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b96f645d-be75-4381-8fc2-dffc362d6daa | In one case the preparation of ham, beef, &c., for sale was found to be carried on under very unsatisfactory conditions, but on my intervention drastic changes were at once made by the owner. 15 Most of the meat sold in the district comes from the Central Meat Market, and has therefore been already carefully examined. Very rarely, indeed, is anything found wrong with meat so procured. Some meat, however, is brought from a neighbouring district, and is less satisfactory. There are three slaughter-houses in the district, and Mr. Robinson, the Assistant Inspector, who is specially trained in food inspection, is usually present on killing days. One carcase was during the year found to be tuberculous, and was at once destroyed. On several occasions during the year, livers, joints, &c., have been destroyed immediately at the request of one or other inspector. There are 18 eating-houses, and two places where ice cream is prepared in the district. |
553bed51-cdc7-483c-8f7f-86ddf2827e94 | These are frequently inspected. The report of Mr. Houghton, the County Inspector under the Food and Drugs Act, who doubtless gives as much time to this district as his very large area of work allows, is given on page 49. The Sewerage and Drainage of the District was referred to in detail in my report for 1908, and in that for 1905 a plan was given which shows the chief lines of our system. During 1909 very little sewerage work of consequence was carried out, other than that of course necessitated by the opening up of new roads by builders. As will, however, be seen on reference to the table given on page 56, in 67 cases defective drains were amended, and in 18 reconstruction was carried out. It was possible during 1909 to give much more time than formerly to systematic drain testing. |
bbce559f-f009-4f1e-8f5e-ffbef5141bfc | 16 The Disposal of House Refuse is still conducted on the lines which have now obtained for some years, and complaints from persons residing in the new houses near to the dock at which the carts tip their contents into the barges are of frequent occurrence. The question of the provision of a dust destructor has again, as for some years past, engaged the earnest attention of the Council, but no conclusion has so far been determined on. I understand that a new process, by which house refuse is rapidly converted into an inoffensive dry powder, has lately obtained favourable comment. So far as my information goes, the process is an excellent one, and suitable for this district. Earlier in the year some communications were made to the Richmond Borough Council, as it was thought that possibly that Authority might favourably consider a plan for the erection of a dust destructor under joint management near to the works of the Joint Sewerage Board. No progress, however, was made with the pourparlers. |
4a1facea-06a3-476f-afda-216101c09100 | Trade refuse is now, I am glad to say, removed by the Council's scavengers by arrangement with those tradespeople who are willing. Complaints frequently reach the Sanitary Department from householders who are aggrieved by the deposition of rubbish in the secondary means of access to their houses. In some parts of the district there are quite long lanes, running between the back gardens of contiguous streets, which afford these secondary means of access, and it appears to be the general practice for householders to deposit dead leaves, the cuttings from lawns, &c., in these lanes, opposite their neighbours' gates. 17 It is not quite easy to find a remedy. The passages are private property, and the Council is not desirous of scavenging these unless the cost is duly apportioned under the P. H. Acts. All that the Sanitary Department can do, if any accumulation is found to be a nuisance, is to serve a notice for its removal on the person to whose house it is contiguous. |
e13d02f7-8225-451f-88b6-21f4bae818c2 | Such person is usually the person aggrieved, and not the person who causes the nuisance to occur. The work undertaken with regard to Nuisances is summarized in tables given on pp. 56 and 57 by Mr. Grylls, to whoseexperience and tact the district has for so many years been indebted. It will be seen that the house-to-house inspections were slightly fewer than 1908, but that more work was done by way of house cleansing and disinfection, there having been more visits to houses in which notifiable disease occurred. No legal proceedings were taken, as in every case the defects were remedied, and in only 36 cases was it necessary to serve a Statutory Notice. No serious nuisances were complained of during 1909, and the general condition of the district is year by year rising to a higher level. It should be observed that the table on page 56 is not merely a record of the nuisances discovered, but of the nuisances abated. |
a8140efc-0c51-4de3-86d7-6517745a8177 | Bye-Laws. For some years past I have, in these reports, alluded to the desirability of some Bye-Law being adopted that would check the construction of double tenements with inordinate "back additions." Early in 1909 the matter was considered by the Council, and after a conference with officials of the Local Government Board, it 18 was decided that application should be made for confirmation of (i) an addition to Bye-Law 3 of the series made on May 10th, 1898, and (ii) a new Bye-Law. Confirmation has not yet been received, but it is hoped that such will shortly be the case. |
9ed57915-b5db-427d-b5dc-f2b04a7f5633 | The proposed addition and new Bye-Law are as follows:— (i) Every person who shall erect a new domestic building of which any part projects in the rear from the main part of such building shall, in addition to the open space required to be provided in connection with such building by any Bye-Law in that behalf, provide on one side of such projecting part an open space, exclusively belonging to such building, which shall be free from any erection thereon above the level of the ground and shall extend laterally throughout the remaining width of such building and longitudinally throughout the entire length of such projecting part, and he shall cause the distance across the last mentioned open space from the side of such projecting part to the boundary of any lands or premises immediately opposite the side of such new domestic building to be not less in any case than 5 feet. |
b7ae3b6d-0a33-447e-9d34-092a4e97f0e7 | If the height of such projecting part be not less than 15 feet, or the length not less than 25 feet, but the height be less than 25 feet and the length less than 25 feet, he shall cause such distance to be 7 feet 6 inches at the least, or, If the height of such projecting part be not less than 25 feet, or the length not less than 25 feet, but the height be less than 35 feet and the length less than 35 feet, he shall cause such distance to be 10 feet at the least. If the height of such projecting part be not less than 35 feet, or the length not less than 35 feet, he shall cause such distance to be 12 feet at the least. |
c39bfc67-dede-48dd-b733-6ea1626916d7 | 19 (ii) That where a window shall be so constructed as to open into an enclosed court or area open only at the top to the external air, such window shall not be deemed to comply with the requirements of the Bye-Law, unless the distance across such court or area, measured from the opening of the wall in which such window is constructed to the opposite wall of such court or area, be equal at least to two-thirds the height measures from the height of the sill of such window to the level of eaves or top of the parapet of the opposite wall." Suggestions for various other amendments have been, from time to time, made by my colleagues and myself, and a committee is now sitting that has been appointed to consider and report on the whole question of the revision of the Building Bye-Laws. No lodging houses, and no offensive trades exist or are carried on in our district now. |
bf253dc0-f205-45ca-bbcd-10f00bbf8ce9 | On November 13th, 1908, a Home Office Order was issued declaring the greater part of Section 81, the whole part of Section 85 (Registries for Servants), the whole part of Section 86 (Marine Stores, etc.), Part 8 and Part 9 of the Public Health Acts Amendment Act, 1907, to be in force in this district. The steps necessary to administer these enactments have been taken, and Bye-Laws under Section 8 have been made and confirmed. On October 29th, 1909, a Local Government Board Order was issued declaring that on and after December 10th, 1909, Part 2, Part 3, Sections 52—65 and 67—68 contained in Part 4, and Part 10, of the same Act, should be in force in this district, subject to certain conditions and adaptations duly scheduled. For some time past an ambulance, provided by subscription at the instance of Dr. |
