TED 16 Urban District of Teddington. ANNUAL REPORT OF THE Medical Officer of Health E. G. GIBBS-SMITH, L.R.C.P., D.P.H. FOR THE Year 1910. TEDDINGTON: PRINTED BY T. W. CHILDS. BROAD STREET. ANNUAL REPORT UPON THE VITAL STATISTICS AND PUBLIC HEALTH ADMINISTRATION OF THE URBAN DISTRICT OF TEDDINGTON FOR THE YEAR 1910. To the Chairman and Members of the Urban District Council of Teddington. Gentlemen, I have the honour to present to you my second Annual Report. It is gratifying to be able to state that the health of the district continues in a satisfactory condition. The death rate—generally very low— is lower than it has been for the past nine years, equalling within a fraction the record rate of 1901. The number of infectious diseases notified during the year was only 47 snewing a decrease of 37 upon last year's returns. The most striking feature of the year's returns is the enormous reduction in the infantile mortality, which shews a decrease of almost 50 per cent upon last year's figures. These facts all tend to prove that the sanitary condition must be on the whole good. 4 In speaking of the saniatry condition in my last year's report I made the following remarks:— "Premises in general, especially the back yards and gardens of the working class houses, with but few exceptions, were very clean and well kept. This is a very important factor in regulating the health of a district, and I have no hesitation in saying that the excellent conditions prevailing are largely due to the thoroughness, tact and ability with which your Sanitary Inspector (Mr. Wheeler) does his work." I would reiterate those remarks this year. I shall comment, where necessary, upon the items of this report under their respective headings, but I wish first to again tender my appreciative thanks to the Chairman and Members of the Sanitary Committee for their invariable courtesy and consideration; to the Clerk, Surveyor, Kate Collector and their respective stafls, for help always most willingly given; and lastly to your Sanitary Inspector for his continued and unselfish assistance, which is invaluable to me. I am Gentlemen, Your obedient servant, ED WD. G. GIBBS-SMITH. 5 AREA TOPOGRAPHY, Etc. The Urban District of Teddington has an area of 1,196 acres of land and 18 acres of water, making a total of 1,214 acres. The sub-soil is almost entirely composed of gravel and sand. The boundaries are:— North—The Urban District of Twickenham. South—The Urban Districts of Hampton and Hampton Wick. East—The River Thames—about 1½ miles of its course —which separates Teddington from the Borough of Kingston-on-Thames, and the District of Ham in the County of Surrey. West—The Parish of Hanworth, which is a portion of the Rural District of Staines. Teddington Lock and Weir are too well known to require any description: at this point there is a footbridge connecting the two adjoining Counties (Middlesex and Surrey) and below this the Thames is tidal. The District is divided into four Wards, viz.:—Fulwell, Upper Teddington, Lower Teddington and South Teddington. About 25 acres of Bushy Park come within the boundary. There is a small public recreation ground overlooking the river, and in the Fulwell division there is a golf course of about 190 acres. 6 POPULATION. The estimated population of Teddington at the middle of the year 1910 was 18,240. It will be observed that I am using the same figures as last year. It is admittedly very difficult in a district of this description to arrive at an accurate estimate, and fearing the possibility of over estimating I have thought it wise to let last year's figures stand. The census will be taken this year, and we shall then get an accurate figure to work upon for a time. It would be more satisfactory for statistical purposes if a census were taken every five, instead of every ten years. The following table gives the population enumerated at the census of 1881, 1891 and 1901, together with the estimate for 1910, and is useful for comparison. Population (enumerated). Population estimated Middle 1910. 1881. 1891. 1901. 6,595 10,025 14,087 18,240 BIRTHS. 406 births were registered in the district during the year. This shews a birth-rate of 22.25 per 1000 of the estimated population. I pointed out last year that the method in vogue for recording the birth-rate might shew a lower rate than actually existed: this will not happen in the future, the Registrar-General having made fresh regulations by which births of residents occurring outside their respective districts (in institutions, etc.) will be accredited to the district to which they belong. 