TW 1039 1903. TWICKENHAM Urban District Council. ANNUAL REPORT OF W. MARSTON CLARK, Diplomate in Public Health, Lond., Medical Officer of Health. Twickenham : printed by H. and C. franklin, king street. 1 9 0 4. Twickenham Urban District Council. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, 1903. Mr. Chairman and Gentlemen, I have the honour to submit to you my Twentieth Annual Report as to the Health and Sanitary condition of the Parish of Twickenham. Appended to the Report are four tables received from the Local Government Board. Table I comprises the vital statistics of the whole district during 1903 and previous years extending from 1893. Table IT. consists of the Births and Deaths registered, and with a view to give more concise information, such table has been sub-divided corresponding with the four Wards of the District, viz.:—South, East, West, and Central. I have estimated the population at 24,000, comprising 5,434 in the South Ward, 6,619 in the East Ward, 7,052 in the West Ward, and 4,895 in the Central Ward. Table III shews the cases of Infectious Diseases notified during the past year. Of the total cases 9 were in the South, in the East 11, in the West 21, and 7 in the Central Wards respectively. 2 The removals to the Infections Diseases Hospital were four from the South Ward, seven from the East Ward, three from the West Ward, and four from the Central Ward. Table TV. embraces the causes and ages at death for the same period. There were 254 deaths; of these 53 occurred in the South Ward, 67 in the East Ward, 80 in the West Ward, and 54 in the Central. The compilation of the tables has necessitated very great care in order to ensure accuracy. In addition to the forgoing, there are four tables furnished by the Middlesex County Council, viz.:- Tables C (I, II, III, IV.) Tables C(1) refers to Inspections of Dwelling Houses, Houses let in separate Dwellings or Lodgings, Common Lodging Houses, Canal Boats used as Dwellings, Moveable Dwellings, Caravans, Tents, &c. Inspections generally and notices served. Table C (II) contains the Inspection of Schools, Workshops, and Work-places, Laundries, Bakehouses, Slaughterhouses, Cowsheds, Dairies and Milkshops, Unsound Food, Adulterated Food, Offensive Trades and Mortuaries. Table C fill) relates to Water Supply and Water Service, Closet-accommodation, Drains, Cesspools, Sewers and Ash-pits. Table C (TVJ deals with Disinfection, Dust Collecting, Dampness, Contagious Diseases of animals, and sundry other nuisances, such as overcrowding, &c. Population. The Vital Statistics are calculated on an estimated population 24,000. The population at the time of the Census of 1891 was 16,026, Census 1901, 20,991. As nearly as can be computed the number of inhabited houses is 5,000. Births. During the year there were 615 births, 308 were males, and 307 were females, giving a birth rate of 26.7 per 1000. The total number of births for 1898 was 466 1899 „ 521 1900 „ 531 1901 „ 576 1902 „ 596 3 Deaths. Although there has been an estimated increase of 3,000 in population since the Census of 1901, the number of deaths 254 is ten less than last year. The death rate is at the average of 10.5 per 1,000 as against 12.0 per 1,000 in the preceding year, and is lower than it has been any time during the previous decade. The number of deaths for 1898 was 266 equal to an average rate of 13.6 per 1000 1899 „ 276 „ „ 13.8 1900 „ 295 „ „ 14.3 1901 „ 254 „ „ 12.9 1902 „ 264 „ „ 12-0 The epitome of the ages at death is as follows:— Under 1 year ... ... ... ... 68 Over 1 year and under 5 years ... 21 Over 5 years and under 15 years ... 12 Over 15 years and under 25 years ... 6 Over 25 years and under 65 years ... 78 65 years and upwards... ... ... 69 A careful analysis of the deaths of persons of 65 years of age and upwards tends to show that the mild climate of the Thames Valley is distinctly favourable to longevity. Of the 69 deaths registered in the district as occurring among the residents of Twickenham, 12 were between the age of 65 and 70 years. 