WIM048 Urban Sanitary District of WIMBLEDON, COUNTY OF SURREY. Report of the Medical Officer of Health For the Year ending December 31st, 1896. Wimbledon Arban District council REPORT OF THE MEDICAL OFFICER OF HEALTH FOE THE YEAR ENDED 31st DECEMBER, 1896. Gentlemen, I have the honour to present my Annual Eeport for the year ended the 31st December, 1896. It is with great pleasure I have again to call attention to the very low death-rate, and also to the improving sanitary condition of this rapidly growing district. Births. The total number of births registered was 875 (462 males and 413 females), equal to a birth-rate of 26.15 per thousand per annum; the birth-rate in England and Wales for the same period is given at 29.7 in the report of the Eegistrar-General. Deaths. The total number of deaths registered was 343 (141 males, and 202 females), equal to a death-rate of 10.3 per thousand living per annum, taking the population at 33,000 (the estimated population at Midsummer, 1896). After making the usual corrections as indicated at the bottom of Table 3, the total number of deaths properly belonging to the district is found to be 365 and the death-rate 11.06. The 2 death-rate for England and Wales for the same period is given as 17.1. The deaths which occurred outside the district among persons belonging thereto, which have come to my knowledge, were 24 in the Kingston Union Workhouse, and one in the County Lunatic Asylum. The deaths which occurred within the district among persons not belonging thereto, which have come to my knowledge, were 3 in the Atkinson-Morley's Convalescent Hospital. Infant mortality is represented by a ratio of 110 deaths under one year of age to 1,000 registered births, as against 148 deaths per 1,000 births in England and Wales for the same period. Between the ages of 1 and 60 there were 150 deaths, and 96 deaths of persons aged 60 years and upwards. The death-rate from all zymotic diseases was 1.63 per thousand of the population per annum. Influenza caused 4 deaths against 14 last year; 10 in 1894, 20 in 1893; and 18 in 1892. There were 24 deaths from bronchitis, 20 from pneumonia, and 16 from phthisis (see Table 6, which shows deaths from all causes). The number of deaths from zymotic diseases (including influenza) was 53, viz.:—From measles, 9; whooping cough, 15; diphtheria, 3; small-pox, 1; typhoid fever, 2; influenza, 4; puerperal fever, 2; diarrhoea, 13; scarlet fever, 2; septicaemia, 1. Table A shows for the last year and the four preceding years, the births, deaths, death-rates, and the deaths at certain ages, and from specified causes. 3 Table B shows for the same years, the number of infectious cases notified, and the deaths from each notifiable disease. Table C shows the death-rate from zymotic diseases for the last 10 years. Table 5 shows the localities in which all the notified cases of infectious diseases have occurred. TABLE A, 1896 1895 1894 1893 1892 Births 875 857 791 780 738 Deaths 343 377 310 363 333 Death-rates 11 06 12.1 10.3 12.9 12.8 DEATHS— Under 1 year 97 102 81 107 90 Over 1 year and under 60 years 150 174 147 166 124 Above 60 years 96 101 82 90 119 From Measles 9 2 6 5 3 ,, Scarlet Fever 2 0 0 3 0 ,, Small Pox 1 0 0 0 1 ,, Diphtheria 3 16 10 3 8 ,, Diarrhcea 13 15 6 16 8 ,, Whooping Cough 15 23 8 1 4 ,, Enteric Fever 3 1 3 0 0 ,, Puerperal Fever 2 1 0 6 3 ,, Erysipelas 0 1 1 2 o ,, Influenza 4 14 10 20 18 ,, Membranous Croup 0 2 0 1 1 4 TABLE B. DISEASES. 1896. 1895. 1894. 1893. 1892. Cases Notified Deaths. Cases Notified Deaths. Cases Notified Deaths. Cases Notified Deaths. Cases Notified Deaths. Small Pox 2 1 1 0 1 0 21 0 5 1 Puerperal Fever 5 2 1 1 0 0 11 6 3 3 Diphtheria 30 3 37 16 43 10 37 3 17 8 Membranous Croup 0 0 2 2 1 0 2 1 1 1 Scarlet Fever 124 2 76 0 93 0 294 3 135 0 Enteric Fever 10 3 14 1 13 3 16 0 7 0 Erysipelas 35 0 33 1 45 1 79 2 49 2 Measles 0 9 0 2 0 6 0 5 0 3 Totals 206 20 164 23 196 20 460 20 217 18 TABLEC. Zymotic Rate. 1896 1895 1894 1893 1892 1891 1890 1889 1888 1887 1.63 2.03 1.50 2.03 1.7 1.15 0.62 1.18 0.81 1.48 Small-pox.] Two cases of small-pox were notified during the year, both of which were imported. The first was that of a man aged 45 years, which was notified in February ; this case, which was of a very malignant type, had not been previously vaccinated. He was removed to the Infectious Diseases Hospital where he died six days after admission. A11 the necessary precautions were taken to prevent the spread of the disease; the other members of the family (five in number, and two of whom had never been vaccinated) were vaccinated at once; isolated for three 5 weeks; and compensation was paid them for the time they were kept from their employment, and also for all the bedding and clothing which was destroyed. Thanks to the prompt and energetic steps taken, the disease was