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a1b1edd2-33ae-4d64-a068-70e6b71218c9 | (b) Slaughter houses. These, in actual use, are few, and fairly well kept. I have found the occupiers of the various premises willing, and indeed eager, to adopt any measures the desirability of which I have pointed out to them. But the slaughter houses themselves are mostly old and roughly constructed of wood. Under the present conditions of the meat trade, they are destined however, in all probability, to gradually fall into desuetude. The local butchers' shops are, as a rule, very well kept. The greater part of the meat sold locally is procured from the dead meat market, and therefore undergoes critical inspection by trained officials before being brought into the district. (c) Bakehouses. The condition of these important places is not always satisfactory, although the letter of the law 13 is usually complied with. |
88782301-0f54-4bd2-ab68-fa15c79e4a8f | But it mutt be confessed that the antiquated and imperfect state of some premises, and the cramped construction of others, hampers the efforts of the occupiers to maintain cleanliness and orderliness. There are five underground bakehouses in the district, and although they are, as such, undesirable, 1 have found them as a rule well kept. In fact, they compare favourably in some respects with others that are above ground. Bakehouses of recent construction are very few, and have not been favoured by the exigencies of the sites on which they have heen erected. (d) Dairies, Cowsheds, and Milk Shops. There are now in Barnes only two, and in Mortlake only one, registered cowkeepers. Of these only two have cowsheds in constant use. The sheds are frequently inspected, and their condition is usually as satisfactory as the construction of the buildings allows. |
7498f88a-4e41-4313-adcd-769a3f7ca8de | The cowkeepers are themselves purveyors of milk, and the milk is in consequence distributed by them to the consumers very shortly after it is drawn. The condition of the milkshops, i.e., trade premises occupied by purveyors of milk who, as a rule, merely distribute to the consumer milk brought from a distance by middle-man companies, is less satisfactory. It is regrettable that beyond the power to enforce registration, the Sanitary Authority has so little effective control over them. It is not unusual for me to find milk standing in open shallow vessels within a few feet of the roadway or other source 14 of dust, on a stone or earthen floor. The usual explanation offered is that this course promotes cooling, and so retards fermentation; but it is not realized that milk so kept becomes laden with the germs of putrefaction, which rapidly become active when the milk is taken into the warm and stuffy kitchens of the poor. |
ecc75bec-9f44-41e4-969c-a66892c11788 | The importance of the bacteriological purity of milk can hardly be overestimated, and it is to the absence of precautions to avoid germ-contamination of milk brought from a distance that much infantile mortality and sickness is to be ascribed. Under the Dairies, Cowsheds, and Milkshops order, no "cowshed or dairy" may be occupied unless certain sanitary requirements are first complied with. It is regrettable that no similar enactment obtains in the case of "milk shops." For it is no infrequent occurrence to find a milkseller occupying premises with nowhere to keep his milk but in the scullery or a fowl house, and nowhere to wash his cans but in the family washtub. Under these circumstances the cost of any alteration or improvement found necessary falls on the tenant, whose resources are perhaps insufficient to supply what should have been provided before he commenced his tenancy. No offensive trades are carried on in Barnes and Mortlake. |
42de1a21-ac65-4dfe-80a2-4ad2024e55ad | Such places as under the old Factories Acts required the occasional visitation of the Inspector of Nuisances have been usually found in a proper sanitary condition. Under the new Factories Act—which operates from January 1, 1902—a large number of workshops and workplaces are to be registered by the Sanitary Authority, and it will be the duty of the Medical Officer of Health to report annually to the Home Office on their condition. This will necessitate the inspection and supervision by him of about one hundred additional places of business or trade. 15 The domestic water supply of Barnes and Mortlake is derived from the Southwark and Vauxhall Water Company. One or two wells, it is true, still exist, and one at least is used for drinking purposes. In no part of the district is a constant water supply provided. |
6ca09cbb-2d4f-4025-8a55-459d3ade7291 | In some places one small cistern contains the entire supply of two cottages during the hours that the water is " turned off," and in not a few streets two families living in one house are dependent on one cistern of 40 or 50 gallons. The question of inadequate cisterns has been laid before the District Council, but it does not appear that either the Council or the Water Company have power to enforce better provision. In a sanitarian's view a constant water supply is the best, if indeed it be not the only remedy for such a regrettable state of affairs. Such action as has been taken during 1901 for the abatement of nuisances is summarized in the report of the Inspector of Nuisances. It will be seen that the greater number of nuisance abated have been such as from time to time occur, or are discovered, in dwelling-houses, and that many of them are such as are injurious to health. |
b4c5850a-2291-4a89-890f-2b395962cd8b | That not a few of them were discovered when seeking the cause of disease is proof of the advisability of house to house inspections being made in all parts of the district. In the summer of 1901, the Inspector of Nuisances and myself gave evidence in support of a summons against the London & South Western Railway Company for failing to abate a nuisance arising from the presence, in the sidings on Barnes Common, of trucks loaded with offensive manure. The nuisance, and also injury to health, was proved, but the summons was dismissed, the Bench holding that it was not proved the defendants 16 kept the trucks on the sidings longer than was necessary for the purpose of their business. Since the hearing of the summons, however, the nuisance has been sensibly less. Certainly no complaints have been received from the persons who were formerly aggrieved. |
ac4b7943-7444-4afd-b7fc-cef495f4a3eb | Complaints are frequently made of offensive smells perceptible in Barnes High Street and on the Terrace, which apparently are due to offensive deposits on the Middlesex side of the river. Representations have been made on more than one occasion to the contiguous Sanitary Authority, but the nuisance recurs from time to time. As soon as is possible, after the Sanitary Officers are made aware of the existence of notifiable disease, the infected house is visited by myself or the Inspector of Nuisances, all necessary inquiries are made, and the patient, if thought fit, is removed to the Isolation Hospital, at Mortlake. The usual statutory notices are now sent from the Council offices to the householder, and with them a paper of directions for preventing the spread of disease. Disinfectants are liberally supplied, when it is desirable so to do, and disinfection is performed by the Inspector in almost every case and at the appropriate time. The method employed is that of disinfection by Nitrous Acid Gas. |
7fa0da82-a3ad-47a3-9fa7-79a4efb42910 | Mattresses and textile substances are disinfected, when desired, in the Steam Disinfector at Mortlake, and the cleansing of infected houses by either landlord or tenant is frequently insisted on. These methods prove, in practice, perfectly satisfactory. In fact the public confidence in them is such that persons not infrequently request the disinfection of rooms, &c., by the Sanitary Officers after the occurrence of certain non-notifiable diseases. The high percentage (70.3 per cent.) of cases of Scarlet Fever and Diphtheria notified that were removed to the Isolation Hospital in 1901 sufficiently demonstrates the popularity of that institution. The present 17 accommodation at the Hospital for patients is, in point of ward space, ample. But the usefulness of the new Block would be greater than it now is if more convenient accommodation had been devised for the Nurses. During 1901 eighteen cases of Scarlet Fever were treated without loss of life, and of 56 cases of Diphtheria only one died. |
1e358553-96b5-4f33-874c-5498d514eec5 | In one successful case Tracheotomy was performed on a child under three, and in this, as in other severe cases, Antitoxin was administered. Three cases of Typhoid Fever were admitted ; in two instances the patients were gravely ill when removed, and removal was necessary to prevent spread of the disease. The removal to Hospital of cases of Scarlet Fever and Diphtheria, is, as a rule, called for both by the interests of the patient and those of the public. But the removal to Hospital of cases of Typhoid Fever is a less simple matter. The process of removal itself is not always free from risk to the patients, who can often be successfully isolated in their own houses. But Typhoid is a disease of long and uncertain duration, calling for the constant care of skilled nurses. For this reason, cases from, not merely the poorest, but from the lower middle classes have for years past been admitted into the wards of General Hospitals. |
44cecfb7-1f81-481a-8d10-969cbbb64136 | Such facilities, are, however, now less easily obtained than formerly, as there is a disposition on the part of those governing the great London Hospitals to exclude from their wards more than a certain percentage of typhoid cases. In consequence, when domestic resources are unable to provide the necessary skilled nursing, admission to local Isolation Hospitals is sought— 18 not for the purpose for which Isolation Hospitals were founded, but in the interests of the patient and the relief of domestic strain. The admission and treatment of such cases is a severe and sometimes sudden strain on the resources of a small Isolation Hospital. With a view, therefore, to meet these and other circumstances, as Medical Superintendent of the Hospital at Mortlake, I have been lately empowered to make provisional arrangements for the reception of certain patients at an adjustable weekly charge. |
