SURBITON Forty-Third ANNUAL REPORT of the Medical Officer of Health, including the VITAL STATISTICS FOR THE YEARS 1916, 1917, 1918, and 1919, together with the REPORT OF THE SANITARY INSPECTOR, 1919. Sun 050 Urban District Cmntril of ^urbiton PUBLIC HEALTH COMMITTEE. Councillor A. J. Lock {Chairman). Councillor Bailey. Councillor Ray. „ Dumper. „ Ribbins. Ferguson. „ Ryland. „ Hawkey. „ Sanger, C.B. (Lady) Martin. ,, Stewart. ,, Mence. „ Trew. PUBLIC HEALTH DEPARTMENT. Staff. Medical Officer of Health : Owen Coleman, M.D., D.P.H., Surg. Lieut.-Colonel. Sanitary Inspector: W. nesfield, A. R. San. Inst. Assistant Sanitary Inspector : R. F. Wheeler, A. R. San. Inst. Veterinary Surgeon: Alfred C. Wild, M.R.C.V.S. Clerk: Miss B. Hallett. Clerk to the Council : Frederick W. Wood. Surbiton Urban District Council Forty-Third Annual Report OF THE MEDICAL OFFICER OF HEALTH, 1919. Mr. Chairman, Ladies and Gentlemen, I have the honour to present to you my Report for the year 1919, upon the health and sanitary conditions of the district under your control in accordance with the instructions of the Ministry of Health. With this Report are embodied those for the years 1916, 1917, and 1918, in so far as the Vital Statistics are concerned, as owing to the war no printed reports were issued for those periods. On the 1st July, 1919, the powers and duties of the Local Government Board were taken over by the Ministry of Health who have also the power to take over and absorb other duties connected with the health and well-being of the people. 4 Early in 1920 it issued to all the Medical Officers of Health a Memorandum as to the contents and arrangement of their Annual Reports for 1919. I have, as far as possible, endeavoured to shape my Report on the lines suggested, which vary very considerably in some respects as to details and sequence with those pertaining to former years, and will necessitate the repetition of many details with which you may be familiar, though these may possibly not be required to be reproduced subsequently. The Ministry has lost no time in striking out on new ground, and, desiring to show the importance it attaches to the Annual Reports of the Medical Officers of Health has issued a Circular letter asking for the consideration of all Sanitary Authorities—" to the important question of taking special steps, now that the war is over, to inform themselves without further delay as to the general condition of the health of the population of their area, under the Public Health Acts, the Maternity and Child Welfare Act, the Midwives Acts, and the other Statutes and Regulations through which the prevention of disease, the diminution of sickness, and the general physical welfare of the people are intended to be promoted." It further states—" Not only, however, is such a scrutiny of the prevailing condition of things now considerably overdue, and on that account specially needed; it has also become doubly requisite in order, first, to bring to light any local consequences of war conditions that mav need special attention; and, secondly, to form the basis for that careful and comprehensive scheme of health developments generally which it is hoped may shortly follow, in every locality, upon the recent unification in the Ministry of Health of the various central functions in respect of all matters affecting the health of the people; since this unification of the central administration implies, and, indeed, cannot be effective without a corresponding co-ordination of local health activities." This Circular letter, in weighty words, goes on to say—" It is further suggested that your Council should arrange for the Report to be distributed locally, as soon as it is available, as widely as possible, and should take steps through the local press and otherwise to bring its contents effectively to the knowledge of the people. One of the main purposes of the compilation of the Report is that, by giving it to the widest possible publicity, it shall engender a popular interest in the subject, and an enlightened public opinion which shall support the Local Authority in realising its high responsibilities for the health of its area, and in remedying, at the earliest opportunity, the various defects which the survey may bring to light, whether arising from war conditions or from other causes. Such an increase of public knowledge and interest in these matters may also become an effective means of educating the citizens in the more 6 important conditions of public health, of warning them against particular dangers, and of securing that highly important co-operation and confidence between them and the Health Authority and its staff, which is essential to successful health administration." Natural and Social Conditions of the District. Population, Census, 1911 ... ... ... ... 17,717. Population estimated to middle of last year (Registrar General)— 1916. 1917. 1918. 1919. For Birth Rate ... 18,691 19,345 20,782 20,828 For Death Rate ... 17,179 17,354 18,548 19,994 Physical Features and General Character of the District. Area of District.—This is officially given as being 3,046 acres, or as 3,031, exclusive of water. The shape is practically a square with a long protruding tongue stretching between Chessington and Claygate. It includes what is known as Surbiton proper or the original area as defined in the Surbiton Commissioners Act of 1885. To this has now been added, in 1905, districts that until then formed part of the area administered by the Kingston Rural Sanitary Authority, viz., Tolworth originally part of the Parish of Long Ditton, Hook and Southborough. Boundaries.-—Un the North by the Borough of Ivingston-upon-Thames, on the- North-West by 7 the River Thames, which has a length within the district of 940 yards and includes within our area the Island known as Raven's Eyot, on the West and partly South-West by the territory of the Urban District Authority of Esher and The jJittons, on the East by the Hogg's Mill River, otherwise locally known as the Maiden River, and by the Maidens and Coombe Urban District, and from South-East to South-West by the country of the Epsom Rural District. Physical Features.—The area of the district is roughly divided into Northern and Southern parts by the London and South-Western Railway which runs in a deep cutting through the entire district from .North-East to South-West, and by the rising ground known as Surbiton Hill, towards which on the Northern aspect the ground slopes upward from the level of the Rivers Thames and Hogg's Mill, forming a ridge which extends from Mmniedale and the parts known as Clay Hill (now re-christened Villier's Avenue) overlooking Kingston, to just oittside the boundary at Cock Crow Hill within the Parish of Long Ditton. The highest part of this ridge within our area is 118'6 feet. Geology.—The greater part of the district is of the Tertiary period embracing the Eocene strata of London Clay. In the portion nearer the river there are post-tertiary deposits of gravel and sand, described in the geological survey as 8 " Valley Brick Earth." This extends from the line of the river up to the railway and then stretches down the Claremont Road to the Kingston boundary. Fossils have been discovered occasionally, but not in any quantity. In the clay there have been found round stones or boulders with iron stained crystals and the deposits of crystalline gypsum. Social Conditions.