STR 5 ANNUAL REPORT on the STATISTICS and SANITARY CONDITION relating to the STRAND DISTRICT, of THE CITY OF WESTMINSTER FOR THE YEAR 1900. by FRANCIS J. ALLAN, M.D., C.M., D.P.H. CAMB., F.R.S. ED. medical officer of health. Printed by Order of the public health Committee. LONDON: DiPROSE, BATEMAN & CO., SHEFFIELD STREET, Lincoln's Inn Fields, W.C. m.d.occci. CONTENTS. page Summary of Statistics 4 Population 5 Births 6 Deaths 7 Causes of Death 9 Notifiable Infectious Diseases 10 Other Communicable Diseases 15 Disinfection 16 Children's Country Holiday Fund 16 Mortuaries 16 Sanitary Work 17 Smoke Nuisances 13 Overcrowding 18 Houses let in Lodgings 19 Legal Proceedings 19 Removal of Human Remains from St. Mary's Church, Charing Cross Road 20 Water-Gas 20 Workshops 22 Inspection and Analysis of Food 23 Departmental Committee's Report, on Milk and Cream 23 Alteration of Area 26 Transfer of Powers 27 Statistical Tables (Appendix) 29 TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE CITY OF WESTMINSTER. My Lords and Gentlemen, I have the honour to submit to you my Annual Report on the Health and Sanitary Condition of the Strand District during the year 1900. It contains the Statistical Tables required by the Local Government Board, and other tables from which an idea may be formed of the position the District occupies from a health point of view, as compared with London as a whole and its various groups of districts. In order that uniform Statistics for the year may be shown, I have reported as if the Strand District still existed up to the end of 1900, and have dealt separately with the alterations caused by the London Government Act, so far as these relate to this part of the City. The meteorological conditions during 1900 proved favourable to health, and except in the first few weeks of the year when an epidemic of influenza prevailed, death-rates were below the average. I have again to call attention to the great difficulty which those classes of the community who are compelled to live in Central London experience in finding accommodation I had hoped that the buildings which the County Council promised to erect, would have been ready for occupation before any large number of persons had been displaced from the Clare Market Area, but now many persons have had to quit their houses without such provision having been made, with the result that overcrowding has largely increased in the neighbourhood. Having lately presented a Special Report giving a view of the health conditions in the Strand District with a resume of the Statistics from the year 1855, I have not dealt as fully in this Report, with the causes which tend to produce a high death-rate in part of the District. It affords me much pleasure to express my satisfaction with the way in which the Sanitary Inspectors and other members of the staff of the Health Department have discharged their duties, and I take this opportunity of testifying to the loyal manner in which during my eight years of office under the Strand Board, they have at all times co-operated with me. I am, my Lords and Gentlemen, Your obedient Servant, FRANCIS J. ALLAN, Health Department, Medical Officer of Health. 5, Tavistock Street, W.C. 20th February, 1901. a 2 SUMMARY OF STATISTICS. Area of the Strand District (exclusive of water) Strand portion 113 acres St. Anne's „ 53 „ 166 acres. Population, estimated to the middle of 1900:— Strand portion 11,500 St. Anne's „ 12,000 23,500 Birth-Rates :— For 1900. Average of 10 years, 1890-99.) England and Wales 28.9 30.1 London 28.6 30.4 Strand District 20.1 23.0 Strand Sub-District 17.3 21.0 St. Anne's ,, 22.7 25.1 Death-Rates:— England and Wales 18.3 18.4 London 18.3 19.6 Strand District 18.6 23.0 Strand Sub-District 21.56 26.8 St. Anne's „ 15.75 19.1 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH of the STRAND DISTRICT of THE CITY OF WESTMINSTER. The following Report deals with the District as it existed under the Strand Board of Works, but special mention is made to deaths and cases of infectious disease which have occurred in those parts which have been the subject of transfer between the City of Westminster and the Borough of Holborn. Population. Prom the changes which are taking place in this District, it is impossible to determine with accuracy the figures which best represent the population of the District. The estimate of the Registrar-General, based upon the rate of decrease in tbe period between the last two census years, is, for tbe year 1900, 22,748; but to this figure there must be added those persons who are resident in the various Poor-Law establishments at Edmonton and elsewhere, and who add considerably to the deatb rate of the District. According to the return prepared under the 6 ON THE SANITARY CONDITION OF STRAND DISTRICT Equalisation of Hates Act, the Registrar-General estimates the population resident in this District as 23,654 (11,685 in St. Anne's, 11,969 in the Strand Sub-District), so that there is a difference of 906 between his two estimates. My own calculation of the population as at the middle of the year 1900, is 23,500, including inmates of the Poor-Law establishments connected with the District. This figure is divided into 11,500 for the Strand portion of the District, and 12,000 for St. Anne's portion, and is possibly too high an estimate. Births. The total number of births registered in the District was 446. This has to be corrected by the addition of 5 births in Poland Street Workhouse, 6 in Edmonton Workhouse, and 24, which I am informed through the courtesy of the Secretary, occurred in the British Lying-in Hospital, Endell Street; while 8 births in Bear-yard Workhouse have to be placed to the credit of St. Martiu-in-the-Fields parish, leaving a total of 473 births. The birth rate is thus 20.1 per 1,000 inhabitants, as against 21.2 in 1899. The birth rate in London for 1900 was 28.6 per 1,000; the average of the previous ten years was 30.4. Table I. shewing the corrected Number of Births (Male and Female) occurring in the Strand District, and each of its SubDistricts, in the Year ending December 31st, 1900. Male. Female. Total. Rate per 1,000 of Population in 1900. Average Rate per 1,000 in the 10 years 1890-99. 1. St. Anne's SubDistrict 139 134 273 22.7 25.1 2. Strand Sub-District 98 102 200 17.3 21.0 Strand District 237 236 473 20.1 23.09 7 OF THE CITY OF WESTMINSTER. Deaths. The total number of deaths, after correction,* which were registered as properly belonging to this District, during the year was 437. Parish. 1894. 1895. 1896. 1897. 1898. 1899. 