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3db2bc11-22d0-4940-aade-c3879d666e7d | In conclusion, I beg to thank the Chairman and Members of the Council for their kind help and co-operation. I am, Gentlemen, Your obedient Servant, G. A. GARRY SIMPSON. 5 SANITARY STAFF. G. A. Garry Simpson, Medical Officer of Health M.R.C.S., F. R. I. P. H. Chief Sanitary Inspector M. W. Kinch, Cert. San. Inst. Assistant Sanitary Inspector A. W. Fraser, Cert. San. Inst. Disinfect or F. King. Nurse Mrs Dawkins. E. Bevan, 4 New Court, County Analyst Lincoln's Inn, W.C. County Inspector under Food and W. Tyler, Town Hall, Drugs Acts Brentford. The Office of the Health Department is at Gothic Villa, Mill Hill Grove. I attend daily at 9.30 a.m., and may be consulted on all matters connected with the health of the district. |
8e42d93a-fafd-44a6-b256-49524b7251bd | Should an urgent matter require immediate attention after office hours, or on Sundays, I can be interviewed at my private residence— Bardon House, East Acton. WARD BOUNDARIES. North Ward. —All north of centre of High Street. West Ward. —South of centre of High Street, from Birch Grove to Railway Bridge, High Street, and west of centre of North London Railway, from Railway Bridge, High Street, to Bollo Lane. East Ward. —South of centre of Uxbridge Road, from Railway Bridge, High Street, to Wilton Road, and east of North London Railway, from Railway Bridge, High Street, to Bollo Lane. VITAL STATISTICS. The following Table gives the Vital Statistics of the whole District during 1902 and previous years :— 6 VITAL STATISTICS OF WHOLE DISTRICT DURING 1902 AND PREVIOUS YEARS. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. |
b96764d8-de29-4015-907b-b9e90961d564 | | 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. N umber. Rate per 1,000 Births registered. Number. Rate.* Number. Rate.* 1892 25,000 763 20.5 141 185 401 16.4 . . 24 425 17.0 1893 26,000 831 31.9 160 192 451 17.3 . . 35 486 18.6 1894 27,600 834 30.2 133 159 368 13.3 . . 25 393 14.2 1895 27,648 874 31.6 147 168. |
96197b4c-95e0-45d8-9e88-55abd5ab0f9b | 1 445 16.1 . . 33 478 17.2 1896 29,454 894 30.3 151 168.9 435 14.7 . . 29 464 15.7 1897 31,632 973 30.7 193 198.3 470 14.8 . . 33 503 15.9 1898 32,562 995 30.5 181 181.9 507 15.5 . . 10 517 15.8 1899 33,684 1,068 31.7 200 187.2 509 15.1 . . ? 509 15.1 1900 38,406 1,080 28.1 182 168.5 528 13.7 15 ... ? |
01e13793-5825-49a4-94aa-1d8cc7a454d0 | 528 13.7 1901 37,744 1,211 32.0 206 170.1 519 13.7 6 ... ? 519 13.7 Averages for years 1892-1901 30,973 952 30.7 169 177.9 463 15.0 ... ... 27 482 15.6 1902 44,565 1,242 27.8 186 149.8 593 13.3 12 ... 6 599 13.4 * Calculated per 1,000 of estimated population. Total population as per Census 1991—All ages, 37,744. Number of inhabited houses, 6,114. Average number of persons per house, 6.1. Area of district in acres (exclusive of area covered by water), 2,304. 7 Population—The population calculated to middle of 1902 was 44,565. |
8c3420d1-212e-4f28-9ace-545199fcfa5c | The number of inhabited houses was 7,392, and uninhabited 213. The following table shows the number of the population and the inhabited houses at the five preceding censuses:— Year. Inhabited Houses. Population. 1861 610 3,151 1871 1,568 8,306 1881 2,844 17,110 1891 4,084 24,207 1901 6,114 37,744 The increase of population by excess of births over deaths during the year amounted to 643, as against 692 in 1901. Birth Rate.— During the year 1902 there were 1,242 births registered. The birth rate per 1,000 persons living was 27.8. The London birth rate was 28.5. The following table shows the births since 1890:— Year. Number of Births. |
3794babd-1b54-4210-9a66-379a6d68cbfd | 1890 704 1891 772 1892 763 1893 831 1894 834 1895 874 1896 894 1897 973 1898 995 1899 1,068 1900 1,080 1901 1,211 1902 1,242 DEATH RATE. General Mortality. —There were 593 deaths registered. The recorded general death rate was 13.4 per 1,000 of the population. The London death rate was 17.2. 8 The death rates for the preceding six years are as follows:— 1897 15.9 1898 15.8 1899 15.1 1900 13.7 1901 13.7 1902 13.4 This is the lowest death rate on record, and is highly satisfactory. It will be noticed that the recorded general death rate has been gradually falling for the last six years. |