7 The birth-rate again shews a decline, and this year is below the average, not only of England and Wales as a whole, but below that of both the large and small towns. In an urban district of approximately 18,000 inhabitants, one would expect to find the birth-rate at least up to the average of the 136 smaller towns, and the question naturally arises as to why it should be on the downward grade. Some of the causes that contribute to a low birth-rate are:—A low marriage rate, late marriages, national unprosperousness, a small proportion of young women, a low infantile mortality. In districts which are largely composed of middle class residents, people are certainly marrying later in life than they used to, and marriages are fewer: not only national prosperity, but the mode of present-day life is accountable for this, and these factors are probably the chief cause as far as this district is concerned, though we must not altogether ignore the low infantile mortality. The births were made up thus:— Males. Females. Total. Legitimate 211 176 387 Illegitimate 10 9 19 Total 221 185 406 DEATHS. The number of deaths, including residents and non-residents, registered in and beyond the district, was 186, and was made up as follows:— 8  Males. Females. Total. Deaths registered in the District 69 79 148 Deaths of Teddington Residents outside the District— In the Kingston Union Infirmary 14 7 21 In Hospitals 4 1 5 In the Middlesex County Asylum 2 3 5 By Accident and Otherwise 4 3 7 Complete Total 93 93 186 Deaths of Non-Residents- In the Teddington and Hampton Wick Cottage Hospital 1 3 4 By Accident in the District or Otherwise 1 6 7 Total of deaths of Non-Residents registered in the District 2 9 11 Deducting this Total from the Complete Total, we obtain the Nett Total of all Deaths belonging to the District 91 84 175 This gives a nett death-rate of 9.59 per 1000 of the estimated population. CORRECTED DEATH-RATE. This has to be shewn for statistical purposes, in order that allowance may be made for the different age and sex distribution of the population in towns, as compared with that in rural districts. The corrected death rate for Teddington is 10 0 per 1000. The following table is given for comparison:— 9 Birth-rate, Death-rate, and Analysis of Mortality during the year 1910. Annual Rate per 1000 Living Deaths under one year to 1000 Births Birth Rate Death Rate Principal Epidemic Diseases Cols. 5—11 Small-Pox Measles Scarlet Fever Diphtheria Whooping Cough Enteric Fever Diarrhoea Crude •Corrected Cols. 1 2 3 4 5 6 7 8 9 10 11 12 England and Wales 24.8 13.4 13.4 0.99 00.0 0.23 0.06 0.12 0.24 0.05 0.29 106 77 Great Towns 25.0 13.4 14.3 1.23 0.00 0.31 0.08 0.12 0.29 0.05 0.38 115 136 Smaller Towns 23.7 12.4 12.9 0.88 0.00 0.16 0.06 0.11 0.24 0.05 0.26 104 England & Wales 25.0 13.6 12.8 0.74 0.00 0.15 0.05 0.12 0.17 0.05 0.20 96 less the 213 Towns Teddington 22.2 9.5 10.0 0.21 0.00 0.00 0.00 0.00 0.21 0.00 0.00 41 *The corrected Death-rates represent the Crude Death-rates in Col. 2 multiplied by the respective Factors for Corrections for differences of sex and age constitution of population. 10 In my report for 1909 I drew attention to what I considered a very low mortality rate, excluding accidents and suicides, amongst persons between the ages of 5 and 65 years, which spoke well for the health of the Thames Valley. The figures for 1910 for the same age period are exactly the same as they were for 1909, viz.—74, which gives a rate 4 per 1000 of the estimated population. The decrease in the death rate for the year is amongst persons at the two extremes of life, as will be seen by referring to the following tables, and also to Table IV page 30. Tables shewing the number of deaths of persons of 70 years of age and upwards. 1909. 70 & under 75 75 & under 80 80 & under 85 85 & under 90 90 & under 95 95 & und'r 100 Males Fmls. Males Fmls. Males Finis. Males Fmls. jMales Fmls. Males Fmls. 22 35 11 26 4 14 2 4 0 2 0 0 57 37 18 6 2 1910. 70 & under 75 75 & under 80 80 & under 85 85 & under 90 90 & under 95 95 & und'r 100 Males Fmls. Males Fmls. Males Fmls Males Fmls. Males Fmls. Males Fmls. 7 13 6 10 3 6 1 4 1 2 0 1 20 16 9 5 8 1 In looking over the returns for the past ten years I find that in no instance did the rate for the year reach 6 per 1000 of the estimated population, and the average for the ten years is 4.6, whilst the average for the last four years is 4. 11 CAUSES OF DEATH. These are fully enumerated in table IV. The four diseases which caused the greatest number of deaths were:—Cancer, Pulmonary Tuberculosis, Heart Disease, and Pneumonia. CANCER. An unusually large number of deaths has been caused by this disease during the year, shewing a mortality much above the average (13) for the past ten years. Twenty-three cases were recorded, giving a percentage of 13.1 of the deaths from all causes, and a rate of l.26 per 1000 of the population. This year the cases were fairly evenly distributed between the four wards; it will be remembered that in last year's report I drew attention to the fact that for two years the bulk of of cancer cases occurred in one of the smaller wards. It must not be assumed that cancer is on the increase in the district: as a matter of fact, in all probability, the disease is not on the increase, either in this or in any other district in the country : that more cases are heard of at the present time than were formerly may be admitted, but the reason for this is more likely to be more accurate diagnoses than an increase in the case rate. Upon referring to table 4 it will be seen that thirteen of the 23 deaths were of persons of upwards of 65 years of age: of these 13, five were of ages varying from 70 to 73 years, and five of ages varying from 78 to 80. HEART DISEASE. Thirteen deaths were recorded under this heading, six of them being in persons upwards of 65 years of age. 12 PNEUMONIA. Twelve deaths were registered