1900. St. Anne, Soho 202 203 231 185 205 210 189 St. Clement Danes 201 254 216 220 244 232 190 St. Mary.le.Strand 49 42 45 35 47 33 28 St. Paul,Covent Garden 33 37 38 40 23 32 26 Precinct of the Savoy 2 8 3 5 2 2 1 Liberty of the Rolls 6 7 4 6 2 5 3 Strand District 493 551 537 491 523 514 437 Upon the basis of the estimated population already referred to, the death.rate for 1900 is 18.6 per thousand persons as compared with 23.05 per thousand, the average rate for the preceding ten years. The death.rates in the four quarters were as follows:— 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. London 24.3 18.1 17.7 16.5 Strand 25.9 19.8 12.8 15.6 The London rate for the year was 18.3 per 1,000, being 1.3 per 1,000 below the decennial average. * The correction above referred to consists in omitting all deaths which took place in hospitals and kindred institutions within this district of persons not properly belonging to it; and, on the other hand, of including every death of such of its inhabitants as has occurred in hospitals, infirmaries, lunatic asylums, &c. throughout the Metropolis generally, and also those of paupers belonging to the several parishes of which the district is constituted, which have happened in the workhouses of the Strand and Westminster Unions respectively. 8 ON THE SANITARY CONDITION OF STRAND DISTRICT TABLE I. Death Rates in the Groups of Metropolitan Districts in 1900, compared with those in the Strand. LONDON. ANNUAL RATE PER 1,000 LIVING. Small.Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus. Enteric Fever. Simple and Undefined Fever, Diarrhoea Phthisis. Deaths of Children under 1 year of age per 1,000 Births. Births. Deaths. principal Zymotic Diseases. West 23.7 16.5 1.83 — 0.47 0.06 0.23 0.22 0.00 0.13 0.00 0 70 1.47 164 North 26.3 16.4 1.97 0.00 0.36 0.06 0.29 0.46 — 0.17 0.00 0 .66 1.55 144 Central 27.8 22.2 2.13 — 0.47 0.11 0.23 0.51 — 0.12 — 0.68 2.81 169 East 35.4 21.8 2.88 — 0.56 0.10 0.44 0.56 — 0.17 0.00 1.02 201 177 South 29.2 17.1 2.19 0.00 0.36 0.01 0.37 0.45 — 0.15 0.00 0.77 1.62 156 All London 28.5 18.3 2.19 o.oo 0 42 0.08 0 34 0.42 0.00 0.15 0.00 0.77 1.71 159 Strand 20.1 18.6 1.27 . 0.25 0.04 0.12 0.21 . 0.17 — 0 .46 3.32 124 Sub.Dists. St. Anne.. 22.7 15.7 1.33 — 0.50 — 0.08 0.08 — 0.25 — 0.41 2.66 131 Strand 17.3 21.5 1.21 — — 0.08 0.17 0.34 — 0.08 — 0.52 4.00 115 Note.—Where the deaths under any heading are too few to express as a rate per 1,000 within two places of decimals, 0 00 is inserted; where no deaths have occurred, it is expressed thus — The Strand District formed one of the Central Group. Appended to this Report (pp. 30.37) are Tables required by the Local Government Board, together with Tables showing the causes of death in the Strand District, and in each of its Sub. Districts at various groups of ages, and distinguishing males and females, Tables V. to IX. From these Tables it may be seen that 495 deaths occurred in the District; 247 of these were of persons who did not belong thereto, and 189 persons belonging to the District died outside its bounds. 136 inhabitants of the District died in Poor Law Institutions, 11 in Lunatic Asylums, 4 in Fever Hospitals and 9 OF THE CITY OF WESTMINSTER. 67 in General and Special Hospitals; thus 49.6 per cent. of the deaths of residents occurred in Public Institutions (37 in St. Anne, 59 2 in Strand Sub.District); 29 1 per cent. of the deaths in all London were under similar circumstances. TABLE II. Deaths in the Strand District, 1900. Showing Locality at time of Death. Registration Sub.District. Sub. Districts. Workhouses and Infirmaries. General and Special Hospitals. Fever Hospitals. Lunatic Asylums. Totals. Males. Females. Males. Females. Males. Females. Males. Females. Males. Females. Males Females. Males and Females. St. Anne Soho 72 47 18 10 24 14 1 — i 2 116 73 189 Strand 53 47 59 49 13 16 3 — 3 5 131 117 248 Strand District 125 94 77 59 37 30 4 — 4 7 247 190 437 Causes of Death.—As in former years, deaths from diseases due to Tubercle (phthisis, scrofula, &c.), and from diseases affecting the Respiratory System occupy a prominent place. Tubercular disease killed 3.91 per 1,000 of the population in the Strand District in 1900, while for all London the rate was only 2.45. In St. Anne's the rate was 3.3, and in the Strand Sub.District it was as much as 4.5. The phthisis rates bear similar proportions. These rates are below the average in St Anne's but above it in the Strand Sub.District. (See p. 30 of Special Report, 1855.1900.) 21 per cent. of the total deaths were due to some form of tubercular disease. Respiratory Diseases.—Except in the first quarter of the year when Influenza was prevalent, the death.rate from diseases of the respiratory organs was below the average, yet more than one.fourth of the total deaths were registered under this heading. 10 ON THE SANITARY CONDITION OF STRAND DISTRlCT Notifiable Infectious Diseases. 149 certificates were received in 1900, relating to 140 cases of infectious disease. The amount paid for certificates during the year was £12. 14s., which is refunded by the Metropolitan Asylums Board. TABLE III. Cases notified per 1,000 resident population in 1900. Disease. London. Strand. St. Anne Sub-District. Strand Sub-District. Smallpox 0.01 — — — Scarlet Fever 3.01 3.52 4.91 1.92 Diphtheria & Membranous Croup 2.61 1.58 2.37 0.73 Typhus Fever 0.00 — — — Enteric Fever 0.93 0.44 0.50 0.36 Continued ,, 0.01 0.00 0.08 — Relapsing „ - — — — Puerperal ,, 0.05 — — — Cholera 0.00 — — — Erysipelas 1.03 0.39 0.50 0.27 Total 7.67 5.99 8.38 3.30 During 1900, no difficulty was experienced in obtaining admission of patients to hospital from the Strand District. 94 per cent. of the Scarlet Fever; 94.3 per cent. of the Diphtheria; 90.9 per cent. of the Enteric Fever; and 22.2 of the Erysipelas cases were so treated. 11 OF THE CITY OF WESTMINSTER. TABLE IV. Infectious Diseases notified, 1890—1900. In London. Year. Small Pox. Scarlet Fever. Diphtheria and Croup. Enteric Fever. Typhus Fever. Other Continued Fevers. Puerperal Fever. Erysipelas Cholera. Relapsing Fever. Totals. 1890 60 15,330 5,870 2,877 35 237 206 4,598 25 7 30,245 1891 114 11,398 6,412 3,372 27 152 221 4,764 23 39 26,552 1S92 423 27,095 8,356 2,465 20 147 347 6,934 54 7 45,848 1893 2.813 36,901 13,694 3,666 22 205 397 9,700 86 4 67,485 1894 1,192 18,440 11,190 3,360 21 162 253 6,080 21 2 40,925 1895 979 19,757 11,223 3,506 14 105 236 5,660 29 3 41,512 1896 225 25,647 13,911 3,190 6 103 279 6,438 13 3 49,845 1897 104 22,84S 13,199 3,103 4 65 264 5,800 38 1 45,361 1898 32 16,894 11,855 3,024 16 55 247 5,169 23 1 37,316 1899 29 18,113 13,704 4,463 14 69 330 5,615 15 1 42,353 1900 87 13,800 11,985 4,291 7 73 237 4,762 5 — 35,247 In the Strand District. 1890 — 60 10 13 — — — 10 — — 93 1891 — 33 13 19 — 1 1 12 — — 79 1892 7 111 33 12 — — 1 22 — — 186 1893 30 143 79 11 — — 1 22 — — 286 1894 5 52 30 15 — 1 — 11 — — 114 1895 5 116 36 24 — — — 17 — — 198 1896 — 130 36 9 — — 1 11 — — 187 1897 8 122 41 18 — — — 17 — — 206 1898 — 45 50 9 — — — 11 — — 115 1899 — 55 37 12 — — — 17 — — 121 1900 — 80 36 10 — 1 — 9 — — 136 12 ON THE SANITARY CONDITION OF STRAND DISTRICT TABLE V. Cases of Infectious Diseases notified during the year 1900, in the Strand District, and during the months of November and December in the portion added. Notifiable Diseases. Cases notified in the Strand District. Total Cases notified in each Sub-District. Number of Cases removed to Hospital. At all Ages. At Ages-Years Strand. St. Anne. Added portion. Strand. St. Anne. Added portion. Totals. 