501f2b16-62f8-4b87-8697-6d0e3222a82b | It is not, however, the practice of the Council to recover the charges legally due in ordinary cases when removal is dictated by regard to the public health, though charges are made if persons other than ratepayers, or persons requiring private wards, are admitted. Typhoid Fever is certain to become more frequent as the district becomes more urban and means of communication are multiplied, and the question of hospital treatment, therefore, requires consideration. A few cases of Measles were admitted in the Spring from the Children's Home, Barnes, under special arrangement with the Guardians, at a time when the Hospital was almost empty. In the Autumn, the outbreak of Small Pox in London led to the consideration of what should be done in the event of the disease appearing in this district, as no means of isolation had been devised when the old Highgate Hospital (to which cases were formerly sent), became disused. |
61b923b4-94a5-4147-8f29-c6e2822c7ad9 | Communications were made to the authorities of every Small Pox Hospital (including the Metropolitan Asylums Board) within reach, but in each case a reply was received that the admission of cases from Barnes could not, under the circumstances, be entertained. 19 The Urban District Council then, having regard to the proximity of Barnes to the Metropolis, proceeded to take steps to provide the district with the means of isolating cases that might occur. A very complete plan was devised for the reception of patients in a temporary building on Sheen Common, but this plan was successfully defeated by action which raised the question of the legal right of the Council to erect such a building on the Common. But appeals had been made, without any success, to every owner of land in any way suitable for the erection of such a building, and it appeared therefore, for some time, likely that the district would be withouc proper means of isolation in the event of an outbreak. |
66d78547-39ca-4ffc-81ff-859da82b7d8c | Representations were then made to the Surrey County Council of the urgent need of some such means, and on almost the last day of the year it was announced that the Surrey County Council had concluded an arrangement with the Joint Small Pox Hospital Board for Croydon and Wimbledon, by which the latter body bound themselves to "admit into their Hospital at Cheam, at a weekly charge, cases of Small Pox occurring within the administrative County of Surrey generally. This arrangement is, for the present, satisfactory, but it is to be hoped that it will shortly give place to another on broader lines. In April, a medical man was prosecuted at the Court at Mortlake for having failed to notify, in compliance with the Act, the occurrence of a case of Typhoid Fever on which he was attendant. As a matter of fact, the case was only notified, and then irregularly, after the unfortunate termination by death of the patient's prolonged illness. |
3761d82f-5daa-4723-9e69-36385dc891bd | 20 A formal summons was also taken out against the widow for having failed to notify the case, and further for having vacated the house in contravention of the Infectious Diseases (Prevention) Act, 1890. Sec. 7. A fine of 20s. was inflicted on the medical man, and the first summons against the widow was withdrawn, as it was only desired to draw attention to the duties imposed by the Act on the relatives of persons suffering from notifiable diseases. A fine of 5s. was imposed in respect of the second summons. In September, it was resolved by the Urban District Council to invite from medical men practising in the district the notification of cases of Phthisis, with the object of enabling the Sanitary Officers to disseminate information, to disinfect rooms, See., when necessary, and to investigate the domestic surroundings of such cases, with a view to taking any requisite action under the Sanitary Acts. |
3c1106c3-072a-4ddb-835b-e91a471c29de | It was also resolved to pay the fee of 2s. 6d. for any such notifications made in the course of private practice, and Is. for any made in an official capacity. These resolutions have already met with considerable success; the pithy memorandum of the Surrey County Council on the Prevention of Consumption has been distributed; and disinfection has been performed in nearly every case of death or removal. It should not be forgotten that the Guardians of the Poor are making at Richmond most excellent provision for the open-air treatment of consumptive persons. Already such have been with advantage removed there from this district, the phthisical poor of which will shortly enjoy the full advantages of voluntary notification, gratuitous disinfection, and "sanatorium" treatment. With respect to the notification of infectious diseases 21 generally, it may be observed that different qualities must be connoted with notifications from different sources. |
24dbf98e-1f35-45ff-8262-9a0b947a0d51 | Medical opinion, on some matters, is at present in a state of flux, and while circumstances may sometimes require the notification of a case as diphtheria on grounds bacteriological rather than clinical, yet at other times notification may be called for rather by the obvious need for isolation than the ascertained presence of a specific organism. Naturally the former set of circumstances obtains most frequently amongst the upper classes, and the latter amongst the lower. With regard to vaccination, it may be said that the District Council, at the beginning of the present outbreak of Small Pox, took every possible step to promote the adoption of this necessary means of protection, and it is largely to the great measure of success that has followed these steps that 1 attribute the immunity of the district during 1901. The Richmond Guardians were officially communicated with, and they courteously and promptly acceded to a request that they would promulgate notices of the need and opportunities for re-vaccination. |
e85046c0-06e3-43c3-a572-f03acbc9e704 | The School Board for Barnes, and the Managers of the National Schools at Mortlake, also responded to communications made to them by taking steps to promote, with all due deference to parental authority, vaccination and re-vaccination amongst their scholars. The general public have also submitted in great numbers to re-vaccination at the hands of private and public vaccinators. I am unable to publish this year, as my predecessor did in times past, any statistics of value in respect of infant vaccination, for, under the new Act vaccination is so generally postponed until the sixth month that any tabulated return would shew 22 almost every child born since July as unvaccinated. And it is owing to the curious anomaly that the most important of protective measures—vaccination—is not under the control of the Sanitary Authority that I am unable to give any numerical estimate of the official re-vaccinations performed during 1901. |
f697afd1-9a7e-42f6-8861-7d9d716a0148 | Such information would be of the greatest interest and value to the Aulhority on which the duty of dealing with Small Pox actually falls. Systematic inspections of the district have been made throughout the year, and much of the work thus done is summarized in the Inspector's Report. Five houses reported as unfit for habitation have been repaired, others have been cleansed and repaired under notice; others have been put in order on verbal request. The unwholesome condition of Barnes Pond was in the summer reported on by me, and its cleansing advised. A scheme for its purification and drainage into the main sewer has been agreed upon by the District Council, and the necessary consent of the Richmond Main Sewerage Board secured. The work will shortly be completed. Steps have been taken to improve the condition of Lodge Avenue, Mortlake, of Malthouse Cottages, and other places. A necessary alteration to the sewer draining St. |
e9e9408f-88bf-42cc-9550-09b9fa70a3f0 | Ann's Passage, Barnes, will also, it is hoped, be shortly carried out. The contemplated improvements in High Street, Barnes, in a sanitary sense are important, and will, it is hoped, lead to the disappearance of certain houses in the vicinity. In December I was required specially to report on the suitability, in a sanitary sense, of the land at East Sheen which it is proposed to acquire for burial purposes. I had no difficulty 23 in pronouncing the site in every way a proper one for the proposed purpose. The same, however, could not have been said of other sites that have been mentioned. In inspecting the district at various times I have noticed the practice of builders to erect rows of shops which are—in trade parlance—afterwards completed to satisfy the requirements of tenants. The practice is a bad one, and leads to the occupation by milksellers, butchers, and other persons, of premises which are not, sanitarily, suitable for the purpose to which they are put. |
566e29fb-a547-414f-af5c-5f6f181d7295 | It is to be desired that no shops should be erected which may be used for certain trades, unless the Sanitary Authority is first satisfied that the proposed structures will admit of the fulfilment of all sanitary requirements. Early in the year an outbreak of Diphtheria occurred in Barnes that was found by the acting Medical Officer of Health to be modified by School Influence. School closure was in consequence enforced with satisfactory results. Later, having occasion to inspect the Board Schools in Barnes, certain sanitary defects were found which, as soon as the Board were made acquainted with, were remedied. Since then no Diphtheria has occurred due to "School Influence." Three brief outbreaks have, however, since occurred in part of the Westfields, Barnes. These were promptly terminated by extra flushings of the drains. It was the occurrence of these cases which led to the report being called for that has already been referred to. |
