To the Chairman and Members of the TWICKENHAM URBAN DISTRICT COUNCIL. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH, 1 8 9 7. Mr. Chairman and Gentlemen, I have the honor to submit to you my Fourteenth Annual Report, as to the Health and Sanitary condition of the Parish of Twickenham. The Report will embrace the vital statistics of the year 1897, which terminated on December the 31st, and a summary of the measures taken for the prevention of the development and dissemination of disease. The forms supplied by the Local Government Board (Tables A and B) accompany; the former, Table A, is that of the deaths; the latter, Table B, that of the population, births, and new cases of infectious sickness, these tables are both classified according- to diseases, ages and localities. Appended also to this Report are the forms supplied by the Middlesex County Council; Table C (i., ii., iii., iv.) An Analysis of the information required, and the sanitary work accomplished during the year is embodied in the text of this Report, under their respective headings, in which are dealt with the various details set forth in the columns of the above table. In reviewing the past year, I have to record an increase, amounting to 53, in the number of death from all causes, as compared with the year 1896. This is attributable in a measure, to an increase in the mortality of children under 5 years of age, there being 79 in 1896, and 115 in the past year. The largest number of deaths, amounting to 38 from all causes, occurred in the month of August. The death rate for the year 1897, is 13.8 per 1,000 ; and the average rate for the past five years is 12.91 per 1,000. There has also been an increase, amounting to 2, in the number of deaths from the Zymotic Diseases. With the exception of an outbreak of Measles, in the West District, towards the close of the year, there has been no prevalence of disease in the above class ; as will be seen from the number of cases notified, which is the lowest since the adoption of the Infectious Diseases Notification Act, in this District in 1890. The vital statistics for the year, are calculated on an estimated population of 18,500 2 The total number of deaths during the year 1897, was 256, which is at the rate of 13.8 per 1,000. This number includes 15 at Whitton, eight at St. John's Hospital, one at the Powder Mills, and two at the Military Quarters at Whitton. The number of deaths in 1896, was 203, average rate, 11.27 per 1,000. „ ,, 1895, ,, 235, ,, 13.8 ,, ,, ,, 1894, „ 207, „ 12.1 ,, „ „ 1893, „ 230, „ 13.6 „ The deaths of persons of 65 years and upwards numbered 58, or 22 65 per cent. of the total number of deaths. The deaths of children under five years of age numbered 115, or 44.92 per cent. of the total number of deaths. There were five uncertified deaths. The causes of death, independent of those included in the six principle Zymotic Diseases, and as recorded in the table in the text of this Report are: 15 from Phthisis, 25 from Bronchitis, Pneumonia, or Pleurisy, 17 from Heart Disease, 1 from Puerperal Fever, 21 from Diarrhoea and English Cholera, 5 from Injuries, and 155 from all other causes. The total number of births for 1897 was 495 ; 261 males, 234 females, which is at the rate of 29.19 per 1,000. The total number of births for 1896, was 455. „ „ ,, 1895, ,, 456 „ ,, ,, 1894, ,, 486. ,, ,, 1893, „ 468. Subjoined is a Table of the mortality from the six principle diseases of the Zymotic class, occurring in the last ten years. 1897 1896 1895 1894 1893 1892 1891 1890 1889 1888 Small Pox 0 0 0 0 0 0 0 0 0 0 Measles 0 1 3 11 0 3 2 2 5 0 Scarlet Fever 0 0 0 0 4 2 i 2 3 1 Diphtheria 4 4 2 14 0 9 7 9 2 2 Whooping Cough 8 6 0 4 10 1 7 11 2 7 Enteric Fever .. 2 1 0 1 3 0 1 2 1 0 14 12 5 30 17 15 18 26 13 10 In addition to the above table, there have been 21 deaths from Diarrhoea and 3 English Cholera (20 occurring in infants under five years of age, and one in a person of 65 years of age) and one from Puerperal Fever. A few remarks are necessary upon some of the above diseases. Measles was little prevalent throughout the year, except towards the close, when an outbreak occurred in the Common District, which necessitated the closing of the Schools in that district. Scarlet Fever was somewhat prevalent during the month of October, the cases not being confined to any particular part, but scattered over the whole district. Ten cases were being