0 to 1 1 to 5 5 to 15 15 to 25 25 to 65 65 and upwards Small-pox — Diphtheria 35 1 13 6 5 10 8 27 8 25 33 Membranous Croup 1 1 1 Erysipelas 9 2 7 3 6 1 1 2 Fevers— Scarlet 83 10 39 23 11 21 58 4 19 56 3 78 Typhus — Enteric 11 3 5 3 1 6 1 4 5 1 10 Continued 1 1 1 Puerperal — — — — — — — — — — — — — — Total 140 1 23 49 36 31 - 36 99 5 32 87 4 123 Plague.—In the Autumn of 1900, considerable apprehension arose lest this disease should be imported into this country, and the Local Government Board issued an order making it compulsorily notifiable. Arrangements were made in London by the County Council, for the prompt identification and isolation of any cases, but fortunately none occurred. Scarlet Fever.—This disease was less prevalent in London in the year 1900, than has been the case in any year since 1891. In the Strand District, however, there were 80 cases notified; 13 OF THE CITY OF WESTMINSTER the larger proportion of these occurred in the parish of St. Anne, and were associated with an outbreak in connection with a police section house. After deducting 3 cases, 2 of which were reported as not being Scarlet Fever, and 1 as being Measles, there were in all 55 cases in that parish. Fortunately the disease was of a very mild type, and no deaths occurred. The remainder of the cases were in the Strand portion, and one of them proved fatal. There were 3 cases of this disease notified in the portion taken over from St. Giles' Parish. Diphtheria.—This disease was less prevalent in London, than in 1899. In the Strand District 35 c.ases were notified, 27 being in St. Anne's, and 8 in the Strand Sub-division. Three persons were, after removal to an Asylum's Board hospital, stated not to be suffering from Diphtheria, but it is evident that the persons must have been so suffering at the date of notification, as not only were there throat symptoms, but the Diphtheria bacillus was isolated by a competent bacteriologist. Two of these cases were in one family, two other members of which, were also suffering from the disease. In connection with these cases, the Strand Board considered there had been a want of care on the part of the authorities at a general hospital of which they were out-patients in not warning the mother of the danger which was suspected, and considerable correspondence took place with the result that the regulations of the institution, which if properly enforced, would have obviated any difficulty, have been since properly carried out, so far as any dealings with this District have been concerned. There were 3 fatal cases, 1 in St. Anne's, 2 in the Strand Sub-district. Mr. Cribb, the bacteriologist appointed by your Board, reports that during the year 1900 he has examined 4 specimens taken from the throats of persons suspected of suffering from Diphtheria, or desirous of knowing that they were free from infection after having been exposed thereto. In three instances the diphtheria bacillus was not found, in the other case it was discovered. Examination of expectoration was made in one case, to determine if the person was suffering from consumption of the lungs, but the tubercle organism was not found. 14 ON THE SANITARY CONDITION OF STRAND DISTRICT Enteric Fever.—The number of cases registered in London was again above the average, though less than in 1899 ; nearly half the total number of cases were notified in the three months October to December. Ten cases were notified in the Strand District, 6 being in St. Anne's (3 of them fatal), 4 in the Strand Sub-district (1 fatal); 1 case also occurred in the St. Giles' portion added to the City. There was also a case of "Continued Fever" notified, which was probably Enteric Fever. Of these 12 cases, 4 undoubtedly contracted the disease in the country, in 5 cases defective drains existed in the houses in which they lived, and in 3 cases the source of infection could not be ascertained. In five instances, the persons affected worked at hotels, restaurants or public houses. Erysipelas.—Nine cases were notified, with no deaths. Smallpox and Vaccination.—No case of Smallpox has occurred in this District since 1897. I am indebted to Mr. J. 11. Penfold and Mr. W. C. Hasted> Vaccination Officers respectively of Westminster Union and Strand Union, for the subjoined details relating to the performance of Vaccination in those parts of the above Unions included in the Strand District for the year 1899. 1899. Births. Successfully Vaccinated. Insusceptible. Died Unvaccinated. Vaccination Postponed. Removed and Address not known. Removed and V. O. informed. Conscientious Objections. Remaining. St. Anne 271 216 — 25 —. 27 — 2 l Strand 202 126 1 34 — 31 4 — 6 Totals 473 312 1 59 — 58 4 2 7 15 OF THE CITY OF WESTMINSTER. In addition to the compulsorily notifiable diseases, I have also obtained information from school teachers and others, of the existence of cases of Measles, Whooping Cough, Mumps, and Chickenpox, distributed as follows:— St. Anne's Sub-District. Strand Sub-District. Portion of St. Giles. Total. Measles 50 24 — 74 Whooping Cough 2 40 — 12 Mumps — 1 — 1 Chickenpox 2 1 3 6 Measles.—The occurrence of two deaths in St. Anne's Parish was the first indication I had that Measles was prevalent. I then found that 55 children were absent from St. Anne's School. Steps were at once taken to ascertain if any children were attending this or other schools, from an infected house, and notices were sent to teachers requesting their exclusion. These cases occurred in March and April. No cases occurred in the Strand Sub-District until May, and through prompt information being given, there were only a few cases. There were 6 deaths from this disease, all in St Anne's. Whooping Cough was prevalent in the Strand Sub-District from April to July, and 4 deaths occurred; 2 cases came to my knowledge in St. Anne's, 1 being fatal. Influenza was prevalent at the end of the year 1899, and continued into the first quarter of 1900, causing 10 deaths directly, besides adding largely to the death-rate through its effects on the respiratory organs. Diarrhceal Disease.—11 deaths occurred from Acute or Infantile Diarrhoea, as against 21 in the preceding year. The improvement which has been taking place in this District, as I have shown in previous reports, still continues. The rate for the 10 years 1890-99, was 0.64 per 1,000, for 1900, 0.46 per 1,000. 16 ON THE SANITARY CONDITION OF STRAND DISTRICT Disinfection. During the twelve months ending 31st December, 1900, 128 premises were purified and cleansed after infectious disease, and 3,438 articles were disinfected at Denzell Street. The use of formic aldehyde as a gas, or in the form of spray, substituted in place of sulphur fumigation, continues to give satisfaction. One important result has been the great reduction in the time inmates of rooms undergoing process of disinfection, have been kept out of them. With the present methods, the " Temporary Shelter " is less likely to be made use of, and during 1900, only 7 persons were admitted thereto. Cleansing of Persons Act.