209e0d66-bbd0-4c26-9f55-8a387d6ee51c | R. D. Mackintosh, has been available in case of sickness or accident, and has been kept at the Council's depot. 20 Owing to the generosity of Dr. Mackintosh and the committee presided over by him, this excellent ambulance has been presented to the Council, and will be in future be maintained by them under Section 50 of the Act just referred to. The Officers of the Council have been directed to frame suggestions for regulating the use of the vehicle, which, under the new conditions, will no doubt be of even greater public benefit than heretofore. The Public Elementary Schools in the district were referred to, and their condition described, in my report for 1908. |
c5a16707-dee2-4660-8088-12afd32bd240 | It will be sufficient now to state that the non-provided (National) schools at Mortlake have been considerably improved; that the new infants' (Council) school at Mortlake is completed and in use ; and that the new Council mixed school, close to the scavenging dock in Lonsdale Road, has also been completed. The playgrounds of these schools are not of impervious material, but are gravelled. During November a slight outbreak of diphtheria occurred at the Green Schools, Barnes, and a few scholars in one or two class-rooms were attacked. Considerable alarm was caused, and much attention given to the outbreak, owing to the fact that coincidently with the outbreak being known there was a failure of the water supply to the school. The first cases however had occurred several days before the failure of the water supply, which was found to be due to the breaking of a lead service pipe some distance away, by reason of the brittleness of age and the growth of trees. |
9f751066-1c40-47d7-a299-9d8d0181f5cb | I understand that the condition of these schools, perhaps the best of the older buildings, is under consideration. The old-fashioned trough closets should certainly be abolished, and the cottage adjoining, used for residential purposes, should be otherwise employed. 21 As the Urban District of Barnes does not, as yet, enjoy autonomy in the matter of public elementary schools, the arrangements for medical inspection are in the hands of the County authorities, and are well carried out by the executive officer, Dr. Jones, Assistant County Medical Officer of Health, with whom we work in the admirable harmony desired by the Board of Education. The last memorandum of the Board of Education, on school closure and the exclusion of scholars, has of course raised some difficult technical points owing to the state of the law. But, while the actual systematic inspection is carried out for Barnes and Mortlake by the special medical examiners appointed by the Education Committee of the Surrey County Council to work under Dr. |
5983c405-ead7-4b27-8706-c4ad564ed0d5 | Jones, I continue gladly to carry on the somewhat thankless task of examining school attendance cases. Owing to an expression of opinion at the Mortlake Petty Sessional Court that medical evidence should always be forthcoming in cases of prosecution for non-attendance owing to dirt, vermin, &c., and the apparent reluctance of anyone or any authority to pay fees in respect of such evidence, a position of some difficulty was at one time reached. The difficulty was, however, resolved, and the activities of the excellent School Attendance Officer, Mr. Chambers, under the direction of his Committee, continue to exert an increasingly beneficent effect. An arrangement has also been arrived at between Dr. Jones and myself whereby the technical and legal difficulties indicated by the memorandum just referred to in respect of school closure on "educational" grounds, and the exclusion of particular children, are overcome. Happily, during the year school closure was only called for in the case of the outbreak at the Green Schools just alluded to. |
d70892fe-56bb-46cd-b63d-1e6bff9c676c | 22 Here a rather noteworthy sequence of events occurred. On the occurrence of two or three cases advantage was taken of the power to close a department only of the school. This was done because the existence of one or two carriers was suspected, and proved; and also in order that the classroom should be cleansed. Formerly of course no such action was possible. But the result was that panic set in, and we were practically forced to close the whole school, as the numbers were so depleted that work could not well be carried on. It would be a deplorable thing if the exercise of power to close a department, or to exclude the number of scholars making up a class, on the occurrence of a few cases, should, in future, thus lead to panic, and the closure of a whole school. Generally, the health of the scholars has been good; there was some measles early in the year, and some chicken-pox later. |
139c2a2c-0856-403c-ab64-6fb7d747678c | There has been no change in our methods of dealing with infectious disease during the year, and the cases which occurred will be dealt with on a subsequent page. At the Isolation Hospital a new and admirable ward block has been completed under Mr. Tomes' supervision, and is satisfactory in every way. It is proposed to use it chiefly for cases of diphtheria, and it contains, in addition to two wards of six beds each, two excellent single wards, one of which has been fitted specially for cases requiring operative treatment. The sanitary annexes to this block are of a particularly useful type, and the building has been well, though economically equipped on the same lines as the best type of surgical ward, with aseptic furniture and fittings. This is a point on which I am inclined to lay great stress. 23 The new mortuary is well fitted for its purpose, and the old mortuary has been thrown into the coach house, giving good accommodation to the new aseptic ambulance supplied by Messrs. |
4b031084-0969-4cb4-bd8a-df9d5ef13cf2 | Carter & Sons, and the old ambulance, now repaired and improved, and adapted for use, should it be necessary to remove patients at any time to the County Small Pox Hospital at Clandon. The old block at the Hospital is about to undergo some necessary alterations to the sanitary annexes, and then will be, no doubt, renovated throughout. The fowls kept at the Hospital continue to be a source of profit, and have provided over 2,000 eggs during the year, whilst 19 young birds have been killed for the food of the patients. Eighty eight cases were admitted during the year under review; of these 46 were cases of scarlet fever. All recovered, while there were 35 cases of diphtheria with 4 deaths. |
b31a1d18-9fb0-4856-9b5d-c60fa8c8469d | Of these cases, 6 had marked laryngeal symptoms on admission; one died suddenly after temporary improval; one, aged 7 months, died of broncho-pneumonia after successful intubation; two others recovered after intubation, and two without operation One of the successful cases of intubation was, on admission, just convalescent from measles and whooping cough, and had, in addition to faucial and laryngeal diphtheria, diphtheria of an unhealed wound after removal of the appendix. Two cases of very severe erysipelas, one case of puerperal septicaemia, and four cases of typhoid fever were admitted. During the last few years the accommodation available had, owing to the growth of the district and other causes, until the opening of the new block, fallen below a convenient standard. |
a025647d-39d6-4967-8cb8-8466f6924823 | It was, therefore, a matter of considerable anxiety to prevent cross infections, etc., but the success of the arrangements which we were, after 1907, able to make, together with the unwearying assistance of 24 Miss Bellinger, were such as to somewhat modify the views formerly held by me of the methods whereby which spread of infection in isolation hospitals might be prevented. These modified views have been recently stated by me to a professional audience, and without going at length here into technical matters, I may say that I am convinced that by a proper ritual of asepsis the dangers attending the introduction of mixed cases, doubtful cases, and cases of mistaken diagnosis may be practically abolished, while at the same time, as we have proved, considerable economy in staffing can be secured. |
afbdc1f9-480c-4f56-8c28-afe734be1bbe | It is, however, absolutely essential for the success of this method that there should never be any diminution in the full amount of air space allotted to each patient, that the equipment of the wards should be kept up to a certain level, and that there should be a sufficient number of wards. If experience confirms these views, 1 believe it will be found that cases of infectious disease may be handled with greater boldness than formerly, and, what will perhaps be regarded as even more satisfactory, there may be a greater economy in the construction and administration of, at any rate small, isolation hospitals. There is no doubt, I think, but that greater attention should be paid to isolation hospitals than is now the case. |