—The district is entirely a residential one, and that of a first-class character; it is situate on the banks of the River Thames, but with a considerable portion of it on hill ground at a height of from 100 to 120 feet above ordnance datum and facing Banstead Downs and the Surrey Hills, whence it derives the pure and invigorating air that in so large a measure accounts for its well known health conditions. A very large proportion of the adult male residents here are engaged in business in London, for access to which the facilities offered by the Southwestern Railway are not surpassed in the case of any similar extra metropolitan district. The tramways also provides a good service, more especially for transit to Kingston and the townships on the other side of the river, besides communications with Richmond and Bushey Parks and Hampton Court. There are no factories or works employing many hands, with the exception of the pumping stations of the Metropolitan Water Board, formerly the Lambeth and Chelsea Waterworks, and of the workers engaged at these 9 the majority are locally resident within the district, the balance living over the border in Long Ditton. There are three large open, pleasantly situate Recreation Grounds, where cricket, hockey, football, lawn tennis, etc., are played, and where flower, horse and other shows from time to time take place, all under the control of a committee of the Council. Originating solely as a residential suburb of London consequent on the South-Western main line running through it, Surbiton has ever since remained of that character, and under the guardianship of successive enlightened and progressive Commissioners and Councillors has, not unsuccessfully, led the way in the matter of sanitary observances, under which I include drainage, water and milk supplies, the construction and maintenance of its roads and paths, the treatment of its infectious sick, and especially in the housing of the working classes. A lead has always been given in these important matters and we have always endeavoured to keep in the forefront of progress, and moreover, thanks to careful administration, these benefits have been obtained and maintained at a cost that bears a most favourable comparison with any first class neighbourhood of a similar character. Situate in a delightful position on the banks of the Thames and in the immediate neighbourhood of the Royal parks and a charming 10 ing district, these added sanitary conditions mentioned above, combine to provide Surbiton with attractions so far in excess of most other places that it has always been and—given a continuance of policy on similar lines—should alwavs be a most popular and populous place. It deserves to be classed as a " health resort" if there is any meaning in such a term, inasmuch as it is a place where good health can be obtained, perpetuated and enjoyed, especially suitable for children and for old people, and in direct contra distinction to that other and baser use of the term which signifies " health resort," to mean a place to which people, out of health, resort in order to be restored to health. Maintaining its character from its inception on the making of the L. & S.W. Railway, Surbiton is de facto a residential neighbourhood with no dominating factories or works. The trade is mainly that which exists for the needs of the residents, a very large proportion of whom travel to and fro London. The only new feature of late is the springing up of a few " Motor Garages," each employing a few hands on the care and repair of cars. After all, these are merely taking the place of Livery Stables and carriage repair shops and are only proportionate to demand. The Electric Light Works and a belated resuscitation of the Tolworth Brickfields represent the leading " Works " and they are not militant factors from a public health point of view. 11 STATISTICAL SUMMARY, 1916.1919. 1916. 1917. 1918. 1919. Population, estimated to middle of year as supplied by Registrar General— For Birth Rate 18,691 19,345 20,782 20,828 For Death Rate 17,179 17,354 18,548 19,994 Population, Census 1911 (17,717). Births 326 244 245 281 Birth Rate per 1,000 population 174 12.6 11.7 13.4 Deaths, corrected, all causes 205 194 234 216 Death Rate per 1,000 population 11 9 111 12.6 10.8 Deaths under one year of age 17 12 15 19 Infantile Mortality, Rate per 1,000 Births ... 52 49 61 67 Zymotic Death Rate 0 05 0.51 0.37 0.50 Excess of Registered Births over Deaths 121 50 11 65 Area of District in acres, exclusive of water—3,031. Rateable Value £181,203 £180,376 £179,838 £179,501 A Rate of Id. in the £ yields £620 £617 £615 £614 12 VITAL STATISTICS IN ENGLAND AND WALES for 1916 to 1919—inclusive. Annual Rates per 1,000 living. Deaths under 1 year to 1,000 Births. Births. Deaths. England and Wales, 1916 21.6 14 0 91.0 1917 17.8 14.4 97 .0 „ 1918 17.7 17.6 97.0 1919 18.5 13.8 89.0 Surbiton, 1916 17.4 11.9 52.0 1917 12.6 11.1 49.0 „ 1918 11.7 12.6 61 .0 1919 134 10.8 67.0 VITAL STATISTICS IN ENGLAND AND WALES for 1919. Annual Rates per 1,000 living. Deaths under 1 year to 1,000 Births. Births. Deaths. England and Wales 18.5 13'8 89.0 96 great towns exceeding 50,000 Census 1911, including London 19.1 139 93 0 148 smaller towns, populations from 20,000 to 50,000 at Census, 1911 18.4 12 7 90.0 London 18.6 13.6 85.0 Surbiton 13 4 10.8 67'0 13 Births.—The number of Births registered during the last four years is as follows Years. No. Birth Rate. Males. Females, Illegitimate. No. Males. Females. 1916 326 174 172 154 12 9 3 1917 244 12-6 135 109 23 9 14 1918 245 11-7 100 145 18 10 8 1919 281 13-4 145 136 27 12 15 1.096 552 544 80 40 40 Deaths.—The total number of Deaths registered during the last four years is as follows :— Years. No. Males. Females. Death Rate. Death-Rate, England & Wales. 1916 205 95 110 11.9 14.0 1917 194 95 99 11.1 14.4 1918 234 100 134 12.6 17.6 1919 216 104 112 10.8 13.8 849 394 455 " Zymotic " Death Rate— Chief Epidemic Diseases :—The number of Deaths due to the seven principal " Zymotic Diseases" during the undermentioned years is as follows :— Years. No. Zymotic Death Rate per 1,000. 1916 1 0 ,05 1917 9 0,51 1918 7 0.37 1919 10 0.50 14 Causes of Death in Surbiton Urban District, 1916, as supplied by the registrar-general. Causes of Death. Females. Males. Total. All Causes (civilians only) 95 110 204 3. Measles 4. Scarlet Fever — 5. Whooping Cough — • — — 6. Diphtheria and Croup — — — 7. Influenza 2 3 5 8. Erysipelas — — — 9. Pulmonary Tuberculosis 9 5 14 10. Tuberculous Meningitis 1 1 2 11. Other Tuberculous Diseases 1 1 •2 12. Cancer, Malignant Disease 12 17 29 14. Meningitis — 4 4 15. Organic Heart Disease 4 16 20 16. Bronchitis 7 9 16 17. Pneumonia (all forms) 8 7 15 18. Other Respiratory Diseases 5 2 7 19. Diarrhcea, &c. (under 2 years) 1 — 1 20. Appendicitis & Typhlitis 1 - 1 21. Cirrhosis of Liver 2 3 5 21a. Alcoholism — — — 22. Nephritis and Bright's Disease 3 2 5 23. Puerperal Fever — — — 24. Parturition, apart from Puerperal Fever — — — 25. Congenital Debility, &c. 3 6 9 26. Violence, apart from Suicide 6 3 9 27. Suicide 2 — 2 28. Other Defined Diseases 28 31 59 Special Causes (included above)— Cerebro-spinal Fever 2 2 Poliomyelitis — — — Total Deaths 95 110 205 Deaths of Infants under 1 year of age 7 10 17 Total Births 172 154 326 Legitimate 163 151 314 Illegitimate 9 3 12 Population, for Birth Rate 18, 691 ,, ,, Death Rate 17,179 15 Causes of Death in Surbiton Urban District, 1917, AS SUPPLIED BY THE REGISTRAR-GENERAL. Causes of Death. Males. Females. Total. All Causes (Civilians only) 95 99 194 3. Measles 2 2 4. Scarlet Fever — _ — 5. Whooping Cough — 3 3 6. Diphtheria and Croup 2 — 2 7. Influenza 2 2 4 8. Erysipelas - 1 1 9. Pulmonary Tuberculosis 5 14 19 10. Tuberculous Meningitis 1 2 3 11. Other Tuberculous Diseases 3 1 4 12. Cancer, Malignant Disease 13 16 29 14. Meningitis — — — 15. Organic Heart Disease 11 8 19 16. Bronchitis 5 2 7 17. Pneumonia (all forms) 6 7 13 18. Other Respiratory Diseases 1 1 2 19. Diarrhoea, &c. (under 2 years) 1 1 2 20. Appendicitis and Typhlitis — — — 21. Cirrhosis of Liver ■— — — 21a. Alcoholism — — 22. Nephritis and Bright's Disease 3 3 6 23. Puerperal Fever — 3 3 24. Parturition, apart from Puerperal Feve — — — 25. Congenital Debility, &c. 3 2 5 26. Violence, apart from Suicide — 3 3 27. Suicide 1 — 1 28. Other Defined Diseases 36 30 66 Special Causes (included above)— Cerebro-Spinal Fever — — — Poliomyelitis — — — Total Deaths 95 99 194 Total Deaths of Infants under 1 year of age 8 4 12 Total Births 135 109 244 Legitimate 126 95 221 Illegitimate 9 14 23 Population—Birth Rate 19, 345 ,, Death Rate 17, 354 16 Causes of Death in Surbiton Urban District, 1918, as supplied by the registrar-general Causes of Death Males Females Total All Causes (Civilians only) 100 134 234 3 Measles 2 2 4 Scarlet Fever — — — 5 Whooping Cough 2 — 2 6 Diphtheria and Croup 2 1 3 7 Influenza 13 30 43 9 Pulmonary Tuberculosis 5 8 13 10 Tuberculous