—Two persons applied during 1900. They were given a warm bath while their clothing was purified by being passed through the disinfecting apparatus. Children's Country Holiday Fund.—As in former years, I have supplied the Local Committees of this Fund with information as to the presence or absence of infectious disease in the houses of those children they proposed sending to the country for a fortnight's holiday. This was done during the months of June, July and August, and I have been able to supply more valuable information than hitherto, as the school teachers have been more careful to notify me of the occurrence of cases of Measles, Whooping Cough, &c. The Hon. Secretary of the Strand and St. Giles' Committee wrote to the late Board to acknowledge the help received by the Committee, and stating that 512 children had been sent away, and in no instance had any illness been conveyed to the districts in which they spent their holiday. Mortuaries in the District. During the year, the number of dead bodies received into the mortuaries in the Strand District were as follows:— 1899. Total number of Bodies. After Infectious Disease. Post-mortem examinations made. Strand Mortuary 55 1 30 St. Anne's „ 8 — — Total 63 1 30 17 OF THE CITY OF WESTMINSTER. Sanitary Work. The following list summarises the work carried out under the supervision of the Department during the year:— Number of visits paid by Sanitary Inspectors* 4,588 Preliminary notices served 273 Statutory Notices 37 Dwelling Houses :— Inspections* 698 Premises in which works have been carried out 270 Letters written 539 Overcrowding abated (by written notice) 20 Cleansed and Whitewashed Throughout 29 Partially 108 Ventilation improved, walls, ceilings and floors repaired 23 Roofs made water-tight 27 Water closets:— Reconstructed and repaired 53 Additional provided 16 Water re-instated 9 Flushing apparatus repaired 20 Obstructions removed from 18 New pans and traps provided 4 Pans and traps cleansed 61 Drainage:— New drains constructed 64 Drains repaired 11 Sink and lavatory waste pipes disconnected and trapped 12 Rain water pipes repaired 23 Obstructions removed from drains 16 Paving required or repaired:— In yards 26 In basements 18 *Exclusive of the weekly inspection of Registered Houses. B 18 ON THE SANITARY CONDITION OF STRAND DISTRICT Dust and dung removal:— Sanitary bins provided 15 Offensive refuse removed from premises 19 Water supply:— Cisterns repaired and cleansed 49 Re-instatement of water after being cut off by Water Company 4 Certificates granted under " Public Health (London) Act," Section 48 3 Under-ground rooms:— Use prevented as separate dwellings 7 The stables and mews, 42 in number, have been regularly inspected, more particularly in regard to the periodical removal of manure. There are no cowsheds or slaughter-houses in this district. Smoke Consumption.—Smoke nuisances coming under Subsection A, of Section 24 of the "Public Health Act," have been dealt with by your Surveyor; those under Sub-section B, have had four statutory notices served upon them through the Health Department. Orders made in regard to chimneys sending forth smoke so as to be a nuisance, have in each case been complied with. Overcrowding.—In my Annual Peport for 1898. I pointed out that many persons displaced from the Clare Market area were finding accommodation in adjoining houses which were quite unsuitable for letting out in tenements, and in my Report for 1899, referring to this matter, I expressed regret that the Council had not erected buildings on the sites in the vicinity acquired by them for the purpose of re-housing persons to be displaced. It is deplorable to have to report that while at least 1,200 persons have now been displaced, no buildings have yet been erected on the acquired sites, several of which have been lying vacant for a long period. Certainly, some blocks of buildings have been erected at Millbank, but I am informed, that none of the persons displaced from the Strand District have become tenants there. 19 OF THE CITY OF WEST MINSTER. The result has been that at every meeting of the late Board, instances of overcrowding had to be dealt with, and the staff has had much extra work in the prevention and abatement of nuisances. Houses let in Lodgings.—113 premises have been inspected under these By-laws during the year 1900, but a number of the houses are now being closed in connection with various schemes of improvement. From the weekly reports of Assistant Inspector Chamberlain, I find that with regard to the 62 registered houses in the Strand Sub-district complaint had to be made in 143 instances that the yards and passages were dirty, in 135 instances that the water closets were in a dirty condition, and in 2 instances that they were obstructed. Overcrowding was reported 3 times. In St. Anne's Parish with respect to 51 houses there were 159 complaints of dirty yards and passages, 117 of dirty water closets, 19 of obstructed water closets, and 8 of overcrowding. The owners or agents of the following premises were cautioned by the Board to exercise greater care in maintaining their premises in a cleanly condition:—On 4th July, in respect of Nos. 2, 4, 6, 8, 10 and 16, Meard Street and No 10, Craven Street, and on the 10th October, in respect of No. 10, Denzell Street, No. 22, Houghton Street, No. 20, Bateman Street, Nos. 8 and 16, Meard Street and No. 26, St. Anne's Court. Systematic Inspection of houses has gone on regularly throughout the year as required by the "Public Health Act." Houses so dealt with are situated in the following streets:— Frith Street, Floral Street, Henrietta Street, Meard Street, Soho Street, St. Anne's Court, and Newport Buildings. Legal Proceedings have been taken:— (1.) Against a firm of builders for permitting a house to be occupied before they had obtained a certificate that the house had a proper and sufficient supply of water. Penalty inflicted, 20s. and 2s. costs. (2.) Against a householder for discontinuing the watersupply of an adjacent tenant without lawful authority. Penalty inflicted, 20s. and 2s. costs. B 2 20 ON THE SANITARY CONDITION OF STRAND DISTRICT (3.) Against an owner of a dwelling house for failure to comply with statutory notice. The work was begun after the issue of the summons, and was eventually completed satisfactorily. The hearing of the summons was adjourned, and finally withdrawn on payment of costs. One builder was cautioned in respect of failure to notify the Board that he was about to erect new water closets, &c. The failure was believed to be due to an oversight and the work had been properly executed. Removal of Human Remains.