9463610a-840a-4b13-ab29-b50eab808916 | It is a pity that there is no machinery for their official inspection, as is the case with asylums, workhouses and infirmaries ; and, though perhaps it is hardly within my province to make the suggestion, still there have been official enquiries into subjects of, perhaps, less importance to the community than the provision and management of these institutions. It is difficult to say which zymotic diseases, if any, will not, a generation hence, be treated by local authorities in specially equipped institutions directly descended from the contemned "fever hospitals" of to-day. 25 As is known, in this district the voluntary notification of cases of Tuberculosis has been practised for some years. But, during 1909 the order of the Local Government Board requiring the notification of such cases from Poor Law officials has of course been in force. During the year five cases were notified by private practitioners voluntarily, and fourteen cases were notified by the Poor Law authorities. |
eb72da57-a4dc-406e-8c4d-bfd543823d91 | Of course some of the latter cases were notified to us several times from different persons; the district medical officer, the relieving officer, the medical officer of the infirmary at Richmond, and so on. In every instance the premises inhabited or vacated by notified persons was visited; the appropriate leaflet of instruction left; the house carefully inspected and if necessary cleansed, and the rooms and contents disinfected at the proper time. The public are without doubt much more alive than formerly to the necessity of disinfection, and there is a growing appreciation of the advantage of free ventilation. In fact there is a greater tendency for phthisis to be classed with other infectious diseases, and I do not doubt that in time public opinion will demand its treatment with them. As a practising physician one cannot but be impressed with the increasingly good results that can be secured by even domestic treatment of tuberculosis, now that the public appreciate the advantages that follow early and confident diagnosis. |
bc4c8993-cacc-4e4d-ba43-e769d3284e1d | It is hesitation in diagnosis that causes most loss of life from phthisis, and there is no excuse for it now that a definite opinion means bold and often successful treatment, 26 By referring to the table given on page 41, the number of cases of Infectious Disease notified during 1909 will be seen. The fifty-six cases of scarlet fever were scattered throughout the district, and few of the twenty occurring in Barnes had any obvious relation to each other. Of the thirty-six cases in Mortlake six arose in connection with a large educational establishment at Richmond attended by girls from this district. No cases were found in this district to have been related to the sharp outbreak of milk-borne scarlatina which, during the summer, affected a part of Surrey and South-West London. The forty-three cases of diphtheria were also, with the exception of the few already alluded to as affecting the Green Schools, apparently not related to each other. |
10c1f649-5d5a-4381-bbb8-9f8bb6ba5e96 | The severity of the cases, and the proportion of those with laryngeal implication was, however, considerable. Our laryngeal cases of diphtheria usually come from Mortlake, and a good many cases of false croup are seen amongst the poor of that parish. The table on page 47 affords an opportunity of comparing our yearly records. It is clear that, although 1909 was not quite so good a year as 1908, our position in respect of the principal infectious diseases continues to improve. It is well known that there is an annual as well as a seasonal curve for infectious diseases, 1909 was a year in which a high wave was due. But the high waves are not so high as formerly, and the occurrence rate of scarlet fever, diphtheria and typhoid is, on the 27 average, little more than half what it was a few years ago. |
4ff4cdb9-93ce-4cec-87dd-3e7ffbdd0a10 | It is true that sixteen cases of typhoid fever were notified during 1909. All but three of these, however, were due to the conveyance of the specific virus from outside the district. The circumstances of this outbreak call for narration and comment. On February 9th, I received from Dr. G. Hovenden intimation that a child in Barnes was, in his opinion, suffering from typhoid fever. On February 10th the case was removed to a London hospital, where the diagnosis made by Dr. Hovenden was contradicted, a fact of which I did not become aware until some weeks later, when the authorities finally corroborated the perfectly accurate diagnosis originally made. Within the next two or three days, two cases of children suffering from intestinal disturbance occurred in my own practice, and, as enquiry established a possible common factor for the three, I was enabled to make a diagnosis of typhoid fever with some confidence. |
86e5f748-1faf-4708-b586-7d729b8223d0 | On February 14th, I saw a fourth case, a child of eighteen months, and in this instance the common factor was also present. Enquiries and activity had, however, already been set on foot, and a purveyor of milk, whose premises were outside this district, agreed to sterilize all milk sold by him. Dr. Caldwell Smith, the Medical Officer of Health for Wandsworth, was communicated with, and he satisfied himself that there was no fault to be found with either the condition of the purveyor's premises or the health of his employees. In the meantime a circular had been sent to the practitioners in this district, with the result that in the course of a few days seven cases more were discovered in Barnes. Dr. Smith also became aware of four cases in Wandsworth. |
0acf3c9f-1cc0-4bf0-b538-72ce561d6f19 | Enquiries as to the 28 source of the milk revealed the fact that it was derived from 36 farms in Wiltshire, and, by February 19th, it had been found that at a certain farm one child had been ill for weeks with typhoid fever. The father of the child, though under contract to inform the London purveyor of any case of illness at his farm, had omitted in this case to do so, and had allayed suspicion by using an ordinary billhead instead of the proper contract note, as if he had been temporarily without the usual forms. The supply of milk from this farm was at once stopped, and a little later the place was visited by Dr. Caldwell Smith and myself, in company with Dr. Streeten, the Medical Officer of Health for Swindon and other districts. |
67c4c127-81b8-4f69-b439-7e41243d90da | By this time the mother of the child just alluded to was also recognised to be suffering from typhoid, and we learned that some months previously another child belonging to the same family had suffered from an illness thought at the time to be tuberculous meningitis. We found, moreover, that one of the farm hands was said to be ill with pneumonia, and suggested further investigation. The case turned out to be typhoid. Assuming that the cases in Barnes and Wandsworth were indeed connected with the state of affairs at this farm in Wiltshire, it may be asked what was the exact nature of the relation. From a comparison of dates it appeared probable that the infection might have been due to a misuse of certain utensils during the first and second weeks in January, when the second child was sickening. But what was the source of the original infection ? |
f2b51ef6-35cc-4b06-a9c4-d5eee8ad7238 | The most careful enquiry failed to reveal the most remote contingency that we could think of for the infection of the first child, who, at the time, was thought to have tuberculous meningitis. Only the water supply of the farm from a neighbouring hill could be implicated by those who are not ashamed to believe in the 29 "de novo" origin of typhoid fever at times. This water supply might have become fouled by simple pollution, but the probability of specific infection was negatived. Of the 11 primary cases which occurred in Barnes, all recovered. Two secondary cases occurred and also recovered. I believe that the cases in Wandsworth also did well. Clinically the outbreak was interesting on account of the number of quite young children infected. I had one case, as already narrated, aged but 18 months. Quite a number of the cases began with symptoms, and some with physical signs of acute lobar pneumonia, and most had a heavy crop of spots. |