treated at the Cottage Hospital during this month; the desirability for the removal of each was thoroughly enquired into, the houses subsequently fumigated and disinfected; and no further spread of the disease occurred. Whooping Cough was the cause of 8 deaths, all of children under 5 years of age. These all occurred during the first half year, the majority having some secondary complication, such as Pulmonary Disease or Convulsions, which was the immediate cause of death. Enteric Fever was the cause of two deaths, although 11 cases of this disease were notified under the act. Four cases were removed to Hospital; the water supply was in each case examined and disinfection carried out wherever necessary. In addition to the above diseases, there were 21 deaths certified as being due to Diarrhoea, or Choleraic Diarrhoea. All occurred towards the end of July and the beginning of A ugust, and were of children under 5 years of age. At this season the weather was very hot and dry. The question why Diarrhoea is so prevalent and fatal, especially in infants, in hot summers, has long been under the consideration of medical authorities. It is the general assumption that it is due to the existence of a germ, which develops into activity when a certain temperature is attained, and finding admission into the system through the stomach or lungs multiplies there, generating a poison which is the immediate cause of the disease. The mucous membrane of the intestinal canal seems peculiarly to bear the stress of all accidental putridities which enter the system, whether they have been breathed, drunk, or eaten. Among other causes that very often occasion Diarrhoea, though not always fatal Diarrhoea, are temporary faults of diet, habitual improper food (especially as regards infants and very young children). Various other personal influences also contribute to the total number of cases of Diarrhoea. Inquests.—Thirteen Inquests have been held during the year, the verdicts returned as to the cause of death being:— 9 Accidental: 1 Asphyxia, from flexure of neck during unconsciousness. 4 1 Asphyxia, suffocation in bed. 1 Crushed by a cab. 1 Run over by a bus. , 3 Drowning. 1 Morphia poisoning. 1 Shock from burns. 1 Want of proper attendance at birth. 1 Heart disease. 2 Suicidal, from being run over by trains. Mortuary.—Seven bodies were removed to the mortuary during the year. The following are the alterations and improvements that have been carried out: A new slate slab for performing post mortem examinations, the previous one refixed against one wall of the building, a new sink and washhand basin provided, the match-boarding of the ceiling reinstated, two of the windows made to open, a gas stove and an extra cupboard provided, and also a hose connected with the main water pipe for washing and flushingpurposes. Cottage Hospital.—Twenty cases of Scarlet Fever have been admitted into the Cottage-Hospital during the year as against 23 admitted in 1896. Nineteen of these have been discharged cured, and one remained under treatment at the beginning of the year. The Hospital has been furnished by the order of the Health Committee, with a Mangle and Wringing Machine. The Ambulance has also been repaired, painted, and varnished. The Nursing Staff have satisiactorily carried out their duties. Infectious Disease Notification Acr.—Of the diseases in this Act, 77 cases have been notified. Subjoined is a table of the scheduled notifiable diseases, with the number of cases occurring in each year since the adoption of the Act in 1890. 1897 1896 1895 1894 1893 1892 1891 1890 Small Pox 0 0 0 1 1 0 0 0 Scarlet Fever 34 44 28 4? 187 59 38 43 Diphtheria & Membranous Croup 20 22 21 45 28 31 25 27 Typhus Fever 0 0 0 0 0 0 0 0 Enteric or Typhoid Fever 11 12 12 9 13 7 8 12 Continued Fever 0 2 0 0 0 0 4 0 Eelapsing Fever 0 0 0 0 0 0 0 0 Puerperal Fever 4 4 2 3 3 4 3 2 Cholera 1 0 0 1 1 2 0 1 Erysipelas 7 25 15 17 30 20 16 13 77 109 78 119 263 123 94 98 5 Water Analysis:—Twelve specimens of well water have been analysed by me with the result that 8 were found to be good and fit for drinking- purposes and 4 bad and unfit. These latter were drawn from four pumps supplying1 nine cottages. To each of these cottages the Company's water has since been laid on, and the wells have been closed. Analyses of the Company's water drawn from different parts have also been made, and have always proved satisfactory. The reports