 1 5 7 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or. Typhoid .. 1 .. .. .. 2 .. 1 .. .. .. 6 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. S. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. \9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 .. .. .. .. .. .. .. .. .. .. .. .. 11 .. .. .. 1 .. .. .. 3 .. 1 .. 5 101 TABLE VIIL — 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. MAKYLEBONE, during September Quarter, 1904; 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 136 83 109 260 92 680 (d) Aged under 5 or over 5. Under 5 5 upwards Under 5 | 5 upwards Under 5 5 upwards Under 5 j 5 upwards Under 5 5 upwards Under 5 5 upwards New Cases op Sickness in Bach Locality coming to thb knowledge of the medical Officbr op Health. Chickenpox 7 9 3 .. 4 1 24 9 33 13 71 32 1. Smallpox .. 2. Scarlatina 10 16 2 3 11 4 11 21 3 3 37 47 3. Diphtheria 3 5 •• 2 2 5 5 5 2 2 12 19 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 1 .. 3 .. 4 .. 8 .. 1 .. 17 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. 1 .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas I 7 3 15 .. 12 4 15 1 12 10 61 Number of such Cases Removed from their Homes in the sbveral Localities for Treatment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2 Scarlatina 8 16 1 2 .. 4 10 20 3 3 .. 45 3. Diphtheria 2 4 .. 2 2 5 5 3 2 2 11 16 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 1 .. 2 .. 4 .. 5 .. .. .. 12 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. 13 .. 2 .. 3 .. 1 .. 19 102 TABLE IX.— Causes of, and Ages at, Death during the 4 weeks ending August 27th, 1904, 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 tinder 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. All Souls. Rectory. St. Mary. Christ Church. ST. John. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough 1 1 .. .. .. .. .. 1 .. .. .. .. 1 Diphtheria and Membranous Croup 1 .. .. 1 .. .. .. .. .. .. .. .. .. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric .. .. .. .. .. .. .. .. .. .. .. .. 1 Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza .. .. .. • • .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. •• .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhoea 46 35 8 .. .. 1 2 6 2 7 25 6 7 Enteritis 11 2 9 .. .. .. .. 2 .. .. 9 .. 2 Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 1 .. .. .. .. .. 1 .. .. .. 1 .. .. Other Septic Diseases 1 .. .. .. .. 1 .. .. .. .. 1 .. 1 Phthisis 14 .. .. •• .. 14 .. 2 .. 3 8 1 15 Other Tubercular Diseases 10 5 1 2 .. 2 .. 3 2 3 2 .. 8 Cancer, Malignant Disease 10 .. .. .. .. 7 3 2 1 3 1 3 11 Bronchitis 12 .. 2 .. .. 6 4 1 1 .. 8 2 6 Pneumonia 6 .. 3 .. .. 3 .. .. .. .. 5 1 2 .. .. .. .. .. .. .. .. .. .. .. .. 1 Other Diseases of Respiratory Organs •• .. .. .. .. .. .. .. .. .. .. .. .. Alcoholism Cirrhosis of Liver 2 .. .. .. .. 2 .. 1 .. .. .. 1 3 Venereal Diseases 2 2 .. •• .. .. .. 1 .. .. .. 1 1 Premature Birth 1 1 .. .. .. .. .. 1 .. .. .. .. 1 Diseases and Accidents of Parturition .. .. .. .. .. .. .. .. .. .. .. .. .. Heart Diseases 16 1 .. .. •• 8 7 7 1 3 3 2 8 Accidents 6 2 .. 1 1 .. 2 .. 1 1 3 1 1 Suicides 1 .. .. .. .. .. 1 1 .. .. .. .. I All other cause 51 14 1 1 .. 15 20 16 4 11 12 8 31 All causes 192 63 24 5 1 59 40 44 12 31 79 26 104 *Of these were Non-Parishioners. 103 TABLE X.— Causes of, and Ages at, Death during the four weeks ending September 24th, 1904, in the Borough of St. Marylebone. CAUSES Of DEATH. Deaths in whole District at subjoined Ages. Deaths in Localities (at all Ages ) Deaths in Public Institutions. All Ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. All Souls. Rectory. St. Mary. Christ Church. St. John. Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 1 ... 1 ... ... ... ... ... ... ... ... 1 1 Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria and Membranous Croup 2 ... 1 1 ... ... ... ... ... 1 1 ... 2 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric ... ... ... ... ... ... ... ... ... ... ... ... ... Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 1 ... ... ... ... ... 1 ... ... ... ... 1 ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea 11 11 ... ... ... ... ... 1 ... 2 8 ... 1 Entiertis 1 1 ... ... ... ... ... ... ... ... 1 ... 1 Puerperal fever ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... Other Septic Diseases 1 ... ... ... ... ... ... 1 ... ... ... ... 1 Phthisis 10 ... ... ... 2 8 ... 3 ... 2 3 2 12 Other Tubercular Diseases 2 ... ... ... 1 1 ... ... ... ... 2 ... 1 Cancer, Malignant Disease 10 ... ... ... ... 7 3 2 2 1 4 1 18 Bronchitis 10 2 ... ... ... 2 6 2 ... 3 5 ... 3 Pneumonia 8 1 3 ... ... 1 3 3 2 3 ... ... 4 Pleurisy ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Respiratory Organs ... ... ... ... ... ... ... ... ... ... ... ... ... Alcoholism Cirrhosis of Liver 2 ... ... ... ... 