23 „ „ 70 „ 80 „ 24 „ „ 80 „ 90 „ 3 died at the advanced age of 90 years. Among the octogenarians 10 males totalled a grand aggregate of 831 years, and 11 females an aggregate of 924 years, giving averages of 83T and 88 years respectively. One uncertified death occurred of an infant under 1 year, and one of a person of 59 years of age. Amongst the deaths from all causes were 4 from Epidemic Influenza, 3 of these being under one year of age, 4 from 4 Diarrhæa, 16 from Phthisis, 21 from Cancer, 31 from Respiratory diseases, 20 from Heart Disease, 11 from Accidents and 14 Premature Births. Twelve deaths occurred in St. John's Hospital; and one in the Infectious Diseases Hospital. The following table summarises the mortality from the principal Zyomtic diseases occurring during the last 10 years. 1894 1895 1890 1897 1898 1899 1900 1901 1902 1903 Small Pox 0 0 0 0 0 0 0 0 1 0 Measles 11 3 1 0 15 0 8 0 8 1 Scarlet Fever 0 0 0 0 1 2 0 3 1 1 Diphtheria 14 2 4 4 2 0 3 3 3 3 Whooping Cough 4 0 6 8 9 3 7 9 9 10 Enteric Fever 1 0 1 2 0 0 1 2 0 0 30 5 12 14 27 11 19 19 22 15 Diphtheria. Diphtheria was the cause of three deaths. Anti-diphtheritic Serum, as hitherto, has been supplied and used in several cases. It has been attended by excellent results, and the possible mortality from Diphtheria has in consequence been undoubtedly reduced. I think I cannot do better than repeat a portion of my previous report, "That this treatment may be adopted with perfect safety as a prophylactic measure to any case which has been in immediate contact with the disease." In my own personal experience this has been carried out with success in every instance. Measles. Last year, I had occasion to report upon the prevalence of this disease which necessitated the closure of three of the Public Elementary Schools at different periods. During the past year the district has been comparatively free. 5 Small Pox. 1 have pleasure in stating that no cases occurred. Due provision was made to meet contingencies. The Mereway Hospital, under the care of an attendant was retained for the reception of patients. The expenditure incurred in respect of the steps taken during the previous year was, upon application being made to the Local Government Board, allowed. The question of combining with other Local Sanitary Authorities in the County for the provision of Hospitals for the accommodation of Small Pox patients has been under the further consideration of the Council, but they were of opinion that under existing circumstances it was inexpedient to become one of the constituent Authorities.. Subjoined is a table of the scheduled notifiable diseases, with the number of cases occurring in each year for the past 10 years. 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 Small Pox 1 0 0 0 0 0 0 0 10 0 Scarlet Fever 43 28 44 34 31 142 97 105 57 23 Diphtheria and Membranous Croup 45 21 2-2 20 19 29 27 31 12 18 Typhu6 Fever 0 0 0 0 0 0 0 0 0 0 Enteric or Typhoid Fever 9 12 12 11 6 9 6 9 9 3 Continued Fever 0 0 2 0 1 1 7 2 0 0 Relapsing Fever 0 0 0 0 0 0 0 0 0 0 Puerperal Fever 3 2 4 4 0 0 4 2 2 0 Cholera 1 0 0 1 0 2 0 0 0 0 Erysipelas 17 15 25 7 8 11 12 10 4 4 119 78 109 77 65 194 153 159 94 48 6 Scarlet Fever. There were only 23 cases of Scarlect Fever notified; of these 4 occurred in the South Ward, 7 in the East Ward, 7 in the West Ward, and 5 in the Central Ward. This number is the lowest on record since the adoption of the Infectious Disease, (Notification) Act 1889. Infectious Diseases Hospital. Eighteen cases of Scarlet Fever were admitted into the temporary hospital referred to in my last report. The Council continued their tenancy of this building. Of the 18 cases, 3 were removed from the West Ward, 4 from the Central, 7 from the East, and 4 from the South. Nurse Quick performed her duties efficiently to the satisfaction of myself, and to the best of my belief to all the other practitioners who had occasion to attend at the hospital. The parents of the children who were under treatment expressed their gratitude for the experienced services rendered. The Council's application for sanction to a loan for the purpose of acquiring land in