Meningitis 1 — 1 11 Other Tuberculous Diseases 2 1 3 12 Cancer, Malignant Disease 6 10 16 13 Rheumatic Fever — 1 1 14 Meningitis — 1 1 15 Organic Heart Disease 14 11 25 i6 Bronchitis o 5 7 17 Pneumonia (all forms) 10 12 22 18 Other Respiratory Diseases 1 — 1 19 Diarrhoea, etc (under 2 years) — — — 20 Appendicitis and Typhlitis — 2 2 21 Cirrhosis of Liver 1 1 2 "2la Alcoholism 1 — 1 22 Nephritis and Bright's Disease 1 i 2 23 Puerperal Fever — 1 1 24 Parturition, apart from Puerperal Fever — 1 1 25 Congenital Debility, etc 2 9 26 Violence, apart from Suicide — 1 1 27 Suicide 1 2 3 28 Other defined diseases 36 36 72 Special Causes (included above) Ccrebro-Spinal Fever Poliomyelitis Total Deaths 100 134 234 Total Deaths of Infants under 1 year of age 8 7 15 Illegitimate 1 1 Total Births 100 145 245 Legitimate 90 137 227 Illegitimate 10 8 18 Population—Birth Rate 20,782 ,, —Death Rate 18,548 Causes of Death in Surbiton Urban District, 1919, as supplied by the Registrar-General. Causes of Death. Males. Females. Total. All Causes (Civilians only) 104 112 216 3. Measles 3 1 4 4. Scarlet fever — 1 1 5. Whooping Cough — 1 1 6. Diphtheria and Croup 1 1 2 7. Influenza 4 6 10 9. Pulmonary Tuberculosis 15 5 20 10. Tuberculosis Meningitis 1 — 1 11. Other Tuberculous Diseases — — — 12. Cancer, Malignant I'isease 8 17 25 13. Rheumatic Fever — 2 2 15. Organic Heart Disease 10 14 24 16. Bronchitis 8 7 15 17. Pneumonia (all forms) 5 9 14 18. Other KeS| iratory Diseases 3 1 4 19. Diarrlnea, Ac. (under 2 years) — 2 2 20. A ppendicitis and Typhliti 1 1 2 21. Cirrhosis of Liver — 1 i 21a. Alcoholism — — — 22. Nephritis and Bright's Disease 6 3 8 23. Puerperal Fever — — — 24. Parturition, apart from Puerperal Fever — 1 1 25. Congenital Debility, &c. 5 4 9 26. Violence, apart from Suicide — — — 27. Suicide 1 2 3 28. Other defined Diseases 34 33 67 Special Causes (included above)— Encephalitis — — — Ceiebro Spinal — — — Poliomyelitis — — — Total Deaths 104 112 216 Total Deaths of Infants under 1 year of age 8 11 19 Illegitimate 1 3 4 Total Births 145 136 281 Legitimate 133 121 — Illegitimate 12 15 Population—Birth Rate 20, 828 ,, Death Rate 19, 994 18 Bacteriological Investigations. The following are the results of the Bacteriological Investigations of the specimens forwarded to the Clinical Research Association, Ltd. :— Year. Disease Suspected. Nature and Specimen. Result. Total. Positive. Negative. 1916 Enteric Fever ... Blood 1 1 2 Total ... 1 1 2 1917 Enteric Fever ... Blood 1 1 Total ... 1 - 1 1918 Diphtheria Swabs from throat, etc. 8 S Tuberculosis Sputum - 2 2 Total .. - 10 10 1919 Enteric Fever ... Blood - 1 1 Diphtheria Tuberculosis Swabs from throat, etc. Sputum 6 1 38 44 1 Total .. 7 39 46 The following diseases were notifiable under .the original Notification Act, 1889 :— Small-pox Cholera Diphtheria Relapsing Fever Bcarlet Fever Erysipelas Enteric Fever Typhus Puerperal Fever Plague Continued Fever By " Orders " since :— Tuberculosis (all forms) Encephalitis Lethargica Measles Influenzal Pneumonia "S German Measles Malaria 5 Ophthalmia Neonatorum Dysentery Cerebro-Spinal Fever Trench Fever Acute Poliomyelitis Acute Pneumonia From April 1st. 19 Measles. An official notice dated 27th November, 1919, was issued to the effect that " The Regulations of 1915, shall, as from 31st December, 1919, be rescinded." So Measles and German Measles are no longer notifiable. Chicken-pox notification is permissive on application by the Local Authority to the Ministry of Health—for a specified period when a Smallpox outbreak has occurred in a district or in a neighbouring authority where danger of spreading may be apprehended. Small-pox.—No case of Small-pox was notified during these last four years. Many contacts of these and other infectious diseases from shipboard were notified to the Department from the various ports of the kingdom. These were all visited and kept under observation until the close of the respective incubation period was reached. All necessary instructions were given as to the immediate reporting of malaise and with respect to removals from the district. There having been no case of small-pox during the year no vaccinations or re-vaccinations were done by me as Medical Officer of Health under the provisions of the (Small-pox Prevention) Regulations, 1917. Influenza.—There was a serious outbreak of Influenza towards the end of 1918, the last three months of that year, with a few cases during the first three months of 1919. This outbreak broke out almost suddenly throughout the country and 20 was extraordinarily fatal. It was of a pneumonic type and in this district was the cause of 40 deaths in 1918 and nine in 1919. The outstanding feature was the high mortality between the ages of 15 and 45, there being 29 deaths, 19 females to 10 males. Though this was in the Winter months only two children died under 2 years of age and only 1 over 65. In addition to the 40 deaths of residents there were those of four non-residents, and these, in due course, were transferred to their respective districts. Deaths from Influenza during 1918. Males. Females. Total. July 1 1 2 October 5 5 10 November 7 16 23 December — 5 5 13 27 40 Age and Sex Distribution, 1918. Age Males. Females. Total. Under 1 year 1 — 1 1 to 2 — 1 1 2 „ 5 — — — 5 „ 15 2 — 2 15 „ 25 4 7 11 25 „ 45 6 12 18 45 „ 65 — 6 6 65 and over — 1 1 13 27 40 21 Whooping Cough. Resulting from a visit to the Hook Schools on December 4th, a statement by the Master, Mr. Garrett, showed that on the morning of that day, out of a total on the books of 201 children there were present 119, equal to only 59 per cent., and that these abstentions were nearly all of them due to Whooping Cough. This Disease not being notifiable it was impossible to give the exact number of houses infected and therefore the Managers were advised that the school should be closed as from that date for four weeks—to January 4th, on which day the holidays terminated, and the re-opening or otherwise, will depend on a further consideration of all the circumstances connected with the outbreak. On January 5th, 1920, there were present 155 out of 201 on the books, equal to 77 per cent, as against 59 per cent, on December 4th last. The schools were therefore re-opened and a further report made at the end of the week was satisfactory. Anthrax. About the middle of November a paragrapn appeared in the Press to the effect that two cases of death from Anthrax had occurred in the Midlands and that another case was under suspicion. It was further stated that it was possible that some shaving brushes recently imported from 22 Japan might be the cause. Thinking this over and remembering that prior to the War I had been called in to see a case hereabouts of suspected Anthrax, I decided to have enquiries made of all hairdressers and barbers in the district as to all purchases of shaving brushes within six months, and addresses of firms from whom purchased. A ful return was obtained, but in no case have I ascertained that any of these firms were under suspicion. About a fortnight after this incident I received a copy of a communication sent to the County Medical Officer by the Medical Officer of Health of one of the London Borough Councils to the effect that he had been advised by the Medical Officer of Health of the City of London that on a certain date " a consignment of shaving brushes suspected of being infected with Anthrax was supplied by a manufacturing company in the City to a wholesale firm in the Borough of which he was Medical Officer of Health." " Further, that on making enquiries it appeared that some portion of the brushes in question had been sold to firms within the County of Surrey." The County Medical Officer of Surrey thereupon sent me a copy of this letter and the address of a firm in my district who had purchased. This was not a hairdresser, but I called at once and found that they had " sold four of the brushes, but as they were cash transactions they had no knowledge as to the purchasers." I thereupon had a second enquiry 23 made of all the chemists and other shops where such articles might be possibly dealt with, but so far no purchase—where made—seem to have been from the firm under suspicion. The matter was not quite disposed of for some time and investigations and enquiries were made for a few weeks longer. Rats Orders 1918-1919.