2 ... 1 ... 1 ... ... 6 Venereal Diseases 4 4 ... ... ... ... ... ... ... ... 4 ... 1 Premature Birth 4 4 ... ... ... ... ... 1 ... 1 1 1 ... Diseases and Accidents of Parturition ... ... ... ... ... ... ... ... ... ... ... ... ... Heart Diseases 8 ... ... 1 1 2 4 3 1 1 1 2 7 Accidents 4 ... ... ... 1 1 2 2 ... ... 1 1 6 Suicides 1 ... ... ... ... 1 ... ... ... ... 1 ... ... All other causes 50 11 ... 1 1 16 21 10 8 6 18 8 23 All causes 130 34 5 3 6 42 40 29 13 21 50 17 87 *29 of these were Non-Parishioners. 104 TABLE XI.— Causes of, and Ages at, Death during the 13 weeks ending September 24th, 1904, 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 ... 3 ... ... ... ... 2 ... ... 1 ... 1 Scarlet Fever 3 ... 3 ... ... ... ... ... ... 1 1 1 3 Whooping Cough 2 1 1 ... ... ... ... 2 ... ... ... ... 1 Diphtheria and Membranous Croup 3 ... 1 2 ... ... ... ... ... 1 2 ... 2 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric ' ... ... ... ... ... ... ... ...... ... ... ... ... 2 Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza 1 ... ... ... ... ... 1 ... ... ... ... 1 ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea 80 65 12 ... ... 1 2 12 3 11 47 7 10 Enteritis 12 3 9 ... ... ... ... 2 ... ... 10 ... 3 Puerperal fever ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 1 ... ... ... ... ... 1 ... ... ... 1 ... ... Other Septic Diseases 2 ... ... ... ... 2 ... 1 ... ... 1 ... 3 Phthisis 33 ... ... ... 2 31 ... 8 1 5 14 5 35 Other Tubercular Diseases 16 6 3 2 1 4 ... 3 2 5 5 1 11 Cancer, Malignant Disease 25 1 3 ... ... 15 6 4 4 7 6 4 41 Bronchitis 33 2 3 ... 1 11 16 8 2 4 15 4 15 Pneumonia 21 4 6 1 ... 7. 3 4 3 5 7 2 11 Pleurisy ... ... ... ... ... ... ... ... ... ... ... ... 1 Other Diseases of Respiratory Organs ... ... ... ... ... ... ... ... ... ... ... ... ... Alcoholism Cirrhosis of Liver 11 ... ... ... ... 11 ... 4 1 3 2 1 11 Venereal Diseases 8 8 ... ... ... ... ... 1 2 ... 4 1 3 Premature Birth 8 8 ... ... ... ... ... 3 ... 1 3 1 3 Diseases and Accidents of Parturition ... ... ... ... ... ... ... ... ... ... ... ... 1 Heart Diseases 40 1 ... 1 2 20 ... 11 4 4 15 6 18 Accidents 12 2 ... 1 2 3 4 3 1 1 4 3 8 Suicides 4 ... ... ... ... 2 2 1 1 ... 1 1 5 All other causes 161 35 4 3 3 58 58 37 18 30 48 28 90 All causes 479 136 48 19 11 165 109 106 42 78 187 66 *281 *83 of these were Non-Parishioners. 105 TABLE XII.— SALE OF FOOD AND DRUGS ACTS. Samples Analysed during September Quarter, 1901. Genuine. Adulterated. Total. DAIRY PRODUCTS— Milk 57 — 57 Butter 18 — 18 Margarine 1 — 1 Lard 5 — 5 Cream 2 — 2 ALCOHOLIC BEVERAGES- Whisky 10 - 10 Brandy 0 — 6 Gin 4 — 4 Rum 1 — 1 NON-ALCOHOLIC BEVERAGES— Coffee 1 - 1 Tea 1 - 1 Cocoa 3 — 3 CONDIMENTS— Pepper 4 - 4 Mustard 4 — 4 Vinegar 1 — 1 Salt 1 — 1 TINNED & BOTTLED GOODS- Condensed Milk 3 -. 3 Lobster 1 - 1 Salmon 1 — 1 Sardines 4 - • 4 Bloater Paste 1 - 1 Herrings 1 — 1 Turkey and Tongue 1 — 1 Pines 3 - 3 Tomatoes 1 - 1 Tomato Sauce 1 — 1 SACCHARINE SUBSTANCES— Jam 5 5 Honey 1 — 1 Sweets 1 1 Golden Syrup 1 — 1 MISCELLANEOUS— 1 1 Cornflour 1 1 Lime Juice 1 1 Olive Oil 2 2 Capers 1 — 1 Ginger Wine 1 — 1 Eucalyptus Oil - - - 151 — 151 106 REGISTER OF SANITARY WORK Month ending 31st August, 1904. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. J. Hodges, No. District. Mr. A. Perry, No. 2 District. Mr. D. J. Andrews, No. 3 District. Mr. T. Gorniot, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. E. Lumley, Dust Inspector. Mr. R. Phillips, Special Duties. Miss F. A. Baker. Total. Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 20 3 23 Periodical Inspections : — ... ... ... ... ... ... ... ... ... ... ... Factories ... ... ... ... ... ... ... ... 3 ... 3 Workshops ... ... ... ... ... ... ... ... 39 4 43 Bakehouses ... ... ... ... ... ... ... ... 20 ... 20 Restaurants, &c. ... ... ... ... ... ... ... ... 35 ... 35 Homeworkers' Premises ... ... ... ... ... ... ... ... ... 11 11 Domestic Workshops ... ... ... ... ... ... ... ... ... ... ... Food and Drugs Act. ADULTERATION. Samples collected for Analysis 6 16 20 ... ... ... ... ... ... ... 42 Correspondence, Legal Procedure, &c. Complaints received 14 5 15 17 12 24 ... ... 13 4 104 Letters and Intimations relating to Abatement of Nuisances 18 12 29 30 5 10 ... ... ... 7 111 Statutory Notices Served ... ... ... ... 7 ... ... ... ... ... 7 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 21 21 20 35 10 15 ... ... 9 5 136 107 REGISTER OF SANITARY WORK Month ending August 31st, 1904. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. D. J. Andrews, No. 3 District. Mr. T. Gorniot, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. E. Lumley, Dust Inspector Mr. R. Phillips, Special Duties. Miss F. A. Baker. Total. Public Health (London) Act. Inspections. Dwelling Houses, &C. 32 34 25 30 16 ... ... ... ... ... 