TED 012 DISTRICT OF TEDDINCTON. ANNUAL REPORT OF THE Medical Officer of Health, TO BE PRESENTED TO THE URBAN DISTRICT COUNCIL OF TEDDINGTON. 1 902. teddington : Parrott & Ashfield, Printers, The Causeway. ANNUAL REPORT on the SANITARY CONDITION of the URBAN DISTRICT OF TEDDINGTON, For the Year 1902. To the Chairman and, Members of the Urban District Council of Teddington. Gentlemen, I have the honour to place before you my Annual Report on the Mortality, Health, and Sanitary Condition of your District for the year 1902. The total number of deaths which occurred and were registered was 206, and included— 13 from Diphtheria. 5 ,, Measles. 2 ,, Epidemic Influenza. 10 ,, Whooping Cough. 13 ,, Pneumonia. 16 ,, Bronchitis. 5 ,, Other Diseases of the Respiratory Organs. 3 ,, Diarrhœa. 8 ,, Enteritis. 19 ,, Diseases of the Nervous System. 14 ,, Heart Disease. 5 ,, Alcoholism. 7 ,, Phthisis. 9 ,, Other Tubercular Diseases. 11 ,, Cancer. 14 ,, Old Age. 14 ,, Premature Birth. 4 1 from Diseases and Accidents during Parturition. 4 ,, Accidents. 1 ,, Suicide, and 32 ,, Various Causes. 206 108 were Males and 98 Females. 49 were under 1 year of age, and 45 were over 65 years. From the number of deaths which were registered in the district we must deduct 2, those of non-residents who had no connection with the district. This brings the number of deaths to 204, giving a mortality rate from all causes of 14-5 per 1000 persons living. The following is the death-rate in the different Wards:— Fulwell Ward 15.44 Lower Teddington Ward 12.25 South Teddington Ward 11.75 Upper Teddington Ward 16.54 The death-rate from the principal zymotic diseases (including diarrhoea) is 2.2, and from the scheduled notifiable diseases, 0.92 per 1000 of population. The number of Births was 351, of which 173 were males and 178 were females. The birth-rate was 25 and the infant mortality 139 per 1000 births. Comparing these figures with the averages for the last 10 years, we find that the death-rate of 1902 is 1.9 higher, the infant mortality 1 lower, and the birth-rate 0.4 higher. 5 INFECTIOUS DISEASES. I.—Not Notifiable. MEASLES. There was a slight epidemic of measles in March and April, and many cases occurred in December. Five deaths were registered, of which four were infants under 6 years. WHOOPING COUGH. Many cases of Whooping Cough occurred after measles had disappeared. They appeared during the summer months. Ten deaths were registered and nearly all were infants. DIARRHCEA. There were fewer cases during the summer months than in former years ; only three deaths of infants were registered. INFLUENZA. Influenza was prevalent in the beginning of the year and also in December. The cases were generally of a mild type; only two cases proved fatal. II.—Notifiable. SCARLET FEVER. Seventeen cases have been notified during the year as against 42 in 1901; there was no death. SMALL POX. Between 29th January and 13th June, 17 cases of Small Pox were notified, and the Small 6 Pox Committee, which was appointed by your Council, held almost daily meetings during the prevalance of the disease. The particulars of the first case, which occurred on 29th January, appeared in my last year's Report. The second case, which was notified on March 2nd, was in no wise connected with the first. It was imported from a lodging-house in the Westminster district, whence the patient came on 24th February. He worked as a baker in a shop in the Causeway, till February 27th, when he fell ill, and was medically attended. On the 2nd of March a rash appeared, and the case was notified to me as Confluent Small Pox. The day being a Sunday, no other steps could be taken that day except to have all the inmates in the house revaccinated, and to ask the Authorities of the Croydon and Wimbledon Small Pox Hospital to admit the case into their Wards. On Monday I received their consent to send the case there. The patient died a few days after his reception. He had never been vaccinated in infancy, and was an anti-vaccinator. After the removal of the patient, the bedroom and the adjoining rooms were thoroughly disinfected, and his few articles of clothing, and his bed, burned. His master consented to close his shop and not to deliver any goods to customers for a fortnight. As there was no advantage to be gained by keeping the other re-vaccinated inmates at home, they were allowed to go out under the condition that they were seen daily by a medical man. No other case resulted from this source. 