against 23 last year. This gives a per centage of 6.85 of the deaths from all causes, and a rate of .65 per 1000 of the estimated population. Eight of the deaths occurred in persons at the two extremes of life. INFANTILE MORTALITY. The number of deaths of infants under one year of age belonging to the district was 18, including one outside death, so the number upon which this rate is calculated is 17, outside deaths not being counted: this gives a rate of 41 per 1000 births registered. The number is exceptionally small, and the lowest that has ever been recorded in Teddington. The average for the past 10 years is 41.4, and the average rate 105.9 per 1000 births. The next lowest rate that I can find recorded is 61 per 1000 births for the year 1908. The rate of Infantile Mortality fluctuates from year to year, and Summer Diarrhœa plays an important part in its regulation: that no case of this disease is registered in the death returns is undoubtedly a big factor, at the same time it would have required a severe epidemic to have brought the returns up to anything like the average. Several factors influence the Infantile Mortality of a district, such as debility, premature birth, accidents (including "overlying"), etc, besides some of the diseases which are so fatal to young children. 13 A very low rate must be striking evidence of two facts, viz:—that the working class population are living under very favourable conditions, and that vice is not rampant. Premature birth only accounted for 3 deaths, and Debility for 4; and the number of deaths of illegitimate infants shews a very satisfactory decrease: only two being recorded out of 19 births, against 5 out of 8 births last year. A detailed account of the Infantile Mortality will be found on Table V. PRINCIPAL EPIDEMIC DISEASES The diseases which come under this category are:—Small-Pox, Measles, Scarlet Fever, Whooping Cough, Diphtheria, the fevers (Typhus, Enteric, and Continued) and Diarrhoea. The total number of deaths resulting from these diseases was four only, and these were all attributable to Whooping Cough. This shows a Zymotic death rate of • 21 per 1000, and a percentage of 2.28 of the deaths from all causes. For comparative rates of other districts see table on page 9. NOTIFICATION OF INFECTIOUS DISEASES. During the year 1910 the total number of cases notified in Teddington was 47, made up as follows: — Scarlet Fever 19 Diphtheria 19 Erysipelas 9 47 14 This gives a case rate of 2 57 per 1000 inhabitants. SCARLET FEVER. Nineteen cases were notified as against 57 last year, there were no deaths. DIPHTHERIA. Nineteen notifications were received as against 15 in 1909. There were no deaths. This disease appears to have been more prevalent in this part of Middlesex than usual and Teddington is very fortunate to have come off so lightly. The free supply of Antitoxin and the examination of Throat Swabs. This appears to be greatly appreciated, especially the examination of Throat Swabs, a good number having been sent in during the year. The following circular letter and form have been sent to all the doctors residing in the district: Dear Sir, I beg to send you form of application for the free supply of Diphtheria Antitoxin and Throat Swabs. Although no definite distinction is made the Council trust that advantage of the free supply will not be taken in the case of well-to-do patients. The Royal Institute of Public Health by whom the Bacteriological Examination is made will telephone the result at the earliest possible moment. Faithfully yours, Edward G. Gibbs-Smith, Medical Officer of Health. 15 Teddington Urban District Council. Application for the free supply of Diphtheria Antitoxin and Throat Swabs. Diphtheria Antitoxin can be obtained from Mr. W. E. Gould, Chemist, Broad Street. Throat Swabs can be had at the Council Offices, or at the Medical Officer of Health's private residence, 27 Hampton Road, when the Offices are closed. These are to be posted as directed. 191 Dear Sir, Kindly supply me with tubes units Diphtheria Antitoxin for curative— Kindly state whether curative or prophylactic. prophylactic—purposes. Whether suspected or contact. Throat Swabs for suspected— contact—cases. Yours truly, The Medical Officer of Health, Teddington. Medical Practitioner. 16 ENTERIC FEVER. No cases were notified. PUERPERAL FEVER. There were no notifications of this disease. SMALL POX. No cases were notified. NON-NOTIFIABLE INFECTIOUS DISEASES. The diseases which come under this classification are:—Measles, Whooping Cough, Epidemic Influenza, Mumps, Epidemic Diarrhoea, and Pulmonary Tuberculosis. * * Poor Law cases of this disease are now notified, and six such notifications were received. PULMONARY TUBERCULOSIS. Thirteen deaths were registered against nine last year, giving a percentage of 7.42 of the deaths from all causes, and a rate of.71 per 1,000 of the estimated population. One death was recorded under this heading of a child seven months old. Pulmonary Tuberculosis as the cause of death in a child of seven months is very rare. The certificate did not state that a post mortem examination had been made. Of other tuberculous diseases, five deaths were recorded against six last year, showing a percentage of 2.85 of the deaths from