137 Tenements 28 12 29 15 13 ... ... ... ... ... 97 Underground Dwellings 22 25 7 12 ... ... ... ... ... 66 Dairies, Milk Shops, Cow Houses 4 3 ... 3 3 ... ... ... ... ... 13 Slaughter Houses 2 2 ... ... 1 ... ... ... ... ... 5 Yards, Stables, and Mews 29 12 30 40 27 ... ... ... ... ... 138 Smoke Shafts ... ... 6 ... ... ... ... ... 6 95 107 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... ... ... ... Refuse Receptacles 7 4 6 9 5 40 ... ... ... ... 71 Enquiries re non-removal of refuse 8 7 6 7 7 200 ... ... ... 2 237 Removal of Bodies to Mortuary ... 1 ... 1 ... ... ... ... ... ... ... 2 Visits to Works in progress 250 230 150 280 84 ... ... ... ... 8 1002 Miscellaneous Inspections 52 48 50 160 26 50 ... ... ... 52 438 UNWHOLESOME FOOD. Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE:— Cases Isolated... 1 ... 1 2 1 ... ... ... ... ... 5 Cases Removed to Hospital 13 ... 14 5 10 ... ... ... ... ... 42 Rooms Disinfected 20 ... 16 18 21 ... ... ... ... ... 75 NEW DRAINAGE:— ... ... ... ... ... ... ... ... ... ... ... Number of Plans Passed ... ... ... 11 ... ... ... ... ... ... 11 New Pipe Drains (feet) 1360 1320 950 940 1426 ... ... ... ... ... 5996 Houses where defects in existing Drainage have been detected and remedied 8 9 6 8 7 ... ... ... ... ... 38 108 REGISTER OF SANITARY WORK Month ending 30th September, 1904. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. D. J. Andrews No. 3 District. Mr. T. Gorniot, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. E. Lumley, Dust Inspector. Mr. R. Phillips, Special Duties. Miss F. A. Baker. Total Factory and Workshop Act. Enquiries as to Occupation 2 4 6 Periodical Inspections:— Factories 4 4 Workshops 39 18 57 Bakehouses 20 20 Restaurants, &C. 18 18 Homeworkers' Premises 8 36 39 Domestic Workshops... Food and Drugs Act. ADULTERATION. Samples collected for Analysis 24 4 24 30 82 Correspondence, Legal ProcedureAc. Complaints received 6 9 18 7 15 26 1 9 91 Letters and Intimations relating to Abatement of Nuisances 24 18 45 16 26 25 8 162 Statutory Notices Served 6 19 10 35 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 32 30 35 20 62 20 10 2 211 109 REGISTER OF SANITARY WORK Month ending 30th September, 1904. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. D. J. Andrews, No.3 District. Mr. T. Gorniot, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. E. Lumley, Dust Inspector. Mr. R. Phillips, Special Duties. Miss F. A. Baker. Total Public Health (London) Act. Inspections. Dwelling Houses, &c. 36 43 39 9 31 158 Tenements 30 35 16 28 109 Underground Dwellings 12 20 3 18 53 Dairies, Milk Shops. Cow Houses 13 3 20 2 14 52 Slaughter Houses 2 4 3 2 11 Yards, Stables, and Mews 33 8 35 30 46 152 Smoke Shafts 6 3 3 4 16 Offensive Trades and Effluvia Businesses Refuse Receptacles 6 4 0 8 9 30 62 Enquiries re non-removal of refuse 4 3 6 3 12 105 133 Removal of Bodies to Mortuary 2 2 Visits to Works in Progress 180 230 130 80 146 766 Miscellaneous Inspections 76 83 75 60 84 20 52 450 UN WHOLESOME FOOD:— Number of seizures made 1 1 INFECTIOUS DISEASE:— Cases Isolated 1 2 3 Cases removed to Hospital 10 2 18 7 12 49 Rooms Disinfected 18* 3 18 13 24 76 NEW DRAINAGE Number of Plans Passed 8 15 9 1 9 42 New Pipe Drains (feet) 984 986 830 630 1212 4642 Houses where defects in existing Drainage have been detected and remedied 12 16 10 3 11 52 THE SANITARY CHRONICLES OF THE B O R O UGH OF ST. MARYLEBONE DURING OCTOBER, 1904, 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. XXIV. 3, Upper Gloucester Place, W., Not. 5th, 1904. No. 9. The week ending October 1st was somewhat foggy. Minimum temperature, 38.8° maximum, 65.7°; mean, 52.1°. Winds variable. On two days slight rain fell (0.14 inch). Sunshine about 34 % of the possible. Mean barometer, 29.8 inches. The week ending October 8th was fairly fine and free from fog. Minimum temperature, 390°; maximum, 62.5°; mean, 47.1°. On two days slight rain fell (0'45 inch). Sunshine registered in Regent's Park 11 %. Mean barometer 30.2 inches. The week ending October 15th was cool and overcast with occasional fogs. Minimum temperature 35.0°; iraximum 57.0°; mean 50.6°. On one day only slight rain fell (0.01 inch). Winds easterly. Sunshine, 14.6%. Mean barometer, 30.0 inches. The week ending October 22nd was foggy. Minimum temperature 39.5°; maximum 64.1°; mean 56.8°. On three days rain fell (0.30 inch). Sunshine in Regent's Park only 3 %. Mean barometer, 29.8 inches. The week ending October 29th was fairly fine. Minimum temperature 40.5°; maximum, 59.0°; mean, 50.1°. On two days rain fell (0.28 inch) Winds W. and W.N.W. Sunshine, 28 %. Mean barometer, 30.0 inches. 