WIMOSI URBAN SANITARY DISTRICT OF WIMBLEDON, COUNTY OF SURREY. Report of the Medical Officer of Health For the Year ending: December 31st, 1900. With the Compliments of The Medical Officer of Health Mr. &. Pocklingtion. Wimbledon Urban District Council. SANITARY DEPARTMENT. THIRTIETH ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, being the report For the Year ended December 31st, 1900. Gentlemen, I have pleasure in presenting my Annual Report for the year ended the 31st December, 1900, and it is satisfactory to be able to state that the District maintains its reputation as an excep tionally healthy one. Births. The total number of births registered was 1075 (528 males, 547 females), which is 44 more than last year, equal to a birth-rate of 24.43 per thousand per annum, being .II lower than last year. The birth-rate in England and Wales, for the same period, is given at 28.9 in the report of the Registrar General. Deaths. The total number of deaths registered was 559 (281 males, 278 females), equal to a death-rate of 12.7 per thousand living per annum; taking the population at 44,000 (the estimated population at Midsummer, 1900.) After making the usual corrections as indicated at the bottom of Table 5, the total number of deaths 2 properly belonging to the district is found to be 570, and the deathrate 12.95. The death-rate for England and Wales for the same period is given as 18.3. The deaths which occurred outside the district among persons belonging thereto, which have come to my knowledge, were 21 at Kingston Infirmary, and 3 in Brookwood Asylum. The deaths which occurred within the district among persons not belonging thereto were 6 in Atkinson Morley's Hospital, 2 at the Cottage Hospital, North Wimbledon, and 3 at the Cottage Hospital, South Wimbledon. Infant mortality is represented by a ratio of 145.11 deaths under one year of age to 1,000 registered births, as against 154 deaths per 1,000 births in England and Wales for the same period. Between the ages of 1 and 60 there were 239 deaths, and 164 deaths of persons aged 60 years and upwards. The death-rate from all Zymotic diseases was 1.77 per thousand of the population per annum. Influenza caused 19 deaths, the same number as last year, 2 in 1898, 4 in 1897, 4 in 1896, 14 in 1895, 10 in 1894, and 20 in 1893. There were 42 deaths from Bronchitis, 61 from Pneumonia, and 20 from Phthisis. (See Table 7, in which is classified the whole of the deaths as to their causes and ages). In column 2 will be seen the chief causes of mortality among the 153 infants who died during the year. Comparing the deaths from Respiratory diseases with those that occurred last year, a marked increase is noted. The deaths from Pneumonia number 61, against 44 last year; and from Bronchitis 42, against 34 last year. The number of deaths from Zymotic diseases (including Influenza) was 78, viz.: from Measles 17, Diphtheria 10, Diarrhoea 19, Whooping Cough 5, Enteric Fever 5, Erysipelas 3, Influenza 19. 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 A. 1900 1899 1898 1897 1896 Births 1075 1031 963 828 875 Deaths 559 547 415 367 343 Death-rates 12.7 13.02 11.6 11. 3 11.06 DEATHS— Under I year 156 163 145 98 97 Over I year and under 60 years 239 230 151 175 150 Above 60 years 164 154 119 94 96 From Measles 17 1 2 l6 9 ,, Scarlet Fever 0 2 2 2 2 ,, Small Pox 0 0 0 0 1 ,, Diphtheria 10 12 7 6 3 ,, Diarrhoea 19 21 56 29 13 ,, Whooping Cough 5 15 3 7 15 ,, Enteric Fever 5 6 1 1 3 ,, Puerperal Fever 0 1 0 1 2 ,, Erysipelas 3 1 3 2 0 ,, Influenza 19 19 2 4 4 4 TABLE B. DISEASES. 1900. 1899. 1898. 1897. 1896. Cases Notified Deaths Cases Notified Deaths Cases Notified Deaths Cases Notified Deaths Cases Notified Deaths Small Pox 1 0 0 0 0 0 0 0 2 1 Puerperal Fever 0 0 4 1 3 0 5 1 5 2 Diphtheria 64 10 64 12 60 7 41 6 30 3 Scarlet Fever 112 0 149 2 98 2 155 2 124 2 Enteric Fever 20 5 47 6 11 1 17 1 10 3 Erysipelas 49 3 72 1 58 3 44 2 35 0 * Measles 1069 17 273 1 55 2 0 16 0 9 Totals 1315 35 609 23 285 15 262 28 206 20 * Measles notifiable since June, 1898. TABLE C. Zymotic Rate. 1900 1899 1898 1897 1896 1895 1894 1893 1892 1891 1.77 1.83 2.0 2.0 1.63 2.03 1.50 2.03 1.7 1 .15 The following table shows estimated death-rates of each ward into which the district is sub-divided. This can only be taken as approximate, as the exact population of each ward is not known. The Registrar-General has, however, issued instructions that at the taking of the census in April next, every district divided into wards is to have its population also 5 taken in wards. The returns of the Medical Officers of Health will in future be founded on such basis. TABLE D. Ward. Occupied Houses. Estimated Population. No. of Deaths. General Death Rate. Nett Death Rate. * * N. Wimbledon. St. Mary's 932 5313 47 8.8 8.8 St. John's 928 5290 50 9.4 9.4 Cottenham Park 530 3022 43 14.2 11.5 S. Wimbledon. Dundonald 874 4984 47 9.4 9.4 Trinity 2227 12696 214 16.8 16.6 South Park. 2226 12695 158 12.4 12.4 North Wimbledon 2390 13625 140 10.2 9.5 South Wimbledon 5327 30375 419 13.7 13.6 Whole District 7717 44000 559 I2.7 *12.9 * Deaths of persons belonging to Wimbledon occurring in Kingston Workhouse have been taken into account in this rate. ** Nett rate is the number of registered deaths after deduction of the deaths of non-residents, such as in Atkinson Morley's Hospital and the Cottage Hospitals. 6 Scarlet Scarlet Fever of a mild type has been present uniformly throughout the year, the greater number of cases being south of the railway lines. In all, 112 cases have been notified, of which 61 were removed to the Infectious Disease Hospital, the remaining 51 being nursed at their homes. No deaths were registered from this disease. Of the 112 cases notified, 65 attended schools, viz.: Trinity Schools, 15; Dundonald Schools, 13; High School for Girls, Mansel Road, 11; Haydon's Road Schools, 6; Effra Road Schools, 5; Catholic Schools, 2; Merton Church Schools, 2; and Private Schools, 11. Diphtheria. Sixty-four cases of Diphtheria were notified during the year, corresponding exactly with the number for the previous year. Ten deaths were registered from this disease, against 6 last year. The cases and deaths were divided amongst the age period as follows:—Under 1 year, 3 cases and no deaths; 1 to 5 years, 15 cases and 6 deaths; 5 to 15 years, 38 cases and 3 deaths; 15 to 25 years, 1 case which died; 25 to 65 years, 7 cases and no deaths. Of the 64 cases notified, 30 attended schools, viz.: Effra Road Schools, 10; Trinity Schools, 5; Merton Church School, 5; Central Schools, 1; Cottenham Park Schools, 1; Catholic Schools, 1; Private Schools, 6; Haydon's Road Schools, 1. The cases were divided amongst the different wards as follows:—Trinity Ward, 31; South Park Ward, 19; Dundonald Ward, 4; St. Mary's Ward, 4; Cottenham Park Ward, 3; and St. John's Ward, 3. Fifty-four of the cases occurred in South