a most eligible part of the district whereon may be erected a hospital most suitable for the requirements of the district has been up to the present unfortunately unsuccessful, the only contention of the Local Government Board appears to be the proximity of the Hounslow Powder Mills. The nearest point of the licensed area of these mills is nearly half a mile from the proposed site. The Council possess buildings in closer proximity, and an important Company have erected factory and numerous buildings in still closer proximity in which a large number of persons are employed. To my knowledge no damage has been sustained. I sincerely trust that the Local Government Board will reconsider their decision. Hospital. Two Conferences were held with a neighbouring Urban District Councils as to the desirability of a combination for establishing an Isolation Hospital. After careful consideration the Council determined that such a course was not advisable at the present time. 7 inquests. During the past year 23 inquests have been held. The findings of the juries were as follows 8 Heart disease. 2 Found drowned. 1 Drowned accidentally. 1 Fractured skull, run over by van. 1 ,, ,, thrown from trap. 1 Apoplexy. 1 Bronchitis. I Killed on railway. 1 From burns. 1 Want of proper attention at birth. 5 From overlaying. Pleasure Grounds. Marble Hill.—With the united efforts of the London County Council, the Middlesex County Council the Borough of Richmond and the Council, this beautifully timbered Park comprising 66 acres was acquired, and the same has been dedicated to the public as an open space for ever. Moor Mead Recreation Ground has been improved by straightening the stream and filling in portions of the old river bed. In parts also, the ground has been raised to assist in preventing the incursion of flood water. Cricket and football pitches have been improved, but further works however are still necessary. Radnor House Grounds have also been considerably improved during the year. The old brick wall in Cross Deep has been removed, and suitable iron railings substituted. Great progress has been made in the work of raising the level of the Island, and. when planted with trees and shrubs, laid out with proper gravel footpaths and the seats replaced in position, it should form a most attractive feature of the grounds, and a distinct acquisition to the public. Water Analyses. Sixteen samples of water drawn from wells were analysed and found to be good and fit for drinking and domestic purposes. 8 Baths and Washhouses Act. Mereway Bathing Place. The Bathing Place was closed for the season on September 30th. The number of bathers attending the Bathing Place during the season is as follows: — 1903. 1902. Total number attending during May ... 2603 ... 486 Highest attendance on any one day 350 ... 183 ... Total number attending during June ... 5427 ... 4167 Highest attendance on any one day 1000 ... 658 ... Total number attending during July ... 15050 ... 8093 Highest attendance on any one day 1100 ... 600 ... Total number attending during August ... 12290 1679 Highest attendance on any one day 800 ... 130 ... Total number attending during September 5046 ... 723 Highest attendance on any one day 1100 ... 136 ... The above figures prove the appreciation of the public of the increased advantages afforded. The Bathing Place has been considerably improved and extended. There were three prosecutions under the Act, a conviction being obtained in each instance. Towards the close of the Bathing Season, a Swimming Tournament was held, under the presidency of Dr. Murphy. A Polo Match, Ornamental and other methods of Swimming, together with a Demonstration in Life Saving, were the chief events of a most successful meeting. The water has been well patronised during the Summer, and the facilities for schools bathing and the opportunities for safely learning the art of swimming have been taken good advantage of. Mortuary. There were twenty-two bodies received into this building during the year. 9 Floods. A portion of the Whitton Road District, including land and houses, by