112 Births and Deaths. During the five weeks ending October 29th there have been registered 281 births and 149 deaths. These births and deaths are divided among the five sub-districts as set forth in Table IV. Fifty-two of the deaths were extra-parochial, as follows:— St. Marylebone Infirmary, Notting Hill 34 St. Mary's Hospital 8 Western Fever Hospital 1 St. Bartholomew's Hospital 1 University College Hospital 2 St. George's Hospital 2 Royal Hospital for Incurables 1 Children's Hospital, Great Ortnond Street 1 Children's Hospital, Paddington 2 St. Pancras Infirmary 1 London Temperance Hospital 1 Cane Hill Asylum 2 London County Asylum 1 Total 52 Thee birth and death-rates, as deduced from the five weeks' statistics, are as follows:— All Souls, birth-rate 18.2; death-rate 0.94. Rectory, birth-rate 14.7 ; death-rate 11.0. St. Mary, birth-rate 30.4 ; dentil-rate 13.2. Christ Church, birth-rate 28.1 : death-rate 11.8 St. John, birth-rate 15.8 ; death-rate 14.3. The whole district, birth-rate 2T9; death-rate 11.6. The average death-rates for five years (1899 to 1903) for the corresponding period were as follows:- All Souls, 13.1; Rectory, 13.7; St. Mary, 14.2; Christ Church, 18.5; St. John, 14.3; the whole district, 14.9. 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: 113 TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE FIVE WEEKS ENDING OCT. 29TH, 1904, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 5 weeks ending Oct. 29th, 1904. Proportion ofthedeaths to 1,000 deaths from all causes. 5 weeks ending Oct. 29, 1904. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1897-1903. 1. Deaths from the chief Zymotic Diseases 9 60 0.70 2.06 2. Pulmonary, other than Phthisi.- 22 147 1.72 2.72 3. Tubercular 20 134 1.56 2.11 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza, Whooping Cough, Erysipelas, Croup, Fever, and Diarrhœa. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. The Public Health of the District during October. The climatic conditions of the month appear to have been favourable to health. The death and zymotic rates were singularly below the average, and the absence of anything approaching to an epidemic has again to be recorded. 114 TABLE II.— Giving the Causes of Deaths during the five weeks ending October 29th, 1904, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John and 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 .. .. .. .. .. .. Erysipelas .. .. .. .. l .. Pneumonia and Pleurisy 1 .. .. .. .. .. Pyaemia 1 .. .. .. .. .. Syphilis .. .. .. .. 1 .. Cancer 10 .. .. .. 2 1 Phthisis & Tuberculosis 4 .. .. .. 4 .. Rheumatism .. .. .. .. .. .. Apoplexy .. .. .. .. 1 .. Paralysis .. .. .. .. 3 .. Bronchitis .. .. .. .. 5 .. Asthma .. .. .. .. .. .. Peritonitis .. .. .. .. .. .. Disease .. .. .. .. .. .. „ Heart .. .. .. .. 1 .. ,, Kidney .. .. .. .. .. .. Liver .. .. .. .. l .. „ Uterus .. .. .. .. .. .. „ Ovary .. .. .. .. .. .. Parturition .. 1 .. .. .. .. Diabetes .. .. .. .. .. .. Fractures and Injuries .. .. .. .. l .. Old Age .. .. .. .. 8 .. Low Vitality, Infants .. .. .. .. .. .. Premature Birth .. .. .. .. .. .. Other causes 13 1 .. 1 5 .. Total *35 †3 •• 2 34 **1 * Of the 35 deaths in the Middlesex Hospital, 31 were those of non-parishioners. † The 3 deaths in Queen Charlotte's Hospital were those of non-parishioners. ** The death in St. John's Hospital was that of a non-parishioner. OCTOBER, 1904. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, TYPHOID FEVER, AND SMALLPOX DURING 1904. 115 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, 1904; classified according to Diseases, Ages, and Localities. (a) All Souls Recrory St. Mary Christ Church St. John Totals Population at all ages. (b)Census 1901 35,391 19,819 18,099 39,536 20,426 133,301 (c) Registered Births 62 28 53 107 31 281 (d) Aged under 5 or over 5 Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards New Casks of Sickness in bach Locality coming to the knowledge ok the mkdical Officer of Health. Chickenpox 3 4 .. 2 1 4 4 6 4 4 12 19 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 6 12 .. 2 1 4 6 9 2 5 15 32 8. Diphtheria 1 1 1 3 1 1 .. 1 2 2 5 8 4 Membranous Croup .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 2 .. 2 .. 3 .. .. .. .. .. 7 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas. 1 1 .. 7 .. 3 .. 6 .. 5 1 22 Number of such cases removed from their Homes il. the several Localities for Treatment in Isolation Hospitals. 1 Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 6 12 .. 1 1 2 6 8 1 2 14 25 3. Diphtheria .. .. .. 1 1 2 .. 1 2 1 3 5 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typbus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. 3 .. .. .. .. .. 3 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. .. .. 6 .. .. .. 1 .. 2 .. 9 116 TABLE IV,— District Births and Deaths for the five weeks ending october 29th, 1904. Population in 1891. Births. Deaths. Males. Fmlls. Males. Fmls. All Souls 35,391 33 29 15 17 Rectorv 19,849 16 12 7 14 St. Marv 18,099 28 25 8 15 Christ Church 39.536 52 55 19 26 St. John 20,426 14 17 17 11 Total 133.301 143 138 66 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. 