4bcb6842-aac8-4a28-8ba8-df3efe10ddbe | There are several other points of interest, notably the enormous importance of the correct diagnosis made, under difficult circumstances, by Dr. Hovenden. This diagnosis was arrived at on clinical grounds, though disputed for weeks by the pathologists of a first-rate London Hospital. Although of course most of the cases were notified after the probable medium of infection was recognised definitely on February 14th, all of them were infected before the sterilization of the milk commenced on February 15th, and as nearly 20,000 persons were being supplied daily by the one purveyor, the possibilities for mischief were very great. Dr. Caldwell Smith was most kind and helpful in his co-operation with me, and we both received all possible assistance from the purveyor, who did everything to help us in elucidating the facts. One or two practical recommendations may perhaps be made. |
1b3716e3-8174-49fe-87d5-99be19c2dc55 | Valuable as it is for Medical Officers of Health in towns to be supplied, by purveyors of milk, with lists of their sources of supply, it would be infinitely better were dairy farmers compelled to furnish 30 local Medical Officers of Health with the names of the purveyors to whom they send supplies. If this had been done in the case I am discussing it would have been useless for the farmer to juggle with his contract note, as, immediately that the presence of typhoid at the farm had been known, the local Medical Officer of Health would have communicated with Dr. Caldwell Smith and myself. Another point is that it is doubtful if statutory powers exist to prevent cheese being made from infected milk. Immediately that the supply of milk to London from his farm was rejected, the farmer began to make cheese from it. What happened to the cheese I know not: but Medical Officers of Health should certainly have the power at once, on discovery, to suspend the sale of such stuff. |
8337bb8b-4c60-4518-aecb-4f9c890216bb | Three cases of typhoid that occurred during 1909 had no relation to this outbreak. In one instance the history pointed to ice cream, purchased at Hammersmith, as the vehicle: in another the lad had drunk water from Beverley Brook, and in the third there was a history of personal contact with a convalescent patient outside the district. Three fatal cases of Puerperal Fever occurred during 1909. All three were delivered by medical men. In one case peritonitis followed difficult instrumental delivery : in both the other cases the patients were, at the time of parturition, suffering from phthisis, and it was difficult to decide how far the deaths were due to septicaemia, and how far to miliary tuberculosis. As stated in my previous reports, since the coming into force of the Midwives' Act the actual inspection of the work of registered 31 midwives in Surrey has been carried out, under arrangement with the Surrey County Council, by the local Medical Officers of Health. |
02def2b0-3bbf-42f1-826d-c76b0a833d51 | Somewhat abruptly, towards the end of 1909, this arrangement was determined by the Surrey County Council, as it was felt that a task which had been shared by the numerous Medical Officers of Health throughout the county, would be better carried out by a lady who would devote half her time to it, and half to the work of the Surrey County Nursing Association. The fact that local Medical Officers of Health, especially when engaged in practice, have abundant opportunity in the course of their daily work of gaining knowledge of the capacity and character of the midwives, has been thought to be outweighed by the advantage of visits two or three times a year by an Inspector, who would be responsible for the whole county. |
a101dee5-8239-417c-b886-22bca9cefa9a | I understand, also, that the suggestion was made that Medical Officers of Health engaged in practice might be induced to take a favourable view of a midwife's work if she were in the habit of calling him in in emergencies, although most, if not all such Medical Officers have been, in the past, glad that their quasi-judicial position has given them an excuse to ask midwives not to send for them on these unprofitable occasions. It is, of course, obvious that under the new regime, the same prompt official action cannot be possible as hitherto in certain cases, and it is not clear as yet how the central supervising authority proposes to obtain information of irregularities, and the practice of unregistered persons. There are at present three trained and registered midwives in Barnes and Mortlake, all of whom are competent and do their work well. Two registered but untrained midwives are also enrolled, though one of them does not practise. |
423a2dda-523b-4e7e-8a52-f8929c48612a | 32 About one half the confinements occurring during 1909 were treated by the midvvives registered under the Act, and the results were certainly extremely good. There is no doubt but that the fact that women attended by midwives cannot so easily procure the early administration of chloroform as when attended by a doctor, means fewer instrumental deliveries, fewer difficulties with the placenta, and less sepsis. On the other hand, it must be remembered that midwives do not always care to attend primiparae, unless a doctor is engaged as well. Under these circumstances the midwife acts technically as a maternity nurse, and not as a midwife. It is in respect of these cases that I apprehend difficulty under the new regime, for either the lady Inspector must attempt the control of work for which doctors are really responsible, or else an important part of midwives' practice will escape official cognizance. |
76402b22-b269-4e83-9baf-13aa60198cae | I hold strongly that any chief Inspector of midwives should be a qualified practitioner, either male or female, and am supported in this opinion by most, if not all, Medical Officers of Health. The estimate given in Table I. of the population of this district for the year 1909, exceeds that for 1908 by 2,000. The estimate is based on the number of inhabited houses enumerated at Midsummer, 1909, and the assumption that the average number of persons per house has slightly decreased since the Census of 1901, bearing in mind the fact that the increase in new houses was greater in the second than in the first half of the year. The number of births during 1909 was 703, and this figure gives us a birth rate of 23, slightly lower than last year. |
d1358c75-4021-4274-83f8-b8ba7503ab53 | The number of births registered in Barnes proper was 278— eight less than in 1899; Morlake, however, is to be credited 33 with no less than 425, or more than twice as many as ten years ago (Table II). The number of deaths of infants under one year of age registered in the district was only 62. This is the lowest number since 1903, in which year the births were only 513. We can therefore boast an infantile mortality rate of 88. Ten years ago the rate was 126, and for the last decade the average has been 116. The total numberof deaths registered in the district was 277, and with our estimated population the uncorrected death rate is therefore only 9 per 1,000, This is the lowest rate yet on record for Barnes and Mortlake, with the exception of that sanitary annus mirabilis, 1908. |
17fc0845-0926-4d26-bbeb-cf7fec25c95f | The deaths of residents registered in public institutions beyond the district were, so far as ascertained, 44. This number is greater than in any former year, because greater pains have been taken to collect the particulars. Their inclusion, however, though bringing the corrected death rate up to 10.5, still leaves us with a record better than that of any year except 1908. It must be remembered that even this rate would be lower if we were able to exclude the deaths of persons whose bodies are found in the river, etc., and who have not resided in the district. Table II. shews, in addition to facts already mentioned, that not only the infantile death rate, but the general death rate, is considerably higher in Mortlake than in Barnes. There are several reasons for this, but differences in the soil and configuration may be noted. There is more clay and loam in Mortlake; more gravelly sand in Barnes. 34 Most of the facts illustrated by Table III. |
827bb784-6cea-455d-8df9-e4609c4c6d82 | have been already referred to, but in connection with what has just been said it may be pointed out that, of 19 cases of phthisis 14 occurred in Mortlake. I am old-fashioned enough to still believe in Dr. Buchanan's classical researches, and think that the connection of the disease with damp soil is undoubted. In Table IV. the causes of, and ages at death are analysed. One death from diphtheria occurred outside the hospital; the death from "croup" was returned from the Richmond Infirmary. Epidemic influenza is stated to have caused 8 deaths, and phthisis 24. Here again it is to be noted that 15 of the 24 deaths have to be credited to Mortlake, Cancer accounts for 27 deaths; this disease and phthisis making up nearly 15 per cent. of the whole. |