all causes, and a rate of .27 per 1000 of the estimated population. The total deaths from tuberculous diseases are therefore three in excess of last year and amount to over 10 per cent. of the deaths from all causes. When we consider that tuberculosis is a disease which at any rate is to some, if not to a considerable extent, both preventable and curable, we cannot but deplore such a high death rate, and I would suggest that some means be considered for the more 17 efficient treatment of certain cases, and for the prevention of spreading the disease. It frequently happens that affected families are quite unable to satisfactorily deal with their cases, therefore a grave danger exists, not only to themselves, but to the community at large, hence the need for the establishment of some means of help. Undoubtedly the first step to take would be for the local authority to get into touch with the existing cases and their immediate constant contacts. With this motive in view I would again mention the necessity for voluntary notification as a preliminary measure. The method by which certain cases should be further dealt with, and helped if necessary, would require to be considered, possibly at first in an experimental way. That some scheme could eventually be envolved that would benefit both the sufferers and the general public there is practically no doubt. Rooms that have been occupied by Phthisical patients are disinfected, when known to the Local Authority. WHOOPING COUGH. This malady again claimed a proportionately large number of victims-four in all -and was one of the chief contributors to Infantile mortality, three of the four deaths occurring in children under one year of age. The disease really requires much more attention than is often given to it, both in the shape of treatment and prevention, for it is very fatal to young children. MEASLES. Very few cases occurred during the year, and no fatal one was recorded. 18 EPIDEMIC INFLUENZA. Four deaths were notified against 6 last year. There was nothing in the shape of an Epidemic. EPIDEMIC DIARHŒRA. No deaths were recorded under this heading, and as far as I know the district has been very free from this disease. ANTHRAX, GLANDERS AND HYDROPHOBIA. No cases were notified by the Inspectors under the Diseases of Animals Act, l894. ISOLATION HOSPITAL ACCOMMODATION. There is an arrangement with the Tolworth Isolation Hospital by which cases can be sent from Teddington; cases can also be sent to the Hampton Isolation Hospital. In some instances cases are recommended to go to the London Fever Hospital. SMALL-POX HOSPITAL ACCOMMODATION. I understand that although no actual agreement exists with any Small-Pox Hospital, there would not be the slightest difficulty in dealing with a case should one occur. CHOLERA. One notice was received from the London Port Sanitary Authority of a passenger coming from a ship which had touched an infected port. The case was kept under observation. PLAGUE. No cases have come under my notice. A rat which caused some suspicion was sent to the Local Government Board Specialist for examination, but no signs of the disease could be detected. 19 The Housing Town-Planning Act, 1910, came into force during the year, and new records of certain properties have to be kept— the following particulars are required:— RECORD INSPECTION OF DWELLING HOUSES. Situation of Dwelling-house and its Name or Number Whether Freehold or Leasehold Name and Address of Owner Name and Address of Owner's Agent (if any) Name of Occupier If of whole or portion of House Particulars of Rent: per week per annum Number of Rooms: ground floor first floor second floor third floor cellars Name of Officer who made the Inspection Date when the Dwelling-house was inspected Date of last previous Inspection and reference to the record thereof State of the Dwelling-house in regard to— 1. The arrangements for preventing the contamination of water supply 2. Closet accommodation 8. Drainage 4. Condition of the Dwelling-house in regard to light, the free circulation of air, dampness and cleanliness 5. The paving, drainage and sanitary condition of any yard or outhouses belonging to or occupied with the Dwelling-house 6. The arrangements for the deposit of refuse or ashes 7. The existence of any room which would, in pursuance of sub- sec. (7) of sec. 17 of the Act of 1909, be a Dwelling-house so dangerous or injurious to health to be unfit for human habitation 8. Any defects in other matters which may tend to render the Dwelling-house dangerous or injurious to the health of an inhabitant Action taken by the Medical Officer of Health, or other Officer of the Local Authority, either independently or on the direction of the Local Authority The result of any action so taken Any further action which should be taken in respect of the Dwellinghouse 20 DISINFECTION. Disinfection is carried out by means of the Formalin Spray. This was done in all cases of Infectious Disease, also in some instances where death had occurred from Phthisis and Cancer. Articles of clothing, bedding, etc., are sprayed with Formalin or are steeped in Jeyes' Fluid. GENERAL HOUSING AND HOUSING OF THE WORKING CLASSES. General inspections were made from time to time besides those made in connection