reason of a heavy rainfall and overflow of the Duke's River, was flooded. A valuable report was presented by the Surveyor as to the steps necessary to be taken to prevent or minimize a recurrence of the overflowing of the river. A special Committee was formed and the subject is under consideration. It must be recognised that from a health point of view some remedial steps should be taken. Street Improvements. Several important improvements, such as opening, widening and enlarging highways were effected. Special mention may be made of Cross Deep, Richmond Road, Edwin Road,Willoughby Road, London Road, Heath Road, &c., resulting in the demolition of several old premises. A Town Improvements Committee was constituted to take into consideration the question of obtaining a Site for a Depot, the erection of Offices and Stables, &c. Education Act, 1902. By virtue of the Provisions of this statute, the Council became the Local Education Authority of the District. Sanitary improvements in the Schools have resulted. I have had occasion to examine children who were believed to be incapable of receiving profitable instruction in the schools, and those who were deaf and dumb or blind were sent to institutions or schools where a suitable education is provided for them. The Council have had under their consideration the question of the number of children attending and the accommodation afforded. My mind has been exercised as to whether further powers are requisite with regard to the inspection of private schools. Employment of Children Act, 1903. The general purpose of the Act, which will shortly come into force, is to provide means for regulating the employment of children or those occupations in which it has hitherto been unregulated, such as work in and about shops (errand running, delivery of milk, parcels, newspapers, &c.) 10 The statute empowers the Council to prescribe for all children, or for boys and girls separately, and either for all occupations generally, or for any specified occupation:— (1). The age below which employment shall be illegal. (2). The hours of the day between, which employment shall be illegal. (3). The daily and weekly maximum number of hours beyond which employment shall be illegal. The Council have power to frame bye-laws regulating street trading, which is defined in the act to include the hawking of newspapers, matches, (lowers and other articles, playing, singing or performing for profits and any other like occupation carried on in streets or public places. These bye-laws may also vary the hours of employment fixed by the act, either generally for all occupations in the district or for any specified occupation. This statute will in due course no doubt receive the careful consideration of the Council. Factory and Workshops Acts, 1901. The total number of workshops as per register is 103, including 35 domestic workshops, 17 retail bakehouses, 28 laundries, 23 other workshops, not including 23 workplaces. With regard to cleanliness notices have been served under the Public Health Acts in respect of 5 workshops and 3 domestic workshops. With respect to the retail bakehouses the sanitary condition of 13 was satisfactory, and of the remaining four which are underground, one was about to be certified as meeting the requirements of the statute, and the others are under the consideration of the Health Committee. In pursuance of Sections 107 to 115, which have reference to Home work, I have received 4 lists representing 7 outworkers, engaged in connection with the making of wearing apparel. Inspection of the Parish. Over 2076 houses have been inspected, followed in 1798 cases by re-inspections. 