7 Notice was given to the Medical Officer of Health for the district of Westminster, that the patient resided in a Lodging House in Bow Street, Covent Garden, before he came to Teddington. On the 25th of February, Dr. Manby, Medical Inspector of the Local Government Board, attended at the Council's Offices to confer with your Committee as to the steps to be taken by the Council to deal with cases of small pox should such occur in the district, and to prevent the spread of the disease. Dr. Manby pointed out the desirability of the Council taking measures to have their employees re-vaccinated, and that a note should be kept of those who declined to be re-vaccinated in case the Inspector of Nuisances should require any assistance on a case of small pox arising, and that only those who had been re-vaccinated should be so employed. The Inspector also considered it desirable that the Inspector of Nuisances should be provided with regular Assistants in fumigating and disinfecting in infectious cases, and suggested that one or more of the Council's workmen should be placed at his disposal. The Inspector also recommended that the Infectious Diseases Prevention Act (i8go) should be adopted, and he pointed out the importance of the Council providing a steam disinfecting chamber. On Monday, 28th April, the third case of small pox was notified in No. 29 Springfield Road. I visited this house without delay and found Mrs. Penfold with a daughter, aged 17, and an unvaccinated baby, aged 5 weeks, lying in the same bed. The mother had a profuse and distinct eruption of small pox, and the daughter was highly feverish. In the latter part of the day the eruption appeared on the daughter, and she and 8 the baby were also notified as suffering from small pox. Our request to the Authorities of the Croydon and Wimbledon Small Pox Hospital to admit the three patients was kindly granted, and all three were taken in the evening to the hospital. It may be remarked here that in this, as in all the other cases, the Vaccination Officer was at once informed of the occurrence of an outbreak, and he visited the scene of the outbreak without delay. He also called at the dwellings in the infected road and persuaded the inhabitants to submit to re-vaccination at once. The Public Vaccinator was also promptly requested to revaccinate the inmates of the infected houses, the inhabitants of neighbouring houses, and the contacts. If such contacts lived out of the district, notice was sent to the Authorities where they resided. On 30th April, William Penfold, aged 9 years, and on 4th May, Susan Penfold, aged 6 years, both living in the same house, were notified as suffering from small pox. Both of these children had been vaccinated in infancy, and the disease was of a very mild type. As they were already in an infected house, I advised the Committee not to send them to the Hospital, especially as my attention was called by the Medical Officer of the Small Pox Hospital to the fact that the demands on the hospital at Cheam were increasing, and that it was very improbable that they would be in a position to take in another case from our district. On the 1st of May, I received information that Mrs. Chalkley, aged 40, residing in the same road, but opposite the Penfold's, was suffering from small pox, and also her two children, aged 12 and 3 respectively. The mother had rather a 9 severe attack, and was removed to the hospital ; the two children had the disease in a very mild form, and bearing in mind the demands on the hospital, I considered it best to keep them at home. On May 7th, another case at 37 Springfield Road was notified. It was that of a boy 6 years old, who had frequently been in contact with the Penfold family. He had a severe attack, and was taken to the hospital. According to the mother's statement the boy was vaccinated when three months old, but only two punctures were made, one of which did not take at all, and the other very slightly. Regarding the cause of the outbreak in these houses in Springfield Road, I came to the conclusion that all nine cases got infected, either directly or indirectly, from one source. A woman living at 31 Springfield Road, the next house to that of the Penfold family, died on April 19th, after a short illness, and the cause of the death was