WIM 052 URBAN SANITARY DISTRICT OF WIMBLEDON, COUNTY OF SURREY. Report of the Medical Officer of Health FOR THE YEAR ENDING DECEMBER 31st, 1902. Wimbledon Urban District Council, SANITARY DEPARTMENT. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, FOR THE YEAR ENDED DECEMBER 31st, 1902. Gentlemen, I have the honour to submit my Annual Report for the year ending December 31st, 1902, with statistical returns of deaths and infectious diseases in the District, the methods adopted for the prevention of disease, and the general work of the Sanitary Department. Its reputation as an exceptionally healthy one is well maintained, as evidenced by its low death rate. Population The calculations for the death and other rates in the tables herein are based on a population estimated to the middle of the year as 43,000, and has been checked on the assumption that the birth rate has remained the same for a series of years as it was found to be at the time of the last census. This figure has been adopted having in view the fact that when the census was taken both in 1891 and 1901 the population was found to be considerably lower than had been estimated. Births. The total number of births registered was 1,144 (577 males, 567 females), which is 70 more than last year, equal to a birth rate of 26.6 per 1,000 per annum, being .81 higher than last year. The birth rate in England and Wales for the same period is given as 28.6 in the report of the Registrar General. Deaths. The total number of deaths registered were 455 (203 males, 252 females), equal to a death rate of 10.5 per 1,000 living per annum. 2 After making the usual corrections, as indicated at the bottom of Table 5, the total number of deaths properly belonging to the district is found to be 497 and the death rate 11.5. The death rate for England and Wales for the same period is given as 16.3. The deaths which occurred outside the district among persons belonging thereto, which have come to my knowledge, were 40 at Kingston Infirmary, and 6 in Brookwood Asylum. The deaths which occurred within the district among persons not belonging thereto were one in Atkinson Morley's Hospital, one at the Cottage Hospital, North Wimbledon, and two at the Cottage Hospital, South Wimbledon. Infant mortality is represented by a ratio of 117.13 deaths under one year of age to 1,000 registered births, as against 133 deaths per 1,000 births in England and Wales for the same period. Between the ages of 1 and 60 there were 192 deaths, and 129 deaths of persons aged 60 years and upwards. The death rate from all Zymotic diseases was 1.02 per thousand of the population per annum. The number of deaths from Zymotic diseases was a. viz. : from measles 11, diphtheria 7, diarrhoea 6, whooping cough 17, enteric fever 3. There were 36 deaths from bronchitis, 46 from pneumonia, and 22 from phthisis, registered in the district. (See Table 7, in which is classified the whole of the deaths, as to their causes and ages, and in column 2 will be seen the chief causes of mortality among infants under one year of age). Comparing the deaths from respiratory diseases with those that occurred last year, a slight decrease is noted. The deaths from pneumonia number 46, against 44 last year; and from bronchitis 36, as against 41 last year. Table A shows, for the last and 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. 1902 1901 1900 1899 1898 Births 1141 1074 1075 1031 963 Deaths 455 457 559 547 415 Death-rates 10 5 1097 127 13.02 116 DEATHS— Under 1 year 134 133 156 163 145 Over 1 year and under 60 years 192 206 239 230 151 Above 60 years 129 118 164 154 119 From Measles 11 10 17 1 2 Scarlet Fever 0 1 0 2 2 „ Small Pox 0 0 0 0 0 „ Diphtheria 7 6 10 12 7 „ Diarrhoea 6 24 19 21 56 „ Whooping Cough 17 13 5 15 3 „ Enteric Fever 3 0 5 6 1 „ Puerperal Fever 0 0 0 1 0 „ Erysipelas 3 0 3 1 3 „ Influenza 6 9 19 19 2 4 TABLE B. DISEASES 1902 1901. 1900 1899 1898. Cases Notified. Deaths. Cases Notified. Deaths.. Cases Notified Deaths. Uases Notified. Dentlis Cases Notified Deaths. Small Pox 9 0 3 0 1 0 0 0 0 0 Diphtheria 80 7 6O 6 64 10 64 12 60 7 Erysipelas 46 3 52 0 49 3 72 1 58 3 Scarlet. Fever 158 0 90 1 112 0 149 2 98 2 Enteric Fever. 16 3 12 0 20 5 47 6 11 1 Puerperal Fever 3 0 2 0 0 0 4 1 3 0 *Measles 1026 11 453 10 1069 17 273 1 55 2 **Chicken Pox 170 0 0 0 0 0 0 0 0 0 Totals 1478 24 672 17 1315 35 609 23 285 15 * Measles notifiable since June. 1898. ** Chicken Pox notifiable from Feb. 3rd to July 22nd, 1892 TABLE C. 1902 1901 1900 1899 1898 1897 1896 1895 1894 1893 Zymotic Rate. 102 15 1 77 1.83 20 20 1.63 203 1 50 203 5 One hundred and twenty eight cases of scarlet fever were notified during the year, none of which terminated fatally, the attack rate being 2.9 per 1,000 of the population. One hundred and two patients were removed to the Infectious diseases Hospital, being 79 per cent, of the cases notified, the remaining 26 were nursed at home. The cases were distributed as follows, in the usual age periods:- Under 1 year, 1 cases to 5 years, 32 cases; 5 to 15 years, 76 cases; 15 to 25 years, 12 cases; 25 to 65 years, 7 cases. Eighty-five per cent, of the patients were below 15 years of age. Of the 128 cases notified, 75 attended, viz:— Effra Road Schools, 13; Dundonald Schools, 6; Haydons Road Schools, 6; Trinity Schools, 11; Central Schools, 5; Catholic Schools, 4; and Private Schools, 26. There were 9 dwellings in each of which two cases occurred, 2 with three cases and 1 with five. The disease was of a very mild type. In several instances the patients showed no signs of illness until they were found to be desquamating, and in this way undoubtedly other persons were infected. Towards the close of the year, the scarlet fever ward was quite full, and the iron hospital was prepared for the reception of patients should it become necessary, but, fortunately, this was not required. Eighty cases of diphtheria were notified during the year, against 60 for the previous year, representing an attack rate of 1.8 per 1.000 of the population. The cases and deaths were divided amongst the age period as follows:—Under 1 year, no cases; 1 to 5 years, 30 cases and 4 deaths; 5 to 15 years, 37 cases and 3 deaths; 15 to 25 years, 6 cases and no deaths; 25 to 65 years, 7 cases and no deaths; giving a case fatality of 8.7 per cent, from this disease. Of the 80 cases notified 37 (46 per cent.) attended schools, viz:—Effra Road Schools, 4; Dundonald Schools, 2; Haydons Scarlet Fever. bipth3ria 6 Road Schools, 7; Trinity Schools, 3; Central Schools, 2; Catholic Schools, 1; Cottenham Park School, 4; Queen's Road Schools, 3; and Private Schools, 11. The 80 cases occurred in 64 houses, in one 4 patients, and in 8 others 2 each. Forty-nine occurred in what I might term old houses, and 31 in houses which have been built within the last 7 years, and where no insanitary condicions, such as defective drainage, were existing. After the premises were thoroughly disinfected on the recovery of the patient or removal to hospital, the drains and sanitary arrangements were examined and tested, alterations being necessary at 20 of the houses, and the drainage system of two were entirely re-constructed. A great majority of the cases occurred in the low lying and damp parts of the district. For some years past I have noticed the frequency with which this disease occurs at premises where fowls are kept in close proximity to the dwellings—this being the case at 21 houses out of 64 during the year. Whether there is any connection between this fact and the disease I am unable to say, but it is a point worthy of note. Sixteen persons were notified during the year as suffering from enteric fever, 3 of whom died, representing an attack rate of .3 per 1,000 of the population, and a case mortality of 18.7 per cent. Last year there were 12 cases and no deaths; in 1900, 20 cases and five deaths ; and in 1899, 47 cases and six deaths. The patients' ages were as follows:—1 to 5 years, one case; 5 to 15 years, seven cases ; 15 to 25 years, one case ; 25 to 65 years, seven cases. The three deaths were patients between the ages of 35 and 45. With the exception of three in one house, which undoubtedly were contracted from each other, there was no connection between the cases. Enteric Fever. 7 Four of the patients were treated in the Cottage Hospital, North Wimbledon, one in Atkinson Morley's Convalescent Hospital, five in the Isolation Hospital, and the remaining six at their own homes. In 6 instances the evidence strongly favours their having contracted the disease outside the district; in 2 the contagion was attributed to oysters, but the source of infection in the other cases could not be traced. On one occasion only was there defective drainage and insanitary conditions found at the patients' residences in Wimbledon. The following are details of each case as far as obtainable : — Locality. Person attacked. Probable Source of Infection, and Remarks. Ridgway Gardens Female, aged 19. Unknown. Drains and sanitary arrangements of house perfect. Defective drainage where she had been staying up to commencement of illness. Wimbledon Hill Female, aged 37. No trace: sanitary conditions of house perfect. Beehive Buildings Female, aged 14. No trace; sanitary arrangements good. Church Road Male, aged 15. Unknown; insanitary defects found and remedied. Shell fish suspected. " Male, aged 17. Infected by previous case. " Male, aged 9. Infected by previous case. Haydons Road Male, aged 35. Cellarman in the West End. Sanitary arrangements at home in good order. Fish suspected. Fatal. 