prevented from spreading. The other case was that of a young man who was employed as a shipping clerk at Gravesend, where he probably contracted the disease, which was of a very mild form; he had been previously vaccinated, and was isolated in his home ; and—as in the other case—every precaution was taken against the spread of the disease. I should like here to say that it has been my experience that all unvaccinated cases of small-pox which have come under my notice have been very severe, and generally fatal, while the vaccinated cases have been usually of a mild form. Scarlet This disease has been present during the whole of the year; the greater number of cases occurred in May, October, November and December (see Table 2), when 73 cases were notified. The total number of cases notified was 124; of which 76 were treated in the Infectious Diseases Hospital, and the remainder in their own homes. There were two deaths from this disease during the year; one at the Hospital, and the other at the patient's home. An outbreak occurred among the scholars of Haydon's Road Infants' and Girls' Schools in October, when I considered it was desirable that these schools should be closed for a period and disinfected. As in previous years, we have sorely felt the want of adequate Hospital accommodation. Several cases of scarlet fever had to be refused admission, and there is no provision for the treatment of diphtheria cases at all. There is no doubt that isolation in the smaller houses is a matter of impossibility; and this disease will never be 6 stamped out in the district until we have better means of dealing with it. In many cases, medical men have not been called in until desquamation has begun, and in two or three instances children have been attending schools when in the peeling stage. A few successful prosecutions would go a good way towards making parents more careful; but the difficulty is to prove guilty knowledge. In all cases where cases have occurred among the children attending school, the masters and mistresses have been informed, and the other children in the houses in which the cases have occurred have been kept from school. Thirty cases were notified during the year, and three deaths registered; against 37 in the preceding year, and 10 deaths. A great many of these cases were imported from other districts. All the cases were treated in their own homes, as there is no provision for the treatment of this disease at the Infectious Diseases Hospital. The first fatal case of diphtheria occurred at Hardy Eoad in January—a man aged 26 years; this was an imported case. The next fatal case occurred in October, at Elmore Terrace, South Eoad, and was that of a child aged 4 years. An examination of the premises proved them to be in a very insanitary condition, a .d as this group of houses had a previous bad history, the necessary steps were taken to examine the whole of the houses (16 in number). The examination revealed a shocking state of affairs; the drains had no fall, were full of solid sewage, and had probably been blocked for months ; the liquid matter had escaped through the joints and saturated the surrounding earth; all the flushing boxes were out of order, and most of the closet pans were cracked or broken. New drains and sanitary fittings are being provided for all these houses. 7 The third fatal case occurred in November, at Ridley Road. The sufferer in this case was a child aged 3 years, who had whooping cough at the same time. The sanitary arrangements were in good order, and the drains sound. The cases and deaths were divided among the age periods as follows: 0—5 years, 6 cases, and 2 deaths; 5—15 years, 11 cases and no deaths; 15—25 years, 5 cases and no deaths; 25—35 years, 5 cases and 1 death; 35 —45 years, 2 cases and no deaths; 45—55 years, 1 non fatal case. At most of the houses where the cases occurred, the sanitary arrangements were good. It is satisfactory to notice the decrease in the number of notified cases (see Table B) and the even greater decrease in the percentage of deaths. School attendance was not responsible for the occurrence of any of these cases. Of the whole 30 cases notified, 10 only attended schools; 1 the High School, 1 the Central, 4 the Haydon's Road Schools, 2 Trinity, 1 the Roman Catholic School, and 1 Wimbledon College. Typhoid Ten cases were notified, and 2 deaths occurred ; against Fever. 14 last year and 1 death, and 13 cases and 3 deaths in 1894. No cases occurred in the months of February, May, July, August, and November; 2 cases occurred in April and 3 in December, and one in each of the remaining months (see Table 2). The first fatal case was that of a man aged 25 years, who contracted the disease at Thames Ditton, in the beginning of January, and came to Gladstone Road to be nursed, where he died a few days after. In March, a death from this disease occurred in Denmark Avenue; the sufferer was a young girl aged 9 years. There is no doubt that defective drains were the cause. 