certified "acute Hoemorrhagic Pupura." Mrs. Penfold, her nearest neighbour, visited her constantly during her illness, and acted, to a certain extent, as her nurse. After the woman's death, certain articles of clothing were moved into Penfold's house. It came also to my knowledge that Mrs. Chalkley, the person living opposite, laid the dead body out, and she was also attacked with small pox a few days after Mrs. Penfold. I have no doubt that the woman who died was suffering from a form of small pox in which the only manifestation of the disease is the formation of Hoemorrhagic spots. Such cases do not resemble those of ordinary small pox, and it is only during an epidemic that we can positively determine them to be due to small pox poison. These cases 10 always end fatally and generally within a very short time after the commencement of the disease. This form of small pox is now very rare. It appears to have been much more common before vaccination was introduced. On May 5th, I received notice that John Mundy, age 35, of 4 Cranmer Place, was suffering from small pox. He was a bricklayer's labourer, and worked at Weston Green, where he had probably contracted the disease. As he had a severe attack, and the accommodation and situation of his house was thoroughly unsuitable for a sick person, I sent him to Cheam, after communicating with the Hospital Authorities. There were two lodgers in his house who worked at Teddington Lock, employed by the Thames Conservancy. The lodgers were re-vaccinated, and also all the men who were employed at the Lock, and who came into contact with them. On Friday, 23rd May, I received information that there was an outbreak of small pox at 3 Gomer Gardens. The house was inhabited by Thomas Stocker, his wife and eight children. I found three children, aged 11,5, and 3, with a fully developed eruption of small pox. Evidently they had had the rash for about four days, but no medical man had been called in. Measures were at once adopted to remove them to the small pox hospital the same evening. Those children had never been vaccinated. Only three out of the eight had been vaccinated in infancy, the reason being that the father had a "bad arm" when he was re-vaccinatcd in the Army. This outbreak gave a great deal of anxiety, as the father and three of the elder children were working at various places. The father and one of his sons were employed on a barge, the eldest daughter worked 11 in a laundry, and another son was employed at a Pawnbrokers. All the inmates of the house were at once vaccinated and re-vaccinated, and also the contacts working in the barge, the inmates of the pawnbroker's shop, and the persons employed at the laundry. It was found that the washing of thirty-four families was stored at the laundry, and would have been sent home the next day to the various owners. I stopped this distribution, and had all the linen disinfected with Formalin Spray. The inmates of Stocker's house were kept under medical supervision for a fortnight. It is very probable that the Stocker children got infected from Chalkley's house, 3 Gomer Gardens being in close proximity to 30 Springfield Road. On June 8th, I was informed that Emily Shepherd, aged 26, of 36 Crundall Villas, York Road, was suffering from small pox. She was employed during the day in a tea shop at Hampton Court. She came home on the 5th feeling very ill, and on Sunday, 8th June, a fully developed eruption of small pox was seen. There were in addition four grown up persons and five children in the house. She was at once removed to the Small Pox Hospital, and all the inmates and contacts were re-vaccinated, and the premises disinfected. The day after her removal, I received a letter from the Medical Superintendent of the Croydon and Wimbledon Small Pox Hospital, asking me not to send any more cases to the hospital, as the Hospital Committee would not admit any case from an outside district. Fortunately the next case was the last we had in the district, and was of a very mild type, so much so that it was not considered desirable to send the patient from home. 12 The patient was James Roughton, aged 39, of 1 Cranmer Road, and was notified as suffering from small pox on 13th June. He had been ill ten days before a medical man saw him, and had a very slight eruption of well-defined small pox pustules. As the case was a very mild one, and only his wife