Wimbledon, and 10 in North Wimbledon, being respectively equal to a case rate of 1.77 and .73. At 27 houses in which the disease occurred, insanitary conditions existed, 11 of which the drainage and sanitary arrangements were entirely reconstructed, and at 16 others amendments of defects were carried out. 7 In 19 instances Anti-Diphtheritic Serum was supplied by the District Council, and used, I believe, generally with favourable results. Typhoid Fever. Twenty cases were notified and five deaths registered, the case mortality being 25%, against 47 cases and 6 deaths during 1899, and 11 cases and 1 death in 1898. Of the fatal cases, 2 were of persons removed to Wimbledon from Bedfordshire, and Chelmsford respectively, both of whom died within 10 days residence here. In 4 others, the evidence points strongly to the infection having been contracted outside Wimbledon, one of these, an asylum attendant, having been nursing an Enteric patient; a second had arrived invalided from South Africa only 2 weeks before notification. The cases and deaths were divided amongst the age period as follows:—5 to 15 years, 4 cases, no deaths; 15 to 25 years, 6 cases, 1 death; 25 to 65 years, 10 cases, 4 deaths. Eighteen of the cases occurred in South Wimbledon, and 2 in North Wimbledon, and were divided amongst the different wards as follows:—Trinity Ward 11, South Park Ward 6, St. John's Ward 2, and Dundonald Ward 1. As in former years, in all cases where a patient was nursed at home, the drains, w.c's, &c., were disinfected daily with perchloride of mercury by the Sanitary Staff, and at the houses where defects in drainage or fittings were discovered steps were promptly taken to have the same remedied. The following are the details of each case as far as obtainable: — 8 Locality. Person Attacked. Probable Source of Infection and Remarks. Queen's Road Female, aged 30. No reaction to Widal's test. New house. Wandle Road Female, aged 36. Stalybridge, Bedfordshire. Ill when came to stay in Wimbledon. Fatal. Sanitary arrangements perfect. Deburgh Road Male, aged 16. Came here ill from Chelmslord. Fatal. Hotham Road Male, aged 15. Shell Fish. Sanitary arrangements good. Hubert Road Male, aged 45. Contracted whilst nursing enteric patient at Asylum, where he was an attendant. Haydon's Park Road Male, aged 46. No trace. Sanitary arrangements good. Had influenza and rheumatic fever during the year. Fatal. Norman Road Female, aged 44. Unknown. Drains, &c., good. Wandle Road Female, aged 12. No trace. Drainage good. Hamilton Road Female, aged 56. No evidence. Sanitary arrangements good. Fatal. William Road Male, aged 14. Shell fish at Gosport. Drainage of house perfect. Effra Road Female, aged 15. No evidence. Sanitary arrangements good. Widal's test gave reaction. Kingston Road Male, aged 38. Drains very defective. Sewer gas had access to interior of premises. Fatal 9 Locality. Person attacked. Probable Source of Infection and Remarks. Kingswood Rd. Male, aged 23. Invalided from South Africa two weeks before notification. Faraday Road Female, aged 39. No evidence. House new. Sanitary arrangements good. Widal's test gave reaction. Cowper Road Male, aged II. Sanitary arrangements good. Widal's test gave no reaction. Had typhoid fever 3 years previous. Faraday Road Male, aged 32. Probably at Bethnal Green, where employed. Drainage perfect. Widal's test reacted. Worple Road Male, aged 19. Employed in London daily. Sanitary arrangements good. Lansdowne Rd. Female, aged 28. Sanitary arrangements perfect. Widal's test gave no reaction. Gladstone Road Male, aged 9. Putrid body of mouse found in draw-off pipe from drinking water cistern. Others in house had suffered from acute diarrhoea. Merton Road Male, aged 16. Shell fish. Small Pox One case of Small-pox was notified during the year, which occurred in March, the patient being a child about 6 months old. I visited the house and saw the patient. The case was, in my opinion, a most doubtful one, and after investigation, I felt justified in permitting the child to be kept at home. In the meantime, every precaution was taken, and all arrangements made, in 10 the event of any further cases occurring, for their prompt removal. The Joint Small-pox Board not having a Hospital yet built, arrangements were made with the Authorities of the South Mimms Small-pox Hospital for the reception of any Wimbledon patients at an agreed sum, the Metropolitan Asylums Board declining to admit this or any other Wimbledon case on their Hospital ships. Measles. During the year a widespread outbreak of Measles occurred in the District. The outbreak commenced amongst the scholars attending the Infants' Department of the Effra Road Schools, then passing to all departments of the Haydon's Road Schools, the Infants' Department of the Catholic Schools, the Dundonald Mixed School, and lastly the Dundonald Estate School. These schools were closed as follows:—Effra Road (Infants'), April 20th to May 7th; Haydon's Road (all departments), May 30th to June 18th; Catholic School (Infants'), October 19th to November 17th; Dundonald Mixed School, December 1st to December 24th; Dundonald Estate School, December 31st to January 14th, 1901. In addition, 7 private schools were voluntarily closed by the Principals, and one Sunday School. The type of the complaint in this epidemic was mild. In all, 1,069 notifications were received, and 17 deaths registered, being equal to a death-rate of .38 per thousand persons living, this being considerably lower than the average rate of the 33 large towns of the kingdom. The cases and deaths were divided amongst the age period as follows:—Under 1 year, 51 cases and 5 deaths; 1 to 5 years, 425 cases and 11 deaths; 5 to 15 years, 540 cases and 1 death; over 15 years, 53 cases and no deaths. In epidemics the mortality of persons attacked with Measles varies greatly according to age, its highest being between the ages of 6 months and 2 years. 