with complaints received. Your Sanitary Inspector made some 6,000 inspections during the year. I myself made between 350 and 400 inspections, generally in company with your Sanitary Inspector and was again pleased to find the houses of the working classes, on the whole, so well kept. FACTORIES AND WORKSHOPS. There are 14 factories in the district where machinery is used, and 36 workshops and workplaces. In ten instances defects (mostly of a minor character) were found, and these were promptly remedied upon notice being given to the occupiers. DAIRIES, COWSHEDS AND MILKSHOPS. There are five dairies, seven cowsheds and twenty-one milkshops in the district. Inspections were periodically made of these premises, at one I had occasion to make some strong complaints, and to eventually get a statutory notice served upon the occupier before the nuisance was abated. 21 The milch cows have been regularly inspected every three months by your Veterinary Inspector and his reports have invariably been that the animals were in a healthy condition. The average number periodically inspected was 64. LAUNDRIES. There are 2 where machinery is used, and 8 worked entirely by hand, These were periodically inspected during the year and always found to be in good order. There are also 19 domestic laundries where the work is done by one or two members of the family. These were also visited from time to time and no cause for complaint was found. BAKEHOUSES. There are 14 on the register: they were inspected from time to time. All the sanitary arrangements were in order. Beyond one or two trivial matters, which when pointed out, were promptly attended to, everything was found to be in a very satisfactory condition. SLAUGHTER HOUSES. There is no public abattoir in the district. The number of private slaughter houses on the register is the same as last year, viz., seven, these were periodically visited and no cause was found for complaint. I was requested by your Sanitary Committee to report upon a proposed site for a new slaughter house. I considered the site in question to be most unsuitable, on account of its proximity to existing houses. I understand that the application was not persisted in and no license was granted. 22 UNSOUND FOOD. In three instances I was called upon by the proprietors of shops to inspect articles of food that had been sent to them from outside the district, viz:—A parcel of fish of about 60 lbs. weight, a parcel of fish of about 126 lbs. weight, and a carcase of beef weighing 400 lbs. In each case the stuff was condemned and destroyed. OVERCROWDING. Twelve cases were investigated, and in five instances it was found necessary to interfere. In each of these the nuisance was promptly abated upon giving verbal notice. We are really very little troubled with cases of overcrowding, and nothing of a serious nature has come under notice, and in fact does not exist. MOVEABLE DWELLINGS. None came under my notice during the year. CANAL BOATS. The inspection of them is undertaken by the Kingston Authority. WATER SUPPLY. The Metropolitan Water Board provide a constant supply over the whole district. There are very few wells now in use for drinking purposes, and should any of them be found to be contaminated, steps would be promptly taken to prevent their further use. SEWERAGE AND SEWAGE DISPOSAL. The method at present employed is one of the water carriage Systems, by which the sewage is first passed into settling tanks, and then on to the land for filtration. No nuisance arising from the Works has been reported to me during the year. 23 CESSPOOLS. Four have been done away with during the year and the premises using them connected with the main drainage. There are still some 50 in use in the district. With one exception no nuisance in connection with them has been brought to my notice, but I consider it a very unsatisfactory form of drainage for a growing neighbourhood, and in my opinion the time has now arrived for doing away with them wherever possible. Fulwell Golf Club has in the past had some difficulty with their drainage : it is now satisfactorily connected with the main sewer. COLLECTION AND DISPOSAL OF HOUSE REFUSE. Carts collects daily—The disposal is by tipping and burning. Complaints have been made from time to time about tipping refuse into disused gravel pits. Every effort is made to cover over with earth, and to cause as little nuisance as possible. This difficulty will cease when the new Sewerage Works are completed, as all the refuse will then be passed through the furnaces. MORTUARY ACCOMMODATION, Etc. There is a Public Mortuary in the Cemetery. SCHOOLS AND SCHOOL INSPECTIONS. The Schools were visited from time to time, and the sanitary arrangements inspected. These were always found to be in good order. The Inspection of Schoolchildren is under the control of the Middlesex County Council, and is carried out by the County Medical Officer of Health and staff of assistants. With a view to keeping all 24 cases of infectious disease under observation, both by the Local Authority and the School Medical Officer, the following method has been in vogue during the past year:— Upon a Schoolmaster or Mistress becoming acquainted with the fact that a scholar is suffering with an infectious disease, notice is sent to both the County and District Medical Officers of Health. In every case in which a child attending school, or a contact case is notified to the District Medical Officer of Health under the Infectious Diseases Notification Act, notice is sent to the County Medical Officer of Health and also to the Head Teacher of the School at which the child attends. 