11 The following is an analysis of the work accomplished: — Houses, Premises, &c., cleansed, repaired, whitewashed, &c. 241 ,, Roofs repaired, &c 142 ,, Guttering and Rain pipes repaired, &c. 66 ,, Ventilation below floor provided 25 ,, Yards paved and drained 61 Foul ditches and stagnant water 11 Nuisances arising from Overcrowding 12 „ „ Smoke 7 ,, ,. Pigs, other Animals & Fowls 16 Other Nuisances not included in the above 53 Water—Wells closed Nil. Water laid on to houses with no supply ... Nil. Cisterns—New provided 103 Cleansed, repaired, covered, &c 60 Flush to W.C.'s 226 Water-Closeta—New constructed 14 New apparatus provided 95 Repaired, cleansed, &c. 86 Supplied with water or supply rendered efficient 251 Ventilated 21 Unsound Food—Articles seized Nil. Disinfection—Rooms fumigated 48 Stripped and Cleansed 34 Drains—Examined, tested, exposed, &c. 34 Unstopped, repaired, trapped, &c. 157 Waste pipes, rain pipes, &c., disconnected 42 Soil pipes and drains ventilated 34 Disconnecting Traps or Chamber inserted ... 22 Reconstructed 17 Relaid 17 Cesspools filled in 1 Cesspools cleaned out 1 Dust.— Dustbins repaired 9 Number of complaints of non-removal 138 New Dustbins provided 141 Movable receptacles substituted for fixed 43 Statutory Orders issued 672 12 In addition to the foregoing, repeated inspections were made and work of whitewashing and cleansing executed in the following buildings:— Contraventions. Laundries 41 2 Slaughter Houses 11 nil. Dairies and Milk-shops 30 nil. Workshops and Workplaces 103 8 Bakehouses 17 nil. Cowsheds 8 nil. Complaints were made as to a serious nuisance arising from the Heston and Isleworth Sewage Disposal Works; these complaints were substantiated on personal inspection, and a report was made by me to the Health Committee. The Council having been memoralised, representation was then made to the neighbouring Sanitary Authorities, and also to the Local Government Board; certain works were executed which apparently have had the desired effect of abating the nuisance. Housing of the Working Glasses Act. I had occasion to report to the Council respecting houses being in such a condition as in my opinion to be unfit for human habitation. Notices were served in pursuance of the statute, and with one exception the Owners complied with the requirements demanded of them by the Council. Where recourse was taken by legal proceedings the Justices made an order prohibiting the occupation of the premises. Water Closets. There were 251 cottages which were deemed to be without a sufficient water-closet accommodation by reason of there being no water laid on for flushing purposes. With a few exceptions the requirements of the Council have been carried out. Those premises in which the Owners have not complied are still under the attention of the Sanitary Inspector. Bye'law Infringements. Several Owners of property erected buildings in the rear of their premises thereby curtailing the air space prescribed by the bye-laws. Notices were served calling upon such Owners to shew cause why such buildings should not be altered, removed, 13 or pulled down. The Council were successful in inducing the Owners to remedy the causes of complaint. Sewers and New Streets. I am indebted to the courtesy of the Surveyor to the Council for the following particulars:— Plans of houses approved (excluding those known to be abandoned) 665 Plans for alterations and additions to existing buildings 36 Connections to soil sewers 283 Connections to surface water sewers 293 The following new streets have been made up under the provisions of the Private Street Works Act, 1892:-Milford Road, Brook Road (Section 2), and Upper Grotto Road. The number of yards of new sewers constructed, 375. Number of yards of surface water sewers constructed, 1,290. New manholes constructed, 23. Sewers have been laid in the following roads:—Heath Road, from Cross Deep to opposite Holly Road, Richmond Road, from St. Stephen's Gardens to Poplar Lodge, Alfgar Road, Hounslow Road, from Nelson Road to Kneller Road, Bonser Road and Albert Road. In conclusion I have to remark that from a sanitary point of view the health of the parish has been most satisfactory. The work occasioned by the increase in population, has been well performed by the Sanitary Inspectors. My personal thanks are due to the Health Committee and Council for the support accorded me in all matters affecting my department. I have the honour to be, Mr. Chairman and Gentlemen, Your obedient Servant, W. MARSTON CLARK, Diplomatc in Public