With D'Wiliams TOT 1 Complimancy TOTTENHAM Local Board of Health. REPORT of The Health of Cottenham FOR THE YEAR 1893, by W. T. WATSON, B.A., M.D., M.R.C.S. Medical Officer of Health for Tottenham. Tottenham: Printed by C. Coventry. REPORT. To the Chairman and Members of the Tottenham Local Board of Health. Gentlemen, I am pleased to be able to give a favourable report of the Public Health in Tottenham during the year 1893. There has been a decrease in the prevalence and fatality from infectious diseases throughout the district, especially in the more crowded neighbourhoods, and your Board and its Officers are to be congratulated on the results of the good sanitary supervision and control exercised by them in the prevention of the spread of contagious diseases, and particularly in the improved sanitary state of dwelling houses, whereby the condition of the people is raised and a higher standard of health established. Houses and Population. The number of houses for which plans were passed by your Board during the year amounted to 206, a decrease on the previous year of 163. Under the Board's Bye-Laws with respect to buildings in course of erection 74 notices were served on builders; the requirements of the notices were in every case complied with, and no legal proceedings ensued. The population estimated to the middle of 1893 amounted to 75,000. 4 Births. The births registered in Tottenham during the year were 2,580, 1,345 males and 1,235 females. The birth-rate, calculated from the total number of births, and the foregoing estimate of population, was 34.4, against 33 0 in 1892. The natural increase of population, that is: the excess of births over deaths was 1,142, that for 1892 being 1,192, and for 1891, 1,448. Deaths. The number of deaths was 1,429, of these 706 were males and 723 females, against 1,237 in 1892, and 1,121 in 1891. From this number must be deducted 200 deaths, which occurred in public institutions, of patients who came from districts outside Tottenham. On the estimated population of 75,000 the 1,229 deaths give an annual rate of mortality of 16 3, against 16 8 in 1892. The deaths last year were distributed as follows:— Under 1 year 379 From 1 to 5 years 300 „ 5 to 20 years 159 „ 20 to 40 years 146 „ 40 to 60 years 188 „ 60 to 80 years 208 Above 80 years 49 In greater London, which is co-extensive with the Metropolitan and City Police Districts, estimated to contain a population of upwards of five-and-a-half millions of persons in the middle of 1893, the deathrate was 19.7 per 1,000. In Inner or Registration London the death-rate was 23.0, and in the Outer Ring it was 15.4. TABLE OF DEATHS during the Year 1893, in the Urban Sanitary District of Tottenham, classified according to Diseases and Ages. Mortality from all causes at subjoined ages. Mortality from subjoined causes, distinguishing Deaths of Children under 5 years of age. At all Ages. under 1 year. 1 and under 5 5 and under 15 15 and under 25 25 and under 65 65 and upwards. 1 2 3 4 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Smallpox. Scarlatina. Diphtheria. Membranous Croup. | Fevers. [ Cholera. | Erysipelas. | Measles. Whooping Cough. Diarrhoea & Dysentery, j Rheumatic Fever. 1 Ague. | Phthisis. Bronchitis, Pneumonia and Pleurisy. | Heart Disease. [ Injuries. All other Diseases. Total. Typhus. Enteric or Typhoid. | Continued. I Relapsing. | Puerperal. (b) (c) (d) (e) (f) (g) (h) (i) 1429 379 300 122 50 354 224 under 5 1 95 33 10 1 1 12 15 52 5 117 4 14 319 679 5 and upwards 50 17 2 16 2 1 2 9 8 62 143 47 19 372 750 6 Zymotic Diseases. The number of deaths under this class amounted to 303, 133 of which were referred to public institutions, and were of patients from outside districts. The death-rate from the principal Zymotic Diseases was equal to 2'2 per 1000, against 2-6 in 1892, and l-7 in 1891. Last year the mortality from these diseases was 2'8 in greater London, 2-9 in inner London, and 2-0 in the outer ring. Number of deaths from Zymotic Diseases in Tottenham daring the year 1893:— Small Pox 1 Measles 12 Scarlet Fever 145 Diphtheria 50 Whooping Cough 17 Fever 17 Diarrhœa 61 303 Table of population, births, and new cases of infectious sickness, coming to the knowledge of the Medical Officer of Health during the year 1893, in the Urban Sanitary District of Tottenham, classified acccording to diseases and ages. Population at all Ages. Registered Births. Aged under 5 or over 5. 