8 The third fatal case occurred in December, in South Park Road; a gentleman 46 years of ago. The defective drains may have accounted for the illness, though there is some evidence of oysters having been the cause. Of the remaining 7 cases, 2 were imported, and in 5 the causes could not be traced. Measles. As will be seen by Table B, there were 9 deaths from measles, while there were only 11 deaths in the year from all the notifiable diseases. Measles is therefore responsible for about as many deaths as all the notifiable diseases together. This is a significant fact, and I strongly advise the notification of this disease in the district, and call attention to the following extract from my Annual Report for 1892: — " As measles is one of the most infectious of diseases and causes as great a mortality as any of those notifiable, I think it would be advisable for the Local Board to avail themselves of the provisions under the Infectious Diseases Notification Act, and make an order to include measles among the diseases already notifiable in the district. "With our present hospital accommodation, isolation would of course be out of the question; but the masters and mistresses of schools might be informed of any cases occurring among their scholars, or among the inmates of houses from which tbeir scholars attend, with a view to preventing children attending from such houses until a certificate be produced from a medical man stating that the premises are free from infection. "It would be a good plan to give this a trial for a specified time, and if it were found to be of no use the order could be revoked." Infectious During the year 77 patients were admitted to the Hospital hospital, 76 of whom were suffering from scarlet fever; and one from small-pox. 9 The small-pox case proved fatal; as also did one of the cases of scarlet fever. The following are the cases of Infectious diseases admitted during the year :— Disease. Age. January. February. March. April. May. June. July. August. September. October. November. December. Total. Small Pox Under 5 ... ... ... ... ... ... ... ... ... ... ... ... 1 5 upwards ... 1* ... ... ... ... ... ... ... ... ... ... 1 Scarlet Fever Under 5 1 1 ... 1 3 1 1 ... 1 1 ... 1 11 76 5 upwards 7 4 2 4 8 ... 4 4 1 13 10 8 65 Total Under 5 1 1 ... 1 3 1 1 ... 1 1 ... 1 11 77 5 upwards 7 5 2 4 8 ... 4 4 1 13 10 8 66 All ages 8 6 2 5 11 1 5 4 2 14 10 9 77 *Treated in a ward in Durnsford Lodge, which was re-opened specially for this case. 10 The following is the scale of fees payable for the maintenance of patients in the Hospital:— Where the rateable value of the house— Per Week. Does not exceed £20 nil. Exceeds £20 and does not exceed £30 10s. „ £30 „ „ £40 15s. „ £40 „ „ £50 21s. „ £50 42s. Servants sent to the Hospital by employers are charged for according to the rateable value of the employer's house, but with a maximum of £1 1s. per week. In several cases the fee is remitted if it is thought desirable by the Council to do so. Proposed Plans were prepared by the Surveyor for the erection of Hospital on the Upper Cemetery Field. A good deal of opposition was made to the site by the owners of surrounding land, at the Local Government Board enquiry, which was held at the end of the year. The disinfection of infected bedding and clothing is carried out by means of a hot air chamber. This arrangement is not a satisfactory one, as the penetrating power of hot dry air is not sufficient to destroy bacteria, which may lodge in the folds of garments, or in the inside of mattresses, pillows, &c. It is impossible to raise the temperature of the oven enough to get sufficient heat in the inside of these articles for their thorough disinfection without scorching and injuring them externally. The only thorough way of disinfecting wearing apparel and bedding is by means of a steam apparatus, and the sooner we have one for the district the better. Besides having the clothes thoroughly done, the saving in time is 11 considerable. The hot air system takes at least 4 hours for one baking, while with the steam apparatus the work is done in 30 minutes. This is a great saving in time, and as it is important that poor people who have their bedding taken away should have it back as soon as possible, this advantage becomes apparent. The number of rooms disinfected was 122. Five Library books were disinfected. A quantity of bedding and clothing was burnt, and the owners compensated. The fees for disinfection were abolished. The following table shows the number of articles disinfected after each disease :— Diseases. Mattresses. Palliasses. Beds. Pillows and Bolsters. Blankets. Dresses. Suits. Other Articles. Totals. Scarlet Fever 22 53 140 276 216 12 16 910 1645 Diphtheria 2 4 15 34 22 ... ... 