93de76d4-1f82-4ef0-9169-ab5706e506fa | It is hoped that the measures to be proposed will prove adequate in the coming year Most other cases of Diphtheria have been sporadic. Some have been imported; in others a connection has been traced with insanitary conditions of domestic origin. In the early part of the year cases of Scarlet Fever were few; but in the later months many more were notified. Not a few times the 24 disease was brought into Barnes by children residing in Lilian Road, or thereabouts, who were attending Board Schools in Hammersmith. It is to be hoped that the extended school accommodation proposed by the Barnes School Board will in future obviate this source of infection. During the spring many cases of measles and mumps occurred, and it was a frequent sight to see children playing in the streets with the obvious signs of these complaints present. It is forgotten, or ignored, that Measles is both indirectly and directly a more frequent cause of death than Scarlet Fever, if not than Scarlet Fever and Diphtheria together. |
128a81b1-3405-4bd8-b5ff-1c824ac5db46 | The number of cases of Typhoid Fever that have been notified is greater than last year. In most instances, if not in all, the infection was contracted, so far as I know, outside the district, and it is gratifying that no secondary cases occurred. In more than one instance the infection was probably from soldiers returned from South Africa, and it is not perhaps generally realized that owing to rapid means of transit a person may be discharged convalescent from hospital abroad and yet reach England in an infective condition. One case of true Dysentery occurred in Barnes during the year. The patient had come from Aldershot, in which place I was subsequently made aware many similar cases were under observation. 25 Statistical Tables. The Tables appended to this Report are those now required by the Local Government Board, and differ from those employed in previous years. |
cb8597b8-25a5-48ed-be19-8045b9173b9b | It will be noticed that the population of the district as enumerated at the census of 1901, is less than the population as estimated for 1899 and 1900. The calculated birth and death rates, therefore, for the last few years have been, so far as they depend on the estimated population, too low. That the birth rate for 1901 happens to be exactly the same as the average of the birth rates as calculated for a series of years, during which the population was over-estimated, tends to prove that the real birth rate is lower than in past years. The cause for the lower birth rate in this district, is probably the same as elsewhere:—a well-understood matter of national importance, the effects of which can only be counteracted by efforts to diminish infantile mortality. From Table I. Cols. |
4cbf8ac2-d6cc-460f-8cc1-0f79c448a769 | 5 and 6, it will be gathered that the heavy mortality amongst children of less than one year does not in this district appreciably decrease, and it is in this fact, coupled with the slightly lowered birth rate, that we must seek some explanation of the disappointing census return, one meaning of which is that the natural increase of the population, as opposed to increase by immigration, is less than formerly. 1 n calculating the death rates for 1901, it has been necessary, from the arrangement of the new Tables, to take account of all 26 deaths registered in this district. Not a few of these deaths are those of persons whose bodies have been recovered from the river, and such deaths were in times past excluded from consideration. For purposes of comparison, therefore, 1 have re-calculated, from the figures at my disposal, the total deaths registered for the last seven years, and the death rates, on the basis now required. |
19d22d79-ffd4-415e-be31-581ad8038074 | This inclusion of the deaths of non-residents is, perhaps, not so unfair as at first appears, for not a few persons from this district die in London Hospitals and elsewhere, their deaths, which should be credited to Barnes and Mortlake, being for statistical purposes lost count of. Particular pains, however, have been taken to make the figures for 1901 in Column 11 accurate, and it will be seen that 24 such deaths have been discovered as against only three in 1900. This fact should be borne in mind when observing the apparent increase of the death rate from 12.1 in 1900 to 13.2 in 1901. This figure (13.2) would be still higher if I were able to give the deaths that have occurred in Brookwood during 1901 of former residents in this district. Table II. affords some means of comparison between the vital statistics of Barnes and Mortlake. |
cf522079-575a-4c3d-ab14-8a37c897c218 | The absolute value of these figures is, of course, affected by the considerations already mentioned as affecting those for the whole district. It appears that in 1901 the infantile mortality was greater in Mortlake than in Barnes—and not only relatively to the lesser population, but absolutely. In previous years the absolute mortality has usually been higher in Barnes. 27 The loss of infant life in the district as a whole is a serious matter, and it should be not forgotten that from the report of the County Medical Officer of Health for 1900 it appears that the Urban District of Barnes occupies in this respect a position less creditable than 30 of the 34 districts into which the administrative County of Surrey is divided. The only districts with a less creditable record are Ham, Richmond, and Wimbledon. Ham is so small that its statistics are of no value; and the difference between the infantile mortality of Richmond and Barnes is a fractional percentage only. |
5cbcf5cb-77cb-4b7f-b0c2-155b9149b03a | I am unable to agree with the opinion frequently expressed that this heavy mortality is due to neglect by mothers working in laundries and market gardens, for the simple reason that in none of the many cases that have come under my personal observation did this factor obtain. I attribute the heavy infantile mortality of Barnes and Mortlake very largely to the germ-laden condition of the milk offered to babies, much of which is supplied by "purveyors of milk"—some of them itinerant and from a distance—over whose proper cleanliness there is little real control. I am not aware of any milkshop in the district in which there is a proper place for the storage of milk during the summer nights, or from which milk in a fresh condition can be obtained after certain hours. Table III. gives the number of cases of infectious disease notified during the year. The number is greater than last year, the increase in the notifications of Diphtheria alone being 50. |
62ada311-09c1-4aa2-8018-927d4f59cc8a | The cases of Scarlet Fever were 3 less and those of Typhoid 7 more than in 1900. 28 In spite of the relatively enormous increase in the number of cases of Diphtheria notified, there was only one death. The case mortality for the district is, therefore, only 1-3 per cent. 1 attribute part of the increase in the notifications of Diphtheria to local circumstances which have resulted in the notification of more cases than formerly on bacteriological grounds alone, and also to an increasing desire to obtain for cases of non-specific but infective sore throat the advantage of hospital treatment. One member of the Hospital Staff contracted Erysipelas in performance of her duties, and it is this case which is tabulated as "removed to Hospital." In Table IV. the cause of deaths during 1901 are set forth with the ages at which death occurred. It will be noticed that no deaths occurred from Measles, and only one from Whooping Cough. |
e900a589-cdc5-483d-a1e0-abc2a7f022df | Fifteen fatal cases of Diarrhoea in infants are recorded, as against 5 in 1900, but there is reason to believe that this is due to increased accuracy of certification and classification. "Zymotic enteritis" is now more generally recognized as an entity than was the case a few years ago. Nineteen deaths were recorded as due to Phthisis. This number is twice as great as in 1900, and considerably greater than the average number of the last 6 years. This, alone (and there are corroborative facts), seems to shew that the disease is increasing, rather than diminishing, locally. It is interesting, therefore, to remember that my predecessor, Dr. Adams, was in the habit of pointing out how the Phthisis mortality of Barnes fell as the ground water sank; and that, in the opinion of Mr. Tomes, the Surveyor, the level of the ground water has lately risen appreciably. |
8e3ad17c-f3c6-4f8b-8cda-37ae81a3ee6d | 49 But at the same time it must not be forgotten that the exceedingly small rooms now occupied by persons of the middle and lower classes are a potent cause of Phthisis; and that these rooms, cramped and small by reason of the demand for low rents and the high price of materials, are rendered more air-tight than is necessary by the general improvement in construction that is maintained. Twenty deaths from Cancer and malignant disease were reported. This number, 8.5 per cent, of the total deaths, confirms the general belief in the prevalence of Cancer in riverside districts, and the Thames Valley in particular. A large number of the total deaths are not classified, but referred to "other causes." Not a few of these are deaths, the causes of which are expressed on the death certificates in terms too vague to be of any statistical or scientific value. 31 TABLE I. Vital Statistics of whole District during 1901 and Previous Years. Year. Population estimated to Middle of each Year. Births. |
d9a4a3ac-ed40-4f7b-b981-8a708ad6846d | Totai. Deaths registered in the District. Total Deaths in Public Institutions in the District. Deaths of Nonresidents registered in Publie Institutions in the District. Deathe of Residents registered in Public Institutions beyond the District. Net Deaths at all Ages belonging to the District. Number. Rate* Under 1 Year of Age At all Ates. Number Rate per 1.000 Births registered Number Rate.* Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1893. 15,600 412 26.4 56 135.9 246 15.7 11 … 29 275 17-6 1894. 16,000 367 22.79 44 119.3 166 10.3 2 … 1 167 10.4 1895. |
67633fb4-1053-4171-97dc-30c46ec24470 | 16,200 397 26.5 51 128.4 218 13.45 7 … 6 224 13.8 1896. 16,800 404 24 61 140.9 191 11.36 4 … 7 198 11.7 1897. 16,950 370 21.8 54 145.9 196 11.56 2 … 5 201 12.4 1898. 17,300 351 20.28 64 182.3 203 11.7 5 … 3 207 11.9 1899. 18,000 458 25.4 58 126.6 225 12.2 5 ... 4 229 12.6 1900. |