877363bf-2a14-479f-8655-f406dcfeff8a | The following table gives the causes of and ages at death during the year 1902:— 9 CAUSES OF, AND AGES AT, DEATH DURING YEAR 1902. 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. North Ward. West Ward. East Ward. Small Pox 6 1 . . 1 4 . 1 3 2 . Measles 32 7 24 1 . . . 3 24 5 . Scarlet Fever 1 . . . 1 . . . . 1 . Whooping Cough 13 5 8 . . . . . 6 7 . |
a5862e11-ac43-49bd-9596-e3f8ebcfcc17 | Diphtheria and Membranous Croup 4 . 2 2 . . . 1 . 3 . Croup . . . . . . . . . . . Fever— Typhus . . . . . . . . . . . Enteric 4 . . . 1 3 . . 2 2 3 Other continued . . . . . . . . . . . Epidemic Influenza 15 2 . 1 1 7 4 5 8 2 1 Cholera . . . . . . . . . . . Plague . . . . . . . . . . . Diarrhœa 23 18 4 . . . . 3 11 9 . Enteritis 7 7 . . . . . 3 3 1 . Puerperal Fever . . . . . . . . . . . Erysipelas 2 1 . . . 1 . 1 1 . . |
ccb15562-7beb-4283-8206-fc426cfe5b14 | Other Septic Diseases . . . . . . . . . . . Phthisis 43 2 1 5 6 29 . 10 23 10 . Other Tubercular Diseases 15 2 5 2 3 2 1 3 6 6 1 Cancer, Malignant Disease 28 . . . . 22 6 11 7 10 . Bronchitis 63 22 9 . . 9 23 16 27 20 . Pneumonia 67 16 27 2 6 14 2 9 37 21 2 Pleurisy 1 . . . . 1 . . 1 . . Other Diseases of Respiratory Organs 1 1 . . . . . . 1 . . Alcoholism — Cirrhosis of Liver 5 . . . . 5 . 1 3 1 . Venereal Diseases . . . . . . . . . . . |
2126591c-83cd-4df9-a30c-8ee8eff5f0d1 | Premature Birth 35 35 . . . . . 8 18 14 . Diseases and Accidents of Parturition 1 . . . . 1 . . 1 . . Heart Diseases 51 1 . 1 6 25 18 22 15 14 1 Accidents 15 8 . 1 . 4 2 5 4 6 2 Suicides 4 . . . 1 3 . 2 1 1 . |
55f194a3-ea57-40df-86c9-85bf338b0971 | All other causes 163 59 14 3 3 45 39 50 64 49 2 All causes 599 187 94 18 29 175 96 154 261 184 12 10 In the following table the death rate and Zymotic death rate are so arranged that comparison can be made for the last fourteen years:— 1889 1890 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 Small Pox . . . . . . . . . . . . . 6 Measles 25 11 9 24 2 15 6 24 2 6 . 16 . 32 Scarlet Fever 1 3 4 . 10 3 3 1 . |
b3ff0ead-4824-4677-9c4c-68755f37b7da | 3 2 6 2 1 Diphtheria 8 7 2 4 2 5 5 8 28 8 7 4 6 4 Whooping Cough 13 3 6 25 5 17 5 21 . 10 14 4 16 13 Typhoid Fever 1 1 . 3 4 2 2 2 2 . 7 4 1 4 Diarrhoea and Dysentery 12 18 24 34 60 17 44 37 80 50 56 50 69 23 Puerperal Fever . . . 1 6 4 2 . . 1 . 1 . . |
1082a03f-cd65-4ed1-a283-537bcf1ed1ba | Total number of Deaths from seven Zymotic Diseases 60 43 45 91 89 63 67 93 130 78 86 85 94 83 Deaths from other Causes 377 298 368 334 396 330 411 371 373 439 423 443 425 516 Total Deaths 437 341 413 425 486 393 478 464 503 517 509 528 519 599 Death Rate from seven Zymotic Diseases per 1,000 2.8 1.9 1.8 3.6 3.4 2.2 2.4 3.1 4.1 2.3 2.5 2.2 2.4 1.8 Death Rate from other Causes per 1,000 16.1 12.0 15.3 13.4 15.2 12.0 14.8 12.6 11.8 13. |
0d008a49-8a72-4769-8f63-a3eb1c488bf0 | 5 12.6 11.5 11.3 11.6 General Death Rate per 1,000 18.9 13.9 17.1 17.0 18.6 14.2 17.2 15.7 15.9 15.8 15.1 13.7 13.7 13.4 The London Zymotic death rate for 1902 was 2.21. 11 INFANTILE MORTALITY. There were 187 deaths registered of Infants under one year of age as against 1,242 births; the proportion which the deaths under one year of age bear to 1,000 births is therefore 149.8 as against 170.1 in the preceding year. The following table compares the death rate of children under one year per 1,000 registered births, and the birth-rate for the last sixteen years:— Year. Birth Rate per 1,000. |