—On the 11th July, 1900,I received a copy of an order made by the Home Secretary, requiring me to supervise the removal of human remains found beneath the floor of St. Mary's Church, Charing Cross Road, and to see that other work ordered was satisfactorily performed. This has been done, and I have certified to that effect. Two lead coffins and a quantity of loose bones were removed and reburied at Brookwood, and concrete has been laid over the area of the church which was not disturbed, and covered with asphalte. Water-Gas.—The attention of the late Board was directed to the fact that many Companies supplying coal gas were adding "water-gas" to it. Water-gas is a much more poisonous gas than ordinary coal gas, and fatal cases resulting from its use have been reported near Liverpool, in Belfast, and in America. A number of precautions to be observed in its use were issued in 1898 by a Departmental Committee, but the public generally are not aware that this gas is being supplied them, and that they are exposed to greater danger. The Health Committee reported to the Board as follows:— "The Committee have considered a report by che Medical "Officer of Health on the use of Carburetted Water Gas, "which is being added by certain companies to ordinary coal-gas. "Water-gas is four times as poisonous as ordinary coal-gas, and "the experience of towns in which it is in extensive use shows " that fatal accidents are much more likely to result therefrom. "No warning to the public, however, appears to be given by "the Gas Companies that they are sending out this gas, and the 21 OF THE CITY OF WESTMINSTER. "Committee are of opinion that users should be made aware of "the danger likely to result if escapes of this gas occur, either "from defective pipes, incomplete combustion, or from want of "proper ventilation to carry off the products of combustion and "unconsumed gas from stoves used for cooking and heating. "From a 'Return relating to all authorised Gas Undertakings " 'in the United Kingdom, other than those of Local Authorities, " 'for the year ending 31st December, 1898,' presented in "compliance with an Order of the House of Commons, and "dated May 16th, 1899, forwarded to the Committee by the 'Secretary and General Manager of the Gas Light and Coke "Company, in reply to an inquiry on this subject, it appears that "of the total quantity of gas sent out by the Company, 26 per "cent. was unmixed with water-gas. As regards the remainder, "73 per cent. contained a maximum proportion of 18 per cent. of "carburetted water-gas; 12 per cent contained a maximum "proportion of 26 per cent; 4 per cent. a maximum proportion "of 28 per cent.; and 11 per cent. a maximum proportion of 37 "per cent. "The Committee find that the Gas Examiners to the London "County Council, in the weekly report submitted to them, make "no mention of any examination being made as to the presence of "water-gas, and on enquiry the Committee find that the Gas "Examiners have no power to make such an examination." The Committee therefore instructed the Public Analyst for the District to test a number of samples of gas supplied to the District and he subsequently reported that the quantity of watergas present in the samples examined, did not exceed the amount (12 per cent.) laid down as permissible by the Departmental Committee. A memorandum was issued by the Chief Inspector of Factories from the Home Office, warning persons using water-gas for gas engines and heating purposes in factories and workshops, of its dangerous nature, and the precautions which should be taken to see that all fittings are frequently examined, and that effective ventilation is provided in order to carry off all fumes and unconsumed gas. 22 ON THE SANITARY CONDITION OF STRAND DISTRICT Workshops. The inspection of workplaces is the special duty of Inspector Martinson, and the nature of the employments chiefly carried out in the District are set out in the list prepared by him of the work done under this heading daring the year 1900. From the way in which dwellings and workplaces are united in the same building, it follows not infrequently, that the house as a whole has been inspected by Chief Inspector Strutt, so that works of re-drainage and such like may be included in the general list rather than under that of "Workshops." Number of inspections 714 „ visits 1,760 Letters written 90 Extra W.C. accommodation provided 4 Overcrowding abated 10 Premises cleansed 301 Ventilation improved 3 Number of outworkers 397 Premises notified to H.M. Inspector 16 „ from „ 6 Complaints from Home Office 4 There are now on the Register 300 Workshops, containing 841 workrooms, in which 3,021 males and 1,003 females are employed. These numbers are exclusive of shops, offices and Covent Garden Market, and show an increase on preceding years. Bakehouses.—The bakehouses have been regularly inspected. The number in the District has been reduced from 24 to 23. Laundries.—There are 20 in the District, and they have been inspected from time to time. Printing Offices have increased to 120. Tailors' workshops, to the number of 90, are on the Register, but this is a constantly varying number, as those engaged in this class of work in a small way, frequently change their place of abode. 23 OF THE CITY OF WESTMINSTER. Inspection and Analysis of Food. The street markets have been inspected every day (including Sundays) and the following list shows the kind and quantity of the food-stuffs which has been condemned during the year :— Bananas 482 crates Asparagus 42 bundles Cherries 17½ cwt Cauliflowers 2 crates Figs 25 baskets French Beans 366 baskets Lemons 13 cases Garlic 175 bags Oranges 56 „ Potatoes 57 cwt. Peaches 2½ cwt Rabbi Tops 74 bags Pears 29 „ Rape Tops 14 „ Plums 167 „ Radishes 27 crates Raspberries 21 ,, Tomatoes 246 boxes Sloes 24 boxes Turnip Tops 462 bags Strawberries 9½ cwt This does not represent all the damaged food-stuffs disposed of, as much refuse fruit and vegetables are collected in Covent Garden Market in the special carts provided for the purpose. Sale of Food and Drugs Acts.—The Acts relating to the sale of food and drugs have been systematically enforced throughout the District as in former years under the supervision of your Health Committee, and from the report of the Public Analyst it will be seen that a large and varied number of articles have been examined by him. Departmental Committee on Milk and Cream. The sale of Food and Drugs Act, 1899, Section 4, gave power to the Board of Agriculture to prescribe what deficiency, if any, in the normal constituents of genuine milk or cream, or what addition of extraneous matter, or proportion of water, in any sample of milk (including condensed milk) or cream, should for the purposes of the Act, and its predecessors raise a presumption, until the contrary is proved, that the milk or cream is not genuine. The Board appointed a Committee to consider and report upon this question. Their report (January 16th, 1901,) is now issued. 