e292436b-4316-45de-b914-36a68425961b | 18,300 416 22.7 56 134.6 220 12.02 1 … 3 223 12.1 Averages for years 1893-1900. 16,893.7 396.6 23.49 55.6 139.6 208.1 12.3 4.62 … 7.37 215.5 128 1901. 17,900 420 23.49 56 133.3 214 11.9 3 … 24 238 13.2 * Rates in Columns 4, 8, and 13 calculated per 1,000 of estimated population. Area of District Exclusive of Area Covered by Water 2,400 acres. Total population of all ages 17,821 Number of inhabited houses 3,403 Average number persons per house 5.23 Census of 1901. |
5aee1ebf-45eb-4ee6-9973-27a35a95baa3 | Institutions within the district receiving sick and infirm persons from outside the district—none. Institutions outside the district receiving sick and infirm persons from the district:—Richmond Infirmary and Workhouse, Richmond General Hospital, Brookwood Asylum. Other institutions, the deaths in which have been distributed among the several localities of the district:—University College Hospital, and West London Hospital, Hammersmith. 32 TABLE II. Names of Localities 1. BARNES URBAN. 2. BARNES. 3. MORTLAKE. Year. Population estimated to middle of each Year. Births registered. Deaths at all Ages. Deaths under 1 Year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 Year. Population estimated to middle of each Year. Births registered. Deaths at all Ages. Deaths under 1 Year. |
3c7e25e2-63ea-467b-b507-43199dc234f8 | a. b. c. d. a. b. c. d. a. b. c. d. 1893 15600 412 275 56 8740 219 138 27 6860 193 137 29 1894 16000 367 167 44 9000 202 85 19 7000 165 82 25 1895 16200 397 224 51 9100 226 107 25 7050 171 117 26 1896 16800 404 198 61 9500 217 104 30 7300 187 94 31 1897 16950 370 201 54 9600 218 101 26 7350 152 100 28 1898 17300 351 207 64 9800 193 126 42 7500 158 81 22 1899 18000 458 229 |
758f32e1-3374-44c9-8ff2-ac7fcfe469cf | 58 10200 286 123 36 7800 192 106 22 1900 18300 416 223 56 10300 230 107 26 8000 186 116 30 Averages) of Years 1893 to 1900. 16893.7 396.6 215.5 55.5 9536.2 221.3 111.2 28.6 7357.4 175.4 104.3 26.6 1901 17900 420 238 56 10100 258 127 26 7800 162 111 30 33 TABLE III. Cases of Infectious Disease notified, during the Year 1901. Notifiable Disease. Cases notified in Whole District. Total Cases notified in each Locality. No. of Cases removed to Hospital from each Loca ity. At all Ages. At Ages—Years. |
c5a9aa1c-ba44-44b6-a6a9-35e7845fab5c | 1 Barnes. 2 Mortlake. 1 Barnes. 2 Mortlake. Under 1. 1 to 5. 5 to 16. 15 to 25 25 to 65. 65 and up'wrds Small-pox - - - - - - - - - - - Cholera - - - - - - - - - - - Diphtheria 76 1 17 43 9 6 - 60 16 49 7 Membranous croup - - - - - - - - - - - Erysipelas 10 - - 16 1 7 2 4 6 - 1 Scarlet fever 29 - 7 - 4 2 — 23 6 13 5 Typhus fever - - - - - - --- - - - - Enteric fever 12 - - - 2 10 - 6 6 2 1 Relapsing fever - - - - - - - - |
32fdcb9b-d89a-410c-b230-8a4c09d224f8 | - - - Continued fever - - - - - - - - - - - Puerperal fever 2 - - - - 2 - - 2 - - Plague - - - - - - - - - - - Phthisis* 5 - - - 1 4 - 5 - - - Total 134 1 24 59 17 31 2 98 36 64 14 * Notifiable voluntarily only. 34 TABLE IV. Causes of, and Ages at, Death during Year 1901. Causes of Death. deaths in or belonging to whole district at subjoined ages. Deaths in or belonging to Localities (at all Ages). Total Deaths in Public Institutions in the District. All ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Barnes. Mortlake. |
e481e7dd-a82b-4f5c-a8bd-28ce3d7c60d1 | Small-pox - - - - - - - - - - Measles - - - - - - - - - - Scarlet fever - - - - - - - - - - Whooping-cough 1 - 1 - - - - 1 - - Diphtheria and membranous croup 1 - - 1 - - - 1 - 1 Croup - - - - - - - - - - Fever Typhus - - - - - - - - - Enteric 5 - - - - 5 - 3 2 2 Other continued - - - - - - - - - - Epidemic influenza 4 - - - 1 2 1 3 1 — Cholera - - - - - - - - - - Plague - - - - - - - - - - Diarrhœa 15 15 - - - - - 7 8 - Enteritis 2 - - - - 1 1 1 1 — |
f2572eb6-66a0-4647-adf1-4bcb9370bebb | Puerperal fever 2 - - - - 2 - - 2 - 35 Erysipelas - - - - - - - - - - Other septic diseases - - - - - - - - - - Phthisis 19 - - 3 3 12 1 11 8 - Other tuberculardiseases 2 1 1 - - - - - 2 - Cancer, malignant „ 20 - - - - 18 2 11 9 - Bronchitis 16 1 - - - 8 7 6 10 - Pneumonia 3 2 - - - - 1 1 2 - Pleurisy - - - - - - - - - - Other diseases of Respiratory organs 8 6 2 - - - - 3 5 — Alcoholism ) Cirrhosis of liver 6 - - - - 6 - 4 2 - Venereal diseases - - - - - - - - - - |
cd955ec7-bfc9-4e93-a07b-679902324b65 | Premature birth 12 12 - - - - - 8 4 - Diseases and accidents of parturition - - - - - - - - - - Heart diseases 23 - - 1 2 16 4 19 4 - Accidents 5 - - - 3 2 - 3 2 - Suicides 6 - - - - 5 1 4 2 - Wilful murder 1 1 - - - - - 1 - - All other causes 87 19 - 2 2 36 28 40 47 - All causes 238 57 4 7 11 113 46 127 111 3 36 REPORT OF Inspector of Nuisances For the Year ending December 31st, 1901. Notices have been served to abate 397 nuisances in the District for the year 1901, as against 316 for the preceding year. |
c5023d89-943f-4397-b20e-7a1cb8637290 | The total number of house to house inspections has been 2,391 as against 2,225. ABSTRACT OF NOTICES. Barnes. Mortlake. Total. Defective drains 11 19 30 Condemned closet pans and traps 9 12 21 Dilapidated closet fittings 2 5 7 Pipes insufficiently ventilated 6 9 15 Defective Hushing cisterns 61 55 116 No proper dust bins 39 46 85 Defects in cisterns 15 17 32 Houses in need of cleansing 11 11 22 Overcrowding 5 2 7 Houses unfit for habitation, |
013ccffb-29e9-4a2e-a311-64dced486f3d | but repaired 4 1 5 Animals so kept as to be a nuisance 3 3 Foul deposits 5 3 8 Defective roofs and gutterings 6 5 11 Yards in need of paving 18 17 35 Total 195 202 397 Number of Cowkeepers 2 1 3 Number of Purveyors of Milk 7 7 14 Number of Bake Houses 5 6 11 Number of Slaughter Houses 2 3 5 Number of persons licensed for Petroleum 2 1 3 |
ae4ea4e9-31cf-4388-b5a0-a8d043e8c200 | BARN 62 The Urban District Council of Barnes. THE ANNUAL REPORT For 1905 OF THE Medical Officer of Health, F. GRAHAM CROOKSHANK, M.D., Lond. Bartnes, S,W. R. W. Simpson & Co., Ltd., Printers, 15 High Street, 1906 The Sanitary Department, Council House, High Street, Mortlake, S.W. January, 1906. Mr. Chairman and Gentlemen, I beg to submit my fifth Annual Report. During the past year a constant water supply has been provided; the re-organisation and completion of the Hospital has progressed; and a considerable amount of routine work has been accomplished. The district continues to grow in population, but at the same time zymotic disease is becoming less than formerly. The statistical reports of the County Medical Officer of Health (Dr. |
f640d54a-eb82-4243-881b-e8ad1b306ce8 | Seaton) shew that our position in the County is, relatively to other districts, better than was, till recently, the case. I am, Gentlemen, Obediently yours, F. GRAHAM CROOKSHANK. The Chairman and Members of the Urban District Council of Barnes. THE Urban District Council of Barnes. Sanitary Committee, 1905=6. Chairman: E. VORLEY NEW, Esq. The Chairman of the Council: S. W. LAMBERT, Esq., J P. The Vice=Chairman of the Council: J. WHITCOMBE Esq., J.P. Messrs. ATKINS, BARTON, BATES, BULL, BUNKER, COLLIER, DAVENPORT, FIRMSTON, HAINES, KITLEY, LANGDON, RANDALL, SEAL, SLATTER, SMITH and SPENCER. |
e8a50b12-bf55-4285-9966-7ce1b7cda6e0 | Medical Officer of Health and Medical superintendent of Isolation Hospital: F. GRAHAM CROOKSHANK, M.D. Lond. Inspector of Nuisances: Mr. T. GRYLLS. Assistant Inspector of Nuisances: Mr. C. H. ROBINSON. Matron of Isolation Hospital: Miss M. BAXTER CLARK. CONTENTS. page GENERAL SUMMARY 9 Vital Statistics 11 Housing: Sewerage, Drainage, &c. 14 Water Supply 20 Nuisances 21 Places over which the Council has Supervision 21 Infectious Disease 22 Hospital Accommodation 26 School Hygiene 31 Mortuary: Baths, Wash-houses, Cemetery, &c. |
d930bebf-0232-429b-8659-00a4921e57a9 | 33 Midwives Act 34 Appendix A: Special Report under Factories and Workshops Act, 1901 35 Appendix B: Tables of the Local Government Board 38 Appendix C: Other Statistical Tables 46 Infectious Disease 47 General Work of Sanitary Department 49 Food and Drugs Act 53 Vaccination 54 GENERAL SUMMARY. The Urban District of Barnes:— Area—exclusive of water 2,400 acres Population—Census, 1901 17,821 Population—(estimated) Midsummer, 1905 24,250 Inhabited Houses—Census, 1901 3,403 Inhabited Houses—Midsummer, 1905 4,685 Rateable Value—Agricultural Land £2,281 Other Hereditaments £212,751 £215,038 Assessable Value £189, |
991377d2-30be-471b-92cb-4415054cf592 | 120 14 0 General District Rate 4/0 Poor Rate—Parish of Barnes 3/3 Poor Rate—Parish of Mortlake 3/3 Birth Rate—Per 1,000 estimated population 24.7 Death Rate—Per 1,000 estimated population 10.4 Corrected Death Rate—Per 1,000 estimated population 11.9 Infantile Mortality—Per 1,000 births 120 For ease of comparison the statistical tables relative to this Report have, for the most part, been placed in Appendices. Appendix A deals with those matters which, under the Factory and Workshop Act of 1901, it is a duty of every Medical Officer of Health to refer to annually; Appendix B consists of those Tables prescribed by the Local Government Board; and Appendix C consists of Tables of more local interest, including, amongst other things, the detail of the work of the Sanitary Department. 11 Vital Statistics. |
a3a986d6-51a8-4f71-8d4a-c0dd35f142d5 | (Appendix B. Tables I., II., III., IV. and V.) The first and most important matter is the just estimation of the population at Midsummer of last year. In former years I have pointed out the reasons why the official method of estimating populations during inter-censal periods has, for this district, so little validity. It is sufficient therefore to indicate now that, as shown by the subjoined table, the inhabited houses in Mortlake have during the last four and a quarter years increased by more than 50 per cent., and those in Barnes by more than 25 per cent. At the present time the inhabited houses in the two parishes are of almost equal number and, assuming that the number of persons per house has remained fairly constant, it is reasonable to estimate the present population of Barnes at about 12,250, that of Mortlake at 12,000, and that of the whole district at 24,250. |
bb71c5f9-335e-4a40-a81e-75e89ec95a51 | That this estimate is for the whole district a fair one appears from the fact that the birth rate, calculated on this estimate, works out at 24.7, or slightly above the average for the last 10 years. If the population were over-estimated the birth rate would be less than the average for the last 10 years. It should be noted moreover that the total births during 1905 were 18 less than during 1904, and that the birth rate is apparently now as high in Mortlake as in Barnes. That this is so is explained by the fact that the greater increase in "villa residents" has lately been in Mortlake. Birth rates are high in "new" districts and "estates"; low in old ones. 12 TABLE. Showing the yearly increase for the whole district, and for the constituent parishes, in the number of houses inhabited. Date of Computation. Number of Houses Inhabited. Barnes (Urban). Barnes. |