8 Locality. Person attacked. Probable Source of Infection, and Remarks. Merton Road Male, aged 41. Returned from seaside three days before notification. Drains choked and larder flooded where he had been staying before coming to Wimbledon. Fatal. " Male, aged 25. Probably contracted on troopship returning from South Africa. Sanitary arrangements perfect " Male, aged 11. No trace. Sanitary arrangements in good condition Dryden Road Male, aged 13. Was ill on return from seaside twelve days before notification Atkinson Morley Conval. Hosp. (Copse Hill) Male, aged 8. Contracted from previous case in same institution. Merton Road Male, aged 42. No evidence of infection. Sanitary arrangements good. Wandle Road a Male, aged 28. Employed in London. Sanitary arrangements of home in good order. Belvedere Grove Male, aged 35. By oysters. Fatal. Hartfield Road Female, aged 38. Attributed to oysters. Small Pox, The fear expressed in my report of last year that there was every probability of the small pox epidemic of London assuming more serious proportions in the following spring was verified, and that owing to the number of persons travelling to and from the Metropolis daily, this would probably be the means of introducing the disease in Wimbledon. Such was the case, and notifications with respect to 9 persons were received. !) I personally saw the patients before their removal to the Hospital, and immediately afterwards the Vaccination officer was informed (by telegram), as required by the Local Government Board, with a view to vaccination or re-vaccination being offered to all contacts. The Vaccination Officer of the Kingston Union then in turn communicated with the Public Vaccinator. I must bear testimony to the prompt manner with which the home of the patients and immediate neighbourhood were visited by the Vaccination Officer, yet would suggest that it would be well if the medical practitioner who is in attendance could undertake the vaccination of contacts, and be remunerated in the same manner as the Poor Iaw Medical Officers. Section 13 of the Vaccination Act (34 and 35 Vict., cap. 98) provides that District Medical Officers in attendance upon any person suffering from small pox should be entitled to payment from the Guardians for vaccinating or re-vaccinating (as the case may be) any person who is resident in the same house as the sick person, and who can lawfully be vaccinrted at the public expense. Seeing how necessary it is that the vaccination of contacts should be performed at once, I think it would be well if this provision were extended to all medical practitioners in attendance on small pox patients. Immediately after the patient's removal to the hospital the complete process of disinfection is carried out, viz. :—The bedding, etc., removed for steam disinfection, the rooms fumigated bv sulphur dioxide or formalin, according to circumstances, the wall paper soaked with a solution of perchloride of mercury, then stripped off and burnt in the room, the walls and ceilings whitewashed, and all floors, doors and woodwork thoroughly washed and cleansed. Further facilities should be provided to Medical Officers of Health and medical practitioners generally for obtaining Iymph of guaranteed efficiency, preferablv from Government sources. The amount of work thrown on the Sanitary Department cannot at all be judged by the number of cases. The system of inter-communication between Medical Officers of Health, wherebv they provide each other with lists of persons who have been in contact with small-pox patients in their districts, involves a 10 large amount of time and extra work. The persons named in the lists were visited daily until the quarantine period of 15 days had expired. At one time there were as many as 50 contacts. I was extremely pleased with the zeal, tact and promptitude with which each outbreak was dealt with bv the Sanitary Staff, and to this I chiefly attribute the gratifying fact that such outbreaks were limited to the initial cases. On March nth, together with the Chairman of the Sanitary Committee, Clerk, and Sanitary Inspector, I met Dr. E. Petronell Manby, Medical Inspector of the Local Government Board, in conference at the Council Offices, in respect to the steps being taken by the Council in the event of a serious outbreak of small pox. After discussing the matter from various standpoints, and showing the preparations made, he, in company with the Sanitary Inspector, visited the Isolation Hospital, the iron hospital, and disinfecting station, and was favourably impressed by the steps taken. On the next page are given particulars with respect to each case. The vaccination history and remarks as to attack are taken from the report on small pox by E. C. Seaton, M.D., Medical Officer of Health for the Surrey County Council, from a return prepared by the Resident Medical Officer of the Small Pox Hospital at Cheam. 11 Locality. Age Sex. Days in Hosp. Vaccination History. Remarks as to Attack. Results General Remarks 1 Balfour Road 36 Male 31 Infancy, not revac., 5 good scars, good area Discrete Recovered Insurance Agent. Had visited houses where Small Pox had occurred 2 Deburgh Road 21 22 Infancy, not revac., 5 good scars of good area Discrete " Fitter to S.W.R , Nine Elms. Infection not traced 3 A.M.O. Hosp , Copse Hill .. 27 " 31 Infancy, not revac , 4 good scars, good area Discrete, severe " Invalid. Contracted before leaving a Metropolitan Hospital 4 Norman Road . 26 Female 61 Infancy, not revac.. 3 fair scars of fair area Confluent, very severe " Wife of plumbei. C«»n tracted in Canning Town 5 Victory Road . 15 Male 28 Infancy, not revac., 4 good scars of good area Discrete, mild " Small Pox at place of business 6 Lower Downs Road 30 Female 18 Infancy, and 20 years ago, 6 good scars of very large area Discrete, mild Had visited Small Pox patients at Hornsey 7 Merton Road ... 28 it 16 Infancy, not revac., 2 gor d scars of good area Discrete, mild ' Infection not traced 8 Merton High Street 38 Male 45 Infancy, stated nol re-vaccinated, none could be seen Discrete, severe local confluence l abourer, contracted at Putney 9 Merton High Street 19 " At Redhill, twelve days previously 12 Notifications were received with respect to 1,026 patients, against 453 last year, and 1,067 in 1900, representing an attack rate of 23.6 per 1,000 of the population Eleven deaths were registered, all being children under 5 years of age, and in nine instances broncho-pneumonia was coupled with measles in the death certificate, in one bronchitis, and in another convulsions, equal to a case mortality of 1.07 per cent. The cases and deaths were divided amongst the age period as follows:-Under 1 year, 40 cases and 2 deaths; 1 to 5 years, 413 cases and 9 deaths; 5 to 15 years, 513 cases and no deaths; 15 to 25 years, 38 cases and no deaths; 25 to 65 years 13 cases and no deaths. Reference to Table 6 will show the streets in which the disease was most prevalent, and to Table 2 the number of notifications received in each month. A widespread epidemic of this disease commenced in January, increasing in numbers each month until it reached its height in June and July, 237 and 243 cases being notified in these two months respectively. It then decreased in August to 61 cases, and in September completely exhausted itself, there being only 5 cases in that month, and sporadic cases at intervals to the end of the year. An outbreak took place in the first 3 months of the year in North Wimbledon, and was principally confined to scholars attending private schools. Of the 101 children who attended school. 99 were from private schools, only 2 attending public elementary schools. On February 4th, a notification was received with respect to a scholar attending the High School for Girls, Mansel Road. Between the 13th and 18th of the same month 28 other scholars were notified, and an additional 34 between February 18th and March 21st, making a total of 63. The first notification of an outbreak of this disease at the Central Schools was received on March nth. followed bv 3 others exactly 10 days after, and between March 11th and April 11th 52 scholars of this school were affected. Measles 13 In May the disease was prevalent in South Wimbledon (South Park Ward), principally amongst the scholars of the Queen's and Effra Road Schools and Trinity School. All the departments of the Effra Road and Central Schools were closed for 2 weeks 10 prevent the spread of the disease. The South Wimbledon epidemic, which resulted in 8 deaths, fortunately occurred in the warm months of the year, otherwise the number of deaths would probably have been very much greater. In December, for instance, with only 12 cases, 3 ended fatally, whereas in May, June and July, with 609 cases, there were only 4 deaths. The following summary shows the schools principally affected, and the number of scholars notified as suffering from measles from each in June, July and August, in which months the greatest number occurred. Date Effra h'oRli Trinity Queen's Road. HayHon's Read. Dundonald Cnttenhain Park. Private June 81 47 17 15 7 5 40 July ... 8 24 31 24 17 10 August ... 2 2 1 1 ... 