—Publicity has been given to the growing prevalence of these rodents, to the enormous destruction of food computed at £15,000,000 yearly or even much more than that; and to the possible spread of disease by their agency. They also do enormous damage to property. It is established that the rat by its fleas is the chief agent in the causation of Plague, and it is also a known carrier of Dysentery, and it is also believed of foot and mouth disease in cattle. It would seem that only organised and continuous efforts are likely to succeed in its destruction as the annual reproduction is at such a rate that spasmodic or intermittent efforts are of little avail. All owners of premises where food is stored should endeavour to render them rat proof. It should be widely known that the Rats and Mice Destruction Act which came into force on January 1st, 1920, compels every person to destroy all rats and mice on his premises. The penalty for noncompliance is, on conviction, £5 to £50. 24 Suitable poisons can be supplied, and advice given on application to the Sanitary Authority. The scheme for carrying these provisions out is associated with that of the County Council. Rabies.—On the 20th April, 1919, a Memorandum was received from the Local Government -Board on the " Procedure to be followed when persons are bitten by aogs suspected to be rabid." On application to the Local Government -Board 24 copies of the above Memorandum were sent down and these were at once distributed amongst the medical men and chemists in this neighbourhood. The treatment suggested was in the nature of " First Aid." SANITARY CIRCUMSTANCES OF THE DISTRICT. Water Supply. The Water Supply throughout the district is that furnished by the Metropolitan Water Board, is of excellent character and the supply to all houses is constant and has been since about 1913. Rivers and Streams. The River Thames forms the North-West boundary of the district for about 940 yards. The Hogg's Mill River, known locally as the Maiden River, forms for part of its course a boundary on the East between Surbiton and Maiden. It 25 receives the effluent from the Sewage Works of Ewell and Maiden, but there is no pollution of the stream. No water supply for any purpose is obtained for the district from it. Drainage and Sewerage. Surbiton Sewage Disposal Works. The Sewage of the District is treated at the Works in Lower Marsh Lane. A portion of the Sewage, a little over half the daily flow, is delivered by gravitation direct into the tanks and the remainder is pumped. Owing to the increased population the daily average treated now amounts to over a million gallons. The process consists of precipitation in tanks by means of lime, and Alteration through two series of percolating filters. It is then discharged through a Humas tank and by an effluent drain to the River Thames. The precipitated sluge is ejected from the tanks by compressed air on to drying beds composed of underdrained clinkers. After air-drying the sludge is readily disposed of to farmers in the district who cart it away free of cost. In connection with the pumping station there is a House Refuse Destructor from which sufficient heat is obtained, with the addition of a small amount of Coke Breeze in the summer, to produce steam for all the power plant and the pumping of the Sewage at the Works. House Refuse Disposal. This is now being carried out by means of two Eiectric Dust Vehicles and two Horses and Carts. 26 The Public Health Committee have recently decided to purchase an additional Electric Vehicle which will displace the horses now employed and the whole of the collection will then be removed to the Destructor by mechanical traction. Closet Accommodation. Every house has a water closet, mostly, if not all, with flushing arrangements. Alterations and cleansings are dealt with in the Sanitary Inspector's Report. Scavenging. House Refuse Disposal.—Section 36 of the Public Health Act, 1875, is enforced in the District, it empowers the Council to insist upon each house being provided with portable galvanized iron dust bins, where no suitable ashpits exists, or where they are unsuitably placed or beyond repair. All the houses are now provided with covered ashbins, most of which are moveable. There are no privies or cesspools within the District other than those at Worcester Park and Tolworth Court Farm, which are not within the sewer area, and these are cleansed by the occupiers. The work of scavenging and removal of house refuse formerly carried out by contract is now in process of being taken over by the Council by means of two Electric Dust Vehicles and two 27 horses and carts. The Public Health Committee have recently decided to purchase an additional Electric Vehicle which, when delivered, will displace the horses now employed, and the whole of the refuse collection will then be removed to the Destructor by mechanical traction. Annual Rainfall. The following is the Rainfall registered each month at the Surbiton Sewage Disposal Works, Lower Marsh Lane, for the year ending 31st December, 1919:— January 2.56 February 2.23 March 2.39 April 2.17 May .32 June .82 July 2.16 August 1.43 September 1.72 October .49 November .97 December 3.38 Total 20.64 I am indebted to the courtesy of Mr. Mather, the Council Surveyor, for the above readings. 28 Premises and Occupations which can be Controlled by Bye-laws or Regulations. The following is a list of the Bye-laws and Regulations in force in the District:— (1) Bye-laws with respect to Nuisances. (2) Bye-laws as to Slaughter-houses. (3) Regulations as to Dairies, Cowsheds and Milkshops. (4) Bye-laws as to New Streets and Buildings. (5) Regulations as to Underground Rooms habitually used as Sleeping Places. (6) Bye-laws as to Public Conveniences. (7) Bye-laws as to Recreation Grounds. (8) Bye-laws as to Allotments. (9) Bye-laws with respect to the Cemetery. (10) Bye-laws as to Means of Escape in Case of Fire in Certain Factories and Workshops. (11) Bye-laws with respect to Tents, Vans, Sheds and Similar Structures. (12) Ditto under Good Rule and Government of the District. (13) Ditto as to Registries for Female Domestic Servants. Local or General Adoptive Acts. The following is a list of the Adoptive and Local Acts in force in the district:— The Surbiton Improvement Act 1855 Infectious Disease Prevention Act 1890 Public Health Acts Amendment Act 1890 Private Street Works Act 1892 Public Health Acts Amendment Act (part of) 1907 Surbiton Urban District Council Act 1910 29 Housing, Town Planning, &c., Act, 1919. As requested by the Ministry of Health the following particulars are given of the Housing conditions of the district:— Form of Survey of Housing Needs. Section 1.—Prevailing Conditions Affecting Shortage of Houses. Industries. 1. Particulars as to the staple industries of the trict (or of any parish or part of the district) Nil 2. Particulars of any anticipated industrial ment Nil 3. Particulars of any considerable reduction which may be anticipated in the number of persons employed in any industry in the district Nil Population. 4. Pre-war population (1914) 18,395 5. Average annual increase of population for the five years before the war 335 6. Estimated present population 22,000 7. Anticipated increase or decrease of working-class population due to industrial changes — Existing Housing Accommodation. 8. Number of dwelling-houses in the district 4,151 9. Number of working-class houses of the types given in the reply to question 15 3,339 10. Average number of working-class houses built annually during the five years before the war ... 19 11. Number of working-class houses built between January 1st, 1915, and December 31st, 1918 ... 10 12. Number of empty buildings which might be (a) made suitable, by repairs or alterations, for housing the working-classes; or (b) converted into (a) — flats for the working-classes (b) 13 30 Overcrowding. 