117 TABLE V.— Causes of, and Ages at, Death during the five weeks ending October 29th, 1904, in the Borough of St. Marylebone. CAUSES OF DEATH. Deaths in whole District at subjoined Ages. Deaths in Localities (at all Ages ) Deaths in Public Institutions. All Ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. All Souls. Rectory. St. Mary. Christ Church. St. John. Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 1 ... ... 1 ... ... ... ... ... ... ... 1 ... Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria and Membranous Croup 1 ... 1 ... ... ... ... 1 ... ... ... ... ... Croup ... ... ... ... ... ... ... ... ... ... ... ... ... 'Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Enteric ... ... ... ... ... ... ... ... ... ... ... ... ... Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 1 ... ... ... ... 1 ... ... ... ... 1 ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea 4 4 ... ... ... ... ... ... 2 1 ... ... 2 Enteritis 1 ... 1 ... ... ... ... ... ... ... 1 ... ... Puerperal fever ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 1 ... ... ... ... ... 1 ... ... ... ... 1 1 Other Septic Diseases 1 ... ... 1 ... ... ... ... ... 1 ... ... 2 Phthisis 19 ... ... ... 3 16 ... 1 3 4 7 4 8 Other Tubercular Diseases 1 1 ... ... ... ... ... ... ... 1 ... ... 1 Cancer, Malignant Disease 9 ... ... ... ... 3 6 3 2 1 1 2 11 Bronchitis 18 ... ... ... ... 6 9 4 2 1 6 5 7 Pneumonia 4 ... 1 ... ... 3 ... ... ... 1 2 1 2 Pleurisy ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Respiratory Organs ... ... ... ... ... ... ... ... ... ... ... ... ... Alcoholism 3 ... ... ... ... 2 1 1 1 ... 1 ... 2 Cirrhosis of Liver Venereal Diseases 2 l ... ... ... 1 ... ... ... 2 ... ... 1 Premature Birth 1 ... ... ... ... ... ... ... ... ... 1 ... ... Diseases and Accidents of Parturition 3 ... ... ... ... 3 ... ... ... 1 2 ... 2 Heart Diseases 12 ... ... ... ... 5 7 2 3 2 4 1 7 Accidents 3 l ... ... ... 1 1 ... 1 1 1 ... 1 Suicides ... ... ... ... ... ... ... ... ... ... ... ... ... All other causes 64 14 3 ... 1 20 26 20 7 7 1 13 33 All causes 149 25 6 2 4 61 51 32 21 23 45 28 80* *35 of these were Non-Parishioners. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. J. Hodges, No. District. Mr. A. Perry, No. 2 District. Mr. D. J. Andrews, No. 3 District. Mr. T. Gorniot, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. E. Lumley, Dust Inspector. Mr. R. Phillips, Special Duties. Miss F. A. Baker. Total. Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 10 18 28 Periodical Inspections:— Factories ... ... ... ... ... ... ... ... 2 1 3 Workshops ... ... ... ... ... ... ... ... 49 90 139 Bakehouses ... ... ... ... ... ... ... ... 25 ... 25 Restaurants, &c. ... ... ... ... ... ... ... ... 30 ... 30 Homeworkers' Premises ... ... ... ... ... ... ... ... 5 59 64 Domestic Workshops ... ... ... ... ... ... ... ... ... ... ... Food and Drugs Act. ADULTERATION. Samples collected for Analysis ... 9 2 2 ... ... ... ... ... ... 13 Correspondence, Legal Procedure, &c. Complaints received ... 22 13 14 17 30 ... ... 8 12 116 Letters and Intimations relating to0 Abatement of Nuisances 22 16 33 46 29 20 ... ... ... 14 180 Statutory Notices Served 6 1 5 2 9 ... ... ... ... ... 23 Proceedings taken before Magistrates ... ... ... ... ... ... ... ... ... ... ... (1) Under Public Health Act 1 ... ... ... ... ... ... ... ... ... ... (2) „ Factory k Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) „ Food & Dr ugs Act ... ... ... ... ... ... ... ... ... ... ... Reports made to Medical Officer of Health 42 32 40 56 61 25 ... ... 39 4 29 BB 118 REGISTER OF SANITARY WORK Month ending 31st October, 1904. 119 REGISTER OF SANITARY WORK Month ending October 31st, 1904. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. ,T. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. D. J. Andrews, No. 3 District. Mr. T. Gorniot, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. F. Lumley, Dust Inspector Mr. R. Phillips, Special Duties. Miss F. A. Baker. Total Public Health (London) Act. Inspection**. Dwelling Houses, &c. 24 29 35 32 36 ... ... ... ... ... 166 Tenements 20 6 25 28 22 ... ... ... ... ... 101 Underground Dwellings 12 ... 15 5 11 ... ... ... ... ... 43 Dairies, Milk Shops, Cow Houses 8 3 10 3 3 ... ... ... ... ... 27 Slaughter Houses 2 5 2 ... 1 ... ... ... ... ... 10 Yards, Stables, and Mews 30 21 35 40 47 ... ... ... ... ... 173 Smoke Shafts ... ... 6 3 3 ... ... ... 6 4 22 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ......... ... ... ... Refuse Receptacles 8 7 6 9 7 20 57 Enquiries re non-removal of refuse 6 4 5 5 4 60 ... ... ... ... 84 Removal of Bodies to Mortuary ... ... 