545326f7-66d3-465c-9b26-ea108ab72d2e | Mortlake. 1901 March (Census) 3403 1893 1510 1902 (Midsummer) 3814 2051 1763 1903 (Midsummer) 4036 2167 1869 1904 (Midsummer) 4435 2315 2120 1905 (Midsummer) 4685 2377 2308 Increase in 4¼ years 1282 484 798 Increase in last year 250 62 188 The death rate for 1905 is so low as 10.4 per thousand of the estimated population, or, when "corrected" by the computation of the deaths of "residents" in public institutions (such as Brookwood Asylum and Richmond Infirmary) outside the district, 11.9 per thousand. |
482f462c-d494-4480-8559-53aa1f8f7b63 | This "correction," required by official usage, is, however, very nearly balanced by the number of "deaths registered in the district," which is really the number of persons, at no time residents of Barnes and Mortlake, whose bodies were found in the river between Kew and Putney. 13 The "uncorrected" death rate of 10.4 per thousand then more nearly expresses the actual death rate than does the so-called "corrected" rate. The infantile mortality, that is to say, the relation which the number of deaths during 1905 of infants under one year of age bears to the number of births during 1905, is expressed as 120 per 1,000 births. These figures are, of course, absolute, and have nothing to do with "estimates." An infantile mortality rate of 120 is still too high, but it is considerably below the average for the last ten years. |
fb42324c-9cd4-4522-95a8-653e76fe3e41 | In my last report some allusion was made in detail to the causes of infantile mortality, and it may perhaps be said here that there is reason to hope that in the next few years the operation of various sanitary measures will tend to still further reduce its local incidence. In Table V., which appears for the first time this year, the causes assigned for the deaths of infants during 1905 are analysed in some detail. It should be noted that in certain columns of Table II., Table IV. and Table V. it has been necessary to include deaths in the workhouse of infants from Mortlake and Barnes. These deaths, not having been registered in the district, are not included in the figures given in cols. 5 and 6, Table I. Again, however, it has to be pointed out that the construction of the official tables does not allow any indication being made of those infantile deaths which have been, through accidental circumstances only, registered in the district. In Table IV. |
83e85f4c-6b3f-4175-b36f-1ffceac8df7a | the causes of and ages at death of persons dying during 1905 are set forth. It will be seen that Phthisis and other tubercular diseases account for about one-eighth of the total deaths. This is an increase on the records of late years. In part 14 it is no doubt accounted for by increasing urbanization, by the steady decrease in the size of bed and living rooms, and by the lessened curtilage to dwelling houses. It is an odd reflection that what sanitation has gained on the one hand has been thrown away on the other. The higher standard required in drain work, closets, bathrooms, and so on has led to an economy in air and light. Whatever be the indecency of overcrowding in parts of London, there is no overcrowding so unhealthy as that which occurs amongst many middle-class families living in small flats and double tenements, even though each person be allotted a separate bedroom. |
1d249313-e6b8-448b-807d-b654a6d37fea | There is no doubt at all but that very many cases of phthisis amongst servants, shop girls and clerks, are directly related to the tiny rooms allotted them for sleeping in dwellings which a builder would describe as "replete with modern and up-to-date sanitary arrangements." The deaths from pulmonary diseases other than phthisis during 1905 were below the average. Probably one reason for this is that there was so little serious influenza. Deaths from zymotic diseases other than those tubercular were also relatively few. So, too, were the deaths between 15 and 65 years of age. Housing. The Workmen's Dwellings constructed by the Council are kept in excellent condition, are keenly sought after, and all are tenanted. Several proposals and schemes for increasing the provision of Workmen's Dwellings have been considered during the year, but no definite steps have been taken. |
e99ca9f8-1ae1-4569-aa19-8eac5a81b39f | 15 In considering the necessity for ensuring such provision the character of the district has to be taken into account. It would seem likely that in a few years the population will lose, to a great extent, its old residential character and will be largely a population made up of (1) persons engaged in London, and their families; (2) tradespeople and their families. As the district becomes filled up and building activities slacken, many of the working class will undoubtedly emigrate; and there are few signs of any development of local industries. As a result of consistent observation of all parts of the district I am bound to say that it appears to me there is far less difficulty for the working man in securing housing than there was five years ago. With perhaps one exception:—the elderly labourer who, having no children, does not need, or cannot afford a whole house, is often badly accommodated in lodgings. |
4149d948-68fe-4c45-bd31-449a28a7ae71 | If new dwellings are provided by the Council I sincerely trust that some airy tenements with two or three good-sized rooms each will be provided for families of two, or at most, three persons. The question of tenements and flats designed for the social strata immediately above those of the artizan and labourer is very important. Building bye-laws are urgently needed to control the blocking of suburban areas by rows of double tenements and maisonettes. As has been ably pointed out by Dr. Sykes and others of late, in Germany arterial roads are made to widen in passing from the centres of town and cities to the outskirts. A system of zonification is in fact enforced, and, as in Paris, the social strata occur vertically. In this country (as in London) the widest roads are in the centres of cities, and on the outskirts they are narrowed and 16 choked, while the social strata are dispersed horizontally. |
ed29a871-f539-4ed7-880f-e01931861c8a | All this has a very important bearing on national physique, and obviously the stimulus for a reversion to better methods must come, not from central authorities, but from suburban councils on the outskirts of the great cities. Sewerage. The increase in the number of houses and streets has thrown great stress on the existing sewers and surface water drains. In consequence of an exhaustive report by Mr. Tomes, Surveyor to the Council, who kindly furnished me with the accompanying plan, works of some magnitude, designed to cope with the present situation and eventualities of no very distant date, are already in progress. As the main sewer, which runs along the towing path, is found to be becoming inadequate to carry off the amount of sewage with which it now has to deal, it is proposed to direct the Mortlake sewage from it into the main sewer of the Joint Sewerage Board at Kew Lane. |
48c43382-0064-437d-a922-2d716bacad0d | This will allow the sewer by the towing path to collect the Barnes sewage only, and will be accomplished by laying a new sewer—shown by a long dotted line on the plan. As a rapid development of building estates is occurring south of the Upper Richmond Road and east of Sheen Lane, severely taxing the capacity of the sewer which at present deals with this part of the district, it is proposed to put in a relief sewer (shown by a round dotted line on the plan) which will take the sewage from this locality by a new route to the Joint Sewerage Board's main sewer. The new sewers have in all cases been designed of capacity sufficient to fully cope with the future development of the various localities. 17 18 The importance of this scheme is very great, and it is a matter for congratulation that the situation has been so boldly treated. That the present outlay, large as it may seem, will prove of the truest economy, there can be no doubt. |
c644a870-b25b-4d4b-a75c-6dd7ddbd334e | Drainage: Cesspools, &c. As will be seen by reference to the table given on page 51, Appendix C., in several instances defective drains have been reconstructed or amended during 1905. The subject of cesspools, earthclosets and ashpits has been again considered (cf., reports 1902—4) and the proposed bye-laws set out below have received the provisional assent of the Local Government Board and will shortly come into operation. BYE=LAWS made by the URBAN DISTRICT COUNCIL OF BARNES with respect to the Cleansing of Earthclosets, Privies, Ashpits, and Cesspools in the urban district council ok barnes. The Cleansing of Earthclosets, Privies, Ashpits, and Cesspools belonging to any premises. 1. |
754ae819-7876-46c0-8c60-9047098b8f94 | The occupier of any premises shall, once at least in every three months, cleanse every earthcloset belonging to such premises and furnished with a fixed receptacle for fœcal matter and with suitable means or apparatus for the frequent and effectual application of dry earth to such matter. 19 2. The occupier of any premises shall, once at least in every week, cleanse every earthcloset belonging to such premises and furnished with a movable receptacle for fœcal matter and with suitable means or apparatus for the frequent and effectual application of dry earth to such matter. 3. The occupier of any premises shall, once at least in every week, cleanse every privy, belonging to such premises and furnished with a fixed receptacle for fcecal matter. 4. The occupier of any premises shall, once at least in every week, cleanse every privy belonging to such premises and furnished with a movable receptacle for fœcal matter. 5. |