13. Tenements with more than two occupants per room : —- Number of Tenements 10 Total number of Occupiers 142 14. Number of houses intended for one family only which are now occupied (without having been specially adapted) by two or more families 478 Rents. 15. Particulars of prevailing rents of the various types of working-class houses in the district: — Type of House. Weekly Rent. (a) Houses with Living Room, Scullery and two Bedrooms 6/6 (6) Living Room, Scullery and three Bedrooms 6/6 (c) Parlour, Living Room, Scullery and two Bedrooms 6/6 to 8/- (d) Parlour, Living Room, Scullery and three Bedrooms 8/6 to 10/6 (e) Parlour, Living Room, Scullery and four Bedrooms 12/6 to 14/- (f) Tenements in block buildings 6/3 to £1 0s. 0d. (g) Other working class dwellings (specifying):— Parlour, Living Room, Kitchen, Scullery, and three Bedrooms 12/6 to 14/- Parlour, Living Room, Kitchen, Scullery and four Bedrooms £1 0s. 0d. Old basement houses containing three to ten rooms £1 0s. 0d. Section II.—Estimate of Housing Needs. No. of Houses. 1. Working-class houses required during the next three years to— (a) Meet the unsatisfied demand for houses (taking account of growth of population, overcrowding, etc.) 100 (b) Re-house persons to be displaced by the clearance of unhealthy areas Nil (c) Replace other dwellings which are unfit for human habitation and cannot be made fit Nil (d) Replace obstructive or other buildings (now inhabited and not included under heading (c) which should be demolished Nil 31 (e) Replace other houses which, although they cannot at present be regarded as unfit for human habitation, fall definitely below a reasonable standard Very few (/) Meet anticipated deficiencies, e.g., arising from new industrial development Nil Total 100 2. Deduct— (a) Working-class houses which it is anticipated will be set free during the next three years as the result of any probable decrease in the population Nil (b) Working-class houses likely to be built during the next three years by persons other than No inforthe Local Authority mation. Total Net estimate of number of houses required 100 Section III.—Areas which are being, or may have to be, dealt with as unhealthy under Part I. or Part II. of the Act of 1890 Nil Section IV.—Insanitary Houses (other than houses in unhealthy areas of which particulars are given in Section III). Prevailing conditions. (1) How many inhabited houses are there in the trict which are not and cannot be made fit for human habitation? Nil (2) Number of persons inhabitating these houses — (3) How many houses are already subject to— (a) Closing Orders? 2 (b) Demolition Orders ? 2 (4) How many houses are seriously defective but See Ans. can be made habitable? to5 (b) Proposed action. (5) What immediate action is contemplated by the local authority with regard to— (а) Houses which are not and cannot be made lit for human habitation? — (b) Houses which are seriously defective but can be made habitable? 32 The procedure which has hitherto been adopted in this district, was to make a systematic house to house inspection in accordance with the provisions of the Housing (Inspection of District) Regulations, 1910. Such inspection was regularly carried out up to the outbreak of the War, every defective house as it was found, being dealt with by notices either under the Public Health Acts, or under the Housing and Town Planning Act, 1909. 438 houses were found to be defective, and were dealt with in this manner as the result of which practically all the defects found were made good. Such survey is now being resumed and the Sanitary Inspector has been provided with an Assistant to expedite the work. (6) Within what time is it contemplated that conditions will be such as to warrant the demolition of the houses which are not and cannot be made fit for human habitation 1 — Section V.—Map. A map of the district, coloured as directed below, should be forwarded with this completed form. The Medical Officer of Health should be responsible for the colouring of the map, which should be accompanied by any report on the subject which he may make. The map should be to the scale of six inches to the mile, and ordnance sheets may be used. Any observations in regard to the Map should be entered below : — The Map mentioned above has not been prepared as the district contains no such areas as these mentioned. Section VI.—Scheme of the Surbiton Urban District Council for the provision of New Houses under Section 1 of the Housing, Town Planning, &c., Act, 1919. The Scheme should include any proposals which have already been submitted for approval as assisted schemes. 1. Approximate number of new houses to be provided : — (a) Houses with living room, scullery and two bedrooms — (b) Living room, scullery and three bedrooms 24 33 (c) Parlour, living room, scullery and two bedrooms — (d) Parlour, living room, scullery, and three bedrooms 60 (c) Parlour, living room, scullery and four bedrooms 16 (/) Block dwellings (Number:— ) Number of separate tenements — (g) Other dwellings (specifying type) :— — Total number of houses and separate tenements 100 2. Approximate number of existing empty houses to be acquired and : — (i) made suitable for housing the working classes — (ii) converted into flats for the working classes Nil Approximate number of families to be housed under (i) and (ii) — 3. Approximate acreage of land to be acquired 20 4. Average number of houses per acre 12 5. Approximate localities in which land is to be acquired (a) Surbiton Hill, (b) Tolworth. 6. Time within which it is proposed that the scheme (or if the scheme is to be carried out by instalments, each part of the scheme) is to be carried into effect: —* Part op Scheme. Approximate Date for Completion. 100 Houses. Cannot be stated but probably within three years. * Any part of the scheme which has already been submitted for approval should be referred to separately. 7. Particulars of any measure necessary, as part of the scheme, for the preservation of existing erections of architectural, historic or artistic interest, or for the preservation of the natural amenities of the locality Nil 8. Any other provision (including provisions for joint action with any other Local Authority) Nil 9. Is it anticipated that the scheme may subsequently require to be amended ? If so, any relevant considerations should be stated — The above scheme was adopted by the above named Council in various stages and at different dates during the last six months. c 34 SALE OF FOOD AND DRUGS ACTS, ETC. Return of Samples Analysed during the Years 1916—1919. articles. analysed. adulterated or deteriorated. prosecutions. convictions. Forma] Informal Total. Formal Informal Total. 1916 Milk 175 — 175 24 — 24 — — Cream — 5 5 — 1 1 — — Butter 8 2 10 - - - - - Cocoa 1 — 1 — — — — — Sugar 1 — 1 - - - - - Totals 185 7 192 24 1 25 — - 1917 Milk 30 — 30 6 — 6 1 — Lard 1 - 1 1 — 1 1 — Totals 31 — 31 7 — 7 2 1918 Milk 71 — 71 13 — 13 4 — Butter — 1 1 - - - - - Drugs 1 1 2 1 1 2 1 — Totals 72 2 74 14 1 15 5 — 1919 Milk 63 — 63 3 — 3 2 — Cheese — 1 1 - - - - - Salad Oil 1 — 1 1 — 1 — — Dripping 1 — 1 — — — — — 65 1 66 4 - 4 2 - 35 Vaccination.—At my request the Vaccination Officer has supplied me with an official statement of the Vaccination Returns for 1919, in this district, as set out in the following Table :— Total Births Registered 281 Successfully vaccinated 158 Certificates of objection granted 76 Deaths, removals and not accounted for 22 Postponements and not yet legally due 25 Percentage of successful vaccinations to Births 56.2 fortunately no cases of small-pox have occurred in this district, yet almost week by week during the last year and a half cases have been notified in London and many of the seaport towns and occasionally have given reason for anxiety, but the measures adopted—immediate removal on diagnosis, vaccination of all contacts, isolation of all inmates of a house when and where considered necessary, thorough disinfection, etc., have so far kept in check the spreading of the disease. At the time of writing these cases are still occurring and the danger has not yet passed. Small-pox is prevalent in many parts of the continent, and with the increase of facilities for travel and with the resumption of trade, we must expect the possibilities for the introduction of infection to continue. But while reaping the benefit of the extensive vaccination of the troops and of the others whose duty called them abroad, D 36 We who are home, per contra, are going on just as we did before the war, exemption certificates are granted on application as though the Vaccination Act was a dead letter, and the total of unvaccinated children year by year is steadily mounting up. In my report for 1913 I showed that up to the end of June of that year—1,314,502 exemptions had been granted throughout the country and that we were approaching, at that time, a total oi very nearly 300,000 unvaccinated children being added to the population annually. As bearing on this I have the permission of the Vaccination Officer to state that he estimates that there are now upwards of 15,000 unvaccinated children in the Kingston Union. No vaccinations were performed by me as Medical Officer of Health during the year, under the Public Health (Small-pox) Prevention Regulations, 1917. Public Schools.