1 ... ... ... ... ... ... ... 1 Visits to Works in progress 140 179 150 270 172 ... ... ... ... 14 925 Miscellaneous Inspections 86 92 100 230 89 90 ... ... ... 79 766 UNWHOLESOME FOOD. Number of seizures made I 1 INFECTIOUS DISEASE:— Cases Isolated 1 ... ... 1 ... ... ... ... ... ... 2 Cases Removed to Hospital 15 4 24 13 18 ... ... ... ... ... 74 Rooms Disinfected 18 6 24 19 31 ... ... ... ... ... 98 NEW DRAINAGE:— Number of Plans Passed 1 4 12 6 14 ... ... ... ... ... 37 New Pipe Drains (feet) 760 926 850 899 1412 ... ... ... ... ... 4847 Houses where defects in existing Drainage have been detected and remedied 8 11 9 10 12 ... ... ... ... ... 50 THE SANITARY CRONICLES BOROUGH OF ST. MARYLEBONE DURING NOVEMBER 1904, 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. XXIV. 3, Upper Gloucester Place W., Nov. 10th, 1904. No. 10. The week ending November 5th was dry and gloomy. Minimum temperature, 45.0°; maximum, 56.0°; mean, 49.3°. Winds N.E. and S.W. On one day slight rain fell (0.01 inch). Sunshine in Regent's Park 8.3% Mean barometer, 30.1 inches. The week ending November 12th was wet. Minimum temperature 41.0°; maximum, 58.0°; mean, 50.0°. On six days rain fell, the total fall being l.44 inch. Winds S.W., Sunshine 17 6 % of the possible. Mean barometer, 29.8 inches. The week ending November 19th was cool and foggy. Minimum temperature, 33.5°; maximum, 55.0°; mean, 49.90. On one day slight rain fell (0.03 inch). S.E. and S.W. airs prevailed. The Sunshine registered in Regent s Park was only one-and-a-half hour. Mean barometer, 30.3 inches. The week ending November 26th was cold and wintry. Minimum temperature, 28.0° ; maximum, 46.1°; mean, 34.60. Winds W.N.W. On three days snow and rain fell, the total rainfall equalling 0.19 inch. Sunshine 13%. Mean barometer, 29.6 inches. 120 Births and Deaths. During the four weeks ending November 26th there have been registered 202 births and 174 deaths. These births and deaths are divided among the five sub-districts as set forth in Table IV. Eighty-six of the deaths were extra-parochial, as follows:— St. Marylebone Infirmary, Notting Hill 59 Western Fever Hospital,-Fulham 1 St. Mary's Hospital 7 Westminster Hospital 2 University College Hospital 2 West London Hospital 1 Brompton Hospital 2 Children's Hospital, Paddington 1 Children's Hospital, Great Ormond Street 1 London Temperance Hospital 1 Lying-in Hospital, Endell Street 1 Hanwell Asylum 1 London County Asylum, Norwood 2 London County Asylum, Friern Barnet 2 Friedenheim 1 In the Serpentine 1 In the streets 1 Total 86 The birth and death-rates, as deduced for the four weeks' statistics are as follows:— All Souls, birth-rate 11.8 ; death-rate 12.3. Rectory, birth-rate 14.7 ; death-rate 12.0. St. Mary, birth-rate 14.4; death-rate 11.5. Christ Church, birth-rate 21'0 ; death-rate 16.6. St. John, birth-rate 14.8 ; death-rate 13.7. The whole district, birth-rate 19.8 ; death-rate 13.6. The average death-rates for five years (1899 to 1903) for the corresponding period were as follows:— All Souls, 13.0 ; Rectory, 18.9 ; St. Mary, 18.5; Christ Church, 20.2; St. John, 16.0; the whole district, 16.9. 121 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 NOV. 26TH, 1904, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES:— Total Deaths. 4 weeks ending Nov. 26th, 1904. Proportion of thedeaths to 1,000 deaths from all causes. 4 weeks ending Nov. 26,1904. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1898-1903. 1. Deaths from the chief Zymotic Diseases 6 34 0.59 1.31 2. Pulmonary, other than Phthisis 47 276 4.59 3.70 3. Tubercular 26 149 2.54 2.34 NOTES. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza, Whooping Cough Erysipelas, Croup, Fever, and Diarrhoea. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. 122 The General Health of the District. Although the death rate as a whole is exceptionally low, yet the gloomy cold weather of November, with the irritating atmosphere inseparable from life in Cities in which coal tires are used, has raised the fatality from respiratory diseases to a figure far in excess of former years. The deaths from bronchitis, pneumonia and similar chest diseases average in a series of Novembers to about 3 7 per thousand of the population but during this last November the rate was 4 6 per thousand. Consumption was also more fatal than in former Novembers; the average rate is about 23. November, 1904 gave 2.5 per thousand. As some compensation the fatality of the infectious fevers has been low and the cases notified below the average. Appeal to the London County Council [Public Health (London) Act Section 41 (3)]. The London County Council has made bye-laws with respect to the construction of water closets and other matters, which bye-laws it is the duty of each local sanitary authority to enforce [Public Health (London) Act Sect. 39 (3)]. Should, however, any person feel himself aggrieved by any notice or act of a sanitary authority in relation to any water closet he may appeal to the County Council whose decision shall be final. The plans of important premises in Berners Street were disapproved by the Public Health Committee because in one of the back areas a water closet in the basement was shown approached from an open space less than live feet across. The words of the bye-law are, that the water closet must be approached directly " from an area or other open space available for purposes of ventilation 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." 