f4f0e10b-6ec9-49b8-9cf1-eef858fa4535 | The occupier of any premises shall, once at least in every week, cleanse every ashpit belonging to such premises, and used only as a receptacle for ashes, dust, and dry refuse. 6. The occupier of any premises shall, once at least in every week, cleanse every ashpit belonging to such premises and used in connection with a privy as a receptacle for fcecal matter, together with ashes, dust, and dry refuse. 7. The occupier of any premises shall, once at least in every twelve months, cleanse every cesspool belonging to such premises. Penalties. 8. Every person who shall offend against any of the foregoing Bye-laws shall be liable for every such offence to a penalty of Five Pounds. |
f7967ea8-1541-40fb-98e0-bc11aee43620 | Provided, nevertheless, that the Justices or Court before whom any complaint may be made, or any proceedings may be taken in respect of any such offence may, if they think fit, ajudge the payment as a penalty of any sum less than the full amount of the penalty imposed by this Bye-law. 20 The Common Seal of the Urban District Council of Barnes was, in pursuance of a Resolution, hereunto affixed at a Meeting of the said Council, held on Tuesday, the 13th day of February, 1906, in the presence of STAMPA W. LAMBERT, Chairman. JOHN EUSTACE ANDERSON, Clerk of the Council. Water Supply. In my last annual report it was stated that, after consideration of a special report presented by me in November, 1904, the Council unanimously resolved that a Constant Water Supply was desirable for this district. |
b73828e6-bde0-4558-9f46-51b6f8f204ed | Further, the resolution of the Council empowered the Clerk and Medical Officer of Health to take all necessary steps to secure the same. In consequence, the Water Board were approached, and most courteously responded, enabling the necessary inspections to be made at a relatively trifling expense to the Council. By March 1st, 1905, 4953 houses (all those not in possession of a constant water supply) had been inspected, and 2,319 had been found to require some alteration to the fittings. On re-inspection later in the year of these 2,319 houses, the issue of 844 additional notices was found necessary. Before the end of September the Water Board were informed that the district was ready for the installation of the constant water supply, and very shortly afterwards the Board was enabled to provide the same. The readiness and public spirit with which the ratepayers responded to the demands which it was necessary to make were no 21 less gratifying than remarkable. |
c5a554b5-1497-46c4-95ce-31e041f5bf2d | But it is only right to state that the happy result of this having been carried through without the least resort to legal proceedings was largely due to the tact and energy of Mr. Goodale, the Assistant Clerk, on whom the whole organization of the work devolved. It is worth mentioning that the secondary results of the carrying through of this matter have been in themselves valuable enough, inasmuch as practically a house-to-house inspection of the whole district has been made for the Sanitary Department, and not a few incidental defects in drains, etc., have been discovered and amended. Nuisances (Appendix C). The general work usually referred to as that in connection with nuisances, has, as in past years, been ably and systematically conducted by Mr. Grylls. That during 1905 practically no serious nuisances occurred is sufficient evidence of the thoroughness with which the work has, in former years, been done. |
92ab72f5-886c-4861-b75f-195f3ff65c2a | The tables given in Appendix C, on pages 50 and 52, shew, perhaps, better than I can here explain, how greatly the routine work has of late increased, and how much attention has been paid to the smaller, but not unimportant details of sanitary administration. Places over which the Council has supervision. Those places over which special supervision is exercised by the Sanitary Officers of the Council are Dairies, Milkshops, Cowsheds, Slaughterhouses, Bakehouses and Petroleum Stores. The statistical particulars relating to Dairies, Milkshops, Cowsheds, Slaughterhouses and Petroleum Stores, will be found in 22 the tables on Pages 49 and 52. Appendix C, and those relating to Bakehouses in the special report under the Factories and Workshop's Act of 1901 (Appendix A). I have found, on my frequent visits to these places, that the general improvement noted in my last report is fully maintained. |
6bd98ed4-fe29-4572-be8c-f17ac97ac151 | Some of the tradespeople are eager and willing to respond to suggestions made to them, and I do not think that any of them have regretted the expenditure they have incurred in making better and more suitable arrangements. But there is still a tendency on the part of many to "muddle along" with chaotic backyards and unclean appurtenances. If the customers of milksellers in particular, instead of succumbing straightaway to the allurements of ornamental shop fronts, would ask to see the places where milk is stored and milk cans washed, there would be very much less sickness amongst infants and children. Infectious Disease. |
a6c14295-de47-4234-837d-180d26e30aa0 | As will be seen by reference to the table on Page 47 (Appendix C), the total number of cases of Scarlet Fever, Diphtheria and Typhoid Fever notified during 1905 was 52, exactly the number notified during 1904, and almost exactly half the average number notified during the years 1895-1904, when the population was much less than it is now. Put in another way the number of cases of Scarlet Fever, Diphtheria and Typhoid Fever notified per 1,000 of the population was, in 1904, 2.2 ; and in 1905, 2.1; while the average for the 10 years, 1895-1904, was 5.5. These figures, which have been carefully verified by comparison with the County Medical Officer of Health's returns, indicate, I think, that we have normally much less of these diseases than in past years. [See accompanying Charts]. |
b9e93cdf-a050-41b5-80da-afd63e75f8a0 | CHARTS Shewing the number of cases of Scarlet Fever and Diphtheria notified weekly during certain years. 1902. CHARTS Shewing the number ot cases of Scarlet Fever and Diphtheria notified weekly during certain years. 1904. 25 Of course, however, at any time an undetected case of* Scarlet Fever or Diphtheria at school may cause an outbreak. The figures which I have given relate to "cases notified" and this is not the same thing as "cases occurring." Medical men not infrequently, and most properly, in the interests of both the patient and the public, notify cases which in the end are found not to be cases of the disease at first suspected. But as a rule a Medical Officer of Health is not justified in publishing, at a year's end, lists of " cases that have occurred " based on a revision of the " cases notified." |
0a6cabf4-28e0-41f8-bf90-f638e43e682d | Such "revisions" appear in practice to consist in the elimination of every "case notified" the history of which does not, in the opinion of the Hospital Superintendent or other person, bear out the original notification. This proceeding, of course, results in a table of "cases which occurred" particularly favourable to the district concerned. For it takes no account of the number of unascertained and unascertainable cases which escape notification. As a rule these undetected cases fairly balance those which are notified in pardonable error, and therefore the publication of lists of "cases notified" as such, is the best and fairest way to determine in various districts the relative prevalence of cases of notifiable disease. The procedure with regard to disinfection has been so recently stated in detail that no reference is now required. |
eeec26bf-4b20-4c9a-be6c-fb12ee2eca7b | It is encouraging to note, however, that the principle of disinfection after death in cases of phthisis has been eagerly accepted by the public and has been carried into effect into almost every instance 26 With regard to notification it may be said that the advantages offered by the Council in the matter of examining bacteriologically cases of sore throat, etc., have been made use of with greater freedom and with valuable results. No serious difficulties have been met with during the year in connection with the notification of cases of infectious disease. Medical men in practice can facilitate the work of Sanitary Officials very greatly by a tactful and judicious paving of the way when speaking to relatives of the patients. Such courteous smoothing of the rough paths is always appreciated, and when coupled with early and prompt notification, and it may be an explanatory note referring to any unusual circumstances, does much to assist officials who have but to carry out statutory duties, and are in nowise anxious to exceed their proper province. |
515c3048-8c8f-4eb2-adc8-ea7a44315ca7 | When dealing with cases of uncertain nature the best course undoubtedly is to notify the case provisionally, explaining to relatives why this is done. The notification can then be either confirmed or withdrawn as occasion arises. In such instances the action of the Sanitary Officers is always in accordance with the exigences and circumstances of the case. Hospital Accommodation. During the year 1905 forty cases of Scarlet Fever and Diphtheria—or nearly 80 per cent, of the cases notified—were sent to the Mortlake Isolation Hospital. This is the highest percentage yet reported, and demonstrates sufficiently the appreciation by the ratepayers of the provision made by the Council. A table given in Appendix C. shews the case mortality for the last, and four previous years. 27 That the mortality for 1905 was somewhat greater than the average is explained by the fact, that of the fourteen cases of diphtheria and croup actually admitted four were serious cases of laryngeal disease requiring tracheotomy. |
d0d83d18-2eb1-4575-bdbf-14bfc437465a | Of these two recovered. Of the two fatal cases, one was complicated by a peculiar congenital malformation of the larynx, and one was admitted too late for more than temporary relief to be afforded. The period of detention in hospital of the cases of Scarlet Fever and Diphtheria was much shorter than in past years, and in consequence the " average number of patients daily " was, during 1905, very low. For this, as also for the immunity from complications enjoyed by the patients, thanks are due to the nursing skill of Miss Clark, the Matron, whose abilities, both nursing and administrative, have been of the greatest assistance. It was stated in my report for 1904 that considerable progress had been made towards the re-organization of the hospital, first suggested in 1901 and 1902. |