4 The difficulty of dealing with this disease was plainly illustrated on several occasions. A school or district which apparently enjoyed immunity from measles one week would have within the following three weeks a large proportion of its children affected. As the period for which the Local Government Board sanctioned the inclusion of meales in the list of compulsory notifiable infectious diseases for this district, under the Infectious Diseases Notification Act, 1899, would expire on June 27th, 1903. the matter was brought before the Sanitary Committee in order that it might consider the advisability or otherwise of continuing the compulsory notification of this disease. u I therefore reported thereon as follows: — October 17th, 1902. " Gentlemen, As regards placing measles in the schedule of notifiable diseases during another period of five years, I cannot express myself in favour of this proposition. I say this for two reasons, namely:—It has not during the last five years been the success I anticipated it would be in preventing the spread of the disease during epidemics, nor decreasing to any appreciable extent the mortality of the disease and its complications during those epidemics ; again, I have not very confident hopes of its doing so in the future on account of my inability to prevent its being spread in private day schools and Sunday schools, as the local authority are unable to close them when I consider such a proceeding necessary. The great point in favour of notification and inspection by the Sanitary Staff is that the parents become impressed with the idea that measles is not a trivial disease, and also that it has dangerous complications. Further, I would point out that as a rule the danger lies not in measles which is properly looked after, but in those cases which are neglected on account of their triviality, and where dangerous complications arise in the course of the illness. On the other hand, notification and visiting by the Sanitary Staff are nearly helpless to prevent the spread of the disease in epidemics, unless combined with a perfect system of isolation, which, in the present state of our accommodation is impossible. Another fact which I should point out to you is that, were we able, by notification, etc., to check the spread for a few years, we should have on our hands a large number of liable children to whom an epidemic would spread very rapidly when it eventually did occur, as would surely be the case. Again, the cost to the rates is somewhat high, but it is for you to judge as to whether this money has been well laid out or not. E. POCKLINGTON." 15 A return was furnished to the Committee by the Sanitary Inspector, Mr. Johnson, with a tabulated statement of replies to a circular which had been sent to local authorities where measles was or had been a notifiable disease, together with tables showing the amount paid for notifications, schools closed, and the death rates for the 5 years during which it had been notifiable, and the preceding 5 years. The 60 replies obtained showed that in 41 instances it nad been revoked, in 9 the opinions were doubtful, 5 considered it useless, and the remaining 5 stated that it was beneficial in jreventing excessive mortality. Measles, unlike scarlet fever, diphtheria, etc., is, as far as at present known, not conveyed by food, milk, water, neither do insanitary conditions directly affect it except in its mortality. It is a highly infectious disease, and easily propogated by the air, thus rendering its control by ordinary preventive measures which are sufficient in the other infectious diseases a matter of great difficulty. The greatest difficulty in preventing its spread lies in the fact that the incubation period, i.e., the time which elapses after a person has become infected and before the disease shows itself, is long, generally about ten or twelve days, but the rash, the only sure manner by which the disease is recognised, does not appear until four days after the patient has sickened. In consequence of this, and the fact that a child which is onl" in the incubation stage is infectious to others, it usually occurs that by the time the rash appears, and before the case is notified, other persons, including the members of the family, may have been exposed to infection for about eight days. These same difficulties do not exist in connection with scarlet fever, enteric fever, and diphtheria, consequently, on receiving notifications of these diseases, it may still be possible by prompt isolation to prevent the further spread of the disease. Six deaths were registered as having occurred from this disease, all of which were below 5 years of age, against 24 last year, 22 in 1900, and 21 in 1899. There were also 1^ deaths from enteritis, 10 of which were children under 1 year of age, against 8 last year, 12 in 1900, and 28 in 1899. 16 This is the lowest number which has been recorded since 1893, when the population was only 28,000, the average being 20 for the past 10 years. The small number of deaths from this disease may probably be accounted for by the coolness of the summer. Erysipelae Forty-six cases of this complaint were notified, and 3 deaths registered, against 52 cases and no deaths last year, and 40 cases and 3 deaths in 1900. Whooping Cougb. There were 17 deaths registered from whooping cough, as against 13 last year, and 5 in 1900. Eleven of the deaths were under 1 year of age, 4 between the ages of 1 and 5, and 2 between the ages of 5 and 15. Influenza. Influenza was the cause of six deaths, 2 occurring in February, 3 in March, and 1 in December. Tuberculosis Thirty-three deaths occurred from phthisis and other forms of tuberculosis, against 43 last year, and 25 in 1900. From Table 7 it will be seen that 75 per cent, of the deaths occurred between the ages of 25 and 55. The following Table shows the death-rate per thousand of the population from tuberculosis in Wimbledon during 1902, and the previous 10 years, with the averages for those years: — Year. Estimated Population. Number of Deaths. Death Rate. 1892 26,000 33 1.2 ig93 28,000 28 1 1894 30,000 34 1.1 189S 31,000 28 .9 1896 33,000 18 .8 1897 35.°°° 21 .6 1898 37.000 35 '.9 1899 38,000 40 1.05 1900 39.5°° 25 .6 1901 41,63° 43 1 .04 Averages for years 1892-1901. 33.913 37 1.1 1902 43,000 33 .7 17 Disinfection of the room, bedding, etc., has been carried out whenever requested by medical attendant or the family of the deceased. Puerperal Fever. Three cases of puerperal fever were notified during the year, one of which ended fatally. Iufani lie Mortality. The number of deaths of infants under one year of age who died during the year was 134, and is represented by a ratio of 117.13 deaths to 1,000 registered births, showing a satisfactory decrease of 6.7 from last year. It will be seen on reference to Table 5 that the infantile mortality rate for this year is 12.7 below the rate for the previous 10 years. Among the institutions in the District which have an effect on this mortality is the South Wimbledon Day Nurserv in Haydons Road, which continues and extends its beneficial operations. Isolation Hospital' During the year 155 patients were removed to the Hospital, 102 being notified as suffering from scarlet fever, 48 diphtheria, and 5 from typhoid fever. There were 7 deaths in the hospital, 6 being from diphtheria and 1 from typhoid fever. The percentage of admissions to notifications in the three classes of disease were as follows:—Scarlet fever, 79 per cent. ; diphtheria, Oo per cent. ; and typhoid fever, 31 per cent. If the 5 typhoid fever patients who were treated in the Cottage Hospital and Atkinson Morley's Convalescent Hospital are considered, the percentage of admissions to cases would be 62 in the disease. The following is a return of the Medical Officer for the Isolation Hospital, Dr. Clapham showing particulars of the patients treated in the Hospital during the year. Cases admitted in 1902 Over 5 years Under 5 years Tot. Deaths over 5 years. Deaths under 5 years. Total Deaths. Remarks. Scarlet Fever 79 23 102 ... ... ... Two of the fatal cases of Diphtheria had Tractotomy performed before admission, and died within 24 hours of admission. Diphtheria 29 20 49 2 4 6 Enteric Fever 5 0 5 1 .. 1 Measles 2 0 2 ... .. .. Septic Tonsillitis 1 0 1 ... ... ... Total 1 16 43 159 3 4 7 Daily average number of Patients 23.25 Cases carried from 1901 Scarlet Fever 6 4 10 Average length of detention in Hospital Diphtheria 8 3 11 Enteric Fever 1 1 Total number of cases treated during year 1902 47 days 130 5 1 181 3 4 7 31st January, 1903. (Signed) EDWARD CLA.PHAM, M.D., Medical Officer. 18 The number of patients admitted during each month of the year, and the totals for the previous four years is shown in the following Table :— Disease Age. January February March April May June July August September October November December Total. 1902 Total, 1901 Total. 1900 Total, 1899 Total, 1898 Scarlet Fever Unrler 5 1 2 5 ... 4 ... 1 1 ... 2 3 3 22 18 10 19 16 5 upwards 6 12 6 7 9 1 6 2 5 7 12 7 80 51 5 85 45 Diphtheria Under 5 2 3 1 2 ... 1 1 2 ... ... 1 3 16 11 1 ... ... 5 upwards 5 1 ... 2 ... 6 1 1 4 2 4 6 32 27 1 ... ... Typhoid Fever Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 5 upwards ... ... ... ... ... 1 ... 2 ... 1 1 ... 5 4 1 ... ... Total All ages 14 18 12 11 13 9 9 8 9 12 21 19 155 112 64 104 61 20 Croydon and Wimbledon Joint Small Pox Board. The Board in 1900 acquired between 50 and 60 acres of land at North Cheam, in the Epsom Rural District, about equal distances from Wimbledon and Croydon, on which a hospital, consisting of a large administrative block, two 24 bed pavilions, and one observation pavilion was erected. There is ample room, and provision has been made for extensions when required. The erection was so far completed as to be able to receive the 3 cases from this district in December last year, and the 9 patients this year. During the small pox epidemic, arrangements were made between the Joint Board and the Surrey County Council for the reception of patients from districts outside the Board's area. Negotiations which, for some time past have been taking place between the Board and the Urban District Council of Penge, for the purpose of including that district within the Joint Board's area, have been completed. Disinfection. The following Table shows the number of rooms and articles disinfected after each decease :— Diseases Rooms. Mattresses. Paliasses. Beds. Pillows and Bolsters. Blankets. Dresses. Suits. Other Articles Totals. Scarlet Fever 167 169 116 93 411 523 56 30 3227 4792 Typhoid Fever 4 17 12 5 47 48 ... ... 