61051b68-4a27-4fad-aa32-82ea57c05d76 | Deaths of Children under one year, per 1,000 Registered Births. 1887 28.7 147 1888 31.1 182 1889 34.1 175 1890 28.3 151 1891 30.8 146 1892 30.5 185 1893 31.9 192.5 1894 30.2 160.6 1895 31.6 168.1 1896 30.3 168.9 1897 30.7 198.3 1898 30.5 181.9 1899 31.7 187.2 1900 28.1 168.5 1901 32.0 170.1 1902 27.8 149.8 In my Annual Report for 1901 I dealt fully on the causes of our Infant Mortality, and among other suggestions I advised the establishment of a creche. |
de40bc36-c5e8-42f3-8cee-6c324237acfe | The Sanitary Committee instructed me to draw up a report. This I did after making full inquiries. On writing to the Local Government Board on the subject we were informed that the Council could not support a creche out of the rates. Its establishment, therefore, would have to be entirely by voluntary contributions, and there is a golden opportunity for some philanthropic person to give it a start. In towns such as Manchester, Norwich, and Deptford, private creches are established, and pay their way. Such an institution is 12 greatly needed in Acton owing to our laundry industry and high infant mortality. If the clergy and ministers of religion would take the matter in hand, and a committee of ladies formed, subscriptions could be invited, and in this way an advance would be made. It is gratifying, however, to be able to report a low infant mortality compared with previous years, viz., 149.8, against 170.1 in 1901. |
5f5b85aa-9e0f-49e4-983e-ce9b6cf79924 | This is due to the diminished number of deaths from epidemic diarrhoea. Twenty-three deaths were registered, as against 69 in 1901, and 50 in 1900. Of the 23 deaths— 18 were children under 1 year of age. 4 were children between 1 and 5. 1 adult over 65 years. WHOOPING COUGH. There were 13 deaths from Whooping Cough. The relation in which this number stands to that of previous years is shown in the table on page 10. With a view of educating the poorer classes I have drawn up the following leaflet, which was widely circulated during the Spring, when the disease is most prevalent. Instructions to the Public as regards Whooping Cough. Leaflet issued by the Acton District Council. This disease is most fatal in young children. Out of every 100 deaths from Whooping Cough, 96 occur in children below five years of age. |
fe71dd93-64e9-4c9e-848b-5baa40788e83 | A Child suffering frotn this Disease should be Isolated, and not brought in contact with any other children until the characteristic spasmodic cough or whoop has disappeared for at least a week. This may be six weeks or more from the commencement of the illness. The Disease is spread by the Breath and Sputa of the Patient. Whatever the child coughs up should be received on paper or rags, and immediately burned. The Medical Officer of Health. Public Health Department, Gothic Villa, Mill Hill Grove, Acton, W. 13 PHTHISIS OR CONSUMPTION. Following the suggestion in my Report of 1901, you have instituted voluntary notification. We were one of the first urban authorities to adopt this valuable preventive measure, and our example has been rapidly followed by all surrounding districts. The notification is always verified by a bacteriological examination. Small sputum bottles have been forwarded to the practitioners in the district, so that they can have an examination made without delay in any suspicious case free of charge. |
d6ed1393-d9f3-41d8-9e1e-24a0cbd698ce | If medical practitioners could be induced as a routine measure to obtain this examination in every suspicious case, much unsuspected infection would be stopped. As a means of preventing re-infection from spitting, the following card has been widely circulated and hung in Public-houses, Laundries, Workshops, and all Public Institutions. The Urban District Council of Acton. Public Health Department. SPITTING IS THE MAIN SOURCE OF THE SPREAD OF CONSUMPTION. The Public are earnestly requested in the interests of Public Health not to expectorate on the ground, but into proper receptacles. Medical Officer of Health. The following is the scheme of preventive measures :— 1. Voluntary notification. 2. Diagnosis by bacteriological examination of sputum. 3. Visit to house, distribution of leaflet, with advice as to fresh air, and danger of spitting except into proper receptacles. 4. Cleansing and disinfection— (а) After notification. |