25 INQUESTS, 1910 Date. Age. Sex. Verdict. Jan. 9th 58 F. Syncope from Valvular Disease of the Heart. Jan. 18th 8 months & 3 weeks M. Syncope under chloroform whilst preparing for an operation. Jan. 19th 50 F. Found drowned. Jan. 26th 21 M. Suicide, fracture of the skull and injuries to his legs caused by placing himself in front of a train, whilst temporarily of unsound mind. Feb. 28th 27 M. Exhaustion, following Septic Peritonitis caused by accidently falling from his engine. March 4th 58 M. Suicide by hanging himself, whilst temporarily of unsound mind March 18tb 29 M. Fracture of the skull by accidently falling from a tower waggon March 23rd 3 & 9 mths. F. Syncope from Congestion of the Lungs and Tuberculosis. April 9th 72 F. Rupture of an Aneurism of the Aorta. May 4th 64 F. Shock and Pneumonia from injuries to the lungs by broken ribs, caused by falling down stairs. May 6th 37 M. Heart Failure whilst under an anasthetic. May 9th 46 M. Suicide by taking Cyanide of Potassium. May 14th Newly born F. Want of proper attention at birth July 17th 60 F. Syncope from fatty heart P.M. 7uly 26th 55 M. Rupture of Aneurism of Aorta P.M. Aug. 8th 2 F. Accidental Burns. Aug. 10th 1 & 9 roths . F. Accidentally run over by a van Sept. 11th 39 F. Thrombosis of Pulmonary Artery and Syncope. Sept. 18th 45 M. Syncope from Valvular Disease of the Heart. Sept. 24th 3 months 8 days M. Accidental Suffocation accerlated by a Thymas Gland Oct. 22nd 49 F. Mennigitis P.M. 26 TABLE I. Vital Statistics for the Whole District of Teddington, during 1910 and previous Years. Year, Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Total Deaths in Public Institutions in the District. Deaths of Nonresidents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. Nett. Deaths at all Ages belonging to the District. Under 1 Year of Age. At all Ages. Number. Rate. * Number. Kate per 1000 Births registered. Number. Rate. * Number. Rate. * 1 2 3 4 5 9 7 8 9 10 11 12 13 1900 14,000 353 25.21 53 150 213 15.22 ... 2 ... 211 15.07 1901 14,029 359 25.67 40 111 130 9.26 5 2 6 134 9.55 1902 14,037 351 25.00 49 139 206 14.60 ... 2 ... 204 1450 1903 15,000 419 27.93 40 95 157 10.46 13 4 17 170 11.33 1904 10,000 391 24.44 50 128 173 10.81 10 3 14 184 11.50 1905 10,350 381 23.30 42 110 172 10.52 7 5 21 188 11.50 1900 17,000 438 25.76 53 121 217 12.76 21 8 29 238 14.00 1907 17,900 391 21.84 25 64 157 8.77 14 3 26 182 10.17 1908 18,125 442 24.39 27 61 161 8.88 19 5 29 185 10.21 1909 18,240 436 23.90 35 80 186 10.19 18 7 22 204 11.18 Averages for years 1900. 1909 16,068.1 396.1 24.74 41.4 105.9 176.2 11.14 10.7 41 10.4 190.0 11.90 1910 18,240 406 22.25 17 41.87 148 8.11 18 7 22 175 9.59 * Rates in columns 4, 8 and 13 calculated per 1,000 of estimated population. Area of District in acres (exclusive of area covered by water), 1,19(5. Total population at all ages, 14,037. Number of Inhabited Houses, 2754. Average number of persons per house, 51. Census, 1901. 27 I. II. III. Institutions within the District receiving sick and infirm persons from outside the District. Institutions outside the District receiving sick and infirm persons from the District. Other Institutions, the deaths in which have been distributed among the several localities in the District. Teddington & Hampton Wick Cottage Hospital. Kingston Union Infirmary. Cancer Hospital, Chelsea Isolation Hospital, Hampton. King's College Hospital. Middlesex Hospital. Richmond Infirmary Isolation Hospital, Tolworth. Middlesex County Asylum, Wandsworth. Middlesex Asylum, Tooting. St. John's Hospital, Twickenham St. Peter's Hospital, Covent Garden There is no Union Workhouse within the District. 28 TABLE II. Vital Statistics of Separate Localities in 1910 and previous Years.—Teddington District. Year. Names of Localities. FULWELL. UPPER TEDDINGTON. LOWER TEDDINGTON. SOUTH TEDDINGTON. 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. 1900 Not then divided. 1901 1902 1,943 ... 30 11 6,710 ... 111 27 3,591 ... 44 7 1,793 ... 21 4 1903 2,030 ... 22 6 7,235 ... 77 23 3,855 ... 36 6 1,880 ... 18 5 1904 2,121 ... 26 8 7,780 ... 75 20 4,128 ... 41 16 1,971 ... 28 6 1905 2,263 ... 24 4 7,816 ... 94 27 4,183 ... 48 11 2,088 ... 22 2 1906 2,353 ... 37 7 8,126 ... 122 29 4,349 ... 53 14 2,172 ... 26 3 1907 2,477 ... 30 1 8,557 ... 88 18 4,579 ... 48 5 5,287 ... 16 2 1908 2,509 ... 31 3 8,664 ... 80 19 4,637 ... 48 6 2,315 ... 20 2 19 2,670 ... 28 4 8,180 ... 102 27 4,830 ... 46 4 2,560 ... 28 3 Avgs. of yrs. 1902 to 1909. 2,295.75 ... 28.50 5.50 7,883.50 ... 93.50 23.75 4,269.00 ... 45.25 8.62 2,133.25 ... 2312 3.37 1910 2.670 ... 23 3 8,180 ... 80 13 4,830 ... 50 1 2,560 ... 22 1 29 TABLE III.—Cases of Infectious Disease Notified during the Year 1910. In the Teddington District. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in Each Locality. No. of Cases Removed to Hospital from Each Locality. At all Ages. At Ages—Years. Fulwell Upper Teddington Lower Teddington South Teddington Fulwell Upper Teddington Lower Teddington South Teddington Total Cases Removed to Hospital. Under 1 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upward Small Pox Cholera Diphtheria (including Membranous Croup) 19 ... ... 6 6 5 2 ............ 3 4 1 11 ...... ...... 1 ...... 1 Erysipelas 9 3 4 2 2 6 1 Scarlet Fever 19 ...... 4 12 3 ...... ...... 1 4 11 3 ...... 3 ...... ...... 3 Typhus Fever Enteric Fever Relapsing Fever Continued Fever Puerperal Fever Plague Totals 47 10 18 11 6 2 6 14 13 14 3 1 4 Isolation Hospital Accommodation. Isolation Hospital, Hampton. Total available Beds, 4. Number of Diseases that can be concurrently treated, 2. Isolation Hospital, Tol worth. No definite number of available Beds. Number of Diseases that can be concurrently treated, 3. 30 TABLE IV. Causes of, and Ages at Death during Year 1910. Causes of Death. Deaths at the subjoined Ages of "Residents" whether OCCURRING IN OR BEYOND THE District. Deaths in Localities (at all ages). Deaths in Public Ins1ttuttons in the District. All ages. Under 1. i 1 & under 5. 5 & under 15. 15 & under 25.' 25 & under 65. 65 &upwards. Fuhvell Upper Teddington Lower Teddington South Teddington Small-pox Measles Scarlet fever Whooping-cough 4 3 1 ...... ...... ...... ...... ...... 3 ...... 1 ............ Diphtheria (including membranous croup) Croup Fever:— Typhus Enteric Other continued Epidemic influenza 4 ...... ...... ...... ...... 3 1 1 2 ...... 1 ............ Cholera Plague Diarrhœa Enteritis * Gastritis Puerperal fever Erysipelas 1 ...... ...... ...... 1 ...... ...... ...... 1 ...... ...... ...... Phthisis (Pulmonary Tuberculosis) 13 1 ...... ...... 1 11 ...... ...... 7 3 3 ...... Other tuberculous diseases 5 ...... ...... 2 1 2 ...... ...... 4 1 ...... 1 Cancer, malignant disease 23 ...... 1 ...... ...... 9 13 5 7 7 4 2 Bronchitis 4 1 3 3 i ............ Pneumonia 12 2 4 1 4 2 3 6 2 1 ............ Pleurisy 1 ...... ...... ...... ...... 1 ...... ...... 1 ...... ...... 1 Other diseases of respiratory organs 2 ...... ...... ...... ...... 1 1 ...... 1 1 ...... 1 Alcoholism 2 ...... ...... ...... ...... 2 ...... ...... ...... 2 ...... ...... Cirrhosis of liver Venereal diseases Premature birth 3 3 ...... ...... ...... ...... ...... ...... 3 ...... ...... Diseases & accidents of parturition 3 2 1 1 1 1 Heart diseases 13 1 6 6 2 6 3 2 1 Accidents 3 1 1 1 3 3 Suicides 6 1 5 3 i All other causes 76 6 1 1 1 27 40 11 29 27 9 9 All causes 175 18 8 4 5 74 66 23 80 49 23 18 31 TABLE V.—Teddington District. Infantile Mortality during the Year 1910 Deaths from stated Causes in Weeks and Months under One Year of Age. Cause of Death. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 month. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under One Year. All Causes Certified 3 ... 2 ... 5 1 1 3 1 1 1 1 3 ... ... 18 Uncertified Common Infectious Diseases: Small-pox Chicken-pox Measles Scarlet Fever Diphtheria (including Membranous Croup Whooping Cough ... ... ... ... ... ... ... 1 ... ... 1 ... ... 1 ... ... 3 Diarrhoeal Diseases : Diarrhcea, all forms Enteritis, Muco-enteritis Gastro-enteritis Gastritis, Gastro- intestinal Catarrh J Wasting Diseases : Premature Birth 1 ... 0 ... 3 ... ... ... ... ... ... ... ... ... ... ... 3 Congenital Defects Injury at Birth 2 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 2 Want of Breast Milk, Starvation Atrophy, Debility, Marasmus ... ... ... ... ... 1 1 ... 1 ... ... ... 1 ... ... ... 4 Tuberculous Diseases: Tuberculous Meningitis Tuberculous Peritonitis: Tabes Mesenterica Other Tuberculosis Diseases ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 Other Causes : Erysipelas Syphilis Rickets Meningitis (not Tuberculous) ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 Convulsions Bronchitis ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... Laryngitis Pneumonia ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... 2 Suffocation, overlying ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 Other Causes ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 3 2 5 1 1 3 1 1 1 1 3 18 District of Teddington Population, estimated to middle of 1010. 18,210. Births in the year Illegitimate. 19 Deaths in the year of Legitimate Infants, 16 Illegitimate „ 2 Deaths from all Causes at all Ages, 175. 32 District of Teddington. I—Inspection of Factories, Workshops & Workplaces Including Inspection made by Sanitary Inspectors or Inspector of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (including Factory Lanndries) Frequent. Workshops (including Workshop Laundries) Frequent. Workplaces Frequent. Total 2—Defects found in Factories, Workshops & Workplaces. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspect'!' Nuisances under the Public Health Acts— Want of cleanliness Want of ventilation Overcrowding Want of drainage of floors Other nuisances 4 4 Sanitary accommodation— Insufficient Unsuitable or defective 4 4 Not separate for sexes 1 1 Offences under the Factory and Workshop Act— Illegal occupation of underground bakehouse (s. 101) Breach of special sanitary requirements for bakehouses (ss. 97 to 100) 1 1 Other offences Total 10 10 33 District of Teddington. 