11 The mode in which the infection of Measles is contracted is, in nearly all cases, personal intercourse, the infection being perhaps greatest during the early stages, when there is Catarrh of the mucous membranes of the eyes, nose, etc. These symptoms are often mistaken by the parents for an ordinary cold, the child being allowed to go to school and mix with other children, therefore, it is not surprising to find that when 2 or 3 cases of Measles occur in a district, they are generally only the fore-runners of a gradually increasing number of cases. The incubation period is usually about 10 days, but it may be shortened considerably in cases of children exposed to infection who are not in a satisfactory state of health. If the first 2 or 3 cases in a district could be isolated, it is possible that an epidemic might be prevented. It is an open question whether Infants' schools should not immediately be closed when even a few cases occur amongst the children, not only because the schools may be assumed to contain a large proportion of children at a susceptible age, but also on account of the mortality in the early ages of life being much higher than in older children. Even when very prevalent, Measles is not now considered a very fatal complaint, providing the patients are well looked after during convalescence. This is shown by the fact that in families of the well-to-do, a fatal case is seldom recorded. Unfortunately this care is impossible to a great extent in the houses of the poorer working classes, the mothers often having to go out to daily work, as well as household duties to perform, and other children to attend to. Yet, in many instances, it is evident that the seriousness of Measles is looked upon far too lightly, and that the rash having disappeared, the children are allowed about again too> early. Under these circumstances a cold may easily be contracted, and Bronchitis or Pneumonia follow. This may have been the case here. The certificates of the 17 deaths show 13 coupled with Broncho Pneumonia, 2 with Dentition and Convulsions, and 2 with Whooping Cough. 12 All the deaths from Measles occurred in South Wimbledon, II of them being in South Park Ward and 6 in Trinity Ward. The streets in which the greater number of cases occurred are as follows:—Florence Road 53, Haydon's Road 50, South Park Road, 38, Clarence Road 29, Palmerston Road 28, Russell Road 27, Deburgh Road 26, Merton Road 25, South Road 25, Pelham Road 24, Victory Road 23, Ilartfield Crescent 23, Nelson Road 22, Hardy Road 22, Wandle Road 20, Caroline Road 19, Gladstone Road 19, Faraday Road 19, Quicks Road 17, Effra Road 16, Cochrane Road 16, Goodenough Road 15. That the notification of Measles, followed as it is by the visits of your Sanitary Officers for the purpose of making the necessary enquiries as to the school attended by all the children in the house, etc., is not agreeable to some of the inhabitants, was only too clearly shown by their abusive conduct and behaviour. Diarrhoea. Twenty-two deaths were registered as having occurred from Diarrhoea, against 21 last year, and 56 in 1898. The age incidence of the fatal cases were as follows:—Under 1 year, 19; 1 to 5 years, 2; 55 to 65 years, 1. There were also 15 deaths from Enteritis (which is a diarrhoeal disease), 12 of which were children under 1 year of age, against 28 last year. Erysipelas. Forty-nine cases of this complaint were notified, and 3 deaths registered, against 22 cases and 1 death last year, and 48 and 3 deaths in 1898. Whooping Cough. Whooping Cough caused 5 deaths, against 15 last year, and 3 in 1898. Influenza. This disease was prevalent in the early part of the year, being especially severe in January, 11 deaths being registered within the first 18 days of that month, 2 others in February, 1 in March, 2 in April, and 1 during December, making a total of 19 in the year. Tuberculosis. Twenty-five deaths occurred from Phthisis and other forms of Tuberculosis, against 40 last year. 13 Puerperal Fever. No cases of Puerperal Fever were notified during the year. Infant Mortality. Considerable attention has of late been drawn to the infantile throughout the County generally. In April last, a conference of Medical Officers of Health of the various districts in Surrey, was called by Mr. Welchs, Chairman of the Sanitary Committee of the Surrey County Council, and among the resolutions passed were the following suggested remedies, viz.: — (1) The dissemination of hygienic knowledge by the tribution of leaflets, etc. (2) Increased care by the Local Authorities concerned in, (a) Premises in which there are young lies, and the prevention of overcrowding, (b) Cowsheds and dairies, and the prevention of milk adulteration. The County Sanitary Committee communicated the resolutions to the various Sanitary Authorities in the County. During the first year of life the number of deaths in Wimbledon was 156, being a decrease of 7 from last year, and is equal to a mortality of 145.11 per thousand children born during the year. The ratios of deaths of infants to 1,000 registered births for this and the previous year shows a decrease of 12.98. Seeing that this death-rate has been rising for the past 6 years (as shown in Table 6), this decrease is satisfactory, and I sincerely hope that it will continue in future years. Referring to the resolutions before mentioned as to the dissemination of hygienic knowledge by leaflets, etc., leaflet literature on this subject relating to, (1) The feeding and care of infants, and the prevention of Diarrhoea, (2) Notes respecting Measles, 14 was distributed from the Sanitary Department, and by the Registrar of Births and Deaths, who kindly consented to furnish each person registering a birth with a copy of the bill relating to the prevention of Diarrhoea. As regards the second resolution, bye-laws were prepared under Section 90 of the Public Health Act, 1875, under which, powers are granted for the registration of houses of the poorer classes let in lodgings or occupied by members of more than one family, and a standard of cubic space set, as well as insisting on the annual cleansing of the walls, ceilings and yards, etc. These regulations, which were prepared and submitted to the Local Government Board about 2 years ago, had not at the close of the year received their sanction. The new regulations made last year under the Dairies, Cowsheds and Milkshops Order, 1885, are found most useful in effecting sanitary improvements in the cowsheds and dairies in the district, particulars of which are given under the heading dealing with these premises. In connection with this subject of Infantile Mortality, I desire to draw attention to the admirable work which is being done by the South Wimbledon Day Nursery, an institution under excellent management, and where, for a nominal charge of 4d. per day, infants may be left from 8 a.m. to 8 p.m., whilst their mothers are obliged to be out at work at the laundries, charing, etc. Infectious Diseases Hospital. During the year 64 patients were removed to the Hospital, 61 being notified as suffering from Scarlet Fever, 2 from Diphtheria, and 1 from Typhoid Fever. There were no deaths from any of these diseases in the Hospital, but 1 death occurred from Measles. The following Table shows the cases admitted to the Hospital during each month of the year, and the totals for the previous 4 years:— 15 Disease. Age. January. February. March. April. May. June. July. August. September. October. November. December. Total, 1900. Total, 1899. Total, 1898. Total, 1897. Total, 1896. Scarlet Fever Under 5 1 1 3 2 ... ... 1 ... ... ... 2 ... 10 19 16 l6 11 5 upwards 6 2 4 5 3 8 4 3 3 4 8 1 51 85 45 80 65 Diphtheria Under 5 ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... 