afad0523-21ec-40c1-b671-607d2a325a12 | Forty-six deaths were due to bronchitis or pneumonia, and again the record from Mortlake is far the worst. Table V. affords particulars of the deaths of children under one year of age, and in this table the deaths of a few which occurred in the infirmary or elsewhere are included. The deaths from diarrhoea and enteritis account for 14 of the total number, and the vague conditions included under the headings of debility, marasmus, etc. for 5. The Notification of Births Act, 1907, has not been adopted in this district, and the continued improvement in the matter of infantile mortality shews that it is perhaps hardly necessary here. Allusion has been already made to the circulars of the Board of Education, but for fuller information on the bearing of these circulars on the work in this district, the report of 35 Dr. Jones, Assistant County Medical Officer of Health (Education), will no doubt be consulted. |
1a499780-897f-4818-98d2-86bdf8a3a7e1 | The administration of the Factory and Workshops' Act has gone on smoothly. The official tables are given on pp. 51 to 53, and additional information on page 54. In one or two instances the Surveyor (Mr. Tomes) has been informed of places in which the provision of means of escape from fire has seemed inadequate, and generally speaking we have had no difficulty in securing compliance with our requirements. One large factory laundry was opened during the year in East Sheen. The Coroner's Court and Mortuary have been improved during the year in various respects, and are now very well adapted and equipped. Forty-four enquiries were held by Dr. Taylor, Coroner for the Kingston division, during 1909. There has been considerable expression of opinion lately in favour of Swimming Baths being provided for the district. |
565085c0-8dde-446e-8dd4-3e47c5e717dc | With this opinion I heartily concur, and have indeed for years past referred to the matter, although I sincerely hope that there will be no attempt at providing an open-air bath filled from the Thames. But, whether or no a swimming bath of any kind is furnished, there is in my opinion distinct need for public single baths. Washhouses are not required. In conclusion, I have to say that I have, as usual, made both systematic and other inspections of the district, and have received the greatest assistance from my colleagues, as well as from the whole staff of the Sanitary Department and Hospital. 36 The action of the Council in allowing the addition of a clerk to the staff of the Sanitary Department is one for which I am grateful. Not only has the routine work been facilitated in consequence, but we have been able to commence a card register of the district, giving the sanitary record of each dwelling-house, shop, factory, etc. |
a3eb95e8-dbe5-4540-a2bf-82d85d08e006 | This record will, in course of time, be very valuable, and materially assist the labours of those who may follow. 37 Statistical Tables. (a) Of the Local Government Board. (b) Other Tables. (c) Work of the Sanitary Department. 39 TABLE I. Vital Statistics of whole District during 1909 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 residents registered in Public Institutions beyond the District. Nett Deaths at all Ages belonging to the District. Number. Rate.* Under 1 year of age' At all ages. Number. Kate per 1,000 births registered Number. Rate.* Number. |
fe3a4db1-5b51-454c-a823-97ea4773ba01 | Rate* 1 2 3 4 5 6 7 8 9 10 11 12 13 1899. 17000 478 26.9 58 126 225 13.2 5 — 4 229 13.4 1900. 17400 416 23.9 56 134 220 12.7 1 — 3 223 12.8 1901. 17900 420 23.5 56 133 214 12.5 3 — 24 237 13.2 1902. 19900 501 25.1 57 113 257 12.9 7 — 27 286 14.2 1903. 21150 513 24.2 57 111 220 10.3 5 — 27 247 11.6 1904. |
efe416bf-2801-4b80-80e9-fc8414e0d6c6 | 23200 618 26.6 83 134 237 10.2 0 — 24 261 11.2 1905. 24250 600 24.7 72 120 254 10.4 3 — 35 289 11.9 1906. 25500 632 24.7 71 112 256 10.0 15 — 32 288 11.2 1907. 28000 684 24.4 63 92 267 9.5 5 — 33 300 10.7 1908. 28500 676 23.7 63 93 213 7.4 2 — 34 247 8.6 Averages lot years 1899.1908. 22280 553 24.8 63 116 236 10.5 46 — 24 260 11.2 1909. |
edff4de6-b7e7-4421-b05f-4eb2969e5b86 | 30500 703 23.0 62 88 277 9.0 6 — 44 321 10.5 * Rates in columns 4, 8, and 13 calculated per 1,000 of estimated population. Area of District in acres (exclusive of area covered by water).2,400 Total population at all ages 17,821 Number of inhabited houses 3,403 Average number of persons per house 5,236 At Census of 1901. 40 TABLE II. Vital Statistics of separate Localities in 1909 and previous years. Name of District—Barnes Urban. Names of Localities. 1. WHOLE DISTRICT. 2. BARNES (Parish). 3. MORTLAKE (Parish). 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. |
7a9c5ae3-9606-4a39-899a-f5fbf377b25f | 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. a b c d a b c d a b c d 1899 17000 478 229 58 9500 286 123 36 7500 192 106 22 1900 17400 416 223 56 9750 230 107 26 7650 186 116 30 1901 17900 420 237 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 |
61f8c8f0-3e0c-48f5-a511-86a2db6ef4e1 | 261 86 12000 293 134 43 11200 325 127 43 1905 24250 600 289 74 12250 310 138 26 12000 290 151 48 1906 25500 632 288 75 12750 284 136 25 12750 348 152 50 1907 28000 684 300 65 13450 277 144 28 14550 407 156 37 1908 28500 676 247 67 13500 266 124 24 15000 410 123 43 Averages of years 1899 to 1908 22280 553 260 65 11525 272 130 30 10755 281 130 35 1909 30500 703 321 66 14200 278 140 25 16300 425 181 41 41 TABLE |
a7ae3516-d65f-493b-a52f-2f4ae2bed447 | III. Cases of Infectious Disease notified during the year 1909. Notifiable Disease. Cases Notified in Whole District. Total Cases notified in each locality. Number of Cases removed to Hospital from each locality. At all ages. At ages—Years. 1 Barnes. 2 M'rtl'ke 1 Barnes. 2 M'rtl'ke. Total Cases removed to Hospital. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upw'ds. Small-pox — — — — — — — — — — — — Cholera — — — — — — — — — — — — Diphtheria (including Membranous Croup) 43 1 13 22 2 5 — 28 15 25 11 36 Erysipelas 10 — — 1 — 8 1 3 7 — |
8c89c581-d276-4a7e-a7fa-035f6e172107 | 2 2 Scarlet Fever 56 — 9 37 7 3 — 20 36 16 32 48 Typhus Fever — — — — — — — — — — — — Enteric Fever 16 — 3 4 3 6 — 15 1 3 1 4 Relapsing Fever — — — — — — — — — — — — Continued Fever — — — — — — — — — — — — Puerperal Fever 3 — — — — 3 — 2 1 1 — 1 Phthisis (1) Poor Law 14 — 1 1 8 8 1 5 14 — — — (2) Voluntary 5 Totals 147 1 26 65 20 33 2 73 74 45 46 91 Isolation Hospital, Mortlake. Total available beds, 36. Number of Diseases that can be concurrently treated, 4. |
7a7b1849-5534-4199-a708-4efa5b12c709 | 42 TABLE IV. Causes of, and Ages at, Death during year 1909. Causes of Death. Deaths at the subjoined ages of "Residents" whether occurring in or beyond the District. Deaths at all ages of "Residents" belonging to Localities, whether occurring in or beyond the District. Total Deaths whether of Residents or residents 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. Small-pox — — — — — — — — — — Measles 6 1 5 — — — — 2 4 — Scarlet fever — — — — — — — — — — Whooping-cough 8 4 4 — — — — 4 4 — Diphtheria (including Membranous croup). 5 — 3 |
55aa9e79-31da-4dba-a576-ef439a7c571d | 1 — — — 2 3 4 Croup 1 — 1 — — — — — 1 — Fever Typhus — — — — — — — — — — Enteric — — — — — — — — — — Other continued — — — — — — — — — — Epidemic influenza 8 — — — 1 3 4 2 6 — Cholera — — — — — — — — — — Diarrhœa 11 10 1 — — — — 3 8 — Enteritis 3 3 — — — — — 1 2 — Puerperal fever 3 — — — — 3 — 2 1 1 Erysipelas 1 — — — — 1 — — 1 1 43 Phthisis (Pulmonary Tuberculosis) 24 — 2 2 4 13 3 9 15 — Other tubercular diseases 1 — — — — 1 |
de248ace-f7e0-4ebe-9269-47d9eed4b056 | — — 1 — Cancer, malignant disease 27 — — — — 19 8 11 16 — Bronchitis 23 8 1 — — 2 12 6 17 — Pneumonia 23 6 2 — 1 9 5 10 13 — Pleurisy — — — — — — — — — — Other diseases of Respiratory organs. 1 — — — — 1 — — 1 — Alcoholism Cirrhosis of liver 3 — — — 1 2 — 2 1 — Premature birth 12 12 — — — — — 8 4 — Diseases and accidents of parturition 1 — — — — 1 — 1 — — Heart diseases 25 2 — — — 12 11 8 17 — Accidents 14 3 3 3 2 2 1 6 8 — Suicides 4 — — — 1 3 — 2 2 |
4e9a24f7-a316-4fb6-8833-9c9d2850f575 | — Found dead 1 — — — — 1 — — 1 — Found drowned 4 — — — — 4 — 3 1 — Tetanus Neonatorum 1 1 — — — — — 1 — — All other causes 111 15 3 1 2 36 54 57 54 — All causes 321 66 25 7 12 113 98 140 181 6 44 TABLE V. Infantile Mortality during the Year 1909. Deaths from stated causes in Weeks and Months under 1 Year of Age. CAUSE OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. |
742d1ecf-8fd9-4b4b-beef-cf0e82ae0278 | 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under 1 year. |
05a9238f-14f6-48f3-8f4b-a18fe475fcd1 | All Causes 15 2 4 3 24 10 4 — 5 4 6 4 3 3 3 — 66 Common Infectious Diseases Small-pox — — — — — — — — — — — — — — — — — Chicken-pox — — — — — — — — — — — — — — — — — Measles — — — — — — — — — — — — — 1 — — 1 Scarlet Fever — — — — — — — — — — — — — — — — — Diphtheria (including Membranous Croup) — — — — — — — — — — — 1 — — — — 1 Whooping Cough — — — — — — 1 — 1 — — 1 — 1 — — 4 Diarrhœal Diseases Diarrhœa, |