and one son lived in the house, I did not consider it necessary to remove him from home even if we had had hospital accommodation for him. He was employed in laying pipes by the Vauxhall Water Company, at Wimbledon, and I informed the Contractor of those works of the man's illness. He made a quick recovery, and none of the inmates of his house or contacts got infected. All the cases which were taken to the hospital were removed in the Council's carriage, which was, after every journey, disinfected. In some of the cases children attended school from an infected house before the case was notified, and, in order to prevent the spread of the disease, the school was closed for a day and disinfected. SMALL POX CASES DURING 1902. No. Name. Sex. Age. Address. Notified. Vaccination. Type. Where treated. Result. 1 Charles White M 23 Fulwell Road 29 Jan. Vaccinated, not revaccinated Moderate severity Removed to Croydon and Wimbledon Smallpox Hospital Recovery. 2 D. Nichol M 29 Causeway 2 Mar. Unvaccinated Confluent Hœmorrhagic „ „ Death. 3 M. Penfold F 36 29 Springfield Road 28 April Vaccinated in infancy Severe „ „ Recovery. 4 F1. Penfold F 17 „ „ Moderate „ „ „ 5 Hetty Penfold F 5 wks. „ „ „ Unvaccinated Severe „ „ „ 6 William Penfold M 10 „ „ 1 May Vaccinated Very mild At home „ 7 Susan Penfold F 6 „ „ 4 „ „ „ „ „ 8 Mrs. Lydia Chalkley F 39 30 Springfield Road 30 April Vaccinated in infancy Severe Sent to hospital „ 9 Edward Chalkley M 3 „ „ 1 May Vaccinated Very mild At home „ 10 Frank Chalkley M 12 „ „ 4 ,, „ Mild „ „ 11 George Bache M 6 37 Springfield Road 5 ,, Vaccinated insufficient Severe Sent to hospital „ 12 John Mundy M 35 4 Cranmer Place 5 „ Vaccinated in infancy „ „ „ „ 13 Olive Stocker F 11 3 Gomer Gardens 23 „ Unvaccinated „ „ „ „ 14 Harry Stoeker M 5 „ „ 23 „ „ „ „ „ „ 15 Arthur Stocker M 3 „ „ 23 ,, „ „ „ „ „ 16 Emily Shepherd F 26 36 Crundall Villas 8 June Vaccinated Moderate „ „ „ 17 James Roughton M 38 1 Cranmer Road 13 „ Vaccinated and revaccinated Very mild At home „ 14 CHICKEN POX. Fourteen cases of Chicken Pox were notified during the year, and I inspected all of them. Chicken Pox ceased to be a notifiable disease after August 7th. DIPHTHERIA. There have been thirty-five notifications of this disease received during the year, thirteen of the cases proving fatal. Thirty occurred in Upper Teddington Ward, two in Fulwell Ward, three in Lower Teddington Ward, and none in South Teddington. Twenty-two cases occurred in March and April, and also the greater number of the thirteen deaths. The high mortality (viz., about 30 per cent) might have been prevented if the parents had sought medical advice at an early stage of the outbreak, when the Antitoxin treatment could have been adopted with success. In many cases it was not adopted at all, and in some when it was too late. The usual measures were taken in each case to prevent the spread of the disease. ENTERIC FEVER. Four cases were notified, and all recovered. In three cases no cause for the origin of the disease could be traced. In one case the patient had eaten oysters ten days before he was taken ill. ERYSIPELAS. Nine cases were notified, but no deaths occurred. 15 INSPECTION AND OTHER SANITARY WORK. FACTORY AND WORKSHOP ACT. A systematic inspection of the District was made in October, November, and December. Many of the usual insanitary conditions were found, such as foul cesspools, overflowing and stopped drains, defective and broken roof gutterings, dilapidated dustbins or want of dustbins, accumulation of rubbish and manure, dirty yards, flushing cisterns out of order, defective water closet apparatus, broken closet pans and water pipes causing dampness of walls, untrapped gullies, leaky cisterns, defective manure pits and yard pavings, dirty pigstves, and broken ventilating pipes. In all cases verbal and statutory notices were given to occupiers or owners, and they were duly complied with. Apart from the systematic inspection, many inspections were made in connection with infectious diseases or complaints received. Several occupiers of houses in Munster Road (which is a private road) complained of the insanitary and dangerous condition of their dwellings, arising from cesspools into which their houses were drained and which are so near to the living rooms that sewage water leaks into the basement. The frequent emptying of the cesspool is also a great source of