24 ON THE SANITARY CONDITION OK STRAND DISTRICT After an exhaustive inquiry, the Committee recommend:— I. That regulations under Section 4, of the Food and Drugs Act, 1899, be made by the Board of Agriculture. II. (a) That in the case of any milk (other than skimmed, separated, or condensed milk) the total milk-solids in which on being dried at 100 degrees Centigrade do not amount to 12 per cent. a presumption shall be raised, until the contrary is proved, that the milk is deficient in the normal constituents of genuine milk. (b) That any milk (other than skimmed, separated, or condensed milk) the total milk-solids in which are less than 12 per cent., and in which the amount of milk-fat is less than 3.25 per cent., shall be deemed to be so deficient in milk-fat as to raise a presumption, until the contrary is proved, that it has been mixed with separated milk or water, or that some portion of its normal content of milk-fat has been removed. In calculating the percentage amount of deficiency of fat the analyst shall have regard to the above-named limit of 3.25 per cent. of milk-fat. (c) That any milk (other than skimmed, separated, or condensed milk) the total milk solids in which are less than 12 per cent., and in which the amount of non-fatty milk-solids is less than 8 5 per cent., shall be deemed to be so deficient in normal constituents as to raise a presumption, until the contrary is proved, that it has been mixed with water. In calculating the percentage amount of admixed water the analyst shall have regard to the above-named limit of 8.5 per cent., of non-fatty milk-solids, and shall further take into account the extent to which the milk-fat may exceed 3.25 per cent. III. That the artificial thickening of cream by any addition of gelatine or other substance shall raise a presumption that the cream is not genuine. IY. That any skimmed or separated milk in which the total milk-solids are less than 9 per cent., shall be deemed to 25 OF THE CITY OF WESTMINSTER. be so deficient in normal constituents as to raise a presumption, until the contrary is proved, that it has been mixed with water. V. That any condensed milk (other than that labelled "machine-skimmed milk" or "skimmed milk," in conformity with Section 11 of the Food and Drugs Act, 1899) in which either the amount of milk-fat is less than 10 per cent., or the amount of non-fatty milksolids is less than 25 per cent., shall be deemed to be so deficient in some of the normal constituents of milk as to raise a presumption, until the contrary is proved, that it is not genuine. mmittee further recommend:— (a) That it is desirable to call the attention of those engaged in the administration of the Food and Drugs Acts to the necessity of adopting effective measures to prevent any addition of water, separated or condensed milk, or other extraneous matter, for the purpose of reducing the quality of genuine milk to any limits fixed by regulation of the Board of Agriculture. (b) That it is desirable that steps should be taken with the view of identifying or "ear-marking" separated milk by the addition of some suitable and innocuous substance, and by the adoption of procedure similar to that provided by Section 7 of the Food and Drugs Act, 1899, in regard to margarine. (c) That it is desirable that, so far as may be found practicable, the procedure adopted in collecting, forwarding, and retaining pending examination, samples of milk (including condensed milk) and cream under the Food and Drugs Acts should be uniform. (d) That it is desirable that, so far as may be found practicable, the methods of analysis used in the examination of samples of milk (including condensed milk) or cream taken under the Food and Drugs Acts should be uniform. 26 ON THE SANITARY CONDITION OF STRAND DISTRICT (e) That it is desirable in the case of condensed milk (other than that labelled "machine-skimmed milk," or "skimmed milk," in conformity with Section 11 of the Food and Drugs Act, 1899), that the label should state the amount of dilution required to make the proportion of milk-fat equal to that found in uncondensed milk containing not less than 3.25 per cent. of milk-fat. (f) That it is desirable in the case of condensed whole milk to limit, and in the case of condensed machine-skimmed milk, to exclude, the addition of sugar. (g) That the official standardising of the measuring vessels commercially used in the testing of milk is desirable. Alteration of Area. By the London Government Act the following premises were transferred on the 9th November, 1900, from St. Giles' Parish to the Parish of St. Clement Danes in the Strand District:— Kemble Street, south-side, Nos. 1 to 28. Sheffield Street, Nos. 1, 2, 11 and 12. Portsmouth Street and Place. Drury Lane, No. 122. Lincoln's Inn Fields, south-side, Nos. 30a, to 49a. Stanhope Street, No. 36. And to the Parish of St. Martin in-the-Fields :— Drury Lane, Nos. 141 to 154. Great Wild Street, Nos. 2 to 7. Great Queen Street, Nos. 46 and 47. Peabody Buildings, Great Wild Street. There has also been transferred from the Strand to St. Giles' Parish in the Borough of Holborn:— Sardinia Street, Nos. 3 to 21. Carey Street Nos. 51 to 60, and New Square. 27 OF' THE CITY OF WESTMIN STER. By these alterations the City gains 1,850 persons to its population, and loses 200, leaving a net gain of 1,650; of which 1,500 persons are added to Covent Garden Ward, 150 to the Strand Ward. In the area transferred to the City there are 5 work-places, and 27 houses were registered by the late Board of Works for the District of St. Giles under old regulations which they had for houses let in lodgings. In the area transferred to the Borough of Holborn, there were two work-places and two houses registered under the By-laws. Deaths.—Two deaths occurred during the two months subsequent to the transference; both were in Peabody Buildings. One death in Sardinia Street has to be transferred to Holborn. Infectious Disease.—3 cases of Scarlet Fever, 1 of Enteric Fever, and 3 of Chickenpox occurred in the new part of the City. Transfer of Powers. The County Council have forwarded lists of dairies, milkshops, cowhouses, slaughter-houses, and premises where offensive trades are carried on in the City of Westminster, the City Council being now responsible for the registration, inspection, &c., of such premises. On the 9 th November, there were according to the County Council's list, in the Strand part of the City, 59 dairies and milkshops, and 1 tripe-boiler; there were no slaughterhouses, or cowhouses. Milkshops. —On inspection of the premises mentioned in the Register, it was found that the sale of milk had been discontinued at three premises mentioned therein, and that milk was being sold by retail at three general shops which were not mentioned in the Register. On notice being served to require registration, the sale of milk was discontinued at one shop, and the other two were registered. It had been the custom of the County Council not to register shops where light refreshments were sold, but the Health Committee having considered the 28 ON THE SANITARY CONDITION OF STRAND DISTRICT matter, resolved that such places where milk was sold should be registered, and accordingly 13 shops have been added to the list. Offensive Trades.