1 2 3 4 5 6 7 8 9 10 11 Census, 1891. Estimated to middle of 1893. j Small Pox. Scarlet Fever. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Typhus. Enteric. Continued. Relapsing. Puerperal. 70,278 75,000 2,580 under 5 4 159 47 14 ... 22 ... ... ... ... 4 5 and upwds 58 492 115 4 ... 124 1 ... 13 ... 75 Total 62 651 162 18 ... 146 1 ... 13 ... 79 7 The following table shows the number of cases reported to the Sanitary Authority under the " Infectious Diseases Compulsory Notification Act," and their distribution by Words in the district. Locality. Small Pox. Choleraic Diarrhoea. Diphtheria. Membranous Croup. Erysipelas. Scarlet Fever. Enteric Fever. Relapsing Fever. Typhus. Continued Fever. Puerperal Fever. Total. West Green Ward 34 2 11 96 13 ... 4 160 St. Ann's Ward 10 1 33 1 25 140 36 ... ... ... 3 249 High Cross Ward 7 40 6 17 153 63 ... ... 1 287 Middle Ward 40 33 7 16 122 14 ... ... 1 2 235 Lower Ward , 1 22 2 10 140 20 ... ... ... 3 198 Total 58 1 162 18 79 651 146 ... ... 1 13 1129 Small Pox. There was one death from Small Pox in 1893, that of a child aged 13 days, at Mitchley Road, Stoneleys South. It will be seen by the table that 62 cases occurred in the district. Out of this number 40 were reported from the Middle Ward, chiefly from the neighbourhood of Stoneleys South. This is a very thickly populated neighbourhood, and there is no doubt that the large number of attacks is to be accounted for by the want of due care on the part of those who were in attendance on the patients, and had the supervision of the various channels of communication. There is reason to believe that several infected articles of bedding, &c., have in some instances been removed from the room the patient occupied before fumigation could be carried out, notwithstanding express warnings to the contrary. Under circumstances such as these it is not difficult to account for the persistent prevalence of a disease like Small Pox. It was found in four cases that the patients had not been vaccinated at all, and very great difficulty was experienced in persuading the inmates of infected houses to be re-vaccinated. 8 The most strenuous efforts were made by your officers to successfully cope with the disease. Immediately a case came to our knowledge, the authorities at the Highgate Small Pox Hospital were communicated with, and if by any means accommodation could be provided, the patient was at once removed to hospital in your ambulance, and the infected premises fumigated. In several instances relatives objected to the removal of patients, and in many cases children who were below the limit of age at which persons are received into the Highgate Hospital, were treated in their own homes. It is very important that increased facilities should be afforded to all who may wish to be vaccinated, as it is only by vaccination and re-vaccination, coupled with isolation and attention to the general sanitary condition of the surroundings, that this disease can be successfully stamped out. Measles. Measles was fatal in 12 instances, against 24 in 1892, and 7 in 1891. This disease is not included in the list of zymotics for compulsory notification, therefore any preventive measures capable of being taken by the Sanitary Authority are imperfect on account of defective information. Table showing Fatal Cases of Measles. Sex. Age. Locality. Date of Death. F. 21 mouths Charles Street, Stamford Hill April 7th F. 1 year Laura Road April 21st M. 13 months St. Ann's Road May 14th F. 23 months Welbourne Road May 16th M. 17 months Glendish Road June 15th M. 9 months Park Lane June 24th M. 4 years Harringay Road July 2nd M. 4 years Beaconsfield Road July 13th F. 11 months Stamford Road August 3rd F. 15 months West Green Road August 17th F. 2 years Seaford Road December 14th F. 2 years Braemar Road December 22nd 9 Scarlet Fever. Scarlet Fever was very prevalent during the year, not only in this district, but generally throughout the country. In Tottenham 145 deaths were registered; of these 128 occurred at the North Eastern