872ef3c3-02a8-424a-b718-452608a7716f | Early in 1905 a report was submitted urging the desirability of at once augmenting the quite insufficient accommodation for the staff, and of building a ward block suitable for the reception of cases of typhoid fever. A Sub-committee was appointed, which, after careful consideration, approved the principle of the recommendations made, but advised the postponement, for the time, of the building of a typhoid block. The report of the Sub-committee was adopted, and the Surveyor to the Council prepared an admirable design for additions to the administrative cottage, which will afford proper and seemly accommodation for the nurses and domestic servants. 28 These plans are being rapidly carried into effect under Mr. Tomes' superintendence, and will, with the addition of the very efficient system of electric lighting and telephonic communication devised by Mr. Davidson, add very materially to the efficiency of the Hospital. |
ec29db76-d625-4dcd-b882-1e7cf461b932 | As Medical Officer of Health, I cannot of course but regret that financial considerations should have led to the postponement of the typhoid pavilion being built; but the necessity for such a block has been recognized, and I am confident that the Council will, at the earliest possible moment, take steps to realize a project the necessity of which, before very long, will be patent to every ratepayer. The district is growing rapidly ; many hundreds of flats and tenements and small dwellings are imminent, and the difficulty of securing the admission of typhoid patients to general hospitals is, every summer, becoming greater. Hospital provision for infectious disease should be anticipatory; like a fire brigade, an isolation hospital is a safeguard; it is most useful when least used. No one would say that expenditure on an efficient fire brigade is wasteful when, in the district served by it, dangerous or fatal fires do net occur. |
0b921bd0-f6a3-47d6-bc67-fd4fb72f277b | Yet many think that an isolation hospital is extravagant unless it is full, or in other words, unless it is failing to perform its function—the prevention of disease. The necessary expenditure on what is called maintenance, and which includes the payment of rates, water rates, insurance and other inevitable charges, cannot, in small isolation hospitals, vary much with the number of patients under treatment. This is so because the expense of maintenance (after payment of rates, insurance premiums and other recurring charges), depends chiefly on the number of wards in use. 29 This number is determined not so much by the number of patients under treatment, as by the necessity for separating:—- (a) Patients of different sex. (b) Patients suffering from different diseases. The admission of four persons may, and frequently does, in this way compel the opening and staffing of four separate wards. |
63e41d42-8843-428d-bc32-354a9d346171 | For these and other reasons, the cost of small Isolation Hospitals is usually considered by those conversant with the subject not in respect of the "average number of patients present daily," but (a) With reference to the population and character of of the district served. (b) With reference to the extent to which the primary purposes of such Hospital are effected. The primary purposes of Isolation Hospitals are (a) To reduce the normal prevalence of certain diseases. (b) To afford security in times of epidemic increase in the prevalence of these certain diseases. The criteria of the efficiency of Isolation Hospitals are, therefore, perfectly obvious. The Local Government Board, some years ago, laid it down that, as a rule, the minimum provision that should be made is that of one patient's bed per thousand of the population. This minimum standard will be, for the first time, reached in this district when the works now in progress at the Hospital are completed. |
95190130-4e91-4ff8-ace6-3951d0ecbc75 | The first year in which no patients were admitted to the Council's Hospital from the "added area" was that corresponding to the financial year ending March 31, 1900, 30 The population was then 17,000; the attack rate from Scarlet Fever and Diphtheria seven per thousand; the cost of "maintenance" £1,369 9s., and the total (annual) cost of the Hospital (including repayment, &c., of loans) £1,850 17s. 3d. This involved a charge on the rates of more than fourpence in the pound. In the year corresponding to the last financial year the population was 23,200; the attack rate from Scarlet Fever and Diphtheria 1-8 per 1,000; the cost of "maintenance" £1,233, and the total (annual) cost of the Hospital (including interest on and repayment of loans) was £1,929. |
9dc296a7-04c9-46e7-aecf-903a9f162750 | This involved a charge on the rates of less than threepence in the pound. During the last five years, therefore, the population has increased by 35 per cent.; the attack rate from Scarlet Fever and Diphtheria has dropped to a quarter of what it was ; the cost of maintenance, in spite of larger expenditure from revenue on permanent improvements, has diminished by 10 per cent., and the charge on the rates has fallen from more than fourpence to less than threepence in the pound. The additional expense now being incurred by the provision for the staff (which will raise the wards to the minimum standard of the Local Government Board) will be more than balanced by the increase in the population and rateable value now accruing. It is very unlikely that the cost of the Hospital for this and the next financial year will, with payment of interest and instalments of all loans, exceed twopence halfpenny in the pound. |
f80b7dec-a7e7-4ac6-93e5-b8c40442a46c | The Small Pox Hospital Order (see report, 1904, p. 42) has been confirmed, but I have no knowledge of further steps having been taken. 31 School Hygiene. In my report for 1903 the arrangements which had been made with the local bodies, then managing Public Elementary Schools, with the aim of checking the spread, at these schools, of various infective disorders, were detailed. During 1904 these arrangements worked admirably, the school attendances reaching a hitherto (for this district) unprecedented percentage. During the latter part of 1904 I was enabled, by arrangement, to examine scholars suspected of disease, and not already under medical observation. These examinations proved very valuable, and co-ordinated easily and advantageously with the arrangements previously made. |
09f6f580-45b3-4278-a33c-a76f41966bd4 | At the beginning of 1905, however, the Local School Attendance Committee made other plans for the carrying out of the medical examination of scholars, and later in the year the County Education Committee appointed as their adviser on medical subjects a special Education Medical Officer. As a result of the policy adopted by the Surrey Education Committee before this appointment was made, local Medical Officers of Health have now no official duties or status in connection with the health of scholars and the hygienic arrangements of public elementary schools. In the recent able and exhaustive report of the County Education Medical Officer, it is true that the advisability of school teachers communicating with and asking the advice of local Medical Officers of Health is plainly urged. But the practical outcome in this district has been that one no longer receives the notifications, arranged for in 1903 from teachers, of children suffering from suspected disease. |
00d3c041-ee7c-4b8c-b6e3-df63302f3ae9 | And the 32 father absurd situation results that, although the Sanitary Department continues to afford to schools and school teachers such information as is possible as to children suffering from notifiable disorders, yet the Medical Officer of Health, who alone can, by reporting to his Authority, secure the compulsory closing, in time of need, of public elementary schools, has practically no regular source of information as to the health of scholars other than the reports in the public press of the quarterly meeting of local school attendance committees. I am strongly of opinion, that in the interests of public health and education, as well as financial economy, advantage should be taken of the local knowledge of Medical Officers of Health, and that they should have, in respect to these questions, powers and duties recognized by Education Committees, co-ordinated it may be with or controlled by the County Education Medical Officer, whether he be the County Medical Officer of Health, or an Officer specially appointed. |
b4d75b13-4003-43ea-8611-65e6153e69ac | This is the position adopted successfully in many counties, and is, of course, in principle that taken up by practically every Local Authority which is also an Education Authority. Unless some such scheme be adopted it becomes a matter of necessity that a medical staff of some magnitude should be appointed to act under the County Education Medical Officer. That the appointment of such a special staff is a matter wasteful both financially and physically is fully obvious. That the officer specially appointed to advise a local sanitary authority on, amongst other subjects, the control of infectious disease and the necessity for hospital accommodation, should have, in regard to elementary schools, absolutely no recognised powers or duties other than the ability to recommend, on belated information, the closing of a school or schools, seems almost ludicrous when it is remembered that more than 90 per cent, of the cases entering 33 isolation hospitals, and so involving a charge on the rates, are either school children or the infected brothers and sisters of school children. |