Health, London. Medical Officer of Health. TABLE I. Vital Statistics of whole District during 1903 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 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. Number. Rate. Under 1 Year of Age. At all Ages. Number. Rate per 1000 Births registered Number. Rate. Number. Rate. 1893 17000 468 27.4 62 132.4 230 15.1 14 1894 17500 486 27.7 53 109.05 207 12.5 11 1895 18000 456 25.3 65 142.5 235 13.05 8 1896 18500 455 24.5 58 127.4 203 10.9 8 1897 19000 495 26.05 82 165.6 256 13.4 8 1898 19500 466 28 8 69 148.06 266 13.6 11 1899 20000 521 26.05 60 115.l 276 13.8 11 1900 20500 531 25.9 82 154.4 295 14.3 16 1901 21000 576 27.4 68 118.0 254 12.09 15 2 1902 22000 596 27.04 83 139.0 264 120 8 0 5 269 12.2 Averages for years 1893.1902. 19300 505 26.6 68.2 1351 248.6 13.07 11 — — — — 1903 24000 615 26.7 71 115.4 254 10.5 11 1 9 262 10.9 Area of District in acres (exclusive of area covered by water), 2415 Total population at all ages, 21,000 Number of inhabited houses, 4224 Average number of persons per house, 4.99 At Census of 1901. TABLE II. Vital Statistics of separate Localities in year 1903 and previous years. Names of Localities. Whole District. South Ward. East Ward. West Ward. Central Ward. Year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. 1893 17000 468 230 62 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1894 17500 486 207 52 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1895 18000 456 235 65 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1896 18500 455 203 58 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1897 19000 495 256 83 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1898 19500 466 266 69 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1899 20000 521 276 60 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1900 20500 531 295 82 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1901 21000 576 249 68 4775 113 58 11 5811 126 63 17 6122 215 75 27 4282 122 53 13 1902 22000 596 269 85 4989 121 46 10 6076 149 65 19 6440 214 100 36 4495 112 58 20 Averages for years 1893 to 1902. 19300 505 248.6 68.4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1903 24000 615 262 71 5434 110 53 7 6619 158 74 22 7052 238 81 31 4895 109 54 11 Table III. Cases of Infectious Disease notified during the Year 1903. Notifiable Diseases. Cases Notified in Whole District. Total Cases Notified in each Locality. No. of cases removed to Hospital from each Locality. H(S.F.) SOUTH WARD. EAST WARD. H (S.F.) WEST WARD, CENTRAL WARD. H (S.F.) SOUTH WARD. EAST WARD. H (S.F.) WEST WARD. CENTRAL WARD. At all Ages. Small-Pox ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... Diphtheria 16 3 3 9 1 ... ... ... ... Membranous croup 2 ... ... 2 ... ... ... ... ... Erysipelas 4 2 ... 2 ... ... ... ... ... Scarlet fever 23 4 7 7 5 4 ... ... ... Typhus fever ... ... ... ... ... ... ... ... ... Enteric fever 3 ... 1 1 1 ... ... ... ... ...Relapsing fever ... ... ... ... ... ... ... ... ... Continued fever ... ... ... ... ... ... ... ... ... Puerperal fever ... ... ... ... ... ... ... ...... ... Plague ... ... ... ... ... ... ... ... ... Totals 48 9 11 21 7 4 7 3 4 Isolation Hospitals Mereway Hospital (Small-pox) Cross Deep House (Scarlet fever). TABLE IV. Causes of, and Ages at, Death during Year, 1903. CAUSES OF DEATH. Deaths in or belonging to whole District at Subjoined Ages. Deaths in or belonging to Localities (at all ages). Total Deaths in Public Institutions in the District. All Ages. Under 1 year. 1 and under 5. 5 and under 15 15 and under 25. 25 and under 65. 65 and upwards. South Ward. East Ward. West Ward. Central Ward. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... Measles 1 ... 1 ... ... ... ... ... ... ... 1 ... Scarlet fever 1 ... ... 1 ... ... ... ... 1 ... ... ... Whooping-cough 10 7 3 ... ... ... ... 3 1 3 3 ... Diphtheria and membranous croup . 3 ... 2 1 ... ... ... ... ... 2 1 ... Croup 2 1 1 ... ... ... ... 2 ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... Enteric ... ... ... ... ... ... ... ... ... ... ... ... Other oontinued ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza 4 3 1 ... ... ... ... ... 