annoyance. The owner was served with a notice to abate the nuisance and provide proper means of drainage for the houses. He agreed to drain eight houses in Munster Road by laying down drain pipes in the roadway and to connect them with the Council's sewer in Kingston Road. 16 Notices had to be served on various owners and occupiers of shops in the Causeway, to put the roadway at the back of their premises into proper repair. After some delay the necessary work was carried out satisfactorily. The footpath behind Victoria Terrace, Victor Road, and part of Stanley Gardens Road were found in a very insanitary condition. They were covered with deep mud and stagnant pools of water, mixed with house refuse and other filth. Gravelling has made a temporary improvement till the road is thoroughly made up, which will take place in the near future. Various inspections were made to the gravel pits in Holmesdale Road in consequence of complaints of a nuisance caused by shooting down house refuse to fill up the excavations. Orders were given to cover all refuse with soil. No further complaint has been made since this was done. A nuisance was reported caused by bad smells from a fried-fish shop in Stanley Road. An order was served on the occupier to abate the nuisance, and no complaint has since been received. All the schools in the district were inspected at various times, and their sanitary arrangements were found satisfactory. The Factory and Workshop Act (1901) caused heavy additional duties on the District Council. In respect to these duties, the following provisions may be classified:— (1) Cleanliness. (2) Air-space for persons employed. (3) Ventilation. (4) Drainage of floors on which wet processes are carried on. 17 (5) Provision of suitable and sufficient sanitary conveniences. In Factories the duties of the Sanitary Committee chiefly refer to sanitary conveniences, and the giving of certificates regarding means of escape in case of fire. A Register of all Workshops situated within the District has to be kept ; the one for Teddington is not complete, but is in course of preparation. Up to the present, many workshops have been visited at the systematic inspection, viz.— Laundries, Bakehouses, Slaughter Houses, Cowsheds and Dairies, Greengrocers and Provision Shops. BAKEHOUSES. Eleven bakehouses are in the district, and they were found in a satisfactory condition. In some instances limewashing was required. There is no bakehouse on the same level with a sleeping place, and they have all a pure water supply. Two are underground bakehouses, which have been in existence many years, and are kept in conformity with the provisions of the Act. LAUNDRIES. In seven Laundries outworkers are employed : in one mechanical power is used, and twenty-six persons, nearly all females, do the work. There is no person under sixteen amongst the workers. The premises are clean, well drained and ventilated, and the sanitary conveniences satisfactory. In two laundries the drainage was insufficient, stagnant water being found on the floor. Notice was given to remedy this defect. 18 With the other laundries no fault could be found. In each of the seven the persons employed sleep in their own homes. In twenty-four laundries the work is done by members of the same family, who sleep on the premises. DAIRIES AND COWSHEDS. These have been periodically inspected, and the following defects were remedied:—Seven cases of nuisances arising from the accumulation of manure, one from foul cesspool, two from dirt within the cowshed, two from defective receptacles for storing manure. In two instances it has been necessary to give frequent attention to the removal of manure, as the premises are situated in close proximity to dwelling-houses. A statutory notice was served upon an owner to provide a proper shed for preparing food for the cattle, and to repair the defective condition of the yard paving and cowshed. This notice was complied with. Many times I called the attention of a tenant of a cowshed to the unsatisfactory condition of his premises, that the buildings were greatly dilapidated, the yard badly paved, the drainage defective, and the manure stored in unsuitable spots. As the tenant was unwilling to incur the expense for the necessary and extensive alterations, your Council represented the case to the owners of the premises, with the result that they agreed to