123 The area in question had more than the forty superficial feet but was only four feet across. The architect appealed against the decision of the Public Health Committee and the appeal was heard before the London County Council Appeal Committee on December 6th. The appellant contended that since the closet faced the longest way of the area the words "a distance across of not less than five feet" were satisfied, because "across" in this instance meant the distance from the closet to the opposite wall. On behalf of the Borough Council it was argued that such a reading was inadmissible, that the words meant the least width from wall to wall of any part of the area ; that if the appellant was correct then a person looking up the street was looking across the street, and that if the appeal was allowed then if it were possible a person could fix a closet abutting on an area 2 feet wide and 20 feet long, for by these dimensions he would get forty feet superficial, and if the door of the closet opened on to and faced the longest dimension then it would be, according to the ideas of the appellant, more than five feet across. The Committee of the London County Council unanimously dismissed the appeal. 124 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 November, 1904; 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 40 28 25 80 29 202 (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 kach Locality coming to thk knowledge of the medical j Officf.b of Health. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina 4 6 1 4 1 .. 2 .. 1 1 9 15 8. Diphtheria .. 3 .. 4 5 .. 1 .. .. .. 6 7 4. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. 1 .. .. .. 2 .. .. .. 1 .. 4 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. k9 Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 \ Erysipelas. .. 4 .. 4 .. 1 .. 3 1 7 1 19 Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospitals. 1. Smallpox .. .. .. .. .. .. .. .. .. .. .. .. 2. scarlatina 4 6 1 3 1 1 3 1 .. 8 12 3. Diphtheria .. 3 .. 4 4 .. 1 .. .. .. 5 7 4. Membranous .. .. .. .. .. .. .. .. .. .. .. .. Fevers. 5, Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid .. .. .. .. .. 2 .. .. .. .. .. 2 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10 Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11 Erysipelas .. .. .. 1 .. 1 .. .. 1 1 1 3 NOVEMBER, 1904. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, TYPHOID FEVER, AND SMALLPOX DURING 1904. 125 TABLE III.— Giving the Causes of Deaths during November, 1904, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, the Hospital of St. John and Elizabeth, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital Queen Charlotte's Eospital. 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 3 .. .. .. 3 .. Pyæmia .. .. .. .. .. .. Syphilis .. .. .. .. 2 .. Cancer 12 .. .. .. 5 .. Phthisis & Tuberculosis 2 .. .. .. 15 2 Rheumatism .. .. .. .. .. .. Apoplexy .. .. .. .. 2 .. Paralysis .. .. .. .. 8 .. Bronchitis 1 .. .. 1 15 .. Asthma .. .. .. .. .. .. Peritonitis .. .. .. .. .. .. Dosease of Brain .. .. .. .. .. .. Heart 2 .. .. .. 2 .. „ Kidney .. .. .. .. .. .. „ Liver .. .. .. .. 1 .. „ Uterus .. .. .. .. .. .. ,, Ovary .. .. .. .. .. .. Parturition .. .. .. .. .. .. Diabetes .. .. .. .. .. .. Fractures and Injuries 1 .. .. .. 2 .. Old Age .. .. .. .. 2 .. Low Vitality, Infants .. .. .. .. .. .. Premature Birth .. 1 .. .. .. .. Other causes 10 2 .. .. 1 2 Total *31 †3 •• 1 59 **4 * Of the 31 deaths in the Middlesex Hospital, 22 were those of non-parishioners, † The 3 deaths in Queen Charlotte's Hospital were those of non-parishioners. ** The 4 deaths in St. John's Hospital were those of non-parishioners. 126 TABLE IV.— District Births and Deaths for the four WEEKS ENDING november 26th, 1904. Population in 1891. Births. Deaths. Males. Fmla Males. Fmls. All Souls 35,391 24 16 16 25 Rectory 19,849 17 11 17 6 St. Mary 18,099 12 13 11 9 Christ Church 39.536 40 40 37 26 St. John 20,426 15 14 14 13 Total 133,301 108 94 95 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. 127 TABLE V.