—A complaint was received from the County Council immediately after the transfer, relative to the insanitary condition of the above mentioned tripe-boiler's premises. These are only rarely used, and are unfit to be so used. As the building in which they are situated is shortly to be pulled down in connection with the Holborn to the Strand Street, the Public Health Committee accepted an undertaking from the owners, that they would not use the premises again without the sanction of the Committee, meanwhile the premises were thoroughly cleansed. APPENDIX. 1. Births and Deaths (Gross Numbers). 2. „ ,, (Nett ,, ). 3. Summary of Causes of Death. 4. Local Government Board Returns. (A. & B.) 30 APPENDIX. TABLE VI. THE CITY OF WESTMINSTER. For Strand District. Year. Population estimated to Middle of each Year. Births. Deaths under One Year of Age. Deaths at all Ages. Total. Deaths in Public Institutions. Deaths of Nonresidents registered in District. Deaths of Residents registered beyond District. Deaths at all Ages. Nett. Number. Rate.* Number. Rate per 1.000 Births registered. Number. Rate.* Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1890 26,300 560 21.29 138 246 685 26.0 229 — - 654 24.82 1891 25,692 640 24.90 136 212 677 26.3 306 — — 696 27.08 1892 25,493 590 23.14 125 211 674 26.4 259 — — 640 25.10 1893 25,288 607 24.00 125 205 686 27.1 298 259 244 671 26.57 1894 25,084 556 22.16 96 172 527 21.0 215 204 170 493 19.65 1895 24,879 618 24.83 105 170 612 24.6 271 260 199 551 22.14 1896 24,673 578 23.36 108 186 550 22.2 260 229 216 537 21.71 1897 24,480 580 23.69 91 156 552 22.5 250 268 206 491 20.01 1898 24,400 542 22.21 86 158 539 22.1 264 236 220 523 21.43 1899 24,000 510 21.20 82 180 544 22.7 250 241 211 514 21.4 Averages for years 1890-1899 25,028 578 23.09 110 190 604 24.1 260 — — 577 23.04 1900 23,500 473 20.1 59 124 495 21.0 218 247 189 437 18.5 * Rates calculated per 1,000 of estimated population. Note.—The deaths included in Column 7 of this table are the whole of those registered during the year as having actually occurred within the district. The deaths included in Column 12 are the number in Column 7, corrected by the substraction of the number in Column 10 and the addition of the number in Column 11. Area of District in acres (exclusive of area covered by water) 166 Total resident population at all ages 23,782 Number of inhabited houses 2,601 At Census Average number of persons per house 9.1 of 1896 31 APPENDIX. TABLE VII. THE CITY OF WESTMINSTER. Births and Deaths in the Strand District and its Sub-Districts. Names of Localities. 1.—THE STRAND DISTRICT. 2.—STRAND SUB-DISTRICT. 3.—ST. ANNE'S SOB-DISTRICT. Year. Population estimated to middle of each Year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each Year. Births registered. J Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. a. b. c. d. a. b. c. d. a. b. c. d. 1890 26,300 560 654 138 13,500 239 367 64 12,800 321 287 71 1891 25 692 640 696 136 13,270 306 103 71 12,422 331 293 65 1892 25,493 590 640 125 13,115 280 379 58 12,378 310 261 67 1893 25,288 607 671 125 12,954 277 393 67 12,334 330 278 58 1894 25,084 556 493 96 12,794 268 291 55 12,290 288 202 11 1895 24,879 618 551 105 12,633 294 348 57 12,246 324 203 48 1896 24,673 578 537 108 12,173 286 306 50 12,200 292 231 58 1897 24,480 580 491 91 12,330 266 306 52 12,150 314 185 39 1898 24,400 542 523 86 12,250 252 318 47 12,150 290 205 39 1599 24,000 510 514 92 11,900 214 304 53 12,100 296 210 40 Averages of Years 1890 to 1899. 25,028 578 577 110 12,721 268 341 57 12,307 309 235 53 1900 23,500 473 437 59 11,500 200 248 23 12,000 273 189 36 32 appendix. appendix. 33 TABLE VIII. SUMMARY OF CAUSES OF DEATH IN THE STRAND DISTRICT IN 1900. CAUSES OF DEATH. Total Deaths AGE AT TIME OF DEATH. REGISTRATION SUB-DISTRICTS. Totals. Under 1 year. 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 and up. St. Anne. Strand. Males Females. Males. Females. Males. Females. Males. Females. Males. Females. Males. Females. Males. Females. Males. Females. Males. Females. Males. Females. Males. Females. Males. Females. Males. Females. I.—SPECIFIC FEBRILE, OR ZYMOTIC DISEASES - 1. Small-pox - - - - - - - - - - - - - - - - - - - - - - - - - - Measles 6 1 - 1 3 1 - - - - - - - - - - - - - - - 3 3 - - 3 3 Scarlet Fever 1 - - 1 - - - - - - - - - - - - - - - - - - - 1 . 1 - Whooping Cough 5 4 - - - - - - - - - - - - - - - - - 1 - 3 1 4 1 Diphtheria 3 — — 2 1 - - - - - - - - - - - - - - - - 1 - 1 1 2 1 Enteric Fever 4 - — - - - 1 1 - 2 - - - - - - - - - - - 2 1 1 - 3 1 Influenza 10 - - - - - - - - - 1 - - 1 - 5 - - 2 - 1 - 1 6 3 6 4 Other Miasmatic Diseases 1 - - - - - - 1 - - - - - - - - - - - - - - - 1 - 1 - 2. Diarrhœal Diseases 11 2 7 - - - - - - - - - - 1 - - 1 - - - - 2 8 1 5 3 8 3. Malarial ,, - - - - - - - - - - - - - - - - - - - - - - - - - - - 4. Zoogenous ,, — - - - - - - - - - - - - - - - - - - - - - - - - - - 5. Phthisis „ 78 1 - 1 2 - - 4 2 14 5 16 9 10 5 4 1 - 2 1 1 23 9 28 18 51 27 Other Tubercular Diseases 14 1 3 5 2 2 1 - - - - - - - - - - - - - - 6 2 2 4 8 6 6. Venereal ,, 5 2 1 - 1 - - - - - - - 1 - - - - - - - - 2 1 - 2 2 3 7. Septic 3 1 - - - - 1 - - - - 1 - - - - - - - - - 1 - 1 1 2 1 II. PARASITIC DISEASES - - - - - - - - - - - - - - - - - - - - - - - - - - - III.—DIETIC DISEASES 9 1 1 - - - - - - - - 2 1 2, - 1 1 - - - - 3 1 8 2 6 3 IV.—CONSTITUTIONAL DISEASES Malignant Disease 20 - - 1 - - - - - 1 - - 2 2 4 - 2 2 3 1 2 4 4 3 9 7 13 Acute Rheumatism 2 - - - - - 1 - 1 - - - - - - - - - - - - - 1 - 1 - 2 Rheumatism and Gout — - - - - - - - - - - - - - - - - - - - - - - - - - Other Constitutional Diseases 2 - - - - - - - - - - - - 1 - - - - - 1 - 1 - 1 - 2 - V.—LOCAL DISEASES— 1. Convulsions and Dentition 3 1 1 - 1 - - - - - - - - - - - - - - - - - 2 1 - 1 2 Other Diseases of Nervous System 38 2 — - 1 - - - 1 1 1 2 — - 5 2 4 5 9 1 4 4 6 9 19 13 25 2. Diseases of Circulatory System 39 — — 1 - - — - - 3 2 2 1 5 3 6 3 4 4 1 4 8 7 14 10 22 17 3. Diseases of Respiratory System 103 9 2 4 5 - 2 2 - 2 — 4 2 9 2 10 9 10 12 11 8 33 16 28 26 61 42 4. Diseases of Digestive System 17 — — 1 - 1 - - - - 2 1 2 1 2 2 1 1 — 1 2 2 5 6 4 8 9 5. Diseases of Urinary System 9 — — - - - - - - 1 — 1 1 1 1 2 — 2 — - — 5 1 2 1 7 2 6. Diseases of Reproductive System 1 - - - - - - - - - - - - - - - - - - - - - - - 1 - 1 7. Diseases of Bones and Joints 1 - - - - - - - - - - - - - - 1 - - - - - - - 1 - 1 - 8. Diseases of Integumentary System 1 — 1 - - - - - - - - - - - - - - - - - - - - - 1 — 1 9. Diseases of Organs of Special Sense 1 - - - - - - - - - - - - - - - - - - - - - - - - - 1 10. Diseases of Gland like Organs - - - - - - - - - - - - - - - - - - - - - - - - - - - 11. Diseases of Lymphatic System - - - - - - - - - - - - - - - - - - - - - - - - - - - VI.