—There are six Public Elementary Schools in the District, of which four are Church of England and two Council Schools, classified as follows :— Surbiton—St. Mark's—C.E. 3 Departments—Boys—Girls—Infants. Surbiton Hill—Christ Church—C.E. 2 Departments—Boys—Girls. Surbiton Hill—Council. 1 Department—Infants. Surbiton—Tolworth, St. Matthew's C.E. 1 Department—Girls. 37 Surbiton—Tolwortk—Council. 2 Departments—Boys—Infants. Surbiton—Hook—St. Paul's C.E. 2 Departments—Mixed—Infants. Council Schools. 1919. Average number on Books 2175 Average Attendance 1939'3 Percentage of Attendance 89.1 Accommodation 2289 These schools are inspected three times a year during the vacations when they are thoroughly disinfected, and once a year the drains and sanitary appliances are tested and examined. The Hook Schools were closed for Whooping Cough from December 4th, 1919, to January 5th, 1920. The report of this appears under the heading of " Whooping Cough." Sanitary Inspection of the District. This subject is dealt with in the Report of the Sanitary Inspector. Premises and Occupations which can be Controlled by By-laws or Regulations. The following is a list of the Bye-laws and Regulations in force in the District:— (1) Bye-laws with respect to Nuisances. (2) Bye-laws as to Slaughter-houses. (3) Regulations as to Dairies, Cowsheds and Milkshops. (4) Bye-laws as to New Streets and Buildings. 38 (5) Regulations as to Underground Rooms habitually used as Sleeping Places. (6) Bye-laws as to Public Conveniences. (7) Bye-laws as to Recreation Grounds. (8) Bye-laws as to Allotments. (9) Bye-laws with respect to the Cemetery. (10) Bye-laws as to Means of Escape in Case of Fire in certain Factories and Workshops. (11) Bye-laws witli respect to Tents, Vans, Sheds and Similar Structures. (12) Ditto under Good Rule and Government of the District. (13) Ditto as to Registries for Female Domestic Servants'. Welfare Centre. Maternity and Child Welfare.—The Statutory Powers and Duties in this connection are now vested in the Surrey County Council under an Order of the Local Government Board (now the Ministry of Health). By arrangement, however, the District Council still retain a large measure of control over the work, which duty is performed by the Public Health Committee who for this purpose have coopted several ladies, representing the churches and other interests. The Centre at which all the work is coordinated has been, up to the time of writing, at the Council House, but a special building in the Council grounds is now nearly finished and will 39 probably come into use during the Autumn. This has been arranged for in conjunction with the Surrey County Council. A mothers' and infants' clinic is held at the Council House weekly on Thursdays at 2.30 in the afternoon. Dr. Hodge is the visiting Lady Medical Officer of the Clinic, and Miss Leigh is the part-time Health Visitor, giving three days work per week within the District. The work of the Clinic, besides the registration of names and addresses and the weighing of babies, includes advice to mothers and attention to minor ailments for which medical assistance is rarely if ever sought. The work is mainly preventive, and infraction of the work of the medical practitioner is carefully avoided. Voluntary members of the Centre attend and help. The infants are regularly weighed and results noted, and advice is given on the feeding of both infants and mothers. With the opening of larger and more suitable premises, ante-natal help will be taken up and expectant mothers invited for advice and instruction. The carrying out of the Milk (Mothers and Children) Order, 1918, entails much more care and work than in the preceding year and cases in receipt of milk are always reported to the Health Committee at their monthly meetings. Great care is taken in order to be sure that only 40 tous cases get the milk required, and that, on the other hand, none was given in unnecessary cases. No accurate statistics are available for the year 1919, as a record has only been kept for the six months July to December. The attendances at the Clinic for 1919 were approximately about ... ... 1070 JN umber of confinements enquired into 220 Number attended by a doctor, a registered midwife being in attendance 132 dumber attended by a registered midwife alone 88 Surbiton Hospital. — This Hospital was first opened with six beds for the reception of patients in October, 1870, in a small semi-detached villa in the Victoria Road on the site now occupied by the present Surbiton Post Office. The site of the present Hospital was purchased in 1881 and the building erected thereon was opened in April, 1883, free of debt and fully equipped for 16 beds. The site is freehold. Cost of Site £1,150. Cost of Building £3,450. Furnishing £ 400. £5,000. 41 In 1907 the building was re-drained and enlarged to provide 21 beds at a cost of £768. The Hospital was erected and maintained to take in cases of sickness and accidents from the districts of Surbiton, now including Hook, Southborough and Tolworth, together with Long Ditton, Chessington and that isolated portion of Old Maiden Parish, situate on the Leatherhead Road beyond Chessington known as Maiden Rushett and which at that time was in the Kingston Union. Plats.—Reference to the Hospital associates the subject of Residential Flats. Throughout the district many of the larger and by degrees most of the basement houses are being converted into Plats which are quickly taken up, but the supply is not equal to the demand. In this way the population is being considerably increased. At the Census of 1911 the population was 17,717, and it was estimated by the Registrar General as being, in the middle of 1919, for the Birth-rate at 20,828, and for the Death-rate at 19,994. One noticeable consequence of this change in the circumstance of the housing of a considerable portion of the inhabitants is the want of accommodation for the exigencies of illness. There is mostly no spare room and in such conditions a nurse as an addition to the family is not possible, to say nothing of the inelastic domestic arrangements in most or many cases. The Committee of the Hospital recognizing this need have lately been considering the practicability of again enlarging the present building 42 with a view to the reception of more paying and private patients. The cost of building, however, is now so considerable that, with the increased cost of maintenance, administration, rates, taxes, etc., that must inevitably follow the addition of more beds, it must at present make the carrying out of this method of relief, so desirable in itself, under such conditions, almost impossible financially. A considerable addition to the subscription list, both in numbers and amount, will no doubt do much towards helping this scheme to fruition in the future, but the Hospital is, in any event, in urgent need of help at the moment. From my intimate association with the Hospital from its opening in 1870 to the present time, I have no hesitation in commending to all the inhabitants, and most especially to the newlyarrived residents, the paramount duty of becoming subscribers to this very deserving and wellmanaged Institution. SURBITON URBAN DISTRICT. List of Certified Midwives who have notified their intention to practise during 1920. No. Name. Address. Date of Enrolment. Qualification. 