5 upwards ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... Typhoid Fever Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... Total All ages 7 3 7 7 3 8 5 3 3 4 10 4 64 104 69 96 76 16 The Isolation Hospital, which the Council decided, in 1896, to erect on the upper cemetery field in Gap Road, was completed late in the year, the approximate cost for building and furnishing being £21,000. The patients were removed from the iron hospital in Durnsford Road on December 4th. The Hospital consists of 3 blocks, the Scarlet Fever ward providing accommodation for 22 patients, the Diphtheria ward 12 patients, and the Typhoid Fever ward 4 patients, making a total of 38 beds, with administrative block, laundry, disinfecting station, coach-houses, porter's lodge, mortuary, and receiving and discharging block. In November of 1899, the Sanitary Committee considered the advisability of extending the new Scarlet Fever block, or building an additional one, owing to the fact that at that time, in the iron hospital and a tent, there were 35 Scarlet Fever patients, being 13 in excess of the number of beds provided in the new hospital. After consideration a resolution was passed "That the question of additional ward accommodation be deferred until the completion of the Hospital." There is sufficient space on the site to admit of ample extensions, and this will undoubtedly be required at no distant date. When in the future any extensions or alterations are to be made, the advisability should be considered of erecting a small isolation or quarantine block, in which cases of a doubtful character can be kept for a period under observation, without being put into one of the infected wards. Such building might be the means of preventing the introduction of infectious diseases, such as Measles, Whooping Cough, etc., into the wards. The following is the scale of fees payable for the maintenance of patients in the Hospital:— 17 Per week. Where the rateable value of the house does not exceed £20 Nil. Exceeds £20, and does not exceed £30 10/- „ £30 „ „ £40 15/- „ £40 ,, „ £50 21/- „ £50 „ „ 42/- Servants sent to the Hospital by employers are charged for according to the rateable value of the employers' houses, but with a maximum of £1 is. per week. In several cases the fee is remitted if it is thought desirable by the Council to do so. Diagnostic Test The number of specimens of secretion and blood submitted to the Clinical Research Association and the Jenner Institute of Preventive Medicine during the year in doubtful cases of Diphtheria, and Typhoid or Enteric Fever, and the results of examination were as follows: — Bacillus found. Bacillus not found. Total. Diphtheria Secretion 24 46 70 Reaction obtained. Reaction not obtained. Total. Typhoid (Blood) 3 8 11 Disinfection. The following Table shows the number of articles disinfected in the disinfecting chamber after each disease. 18 Diseases Mattresses. Palliasses. Beds. Pillow s and Holsters. Blankets. Dresses. Suits. Other Articles. Totals. Scarlet Fever 71 3 238 609 468 52 37 1965 3443 Diphtheria 38 1 107 215 203 8 14 574 1160 Typhoid Fever 14 ... 16 37 24 ... ... 39 130 Other Diseases 5 ... 30 54 39 7 3 145 283 Totals 128 4 391 915 734 67 54 2723 5016 The disinfection of infected bedding and clothing in the past * has been carried out by means of a hot-air chamber, heated by gas. Now, at the new hospital, an Alliott and Paton's improved Lyons steam disinfecting apparatus has been fixed. This is a disinfector of the most modern type, by means of which it will enable bedding to be returned the same day as removed, if necessary, this being a great boon in the poorer classes who have no reserve bedding. With this apparatus, either hot air or steam is used as the nature of the article to be disinfected requires. The number of rooms disinfected was 213. Twenty-eight library books were disinfected. Drinking Water Cisterns. The investigation in connection with cases of infectious disease has revealed, in many instances, the improper positions in which the drinking water cisterns are placed. They were found in every conceivable position, often almost inaccessible, and generally uncovered, in coal cellars, water-closets, and under bedroom floors, in the latter cases the ill-fitting boards of the floor forming the cover. This increases the difficulty of the occupier 19 to cleanse the cistern if he should so desire, but, unfortunately, this precaution is often neglected. Cisterns have been found to become the last resting place of mice, birds, etc., and these decomposing, cannot possibly benefit the persons using the water. The best remedy for these evil conditions would be for every house to be provided with a draw-off tap direct from the rising main for drinking purposes. This cannot be done, as the Water Companies supplying the district do not give a constant service. New regulations deposited by them with the Board of Trade for approval, however, require that "every cistern used in connection with the water supplied by the Company, shall be made, and at all times maintained water tight, and be properly covered with a close fitting lid, and placed in such a position that it may be readily inspected and cleansed." If approved, this regulation should prevent in the future the evil conditions mentioned above. Overcrowding. Four overcrowding nuisances were abated without the aid of legal proceedings. The bye-laws mentioned in my last report had not, at the close of the year, received approval by the Local Government Board. Dairies, Cowsheds and Milk shops. The Dairies, Cowsheds and Milk shops have been inspected quarterly during the year, as well as at odd periods, and generally found in a fair condition. There are now 45 persons registered as dairymen and purveyors of milk, and 5 as cow keepers. During the year the number of cowsheds have been reduced by 5, one, a splendid brick building with drainage and ventilation of the best, has been demolished owing to the part of the district in which it is situated being developed as a building estate. Another was closed on account of the proprietors having purchased an estate outside this district in which cowsheds have been erected. Two others, which were old wooden structures and in a 20 ated state, the owners have preferred to discontinue their use, rather than place them in such a condition as to comply with the requirements of the new regulations. The house attached to one of the last mentioned was dealt with and closed by the Council, under the Housing of the Working Classes Act, as unfit for human habitation. This portion is also being developed as building land. The fifth was closed owing to the lease running out and a renewal not being granted. The reduction in the number of cowsheds owing to portions of the district having developed as building land, has caused the cowkeepers to remove outside Wimbledon where land is cheaper. Of the cows still kept in the district, 90% are under