122 199 Small Pox ... ... 7 15 1 ... ... 10 33 Typhoid Fever ... 4 2 3 4 ... ... 7 20 Puerperal Fever ... 4 1 2 1 ... ... 1 9 Measles 2 ... 2 4 4 ... ... 7 19 Totals 26 65 167 334 248 12 16 1057 1925 Housing of In my report for last year, I stated that a notice had Classes Act, been served on the owner of Nos. 1 to 23 Berkeley Road under 1890. this Act, and I also stated that the work was in progress. The houses were in a very dilapidated state; the walls and ceilings were foul with the accumulating filth of years; most 12 of the roofs were leaky; and the flooring was so rotten that in places it was absolutely dangerous to walk upon. The sites of the houses were flooded owing to the leakage from the waterpipes, and all the drains and sanitary arrangements were defective. The work that was being carried out, however, was merely patchwork, and not sufficient to render the houses fit for habitation. Under these circumstances, a closing order was applied for and granted in March. The houses were closed, and have remained so ever since; they are now in a ruinous state, and if the owner fails to carry out an agreement made in December, a demolition order is to be applied for. Factory and Several of the workshops have been inspected; some on Acts. complaint from Inspectors of Factories. One workshop was closed, being without proper sanitary accommodation for the workers, and having no water laid on. Two laundries were redrained, and new w.c. accommodation provided. Dairies, The dairies, cowsheds, and milkshops have been inspected and Cowsheds periodically and at intervals, and, with a few exceptions, have Milkshops. been found to be kept in accordance with the regulations. There are 39 of these premises in the district, two having been registered during the year. In one case the drains of a milkshop were relaid. In 4 cases notices were given for the cleansing of milk utensils. In November the Inspector reported to the Council on the desirability of having the cowsheds in Effra Road abolished, as the land in this part of the district is being rapidly built over. The sheds (which contain between 40 and 50 cows) are now almost surrounded by houses of the small villa type; 13 and as the sheds are of a temporary nature, and not properly paved and drained, the Council decided to call upon the owner to carry out considerable work, or pull down the sheds. This matter was in abeyance at the end of the year. Slaughter The slaughter-houses have been inspected frequently, and found to be kept in accordance with the Bye-laws. There are only 6 of these premises in the district, and 3 are not much used. Bakehouses. The bakehouses, 22 in number, were inspected during the year; of these two were redrained under modern requirements, and at one a smoke nuisance was abated. • Water Several more houses, that were supplied by artesian Supply. wells, have had a water supply laid on from the water company's mains; the water in the wells having failed owing to the Lambeth Waterworks Company's pumping operations at Streatham, in 1895. These operations drained the wells that supplied 116 houses, and last year between 20 and 30 houses were affected. OverFive bad cases of overcrowding were abated without the crowding. aid of legal proceedings, and several complaints were made respecting houses being in a filthy state. Unfortunately there is a good deal of overcrowding in South Wimbledon, and if the necessary cubic space for the maintenance of good health were insisted on, I am afraid many families would be homeless. Needless to say, overcrowding and dirt go together; and it is surprising to find what a number of the poor can only be kept clean and decent by means of the law. There appears to be strong aversion to cleanliness among a certain class, and if baths were put into the houses they would probably be used for rabbit hutches, or as depositories for rubbish. 14 The attention of the Sanitary Inspector was drawn to a filthy house in the district only a few days ago by the coroner, where the occupants were so filthy that his officer had to order one of them to wash herself before appearing at the Coroner's Court as a witness. It is a pity that District Visitors and the Lady Workers in the poorer districts are not more numerous; there is a good field for them to use their influence in inculcating cleanliness and general decency, which are the elementary steps of sanitation. Animals a nuisance. The improper keeping of animals, such as pigs, horses, ducks, fowls, rabbits, &c., has been a source of trouble, and in two cases legal proceedings were taken before animals could be removed. Brick Ashpits. The costermonger class are the chief offenders in this respect: they run up temporary stalls of old boards in their back