Hospital, and were from other localities, so that the actual number to be referred to Tottenham amounts to 17, against 15 in 1892, and 15 in 1891. Table showing Fatal Cases of Scarlet Fever. • Sex. Age. Locality. Date of Death. F. 1 year Westerfield Road February 12th F. 14 months Poynton Road April 27th F. 4 years Spencer Road June 8th M. 4 years Vartry Road May 24th M. 17 years High Road July 10th M. 3 years Tottenham Terrace July 12th M. 1 year Harringay Road July 29th M. 3 years St. George's Road August 10th M. 8 months Williamson's Potteries August 21st F. 23 years Antill Road August 13th M. 14 months Seven Sisters' Road October 13th F. 2 years Heybourue Road October 15th M. 5 years Harold Road November 1st F. 14 years Baronet Road December 19th F. 3 years Whitehall Street December 18th F. 12 years Antill Road December 20th M. 8 years Antill Road December 22nd Diphtheria. The Deaths ascribed to Diphtheria numbered 50, against 18 in 1892 and 15 in 1891. It will be seen by the table that 162 cases were notified to the Sanitary Authority, most of the cases were referred to the High Cross and West Green Wards. I may mention that Diphtheria was very prevalent in London, and also throughout the country, last year, indeed Diphtheria has been steadily increasing as a cause of death in most of our large towns for some years. In London the deaths from this disease are almost as many as from Measles and Whooping Cough, and exceed those from Scarlet Fever. Sanitary improvements appear to have little influence in preventing the mortality from Diphtheria, while they have a marked effect on the spread of Enteric Fever. 10 Table showing Fatal Cases of Diphtheria. Sex. Age. Locality. Date of Death. F. 9 months Hospital (Stroma Terrace) January 15 th M. 3 years Scales Road February 8th F. 2 years Scales Road February 14th F. 7 years Newlyn Road February 22nd F. 2 years Hospital (Scales Road) March 25th F. 7 years Scales Road April 4th M. 8 years Scales Road April 8th M. 4 years Burlington Road April 9th M. 3 years Hanover Road April 20th M. 12 years Welbourue Road May 6th F. 6 years Welbourne Road May 8th M. 3 years N. E. Hospital May 9th M. 17 months Malvern Road May 24th F. 4 years Lawrence Road June 10th F. 9 years High Road June 12th F. 4 years Hospital (Wood Green) June 12th M. 11 years N. E. Hospital June 15th F. 3 years Wingmore Road June Kith F. 3 years Lawrence Road June 22nd M. 12 years Montague Road July 4th F. 17 months Hospital (Newton Road) July 24th F. 6 years Brunswick Road July 25th M. 3 years Wilton Road July 27th M. 6 months Rangemore Road July 28th M. 8 years Greenwood Road August 3rd M. 2 years N. E. Hospital August 6th F. 34 years Brograve Road August 28th F. 8 months Scales Road August 28th F. 4 years Ghesnut Road September 14th F. 3 years N. E. Hospital September 15th F. 2 years Avenue Road September 20th F. 2 years N. E. Hospital September 24th F. 2 years Paignton Road September 26th M. 4 years Tilson Road October 5th M. 5 years Somerset Road October 23rd F. 4 years High Road October 24th M. 3 years Clarendon Road October 27th F. 4 years North Grove October 30th F. 6 years Ashford Road November 1st M. 2 years St. John's Road November 3rd M. 2 years Hospital (Clyde Road) November 5th F. 2 years Stamford Road November 5th M. 3 years Hospital (Malvern Road) November 15th F. 3 years Church Road November 22nd M. 2 years Hospital (Elsden Road) December 4th M. 10 years Belmont Road December 6th F. 7 years Milton Road December 8th M. 10 months N. E. Hospital December 17th F. 2 years Gleuwood Road December 22nd F. 2 years Railway Cottages, Hale December 23rd Analysis of Births and Deaths in Tottenham in 1893. Week ending Jan. 7 th. Jan. 14th. Jan. 21st. Jan. 28th. Feb. 4th. Feb. 11th. Feb 18th Feb 25th Mar 4th. Mar 11th . Mar. . 