periodical veterinary inspection. At 3 of the dairies the drainage and sanitary arrangements have been reconstructed throughout. A new spacious, light, and well ventilated dairy has been erected, with steam appliances for can washing purposes at one of these. Bakehouses The bakehouses, 25 in number (24 retail and 1 wholesale), 21 of which are above ground and 4 below, were inspected twice during the year, namely in March and September. The premises on the whole are kept in good condition, although several had intimation notices served on them requiring the necessary periodical cleansing. At 1, the drainage system was entirely reconstructed, and at 4 others, sanitary amendments were made and the ventilation improved. Slaughterhouses. Of the 6 slaughter houses, 4 are in regular use, another occasionally, and the sixth has been disused for some years. All the premises have been visited frequently during the year, and the bye-laws of the Council enforced. ?1 Customs and Inland Revenue Acts, 1890-91. Applications were made to me for certificates under the provisions of the above Acts, and having regard to the decision in the case of Seaman v. Lee in the Queen's Bench Division of the High Court of Justice, I consulted Dr. Sykes, the Medical Officer of Health for St Pancras, who has had considerable experience in the working of these Acts, as to his requirements before granting the certificate. I also had interviews with the Income Tax Authorities, and adopted the following form of certificate, viz.:— I hereby certify that I have examined the house described below, and am of opinion that the house is so constructed as to afford suitable accommodation for each of the persons inhabiting it, and that due provision is made for their sanitary requirements, these words being interpreted to mean that the house is so constructed:— 1.—That each of the persons inhabiting it is provided with at least 400 cubic feet of air space. 2.—That each of the living or sleeping rooms is at least 8 feet in height, and at least 96 square feet in area. 3.—That there is at least 1 draw-tap and sink, with a sufficient supply of water thereto, for every 10 occupants or less, on each floor. 4.—That there is at least one water closet, properly supplied with water, for every 10 occupants or less, on each floor. 5.—That the drainage of the premises is in accordance with the Regulations recognised by this Authority. 6.—That accommodation for clothes-washing is provided, sufficient for the number of persons inhabiting the house. Certificates were granted with respect to the following premises: — Nos. 1 and 2, Warbury Villas, Fairlawn Road. Nos. 49 to 67, Faraday Road. Nos. x to 12, Granville Terrace, Cowper Road. Nos. 1 to 4, Rosebury Villas, Pelham Road. 22 The duty of the Medical Officer of Health under these Acts is to certify that in his opinion the house is so constructed as to afford suitable accommodation for the families or persons inhabitating it and that due provision is made for their sanitary requirements. It is for the Inland Revenue Authorities to make enquiries that the rent paid comes within the amount prescribed in the Act. Sanitary Improvement. Among the works in hand and carried out that affect the Sanitary conditions of the District the following may be mentioned:— Diversion of Middle Level Sewer. The diversion of the middle level sewer at a point before reaching the cemetery will not only prevent the floodings which have taken place in the past, but provide additional burial ground sufficient for 145 grave spaces, or accommodation for about 450 interments. Refuse Destructor. The wish expressed in my last Annual Report that the refuse of the district would soon be disposed of by means of the Refuse Destructor at the Electric Lighting Station, has not been realised, owing to some unforeseen circumstances having arisen which prevents its present use. Private Roads. The following roads have been made up during the year and declared "Highways repairable by the inhabitants at large." Alexandra Mews. Ashley Road. Balfour Road. Broadway Yard. Faraday Road. Garfield Road. Lake Road. Merton Hall Road. Vineyard Hill Road. Contracts were entered into for making up the following roads, which have not yet been completed:— Cowdrey Road. Hotham Road. Leopold Road. Tennyson Road. House Drainage. The drains of 264 houses and premises have been entirely reconstructed, and laid to stand the water test, with manholes, etc., for inspection and cleaning purposes. The following blocks of houses have been redrained:— 20 to 27, Crooked Billet, 8 houses. 23 1 to 27, Caroline Road, 14 houses. 1 to 29, William Road, 15 houses. * 49 to 55, Amity Grove, 4 houses. ** 39 to 47, Amity Grove, 5 houses. * 72 to 85, Kingston Road, 14 houses. 88 to 106, Gladstone Road, 10 houses. * 3, 4, 5, 6, Amity Terrace, Coombe Lane, 4 houses. * 1 to 11, Good enough Road, 6 houses. 1 to 6, Wandle Terrace, Wandle Bank, 6 houses. Bertram Cottages, Gladstone and Hartfield Road, 34 houses. * 1 to 27, Caxton Road, 14 houses. 54 to 80, Gladstone Road, 14 houses. *** 95 to 111, Gladstone Road, 9 houses. * 62 and 64, Pelham Road, 2 houses. During the year 346 complaints of nuisances were received and investigated. This has been an exceptionally busy year owing, chiefly, to the epidemic of Measles in the district, and to promptly deal with this and urgent work in connection with other infectious diseases and the removal of nuisances, etc., it necessitated the devoting, by the Staff of the Department, of a considerable amount of time beyond official hours. This I am pleased to say was given voluntarily and willingly as the occasion required. In regard to the work of the Sanitary Inspector (Mr. Johnson) and his staff, I can only say that the high state of efficiency with which they have worked in the past has been maintained, and the work of the year only adds to the high reputation I have formed of him and them. I have the honour to be, Your obedient servant, E. POCKLINGTON, Medical Officer of Health. * The main drains at these houses were reconstructed by the Council at the costs of the owners, they having made default in complying with the notices served upon then). ** These main drains were reconstructed by the Council as sewers within the meaning of the Public Health Act, 1875. *** Notices were served on the owners to relay the main and branch drains of these premises. Owing lo the diversion of the main drain into a more recently constructed sewer, it was reconstructed at the cost of the Council. TABLE 1 The following is a Summary of the Nuisances complained of and inspected during the year, and the work carried out under the supervision of Mr. Johnson, the Sanitary Inspector:— Animals Removed 4 Accumulations Removed 87 Cisterns Provided 35 Cisterns Cleansed or Covered 75 Cisterns Repaired 36 Cesspools Removed 1 Dilapidated Houses Repaired 3 Drain Stoppages Removed 71 Dust Bins Provided 128 „ Repaired 10 Drains, New, Provided 264 Drains, Repaired and Altered 51 Flushing Boxes, New, Provided 278 Flushing Boxes Repaired 74 Guttering and Spouting Provided 16 Guttering and Spouting Repaired 26 Houses Cleaned and Whitewashed 24 Manure Receptacles Provided 2 Overcrowding Nuisances Abated 4 R.W. Pipe and Waste Pipes Disconnected 268 Roofs, Leaky, Repaired 49 Smoke Nuisances Abated 7 Soil Pipes, New, Provided 106 Urinals, Water Laid on, Cleansed, &c. 1 Ventilating Pipes, New, Provided 323 Ventilating Pipes Repaired 34 Waste Pipes Trapped and Repaired 105 Water Closets, Container Pattern, Removed 4 Water Closets Repaired and Ventilated 27 Water Closets, New, Provided 352 Water Service Restored 31 Yards Cleansed 30 Yards Paved 154 Total 2680 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 1900. Total 1899. Total 1898. Small Pox under 5 ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... 