092345ac-05e8-49d2-a200-69f026a6c26d | (b) After change of address. (c) After death. 5. Investigation of sources of infection (Office and Workshop —Home). 6. Removal of patient if possible for sanatorium treatment. 7. Removal of food infection. 14 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1902. 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. North Ward. West Ward. East Ward. North Ward. West Ward. East Ward Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small Pox 31 1 4 4 6 16 . 4 23 4 4 22 4 Cholera . . . . . . . . |
6fca2597-f43b-4d27-a95c-d36e046a5d31 | . . . . . Diphtheria 33 . 9 13 5 6 . 9 8 16 1 1 1 Membranous Croup 3 . 3 . . . . 1 . 2 . . 1 Erysipelas 24 2 1 1 1 18 1 6 7 11 . . . Scarlet Fever 109 1 29 55 15 9 . 41 30 88 2 . 4 Typhus Fever . . . . . . . . . . . . . Enteric Fever 14 . 1 2 2 9 . 5 5 4 . 4 3 Relapsing Fever . . . . . . . . . . . . . Continued Fever . . . . . . . . . . . . . Puerperal Fever 1 . . . . 1 . 1 . . . . . Plague . . . . . . . . . . |
5074ff5c-ff97-46f6-9f53-1c630ecb4803 | . . . Chicken Pox 183 18 78 84 2 1 . 48 78 57 . . . Totals 398 22 126 159 31 60 1 115 151 132 7 27 13 15 The number of cases notified during the year, excluding Chicken Pox, was 215, against 172 in the preceding year. One hundred and eighty-three cases of Chicken Pox were notified. The following table gives the number reported each year since the Act came into force :— 1890 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 Small Pox . . 13 7 2 . . . . . |
a3e5b7c5-0007-4edf-9229-52e50c5305aa | 2 1 31 Scarlet Fever 108 63 74 192 86 67 193 93 167 111 243 82 109 Diphtheria 14 8 27 41 22 32 23 89 35 49 28 34 83 Membranous Croup 4 . 13 1 . . . 4 . . 1 1 3 Typhoid Fever 13 13 15 19 15 28 14 10 9 46 29 27 14 Continued , . . . 1 . . . . . . 2 . . Puerperal , 1 . 1 2 1 3 3 . 1 . . |
34ea3746-2b3a-4403-85e3-15e78d50fecc | 1 1 Erysipelas 22 18 37 77 41 31 26 25 22 31 28 26 24 162 102 180 340 167 161 259 221 234 239 333 172 215 THE SMALL POX OUTBREAK. Origin and Cause of the Epidemic. The Epidemic started in London about July 1901, and made its appearance in Acton on 18th November 1901, when a case was notified from Meon Road, South Acton. The next case occurred on 1st January 1902, when I found a man suffering from malignant Small Pox lying in a shed in Gladstone Road, Acton Green. 16 The following table shows the number of cases notified each month during 1902, up to August, after which no further cases occurred:— January 4 cases. |
09399be3-fd68-4c90-b4b2-07230d89a35c | February 5 „ March 5 „ April 3 „ May 3 „ June 1 ,, July 6 ,, August 4 „ 31 In the following table particulars will be found of the cases as regards age-distribution, vaccination, and mortality :— Ages. Vaccinated. Doubtful. Unvaccinated. Total Cases & Deaths. Cases. Deaths. Mortality per cent. Cases. Deaths. Mortality per cent. Cases. Deaths. Mortality per cent. Cases. Deaths. |
f2c122cc-44ef-4468-a23f-72135c2f1296 | Under 5 2 ... ... ... ... ... 3 1 ... 5 1 5 to 10 1 ... ... ... ... ... ... ... ... 1 ... 10 „ 15 3 ... ... ... ... ... ... ... ... 3 ... 15 „ 25 7 1 ... ... ... ... ... ... ... 7 1 25 „ 40 7 2 ... ... ... ... 1 1 ... 8 3 40 „ 60 6 1 ... 1 ... ... ... ... ... 7 1 60 upwards ... ... ... ... ... ... ... ... ... ... ... Total 26 4 15.38 1 ... ... 4 2 50 31 6 Of the 31 cases, a clue to the origin of the infection was discovered in 22 cases. 17 Steps taken to deal with the Outbreak. Notification.—Immediately on receiving notice of a case, whether of a suspicious nature or not, I visited the patient without delay. |