erect new temporary buildings with better accommodation for the business of a cowkeeperand dairyman. SLAUGHTER HOUSES. Inspections were made of these premises, and only on one occasion was it necessary to give a verbal notice as to a nuisance, which was at once attended to. 19 WATER SUPPLY. The water supply from the Grand Junction Water Company was satisfactory. Three samples of well-water were analysed, and one was found to be contaminated with organic matter. The well was closed, and a supply obtained from the Water Company. OVERCROWDING. Several investigations were made as to overcrowding. In only one case a cottage was found over-populated. After serving an order on the owner and tenants, the former got rid of all the inmates and let the cottage to another tenant. DUST AND HOUSE REFUSE. Applications continue to be received for a more frequent removal of the contents of the dustbins, but the expense of doing so has so far debarred your Council from complying with the request of the applicants. SEWERAGE AND DRAINAGE. Eighty-one connections have been made to the Sewerage System during the year, through which the sewage from 130 new and 12 existing houses will ultimately flow. This work has also resulted in the disconnection and disuse of a number of old cesspools. The Sewerage System has been extended in Stanley Road for the purpose of draining the Car Sheds. This has necessitated the construction of a syphon under the railway line. In several cases the surface water drains have been relaid, cleansed, and in some cases, extended ; particularly in Victor Road, Wick Road, Kingston Road, Kingston Lane, Hampton Road, and Broad Street. 20 SEWAGE DISPOSAL WORKS. With the exception of one complaint, the Sewage Disposal Works have been conducted in a satisfactory manner. MIDWIVES' ACT, 1902. This Act comes into operation on the 1st of April next, and the Middlesex County Council becomes the supervising Authority over midwives within the County. I supplied a list of the persons at present using the title of midwife within our district. ISOLATION AND SMALL POX HOSPITALS. Negotiations with neighbouring Authorities for making provision for the erection of an Isolation Hospital were again opened, but no decision has been arrived at. In my last Report I mentioned that the result of the Conference of various District Councils at the Westminster Guildhall with reference to the erection of permanent Small Pox Hospitals did not assist our District in our difficulty. As the neighbouring Districts, Hampton and Hampton Wick, were in the same position, the Chairmen of the three Councils agreed to erect a temporary hospital on a piece of land situated in the parish of Hampton. The land was taken on a tenancy for three years, and the temporary hospital ha9 been erected for 8 males and 4 females. All expenses were to be borne by the three Councils in proportion to the population at the last census, and they 21 were to have equal rights to use the hospital. The cost of nursing, medicine, and medical attendance was to be paid by the Council sending the patient. The Agreement was sealed on 6th October, 1902. I remain, Gentlemen, Your obedient Servant, TH. GUNTHER, M.D., Medical Officer of Health. 22 INQUESTS DURING 1902. Date. Age. Verdict. Jan. 22 2 yrs. 9 mnths. Suffocation at a fire. Accidental. Jan. 21 7 months Syncope from general debility p.m. May 8 5 months Pneumonia. p.m. May 17 58 years Apoplexy. p.m. July 7 12 months Concussion of brain. Accidental fall. p.m. Aug. 6 52 years Suicide by revolver shot while of unsound mind. Aug. 8 65 years Syncope. p.m. Nov. 26 Newly-born Want of proper attention at birth. Dec. 1 49 years Fatty degeneration of the heart. Dec. 6 22 months Congestion of the lungs. Dec. 4 48 years Valvular disease of the heart. Dec. 2 3 hours Syncope, due to obstruction in the lungs. Natural causes. Dec. 7 40 years Ptomaine poisoning caused by eating shrimps. 