of the analysis of the Public Analyst, submitted to me every month, have always shown the water of the Grand Junction Water Company to be of excellent quality. One of the rooms at the Town Hall'has, by the sanction of the Town Hall Committee, been fitted up with all the requirements necessary for the performance of water analysis. Laundries:—Throughout tbe Parish there are 12 Laundries which come within the act relating thereto; these are two in addition to those of 1896. They have all been primarily inspected by myself and periodically by the Sanitary Inspector. In one, considerable alterations and improvements have taken place. Cowsheds, Dairies, and Milk Shops Of these there are 29 throughout the Parish, or five in addition to 1896. They have all been inspected by myself and frequently by the Sanitary Inspector. Bakehouses—There are 17 Bakehouses at the present time throughout the Parish. This number is two above that of 1896. These are periodically inspected twice a year, in April and October, when the necessary cleansing and whitewashing is required to be done under the Act relating thereto. Slaughter Houses.—Of these there are twelve throughout the Parish. They have all been inspected by myself, and also by the Sanitary Inspector. They are limewashed generally once a month, and oftener if necessary. Complaints had to be made as to the condition in which some of these were kept as regards cleanliness and dilapidations, but in the majority of instances when visited they were found to be in a cleanly state. Reports as to the condition of all the above have from time to time been made to the Health Committee. Contagious Diseases (Animals) Act.—Under this Act I have received declarations from the County Inspector, of Swine Fever existing in four piggeries. In one instance the keeping of pigs was discontinued, and in the others the styes were disinfected, cleansed, and lime-washed. Forty-nine pigs suffering from this disease were killed and buried. 6 Local Government Board.—1 have received from the Local Government Board a memorandum as to the closing- of Public Elementary Schools. This question being of importance at the present time, I have considered it necessary to attach to this Report, an official copy for the perusal of each member of the Council. I have also received from the same Authority a copy of an Act, cited as, the Cleansing of Persons Act, 1897. This is an Act " permitting" Local Authorities to provide cleansing and disinfection for persons infested with vermin. Inspection of the Parish.—The total number of houses, premises, etc., primarily inspected, was about 1,100. The total number of reinspections after order of notice, was approximately 660. The following is an analysis of the work accomplished :— Houses, Premises, etc., cleansed, repaired whitewashed, etc. .. 30 „ Roofs repaired, etc. 15 „ Guttering and Rain Pipes repaired, etc. 20 „ Yards paved and drained 10 Nuisances arising from overcrowding 6 „ „ Smoke 5 ,, „ Pigs other Animals, and Fowls 10 n » Fish Frying 1 „ „ Accumulation of Refuse (including one in a Barge moored on the Thames, at the headofEel Pie Island) 39 Other Nuisances not included in the above 42 Water—Pumps cleaned, repaired, etc. 4 Wells closed as polluted 4 Water laid on to houses with no supply 11 Water laid on to new houses and premises 308 Cisterns—New provided 12 Cleansed, repaired, covered, etc. 25 Flush to w.c.'s 21 To new houses 308 Water Closets—New constructed 3 New apparatus provided 29 Repaired, cleansed, etc. 83 Supplied with water or supply rendered efficient 37 To new houses 308 Ventilated 20 7 Drains—Examined, tested exposed, etc. 15 Unstopped, repaired ,trapped, etc. 175 Waste Pipes, Rain Pipes, etc., disconnected 10 Soil Pipes and Drains ventilated 10 Disconnecting Traps or Chambers inserted 16 Reconstructed 13 Dust.—Dustbins repaired 20 Moveable receptacles substituted for fixed 18 Number of complaints of non-removal 90 Statutory orders issued 26(5 New Sewers.