yards, and keep horses, without making any attempt at paving or draining the stables. The nuisances arising from the large old-fashioned brick ashpits, which are often the receptacles for all sorts of animal and vegetable matter, must not be overlooked, as the odours which escape from decomposing organic matter are very dangerous, especially to children, who use the back yards as playgrounds. These are being gradually abolished and substituted by galvanized iron bins of small capacity, which necessitates the frequent removal of the rubbish. Sanitary Work. New sewers have been provided for the Summerstown portion of the district. The new main sewer is taken under the River Wandl9, and discharges into an ejector station on the Sewage Farm. 15 Before this work was carried out, this portion of the district was quite undrained, and about 20 houses, which at present drain into cesspools, are to be connected up. The Water Company's mains have also been extended in this district, as the artesian wells have failed. Among the works carried out that affect the sanitary condition of the district, the following may be mentioned:— A portion of the high-level sewer between Somerset Road and New Park Road, having a length of about half a mile, was reported by the Surveyor as defective, and has been relaid at a cost of about £600. Considerable progress has been made with the construction of an additional acre of cultivation filter for the treatment of tank effluent at the Sewage Farm. House The drains of 160 houses and promises have been entirely Drainage reconstructed, and laid to stand the water test, with manholes for inspection purposes, and all up-to-date improvements. The following blocks of houses have been redrained; the main drains were put in, in most cases, by the District Council, at their own cost: — Nos. 7, 8, 9 and 10 Alston Villas. ,, £7, 59, 61, 63 and 65, Amity Grove. „ 3, 4 and 5 Amity Terrace. ,, 17, 18, 19 and 20, Denmark Road. ,, 22, 24, 26, 28, 30, 32 and 34, Dundonald Road. ,, 48, 50, 52, 54 and 56, Durham Road. ,, 62, 64 and 66, Durham Road. „ 1, 2, 3, 4 and 5, Evelyn Villas. „ 153, 155, 157, 159,161, 163, 165 & 167,Graham Road. ,, 142, 144, 146, 148, 150 and 152, Haydon's Road. „ 131, 133, 135 and 137, Merton Road. ,, 6, 8, 10, 12, 14 and 16, Palmerston Road. 16 Nos. 88, 90 and 92, South Road. ,, 1, 3, 5, 7, 9 and 11, Victory Road. ,, 2, 4, 6, 8, 10 and 12, Victory Road. „ 46, 48, 50, 52, 54, 56, 58, 60 and 62, Wandle Road. Besides these, several pairs of houses have been redrained, and many single ones. There are several groups of houses which require redraining, and which are scheduled by myself to be dealt with in the future. It is a false economy to spare expense where lives may be endangered. It should be borne in mind that sanitary work is a preventative work, and not a curative one, and it would be a sad reflection if deaths occur through any delay in carrying out the work. The block of 16 houses in Elmore Terrace, which I have already referred to, are about to be redrained. The Council has put in the new main drain. Nuisances. Several complaints were made (some anonymously) with reference to nuisances alleged to exist on other people's premises; these were all attended to, but in some cases the complaints were of a very frivolous nature. The nuisances dealt with are summarized in Table 1. It is with much pleasure that I again testify to the great assistance I have received from Mr. Mayne in this as in former years. I have the honour to be, Your obedient Servant, E. POCKLINGTON, M.O.H. 17 TABLE 1. The following is a Summary of the Nuisances complained of and inspected during the year, and carried out under the supervision of Mr. Mayne, the Sanitary Inspector : — Animals Removed 67 Ashpits Provided 94 Ashpits Repaired 4 Accumulations Removed 23 Bakehouses Cleansed 2 Cisterns Provided 9 Cisterns Cleansed 9 Cisterns Repaired 67 Corpses Removed 5 Drains, New, Provided 160 Drains, Repaired and Altered 22 Flushing Boxes, New, Provided 213 Flushing Boxes, Repaired 14 Guttering and Spouting Provided 19 Guttering and Spouting Repaired 53 Houses Disinfected 122 Houses Cleaned and Whitewashed 34 Houses, Sites Concreted 4 Manure Pits Provided ... 4 Overcrowding Nuisances Abated 5 R.W. Pipes Provided, Disconnected and Repaired 221 Roofs, Leaky, Repaired 21 Soil Pipes Ventilated and Altered 58 Urinals, Water laid on, Cleansed, &c. 4 Ventilating Pipes, New, Provided 168 Ventilating Pipes, Repaired ... 15 Waste Pipes, Disconnected, Trapped and Repaired 128 Water Closets, Container Pattern, Removed 8 Water Closets, Repaired and Ventilated 14 Water Closets, New, Provided 232 Yards Cleansed 3 Yards Paved 74 Total 1876 TABLE 2. Table shewing the Number of Infectious Cases notified during each month of the Year. Diseases. January February March April May June July August September October November December Total. Small Pox under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 5upw'ds ... 