897bb864-8bc7-4c22-ae0a-f3cb3824838a | I need hardly say, however, that such assistance as can at any time be given, by reason of local knowledge or propinquity, to County the Education Medical Officer will always be most readily forthcoming. But the disadvantage of not having recognised status and the power to act promptly and decisively, if necessary, without appealing to a distance, cannot be balanced easily, and 1 do not anticipate that the freedom from disease amongst scholars which we have lately enjoyed will continue. Mortuary and Coroner's Court. The alterations that have been made to these places have proved both convenient and suitable. I hope that something may be done shortly to improve the internal arrangements of the Mortuary which, now that the hospital buildings approach it so nearly, leave a good deal to be desired. Thirty-three inquests were held during 1905. Of these 16 were on the bodies of residents, and 17 on the bodies of non. residents, almost all of which were recovered from the river. |
66fd13d3-8c3a-438e-84a1-7623809cf3f1 | The verdicts were, in 11 cases, "Found drowned" or "Found dead"; in 5 cases "Suicide"; and in 2 cases (those of infants whose bodies were found on the Common) " Wilful murder." 10 deaths were found due to natural, and 5 to accidental causes. Baths and Washhouses. No further steps have been taken in regard to this matter. 34 Cemetery. The new cemetery provided by the District Council in part of the so-called " added area " bas been opened formally and already used for interments. The cemetery at Mortlake is not yet full, but it is stated that that on Barnes Common has not very much space left available for burials. The Midwives' Act, 1902. Extract from the Report for 1905 of the Medical Officer of Health for Barnes, to the Local Supervising Authority—the Surrey County Council. |
a21fd14d-6bfd-4b4e-807f-167bfbdb43b0 | "(2) The certified midwives said to practice in this district, of whom I have obtained information, are six in number. I have repeatedly during the year visited their residences, and have obtained such information relative to their mode of practice, and their compliance or otherwise with the Act as has been possible. "(4) There are several midwives in the district who are not certified or registered. They are fully aware that there is, under the Act, no power to deal with them at present, so long as they do not incorrectly describe themselves. "(5) No steps have been taken to instruct the midwives who are registered more particularly than can be done viva voce by myself at my visits, inasmuch as there are only two that need instruction, and of these one is totally illiterate. |
defb6846-31d2-4b02-a638-6da1ddc3c11c | "(6) No difficulties have arisen with respect to the payment of fees to medical men, and no case of irregularity or disease has been brought to my notice as having occurred in the practice of any of the midwives, registered or unregistered, during the past year." 35 Appendix A. Special Report under the Faetory and Workshop Act, 1901. The various places which in this district are, so far as the Local Sanitary Authority is concerned, under the operation of this Act, have been, during the past year, frequently visited by myself and the Sanitary Inspectors. The tables required by the Home Office immediately follow this note, and, in Appendix C, some further particulars are afforded on pages 50 and 52. It will be seen that, though continued and careful attention has been paid to the working of the Act, no very serious matters have required attention, and the written notices served have been in all cases complied with. |
c8a96531-f4b1-4b96-b428-0cc983e5c5af | I have again, however, to record the statement that no steps have been taken to make bye-laws " providing for means of escape from fire in the case of any factory or workshop," or to see that, as the Act directs, " every factory and workshop in the district is provided with sufficient means of escape from fire." 36 Annual Report for 1905 of the Medical Officer of Health for the Urban District of Barnes on the administration of the Factory and Workshop Act, 1901, in connection with FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES' AND HOMEWORK. I.-INSPECTION. Inspections made by Sanitary Inspectors Premises. Number of Inspections. Written Notices. Frosecutiors. |
b4a61a6f-83a6-4a4b-b2c1-1e85acc41deb | Factories (Including Factory Laundries) 26 3 — Workshops (Including Workshop Laundries) 200 23 — Workplaces 25 1 — Homeworkers' Premises 12 — Total 263 27 — 2.—DEFECTS FOUND. Particulars. Number of Defects Number OF tions. Found. Remedied. Referred to H.M . Inspector Nuisances under the Public Health Acts :— Want of cleanliness 12 12 — Want of ventilation — Overcrowding 2 2 — — Want of drainage of floors 2 2 — — Other nuisances 11 11 — — Sanitary accommodation insufficient — — unsuitable or defective — — — not separate for sexes — — — — Offences under the Factory and Workshop Act: — Illegal occupation of underground bakehouse (S. 101) - - - - Breach of special sanitary requirements for bakehouses (SS. |
6faa5230-f1eb-4575-807f-b9d296b76ca1 | 97 to 100) - - - - Failure as regards lists of ou workers (S. 107; - - - Giving out work to be done in premises which are unwholesome (S. 108) - infected (S. 110) — — — — Allowing wearing apparel to be made in premises infected by scarlet fever or smallpox (S 109) - - - - Other offences — - - - Total 27 27 - - 37 3.—OTHER MATTERS. Class Number. Matters notified to H.M. Inspectors of Factories :— - Failure to affix Abstract of the Factory and Workshop Act (S. 133) - Action taken in matters referred by H.M. Inspectors as remediable under the Public Health Acts, but not under the Factory Act (S. 5) Notified by H.M. Inspectors - Reports (of action taken) sent to H.M, Inspectors - Other — Underground Bakehouses (S. |
acf913a6-1895-4d90-bd14-811a0425c713 | 101): — Certificates granted during the year — In use at the end of the year 5 Homework : Number of Lists of Outworkers (S. 107): — Lists. Outworkers. Lists received - — Addresses of outworkers ' forwarded to other Authorities . - - received from other Authorities 6 17 Homework in unwholesome or infected premises :— Wearing Apparel. Other. Notices prohibiting homework in unwholesome premises (S. 108) Cases of infectious disease notified in homeworkers' premises - - Orders prohibiting homework in infected premises (S 110.) — — Workshops on the Register (S. 131) at the end of the year Important classes workshops, sushs workshop bakehouses, may be enumerated i ere. Workshop Laundries 14 Dressmakers' Premises 29 Shoemakers' Premises 15 Bakehouses 10 Total number of workshops on Register 124 38 Appendix B. Tables of the Local Government Board. |
3bb9602d-64db-46ad-9f5d-c3c795e6bd62 | I.— Vital Statistics of whole District during 1905 and previous years. II.— Vital Statistics of Localities during 1905 and previous years. III.—Cases of Infectious Disease notified during 1905. IV.— Causes of, and ages at, death during 1905, V.—Infantile Mortality. 39 TABLE I. Vital Statistics of whole District during 1905 and previous Years. Name of District -Barnes Urban. Year. Population estimated to Middle of each Year Births. Total Deaths Registered in the District. Total. Deaths in Public Institutions in the District. Deaths of Nonresidents registered in Public Institutions in the District. Deaths of Residnts registered in Public Institutions beyond the District. Nett Deaths at all ages Beloning to 'the District. Number. Rate*. Under 1 Year of Age. At all Ages. Number. Rate per 1,000 Births registered. Number. |
b01b350c-cdea-4972-bb41-4389ee4aa4c8 | Rate Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1895. 15950 397 24.1 51 128.4 218 13.6 7 ... 6 224 14.1 1896. 16200 404 24.9 61 140.9 191 11.7 4 ... 7 198 12.2 1897. 16450 370 22.5 54 145.9 196 11.9 2 ... 5 201 12.2 1898. 16700 351 210 64 182.3 203 12.1 5 ... 3 207 12.4 1899. |
a75e1c2e-da70-4174-8c76-bf233383036b | 17000 458 26.9 58 126.5 225 13.2 5 ... 4 229 13.4 1900. 17400 416 23.9 56 134.6 220 12.7 1 ... 3 223 12.8 1901. 17900 420 23.5 56 133.3 214 12.5 3 ... 24 238 13.2 1902. 19900 501 25.1 57 113.7 257 12.9 7 ... 27 286 14.2 1903. 21150 513 24.2 57 111.1 220 10.3 5 ... 27 247 11.6 1904 Averages for Years 1895-1904. |
fb4cccda-9204-431e-a572-c241ef6d01df | 23200 618 26.6 83 134.3 237 10.2 0 ... 24 261 11.2 18185 444.8 22.4 59.7 134.4 218.1 11.9 39 ... 13 231.4 12.7 1905. 24250 600 24.7 72 120 254 10.4 3 ... 35 289 11.9 Area of District in acres (exclusive of area covered by water). 2,400. *Rates in Columns 4, 8, and 13 calculated per 1,000 of estimated, population. Total population at all ages Number of inhabited houses Average number of persons per house 17.821 3,403 5 236 At Census of 1901. 40 TABLE II. Vital Statistics of Separate Localities in 1905 and previous years. |
bedd3fcd-b704-467f-8d22-bfd937901b1f | Names of Localities 1. BARNES (URBAN). 2. BARNES, 3. MORTLAKE. Year Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under I year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to micdle of each year. Births regis t red Deaths at all ages. Deaths under 1 year. a b c d a b c d a b c d 1895 15950 397 224 51 8950 226 107 25 7000 171 117 26 1896 16200 404 198 61 9100 217 104 30 7100 187 94 31 1897 16450 370 201 54 6230 218 101 26 |
5f0f2000-2cd4-43d1-ac10-43d14d6a5bd8 | 7220 152 100 28 1898 16700 351 207 64 9350 193 126 42 7350 158 81 22 1899 17000 458 229 58 9500 286 123 36 7500 192 106 22 1900 17400 416 223 56 9750 230 107 26 7650 186 116 30 1901 17900 420 238 57 10100 258 127 27 7800 162 110 30 1902 19900 501 286 60 10700 259 140 32 9200 242 146 28 1903 21150 513 247 59 11250 263 133 32 9900 250 114 27 1904 23200 618 261 86 12000 293 134 43 |
e9ee22bc-ae79-4903-ad35-1d7e615fde7f | 11200 325 127 43 Averages of Years 1895 to 1904 . 18185 444 231 60 9993 244 120 31 8192 200 111 28 1905 24250 600 289 74 12250 310 138 26 12000 290 151 48 TABLE III. Cases of Infectious Disease notified during the Year 1905: Name of District—Barnes Urban. Notifiable Disease. Cases Notified in Whole District. Total Casec Notified in each locality. Number of Cases removed to Hospital from each locality. At all Ages. At Ages Years. 1 2 1 2 Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65 65 and Upwrds Barnes Mortlake. Barnes. Mortlake. Small Pox — — — — — |
d05e6613-f6c8-4d96-87a2-0f52654f9792 | — — — — — — Cholera — — — — — — — — — — — Diphtheria 17 — 4 7 3 3 — 8 9 6 8 Membranous croup 1 — 1 — — — — — 1 — 1 Erysipelas 10 — — — 2 8 — 6 4 — 2 Scarlet Fever 31 — 9 19 2 1 — 21 10 19 6 Typhus Fever — — — — — — — — — — — Enteric Fever 4 — — — 1 3 — 2 2 — — Relapsing Fever — — — — — — — — — — — Continued Fever — — — — — — — — — — — Puerperal Fever 1 — — — 1 — — — 1 — — Plague — — — — — — — — — — — Totals 64 — 14 26 |
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