4af5c7c7-1727-4707-af8a-aedd752d7bb4 | all forms — — — — — 2 1 — 1 2 — 1 1 1 1 — 10 Enteritis, Muco-enteritis Gastro-enteritis — — 1 1 2 2 — — — — — — — — — — 4 Gastritis, Gastrointestinal Catarrh — — — — — — — — — — — — — — — — — Wasting Diseases Premature Birth 8 1 1 1 11 — — — 1 — — — — — — — 12 Congenital Defects — — — — — — — — — — — — — — — — — Injury at Birth — — — — — — — — — — — — — — — — — Want of Breast-milk, Starvation — — — — — — — — — — — — — — — — — Atrophy, Debility, Marasmus 3 — 1 — 4 1 — — — — — — — — — |
98621525-df40-4425-a8a8-2f2f54786b75 | — 5 45 Tuberculous Diseases Tuberculous Meningitis — — — — — — — — — — — — — — — — — Tuberculous Peritonitis: Tabes Mesenterica — — — — — — — — — — — — — — — — — Other Tuberculous Diseases — — — — — — — — — — — — — — — — — Other Causes Erysipelas — — — — — — — — — — — — — — — — — Syphilis — — — — — 1 — — — — — — — — — — 1 Rickets — — — — — — — — — — — — — — — — — Meningitis (not Tuberculous) — — — — — — — — — — 1 — — — — — 1 Convulsions — — — — — — — — — — — — — — — — — Bronchitis — — — 1 1 2 — — 1 1 |
5b16c65e-3673-472f-9ee6-a7dcbc46a92a | 2 — 1 — — — 8 Laryngitis — — — — — — — — — — — — — — — — — Pneumonia — — — — — 2 — — — 2 1 — — 1 — 6 Suffocation, overlying — — — — — — — — — — — — — — — — — Other Causes 4 1 1 — 6 2 — — 1 1 1 — 1 — 1 — 13 15 2 4 3 24 10 4 — 5 4 6 4 3 3 3 — 66 Population (estimated to middle of 1909), 30,500. Births in the year:- Barnes, 278; Mortlake, 425. Deaths in the year of infants:— Barnes, 25; Mortlake, 41. Deaths from all causes at all ages, 321. |
1683e77d-5029-40c9-b6f5-084643b1f40e | 46 TABLE Showing the yearly increase in the number of inhabited houses since the last Census. Date of Computation. Number of Inhabited Houses. Harnes. Mortlake. Total. |
04bd447b-109e-4939-b39e-e0ff386c79a6 | 1901 Census, March 1893 1510 3403 1902 Midsummer 2051 1763 3814 1903 „ 2167 1869 4036 1904 „ 2315 2120 4435 1905 „ 2377 2308 4685 1906 „ 2459 2464 4923 1907 „ 2576 2756 5332 1908 „ 2612 2942 5554 1909 „ 2745 3147 5892 Increase in 8.25 Years 852 1637 2489 47 TABLE Showing the number of cases of Scarlet Fever, Diphtheria and Enteric Fever notified annually since 1895, with the estimated populations and case rates for each year, the quinquennia 1896-1900 and 1901-1905, and the years 1906-1909. Year. Estimated Population. |
53bf67db-c307-409c-8da8-1d25d74deb3c | Cases Notified. Cases per 1.000 estimated Population. Scarlet Fever. Diphtheria. Enteric Fever. Totals. 1896 16,200 66 28 10 104 6.4 1897 16,450 41 44 7 92 5.7 1898 16,470 73 38 12 123 6.9 1899 17,000 90 24 9 123 7.2 1900 17,400 32 26 5 63 3.6 Mean. |
11e3116a-3705-4050-9b29-bb137b0b33cd | 16,750 60.4 32 8.6 101 6.08 1901 17,900 31 75 12 118 6.5 1902 19,900 75 61 8 144 7.2 1903 21,150 30 55 8 93 4.3 1904 23,250 31 14 7 52 2.2 1905 24,250 31 17 4 52 2.4 Mean. |
181736a2-27e3-4214-b26c-fa9590dabe04 | 21,290 39.6 44.4 7.8 91.8 4.3 1906 25,500 38 115 8 161 6.2 1907 28,000 57 29 2 88 3.1 1908 28,500 36 29 5 70 2.4 1909 30,500 56 43 16 115 3.7 Mean. 28,125 46.7 54 7.7 108 3.8 48 TABLE Showing Case Mortality from certain diseases at the Isolation Hospital, Mortlake, since 1901. Year. SCARLET FEVER. DIPHTHERIA. Admissions. Deaths. Mortality per cent. Admissions. Deaths. Mortality per cent. |
d62915e3-a6bf-428c-befe-991b197b513e | 1902 56 1 1.7 46 6 13.0 1903 21 1 4.7 45 3 6.5 1904 21 0 0.0 9 0 0.0 1905 24 1 4.1 14 2 14.2 1906 25 1 4. 0 105 11 10.4 1907 50 1 2.0 17 2 11.7 1908 20 0 0.0 19 1 5.2 1909 46 0 0.0 35 4 11.4 Totals 263 5 1.9 290 29 10 Altogether 88 cases were admitted during 1909. |
4078d5e0-c85d-4534-9c07-00c054f92f1a | They were made up as follows r— Diphtheria 35 Erysipelas 2 Scarlet Fever 46 Puerperal Fever 1 Typhoid Fever 4 Of the 35 cases of diphtheria 6 were laryngeal. One was admitted at a late stage and died suddenly; one, aged 7 months, died of broncho-pneumonia following intubation; and 4 recovered, 2 after intubation, and 2 without operation. 49 TABLE Showing the Proceedings taken during 1909, under the Food and Drugs Act, by the County Inspector, Mr. Houghton. Articles Purchased. Samples taken. Found Genuine. Slightly Adulterated, etc. Cases in which proceedings taken. Convictions obtained. Fines Inflicted. |
bf472652-4662-4bbd-89e3-86b2e4d12942 | Milk 84 72 9 3 3 £27 12 0 Butter 3 3 Spirits 4 4 Totals 91 79 9 3 3 £27 12 0 50 TABLE Showing the administration of the Vaccination Acts in the Mortlake Registration Sub-District (which includes the parishes of Barnes and Mortlake) according to the return made by Mr. Umney, Clerk to the Richmond Guardians. Return for the period January lst to December 31st, 1908. Registration Sub-District Comprised in the Vaccination Officer's District. No. of Births returned in the Birth List Sheets as registered. Number of these Births duly entered by 31st January, 1910, in Cols. 1, 2, 4, & 5 of the Vaccination Register (Birth List Sheets), viz. |
17e856b7-ed6c-43db-ad0d-3a3fa1727fef | : Number of these Births which on 31st Jan., 1910 remain unentered in the Vaccination Register on account (as shown by Report book) of Number of these Births remaining on 31st Jan., 1910, neither duly entered in the Vaccination Register (Cols. 3, 4, 5, 6, & 7 of this return) nor temporarily accounted for in the Report Book (Cols. 8, 9, & 10 of this Return) Number of Certificates of Conscientious Objection actually received by the Vaccination Officer irrespective of the dates of Births of the Children to which they relate during the year 1909 Total number of Certificates of successful Primary Vaccination at all ages received during the calendar year 1909. Col. 1. Column 2. COL. 4. Number in respect ofwhom Certificates or Statut'y Declarations of Conscientious Objection have been re- Col. 5. |
17fb8bc1-ce28-4ffd-a1ec-a0744d7da562 | Postpone ment by Medical Certificate. Removal to Districts the Vac cination Officer of which has been duly ap prised. Removal to place unknown or which cannot be reacheo and cases not having been found. Successfully Vaccinated. Insusceptible of Vaccination. Had Small Pox. Dead un vaccinated. 1 2 3 4 5 6 7 8 9 10 11 12 13 MORTLAKE 675 555 5 0 49 39 4 9 14 0 0 608 Return for the Period January-June, 1909. (Supplementary). |
34896ba3-a596-47a2-aa28-4e9b69109686 | MORTLAKE 331 269 1 0 31 20 4 2 5 0 120 0 51 Annual Report of the Medical Officer of Health for the year 1909 for the Urban District of Barnes on the administration of the Factory & Workshop Act, 1901, in connection with FACTORIES, WORKSHOPS, WORKPLACES, and HOMEWORK. 1.- INSPECTION. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices Prosecutions. Factories (Including Factory Laundries) 36 4 — Workshops (Including Workshop Laundries) 295 13 — Workplaces (Other than Outworkers' premises included in Part 3 of this Report) 65 — — Total 396 17 — 2.—DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecutions. Found. |
209786cc-6749-42c0-b723-79a5a772766a | Remedied. Referred to H. M. Inspector Nuisances under the Public Health Acts:— Want of cleanliness 11 11 — — Want of ventilation — — — — Overcrowding — — — — Want of drainage of floors 1 1 — — Other nuisances 4 4 — — Sanitary accommodation insufficient — — — — unsuitable or defective 1 1 — — 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. 97 to 100) — — — — Other offences — — — — (Excluding offences relating to outwork which are included in Part 3 of this Report). Total 17 17 — — Sec. 22 of P. H A. A.A., 1890, is in force, and 1 closet is required for 20 persons, or less, of each sex. |
d9baf0d2-3229-4901-b072-e69aa59cbef0 | 52 3.—HOME NATURE OF WORK. OUTWORKERS' LISTS Lists received from Employers. Numbers of Addresses of Outworkers received from other Councils. Numbers of Addresses of Outworkers forwarded Twice in the year. Once in the year. Lists. Outworkers. Lists. Outworkers. Wearing Apparel— (1) making, &c. 1 2 1 5 11 — (2) cleaning & washing Lace, lace curtains & nets Furniture and Upholstery Fur pulling Umbrellas Paper Bags and Boxes Brush making Stuffed Toys File making Electro Plate Cables and Chains Anchors and Grapnels Cart Gear Locks, Latches and Keys Total 1 2 1 5 11 — 4—REGISTERED WORKSHOPS. Workshops on the Register (S. 131) at the end of the year. Number. Important classes of workshops, such as workshop bakehouses. may be enumerated here. |
a2d3b8f6-118d-4f94-a908-c2c819705d93 | Laundries 18 Dressmakers 21 Shoemakers 31 Bakehouses 13 Total number of workshops on Register 152 53 WORK. SECTION 107. Number of Inspections of Outworkers' premises. OUTWORK IN UNWHOLESOME PREMISES (SEC. 108). OUTWORK IN INFECTED PREMISES (SECS. 109 110). Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (S. 110). Prosecutions (Sections 109, 110). Failing to keep or permit inspection of lists. Failing to send lists. — — 32 — — — — — — — — 32 — — — — — — 5.—OTHER MATTERS. Class. Number. Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (S. |