128 261 Diphtheria 86 71 58 62 255 227 35 19 1959 2772 Measles 42 61 16 6 104 151 14 22 1294 1710 Small Pox 30 55 30 8 84 85 9 8 606 915 Other Diseases 17 36 10 2 52 61 21 3 500 702 Totals 346 409 242 176 953 1095 135 82 7714 11152 There were twenty Library books disinfected. The disinfection of infected bedding, clothing, etc., which is removeable, is carried out at the disinfecting station adjoining 21 the hospital in Gap Road, by means of a steam disinfector, which can be used in a variety of ways, such as a simple hot air oven, with a current of hot air, as a low, or high pressure steam disinfector, or a low or high pressure "current" machine. After the fumigation of the infected rooms by the use of sulphur, sulphur and formalin candles, concentrated sulphur dioxide in metal cylinders, or the formalin spray, the owner or occupier is required to complete the process of disinfection by stripping the walls of paper, etc.. etc. Diagnostic Tests 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 22 39 61 Reaction obtained. Reaction not obtained. Total Typhoid (Blood) 4 3 7 Mortuary One hundred and five bodies were received into the Mortuary during the year, and 38 post mortems made (18 males. 20 females). Inquests were held by the Coroner with respect to 39 bodies, being equal to 8.5 per cent. of all deaths registered in the district. Dairies, Cowsheds and Milkshops At the close of the year the register contained the names of 7 cowkeepers and 48 dairvmen or purveyors of milk. During the year there were 5 dairymen registered. The whole of these premises have been periodically inspected, and generally found in fair order and condition. With few exceptions there appears to be every effort made by the persons registered to carry on their businesses in accordance with the regulations governing these premises. Minor breaches of regulations were discovered, but imme- 22 diately remedied when the occupiers' attention was called, in two instances only it being found necessary to serve notices in order to enforce compliance. At one cowshed on two or three occasions more cows were found to be kept than is permissible reducing the cubical air space below the standard required. This was remedied by diminishing the number of cows. The circular sent to cowkeepers drawing their attention to the necessity of limewashing their cowsheds twice a year was promptly complied with. One large cowshed, and probably the best in the district as regards construction, situation and surroundings, has been disused. Slaughter houses. The number of premises on the Register of Slaughterhouses is six, one of which has not been used as such for some years, at two others the business is carried on at irregular intervals, and the remaining three are in constant use. All of these have been inspected frequently, both day and night, when the business is in progress, and the bye-laws respecting the removal of offal, periodical limewashing, cleansing of premises, water supply, etc., enforced. The drainage system of one of these buildings has been entirely re-constructed (in iron), also the house to which it is attached, the internal surface of the walls of the slaughterhouse to about 6 feet from the floor level faced with glazed bricks, a good concrete floor laid down, and the yard cement paved. Common Lodging Houses. For some considerable time I had reason to believe that a portion of the premises 186-188, High Street, Merton, were being used as a common lodging house, and the matter had been before the Sanitary Committee some three years ago, but it was felt that the evidence was insufficient at that time. A case of small pox occurred here in June, and, during the process of removing and returning the bedding and disinfection of the premises, which occupied a great part of the day and night, notes were taken by the Sanitary Inspector as to the number and sex of occupants. From observations made in the early morning, 35 persons were found to have slept there. Some of the apartments were cubicles, and others large bedrooms with 4 or 5 beds each, all of which were in a filthy condition. The Sanitary Committee gave instructions for a summons to be applied for 23 against the proprietor for keeping a common lodging house without being registered as such. The defendant did not appear, and the case was adjourned for a fortnight. At the second hearing, the magistrates, after hearing evidence, decided to convict, and fined him. The proprietor then made application for the house to be placed on the register for common lodging houses, but, before this could be done, structural alterations were necessary to provide proper light and ventilation for the premises. After considerable delay these were executed, and, on December 10th, the part of the building situated in Hardy Road was registered. Overcrowding. Complaints, some anonymous, were received, alleging overcrowding. Careful observations were continually made of the premises, and night visits paid frequently. In seven instances notices were served for the abatement of the nuisance, 2 respecting workrooms, and 5 dwelling houses. Complaints are from time to time being received in respect to certain property in South Wimbledon, which is modern, well built, with good sanitary arrangements, and provided with baths, but, owing to the want of cleanliness on the part of the tenants, who are constantly changing, the houses are usually in an unwholesome condition. Housing of the Working Classes Act, 1890. It will be remembered that proceedings were taken last year against the owners of the property, Nos. 2 to 11, Thornton Road, and Nos. 2 to 14, South Place, application being made to the magistrates for a closing order, as the owners had not complied with the notice requiring them to make the said premises fit for human habitation. When the counsel for the defendants undertook that the houses should be made habitable, the Bench adjourned the summons for three months for this to be done. The period elapsed, but no steps were taken to carry out any alterations to the premises, and on January 23rd the solicitors for the defendant wrote asking if the Council would agree to a further adjournment of three months, in order that the necessary arrangements might be made by them for pulling down and rebuilding the property. This period was again extended in May, and, from time to time since. The houses, with two exceptions, are now unoccupied, the sites of several cleared and new buildings erected. 24 Rig ht of Entry- High School for Girls. Man Bel Road. The appeal of the Council mentioned in my last year's report against the decision of the Surrey Quarter Sessions at Kingston, given on January 3rd, 1902, was heard in the Court of King's Bench on June 24th, before the Lord Chief Justice, Mr. Justice Darling and Mr. Justice Channell. Mr. A. Russell, K.C., and Mr. Humphreys appeared for the Council ; and Mr. Macmorran, K.C., and Mr. Daldy for the respondent. Mr. Macmorran contended that the provisions of the Public Health Act, 1875, only applied to dwelling-houses, and that this, being a day school, was not a dwelling-house, nor were the scholars " inmates." He also urged that the magistrates ought not to have rejected evidence on the application for the order to admit, which was tendered to show that a less number of pupils were in the class-room than was alleged, they having held that the only matters they had to inquire into were the complaint and the refusal to admit. The Lord Chief Justice said that by the interpretation clause (Section 4), "house" included schools and factories, and prima facie there was no reason why the Act should not apply. In face of " R. v. Mead" (64 L.J., M.C., 169), he did not think the word should be limited to dwelling-house. As to the rejection of evience, the magistrates might have to consider whether there is reasonable ground to suspect a nuisance before making an order, and ought not, therefore, to reject evidence on that point. The case would, therefore, go back to the magistrates for them to hear the evidence if necessary. Mr. Justice Darling and Mr. Justice Channell concurred. The Day School Company belonging to the High School have extended their accommodation for scholars between the ages of 4 and 8, by taking the premises, No. 76, Wimbledon Hill, is a preparatory division, and, whatever might have been the condition of affairs when the complaint was received, there is little probability that the premises would now be found overcrowded. The Council's object having been attained, the necessity for taking the case further ceased. At the Surrey Quarter Sessions on January 7th, 1903, an application was made by Mr. George Humphreys, on behalf of the Urban District Council, for the return to the Local Authority of the sum of £49 4s. 5d.. which had been paid by the Council to the Clerk of the Peace under an order of Court of Quarter Sessions. 