—30.24 yards in length were laid in the following roads : Gould, Gravel, Alexander, Morley, Rutland, Napolean, Heath, Sydney, Tower, Grinwood, and North End Avenue. The number of Ventilating Shafts erected was: three public ones, and a number of private ones fixed on private houses. The number of Manholes Built was fifty-three. The number of Drainage Connections was 241. Plans submitted and approved for 308 houses, all of which were connected with the main Sewers, and water laid on to each house and closet. Reports have been made to the Health Committee as regards the condition of the Urinals in connection with the Public Houses throughout the District. To the large majority of these a water supply has since been laid on. Those instances in which this work has not been completed or carried out, are still under the consideration of this Committee. Legal proceeding's were taken in respect of nuisances arising from horses standing at the Drawdock at Richmond Bridge, and also from Caravans on the Common. A conviction was obtained in the former case. I have the honour to be, Mr. Chairman and Gentlemen, Your obedient Servant, March, 1898. W. MARSTON CLARK, D.P.H., Medical Officer of Health. K23.(A)TABLE OF DEATHS during the Tear 1897, in the District, \il/ classified according to Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics; public institutions being shown as separate localities. (See note 4 onbackof sheet.) (Columns for Population and Births are in Table B.) (a) mortality *KOM all caus-kft, mortality from subjoined causes, distinguishing deaths of children under flve years OF age. at subjoined ages. At all ages. (b) Under' X year. (C) i and under 5. (d) 5 and under 15. (e) 15 and under 25. (f) 2\ and under <55. (g) 65 and upwards (h) (i) i 2 3 j 4 ° 6 7 8 y 10 ii 12 | 13 14 , 15 16 1 17 | 16 1 i9 || 20 21 22 Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. C holera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery liheumatic Fever. Phthisis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. # Injuries. All Other Diseases. Total. Typhus Enteric or Typhoid. Continued Relapsing Puerperal ??? Under 5 3 7 3. 3 11. 100. 210. 71 29 4 5 66. 3T 5 upwds. 2. 1. 1. 10 13 17 82 130. ??? 1 Under 5 6 1. 2. 8 12 15 11 1 2. 5 upwds. i 1. 3. ??? Under 5 1 1. 8. . 1. - 2. 4 1. 5 upwds. 1. 1 7 ??? Under 5 1. - - - 1. - 5 upwds. 1 1. ??? 2. - 2. - Under 5 2 2. 5 upwds. ??? Under 5 5 upwds. ??? Under 5 5 upwds. Under 5 5 upwds. Under 5 5 upwds. 1 Under 5 5 upwds \ Totals 256. 82. 33. 4. 8. 71. 58. Under 5 4. -2. 2 1. 5. 8 15 3, 11. 1. 166. 115 5 upwds 1. 1. 12. 14. 17. 4. 89. 141. The subjoined numbers have also to be taken into account in judging of the above records of mortality. See Note 5 on back. ' Deaths occurring outside the district among persons belonging thereto. Under 5 5 upwds. Deaths occurring within the district among persons not belonging thereto. Under 5 5 upwds. # The heading of column 19 is left blank for the insertion of Influenza, or any other disease which it may be thought desirable to record. UOTBS 0nT TABLES ..A_ J^ISTJD Note 1. Medical Officers of Health of "Combined Districts" must make a separate Return for the District of each District Council. 2. Medical Officers of Health acting for a. portion only of the District of a District Council should write, in the heading of the Table, the designation of the Division for which they act. 3. The words " Urban," "Rural," or "Metropolitan" must be inserted in the appropriate space in the heading, according as the District is Urban or Rural, or is within the Metropolitan Area. 4. The "Localities " adopted for the purpose of these statistics should be areas of known population ; suoh as parishes, groups of parishes, townships or wards. As stated at the head of the first column iu each Table, Public Institutions should be regarded as separate localities, and the deaths in them should be separately recorded. Workhouses, Hospitals, Infirmaries, Asylums, and other establishments into which numbers of people, and especially of sick people, are received are Public Institutions for the purpose of these statistics. 5. The deaths which have to be classified in this Table (A), and summed up in the horizontal line of " Totals," are the whole of those registered as having actually occurred in the several localities comprised within the Division or District. But the registered number of deaths frequently requires correction before it can give an exact view of the mortality of a Division or District; and the two lowest horizontal lines are provided for the purpose of enabling Medical Officers of Health to indicate, to the best of their ability, what the extent of such corrections shoidd be. Details concerning the corrective figures, e.g., the institutions that have been considered, or the particular localities to which corrections apply, may appear in