23 Sanitary Work done by the Inspector of Nuisances during 1902. Complaints Received 28 Total number of Houses Inspected and re- Inspected (about) 1946 Letters written 88 Cautionary Notices given 15 Statutory Orders Issued 20 Houses, Premises, etc. cleansed and repaired 29 Periodical Inspections of Schools . monthly. Periodical Inspections of Slaughter Houses half-yearly. Houses Demolished 0 Periodical Inspections of Cow Sheds 36 Contravention of Bye-laws 14 Periodical Inspections of Dairies and Milk Shops 36 Cisterns cleansed, repaired, covered, etc. 73 24 Water Closets:— New apparatus provided 15 Repaired, cleansed, etc. 32 Supplied with water, or supply rendered efficient 83 Ventilated 12 Drains examined, tested, exposed, etc. 15 Drains unstopped, repaired, trapped 145 Soil Pipes and Drains ventilated 6 Cesspools emptied, cleansed, etc. 15 Rooms fumigated 62 Rooms stripped and cleansed 30 Dust-bins repaired 34 New Dust-bins provided 31 Roofs of Houses repaired 28 Guttering and Rain Pipes repaired 74 Accumulation of Refuse 16 Stagnant water 2 Foul pigs and other animals 1 Other nuisances 7 TABLE I. For Whole 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 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 1892 10,525 293 27 90 25 85 140 13.33 140 13.33 1893 11,000 277 25.18 47 169 163 14.81 163 14.81 1894 11,000 298 27 09 41 137 140 12.72 2 138 12.55 1895 11,187 269 24.05 55 204 178 16 178 16 1896 12,100 260 21.48 34 130 136 11.24 136 11.24 1897 13,000 294 22.6 42 143 156 12 156 12 1898 14,000 287 20.28 41 144 149 10.66 2 147 10.5 1899 14,425 351 27.7 45 128 167 11.65 4 163 11.29 1900 14,500 353 24.35 53 150 213 14.7 2 211 14.35 1901 14,029 359 25.67 40 111 130 9.26 5 2 6 134 9.55 Average for years 1892-1901. 12,576 304 24.6 42.3 140 157 12.6 2.4 156 12.5 1902 14,037 351 25 49 139 206 14.6 2 204 14.5 * Rates calculated per 1,000 of estimated population. Note.—The deaths to be included in Column 7 of this table are the whole of those registered during the year as having actually occurred within the district or division. The deaths to be included in Column 12 are the number in Column 7, corrected by the subtraction of the number in Column 10 and the addition of the number in Column 11. By the term "Non-residents" is meant persons brought into the district on account of sickness or infirmity, and dying in public institutions there; and by the term "Residents" is meant persons who have been taken out of the district on account of sickness or infirmity, and have died elsewhere. Area of District in Acres (exclusive of area covered by water) 1,214 Total population at all ages (at Census of 1901) 14,037 Number of inhabited houses (at Census of 1901) 2,754 Average number of persons per house ,, 5.09 VITAL STATISTICS OF SEPARATE WARDS IN 1902. Names of Localities. Fulwell Ward. Lower Teddington Ward. Sooth Teddington Ward. Upper Teddington Ward. 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. 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. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. 1902 1,943 30 11 3,591 44 7 1,793 21 4 6,710 Ill 27 TABLE IV. Causes of, and Ages at, Death during Year 1902. Causes of Death. Deaths in whole District at subjoined ages. Deaths in localities (at all Ages). Deaths in Public Institutions. All ages. Under 1. 1 & under 5. 4 & under 15. 15 & under 25. 25 & under 65. 65 & upwards. Small-pox Measles 5 4 1 Scarlet fever Whooping-cough 10 2 7 1 Diphtheria and membranous croup 13 1 7 5 Croup Fever— Typhus Enteric Other continued Epidemic influenza 2 1 1 Cholera Plague Diarrhoea 3 2 1 Enteritis 8 6 1 1 Puerperal fever Erysipelas Other septic diseases Phthisis 7 1 1 5 Other tubercular diseases 9 1 2 2 1 3 Cancer, malignant disease 11 9 2 Bronchitis 16 7 4 2 3 Pneumonia 13 2 2 6 3 Pleurisy Other diseases of respiratory organs 5 5 Alcoholism 5 5 Cirrhosis of liver Venereal diseases Premature birth 14 14 Diseases & accidents of parturition 1 1 Heart diseases 14 1 11 2 Accidents 4 2 1 1 Suicides 1 1 All other causes 65 13 3 2 2 17 28 All causes 206 49 33 12 5 62 45 TABLE III. Cases of Infectious Disease notified during the Year 1902 in Teddington District. Notifiable Disease. At all Ages. Cases Notified in Whole District. Total Cases Notified in Each District. No. of Cases Removed to Hospital from each Locality. At Ages—Years. Fulwell Ward. Lower Teddingt'n South Teddingt'n Upper Teddingt'n Fulwell Ward. Lower Teddingt'n South Teddingt'n Upper Teddingt'n Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards Small-pox 17 1 2 6 2 6 1 12 4 1 8 3 Cholera Diphtheria 35 11 13 4 7 2 3 30 Membranous Croup Erysipelas 9 1 6 2 1 2 6 Scarlet Fever 17 3 8 3 3 1 6 3 7 Typhus Fever Enteric Fever 4 2 2 2 2 Relapsing Fever Continued Fever Peurperal Fever Plague Chicken-pox 14 1 5 6 1 1 3 1 10 Totals 96 2 21 36 10 25 2 5 28 4 59 1 8 3 No Isolation Hospital in this District.