1 ... ... ... 1 ... ... ... ... ... ... 2 Scarlet Fever under 5 1 2 ... 2 8 1 4 1 2 2 3 2 28 124 5upw'ds 9 5 2 4 9 1 6 7 4 16 22 11 96 Diphtheria under 5 ... ... ... ... ... 2 ... ... ... 2 2 ... 6 30 Supw'ds 4 1 1 ... 1 3 5 2 ... ... 1 6 24 Typhoid Fever under 5 ... ... ... ... ... ... ... ... ... ... ... 1 1 10 5upw'ds 1 ... 1 2 ... 1 ... ... 1 1 ... 2 9 Puerperal Fever under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... 5 5upw'ds 2 ... 1 ... ... ... ... 1 ... ... 1 ... 5 Membranous Croup under 5 ... ... ... ... ... ... ... ... • • • ... ... ... ... 5upw'ds ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas under 5 ... ... ... 1 ... ... ... ... ... ... 1 ... 2 35 5upw'de 2 3 1 3 4 3 2 2 4 6 2 1 33 Totals under 5 1 2 0 3 8 3 4 1 2 4 6 3 37 206 5upw'ds 18 10 6 9 14 9 13 12 9 23 26 20 169 19 12 6 12 22 12 17 13 11 27 32 23 206 TABLE 3. Table of Deaths during the Year 1836, in the Urban Sanitary District of Wimbledon, classified according to Diseases, Ages, and Localities. Localities. Public Institutions being shown as separate localities. (a) Mortality from all causes, at subjoined ages. (i) Mortality from subjoined causes, distinguishing Deaths of Children under Five Years of Age. At all Ages. (b) Under 1 year. (c) 1 and under 5 (d) 5 and under 15 (e) 15 and under 25 (f) 25 and under 65 (g) 65 and upwards (h) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Smallpox. Scarlatina. Diphtheria. Enteric or Typhoid Fever. Puerperal Fever. Erysipelas. Measles. Whooping Cough. Diarrhœa and Dysentery. Phthisis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease Influenza. Injuries. All other Diseases. Total. WIMBLEDON ... ... ... ... ... ... ... Under 5 ... 1 2 ... ... ... 8 15 12 ... 14 ... ... 2 88 142 333 96 46 13 8 99 71 5 upwards ... ... 1 3 2 ... 1 ... 1 15 27 22 4 5 110 191 ATKINSON MORLEY'S HOSPITAL ... ... ... ... ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... ... ... 1 1 1 5 upwards ... ... ... ... ... ... ... ... ... 1 2 ... ... ... ... 3 COTTAGE HOSPITAL ... ... ... ... ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 ... ... ... 1 3 1 5 upwards ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 4 5 DURNSFORD ROAD HOSPITAL ... ... ... ... ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... 1 ... 1 ... 5 upwards 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 TOTALS 343 96 46 14 10 104 73 Under 5 ... 1 2 ... ... ... 8 15 12 ... 14 ... ... 2 88 142 5 upwards 1 1 1 3 2 ... 1 ... 1 16 30 22 4 5 114 201 The subjoined Numbers have also to be taken into account in judging of the above Records of Mortality. Deaths occurring outside the district among persons belonging thereto. 25 4 ... 1 ... 11 9 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 4 5 upwards ... ... ... ... ... 1 ... ... ... 4 ... 4 ... ... 12 21 Deaths occurring within the district among persons not belonging thereto. 3 ... ... ... 1 1 1 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... ... ... ... ... ... 1 2 ... ... ... ... 3 TABLE 4. Table of Population, Births, and of New Cases of Infectious Sickness coming to the knowledge of the Medical Officer of Health during the year 1896, in the Urban Sanitary District of Wimbledon classified according to Diseases, Ages, and Localities. Names of Localities. (a) Population at all ages. (d). Registered Births. Aged under 5 or over 5. (e) New cases of sickness coming to the knowledge of the Medical Officer of Health. No. of such cases remov'd to Hospital. 1 2 3 4 5 6 1 2 Census, 1891. (b) Estimated to Middle of 1896. (c) Smallpox. Scarlatina. Diphtheria. Enteric or Typhoid Fever. Puerperal. Erysipelas. Smallpox. Scarlatina. WIMBLEDON (H.) 25,761 33,000 875 under 5 ... 28 6 1 ... 2 ... 11 5 upwards 2 96 24 9 5 32 1 65 ATKINSON MORLEY'S HOSPITAL Yearly average Number of Patients 961. under 5 ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... ... 1 ... ... TOTALS 25,761 33,000 875 under 5 ... 28 6 1 ... 2 ... 11 5 upwards 2 96 24 9 5 33 1 65 The Infectious Diseases Notification Act has been compulsory in the District since 1889. The Isolation Hospital for the treatment of patients is an iron building situated in Durnsford Road, and is capable of accommodating 16 Scarlet Fever Patients. NOTES ON TABLES 3 AND 4. 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; such as parishes, groups of parishes, townships, or wards. As stated at the head of the first column in 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 (3), 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 should 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 3,220 Population (1891) 25,761 „ (Estimated to middle of 1896) 33,000 Death Rates. General 11.06 per 1,000 Population estimated to middle of 1896. Infant (under one year of age) 110 per 1,000 Births Registered. In recording the facts under the various headings of Tables 3 and 4, attention has been given to the notes endorsed on the Tables. SUMMARY OF TABLE 6. No. of Deaths. No. of Deaths. I.