the text of the report or in supplementary tables. Area and Population of the District or Division to which this Return relates. Area in Acres Population (Last Census) 16,026 / Estimated to ) \ middle of 1897)18,500 Perl,000 Population, esti- General _13.8 mated to middle Death of 1897. Rates, Infant (under 40.59pert 1,000 Births Registerde. one year of age In recording the facts under the various headings of Tables A and B, attention has been given to the notes endorsed on the Tables. Medical Officer of Health. (Date.) _ , 1898, W B & I. (555o) -79031—10000-10,97 1 k2 11 1 TABLE OF POPULATION, BIRTHS, AND OF NEW CASEJ5 OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical (B) Officer of Health, during the year 1897, in the District.; classified according to Diseases, Ages and Localities. Names of Localities adopted for the purpose of these Statistics; I Public Institutions being shown as separate localities. {See Note 2 on back of sheet.) (a.) Population at all Ages. (d)Registered Births. Aged under 5 or over 5. (e.) New Cases of Sickness in each Locality, coming to the knowledge of the Medical Officer of Health. Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospital. Last Census. (b) Estimated' to middle of 1897. (c.) 1 a 3 4 5 6 7 8 9 10 11 12 13 1 2 3 4 5 6 7 8 | 9 10 11 12 13 Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevees. Cholera. Erysipelas. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Typhus. Enteric or Typhoid. Continued Relapsing Puerperal Typhus. Enteric or Typhoid - Continued Relapsing Puerperal ??? 16.026 18.509 495 Under 5 31 13 1 10 4 1 7 ??? 5 upwds. ??? ??? Under 5 r ??? 5 upwds. / ??? Under 5 1 ??? 5 upwds. ??? Under 5 1 5 upwds. ??? Under 5 2 2 5 upwds. ??? Under 5 2 1 ??? 5 upwds. Under 5 5 upwds. Under 5 5 upwds. Under 5 5 upwds. Under 5 5 upwds. Under 5 5 upwds. Totals Under 5 3 // 4 / r 4 : 5 upwds. State here whether " Notification of Infectious Disease " is compulsory in the District- , . Since when ? /(f & & *■- Besides the above-mentioned Diseases, insert in the columns with blank headings the names of any that are notifiable in the District, and fill the columns accordingly. ✓ State here the name of the Isolation Hospital used by the sick of the District. Mark (H) the Locality in which such Hospital is situated; and if not within the District, state where it is situated NOTES ON TABLE B. (See also Notes on back of Table A.) Note 1. The present Table B. is concerned with population, births, and sickness (not with mortality) in the district or division to which the Table relates. 2. As stated in the heading of Col. (a), Public Institutions should be regarded as separate localities, and the new cases o£ sickness in them should be separately recorded. Workhouses, Hospitals, Infirmaries, Asylums, and other establishments into which numbers of people, and especially of sick people, are received, are Public Institutions for the purpose of these statistics. 3. Comments on any unequal incidence of notifiable disease upon the several localities, and considerations as to the local incidence of Consumption and other prevalent diseases, should be made in the text of the Report. ffBH (FG5u) -79033—10000-10-97 222 1895 (C I) COUNTY OF MIDDLESEX.—SANITARY WORK, Sanitary Districts. ► Inspections. Notices. Dwelling Houses. Houses let in separate Dwellings or Lodgings. Common Lodging Houses. Canal Boats used as Dwellings. Movable Dwellings, Caravans, Tents, &c. Note.—Asterisks or other si^ns appearing opposite a District, signify that thosecolumns of the District ^ are taken together. Complaints Received. Cases of Infectious Disease Notified. Number of Premises periodically Inspected. Houses Inspected from House-toHouse. Total Number of Houses, Premises, &c., Inspected. Total Number of Re-inspections after Order or Notice. Total Number of Inspections and Re-inspections. Letters Written. Cautionery Notices Given. Statutory Orders Issued. Summonses Served. Convictions Obtained. Houses, Premises, &c., Cleansed, Repaired, &c. Closed as Unfit for Habitation. Re-opened after Repairs, Alterations, &c. Demolished. Illegal Underground Dwellings Vacated. Number Registered under Bye-laws. Periodical, Frequency, or Number of Inspections. Number of Contraventions. Number Registered under Bye-laws. Periodical, Frequency, or Number of Inspections. Number of Contraventions. Number Registered under the Acts. Periodical, Frequency, or Number of Inspections. Number of Contraventions of Regulations. Number Observed during the Year. Number of Nuisances therefrom Abated. Number Removed from District. ??? 