5 upw' ds ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever under 5 2 2 5 4 2 ... 1 ... 1 1 2 1 112 149 98 5 upw'ds 9 13 8 7 6 12 9 5 6 5 9 2 Diphtheria under 5 2 ... 3 ... ... 1 ... 1 1 6 2 3 64 64 60 5 upw'ds 10 4 3 1 3 4 2 5 5 5 1 2 Typhoid Fever under 5 ... ... ... ... ... ... ... ... ... ... ... ... 20 47 11 5 upw'ds 3 i 3 1 1 1 3 ... 3 1 ... 3 Measles under 5 3 9 18 40 93 113 34 8 ... 21 36 101 1069 273 55 5 upw'ds 8 26 39 90 106 68 56 6 2 23 24 145 Erysipelas under 5 1 ... ... ... ... ... ... ... 2 1 ... 1 49 72 58 5 upw'ds 3 3 5 1 9 5 2 ... 5 3 3 5 Totals under 5 8 11 27 44 95 114 35 9 4 29 40 106 522 136 77 5 upw'ds 33 47 58 100 125 90 72 16 21 37 37 157 793 473 208 41 58 85 144 220 204 107 25 25 66 77 263 1315 609 285 TABLE 3. Cases of Infectious Diseases notified during 1900. Notifiable Diseases. Cases Notified in whole District. Population at Census 1891—25,761. Estimated to middle of 1900—44,000. Cases Notified in each Locality. No. of Cases Removed to Hospital from each Locality. Atkinson Morley's Hospital. No. of Patients, 1157. Cottage Hospital, N. Wimbledon. No. of Patients, 136. * Cottage Hospital, S. Wimbledon. No. of Patients, 97. Whole District. Atkinson Morley's Hospital. Cottage Hospital, North Wimbledon. Cottage Hospital, South Wimbledon. At all Ages. Under 1 to 5 5 to 15 15 to 25 25 to 65 65 and upwds Small Pox 1 1 ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 64 3 15 38 1 7 ... ... ... ... 2 ... ... ... Erysipelas 49 2 3 7 2 30 5 5 ... ... ... ... ... ... Scarlet Fever 112 ... 23 65 15 9 ... 1 ... ... 61 1 ... ... Enteric Fever 20 ... ... 4 6 10 ... ... ... ... 1 ... ... ... Measles 1069 51 425 540 39 14 ... ... ... 2 ... ... ... ... Totals 1315 57 466 654 63 70 5 6 ... 2 64 1 ... ... The Infectious Diseases Notification Act has been compulsory in this District since 1889. The New Isolation Hospital is situated in Gap Road and provides accommodation for Scarlet Fever, Enteric Fever and Diphtheria Patients. * Opened July 1st, 1900. L.G.B. 111 TABLE 5. Table of Deaths during the Year 1900, in the Urban Sanitary District of Wimbledon, Classified according to Diseases, Ages and Localities. Localities. Public Institutions being shown as separate localities. Mortality from all causes at subjoined ages. (i) Mortality from subjoined causes, distinguishing deaths of children under 5 years of age. At all Ages Und'r 1 year 1 and und'r 5 5 and und'r 15 15 and und'r 25 25 and und'r 65 65 and up- w'rds. 1 2 3 4 5 6 7 8 9 10 11 12 Scarlatina. Diphtheria. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Phthisis. Bronchitis*, Pneumonia and Pleurisy. Heart Disease. Injuries. All other Diseases. Total (a) (b) (C) (d) (e) (f) (g) (h) WIMBLEDON 541 156 56 25 l6 171 117 Under 5 ... 6 1 15 5 19 2 43 3 3 115 212 5 upwards ... 4 2 1 ... ... 18 64 46 10 184 329 ATKINSON MORLEY'S HOSPTL. 6 ... ... ... ... 4 2 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... ... ... ... ... ... ... 6 6 COTTAGE HOSPITAL (North Wimbledon). 6 ... ... 1 ... 5 ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... ... ... ... ... ... 1 5 6 COTTAGE HOSPITAL (South Wimbledon). 5 ... 1 ... ... 4 ... Under 5 ... ... ... ... ... ... ... ... ... ... 1 1 5 upwards ... ... ... ... ... ... ... ... ... 1 3 4 ISOLATION HOSPITAL (Gap Road). 1 ... 1 ... ... ... ... Under 5 ... ... ... 1 ... ... ... ... ... ... ... 1 5 upwards ... ... ... ... ... ... ... ... ... ... ... ... TOTALS 559 156 58 26 16 184 119 Under 5 ... 6 1 16 5 19 2 43 3 3 116 214 5 upwards ... 4 2 1 ... ... 18 64 46 12 198 345 The subjoined numbers have also been taken into account in judging of the above records of mortality. Deaths occurring outside the district among persons belonging thereto. 24 3 ... 1 3 6 11 Under 5 ... ... ... ... ... ... ... ... ... ... 3 3 5 upwards ... ... ... ... ... ... 5 2 2 ... 12 21 Deaths occurring within the district among persons not belonging thereto. 13 ... ... ... ... 11 2 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... ... ... 1 ... 1 3 8 13 TABLE 6. Table showing Vital Statistics for 1900 and previous 10 years. Year. Population estimated to Middle of each Year. Births. Deaths under One Year of Age. Deaths at all Deaths in Public Institutions. Deaths of Nonresidents registered in District Deaths of Residents registered beyond District. Deaths at all Ages. Total. Ages. Nett. Number. Rate. * Number. Rate per 10000 Births registered. Number. Rate. * Number. Rate. * 1. 2 3 4 5 6 7 8 9 10 11 12 13 1890 27,000 689 25.51 75 108.85 287 10.62 No records for these years. 1891 26,000 711 27.3 76 106.89 334 12.8 1892 26,000 738 28.3 90 114.94 333 12.8 1893 28,000 780 27.8 107 137.17 363 12.9 1894 30,000 794 26.4 81 102.01 310 10.3 1895 31,000 857 27.6 102 119.01 377 12.1 6 6 3 374 12.06 1896 33,000 875 26.51 96 109.71 343 10.3 10 3 25 365 11.06 1897 35,000 828 23.65 98 118.35 367 10.4 6 2 33 398 11.3 I898 38,000 963 25.3 145 150.05 415 10.9 11 5 32 442 11.6 1899 42,000 1031 24.53 163 158.09 547 13.02 18 12 33 568 13.52 Averages for years 1890-1899 31,700 826 26.05 103 124.69 367 11.59 10 5.6 25.2 429.4 13.54 1900 44,000 1075 24.43 156 145.11 559 127 18 13 24 570 12.95 * Rates calculated per 1000 of estimated population. By the term "Non-residents" is meant persons brought into the district on account of illness, and dying there ; and by the term 44 Residents " is meant persons who have been taken out of the district on account of illness, and have died elsewhere. Area of District in Acres (exclusive of area covered by water)... 3,173 Total population at all ages (a». Census of 1891) 25,761 Number of inhabited houses (at Census of 1891) ... ... 4,514 Average number of persons per house ,, ... ... 5*6 SUMMARY OF TABLE 7. No. of Deaths. Brought forward No. of Deaths. I.—SPECIFIC FEBRILE or ZYMOTIC DISEASES:— 482 1. Miasmatic Diseases 56 V.— LOCAL DISEASES—continued:– 5. Diseases of Gland-like Organs of Uncertain Use 1 2. Diarrhœal „ 22 3. Venereal „ 1 6. Diseases of Urinary System 21 4. Septic 4 II.