19,828 Deacon, Harriett 84, Red Lion Rd., Tolworth. 27/4/05 In practice July, 1901. 21,236 Feast, Alice Charlotte 7, James Street, Surbiton. 27/4/05 In practice July, 1901. 43 Public Baths. In my report for 1910 I strongly urged the formation of an open-air swimming bath and was sanguine enough to think that support might be forthcoming for it, but though nobody could or would gainsay the desirability of such an additional asset to our amenities, yet nevertheless the question of expense was deemed to be insuperable and nothing came of it. However, in view of the added population year by year since the Census of 1911, together with the prospective and certain increase that must take place during the next few years, consequent on the housing impetus, it is in my opinion imperative that the idea should be kept in the foreground and ever pressed forward until accomplished. Eligible sites are few and must become fewer as building progresses, so that if the matter is relegated indefinitely to the distant futuresay another ten years—it will surely then be held that golden opportunities have been lost to the inhabitants of having public baths, or at least an open-air swimming bath, under our own control for benefit of the residents and for the instruction of hundreds of boys and girls in the necessary art of swimming. If facilities were given for swimmers to indulge their fancies, and the opportunity of instruction in swimming were held out as an inducement, I am sure there would be a very large number ready and eager to seize it. E 44 We have only a half mile or so of river frontage and this is not available except on a very limited scale indeed, and then only to swimmers, and so the Kingston Baths are frequented by a not inconsiderable number of Surbiton people, especially by children when at home for the holiday and by those at the various schools. The Education Act of 1918 gives local authorities powers to build baths attached to schools, and the London Schools Swimming Association, of which Sir Cyril S. Cobb, M.P., Chairman of the Education Committee of the L.C.C., a former resident for some years on Surbiton Hill, is the president, has done all in its power for many years " to foster and encourage the art of swimming and the practice of life saving " with excellent results. The Kingston Baths are of very limited capacity, and owing to the numbers flocking there restrictions to a frequent use of them are inevitable but must be enforced, and so it is that the need for our own summer swimming bath is becoming more and more pressing for the pleasurable enjoyment and the well being of the inhabitants of Surbiton. In conclusion I desire to thank you Mr. Chairman, your predecessor and the Members of the Council for the kindness, consideration and forbearance shown me during the past four years, 45 especially so during the year of my illness. During this latter period I have had many occasions to be most grateful to Mr. Nesfield, the Sanitary Inspector, who was most ready and helpful whenever needed, and also to Mr. Wood, the Clerk, Mr. Mather, and all the officials of the Staff for their most efficient and kind assistance, always most ungrudgingly given. I am, Mr. Chairman, Ladies and Gentlemen, Yours obediently, OWEN COLEMAN, M.D., D.P.H., Medical Officer of Health August, 1920. E2 46 SANITARY INSPECTOR'S ANNUAL REPORT. July, 1920. To the Chairman and Members of the Urban District Council of Surbiton. Ladies and Gentlemen, I have the honour to present to you my Twentyfourth Annual Report showing the Inspections made during the year ending December 31st, 1919, together with particulars of nuisances abated and improvements effected in the District in consequence of such inspections. As no Report was made during the years 1916 to 1918, I have included the particulars of the work done for these periods. 47 COMPLAINTS. 1916 1917 1918 1919 Defective condition of house drainage 26 28 33 17 Insanitary condition of house 13 7 10 24 Insanitary condition of yards and paths 7 1 3 — Nuisance from dampness in house walls or floors 10 14 13 11 Defective water closets 5 4 9 7 Defective roofs 5 15 4 8 Accumulations of refuse or manure 3 2 4 5 Nuisance from animals improperly kept 4 1 2 9 Houses not provided with a sufficient receptacle for household refuse 7 284 4 19 Smoke nuisances 1 — — 1 Alleged overcrowding 3 2 — 5 Non-removal of house refuse 3 13 19 18 Offensive smells from various causes 10 12 11 16 Houses without a supply of water 2 20 10 9 Drinking water supplied from dirty storage tank 2 — — — Defective eaves gutters 2 — — — Water in Basements 7 8 7 2 Insanitary condition of a Bakehouse — — — 1 Defective sink waste pipes — 2 2 2 Insanitary condition of urinals — 1 — 5 Workshop without sanitary accommodation - - - 1 Burst water pipes ... — — 4 — Miscellaneous 15 5 4 16 Totals 125 419 139 176 48 INSPECTION OF DISTRICT. 1916 1917 1918 1919 Number of houses and premises inspected (ordinarily) 329 446 486 191 ,, houses inspected (H. T. P. Act) 31 1 — 67 ,, houses and premises reinspected 499 681 350 523 „ miscellaneous visits 112 186 168 283 „ stables inspected 39 — — — „ visits re cases of infectious disease 61 119 99 163 ,, visits to works in progress 1208 655 155 964 ,, visits to bakehouses 52 39 57 56 ,, visits to slaughter-houses 107 55 13 40 „ visits to dairies, cow-sheds, and milkshops 108 84 75 102 ,, visits to workshops ... 55 8 1 6 „ visits to factories 3 2 2 1 ,, visits to homeworkers' premises 13 14 10 13 ,, visits to workplaces 1 — — — ,, visits to schools 34 19 13 19 ,, food inspections 42 435 678 189 Totals 2694 2744 2107 2617 49 NOTICES SERVED. 1916 1917 1918 1919 Informal Notices 163 149 98 172 Statutory Notices under Section 36, Public Health Act, 1875, to provide a sufficient dust receptacle 88 335 88 29 Statutory Notices under Section 49, Public Health Act, 1875, to remove offensive accumulations 2 - - 1 Statutory Notices under Section 41, Public Health Act, 1875, to relay drains 1 - - - Statutory Notices under Section 94, Public Health Act, 1875, to abate nuisances 42 42 13 17 Statutory Notices under Section 25, Public Health Acts Amendment Act, 1907, to pave yards 12 - - 8 Statutory Notices under Section 49, Public Health Acts Amendment Act, 1907, to provide sink or drain 3 - 2 - Statutory Notices under Section 36, Housing, Town Planning, &c., Act, 1609, of intention to survey and examine dwelling house 4 - - - Closing Orders 2 — — — Statutory Notices under Section 17, Sub-Section (4), Housing. Town Planning, &o., Act, 1909, that Closing" Orders had become operative 2 - - - Statutory Notices under Section 18, Sub Section (2), Housing, Town Planning, Sic., Act, 1909, giving time and place at which the question of demolition of a dwelling house would be considered 6 - - - Demolition Orders 2 — — — Statutory Notices under Section 17, Sub-Section (6), Housing, Town Planning, &c., Act, 1909, refusing to determine Closing Orders - - - 2 Statutory Notices under Section 17, Sub-Section (7), Housing, Town Planning, &c., Act, 1909, prohibiting the use of underground rooms for human habitation - - - 1 Statutory Notice under Factory and Workshop Act, 1901, to cleanse Bakehouse - - - 1 Totals 287 526 201 231 50 RESULT OF INSPECTIONS. 1916 1917 1918 1919 Drainage systems exposed for examination under Section 41 of the Public Health Act,. 1875 3 8 - - Drains tested with water 131 40 16 33 Soil or ventilating pipes tested with smoke or air 142 34 5 20 Defective drains repaired, clean-ed, etc. 47 44 41 15 Drainage systems re-constructed 50 11 3 7 Additional drains provided 4 2 1 2 Houses subsoil drained 2 1 2 2 New intercepting traps fixed 31 10 2 6 New stoppers fixed in raking arms of intercepting traps 2 4 — 3 Approved iron or stoneware gullies fixed in lieu of defective stoneware, brick or iron bell traps 111 63 18 27 New manholes built 62 24 6 19 Manholes altered or repaired 21 4 — 4 Defective ventilating shafts repaired 17 1 — - Defective ventilating shafts removed and new ones fixed 11 6 — 2 Additional ventilating shafts provided 19 5 1 1 Mica flap fresh air inlet valves repaired or new fixed 5 4 1 10 Water closets rebuilt — 1 2 1 ,, lighted or ventilated 1 — — — ,, roofs repaired 4 2 — — ,, ceiling? repaired or renewed 1 — — — ,, internal walls repaired 6 8 — — ,, floors repaired or relaid 24 3 — 1 ,, doors repaired or renewed 2 6 1 1 51 RESULT OF INSEPCTIONS-contd. 