18th. Mar. 25th. Apl. 1st. Apl. 8th. Apl. 15th. Apl. 22nd. Apl. 29th. May 6th. May 13th May 20th. May 27th. June 3rd. June 10th. June 17th. June 24th. July 1st. July 8th. July 15th July 22nd July 29th. Aug. 5th Aug 12th Aug 19th Aug 26th Sept 2nd. Sept 9th. Sept 10th Sept 23rd Sept 30th Oct. 7th. Oct. 14th Oct 21st Oct. 28th. Nov. 4th. Nov 11th Nov. 18th. Nov. 25th. Dec 2nd. Dec. 9th. Dec 16th Dec 23rd Dec 30th TOTAL. Births 57 54 56 50 56 52 59 55 33 62 66 48 58 45 52 46 29 52 52 40 45 54 44 43 47 41 65 48 50 56 44 37 45 53 48 55 54 54 56 45 48 44 63 51 43 41 51 41 46 56 45 50 2580 Total Deaths 21 23 26 33 24 17 28 20 18 25 27 20 33 24 25 31 20 27 19 22 23 19 16 26 3 1 32 27 36 32 41 27 31 31 21 20 35 26 23 17 29 26 29 25 27 25 32 43 42 44 43 34 34 1429 0 to 20 9 8 14 18 17 9 14 11 8 14 19 9 19 12 14 23 10 9 7 15 10 10 10 12 19 23 19 29 26 29 16 20 14 13 10 24 11 10 11 17 15 17 10 19 19 17 27 22 28 30 22 20 838 20 to 40 2 5 2 3 1 1 6 ... 1 5 1 3 3 6 2 3 2 5 5 2 1 1 1 5 2 2 1 3 2 5 4 4 6 2 3 2 4 2 2 ... 3 2 6 4 2 1 6 4 3 4 ... 1 146 40 to 60 7 4 6 3 3 3 1 2 1 ... 2 2 6 4 4 2 4 8 1 4 7 6 2 6 8 3 2 3 3 3 3 2 6 3 4 2 1 3 2 5 3 6 1 1 2 7 3 6 5 1 8 4 188 60 to 80 1 5 3 7 3 2 6 6 6 5 2 6 5 2 5 2 4 4 5 1 4 2 3 2 1 2 1 1 1 4 3 2 5 3 1 6 10 7 2 7 4 3 6 2 2 6 6 9 7 5 3 8 208 60 and upwards 2 1 1 2 ... 2 1 1 2 1 3 ... ... ... ... 1 ... 1 1 ... 1 ... 1 ... 2 4 ... ... ... 1 3 ... ... 2 1 ... 1 ... ... 1 1 2 1 ... 1 1 1 1 3 1 1 49 Deaths of Children— Under 1 year 2 6 7 5 6 6 3 7 2 4 8 2 9 6 3 8 3 1 2 4 4 6 4 3 7 12 15 14 18 15 11 13 7 7 4 11 9 3 5 4 7 10 5 12 6 7 14 7 13 13 11 8 379 1 to 5 4 1 5 12 4 2 7 2 2 7 10 6 8 2 6 9 6 3 2 10 5 3 2 6 11 7 4 6 5 7 4 5 5 3 4 10 2 5 1 9 4 3 4 4 10 6 9 11 7 13 7 10 300 5 to 20 4 1 2 1 7 1 4 2 4 3 1 1 2 1 4 4 5 1 5 3 1 1 1 4 3 1 4 1 9 2 7 1 2 2 3 2 3 3 5 4 4 4 1 2 3 4 4 4 8 4 5 2 159 Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... 2 ... ... ... 1 1 ... 1 1 ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 12 Scarlet Fever 4 1 2 6 6 2 5 2 3 ... 7 4 4 1 2 1 4 2 1 1 2 2 3 3 2 6 ... 9 1 8 2 3 3 2 ... 8 ... 1 1 2 2 2 ... 2 4 1 2 2 1 4 6 1 145 Diphtheria ... ... 1 ... 1 1 1 ... ... ... ... 1 1 2 1 ... 1 2 ... 1 ... 1 3 2 ... 1 ... ... 4 ... 2 ... ... 2 ... 1 2 2 1 ... ... 3 3 2 1 1 ... 3 2 ... 1 50 Whooping Cough 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ••• ... 2 1 2 3 1 2 1 ... 17 Fever ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 1 1 ... ... 1 ... ... 1 ... 1 ... ... ... 2 ... ... ... 3 ... ... 3 17 Diarrhœa ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 2 1 5 3 8 6 5 4 5 2 1 8 3 1 I 1 1 1 ... ... ... 1 ... ... ... ... ... ... 61 Total Deaths from Zymotic Diseases 5 2 3 7 6 3 6 3 3 2 7 4 5 2 5 2 5 3 4 4 5 2 4 8 7 7 7 13 9 18 9 10 11 4 3 17 5 4 5 4 4 3 3 5 10 4 5 5 8 9 8 5 303 Dis. of Kesp. System 5 8 3 4 2 5 6 5 ... 5 3 5 7 5 6 12 3 8 2 2 5 3 1 3 2 2 4 3 5 3 2 1 2 1 4 3 3 3 2 4 3 7 7 2 3 12 9 10 13 18 12 12 260 Phthisis 2 1 1 2 ... ... 2 ... ... 3 3 2 2 2 2 ... ... 1 1 2 1 1 1 2 1 ... ... 2 1 2 ... 2 2 3 2 1 2 ... 1 2 2 1 2 1 1 2 2 2 ... 1 1 ... 67 Dis. of Circry. System 1 ... 3 1 1 1 ... ... 4 3 2 1 2 1 ... ... ... 1 ... ... ... 1 1 1 1 ... 2 2 1 2 ... ... 3 1 1 ... 2 1 ... 1 2 3 ... ... ... 1 1 ... 1 ... 1 1 51 Violent Deaths 1 ... 2 2 ... 1 ... ... ... ... 2 ... 3 ... 4 4 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 . . . 3 ... ... ... ... ... ... ... 2 ... 2 1 ... ... 2 ... 1 ... ... 33 Deaths in Public Institutions 4 3 4 8 9 3 5 3 6 4 8 5 6 5 9 5 6 6 4 4 3 2 2 7 2 6 1 9 1 11 3 6 7 4 1 12 ... 4 3 5 2 4 3 2 6 1 2 4 6 8 4 5 243 Annual Death Rate per 1000 from all Causes 16.3 „ Zymotic Diseases 2 2. W. TYNOALE WATSON, M.D. 11 Cases of Diphtheria notified to the Urban Sanitary District of Tottenham during the last three years. Locality. 1891. 1892. 1893. Total. West Green Ward 13 25 34 72 St. Ann's Ward 28 25 33 86 High Cross Ward 39 38 40 117 Middle Ward 12 11 33 56 Lower Ward 7 6 22 35 Total 99 105 162 366 Whooping Cough. The deaths from this infantile disease amounted to 17, against 47 in 1892, and 35 in 1891. The deaths included:— 2 children under 1 year 5 children from 1 to 5 years 8 children from 2 to 5 years 1 child aged 7 years 1 child aged 8 years This disease is not included in the list of Zymotics for compulsory notification. Fever. There were 18 deaths from Fever during the year, the same number as in 1892; in 1891 there were 16 fatal cases. The total number of cases reported to the Sanitary Authority amounted to 146; of these 63 were referred to the High Cross Ward, 36 to St. Ann's Ward, 20 to the Lower Ward, 14 to the Middle Ward, and 13 to the West Green Ward. It will be seen that the greatest number of Fever cases occurred in the High Cross district. There was no special outbreak in any locality. The Lower Ward, which was at the head of the list in 1892, was last year in a much healthier condition. 