38 77 109 1100 660 1760. 160. 50 266. 3. 2. 30. nil nil nil nil nil nil nil nil nil nil nil nil nil 2. 2. all 223 1895 (C II) COUNTY OF MIDDLESEX.—SANITARY VVOKK, lb^. Sanitary Districts. Schools. Workshops and Work-places. Laundries. Bakehouses Slaughter-houses. Cow-sheds. Dairies and Milk- 1 shops. Unsound Food. Adulterated Food. Offensive trades. Mortuaries. Note.—Asterisks or other signs appearing opposite a District, signify that those |p columns of the District are taken together. Number in District. Periodical Frequency or Number of Inspections. Number found defective. Number in District. Periodical Frequency or Number of Inspections. Contraventions of Factory Acts. Number in District. Periodical Frequency or Number of Inspections. Contraventions of Factory Acts. Number in District. Periodical Frequency or Number of Inspections. Contraventions of Factory Acts. Number on Register. Periodical Frequency or Number of Inspections. Contraventions of Bye-laws. Number on Register. . Periodical Frequency or Number of Inspections. Contraventions of Bye-laws. Number on Register. Periodical Frequency or Number of Inspections. Contraventions of Bye-laws. Animals seized. Articles or parcels seized. Samples taken. Found adulterated. Number of premises in District. Periodical Frequency or Number of Inspections. Contraventions of Bye-laws. Accommodation. dumber of bodies received. ??? 15. ??? ??? 24. ??? 1. 12. ??? ??? 17. ??? ??? 12. ??? 3. 10. ??? ??? 19. ??? ??? ??? ??? ??? ??? ??? ??? ??? 4.??? 7. K4 1895 (C III). COUNTY OF MIDDLESEX.—SANITARY WORK, 1897. Sanitary Districts. Water Supply and Water Service. Drainage and Sewerage. Nora.—Asterisks or other signs appearing opposite a District, signify that those columns of the District are taken together. Wells. 1 „ 1 Houses, Water Laid on to. Percentage of Houses Supplied from Mains. Cisterns. Flush Cisterns Provided to W.C's. Draw-Taps Removed from Cisterns to Mains. Percentage of Houses Supplied on Constant System. Privy and Ash Pits. Ash and Earth Closets. I Water Closets. Percentage of Houses Provided with Water Closets. Drains. Cesspools. Percentage of Houses Draining into Sewers. Sewers. New Sunk. Cleansed, Repaired. Etc. ! Cloted as Polluted. New, Provided. Cleansed, Repaired, Covered, Etc. Overflow Pipes Disconnected from Drains. Above Ground Receptacles Substituted for Pits. Movable Receptacles Substituted for fi*ed. W ater Closets Substituted for Dry Receptacles. New Constructed. New Apparatus Provided. Repaired, Cleansed, Etc. Supplied with Water, or Supply Rendered Efficient. Ventilated. Examined, Tested, Exposed, Etc. Unstopped, Repaired, Trapped, Etc. Waste Pipes. Rain Water Pipes, Etc., Disconnected i Soil Pipes and Drains Ventilated. Disconnecting-Traps or - Chambers Inserted. Reconstructed. New Laid. Rendered Impervious, Emptied. Cleansed, Etc. Abolished, and Drain Connected to Sewer. Yards of New Sewers Laid. \arda of Sewers Reconstructed. ??? ??? 4. 4. 11. 9090. 12. 25. ??? 21. ??? 9090. ??? ??? ??? 3. 29. 83. 37.??? 20. 75.% 15. 175. 16. 10. 16. 13. 6. ??? ??? 991. 3024. 285. - 225 W 1895 (C IV) COUNTY OF MIDDLESEX.—SANITARY WORK, 189/. Sanitary Districts. Disinfection. Dust. Dampness. Sundry nuisances abated. Contagious Diseases of Animals. Infant life Protection Act. Note.—Asterisks or other signs appearing opposite a District signif y that those columns of the District are taken together. Rooms fumigated. Rooms stripped and cleansed. Articles disinfected or destroyed. Dust-bins repaired. New bins provided. Movable receptacles substituted for fixed. Periodical frequency of dust removal. Number of complaints of nonremoval i-eceived. Roofs repaired, &c. Guttering and rain-pipes repaired, &c. Gardens, Areas, &c., levelled and drained. Yards paved and drained. Surface adjoining houses paved. Dry areas provided. Ventilation below floor provided. Basements rendered impervious. ! Overcrowding. Smoke. Accumulations of refuse. Foul ditches, ponds, &c., and stagnant water. Foul pigs and other animals. Other nuisances. Outbreaks. Animals infected. Animals destroyed. Number of licensed premises. Number of children. Number of deaths. ??? 31. 15. ??? 120. 20.??? 18. ??? 90. 15. 20. ??? 10. ??? ??? ??? ??? 6. 5. 39. ??? 10. 42. ??? 49. 49. ??? ??? ???