–DIETIC DISEASES 4 (a) Diseases of Organs of Generation (b) Diseases of Parturition 1 III.–CONSTITUTIONAL DISEASES 66 (c) Injuries during Delivery 1 8. Diseases of Bones and Joints 1 IV.–DEVELOPMENTAL DISEASES 59 9. Diseases of Integumentary System 4 V.–LOCAL DISEASES:– VI. -VIOLENCE:— 1. Accident or Negligence 10 1. Diseases of Nervous System 48 2. Suicide 5 2. Diseases of Circulatory System 54 3. Diseases of Respiratory System 113 VII.-ILL-DEFINED AND NOT SPECIFIED CAUSES 33 4. Diseases of Digestive System 55 Carried forward 482 Total 559 30 NOTES ON TABLES 3, 6, AND 7. It will be observed that the forms required by the Local Government Board for the record of statistical data differ from those supplied in former years. Four tables have been substituted for Tables "A" and "B." The details of Table No. 2 cannot be filled in until after the Census, when the population of each ward will be taken. The following notes are from the instructions of the Local Government Board:— In Table 6 L.G. B. I should be stated for the whole district under the superintendence of a Medical Officer of Health the number and rates of births, and of deaths under one year and at all ages, and the data on which the nett death-rate is based. Spaces are given for the insertion of the corresponding figures for the ten previous years for purposes of comparison. Table 3 L.G.B. III provides for the number of notified cases of infectious disease during the year, classified according to ages of patients and localities, and also the number of cases removed to hospital from each locality. As regards the classification according to locality, the same considerations apply to the records of sickness as to those of deaths. Table 7 L.G.B. IV. Provides for the deaths during the year from various causes, classified according to ages and localities. In populous districts a more extended table in a similar form containing a more complete classification of causes of deaths may with advantage be substituted for this form. TABLE 4 DISTRIBUTION AND PARTICULARS OF INFECTIOUS CASES NOTIFIED Diseases. Albeit Road. Alexandra Road. Amity Grove. Arterberry Road. Arthur Road. Ashbourne Terrace. Atkinson Morley's Hospital. Balfour Road. Beehive Buildings. Berkeley Place. Bernard Gardens. Beulah Road. Broadway. Caroline Road Caxton Road. Cecil Road. Church Road. Clarence Road. Cochrane Road. Common. Coombe Lane. Copse Hill. Cottenham Park Road. Courthorpe Villas. Cowdrey Road. Cowper Road. Crescent Road. Cromwell Road. Crooked Billet. Cross Road. Deburgh Road. Delamere Road. Denmark Avenue. Denmark Road. Drive (The) Dryden Road. Dundonald Road. Durham Road. Durnsford Road. East Road. Effra Road. Ethelbert Road. Evelyn Road. Faraday Road. Florence Road. Gap Road. Gladstone Road. Goodenough Road. Graham Road. Griffiths Road. Hamilton Road. Harcourt Road. Hardy Road. Hartfield Crescent. Hartfield Road. Havelock Road. Haydon Park Road. Haydon Road. Herbert Road. High St., Wimbledon. High Street, Merton. Hill Road. Homefield Road. Hotham Road. Hubert Road. Isolation Hospital. K.enilworth Avenue. King's Road. Kingston Road. Kingswood Road. Small Pox under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .1 ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 4 ... ... ... ... ... .3 ... 1 ... ... 1 ... ... ... ... 1 ... ... ... ... ... 1 ... 5 upwards 1 ... 2 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 3 ... ... ... ... ... ... ... 1 ... 2 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 5 ... ... 4 ... 1 3 1 ... 1 ... ... ... ... ... 2 ... ... ... ... ... ... ... ... 1 1 ... Membranous Croup under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas under 5 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... 2 ... ... ... 1 5 1 ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 2 ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... 1 ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever under 5 ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 1 ... ... ... ... 1 1 ... ... ... ... ... 1 2 ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... 1 ... ... ... ... 1 ... 1 ... ... 1 1 1 ... ... ... 1 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... 2 1 1 ... ... 1 ... ... ... ... ... 1 8 ... 2 1 5 1 ... 1 2 1 ... ... ... 1 2 ... 1 ... ... ... ... ... 1 ... 1 ... Enteric or Typhoid under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... 2 ... ... 1 ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 ... ... ... 1 1 Measles under 5 ... 2 5 ... 1 ... ... 4 ... ... ... ... 1 12 2 6 1 8 10 1 1 ... ... 1 ... 8 ... 5 ... 2 17 1 2 ... ... 8 9 1 ... 2 10 1 2 3 24 ... 9 11 6 2 4 2 4 14 2 2 3 30 4 1 4 ... ... 7 4 6 1 ... 6 1 5 upwards ... 16 2 3 3 2 ... 1 ... ... 2 ... 6 7 3 5 2 21 6 2 ... ... 4 5 1 3 1 6 2 3 9 4 ... 1 ... 2 8 1 1 1 6 5 4 16 29 2 12 4 8 9 3 ... 18 9 6 2 3 20 8 5 6 1 3 6 4 2 4 2 6 1 Totals under 5 ... 2 5 ... 1 ... 1 4 ... ... ... ... 3 12 2 7 1 9 10 1 1 ... ... 1 ... 8 ... 6 1 2 19 2 2 ... ... 8 10 2 ... 2 10 1 2 5 26 1 13 11 6 2 4 2 8 15 3 2 3 33 4 1 4 ... 1 7 4 6 1 ... 7 1 5 upwards 1 19 4 3 3 3 6 3 1 1 2 1 7 8 3 5 2 26 6 2 ... 2 4 5 1 6 1 10 2 3 10 6 2 3 1 2 8 2 1 2 7 5 4 25 37 2 19 5 15 13 5 1 22 10 6 2 5 21 12 5 7 1 3 7 5 2 5 3 9 2 TABLE—Continued. Diseases. Lambton Road. Lansdown Road. Latimer Road. Lauriston Road. Leyton Road. Lingfield Road. Lower Downs Road. Malcolm Road. Mansel Road. Merton Road. Merton Hall Road. Milton Road. Nelson Road. Newton Road. Norman Road. North Road. Palmerston Grove. Palmerston Road. Pelham Road. Prince's Road, South Wimbledon. Queen's Road. Quick Road. Railway Path. Railway Place. Richmond Road. Ridgway. Ridgway Gardens. Ridgway Place. Ridley Road. Russell Road. Salisbury Road. Somerset Road. South Place. South Road. Southey Road. Southdown Road. South Park Road. Spencer Hill. Springfield Road. Stanley Road. St. George's Road. St. Mark's Place. St. Mary's Road. Sunny side. Tabor Grove. Tennyson Road. Thornton Hill. Thornton Road. Thurstan Road. Trafalgar Road. Trevor Road. Trinity Road. Victory Road. Vineyard Hill. Waldemar Road. Wandle Bank. Wandle Road. William Road. Woodside. Woodside Parade. Worple Road. Worple Road West. Wycliffe Road. York Road. Total. Small Pox under 5 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 5 upwards ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 18 63 5 upwards ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... 3 1 ... 1 ... ... ... 1 ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... 1 2 ... ... ... ... ... ... ... ... ... ... ... 45 Membranous Croup under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 5 upwards ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 5 49 5 upwards ... ... ... ... ... 1 ... ... ... 1 ... ... 2 ... 1 1 ... ... ... ... 1 1 ... ... 1 1 ... ... 1 ... ... ... ... ... 1 1 3 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 1 ... ... ... ... ... ... ... 