25 Mr. Humphreys stated that the money was paid upon an order of that Court, dated 3rd January, 1902, the amount being the costs allowed the appellant. That Court stated a case for the opinion of the Divisional Court, and their Lordships in the Higher Court ordered the appeal to be allowed, the order of Quarter Sessions set aside, and remitted the case to that Court for lehearing. The Chairman (Mr. George Cave) said that the Council was clearly entitled to the money. This decision of the High Court will undoubtedly be of great service to local authorities in similar cases, as it decides the important points that schools are houses, and the scholars inmates of them. Factory and Workshop Act, 1901. This Act, which came into force on January 1st, 1902, was for one of its principle functions the consolidation of previous Acts, which were very complicated and confusing. Early in the year a circular was issued from the Home Office to local authorities explaining these new powers and duties imposed on them. The principal points in that circular are as follows:— FACTORIES. In the case of factories the duties of District Councils are few, the most important of which is, seeing that every factory in which more than 40 persons are employed, is provided with sufficient means of escape in case of fire. If the construction of the building is after January 1st, 1892, it must be furnished with a certificate from the District Council in whose district it is situated that sufficient means of escape are provided. In all other cases in which more than 40 persons are employed it is the District Council's duty to ascertain whether such means are provided, and, if not, to take steps to enforce such provisions. Power is also given to make bye-laws requiring the provision of means of escape from fire in the case of any factory (subject to confirmation by the Local Government Board), and under these, factories where less than 40 persons are employed can be dealt with. In districts where Part III of the Public Health Acts Amendment Act, 1890, has been adopted, which is the case in 26 don, the enforcement of the requirements in Section 22 of that Act, as to the provision of suitable and sufficient sanitary conveniences, rests with the local authority, but the factory inspector is responsible for the sanitary conditions, which include cleanliness, air space, ventilation, drainage of floors, etc. WORKSHOPS AND WORKPLACES. With regard to workshops and workplaces, District Councils have important duties, which may be classified under four heads. —(1) General sanitation ; (2) provision of means of escape from fire ; (3) special sanitary regulations for bakehouses ; (4) homework. 1.—Sanitation.—This included cleanliness, air space, ventilation, drainage of floors, and sanitary accommodation. The general provisions regarding ventilation are supplemented in the case of workshops by a special requirement, introduced for the first time by this Act, requiring that in every room in a workshop sufficient means of ventilation must be provided and maintained, and where a standard of ventilation has been prescribed by the Secretary of State (as he has power to do) for any class of workshops, that standard must be observed. Drainage of floors is a new provision, and requires that in every workshop, in which any process is carried on which renders the floor liable to be wet to such an extent that the wet can be removed by drainage, adequate means shall be provided. These last two provisions, viz., ventilation and drainage of floors, do not apply to workshops where men only are employed. Respecting sanitary accommodation, where Part III of the Public Health Amendment Act, 1890, has been adopted, every workshop or manufactory, or where persons are employed in any trade or business, must be provided with sufficient and suitable accommodation in the way of sanitary conveniences. The Home Secretary has recently circulated draft of an order under Section q of the Act, showing what sanitary accommodation will be deemed suitable and sufficient. 2.—Fire Escape.—These provisions are similar to those required in factories where more than 40 persons are employed. 3.—Bakehouses.—In addition to the provisions as regards bakehouses hitherto enforced, the following new duties are placed by Section 101 on District Councils with respect to underground bakehouses: — 27 (i) The Act provides that 1.0 underground bakehouse shall be used as such unless it was so used on the 17th August last; (ii) Moreover, after 1st January, 1904, it will not be lawful to use any underground bakehouse (whenever established) unless the Council are satisfied it is suitable for the purpose, in regard to construction, light, ventilation, and in all other respects, and have given it a certificate of suitability. This applies to all bakehouses, whether wholesale or retail. Every bakehouse will be deemed underground if any room used for baking, or for any process incidental thereto, is so situate that the surface of the floor is more than three feet below the surface of the adjoining street, or of the ground adjoining or nearest to the room. An underground bakehouse used in contravention of these provisions will be deemed to be a workshop not kept in conformity with the Act. 4.—Homework.—Very important powers of controlling the conditions under which certain classes of work are done in the homes of the workers, are for the first time given to District Councils by the Act. These powers aim at the prevention of home work being done, (1) in dwellings which are injurious or dangerous to the health of the workers themselves, e.g., through overcrowding, want of ventilation, or other insanitary conditions ; (2) in premises where there is dangerous infectious disease. Occupiers of factories, workshops, or any place from which work is given out, and contractors employed by such occupiers are required, in regard to such classes of work as may be fixed by the Secretary of State, to keep lists showing the names and addresses of all persons employed by them, either as workmen or as contractors outside such factory, workshop or place, and the place where they are employed, and to send to the Council twice a year. These are to be examined, and the names and places of employment of outworkers residing in other districts to be furnished to the Council of those districts. Workplace is not defined in the Act, but in a case under the Public Health (London) Act, 1891, where the same phrase as in this Act occurs, viz: "factory, workshop and workplace," it was 28 held that the word is not to be limited to places where something is being manufactured or made, but includes any "place where work is done permanently, and where people assemble together to do work permanently of some kind or other." It is, therefore, a word of wider signification than the word "workshop." In the case in question a stable and stable yard where men were employed as cab cleaners and horse keepers was held to be a workplace. DOMESTIC FACTORIES AND WORKSHOPS. This class is defined as a private house, room, or place, which, though used as a dwelling, is by reason of the work carried on there, a factory or workshop as the case may be within the meaning of the Act, and in which no mechanical power is used, and in which the only persons employed are members of the same family dwelling therein. Further, it is necessary that the work should be carried on regularly, and provide the whole or principle means of living to the family. These are exempt from many of the provisions of the Act, but, so far as sanitary conditions are concerned, they are to be treated as ordinary workshops. The District Council is to keep a register of all workshops situated within their district, and the Medical Officer of Health is required in his annual report to them to report specifically on the administration of the Act in workshops and workplaces as far as the matters under the charge of the Council are concerned, and to send a copy of such report on the subject to the Secretary of State. Report to Secretary of Stats. As required by section 132 of the Act, I forwarded my report on the administration in respect to workshops and workplaces of the Secretary of State, as below. In February, the Clerk and Solicitor to the Council, Mr. R. H. S. Butterworth, presented a report to the Sanitary Committee on the Act, and the powers and duties of the Council thereunder. At the March Meeting, the Sanitary Inspector submitted a report recommending a re-arrangement of the staff in his department, in order to meet the additional work thrown on that department, in carrying out the provisions of the Act. Mr. E. S. Robinson was appointed Second Assistant Inspector, and the duty of inspecting the premises, together with the making of the register, allocated to him. The work was then 29 proceeded with, and the particulars taken included the measuring and obtaining the cubic capacity of each workroom. the method and efficiency of ventilation, the number of persons employed, and outworkers, if any, the provision and condition of sanitary conveniences, general condition of the premises as to cleanliness, nuisances from drains, etc., etc. Of the premises visited, 210 require to be placed on the register, viz:—Boot repairers 30, cabinet makers and upholsterers 7, cycle repairers 12, dressmakers 41, ironmongers and smiths 7, laundries 37, milliners 15, printers 8, tailors 13, watch repairers 9, and other trades 31. The lists of outworkers received were examined, and the places of employment ot the persons in this district inspected. At 15 workshops where either women, young persons or children were employed, and no abstracts affixed, the Factory Department were communicated with. This work progressed for some time, but had to be suspended in consequence of an epidemic of measles, which required the services of the available staff. Mr. Kramm, Assistant Inspector, cbtained an appointment elsewhere, and during the period which elapsed between him leaving and the appointment of a successor, nearly three months, his work of general inspection was carried out by the Workshop Inspector. During the coming year, I anticipate the completion of the register, when the re-inspections can be commenced. In the course of inspection, insanitary conditions which, but for this Act, might have existed for a considerable period, were found, and steps taken for their abatement. Bakehouses. The usual half-yearly inspections of these were made, and in all except 5, the requirements of the Act as regards cleansing, limewashing of walls, etc., had been complied with, those tn default carrying out the necessary work after written notice. The number of these premises on the register remains the same as last year, viz., 25, 19 of which are above ground level, and 6 underground. The latter cannot be used as bakehouses after the 1st January, 1904, unless the Sanitary Authority certify them to be suitable for the purpose as regards construction, light, ventilation, and in all other respects. 