12 No fatal cases were reported from Brunswick Court, where the entire water service pipes and drainage were re-modelled by order of your Board. Table showing Fatal Cases of Fever. Sex. Age. Locality. Date of Death. M. 26 years Hospital (Woodberry) January 9th M. 26 years Chesnut Road January loth F. 36 years Hospital (Catherine Road) January 23rd F. 37 years Hospital (Stoke Newington) May 8th M. 26 years St. Paul's Road July 31st M. 39 years Hospital (Siddons Road) August 4th M. 27 years Hospital (Rangemore Road) August 15th F. 41 years Hospital (Sutton Road) September 5th F. 40 years Bruce Grove Road September 27th F. 14 years Markfield Road October 9th F. 20 years Church Road November 3rd F. 11 years Hospital (South Horusey) November 6th F. 8 years Hospital (High Cross Road) December 4th M. 6 years Hospital (Bernard Road) December 9th M. 4 years Saven Sisters' Road December 8th M. 14 years Hospital (Rangemore Road) December 22nd M. 21 years Lansdowne Road December 28th F. 41 years Hospital (Osman Road) December 24th Diarrhœa. The deaths from Diarrhoea amounted to 61, against 47 in 1892, and 36 in 1891. 53 of the deaths occurred in the months of July, August, and September, the time of greatest heat; it will be seen by Mr. Worth's tables that the temperature during those months was considerably above the average for the previous 5 years. The deaths included:— 37 of children under 6 months. 14 of children from 6 to 12 months, 3 of children from 1 to 3 years. 1 child at 6 years. 2 persons aged 52 and 55. 2 persons aged 62 and 63. 2 persons aged 82 and 84. 13 Pulmonary Diseases. Diseases of the Respiratory Organs caused 260 deaths, against 272 in 1892, and 257 in 1891. Phthisis. The deaths from Phthisis amounted to 67, .against 79 in 1892, and 86 in 1891. Diseases of the Circulatory System. Under this head 50 deaths were registered. Violent Deaths. Different forms of violence caused 33 deaths. Of these 11 were referred to burns and scalds, 4 to drowning, 4 to suffocation, 4 to falls, 5 to shock, 2 to poison, 1 to being run over by railway train, 1 to cut throat, and 1 to blow from a ball. Sanitary Proceedings. The past year has been marked by a most thorough and systematic inspection of houses in the District, especially where notices have been received of the existence of infectious disease. At each house careful enquiries are made as to overcrowding, infectious disease, or nuisance of any kind; there is also a careful examination of traps, closets, and cisterns, the drains being examined by the smoke test. It will be seen on referring to the Summary of Nuisances, and other matters reported and attended to by the Sanitary Inspector and his assistants, that a great deal of work has been carried out during the year. 2,485 notices were served for the abatement of nuisances, 1,023 drains were examined and tested for defects, 1,704 visits were paid to cases of infectious diseases, and 556 rooms were disinfected after cases of contagious diseases. There was periodical inspection of all Bake-houses, Slaughterhouses, and Dairies. Special attention was given to all premises used 14 for the sale of milk, and in all cases where application for registration was received, the general sanitary condition of the premises was investigated, drains were tested and notice served for rectifying any defects. Summary of Nuisances and other matters reported and attended to by the Inspector of Nuisances from January 1st to December 31st, 1893. TOTAL. Nuisance Complaints received and attended to 590 Dust Applications 245 Cases of Infectious Diseases, visits paid 1704 Loads of House Refuse collected 11900 Loads of Trade Refuse collected 800 Slaughter Houses, visits paid 500 Bake-houses „ 500 Lodging-houses „ 100 Milk Shops 400 Notices served for the Abatement of Nuisances 2485 Rooms Disinfected after cases of Infectious Diseases 556 Articles of Bedding, etc., destroyed 59 Drains examined and tested for Defects 1023 Factory and Workshops, visits paid 90 Water Closets and Urinals cleansed or repaired 20 Dwelling-houses, visits