- SPECIFIC FEBRILE, or ZYMOTIC DISEASES 1. Miasmatic Diseases 37 Brought forward 309 2. Diarrhœal „ 13 IV.- LOCAL DISEASES—continued. 3. Septic ,, 3 5. Diseases of Urinary System 8 II.— CONSTITUTIONAL DISEASES 71 6. Diseases of Reproductive System (a) Diseases of Organs of Generation 2 III. —DEVELOPMENTAL DISEASES 46 V.- VIOLENCE. IV. -LOCAL DISEASES. 1. Accident or Negligence 5 2. Homicide 1 1. Diseases of Nervous System 26 3. Suicide 1 2. Diseases of Circulatory System 29 VI. —ILL-DEFINED AND NOT SPECIFIED CAUSES 17 3. Diseases of Respiratory System 48 4. Diseases of Digestive System 36 Carried forward 309 Total 343 TABLE 5. Distribution and Particulars of Infectious Cases Notified. Diseases. Alexandra Road. Amity Grove. Atkinson Morley's Hospital. Berckley Road. Broadway. Caroline Road. Caxton Road. Cochrane Road. Common. Copse Hill. Cowdry Road. Cowper Road. Cromwell Road. Crooked Billet. De Burgh Road. Denmark Avenue. Drive (The). Dryden Road. Dundonald Road. Durham Road. Effra Road. Florence Road. Gap Road. Gladstone Road. Goodenough Road. Graham Road. Grange (The). Griffiths Road. Hamilton Road. Hardy Road. Hartfield Crescent. Hartfield Road. Haydon Road. High Street, Wimbledon. Hill Road. Hubert Road. King's Road. Kingston Road. Lambton Road. Latimer Road. Lower Downs Road. Merton Road. Milton Road. Montague Road. Nelson Road. Newton Road. Norman Road. North Road. Palmerston Grove. Palmerston Road. Pelham Road. Queen's Road. Quick Road. Richmond Road. Ridgway. Ridgway Gardens. Ridley Road. Russell Road. South Road. South Park Road. St. John's Road. Thornton Road. Thurston Road. Trevor Road. Victory Road. Vineyard Hill. Wandle Road. Wimbledon Park. Woodside. Worple Road. Wycliffe Road. Total. Small Pox under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 0 2 5 upw'rds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... 2 Cholera under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upw'rds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... 2 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... 6 30 5 upw'rds 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 1 ... 1 ... ... ... 1 1 ... ... ... 1 ... 1 ... 1 ... 3 1 ... ... ... 1 ... 1 2 ... ... ... ... 1 ... ... 1 ... ... ... ... ... 3 ... ... 24 Membranous Croup under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upw'rds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas under 5 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 35 5 upw'rds 1 1 1 ... ... ... ... ... ... 1 ... ... 1 ... 2 ... ... ... 1 ... ... ... ... 1 2 ... 1 2 1 2 ... ... 2 1 ... ... ... ... 1 ... 2 1 ... ... ... ... ... ... 2 ... ... ... ... ... ... 1 1 1 2 1 ... ... ... ... 1 ... ... ... ... ... 33 Scarlet Fever under 5 ... ... ... ... ... ... ... ... 3 ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... 3 1 2 1 ... ... 4 ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 2 1 ... ... ... 1 ... ... ... 1 ... 1 ... ... ... ... ... 1 ... ... 1 ... ... ... ... 1 1 28 124 5 upw'rds ... 4 ... ... 1 1 4 2 1 ... 2 3 ... 1 1 ... 1 ... ... i ... 1 2 5 1 ... 1 ... 3 1 2 ... 11 3 ... 1 ... ... 1 1 ... 1 5 3 ... 1 2 3 1 ... ... 3 ... 5 2 ... ... 2 4 ... ... ... 1 1 1 ... ... 2 1 3 ... 96 Typhus under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upw'rds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric or Typhoid under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 10 5 upw'rds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 2 1 ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 9 Puerperal Fever under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 0 5 5 upw'rds ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 5 Relapsing Fever under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upw'rds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals under 5 ... ... ... ... ... ... ... ... 3 ... ... 2 ... ... ... ... ... 1 ... ... 1 ... ... 3 1 2 1 ... ... 4 ... ... ... 1 ... ... ... ... ... ... ... ... 1 1 2 1 ... ... ... 1 1 ... 1 1 ... 1 2 ... 2 ... ... 1 ... ... 1 ... ... ... ... 1 1 37 206 5 upw'rds 2 5 1 1 2 1 4 2 1 1 2 3 1 1 3 1 1 ... 1 1 ... 1 2 7 2 2 1 1 7 3 4 1 13 6 1 2 1 1 1 2 1 3 9 3 1 1 5 4 1 3 ... 4 1 6 4 ... 1 3 6 4 1 ... 2 1 1 1 1 2 5 3 ... 169 TABLE 6. WIMBLEDON URBAN SANITARY AUTHORITY. Table showing Deaths from all causes and at different ages. Cause of Death. AGES. 2. 3. 4. 5. 6. 7. 8 9. 10. 11. 12. 13. 0 to 1 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 and up wards Total. Classes. I.—Specific Febrile, or Zymotic Diseases 21 17 3 1 5 1 1 1 2 1 ... 53 II.