30 They have been inspected by myself once, and by the Sanitary Inspector several times, with a desire to help the occupies by advising upon any suggestions made by them for alterations to their bakehouses, with a view to obtaining the necessary certificate of fitness. House Refuse Collection and Disposal The alterations at the Electric Lighting Station, which prevented the working of the Refuse Destructor, were completed during the year, since which time the whole of the sludge from the sewage presses and the house refuse has been burnt practically as produced. In consequence of the duplication of work involved in the investigation of complaints of non-removal of dust, both by the Surveyor's and Sanitary Departments, it was decided that for the future this should be dealt with by the former, by whom the weekly collection is supervised. The large quantity of house refuse (in respect to which several complaints were received) which had accumulated on the Sewage Farm during the alterations at the Electrical Generating Station, is being removed and used for the purpose of making up a low lying portion of the farm. Paving of Yards The carrying out of this work has again received considerable attention. The portion of the yards immediately around ihe walls of the back additions of 101 houses has been paved with cement or tar-paving, usually of a width of not less than 3 feet, and is a great benefit to the health and comfort of the tenant. House Drainage The drains of 142 houses and premises have been entirely re-constructed, and laid to stand the water test, with manholes, etc., for inspection and cleaning purposes. 31 The following blocks of houses nave been re-drained: — 75 to 83 Graham Road, 5 houses. 41 to 46, Denmark Road, 6 houses. 52 to 68, Deburgh Road, 9 houses. 1 to 19, Milton Road, 10 houses. * 241 243, Queen's Road, 2 houses. 108 to 114, Gladstone Road, 4 houses. 20 to 38, Leyton Road, 10 houses. 116 to 120, Gladstone Road, 3 houses. 33 to 37, Norman Road, 3 houses. 1 to 11, Newton Road, 6 houses. 83 to 97, Haydons Road, 4 houses. 2 to 18, Leyton Road, 9 houses. 17 to 23, Palmerston Road, 4 houses. 39, 41, 47, 49, Hartfield Crescent, 4 houses. 14, 15, 16, The Broadway, 3 houses. ** 80 to 86, Norman Road, 4 houses. 119 to 123, Hartfield Road, 3 houses. * 31, 33, Hartfield Crescent, 2 houses. The joint drain between Nos. 31 and 33, Hartfield Crescent, was re-constructed by the Council in default of the owners, one of whom contended it was a sewer. A summons was issued for the recovery of the costs incurred in executing the work. At the hearing in November, after considerable legal arguments and technical objections as to the form of notice served, etc., the Magistrates reserved judgment, and, on December 10th, gave their decision in the Council's favour on all points raised. * The main drain reconstructed by the Council at the cost of the owners, they having made default in complying with the notices served upon them. * * The main drain, reconstructed by the Council as a sewer within the meaning of the Public Health Act, 1875. 32 1 cannot close my report without bearing testimony to the great zeal and energy displayed by Mr. Johnson. During the past year the work of the department has very materially increased, owing to the small pox outbreak, and the new Act relating to workshops, etc. Although this increase has taken place, I can say with confidence, that all new responsibility has been thoroughly met, and there has been no falling off in the high state of efficiency of the work generally. Again I have the pleasure of tendering my sincere thanks to Mr. Johnson and the Staff for their great assistance, and I am of opinion that the manner in which my instructions were executed in regard to small pox patients and contacts in all probability prevented a much more severe outbreak in Wimbledon. I have the honour to be, Your obedient servant, E. POCKLINGTON. Medical Officer of Health. TABLE 1. The following is a summary of the nuisances abated and sanitary improvements made under the supervision of Mr. Johnson, the Sanitary Inspector Animals Removed 12 Accumulations Removed 57 Cisterns Provided 14 Cisterns Cleansed or Covered 90 Cisterns Repaired 13 Drain Stoppages Removed 93 Dust Bins Provided 63 Dust Bins Repaired 3 Dilapidated Houses Repaired 1 Drains, New, Provided 142 Drains, Repaired and Altered 81 Flushing Boxes, New, Provided 199 Flushing Boxes Repaired 61 Guttering and Spouting Provided 7 Guttering and Spouting Repaired 32 Houses, Sites Concreted 2 Manure Receptacles Provided 20 Overcrowding Nuisances Abated 7 R.W. Pipes and Waste Pipes Disconnected 85 Roofs, Leaky, Repaired 50 Rooms Disinfected 346 Rooms Cleansed and Whitewashed 122 Smoke Nuisances Abated 1 Soil Pipes, New, Provided 41 Urinals, Water Laid on, Cleansed, etc. 7 Ventilating Pipes, New, Provided 197 Ventilating Pipes Repaired 47 Waste Pipes Trapped and Repaired 70 Water Closets, Container Pattern, Removed 3 Water Closets, New, Provided 227 Water Closets, Repaired and Ventilated 35 Water Service Restored 47 Yards Cleansed 80 Yards Paved 101 Total 2356 TABLE 2 -Table showing 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, 1902, Total, 1901. Total, 1900. Small Pox under 5 ... ... ... ... ... ... ... ... ... ... ... 9 3 1 5 upw'rds ... 1 ... 3 4 1 ... ... ... ... ... ... Diphtheria under 5 3 5 3 2 ... 1 2 4 ... ... 4 5 80 60 64 5 upw'rds 6 3 5 2 1 6 1 1 7 7 6 6 Erysipelas under 5 ... ... ... 1 1 ... 2 ... 1 1 ... ... 46 52 49 5 upw'rds 1 2 3 4 1 2 4 4 2 7 5 5 Scarlet Fever under 5 3 3 6 1 7 1 1 1 1 3 3 3 128 90 112 5 upw'rds 8 12 6 8 9 1 5 3 7 11 17 8 Typhoid under 5 ... ... ... ... ... ... ... ... ... ... 1 ... 16 12 20 5 upw'rds ... 1 ... ... ... 3 3 3 ... ... 3 1 Puerperal Fever under 5 ... ... ... ... ... ... ... ... ... ... ... ... 3 2 ... 5 upw'rds ... 1 ... ... ... ... ... 1 ... ... 1 ... Measles under 5 9 18 28 45 45 128 135 42 3 1 1 5 1026 453 1069 1.5 upw'rds 14 73 69 90 84 109 98 19 2 ... 1 7 *Chicken Pox under 5 ... 14 10 12 11 8 13 ... ... ... ... ... 170 ... ... 5 upw'rds ... 22 20 ... 9 20 18 ... ... ... ... ... Totals under 5 15 40 47 61 64 138 53 47 5 5 9 16 600 289 522 5 upw'rds 29 115 103 120 108 142 129 31 18 26 33 24 878 383 793 44 155 150 181 172 280 282 78 23 31 42 40 1478 672 1315 * Notifiable from February 3rd until July 22nd, 1902. TABLE 3. Cases of Infectious Diseases notified during the Year 1902. Notifiable Diseases. Cases Notified in whole District Population at Census 1901 — 41,631. Cases Notified in each Locality. No. of Cases Removed to Hospital from each Locality. Atkinson Morleys Hospital. Cottage Hospital, N. Wimbledon. Cottage Hospital, S. Wimbledon. Whole District Atkinson Morley's Hospital. Cottage Hospital, N. Wimbledon. Cottage Hospital, S. Wimbledon, At all Ages. Under 1 1 to 5 5 to 15 15 to 25 25 to 65 65 and upwards Small Pox 9 ... ... ... 3 6 ... 1 ... ... 9 1 ... ... Diphtharia 80 ... 30 37 6 7 ... ... ... ... 48 ... ... ... Erysipelas 46 5 1 4 1 32 3 ... ... ... ... ... ... ... Scarlet Fever 128 1 32 76 12 7 ... ... ... ... 102 ... ... ... Enteric Fever 16 ... 1 7 1 7 ... 1 ... ... 5 1 ... ... Puerperal Fever 3 ... ... ... ... 3 ... ... ... ... ... ... ... ... Measles 1026 49 413 513 38 13 ... ... ... ... ... ... ... ... Chicken Pox 170 5 63 96 5 1 ... ... ... ... ... ... ... ... Totals 1478 60 540 733 66 76 3 2 0 0 164 2 0 0 The Isolation Hospital for Scarlet Fever, Enteric Fever, and Diphtheria Patients is situated in Gap Road, Wimbledon, and the Hospital for Small Pox (Croydon and Wimbledon Joint board) at Cheam. TABLE 4 Table of Deaths during the year 1902, in the Urban Sanitary District of Wimbledon, Classified according to Diseases, Ages and Localities. LOCALITIES. Mortality from all causes at subjoined ages. Mortality from subjoined causes, distinguishing deaths of children under 5 years of age. At all Ages Under 1 year 1 and under 5 5 and under 15 15 and under 25 25 and under 65 65 and upwards 1 2 3 4 5 6 7 8 9 10 11 Public Institutions being shown as seperate localities. Scarlatina Diphtheria Measles Whooping Cough Diarrhoea and Dysentery Phthis Bronchitis, Pneumonia & Pleurisv Heart Disease Injuries All other Diseases Total (a) (b) (C) (d) (e) (f) (g) (h) (i) Wimbledon 434 131 41 11 15 130 106 Under 5 ... ... 11 15 6 1 34 1 2 102 172 5 upwards ... 1 ... 2 ... 21 48 50 6 134 262 Atkinson Morley's Hpl. 1 ... ... ... ... 1 ... Under 5 ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... ... ... ... ... ... 1 1 Cottage Hospital (North Wimbledon) 5 ... ... 1 ... 3 1 Under 5 ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... ... ... 1 1 1 2 5 Cottage Hospital (South Wimbledon) 8 3 1 1 ... 