1916 1917 1918 1919 Water closet pans cleaned or repaired 3 1 1 5 ,, new pans fixed 63 27 12 17 ,, flushing cisterns repaired 32 17 8 14 ,, new flushing cisterns fixed 27 8 6 5 Additional water closets constructed 1 — — — Defective soil pipes repaired 3 9 — 2 Defective soil pipes removed and new ones fixed 10 9 3 3 Additional soil pipes provided 1 1 — 3 Anti-syphonage pipes provided 3 2 — 2 Anti-syphonage pipes repaired 1 — - — Sink or other waste pipes trapped or disconnected from drain 3 10 1 10 Sink or other waste pipes repaired 4 3 3 — New trapped waste pipes provided to sinks, baths, etc. 60 35 13 9 Defective sink or lavatory basins abolished and new fixed 48 34 13 5 Additional sinks, baths, lavatory basins, etc., provided 12 1 — 3 Sinks, baths, etc., repaired 5 1 — - Rainwater pipes disconnected from drain or soil pipe 8 4 1 1 Defective rain-water pipes repaired 18 7 6 8 New rain-water pipes provided 19 2 — — Defective eaves gutters repaired 16 11 6 10 Roofs provided with eaves gutters 15 3 2 1 Defective roofs repaired and made weatherproof 38 27 13 21 Water supply pipes repaired 1 15 24 11 52 result op inspections—Contd. 1916 1917 1918 1919 Cold water draw off taps disconnected from storage cisterns and connected direct to the main 19 7 6 Storage cisterns abolished and all water fittings connected direct to the main 22 6 3 3 Water supply reinstated or laid on to house 1 19 6 7 Storage cisterns cleansed 4 4 2 4 Storage cisterns provided with a cover 4 4 — 1 Damp walls provided with damp-proof courses 8 14 — 2 ,, repointed or repaired 1 1 — 2 ,, rendered externally with Portland cement 11 3 2 — ,, treated externally with damp preventing solution 1 3 — 10 Sites of dwelling houses concreted to remedy dampness 8 9 — 3 Ventilation under floors provided 9 9 — — Defective house floors repaired or renewed ... 36 17 4 7 Defective house walls repaired 10 10 1 5 Defective ceilings repaired and renewed 5 3 2 10 Ceilings provided 1 2 — — Defective doors repaired or renewed 3 2 1 — Defective windows repaired or renewed 19 3 3 9 Fixed windows made to open 7 4 — 1 Sash cords repaired 28 12 2 12 Window cills throated 61 22 — 5 Window cills renewed 3 — — — Additional windows provided 12 - — — Rooms ventilated 1 5 — — 53 RESULT OF INSPECTIONS—Contd. 1816 1917 1918 1919 Dirty or infectious rooms cleansed 252 139 78 175 Yards paved 45 10 3 3 Yard paving repaired 5 3 1 — Yards cleansed 5 2 1 4 Receptacles for house refuse provided 63 208 67 22 Receptacles for house refuse repaired 1 2 5 1 Manure receptacles provided 1 1 — — Manure receptacles repaired 2 — — — Offensive accumulations removed 7 2 8 6 Nuisances from overcrowding abated 1 — — — Public House urinals cleansed 2 2 1 — Public House urinals reconstructed 3 — — — Nuisances from animals being improperly kept abated 1 1 2 1 Miscellaneous 18 11 1 7 54 DISINFECTION. The cases of infectious diseases necessitating the disinfection of rooms, bedding, clothing, etc., were as follows:— 1916 1917 1918 1919 Scarlet Fever 10 20 37 44 Diphtheria 7 11 22 33 Consumption 11 21 6 15 Cancer 6 3 4 Typhoid Fever 2 1 — — Infantile Paralysis 1 — — — Cerebro-Spinal Meningitis 1 1 — — Measles 1 — — 2 Itch — 1 — 1 Cardiac Dropsy and Syncope — — — 1 Pneumonia — 1 1 1 Verminous clothing, etc. 3 1 1 1 Scabies — 3 2 2 Erysipelas ... — 1 — — Poliomyelitis — 1 — — Bladder disease — 1 — — Miscellaneous — 17 1 — Totals 42 89 73 104 55 The following articles of bedding, wearing apparel, etc., were removed to the Tolworth Isolation Hospital for steam disinfection:- 1916 1917 1918 1919 Beds 18 31 121 11 Mattresses 59 107 30 124 Palliasses 14 16 1 31 Bolsters 40 53 64 77 Pillows 104 227 75 182 Sheets 34 42 17 26 Blankets 155 247 317 254 Counterpanes 26 42 7 50 Carpets 33 54 115 45 Rugs 42 37 36 34 Cushions 39 39 54 47 Toilet Covers 12 14 2 5 Towels 22 10 — 27 Wearing Apparel 618 808 600 756 Curtains 66 31 8 50 Sundries 42 8 — 39 Bed Valances 1 8 — — Quilts 17 18 45 38 Pillow Cases 29 20 2 1 Mattress Covers 14 33 14 1 Blinds — 14 28 9 Miscellaneous — 149 24 98 Totals 1385 2008 1560 1905 56 UNSOUND FOOD. The following table shows the quantities of diseased meat and other unsound foods destroyed or otherwise dealt with so as to prevent them being used for the food of man in the years 1916, 1917, 1918, and 1919:— 1916 1917 1918 1919 Beef — — 1671 lbs. 3493 lbs. Beef offal — — 78 „ 1288 ,, Mutton — — 65 „ 32 „ Pork — — — 300 „ Bacon — — 126 „ 1019 „ Herrings 250 — — — Mackerel — — 2 boxes 10 boxes Bloaters — — 300 — Kippers — — 200 — Corned Beef — — — 27 tins Butter — — — 54 lbs. Cheese — 25 lbs. 13 lbs. — Eggs — — — 63 Bread — 680 lbs. — — Barley Flour — — 76 lbs. — 57 LEGAL PROCEEDINGS. Legal proceedings were taken before the Magistrates in respect of the following cases:— No. Nature of Offence. Result of Proceedings. 1916. 1. Failing to provide stable with a suitable receptacle for the storage of manure. Fined £1. 2. Failing to obey a notice served under Section 17 of the Housing, Town Planning, &c. Act, 1909, to cease to inhabit a dwelling house in respect of which a Closing Order had been made. Order made for notice to be compiled with within 28 days, and for the payment of a fine of 50/- and £2 12s. 6d. costs. 3. Failing to obey a notice served under Section 17 of the Housing, Town Planning, &c. Act, 1909, to cease to inhabit a dwelling house in respect of which a Closing Order had been made. Order made for notice to be complied with within 28 days, and for the payment of a fine of 50/- and £2 12s. 6d. costs. 4. Failing to obey an Order made by the Magistrates under Section 17 of the Housing, Town Planning, &c. Act, 1909, to cease to inhabit a dwelling house in respect of which a Closing Order had been made. Order made for the house to be vacated within 7 days failing which a penalty of 10/- per day to be imposed. 5. Failing to obey an Order made by the Magistrates under Section 17 of the Housing, Town Planning, &e. Act, 1909, to cease to inhabit a dwelling house in respect of which a Closing Order had been made. Order made for the house to be vacated within 7 days failing which a penalty of 10/— per day to be imposed. 6. Failing to comply with a notice served under Section 94 of the Public Health Act, 1875, to abate a nuisance arising from the back approach to six houses being in a bad state of repair. 1917. Order made for the roadway to be paved within 28 days and for payment of 18/- costs. 1. Failing to comply with a notice served under Section 94 of the Public Health Act, 1875, to abate a nuisance arising from choked drains. Summons withdrawn on payment of 4/- costs, drains having been repaired the day following service of summons. 58 LEGAL PROCEEDINGS—Contd. No. Nature of Offence. Result of Proceedings. 1917. 2. Failing to comply with a notice served under Section 94 of the Public Health Act, 1875, to abate a nuisance arising from two houses being without a supply of water. 1918. Summons dismissed on payment of £1 Is. 0d. costs, water supply having been re-instated the day previous to the hearing. 1. To recover the sum of 18s. 6d. expenses incurred in the provision of a proper receptacle for the storage of ashes and other refuse. Order made for the payment of the amount claimed together with 10/6 costs. 2. Slaughtering pigs on unlicensed premises. 1919. Fined £4. 1. Failing to comply with a notice served under Section 94 of the Public Health Act, 1875, to abate a nuisance arising from overcrowding. Order made to abate nuisance within 14 days, and for payment of £3 3s. 0d. costs. 2. For allowing two houses in respect of which a Closing Order was in force to be occupied contrary to the provisions of Section 32 of the Housing, Town Planning, &c. Act, 1919. Fined £40 and 4 guineas costs. I am, Ladies and Gentlemen, Your obedient Servant, W. NESFIELD, A.R.San.I., Sanitary Inspector.