— Causes of, and Ages at, Death during the four weeks ending November 26th, 1904, 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. Ail Souis. Rectory. St. Mary. Christ Church. St. John. Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria and Membranous Croup 1 1 ... ... ... ... ... ... 1 ... ... ... 1 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... Fever- Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric ... ... ... ... ... ... ... ... ... ... ... ... ... Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 1 ... ... ... ... 1 ... ... ... 1 ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea 3 1 ... ... ... ... 2 ... 2 1 ... ... l Enteritis 1 1 ... ... ... ... ... ... ... ... 1 ... ... Puerperal fever ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... Other Septic Diseases 3 ... ... ... ... 3 ... 1 ... 1 1 ... 3 Phthisis 22 ... 1 1 ... 19 1 2 5 ... 11 4 19 Other Tubercular Diseases 4 1 2 1 ... ... ... 1 1 1 1 ... 2 Cancer, Malignant Disease 12 ... ... ... 1 7 4 2 2 2 3 3 15 Bronchitis 31 8 1 ... 1 6 18 6 4 3 19 2 20 Pneumonia 12 5 1 ... ... 3 3 3 2 ... 5 2 5 Pleurisy 1 ... ... ... ... ... 1 ... ... ... ... 1 ... Other Diseases of Respiratory Organs ... ... ... ... ... ... ... ... ... ... ... ... ... Alcoholism Cirrhosis of Liver 3 ... ... ... ... 3 ... 1 ... ... 2 ... 2 Venereal Diseases 3 2 1 ... ... ... ... ... ... 1 1 1 2 Premature Birth 7 7 ... ... ... ... ... 1 ... 2 4 ... 2 Diseases and Accidents of Parturition ... ... ... ... ... ... ... ... ... ... ... ... ... Heart Diseases 15 ... 1 2 1 5 6 4 3 1 5 2 5 Accidents 6 2 3 ... ... ... 1 2 ... ... 1 3 5 Suicides 3 ... ... ... ... 2 1 ... ... 2 1 ... 3 All other causes 43 7 ... 1 1 17 17 18 3 5 8 9 31 All causes 174 35 10 5 4 66 54 41 23 20 63 27 116 28 of these were Non-Parishioners. 128 REGISTER OF SANITARY WORK Month ending 30th November, 1904. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. D. J. Andrews. No. 3 District. Mr. T. Gorniot, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. E. Lumley, Dust Inspecto Mr. R. Phillips, Special Dutios. Miss F. A. Baker. Total Public Health (London) Act. Inspections. Dwelling Houses, &c. 30 36 25 30 28 ... ... ... ... ... 149 Tenements 48 ... 52 25 39 ... ... ... ... ... 164 Underground Dwellings 18 ... 20 4 16 ... ... ... ... ... 58 Dairies, Milk Shops, Cow Houses 8 3 5 6 12 ... ... ... ... ... 34 Slaughter Houses 2 3 ... ... 2 ... ... ... ... ... 7 Yards, Stables, and Mews 32 19 25 40 36 ... ... ... ... ... 152 Smoke Shafts ... ... ... ... 3 ... ... ... 39 2 44 Offensive Trades and Effluvia Businesses ... ... ... ... ... ... ... ... ... ... ... Refuse Receptacles 10 6 5 9 11 30 ... ... ... ... 71 Enquiries re non-removal of refuse 4 3 6 6 11 155 ... ... ... ... 185 Removal of Bodies to Mortuary ...... ... ... ... ... ... ... ... ... ... ... Visits to Works in progress 168 363 150 270 171 ... ... ... ... 21 1143 Miscellaneous Inspections 84 46 75 120 86 25 ... ... ... 88 524 UNWHOLESOME FOOD. Number of seizures made ... ... ... ... ... ... ... ... ... ... ... INFECTIOUS DISEASE:— Cases Isolated 1 1 2 2 3 ... ... ... ... ... 9 Cases Removed to Hospital 2 1 11 10 13 ... ... ... ... ... 37 Rooms Disinfected 6 2 11 18 26 ... ... ... ... ... 63 NEW DRAINAGE:— Number of Plans Passed ... ... ... 9 7 ... ... ... ... ... 16 New Pipe Drains (feet) 1230 1570 930 870 1286 ... ... ... ... ... 5916 Houses where defects in existing Drainage have been detected and remedied 5 8 6 5 10 ... ... ... ... ... 34 129 REGISTER OF SANITARY WORK Month ending 30th November, 1904. PUBLIC HEALTH DEPARTMENT. District Inspectors. Mr. ,T. 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 Mr. E. Lumley, Dust Inspector. Mr. R. Phillips, Special Duties. Miss F. A. Baker. Total. Factory and Workshop Act. Enquiries as to Occupation ... ... ... ... ... ... ... ... 18 14 32 Periodical Inspections:- Factories ... ... ... ... ... ... ... ... 3 1 4 Workshops ... ... ... ... ... ... ... ... 75 77 152 Bakehouses ... ... ... ... ... ... ... ... 69 ... 69 Restaurants, &c. ... ... ... ... ... ... ... ... 30 ... 30 Homeworkers' Premises ... ... ... ... ... ... ... ... 12 68 80 Domestic Workshops ... ... ... ... ... ... ... ... 3 1 4 Food and Drugs Act. ADULTERATION. Samples collected for Analysis 30 18 21 18 18 ... ... ... ... ... 105 Correspondence, Legal Procedure, &e. Complaints received 10 10 10 14 12 28 ... ... 1 10 101 Letters and Intimations relating to Abatement of Nuisances 35 23 31 35 27 20 ... ... ... 20 191 Statutory Notices Served ... ... ... ... ... ... ... ... ... ... ... Proceedings taken before Magistrates ... ... ... ... ... ... ... ... ... ... ... (1) Under Public Health Act 2 ... ... ... ... ... ... ... ... ... 2 (2) „ Factory & Workshop Act ... ... ... ... ... ... ... ... ... ... ... (3) „ Food & Drugs Act 2 ... ... 2 ... ... ... ... ... ... 4 Reports made to Medical Officer of Health 38 36 35 60 56 15 ... ... 39 8 287 *