—DEVELOPMENTAL— Debility at Birth 13 9 3 1 - - - - - - — - - - - - - - - - — 5 2 5 1 10 3 Old Age 22 - - - - - - - - - - - - - - 1 — 2 — 10 9 5 5 8 4 13 9 VII.—ACCIDENT AND VIOLENCE 14 4 2 1 1 - 1 2 - 1 - 1 — - - - - - 1 - — 4 2 5 3 9 5 VIII—PLUMBISM 1 — — — — — — 1 — — — — — — — — — — — — — 1 — — — 1 — Totals 437 38 21 19 18 4 7 11 4 25 11 30 19 33 22 34 24 26 33 27 31 116 73 131 117 247 190 C Local Government Board. Form A. TABLE IX. SUMMARY OF TABLES and showing DEATHS during the Year 1900, in the Metropolitan Sanitary District of STRAND, classified acccording to Diseases Ages, and Localities. Names of Localities adopted for the purpose of these Statistics; Public Institutionsbeing shown as separate localities. (Columns for Population and Births are in Form b.) Mortauty from all causes, at subjoined Ages. Mortality from subjoined causes, distinguishing Deaths of Children under Five Years of Age. At all ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhœa and Dysentery. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease. Injuries. All other Diseases. total. Typhus. Enteric or Typhoid. Continued Relapsing Puerperal. (a) (b) (c) (d) (e) (f) (g) (h) (i) Strand District 227 53 25 5 7 89 48 Under 5 5 5 10 2 19 4 33 78 5 upwds 1 1 1 1 34 43 14 4 50 149 In Hospitals, &c., in District 268 23 20 17 16 170 22 Under 5 2 1 3 4 3 12 2 16 43 5 upwds 8 1 1 3 17 21 30 16 128 225 TOTALS 495 76 45 22 23 259 70 Under 5 2 6 8 14 5 31 6 49 121 5 upwds 9 2 2 4 51 64 44 20 178 374 The subjoined numbers have also to be taken into account in judging of the above records of mortality. Deaths occurring outside the district among persons belonging thereto 189 5 9 2 6 101 66 Under 5 3 1 1 1 8 14 5 upwds 3 1 38 37 18 2 76 175 Deaths occurring within the district among persons not belonging thereto 247 24 15 13 14 161 20 Under 5 1 1 3 5 3 12 1 13 39 5 upwds 8 1 1 2 16 17 28 16 119 208 2c Local Government Board. Form A. TABLE IXa. Table of DEATHS during the Year 1900, in the STRAND Sub-District, classified according to Diseases, Ages and Localities. Names of Localities adopted for the purpose of these Statistics; Public Institutions being shown as separate localities. ( Columns for Population and Births are in Form B.) Mortality from all causes, at subjoined Ages. Mortality from subjoined causes, distinguishing deaths of Children under Five Years of Age. At all ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25, 25 and under 65. 65 and upwards. 1 2 3 4 5 1 6 1 7 1 8 1 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Smallpox. Scarlatina. Diphtheria. Membranous Croup. Typhus. Fevers. Puerperal. Cholera. Erysipelas. | Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease Injuries. All other Di seases. TOTAL. Enteric or Typhoid. Continued |Relapsing, (a) (b) (c (d) (e) (f) (g) (h) Strand Sub-District 105 19 6 1 3 50 26 Under 5 4 4 1 3 2 11 25 5 upwds 1 19 22 8 3 27 80 Strand Union Casual Wards, Bear Yard 15 14 1 Under 5 5 upwds 1 2 7 2 3 15 King's College Hospital 205 21 20 16 14 117 17 Under 5 2 1 3 4 3 12 1 15 41 5 upwds 8 1 3 14 13 26 11 88 164 St. Peter's Hospital 20 18 2 Under 5 5 upwds 1 19 20 River Thames 6 1 1 1 2 1 Under 5 1 1 5 upwds 5 5' TOTALS 351 41 26 18 18 201 47 Under 5 2 1 7 8 4 15 4 26 67 5 upwds 8 1 2 3 36 42 36 19 137 284 The subjoined numbers have also to be taken into account in judging of the above records of mortality. Deaths occurring outside the district among persons belonging thereto 119 1 4 1 63 50 Under 5 2 3 5 5 upwds 1 1 24 25 11 ] 51 114 Deaths occurring within the district among persons not belonging thereto 222 21 15 13 13 141 19 Under 5 1 1 3 4 3 12 1 11 36 5 upwds 8 1 1 2 16 16 25 16 101 186 Local Government Board. Form A. TABLE IXb. Table of DEATHS during the Year 1900, in the ST. ANNE'S Sub-District, classified according to Diseases, Ages and Localities. Names of Localities adopted for the purpose of these Statistics; Public Institutions beingshown as separate localities. (Columnsf or Population and Births are in Form B.J Mortality from all causes, at subjoined Ages. Mortality from subjoined causes, distinguishing deaths of children under Five Years of Age. At all ages. U uder 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and u p wards. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia and Pleurisy, Heart Disease. Injuries. All otherj Diseases. TOTAL. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a.) (*) (e) (d <«) (/) (9) (h) (i) St. Anne's Sub-District 122 34 19 4 4 39 22 Under 5 5 1 6 1 16 2 22 53 5 upwds 1 1 1 15 21 6 1 23 69 Hospital for Women, Soho Square 17 1 1 15 Under 5 1 1 5 upwds 16 16 Hospital for Diseases of the Heart, Soho Square 4 3 1 Under 5 5 upwds 1 o 1 4 Lock Hospital 1 1 Under 5 5 upwds 1 1 TOTALS 144 35 19 4 5 58 23 Under 5 5 1 6 1 16 2 23 54 5 upwds 1 1 1 15 22 8 1 41 90 The subjoined numbers have also to be taken into account in judging of the above records of mortality. Deaths occurring outside the district among persons belonging thereto 70 4 5 2 5 38 16 Under 5 1 1 1 1 5 9 5 upwds 2 14 12 7 1 25 61 Deaths occurring within the district among persons not belonging thereto 25 3 1 20 1 Under 5 1 2 3 5 upwds 1 3 18 22 Local Government Board. Form B. TABLE X. Table of POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, during the year 1900 (52 weeks) in the Metropolitan Sanitary District of STRAND, classified according to Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics; Public Institutions being shown as separate localities. Population at all Ages. Registered Births. Aged under 5 or over 5. New Cases of Sickness in each Locality, coming to the knowledge of the Medical Officer of Health. Number of such cases removed from their homes in the several Localities for treatment in Isolation Hospital. Census1896. Estimated to I middle of 1899. 1 2 3 4 5 6 7 8 1 9 10 11 1 2 3 4 5 | 6 | 7 | 8 | y 10 11 Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. TOTALS. Smallpox. Scarlatina. Diphtheria. j Membranous Croup. Fevers. Cholera. Erysipelar. TOTALS Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a) (b) (c) (d) (e) SUB-DISTRICTS— Under 5 7 9 16 7 9 16 St. Anne, Soho 12,048 12,000 247 5 upwds 51 18 1 6 1 6 83 49 16 5 1 71 Strand 11,734 11,500 177 Under 5 1 4 5 1 4 5 5 upwds 20 4 4 3 31 18 4 4 1 27 St. Giles Under 5 5 upwds 4 I 5 3 1 4 Westminster Workhouse, Poland Street 158 5 Under 5 5 upwds Strand Union Workhouse, Edmonton 774 6 Under 5 5 upwds Do. do. Bear Yard 22* Under 5 5 upwds King's College Hospital Under 5 5 upwds Under 5 8 13 21 8 13 21 TOTALS 24,714 23,500 457† 5 upwds 75 22 1 11 1 9 119 70 20 10 2 102 * 8 of these Births belong to the Parish of St. Martin-in-the-Fields. † 24 Births belonging to this District took place in the British Lying-in Hospital, Endell Street.