1 1 2 ... 44 Scarlet Fever under 5 ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 21 112 5 upwards ... 1 ... 1 ... 1 ... 1 1 3 1 1 ... 1 ... ... ... ... 1 1 1 2 ... ... ... ... 1 1 ... 2 ... ... ... 1 ... ... 1 6 ... ... ... ... ... 1 ... ... ... ... 1 ... 5 4 ... ... 1 ... ... 4 2 ... 3 ... ... 1 91 Enteric or Typhoid under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 20 5 upwards ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 1 ... ... 1 ... ... ... 20 Measles under 5 1 ... 4 1 6 ... ... ... ... 9 1 6 8 9 3 1 1 15 9 3 3 8 1 1 ... ... ... ... 8 18 ... ... 3 17 ... ... 15 ... ... 1 ... 1 ... ... ... 3 ... 1 ... 3 5 2 10 ... ... ... 12 6 3 ... 1 ... 1 3 476 1069 5 upwards 5 7 4 2 2 1 1 ... ... 16 2 4 14 7 1 4 3 13 15 8 14 9 1 ... 1 5 ... 1 6 9 1 ... ... 8 ... ... 23 1 1 5 2 1 ... ... 1 ... 2 ... ... 2 4 7 13 1 ... 1 8 5 5 2 5 1 2 ... 593 Totals under 5 1 ... 5 1 6 ... ... ... ... 9 1 6 10 9 3 1 1 15 11 3 3 8 1 1 ... ... ... ... 11 18 ... ... 3 17 ... ... 16 ... ... 1 ... 1 ... ... ... 3 ... 1 1 3 7 2 10 ... ... ... 13 6 3 ... 1 ... 2 3 522 1315 5 upwards 5 9 4 3 2 3 1 1 1 21 4 5 16 8 3 5 3 13 16 9 18 12 1 1 2 6 1 2 10 12 1 1 ... 9 1 2 27 7 1 5 2 2 1 1 1 ... 3 ... 1 2 9 13 16 1 1 1 10 10 7 2 10 2 4 1 793 TABLE 7. 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 upwds Totals. Classes. I.—Specific Febrile, or Zymotic Diseases 30 21 4 2 2 5 5 4 7 1 2 83 II.—Dietic Diseases ... ... ... ... ... 1 ... 2 1 ... ... 4 III.—Constitutional Diseases 2 5 7 7 7 6 7 14 9 1 1 66 IV.—Developmental Diseases 37 1 ... ... ... ... ... ... 1 10 10 59 V.—Local Diseases 61 29 13 7 10 20 32 51 49 24 3 299 VI.—Deaths from Violence 1 2 1 ... 1 1 4 5 ... ... ... 15 VII.—Deaths from III-Defined and Not Specified Causes 25 ... 1 ... 3 1 3 ... ... ... ... 33 Totals 156 58 26 16 23 34 51 76 67 36 16 559 I.—Specific Febrile, or Zymotic Diseases. i. —Miasmatic Diseases. Measles 5 11 1 ... ... ... ... ... ... ... ... 17 Whooping Cough 4 1 ... ... ... ... ... ... ... ... ... 5 Diphtheria ... 6 3 1 ... ... ... ... ... ... ... 10 Enteric or Typhoid Fever ... ... ... 1 ... 2 2 ... ... ... ... 5 Influenza ... 1 ... ... ... 3 2 3 7 1 2 19 2. —Diarrhœal Diseases. Simple Cholera 2 ... ... ... ... ... ... 1 ... ... ... 3 Diarrhoea. Dysentery 17 2 ... ... ... ... ... ... ... ... ... 19 3.— Venereal Diseases. Syphilis 1 ... ... ... ... ... ... ... ... ... ... 1 4.—Septic Diseases. Erysipelas 1 ... ... ... 2 ... ... ... ... ... ... 3 Pyæmia, Septicæmia ... ... ... ... ... ... 1 ... ... ... ... 1 II.—Dietic Diseases. Chronic Alcoholism ... ... ... ... ... 1 ... 2 1 ... ... 4 III.—Constitutional Diseases. Rheumatic Fever, Rheumatism of the Heart ... ... 1 ... ... ... ... ... 1 ... ... 2 Rheumatism ... ... ... ... ... ... 1 ... ... ... ... 1 Cancer, Malignant Disease ... ... ... ... ... 1 5 10 5 1 ... 22 Tabes Mesenterica ... 1 ... ... ... ... ... ... ... ... ... 1 Tubercular Meningitis, Hydrocephalus 1 3 2 ... ... ... ... ... ... ... ... 6 Phthisis 1 1 2 6 6 3 ... ... 1 ... ... 20 Other forms of Tuberculosis, Scrofula ... ... 1 ... 1 2 ... 1 ... ... ... 5 Anæmia, Chlorosis, Leucocythæmia ... ... 1 1 ... ... ... 1 1 ... ... 4 Glycosuria, Diabetes Mellitus ... ... ... ... ... ... 1 2 1 ... 1 5 IV.—Developmental Diseases. Premature Birth 20 ... ... ... ... ... ... ... ... ... ... 20 Old Age ... ... ... ... ... ... ... ... 1 10 10 21 Marasmus 17 1 ... ... ... ... ... ... ... ... ... 18 V.—Local Diseases. 1.—Diseases of Nervous System. Inflammation of Brain or Membranes ... 6 2 ... 1 ... ... 1 ... ... ... 10 Apoplexy, Softening of Brain, Hemiplegia, Brain Paralysis ... ... ... 1 ... 2 3 2 5 2 ... 15 Insanity, General Paralysis of the Insane ... ... ... ... ... ... 2 1 ... ... ... 3 Epilepsy ... ... ... ... ... 1 ... ... ... ... ... 1 Convulsions 4 5 ... ... ... ... ... ... ... ... ... 9 Laryngismus Stridulus (Spasm of Glottis) ... 4 1 ... ... ... ... ... ... ... ... 5 Disease of Spinal Cord, Paraplegia, Paralysis Agitans ... ... ... ... 1 2 ... ... ... ... ... 3 Other Diseases of Nervous System 1 ... ... ... ... 1 ... ... ... ... ... 2 2.—Diseases of Circulatory System. Pericarditis ... ... 1 ... ... ... ... ... ... ... ... 1 Acute Endocarditis ... ... ... ... ... 1 ... ... ... ... ... 1 Valvular Diseases of Heart ... ... 2 2 ... ... 2 6 4 ... ... 16 Other Diseases of Heart 3 ... 1 3 ... 1 2 6 11 3 1 31 Aneurism ... ... ... ... ... ... 1 3 ... ... ... 4 Embolism, Thrombosis ... ... ... ... ... ... 1 ... ... ... ... 1 3. — Diseases of Respiratory System. Emphysema, Asthma ... ... ... ... ... ... 2 2 1 1 ... 6 Bronchitis 7 4 1 ... ... 1 4 10 5 8 2 42 Pneumonia 24 8 3 ... 5 6 3 3 4 5 ... 61 Pleurisy ... ... ... ... ... ... 2 ... 1 1 ... 4 4. —Diseases of Digestive System. Dentition 2 1 ... ... ... ... ... ... ... ... ... 3 Diseases of Stomach 2 ... ... ... 1 1 ... 4 1 ... ... 9 Enteritis 12 1 ... ... ... ... 1 ... 1 ... ... 15 Obstructive Diseases of Intestine 1 ... ... ... ... ... 1 2 2 2 ... 8 Peritonitis ... ... 1 1 1 ... 1 ... ... ... ... 4 Cirrhosis of Liver ... ... ... ... ... ... 5 3 3 ... ... 11 Jaundice and other Diseases of Liver 2 ... ... ... ... 1 ... ... ... 1 ... 4 Other Diseases of Digestive System ... ... ... ... ... ... ... 1 ... ... ... 1 3.—Diseases of Gland-like Organs of Uncertain Use. (e.g.. Bronchocele, Addison's Disease) ... ... ... ... ... ... ... ... 1 ... ... 1 6.—Diseases of Urinary System. Nephritis 1 ... 1 ... ... ... 1 2 4 ... ... 9 Bright's Disease, Albuminuria ... ... ... ... ... ... ... 4 4 1 ... 9 Disease of Bladder or of Prostate ... ... ... ... ... 1 ... .... ... ... ... 1 Other Diseases of the Urinary System ... ... ... ... ... ... ... 1 1 ... ... 2 7.—Diseases of Reproductive System. a. Of Organs of Generation. Female Organs ... ... ... ... ... 1 ... ... ... ... ... 1 b. Of Parturition. Placenta prævia, Flooding ... ... ... ... 1 ... ... ... ... ... ... 1 8. —Diseases of Bones and fowls. Caries, Necrosis ... ... ... ... ... ... 1 ... ... ... ... 1 9.—Diseases of Integumentary System. Carbuncle, Phlegmon ... ... ... ... ... 1 ... ... ... ... ... 1 Other Diseases of Integumentary System 2 ... ... ... ... ... ... ... 1 ... ... 3 VI.—Deaths from Violence. 1.—Accident or Negligence. Fractures and Contusions ... ... 1 ... ... ... 4 1 ... ... ... 6 Burn, Scald ... 1 ... ... ... ... ... ... ... ... ... 1 Suffocation 1 1 ... ... ... 1 ... ... ... ... ... 3 2.—Suicide. Gunshot Wounds ... ... ... ... ... ... ... 1 ... ... ... 1 Cut, Stab ... ... ... ... ... ... ... 1 ... ... ... 1 Poison ... ... ... ... ... ... ... 1 ... ... ... 1 Hanging ... ... ... ... 1 ... ... 1 ... ... ... 2 VII—Deaths from Ill-Defined and not Specified Causes. Debility, Atrophy, Inanition 25 ... ... ... ... ... ... ... ... ... ... 25 Tumour ... ... ... ... 1 ... 1 ... ... ... ... 2 Abscess ... ... 1 ... 1 1 2 ... ... ... ... 5 Hæmorrhage ... ... ... ... 1 ... ... ... ... ... ... 1