1963c590-dbca-49da-a869-301bcdef1800 | 133) — Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (S. 5) Notified by H.M. Inspector — Reports (of action taken) sent to H.M. Inspector — Other — Underground bakehouses (S. 101)— Certificates granted during the year — In use at the end of the year 5 54 TABLE Showing the work done by the Sanitary Inspectors during 1909 with regard to places under the Factory and Workshops Act, 1901. BARNES. MORTLAKE. TOTALS. No. Visits. No. Visits. No. Visits. A.—FACTORIES— Brewery . . 1 2 1 2 Electric Lighting Works . . 1 2 1 2 Printers 1 1 2 4 3 5 Coachbuilders . . |
03c9c971-715a-48c6-97fc-7ecde3c8ad78 | 1 2 1 2 Excelite Works . . 1 2 1 2 Motor Works . . 1 6 1 6 Golf Club Maker . . 1 2 1 2 STEAM LAUNDRIES— Over 40 employees 1 3 . . 1 3 Under 40 employees 2 4 4 8 6 12 B.—WORKSHOPS— Engineering Works 2 4 . . 2 4 Tailors 6 10 4 7 10 17 Dressmakers 12 24 9 18 21 42 Shoemakers 14 20 17 23 31 43 Cycle and Motor 6 12 4 7 10 19 Saddlers 1 1 1 1 2 2 Photographers . . 3 3 3 3 Paving Works 1 2 . . |
3e78663a-a7ee-41e3-846a-d5261f93f5d5 | 1 2 Smiths 2 2 3 5 5 7 Aluminium Casting Co. |
62b26bd0-6a71-4a33-b6fd-dd6f500af667 | 1 2 ... ... 1 2 Upholsterer ... ... 2 2 2 2 Coachbuilder ... ... 1 1 1 1 Cabinet Maker ... 1 1 1 1 HAND LAUNDRIES— Under 40 employees 3 9 8 23 11 32 BAKEHOUSES— 4 12 9 31 13 43 C.—DOMESTIC WORKSHOPS Dressmakers 14 20 12 21 26 41 Family Laundries 6 11 12 27 18 38 D.—WORKPLACES— Stable Yards 7 12 5 5 12 17 Restaurants 5 12 13 32 18 44 Ice Cream Makers 2 4 ... ... 2 4 Totals 90 165 116 235 206 400 55 TABLE Work done by the Sanitary Inspectors during 1909, having relation to the Housing of the Working Classes. |
b7f9c0cf-d6d8-44f0-bbf7-9879d84f3f94 | BARNES. MORTLAKE. TOTALS. Houses found unfit for habitation 8 8 Overcrowding 1 2 3 Premises cleansed by owners 55 104 159 Visits made to dwelling houses 1751 2354 4105* TABLE Showing the number of certain places under the Council's supervision, and the visits made to them by the Sanitary Inspectors during 1909. BARNES. MORTLAKE. TOTALS. No. Visits. No. Visits. No. Visits. |
c46af0d4-cf7c-419e-9830-a68b32b7e84d | Dairies and milk shops 10 40 IB 64 26 104 Other places where milk is sold 6 14 10 23 16 37 Slaughterhouses 1 10 1 15 2 25 Places where petroleum is stored 6 12 7 54 13 66 Servants' Registry Offices 2 4 4 10 6 14 Marine Stores 2 6 1 2 3 8 TABLE Work done by the Sanitary Inspectors during 1909 with relation to infectious diseases. BARNES. MORTLAKE. TOTALS. |
06678314-d2e2-499f-b590-f20f3c0eea42 | Visits to cases of notifiable disease 160 129 289 Disinfections performed 65 70 135 Lots disinfected by steam 65 70 135 Premises cleansed under Infectious Diseases Prevention Act 23 24 47 *These do not include the numerous visits of supervision made to premises, the owners of which have had notice to abate nuisances. 56 TABLE Showing the number and kind of general nuisances discovered and remedied during 1909. Barnes. Mortlake. Total. Defective drains amended 17 50 67 Defective drains reconstructed 8 10 18 Defective closet pans, etc. |
0b41cc46-1b58-410e-b509-14d58a560200 | 6 17 23 Defective waste pipes 4 15 19 Defective flushing cisterns 31 63 94 Cisterns cleansed and covered 14 7 21 Taps provided on rising main 2 5 7 Dustbins replaced 49 66 115 Yards paved and repaired 8 29 37 Mica valves made good 3 31 34 Caps to interceptors replaced ... 15 15 Nuisances from animals ... 3 3 Foul accumulations removed 4 2 6 Defective gutterings and roofs 21 17 38 Totals 167 330 497 Statutory notices served 36 Summonses taken out 0 57 TABLE Showing the general work done in the Sanitary Department during 1909, and in the four preceding years. Nature of Work Done. |
f0109080-ae24-4f0d-afef-07254c3160ad | 1905 1906 1907 1908 1909 Inspections of houses and premises made 4454 4315 4043 4284 4105 Notices served for abatement of defects 681 782 715 486 400 Houses and Premises cleansed and repaired 96 178 96 129 159 Houses disinfected 68 156 92 74 135 Defective drains (amended) 42 46 42 69 67 Defective drains (reconstructed) 31 28 19 31 18 Defective soil pipe ventilators (madegood) 18 1 3 6 . Defective closet pans and traps (replaced) 126 87 49 38 23 Caps to interceptors replaced . . . . |
d3f5533b-9234-4af6-990d-4f4320a8d6f0 | 15 Dustbins (replaced) 102 79 103 91 115 Defective flushing cisterns (repaired) 99 102 85 123 94 Cisterns cleansed and covered . 45 50 41 39 21 Premises on which animals causing nuisance 8 3 2 3 3 Foul accumulations (removed) 2 6 7 17 6 Defective roofs and eaves' gutterings 19 60 30 37 38 Insanitary Yards paved 32 74 94 76 37 Floors ventilated 50 24 13 34 Defective Mica Valves (made good) 42 9 42 31 12 Burst pipes repaired . . . 10 . |
fba29a44-c245-473b-9bc4-6e92816fc0d0 | No proper receptacle for manure or offal Overcrowding (abated) 3 4 3 2 1 3 Houses found unfit for habitation 21 1 0 8 Bakehouse inspections 10 12 14 13 13 Dairy inspections 22 21 25 26 26 Licensed slaughter-house inspections 4 4 3 3 2 Factory and Workshops inspections 154 180 194 206 206 Number of visits to notifiable disease 70 176 106 81 289 Premises licensed for storage of Petroleum 12 13 12 14 13 Complaints received 45 49 42 46 52 Summonses for abatement of Nuisances 1 1 2 8 . |
e4b54423-6121-4319-8c50-b6bf524ce588 | BARN 59 The Urban District Council of Barnes. THE ANNUAL REPORT For 1910 OF THE Medical Officer of Health, F. GRAHAM CROOKSHANK, M.D. LOND., M.R.C.S., L.R.C.P. Fellow ROY. Soc. Medicine. Chairman Med. Offr. of Health Assoc. Fellow (Late President Home Cos. Branch), Soc. of Med. Ofrs. Health. Barnes SW R. W. Simpson & Co., Ltd., Printers, 15 High Street, 1911. THE MALTHOUSE AREA, BARNES. The Council House, Mortlake, S.W., January, 1911. Gentlemen, I have the honour to present my tenth Annual Report on the health and sanitary circumstances of the Urban District of Barnes. |
447a9d9e-0354-4f47-9ed7-c16c00ca8da3 | I beg to thank you for the support and consideration which have been extended to me during my tenure of service as your officer, and particularly desire that you will allow me to express, in this place, my sincere gratitude, to my official colleagues for their ever ready help, and to the staffs of the Public Health Department and the Hospital, for their loyal and much appreciated services. I am, Gentlemen, Obediently yours, P. G. CROOKSHANK. The Chairman and Members, The Urban District Council of Barnes, THE Urban District Council of Barnes The public health committee, 1910=11. Chairman: Councillor WATSON. The Chairman of the Council: Councillor S. W. LAMBERT, J.P. Che Vice=Chairman of the Council: Councillor J. D. FIRMSTON. |
805c7da3-53e1-4c9a-80e9-6241920cd920 | Councillors BATES, DAVENPORT, HAMPTON, JONES, KITLEY, LANGDON, MEDUS, MERRICK, MOONAN, PALMER, RANDALL, SHEARMAN, SMITH, SPENCER, TIMSON, WAKEFIELD, and WATSON. The hospital Sub=committee, 1910=11: Councillor MEDUS - - (Chairman). Councillors BATES, RANDALL, WAKEFIELD, and WATSON. medical Officer of Health and medical Superintendent of the Isolation Hospital: F. G. CROOKSHANK, M.D. Lond. Inspector of nuisances: Mr. T. GRYLLS. Assistant Inspector of nuisances: Mr. C. H. ROBINSON. matron of the hospital: Miss BELLINGER. TABLE OF CONTENTS. |
315bc490-4eae-4423-bc5e-c6e023175829 | PAGE SUMMARY 9 Introductory Remarks 11 Housino 12 Water Supply 17 Milk and Food 18 Sewerage and Drainagr 24 Dust and Refuse Disposal 27 Bye-Laws 29 Public Elementary Schools 30 The Control of Inpectious Disease 32 The Isolation Hospital 34 The Control of Tuberculosis 39 Incidence of Disease in 1910 40 Factories and Workshops 42 Nuisances 43 Infantile and General Mortality in 1910 44 Tables of the Local Government Board 53 Other Statistical Records 60 General Work of the Public Health Department 68 9 SUMMARY. |
6121ef24-e057-4de3-95da-cd0ad6ff4395 | Area—exclusive of water 2,400 acres Population—Census, 1901 17,821 „ Midsummer, 1910 32,500 Inhabited Houses—Census, 1901 3,403 ,, „ Midsummer, 1910 6,487 Rateable Value—Agricultural Land, Oct., 1910 £2,004 Other Hereditaments, Oct., 1910 £257,296 Assessable Value—Oct., 1910 £234,981 5s. |
4a192a5a-117f-4003-b3e0-54f0da85c470 | General District Rate 3/10 Poor Rate—Barnes 3/1 „ Mortlake 3/6 Birth Rate—Per 1,000 population, 1901 23.5 1910 20.1 Death Rate „ „ 1901 12.5 1910 6.5 Corrected Death Rate—Per 1,000 population, 1901 13.2 1910 7.9 Infantile Death Rate—Per 1,000 births, 1901 133 „ 1910 69 II ONCE in every ten years a medical officer of health is faced with a peculiar difficulty: he has to write his annual report, which, very largely, is concerned with the deductions from statistical matter, whilst the results of the decennial census are as yet unknown. In consequence, his primary datum is not an ascertained quantity, but a factor which may happen, within a few weeks, to be proven quite inaccurate. |