1 1 2 ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa 5 5 ... ... ... ... ... ... 1 4 ... ... Enteritis 5 2 2 ... ... 1 ... ... l 3 1 ... Puerperal fever. ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... Other septic diseases 3 1 ... ... 1 1 ... ... l 1 1 2 Phthisis. 16 ... ... ... 2 13 1 7 2 2 5 ... Other tubercular diseases 8 ... 1 4 1 1 ... 1 4 2 1 1 Cancer, malignant disease. 21 ... ... 1 ... 11 9 5 4 8 4 ... Bronchitis 8 ... 1 ... ... 1 6 1 3 3 1 ... Pneumonia 19 4 3 2 ... 8 2 3 5 9 2 ... Pleurisy ... ... ... ... ... ... ... ... ... ... ... 1 Other diseases of Respiratory organs 5 1 1 ... ... 2 1 1 3 1 ... ... Alcoholis 5 ... ... ... ... 5 ... 1 2 1 1 ... Cirrhosis of liver Venereal diseases ... ... ... ... ... ... ... ... ... ... ... ... Premature birth 14 14 ... ... ... ... ... 1 5 5 3 ... Diseases and accidents of parturition 1 ... ... ... ... 1 ... 1 ... ... 1 Heart diseases 21 1 ... ... 1 12 7 5 7 3 6 ... Accidents 11 4 2 ... 1 3 1 ... 1 3 7 l Suicides ... ... ... ... ... ... ... ... ... ... ... ... All other causes 99 27 4 2 ... 23 43 22 32 80 15 6 all causes 262 71 22 11 6 82 70 53 74 81 54 12 C(1). COUNTY OP MIDDLESEX.—SANITARY WORK, 1903. Name of Sanitary District : TWICKENHAM. Inspections. Notices. Dwelling Houses. Houses let in separate Dwellings or Lodgings. Common Lodging Houses. Canal Boats used as Dwellings. Movable Dwellings Caravans, Tents, &c. Complaints Received. Cases of Infectious Disease Notified. Number of Premises periodically Inspected. Houses Inspected from Houseto-House. Total Number of Houses, Premises, &c., Inspected. Total Number of He-inspections after Order or Notice. Total Number of Inspections and Re-inspections. Letters Written. Cautionary 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. j 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. 146 48 207 2076 1798 4184 303 114 672 1 1 241 1 - - - - - - - - - - - - - - - C(II). county of Middlesex.—sanitary work, 1903. Name of Sanitary District : TWICKENHAM. Schools. Workshops and Work-places. Laundries. Bakehouses. Slaughter-houses. Cow-sheds. Dairies and Milkshops. Unsound Food. Adulterated Food. Offensive trades. Mortuaries. 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. Number of bodies received. 17 Occasionally. 1 103 Frequently. 8 41 Frequently. 2 17 Monthly. - 11 Frequently. - 8 Frequently. - 30 Frequently. - - 3 - - - - - 4 22 C (III) COUNTY OF MIDDLESEX.—SANITARY WORK, 1903. Name of Sanitary District : TWICKENHAM. Water Supply and Water Service. Privy and Ash Pits, Ash and Earth Closets. Drainage and Sewerage. Wells. 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. Water Closets. Percentage of Houses provided with Water Closets. Drains. Cesspools. Percentage of Houses Draining into Sewers. Sewers. New Sunk. Cleansed, Repaired, etc. Closed as Polluted. New, provided. Cleansed,Repaired,Covered, etc. Overflow Pipes disconnected from Drains. Above Ground Receptacles Substituted for Pits. Moveable Receptacles Substituted for fixed. Water 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. Soil Pipes and Drains Ventilated. Disconnecting Traps or Chambers inserted. Reconstructed. New, Laid. Rendered Impervious, Emptied, Cleaned, Etc. Abolished, and Drain connected to Sewer. Yards of New Sewers Laid. Yards of Sewer reconstructed. - - - - 99% 103 60 - 248 - 99% - - - 14 149 86 251 21 60% 34 157 42 34 22 17 17 - - 99% 1665 - C(iv). COUNTY OF MIDDLESEX. —SANITARY WORK, 1903. Name op Sanitary District : TWICKENHAM. Disinfection. Dust. Dampness. Sundry Nuisances Abated. Contagious Diseases of Animals Infant Life. Protection Act. Rooms fumigated. Rooms stripped and cleansed. Artioles disinfeoted or destroyed. Dust-bins repaired. New bins provided. Moveable receptacles substituted for mixed. Periodical frequency of dust removal. Number of complaints of nonremoval received. Roofs repaired, &c. Guttering & 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. 48 34 A large number. 9 141 43 Weekly. 138 142 66 - 61 - - 25 - 12 7 24 11 16 53 2 2 5 - - -