3—Home Work. Outworkers' Lists, Section 107'. Addresses of Outworkers received from other Councils. Wearing Apparel— (1) Making, &c. 0 (2) Cleaning and Washing Lace, Lace Curtains and Nets ... ... 0 4—Registered Workshops. Workshops on the Register (s. 131) at the end of the year. Number. Bakehouses 14 Dressmakers 11 Tailors 4 Various 7 Total number of workshops on Register 36 5 —Other Matters. Class. Number. Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5):— Notified by H.M. Inspector 1 Reports (of action taken) sent to H.M. Inspector 1 Other Underground Bakehouses (s. 101):— Certificates granted during the year In use at the end of the year - No. 1. COUNTY OF MIDDLESEX.—SANITARY WORK, 1910. District of Teddington. Particulars as to Staff employed in Sanitary Department, specify if Inspectors are engaged in any other duties, and if so, what. Inspections.* Notices. Dwelling Houses. Houses let in Lodgings. (Tenement Houses.) Common Lodging Houses. Laundries. Part time Medical Officer of Health, One whole time Inspector, who only has help when disinfecting premises. Number of Premises Inspected on Complaint. Number of Premises Inspected in connection with Infectious Diseases. Number of Premises under Periodical Inspection. Houses inspected from House-toHouse. Total Number of Inspections and Re-inspections made. Cautionary or Intimation Notices Given. Statutory Orders Issued. Summonses Served. Convictions Obtained. Houses, Premises* &c., Cleansed, Repaired, &c. Closed as Unfit for Habitation (a) As result of action under H.fV.C. Acts. (b) Otherwise. Re-opened after Repairs, Alterations, &c.. Demolished. Illegal Underground Dwellings Vacated. Number Registered under ByeLaws. Number of Contraventions. Number Registered under ByeLaws. Number of Inspections made. Number of Contraventions. Number in District. Contraventions of Factory Acts. (1) (2) (3) (4) (5) a b 29 150 189 700 6025 83 5 73 No Bye- laws. None in district. 10 * N.B.—(3) Includes all classes of premises under periodical supervision, such as Cowsheds, Dairies, Slaughterhouses, Workshops and Work-places, &c. (5) Includes all visits and re-visits made by Sanitary Inspector in connection with 1—4. No. 2. COUNTY OF MIDDLESEX.—SANITARY WORK, 1910. District of Teddington. Canal Boats used as Dwellings. Movable Dwellings, Caravans, Tents, &c. Bakehouses. Slaughterhouses. Cow-sheds. Dairies and Milkshops. Unsound Food. Adulterated Food. Offensive Trades. Water Supply and Water Service. Wells. Cisterns. Draw-Taps placed on Mains. Percentage of Houses supplied on Constant System. Number of Samples obtained for analysis, (a) from Local Wells (b) from Public Supply. Number Registered under the Acts. Number of Contraventions of Regulations. Number Observed during the Year. Number of Nuisances therefrom Abated Number Removed from District. Number in District. Contraventions of Factory Acts. Number on Register. No. Number of Inspections made Frequency and frequency of inspection. Contraventions of Bye-Laws. Number on Register. No. Number of Insnections made Frequency and frequency of inspection.! Contraventions of Regulations. Number of Milch Cows in District. Number on Register. No. Number of Inspections made Frequency and frequency of inspection. Contraventions of Regulations. (a) Animals seized. (6) Articles or Parcels seized. Condemned by Magistrate (a & b). Articles or Parcels surrendered. Samples taken (if any) by the District Local Authority. Found adulterated. Number of Premises in District. Number of Inspections made. Contraventions of Bye-Laws. New Sunk. Cleansed, Repaired, &c. Closed as Polluted. Percentage of Houses supplied from Public Water Service. New Provided. Cleansed, Repaired, Covered, &c. a b a b a b 14 7 21 3 times a year. 7 28 6 64 26 312 Monthly. 3 99 2 24 99 No. 3. COUNTY OF MIDDLESEX. —SANITARY WORK, 1910. District of Teddington. Drainage and Sewerage of existing Buildings. Disinfection. Dust. Sanitary Nuisances Abated. Remarks as to any other matters or in explanation of previous columns. Water Closets. Drains. Cesspools. Percentage of Houses Draining into Sewers. Number of Water Closets substituted for Dry Receptacles Repaired, Supplied with Water, or otherwise Improved. Percentage of Houses provided with Water Closets. Examined, Tested, Exposed, &c, Unstopped, Repaired, Trapped, &e. Waste Pipes, Rain Water Pipes, Disconnected, Repaired, &c. New Soil Pipes or Ventilating Shafts fixed. Existing Soil Pipes or Ventilating Shafts Repaired. Disconnecting Traps or Chambers Inserted. Reconstructed. Rendered Impervious, Emptied, Cleansed, &c. Abolished, and Drain connected to Sewer. -Rooms Disinfected (a) Ordinary infections diseases, (b) Phthisis, (c) Various Causes. Rooms Stripped and Cleansed, Articles Disinfected or Destroyed, (a) Ordinary infectious disease, (b) Phthisis. New Bins provided. How frequently is dust removed from each house ? Number of Complaints of NonRemoval received. Method of Disposal (a) Destructor, (b) by Tipping, (c) Other, state method. Overcrowding. Smoke. Accumulations of Refuse. Eoul Ditches, Ponds, &c., and Stagnant Water. Foul Pigs and other Animals. Dampness. Yards repaved or repaired. Other Nuisances. a b c a b a b c 93 100 150 22 3 7 2 4 1 98.6 34 5 1 5 Daily Tipping & Burning. 5 18 1 5 20 19