paid 100 Slaughter-houses „ 32 Bake-houses „ 25 Lodging-houses „ 4 Yards, Passages, etc., paved 80 Cisterns cleansed 120 Yards, Stables, Styes, etc., cleansed 70 Offensive Accumulation removed 82 Animals kept improperly „ 60 Insanitary Closets and Traps removed 72 Water Supply provided to W.C's 24 Water Supply of W.C's. disconnected from Domestic Supply 180 Sink and Baths Wastes disconnected from Drains 122 Drains Ventilated 43 Smoke Nuisance abated 4 Yard Drains trapped 20 Drains re constructed or repaired 780 W.C's. or Fittings „ 39 Water ,, „ 92 Dust Bins provided 63 Cesspools cleansed 8 Soil Pipes removed 42 Gipsy Encampments removed 23 Dust Bins repaired 42 Houses, or parts of, repaired 25 Bodies received in Mortuary 135 Uusound Fish seized and destroyed 8 cwt. Fruit ( Plums 2 bushels Tomatoes 4 „ Apples 5 barrels Peas 2 sacks 15 Notification of Infectious Diseases to the School Board Authorities. In consequence of the danger to be feared of children from infected houses attending Schools in the District, it was found necessary to adopt measures whereby the School Authorities could be quickly notified of the existence of an infectious disease at houses from whence children attended School. As soon as possible after such houses are visited, a form containing all the necessary information is now sent to the School Board, and a further intimation is sent after the premises have been properly disinfected. This system works admirably for preventing the spread of infectious diseases. Infectious Diseases Hospital. Numerous applications for removal to Hospital have been made during the year on behalf of persons who were suffering from Diphtheria or Scarlet Fever, but unavoidable delay in completing the negotiations between your Board and the Metropolitan Asylums Board has (for the time being) rendered the removal of infected persons to Hospital impracticable. There is no doubt, however, that suitable arrangements will be made for admission of patients. This will be of great importance to Tottenham, and will very materially benefit the residents in the District. Refuse Destructor. Owing to the want of a convenient and proper shoot, as place of deposit for the house refuse collected in the District, very great difficulty has been experienced during the year in carrying out this important work. I need hardly remind you that the regular removal of all the contents of dust-holes and dust bins is very necessary, there are few sources from which foul and dangerous odours emanate more readily than from these receptacles, owing chiefly to the decaying animal and vegetable matter, which is more often than not mixed with the ashes, &c., in addition to which it is more than probable that infectious rubbish is frequently deposited in them. I would urge upon your Board, therefore, the necessity of taking into consideration the 16 question of providing a Refuse Destructor or other equally practical and efficient means of dealing with the rapidly increasing mass of house and trade refuse. Gipsy Encampments, During the year numerous complaints have been received as to the nuisance caused by gipsies encamping on vacant land in close proximity to dwelling houses. Owing to the absence of statutory powers dealing directly with this class of nuisance, very great trouble has been experienced in having the caravans removed. It is most desirable that the efforts of your Board to obtain effective legislation in this direction will result in ridding the district of this intolerable nuisance. Scotland Green. A house to house inspection and an exhaustive examination of the drainage of this part of the district has been made within the past year, numerous defects and insanitary conditions have been discovered, the remedying of which will effect a material improvement. Removal of Bodies to Mortuary. The arrangements for removing bodies to your Mortuary have undergone considerable improvement. A hearse is now provided for this purpose instead of your ambulance, which was made use of in the past. A register is now kept in which all particulars relating to the removal of each body to and from the Mortuary are entered, and no effort is spared to perfect as far as possible the important work in connection with this branch of my department. Water. The number of houses inspected for the detection of waste of water was 2,279. Defective fittings were found in 1,181 houses. New service pipes were laid on to 80 houses. New fire plugs were fixed in 40 cases. The service pipes to 51 old houses were renewed. 