—Constitutional Diseases 10 8 4 4 6 12 8 10 5 4 ... 71 III —Developmental Diseases 25 1 ... ... ... ... ... ... 3 12 5 46 IV.—Local Diseases 31 18 6 3 5 8 15 25 26 9 3 149 V.—Deaths from Violence 1 1 1 1 ... ... 1 1 1 ... ... 7 VI.—Deaths from Ill-Defined and Not Specified Causes 8 1 ... 1 ... ... 1 4 ... 2 ... 17 Totals 96 46 14 10 16 21 26 41 37 28 8 343 I.-Specific Febrile,or Zymotic Diseases 1.—Miasmatic Diseases. Smallpox—Unvaccinated ... ... ... ... ... 1 ... ... ... ... ... 1 Measles 1 7 1 ... ... ... ... ... ... ... ... 9 Scarlet Fever ... 1 1 ... ... ... ... ... ... ... ... 2 Whooping Cough 10 5 ... ... ... ... ... ... ... ... ... 15 Diphtheria ... 2 ... ... 1 ... ... ... ... ... ... 3 Enteric or Typhoid Fever ... ... 1 ... 1 ... 1 ... ... ... ... 3 Influenza ... ... ... ... 1 ... ... 1 1 1 ... 4 2.—Diarrhœal Diseases. Diarrhœa, Dysentery 10 2 ... ... ... ... ... ... 1 ... ... 13 3.—Septic Diseases. Septicæmia ... ... ... ... 1 ... ... ... ... ... ... 1 Puerperal Fever ... ... ... 1 1 ... ... ... ... ... 2 53 II.— Constitutional Diseases. Rheumatism ... ... 1 ... ... 2 ... ... ... ... ... 3 Gout ... ... ... ... ... 1 ... 1 ... 1 ... 3 Cancer. Malignant Disease ... ... ... ... ... 1 2 6 5 2 ... 16 Tabes Mesenterica 3 ... ... ... ... ... ... ... ... ... ... 3 Tubercular Meningitis, Hydrocephalus 4 6 1 ... ... ... ... ... ... ... ... 11 Phthisis ... ... ... 1 5 5 4 1 ... ... ... 16 Other forms of Tuberculosis, Scrofula 3 2 2 2 ... 1 2 ... ... ... ... 12 Anæmia, Chlorosis, Leucocytlæmia ... ... ... ... ... ... ... ... ... 1 ... 1 Diabetes Mellitus ... ... ... ... ... 2 ... 2 ... ... ... 4 Other Constitutional Diseases ... ... ... ... 1 ... ... ... ... ... ... 1 Asthenia ... ... ... 1 1 71 III.—Developmental Diseases. Premature Birth 17 ... ... ... ... ... ... ... ... ... ... 17 Atelectasis 2 ... ... ... ... ... ... ... ... ... ... 2 Old Age ... ... ... ... ... ... ... ... 3 12 5 20 Marasmus 6 1 ... ... ... ... ... ... ... ... ... 7 46 IV.—Local Diseases. 1.—Disease of Nervous System. Cerebral Tumour ... ... ... ... ... ... 1 ... ... ... ... 1 Inflammation of Brain or Membranes ... 2 ... ... ... ... ... ... ... ... ... 2 Apoplexy, Softening of Brain, Hemiplegia, Brain Paralysis ... ... ... ... ... ... ... ... 4 4 ... 8 Convulsions 7 2 2 ... ... ... ... 1 ... ... ... 12 Dis. of Spinal Cord, Paraplegia, Paralysis Agitans ... ... ... ... ... 1 ... ... ... ... ... 1 Locomotor Ataxy ... ... ... ... 1 ... ... ... ... ... ... 1 Tetanus 1 ... ... ... ... ... ... ... ... ... ... 1 2.—Diseases of Circulaory System. Pericarditis ... ... ... ... ... ... 1 ... ... ... ... 1 Other Diseases of the Heart ... ... 2 1 ... 2 4 6 4 ... ... 19 Fatty Degeneration of the Heart ... ... ... ... ... ... 1 1 ... ... 1 3 Aneurism ... ... ... ... ... ... ... 1 ... ... ... 1 Embolism, Thrombosis ... ... ... ... ... ... ... ... 1 ... 1 2 Syncope 1 ... ... ... ... ... ... 2 ... ... ... 3 3.—Diseases of Respiratory System. Laryngitis ... 1 ... ... ... ... ... 1 ... ... ... 2 Croup ... 1 ... ... ... ... ... ... ... ... ... 1 Asthma ... ... ... ... ... ... ... 1 ... ... ... 1 Bronchitis 5 2 ... 1 ... 1 ... 1 9 4 1 24 Pneumonia 3 4 2 1 2 1 1 4 1 1 ... 20 4.—Diseases of Digestive System. Dentition 4 2 ... ... ... ... ... ... ... ... ... 6 Enteritis 10 ... ... ... ... ... ... ... 2 ... ... 12 Obstructive Diseases of Intestine ... 2 ... ... ... ... ... ... 1 ... ... 3 Hernia ... ... ... . ... ... 1 ... ... ... ... 1 Peritonitis ... 1 ... ... 1 1 2 1 ... ... ... 6 Cirrhosis of Liver ... ... ... ... ... 2 2 2 ... ... ... 6 Other Diseases of Digestive System ... ... ... ... ... ... ... 1 ... ... ... 1 Sarcoma of Stomach ... ... ... ... ... ... 1 ... ... ... ... 1 5.—Diseases of Urinary System. Nephritis ... ... ... ... ... ... ... ... 2 ... ... 2 Bright's Disease, Albuminuria ... 1 ... ... 1 ... ... 1 ... ... ... 3 Disease of Bladder or of Prostrate ... ... ... ... ... ... 1 ... ... ... ... 1 Uræmia ... ... ... ... ... ... ... 2 ... ... 2 6. —Diseases of Reproductive System. a. Organs of Generation. Female Organs Sarcoma of Uterus ... ... ... ... ... ... ... 1 ... ... ... 1 Tumour of Uterus ... ... ... ... ... ... ... 1 ... ... ... 1 V. Deaths from Violfince. 149 1.—Accident or Neligence. Fractures and Contusions ... ... ... ... ... ... ... 1 1 ... ... 2 Burn, Scald ... 1 ... ... ... ... ... ... ... ... 1 Suffocation ... ... 1 ... ... ... 1 ... ... ... ... 2 2.—Homicide. Murder 1 ... ... ... ... ... ... ... ... ... ... 1 3.—Suicide. Poison ... ... ... 1 ... ... ... ... ... ... ... 1 7 VI.—Deaths from Ill-Defined and Not Specified Causes. Dropsy ... ... ... ... ... ... ... ... ... 1 ... 1 Debility, Atrophy, Inanition 8 1 ... ... ... ... ... ... ... 1 ... 10 Gangrene of Lungs ... ... ... ... ... ... ... 1 ... ... ... 1 Abscess ... ... ... 1 ... ... ... ... ... ... ... 1 Hæmorrhage ... ... ... ... ... ... 1 3 ... ... ... 4 17