3 ... Under 5 ... ... ... ... ... ... ... ... 1 3 4 5 upwards ... ... ... ... ... ... 1 ... 1 2 4 Isolation Hospital (Gap Road) 7 ... 4 2 ... 1 ... Under 5 ... ... ... ... ... ... ... ... ... ... 4 5 upwards ... 2 ... ... ... ... ... ... ... 1 3 Totals 455 134 46 15 15 138 107 Under 5 ... 4 11 15 6 1 34 1 3 105 180 5 upwards ... 3 ... 2 ... 21 50 51 8 140 275 The subjoined numbers have also beeu taken into account in judging of the above recerds of mortality. Deaths occurring outside the district among persons belonging thereto. 46 2 1 ... 1 19 23 Under 5 ... ... ... ... ... ... ... ... ... 3 3 5 upwards ... ... ... ... ... 4 3 10 ... 26 43 Deaths occurring within the district among persons not belonging thereto. 4 1 ... ... ... 3 ... Under5 ... ... ... ... ... ... ... ... 1 ... 1 5 upwards ... ... ... ... ... ... ... ... ... 3 3 TABLE 5 Table showing Vital Statistics for 1902 and previous 10 years. Year. Population estimated to Middle of Each Year Births. Total Deaths Registered in the District Total Deaths in Publics Institutions in the District. Deaths of Nonresi dents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyondthe District Nett Deaths at all Ages belonging to the District. Number. Rate* Under 1 Year of Age At all Ages. Number. Rate per 1000 Births registered Number. Rate.* Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1892 26,000 738 28.3 90 114.94 333 12.8 No records for these years. 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 1898 37,000 963 26.02 145 150.57 415 11.2 11 5 32 442 11.9 1899 38,000 1031 27.13 163 158.09 547 14.3 18 12 31 568 14.9 1900 39,500 1075 27.21 156 145.11 559 14.1 18 13 24 570 14.4 1901 41,631 1074 25.79 133 123.85 457 10.9 20 4 40 493 11.8 Averages for years 1892-1901. 33,913 901 26.52 117 129.85 407 12 12 6 27 458 13.5 1902 43,000 1144 26.6 134 117.13 455 10.5 21 4 46 497 11.5 * Rates in Columns 4, 8 and 13 calculated per 1,000 of estimated population. By the term "Non-residents," is meant persons brought into the district on account of sickness or infirmity, and dying in public institutions there; and by the term "Residents," is meant persons who have been taken out of the district on account of sickness or infirmity, and have died in public institutions elsewhere. Area of District in Acres (exclusive of area covered by water) 3,173 Number of inhabited houses (at Census of 1901) 7,572 Total population at all ages (at Census of 1901) 41,631 Average number of persons per house „ 5.49 TABLE 6. DISTRIBUTION AND PARTICULARS OF INFECTIOUS CASES NOTIFIED. Diseases. Alexandra Road. Amity Grove. Arterberry Road. Arthur Road Atkinson Morley's Hospital. Belvedere Drive. Berkeley Place. Bernard Gardens. Broadway. Caroline Road. Caxton Road. Church Hill. Church Road. Cochrane Road. Common. Coombe Lane. Copper Mill Lane. Cottenham Park Road Courthope Villas. Cowper Road. Crescent Road. Cromwell Road. Crooked Billett. Cross Road. Deburgh Road. Delamere Road. Denmark Avenue. Denmark Road. Derby Road. Downs, (The) Dryden Road. Dundonald Road. Durham Road. Durnsford Road. East Road. Edge Hill. Small Pox under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .. ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upw'rds ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... Chicken Pox under 5 1 7 ... ... ... ... ... ... ... ... ... ... ... 5 1 ... ... ... 1 ... .. ... ... ... 2 ... ... 1 ... ... ... 2 1 ... 1 ... 5 upw'rds 2 6 ... ... ... ... ... ... ... ... 1 ... 2 ... 1 ... ... ... ... 1 1 1 1 ... ... ... ... 2 ... ... 1 1 3 ... ... ... Diphtheria under 5 2 2 . ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 ... 5 upw'rds ... 5 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 ... Measles under 5 ... 16 ... 2 ... ... ... ... 1 7 3 ... 5 3 9 1 1 ... 1 5 ... 2 5 2 8 2 ... 5 1 3 8 14 13 1 ... ... 5 upw'rds 4 10 3 4 ... ... ... ... 3 1 1 ... 9 1 10 2 1 1 1 2 1 9 9 ... 2 1 5 16 2 13 3 7 6 5 1 1 Erysipelas under 5 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upw'rds 2 ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... 4 ... ... ... ... ... 1 ... ... Scarlet Fever under 5 ... ... ... ... ... ... ... 1 ... ... ... ... ... 2 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 5 upw'rds ... ... ... ... ... 1 ... ... 1 ... 4 ... 1 ... ... ... ... 2 1 ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... Enteric or Typhoid under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 5 upw'rds ... ... ... ... 1 ... ... ... ... ... ... 1 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upw'rds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals under 5 3 25 ... 2 ... ... ... 1 1 9 3 ... 5 10 10 1 1 ... 2 5 ... 3 5 2 10 2 ... 6 1 3 8 17 15 1 3 ... 5 upw'rds 8 21 3 4 2 1 1 ... 5 2 7 1 14 1 11 2 1 3 4 4 2 10 10 ... 4 1 5 24 2 13 6 8 10 6 2 1 TABLE 6. -cont1nued D1seases. Effra Road. Ethelbert Road. Evelyn Road. Fa1rlawn Road. Faraday Road. Florence Road. Franc1s Grove. Gap Road. Ga1t1eld Road. G1lbert Road. Gladstone Road. Goodenough Road. Graham Road. Grange (The) Granv1lle Road. Gr1ff1ths Road. Grosvenor H1ll. Ham1lton Road. Harcourt Road. Hardy Road. Hartf1eld Crescent. Hartf1eld Road. Havelock Road. Haydon Park Road. Haydon Park Terrace. Haydons Road. Herbert Road. H1gh street, W1mbledon. H1gh Street, Merton. H1ll Road. H1ll S1de. Home Park Road. Hotham Road Hubert Road. Ken1lworth Avenue. K1ngs Road. K1ngston Road. K1ngswood Road. Klondyke Road. Kohat Road, Lamlton Road. Lancaster Place. Lancaster Road. Small Pox under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upw'rds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .. ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ch1cken Pox under 5 1 ... 1 ... ... 4 ... ... ... ... 3 1 1 ... ... ... ... 1 ... 1 1 ... 2 ... ... 4 ... ... ... ... ... ... 1 ... ... ... ... 2 ... ... ... ... ... 5 upw'rds 1 ... 1 ... ... 5 ... 2 ... ... ... 1 1 ... ... 3 ... 1 ... 2 ... 4 1 1 ... 3 ... ... 1 1 ... ... 1 ... 1 ... ... 1 ... ... ... ... ... D1phther1a under 5 ... ... ... ... ... 1 ... ... ... ... ... 1 1 ... ... ... ... ... ... ... 1 ... ... 2 ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... 5 upw'rds 1 ... 1 ... ... 4 ... ... ... ... 3 1 3 1 ... 1 ... ... ... 1 1 ... ... ... ... 2 ... 1 ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... Measles under 5 5 2 6 ... 5 26 ... 1 ... 1 7 3 4 ... 2 5 ... 5 2 3 9 3 5 5 ... 20 ... 5 1 ... ... 1 5 1 1 1 5 2 4 2 6 ... ... 5 upw'rds 4 4 2 ... 4 20 1 2 ... ... 9 3 8 1 1 4 ... 1 2 9 2 8 4 8 ... 21 2 5 3 2 ... 1 2 3 9 5 5 1 2 5 7 2 2 Erys1pelas under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upw'rds 2 ... 1 ... ... 1 ... ... ... ... 3 1 ... ... ... ... ... ... ... 1 ... 4 1 ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... Scarlet Fever under 5 ... ... ... 1 ... 2 ... ... ... ... ... 2 ... ... ... 1 ... ... ... ... ... ... ... ... 1 2 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upw'rds 2 1 1 ... 1 6 ... 2 1 ... 2 4 ... ... ... 2 1 ... ... 3 2 1 1 4 ... 3 1 5 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 Enter1c or Typho1d under 5 ... ... ... ... ... ... . . ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upw'rds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upw'rds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... Totals under 5 6 2 7 1 5 33 ... 1 ... 1 10 7 6 ... 2 6 ... 6 2 4 12 3 7 7 1 27 1 6 2 ... ... 1 6 1 1 1 5 4 5 3 6 ... ... 5 upw'rds 10 5 6 ... 5 36 1 6 1 ... 17 10 12 2 1 10 1 2 2 16 5 18 7 13 ... 32 3 11 7 3 1 1 3 3 11 7 6 2 2 5 8 2 3 TABLE 6. —cont1nued D1seases. Landgrove Road. Lansdown Road. Lat1mer Road. Laur1ston Road. Leopold Road. Leyton Road. L1ngf1eld Road. Lower Downs Road. Mansel Road. Merton Road. Merton Hall Road. M1lton Road. Montague Road. Nelson Road. Newton Road. Norman Road. North Road. Oldf1eld Road. Palmerston Grove. Palmerston Road. Pelham Road Pepys Road. Pr1nces Road. Queen's Road. Qu1cks Road. Ra1lway Place. Rayle1gh Road. R1chmond Road. R1dgway. R1dgway Gardens. R1dgway Place. R1dley Road. Rostrevor Road. Russell Road. Sal1sbury Road. South Place. South Road. Southey Road. Southdown Road. South Park Road. Spencer H1ll. Spencer H1ll Road. Spr1ngf1eld Road. Small Pox under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upw'rds ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ch1cken Pox under 5 1 ... ... ... ... ... ... ... ... 1 2 3 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 2 ... ... ... 1 ... ... 1 ... ... 1 1 ... ... ... 5 upw'rds 2 1 ... 2 ... ... 1 ... ... 3 2 3 1 ... 2 ... ... 3 ... 1 1 ... ... ... ... ... ... ... 4 ... ... 1 ... 1 ... 1 ... ... ... 1 ... 1 ... Diphtheria under 5 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... ... ... 2 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 5 upw'rds ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... ... ... Measles under 5 ... ... 2 2 ... ... ... ... 1 3 ... 10 1 2 3 1 2 1 2 8 10 ... 2 2 10 1 1 ... 2 ... ... 3 ... 15 ... ... 7 ... ... l6 3 ... ... 5 upw'rds 1 1 ... 9 1 ... ... 2 9 3 4 7 2 8 2 2 ... 3 1 4 8 6 4 3 7 ... ... 3 8 2 3 6 ... 5 1 2 ... ... ... 14 9 ... 3 Erys1pelas 5 under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upw'rds ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 2 ... ... ... Scarlet Fever under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 1 ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... 2 ... 2 ... ... 1 ... ... 1 ... ... ... 5 upw'rds ... ... 1 1 ... ... ... ... ... ... 1 ... ... 3 1 1 ... ... 1 ... ... ... ... 1 1 ... ... ... ... ... ... ... ... 1 ... 1 1 1 ... 3 ... ... ... Enter1c or Typho1d under 5 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upw'rds ... ... ... ... ... ... ... ... ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upw'rds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals under 5 1 ... 2 2 ... ... ... ... 1 5 2 14 1 4 5 2 2 1 2 11 10 1 2 5 11 1 1 ... 4 ... ... 5 1 18 ... 1 8 ... 1 18 3 ... ... 5 upw'rds 3 2 1 12 1 2 1 3 9 10 8 10 3 12 5 4 ... 6 2 5 13 7 4 6 8 ... ... 3 12 3 3 7 ... 7 1 4 2 1 1 22 9 1 3 TABLE 6.-cont1nued D1seases. Stanley Road. St. George's Road. St. Mary's Road. Sunnys1de. Tabor Grove. Tennyson Road. Thornton H1ll. Thornton Road. Thurston Road. Tolverne Road. Trevor Road. Trew1nce Road. Tr1n1ty Road. V1ctory Road. V1neyard H1ll. Waldemar Road. Wandle Bank. Wandle Road. W1ll1am Road. W1mbledon H1ll. W1mbledon Park. Woods1de. Woods1de Parade. Worple Road. Wycl1ffe Road. Ashcombe Road. Avondale Road. Balfour Road. Beeh1ve Bu1ld1ngs. Belvedere Grove. Burghley Road. Camp Ro1d. Cec1l Road. Clarence Road. Courthope Road. Cowdrey Road. TOTAL. Small Pox under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9 5 upw'rds ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 9 Ch1cken Pox under 5 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 2 ... ... 1 ... 2 ... ... ... 2 ... ... ... ... ... 1 ... ... 68 170 5 upw'rds 2 ... ... 1 ... ... ... 1 ... ... 1 1 1 ... ... ... ... 1 1 ... ... 2 ... ... ... ... ... ... 2 ... 3 ... ... 1 ... ... 102 D1phther1a under 5 ... ... ... ... ... ... ... ... ... ... ... 3 ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... 30 80 5 upw'rds ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... 4 1 ... ... 50 Measles under 5 ... 1 ... ... ... 4 2 1 ... 1 3 1 3 9 ... 1 2 7 ... ... 2 1 3 ... 1 1 3 8 1 ... 1 8 15 ... 2 462 1026 5 upw'rds ... 1 1 1 1 3 2 4 ... 4 1 4 ... 4 3 1 1 1 ... 2 1 6 ... 18 1 3 ... ... 14 1 5 ... 5 19 2 3 564 Erys1pelas under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 46 5 upw'rds ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... 40 Scarlet Fever under 5 ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 1 ... ... 33 128 5 upw'rds ... ... ... ... ... ... ... ... ... ... ... 1 1 3 ... ... ... ... ... 1 ... 1 1 4 ... 1 ... ... ... ... ... ... 5 1 ... ... 94 Enter1c or Typho1d under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 16 5 upw'rds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... 15 Puerperal Fever under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 5 upw'rds ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Totals under 5 ... 1 ... ... ... 4 2 1 ... 1 4 4 4 10 ... ... 1 3 11 ... ... 3 1 5 1 1 1 6 8 1 ... 1 9 18 ... 2 1478 5 upw'rds 2 1 2 3 1 3 2 5 1 4 2 1 2 8 3 1 1 4 1 4 1 9 1 23 1 4 ... 2 18 2 8 ... 15 22 2 3 SUMMARY OF TABLE 7. No. of Deaths No. of Deaths 1.—Specific Febrile or Zymotic Diseases:— Brought forward 439 V.—Local Diseases (continued)— 1. Miasmatic Diseases 44 5 Diseases of Gland-like Organs 2. Diarrhœal „ 6 Uncertain Use 1 3. Venereal „ 1 6. Diseases of Urinary System 17 3 Septic „ 10 7. Diseases of Reproductive System— II.—Dietic Diseases 1 Diseases of Parturition 2 8. Diseases of Bones and Joints 3 III.—Constitutional Diseases 79 VI.—Violence :— IV.—Developmental Diseases 63 1. Accident or Negligence 5 V.—Local Diseases : 2. Homicide 2 1. Diseases of Nervous System 54 3. Suicide 4 2. Diseases of Circulatory System 57 VII.—Ill-defined and not specified Causes 24 3. Diseases of Respiratory System 84 4 Diseases of Digestive System 40 Carried forward 439 Total 497 TABLE 7. WIMBLEDON URBAN SANITARY AUTHORITY. Table show1ng Deaths from all causes and at d1fferent ages dur1ng the Year 1902. Note.—The deaths of Non-Res1dents occurr1ng 1n Publ1c Inst1tut1ons s1tuated 1n the D1str1ct are excluded, and the Deaths of Res1dents occurr1ng 1n Publ1c Inst1tut1ons s1tuated beyond the l1m1ts of the d1str1ct are 1ncluded. 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 & upwards TOTALS. Classes. 1 I.—Spec1f1c Febr1le, or Zymot1c D1seases 23 17 7 2 1 7 ... ... 4 ... ... 61 II.—D1et1c D1seases ... ... ... ... ... 1 ... ... ... ... ... 1 Ill —Const1tut1onal D1seases 11 5 2 3 10 13 13 7 10 5 ... 79 IV.—Developmental D1seases 34 ... ... ... ... ... ... ... 3 19 7 63 V.—Local D1seases 52 21 5 9 13 20 28 30 43 29 8 258 VI —Deaths From V1olence ... 3 1 1 1 2 2 1 ... ... ... 11 VII.—Deaths from Ill-def1ned and Not Spec1f1ed Causes 15 1 ... 1 1 ... ... 4 ... 2 ... 24 Totals 135 47 15 16 26 43 43 42 60 | 55 15 497 1.—Spec1f1c Febr1le, or Zymot1c D1seases. 1. M1asmat1c D1seases. Measles 2 9 ... ... ... ... ... ... ... ... ... 11 Whoop1ng Cough 11 4 2 ... ... ... ... ... ... ... ... 17 D1phther1a ... 4 3 ... ... ... ... ... ... ... ... 7 Enter1c or Typho1d Fever ... ... ... ... ... 3 ... ... ... ... ... 3 Int1uenza ... ... 1 1 ... 2 ... ... 2 ... ... 6 2. D1arrheal D1seases. D1arrhoea. Dvsenterv 6 ... ... ... ... ... ... ... ... ... ... 6 3. Venereal D1seases. SvDh1l1s ... ... ... ... ... 1 ... ... ... ... ... 1 4. Sept1c D1seases Erys1pelas 3 ... ... ... ... ... ... ... ... ... ... 3 Pyaem1a, Sept1caem1a 1 ... 1 1 1 1 ... ... 2 ... ... 7 2.—D1et1c D1seases. Chron1c Alcohol1sm ... ... ... ... ... 1 ... ... ... ... ... 1 3.—Const1tut1onal D1seases. Rheumat1c Fever, Rheumat1sm of the Heart ... ... ... ... ... 1 ... ... ... 1 ... 2 Gout ... ... ... ... ... ... 1 ... 1 ... ... 2 R1ckets 1 1 ... ... ... ... ... ... ... ... ... 2 Cancer, Mal1gnant D1sease ... ... ... ... ... 1 6 4 6 2 ... 19 Tabes Mesenter1ca 1 1 ... ... ... ... ... ... ... ... ... 2 Tubercular Men1ng1t1s, Hydrocephalus 7 2 2 1 ... ... ... ... ... ... ... 12 Phth1s1s 1 ... ... 2 5 11 2 ... 1 ... ... 22 Other forms of Tuberculos1s, Scrofula 1 ... ... ... 5 ... 2 2 1 ... ... 1l Ansem1a, Chloros1s, Leucocythaem1a ... 1 ... ... ... ... 1 1 1 1 ... 5 Glycosur1a, D1abetes Mell1tus ... ... ... ... ... ... 1 ... ... 1 ... 2 4,—Developmental D1seases. Premature B1rth 20 ... ... ... ... ... ... ... ... ... ... 20 Atelectas1s 4 ... ... ... ... ... ... ... ... ... ... 4 Congen1tal Malformat1ons 2 ... ... ... ... ... ... ... ... ... ... 2 Old Age ... ... ... ... ... ... ... ... 3 19 7 29 Marasmus 8 ... ... ... ... ... ... ... ... ... ... 8 5 Local D1seases. 1. D1seases of Nervous System. Inflammat1on of Bra1n or Membranes, Men1ng1t1s 2 3 1 ... ... ... ... ... ... 1 ... 7 Apoplexy, Soften1ng of Bra1n, Hem1pleg1a, Bra1n Paralys1s ... ... ... ... 3 1 5 8 7 3 2 29 Insanity, Genral Paralysis of the Insane ... ... ... ... ... ... 2 ... ... ... ... 2 Ep1lepsy ... ... ... ... ... ... 1 1 ... ... ... 2 Convuls1ons 7 ... ... ... ... ... ... ... ... ... ... 7 Laryng1smus Str1dulus (Spasm of Glott1s) ... 1 ... ... ... ... ... ... ... ... ... 1 D1sease of Sp1nal Cord Parapleg1a, Paralys1s Ag1tans ... ... ... ... ... 2 ... ... 1 ... ... 3 Other D1seases of Nervous System ... ... ... ... ... 1 1 ... ... 1 ... 3 2. D1seases of C1rculatory System. Per1card1t1s ... ... ... ... ... ... ... 1 ... ... ... 1 Acute Endocard1t1s ... ... ... 1 ... ... 2 ... ... ... ... 3 Valvular D1seases of Heart ... 1 ... 1 ... ... 1 1 2 1 ... 7 Other D1seases of the Heart ... ... 1 2 3 5 5 7 10 6 2 41 Aneur1sm ... ... ... ... ... ... ... ... 1 ... ... 1 Embol1sm, Thrombos1s ... ... ... ... ... 1 1 ... ... ... ... 2 Other D1seases of Blood Vessels 1 ... ... ... ... ... ... ... 1 ... ... 2 3 D1seases of Resp1ratory System. Emphysema, Asthma ... ... ... ... ... ... ... ... 1 ... ... 1 Bronch1t1s 7 4 ... ... 1 ... ... 2 11 8 3 36 Pneumon1a 16 7 2 3 2 3 2 3 3 5 ... 46 Pleur1sy ... ... ... ... ... ... ... ... ... ... 1 1 4. D1seases of D1aest1ve System. Dent1t1on 2 3 ... ... ... ... ... ... ... ... ... 5 Sore Throat, Qu1nsy ... ... ... 1 ... ... ... ... ... ... ... 1 D1seases of Stomach 1 1 ... ... 2 ... 2 ... 1 ... ... 7 Enter1t1s 10 1 1 ... ... ... 1 ... ... ... ... 13 Obstruct1ve D1seases of the Intest1nes 3 ... ... ... ... 1 1 ... ... ... ... 5 Per1ton1t1s ... ... ... ... ... ... 1 ... ... ... ... 1 C1rrhos1s of L1ver 1 ... ... ... ... 3 ... 2 ... ... ... 6 Jaund1ce, and Other D1seases of the L1ver ... ... ... ... ... ... 1 ... ... ... ... 1 Other D1seases cf D1gest1ve System ... ... ... ... ... ... ... ... ... 1 ... 1 5. D1seases of Gland like Organs of Uncerta1n use (e.g., Bronchocele, Add1son's D1sease) ... ... ... 1 ... ... ... ... ... ... ... 1 6. D1seases of Ur1nary System. Nephr1t1s 1 ... ... ... ... 1 ... ... 1 1 ... 4 Bl1ght's D1sease, Album1nur1a ... ... ... ... ... 1 1 3 3 ... ... 8 D1sease of Bladder or of Prostate ... ... ... ... ... ... ... 1 ... 2 ... 3 Other D1seases of the Ur1nary System ... ... ... ... ... ... 1 1 ... ... ... 2 7. D1seases of Reproduct1ve System. Abort1on, M1scarr1age ... ... ... ... 1 ... ... ... ... ... ... 1 Placenta praev1a, Flood1ng ... ... ... ... 1 ... ... ... ... ... ... 1 8. D1seases of Bones and Jo1nts. Arthr1t1s, Ost1t1s, Per1ost1tis 1 ... ... ... ... 1 ... ... 1 ... ... 3 6. Deaths from V1olence. 1. Acc1dent or Negl1gence. Fractures and Contus1ons ... ... 1 ... ... ... ... ... ... ... ... 1 Burn, Scald ... 2 ... ... ... ... ... ... ... ... ... 2 Otherw1se ... 1 ... 1 ... ... ... ... ... ... ... 2 2. Hom1c1de. Manslaughter ... ... ... ... ... ... 1 ... ... ... ... 1 Murder ... ... ... ... 1 ... ... ... ... ... ... 1 3. Su1c1de. Gunshot Wounds ... ... ... ... ... ... 1 ... ... ... ... 1 Cut, Stab ... ... ... ... ... 1 ... 1 ... ... ... 2 Po1son ... ... ... ... ... 1 ... ... ... ... ... 1 7. Deaths from Ill-def1ned and not spec1f1ed Causes. Deb1l1ty, Atrophy, Inan1t1on 14 1 ... ... ... ... ... ... ... ... ... 15 Mort1f1cat1on ... ... ... ... ... ... ... ... ... 1 ... 1 Tumour ... ... ... 1 ... ... ... 1 ... ... ... 2 Abscess ... ... ... ... 1 ... ... 1 ... ... ... 2 Haemorrhage ... ... ... ... ... ... ... 1 ... ... ... 1 Causes not Spec1f1ed or Ill-def1ned 1 ... ... ... ... ... ... 1 ... 1 ... 3