460 yards of mains were laid. 449 yards of mains were re-laid. 17 Roads. The following Roads were declared public highways:— Glenwood Road. Rangemore Road. Cape Road. Townsend Road. Asplin's Road. Vincent Road. Park Road (part of.) Winchelsea Road. Seaford Road. Forster Road. Lincoln Road. Total length about 2 miles. Total cost nearly £14,000. Watering the Roads took place 147 days during the year. Permanganate of Potash was used in the water carts as a deodorant and disinfectant throughout the summer, and was most successful. There are now 8 roads in the hands of the contractors, and 36 more under the consideration of your Board. Sewers. The following Sewers have been laid during the year:— 1,000 feet of 12in. pipes. 560 feet of 9in. pipes. 3,000 feet of 6in. pipes have been used in making 200 connections to the Sewers. Surface Water Drains. The following Surface Water Drains were laid:— 90 feet of 15in. pipes. 860 feet of 12in. pipes. 1,240 feet of 9in. pipes. 4,000 feet of 4in. pipes were used in making 300 connections to the Surface Water Drains. W. TYNDALE WATSON, M.D. March 10th, 1894. METEOROLOGICAL OBSERVATIONS, 1893. (As supplied Monthly to the Registrar General, Somerset House, London.) Taken at TOTTENHAM at a Station 47 feet above mean sea level at Liverpool. Latitude 51° 36' N., Longitude 0° 4' W. MONTH. Pressure of Atmosphere in Month. Temperature of Air in Month. Mean Temperature. VAPOUR. Mean Degree of Humidity Saturation=100. Mean Weight of a Cubic Foot of Air. Mean Reading of minimum on Grass. WIND. Mean Amount of Cloud, 0—10. RAIN. Highest. Lowest. Range. Mean. Air. Dew Point. Elastic Force. In a Cubic Foot of Air. Estimated Strength 0—6. Relative proportion of No. of Days .010 or more fell. Amount Collected. Evaporation. Mean. Range Of all ; Highest. Of all Lowest. Daily Range. Mean, j Short ofSaturation. N. E. S. W. Calm. 1893. inches inches deg. deg. deg. deg. deg. deg. deg. deg. inch grns. grns grns. deg. inches inches January 30.070 0.996 52.1 15.9 36.2 40.0 31.2 8.8 35.5 32.8 187 2.1 0.3 90 562 28.7 0.8 9 4 7 10 1 8.4 12 1.242 0.382 February 29.700 1.652 56.2 23.0 33.2 46.6 35.8 10.8 40.8 38.0 .230 2.7 0.3 90 549 33.1 0.9 3 4 8 11 2 8.4 20 2.924 0.600 30.146 0.820 67.1 24.4 42.7 56.7 35.5 21.2 44.7 39.9 .247 2.8 0.5 84 552 32.1 0.9 7 7 4 11 2 4.5 5 0.460 1.825 April 30.177 0.566 77.4 30.4 47.0 64.1 40.2 23.9 50.3 40.9 .256 2.9 1.2 71 547 38.0 0.9 8 15 3 4 ... 3.2 3 0.110 3.550 May 30.069 0.808 76.6 39.9 36.7 67.1 47.8 19.3 55.8 46.5 .319 3.6 1.3 71 539 45.6 1.0 5 9 6 11 ... 5.5 6 0.680 4.420 June 30.013 1.090 85.5 38.8 46.7 71.2 51.6 19.6 59.3 48.2 .337 3.8 1.9 67 534 49.9 1.0 6 13 3 8 ... 5.5 10 0.750 4.435 July 29.897 0.752 85.0 47.7 37.3 71.0 55.7 15.3 61.5 53.9 .415 4.6 1.4 77 529 53.4 0.9 5 6 9 10 1 5.7 14 2.167 3.557 August 30.028 0.672 91.1 43.7 47.4 73.8 56.5 17.3 63.4 54.9 .433 4.8 1.7 74 530 53.5 0.8 6 4 6 11 4 4.6 11 1.195 3.680 September 29.883 1.024 77.3 37.4 39.9 65.5 48.8 16.7 55.6 49.1 .351 3.9 1.0 80 535 46.0 0.9 7 4 5 11 3 4.9 10 1.359 2.000 October 29.914 1.238 65.4 29.2 36.2 58.7 44.9 13.8 50.5 46.6 .318 3.6 0.5 87 542 41.4 0.8 3 1 6 18 3 4.4 16 3.577 1.500 November 29.982 1.352 59.4 26.8 32.6 47.7 36.0 11.7 41.5 37.2 .225 2.5 0.5 87 553 33.4 1.0 12 4 5 9 ... 7.5 14 2.058 0.660 December 30.007 1.716 56.2 19.0 37.2 45.7 34.6 11.1 40.2 37.0 .220 2.5 0.4 89 553 31.1 0.8 5 2 13 10 1 7.7 13 2.034 0.384 Barometer corrected and reduced to 32° Fahr. at sea level. Highest reading of Barometer 30.732 inches on 30th December. Highest reading of Thermometer in shade, 91.1 deg. on 18th August. Lowest do. do. 28.750 inches on 21st February. Lowest do. do. do. 15.9 deg. on 5th January. Ranges of Atmospheric Pressure during the year, 1.982 inches. Ranges of Temperature during the year, 75.2 degrees. Observations taken at 9 a.m. daily. JNO. ED. WORTH, M. Inst. C.E., F.R. Met. Soc., &c. THE WEATHER, 1893. Diagram Showing the Monthly Means, & with their Variations from their respective Averages Jno Ed Worth, FR MetSoc M Inst Civil Engineers 3 REGISTER OF RAINFALL, Collected at Tottenham from Jan. to Dec., 1893. Measured at 9 a.m. Latitude 51° 36' N.; Longitude 0° 4' W. 47 feet above mean sea level. Day of Month. January. February. March. April. May. June. July. August. September. October. November. December. 