17b75a25-777c-4098-a8cf-86a80367e22c | Although for the purpose of this report I have made a very careful estimate, and have, as in former years, checked my computation by reference to the rate books, yet the possibilities of my being wide of the mark are very considerable, inasmuch as, since the last census, the character of the district has changed almost entirely and, although the number of houses inhabited at last Midsummer is known with fair accuracy, yet it is impossible to estimate closely the average number of persons now dwelling in each house. Should my estimate of the population of the district on last Midsummer day prove to be quite in excess of the population of the district at the time of the census shortly to be taken, then, obviously, my estimate of the general death-rate for 1910 will be too low; but, if on the other hand, my estimate of the population for last Midsummer proves much lower than the census returns, the deathrates will have been set at too high a figure. One statistical result expressed as a rate is alone independent of the census return. |
3e69eecc-2e93-4525-a32d-e49d63534688 | I refer to the infantile death-rate, calculated as it usually is on the number of births during the year. Here we can record progress, without fear of cavil. In the year 1901, 420 babies were born, and 56 died under the age of twelve months. This gave an infantile death-rate of 133 per 1,000 births. In 1910, 682 births were registered, and only 47 deaths under twelve months of age, giving us a rate of but 69 per 1,000 births. 12 Nor is this result merely apparent, and due to happy statistical coincidence: a study of the figures for the intervening years shews that the improvement has been practically one of annual gradation. The causes of this will be referred to in the appropriate place in some detail, but I desire to call particular attention to it here. |
3a91220b-fc85-4e80-8e3e-3bc1d37bbb47 | On page 60 is a table which shews, year by year, the number of inhabited houses as computed each Midsummer by the ratecollectors ; and, from a study of this and from other facts, I reckon the population of the whole district for 1910 to have been 32,500 and the respective populations of the two parishes of Barnes and Mortlake to have been 15,200 and 17,300. In the last ten years the district has, then, very nearly doubled the number of its inhabitants; and so great a relative change cannot have occurred without a profound variation in the character of the community, and in outward seeming. |
0301be68-899d-4260-8cc5-74295fa85e4d | The change is, I suppose, to be chronicled as one of development " ; and the figures that I have to record at any rate shew that the process, let it be called what it may, has not been accompanied by the more manifest ill effects of urbanization, and that, so far as morbidity and liability to zymotic disease are concerned, there has been a very distinct advance on the days when Barnes was more picturesque, but very much less healthy. Twenty, and indeed even fewer years ago, Barnes and Mortlake were two isolated villages, with local life and interests. In a very few years more they will be but two cubicles in the great dormitories for London workers. So far as Barnes proper is concerned the houses erected during the year may be described as mostly of a superior class, of rentals exceeding £40 and £50 per year. |
355ccb50-bcb2-476c-b217-e44d2abc95ba | In Mortlake and Sheen, on the 13 other hand, the new property is less substantial and less expensive, and is particularly designed to attract the newly-married town worker. Consequently, a tendency which I have noted for some time past has become accentuated, and, without doubt, the figures of the new census, when investigated, will shew a difference in the character and age of the two populations. In Barnes the population is, on the whole, an older and more prosperous one than that of Mortlake, and in this fact is to be found the explanation of certain statistical results; such as the higher birth-rate and infantile death-rate of Mortlake. The higher average age of the Barnes population on the other hand, is the reason that the general death-rate of this parish is slightly higher than that of Mortlake, although there is no doubt that, in popular terms, Barnes is the more " healthy " of the two places. |
65b1bec0-3a8c-4eee-8861-6d34d533966a | The figures will be found in Tables I. and 11., on pages 53 and 54. In my report for last year I mentioned that a sub-committee was then earnestly at work on the Malthouse area question, and, too optimistically, I expressed the opinion that, this year, I should be able to report that some practical steps had been taken. The subcommittee just mentioned fully considered the matter, and presented to the Council an exceedingly valuable report, recommending the adoption of a very satisfactory scheme. This scheme provided for a widening of the existing alleys known as Malthouse Passage (see frontispiece), the removal of certain cottages and the erection of others, and, incidently, would open up the waste land at the back of Thornes' Cottages and facilitate the creation of a roadway through to Grove Road. |
b8730043-f933-4c2c-9c2c-5015a80aa2c0 | Some desultory correspondence with the Local Government Board has ensued, I believe, but practically the matter stands, I very much regret to say, as it did ten years ago, when I first brought it to the notice of the Council. In the meantime the virtual loss to the rates from the melancholy condition of what is known as the High Street 14 Improvement must be remembered as well as the cost to charge on the rates that would occur from improvement of the Malthouse Area ; and it is safe to say that, as soon as the latter area is properly dealt with, there will be a compensating increment to the rates from the adjoining, and now unprofitable, property in the High Street. It is sometimes said that, instead of an improvement or clearance scheme being suggested for this Malthouse Area, individual houses should be dealt with. The difficulty is that no one has yet shown how this can be done. |
a8338b88-8bf2-4a26-965c-6634f3b038f7 | A landlord cannot be made to pull down other people's houses because they block out the light from his own property; and, as I have repeatedly said, the intrinsic characteristics of some of the cottages are not so bad. Some indeed, if placed on the Surrey hills and kept clean, would make quite nice week-end resorts; dumped away behind the High Street and the Terrace, cut off from light and air, surrounded by damp and undrained mud spaces, they make up an area not very great in size, and only, but easily, to be dealt with, in my opinion, by a clearance, and rearrangement of the streets and alleys therein. In last year's report I went on to say that I hoped some improvement would be made in the state of the Lilian and Glentham Roads; in the condition of the area known as Littleworth End ; in parts of Mortlake High Street, and other places; and that the proper paving and channelling of White Hart Lane would not longer be delayed. |
0dbd0c50-74e3-4fb2-adbc-c19ca6772bc7 | I am glad to say that the carrying out of the works, repeatedly urged in these reports, is now in a fair way to be realised. White Hart Lane, Lilian Road, Glentham Road and Fanny Road are all to be properly dealt with, and, I have no doubt, in course of time, the part locally known as Charlestown, also. At Littleworth End an enormous improvement, resulting in the disappearance of some old property and the opening up of 15 other, has been effected by way of a road widening scheme. The road to Richmond was, in this place, undoubtedly dangerous, and needed widening ; but it is curious how greatly the obvious, though from the actuarial point of view, inconsiderable, danger from traffic in a narrow street affects the public mind, moving it to endorse considerable expenditure; while little practical impression is made by the steady deterioration of health and character that is going on everywhere as a result of life in unhealthy areas. |
cec2d19a-b48e-4ca9-9ccd-ec410a49138e | We are of course, as I heard it lately put with unconscious humour, all in favour of clearing unhealthy areas " without cost to the rates or loss to owners of property." But, when it is a question of road widening, the cost is cheerfully borne by the community, though here, if anywhere, is a just opportunity of effecting public improvement at the owner's expense; inasmuch as he is usually the first person to reap financial benefit from the undertaking ! During the year two houses in Benham's Place, High Street, Mortlake, were closed, by order of the Council, under the Housing and Town Planning Act. They have since been demolished. The ancient buildings constituting Holman's Place, long disused, have been demolished as the result of a representation made by me under the old Housing of the Working Classes Acts. Thus a commencement has been made with what will, I hope, lead to the virtual destruction of Mortlake High Street as it now stands. |
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