1 ... ... .090 ... ... ... ... .050 .340 ... ... .147 2 ... .310 .185 ... ... ... ... .150 ... .025 .212 ... 3 ... .150 .040 ... ... ... ... ... ... .205 .010 ... 4 ... ... .085 ... ... ... ... .200 ... ... ... ... 5 ... ... ... ... ... .020 .110 .215 ... .030 .030 ... G ... ... ... ... ... ... ... ... ... .190 ... ... 7 .010 .080 ... ... ... .090 ... .020 .050 .070 ... .030 8 .035 .030 ... ... ... ... ... ... ... .118 ... ... 9 .110 ... ... ... ... ... .260 ... .210 ... ... .280 10 .250 .170 ... ... ... ... .150 .135 ... .990 ... .010 11 ... .035 ... ... ... ... ... ... ... .190 ... .095 12 .047 .110 ... ... ... ... .225 .090 ... .560 ... .030 13 ... .010 ... ... ... ... .130 .010 ... ... ... .310 14 .020 .095 ... ... ... ... ... ... ... .103 ... .375 15 ... .090 ... ... ... .040 ... ... ... .070 .560 ... 16 ... .064 ... ... ... ... .072 ... ... ... .040 ... 17 .200 .020 .060 .030 .070 ... .045 ... .130 ... .030 ... 18 .050 .030 ... ... .405 ... ... ... ... .670 .113 ... 19 .110 .120 ... ... .040 ... .075 ... ... ... .410 ... 20 ... ... ... .060 .020 .015 .170 ... .070 ... .070 .210 21 ... .205 ... ... ... ... .140 .020 .120 ... .010 .325 22 .050 .445 ... ... ... ... ... ... ... .175 ... ... 23 ... .145 ... ... ... .220 ... .050 ... .123 ... .175 24 ... ... ... ... .050 .040 .350 .250 ... ... .070 .010 25 ... ... ... ... ... ... ... ... ... ... .015 .037 2G ... .210 ... ... ... .010 ... ... .115 .048 .380 ... 27 .285 .170 ... ... ... .060 .220 ... .150 ... ... ... 28 ... .435 ... ... ... .245 ... ... ... ... .108 ... 29 .075 ... ... ... ... .010 ... ... .125 .010 ... ... 30 ... ... ... 020 •095 ... 070 ... .049 ... ... ... 31 ... ... ... ... ... ... •150 •005 ... ... ... ... Total Rainfall for Month. 1.242 2.924 0.460 0.110 0.680 0.750 2.167 1.195 1.359 3.577 3.058 2.034 Greatest Fall in 24 Hours. 0.285 on 27th 0.445 on 22th 0.185 on 2th 0.060 on 20th 0.405 on 18th 0.245 on 28th 0.350 on 24th 0.250 on 24th 0340 on 1st 0.0990 on 10th 0.560 on 15th 0.375 on 14th No. of Days on which •010 or more fell 12 20 5 3 6 10 14 11 10 16 14 13 Readings are entered against the day on which they are read. Total Rainfall in the above twelve months 18-656 inches. Number of days on which .010 or more rain fell 134. Greatest fall in 24 hours, 0.990 inches, on 10th October. Jno. Ed. WORTH, M. Inst. C.E., F.R. Met. Soc., &c. TOTTENHAM LOCAL BOARD OF HEALTH SEWER GAS & HOUSE DRAIN VENTILATION. The Local Board of Health begs to call the serious attention of the inhabitants of Tottenham to the great importance of House Drain Ventilation. This is recommended by the Government and all other Sanitary authorities as the only means (when coupled with effective trapping) of entirely keeping out of Houses dangerous sewer gases. Those gases which are harmless when they escape freely into the open air are known to be the frequent cause of serious and even fatal illness when they find their way into the interior of dwelling houses. The soil pipe of every water-closet should be ventilated by means of a pipe from it carried upwards outside the house until it is clear of the eaves. The sink-pipe and the waste-pipe from basins and baths can be ventilated in the same way, but in these cases a still better and cheaper plan of keeping out sewer gas is usually possible. This is to sever the pipes outside the House, and to place a trap below the point of severance. Overflow pipes from cisterns and baths should never enter the sewer, but should always end in the open air. When it can possibly be avoided, no pipe issuing from the house (except the closet soil-pipe) should pass into the sewer without a break. Rain-water pipes should never be used for the purpose of ventilating drains. House-drain ventilation can be carried out at a moderate cost. Further information can be obtained at the Board's Offices. By order of the Board, EDWARD CROWNE, CLERK.