686fbb9b-8848-43ae-a09a-c331aff59004 | If the case turned out to be one of true Variola, I at once informed the Public Vaccinator and the whole of my Staff, who stood to their posts. Isolation.—Isolation was secured in every case, except one, by the removal of the patient to the Clare Hall Hospital, South Mimms. This removal was generally managed within two hours of the case being notified, with the exception of cases discovered in the evening. The Hospital refuses to take cases after 8 p.m., and under these circumstances the patients were removed early the following morning. Disinfection.—The rooms were fumigated with Formic Aldehyde, the floors washed down with liquid disinfectant, and the walls stripped. All bedding and textile articles were disinfected by steam in our Washington Lyons disinfector. Vaccination.—Without loss of time Dr Aird Jolly, the Public Vaccinator, visited the premises and vaccinated or re-vaccinated all contacts. I am much indebted to this gentleman for his prompt and valuable assistance. |
7ce8bdda-c9af-4eb8-957c-a6b3ff8f9e72 | Contacts.—The names and addresses of all contacts were taken, together with premises they had recently visited and where they were working. Some of them it was thought advisable to quarantine, and to pay them each week in order to secure confinement to the house. Where it was possible to re-vaccinate certain contacts and to disinfect their clothes and bodies, we allowed them to follow their usual occupations. No contact or person who was residing in a recently infected house was allowed to continue their work at a laundry until all danger from infection was over. In these cases the Council sanctioned a weekly payment. All recently infected houses were visited either by myself or the Sanitary Inspectors day by day in order to deal promptly with any fresh cases that might arise. The number of contacts averaged about six to each case notified, making a total of 180. 18 Other Precautions taken. In every case where I could trace a source of infection to another district I immediately communicated with the Medical Officer of Health of that district. |
f798dd90-1353-4069-b0b1-6c8c4fafa1c5 | In case of a contact leaving my district, and his destination being known, I at once informed the Medical Officer of Health of that district. Procrastination would be fatal in Small Pox epidemics. The Medical Officer of Health and his Staff must be always alert and on duty, for by visiting cases at once the spread of the infection by contacts is arrested. I will only quote one case out of many to verify the above remarks. One evening, at 10.30 p.m., I was informed of a case in a crowded neighbourhood. I went at once, and found a man who had been sitting by the patient for some hours in a close stuffy little room, on the point of leaving for the Common Lodging House. I got the man to consent to remain in the house until the patient had been removed and the premises and clothing, &c., thoroughly disinfected. As a consequence, no other case occurred. |
d312d2b9-23a2-438f-a1db-82a1bf389bbd | In the Autumn of 1901, at my suggestion, you made Chicken Pox notifiable, and this measure has on more than one occasion been of the greatest value. Every case of Chicken Pox notified during the last eighteen months has been personally visited by myself. Early in the outbreak the whole of the members of the staff were re-vaccinated, with one exception. This was one of the men employed in removing infected bedding; he refused to undergo the operation and promptly caught the disease. During the epidemic house-to-house inspection was made where circumstances seemed to point to the desirability of such a step. Lessons to be Learnt from the Epidemic. (1.) That it is possible to modify or even entirely prevent an attack of Small Pox by vaccination performed some days after infection. This is especially the case with re-vaccination, the incubation of which is often shorter than in primary vaccination. The period of incubation in Small Pox is, twelve days. |
46928beb-c4f7-4c08-b804-7dcf868d3835 | Cases to illustrate the above remarks.—One man had been ill for eight days when I saw him, and had not sought medical advice. He was well advanced in the vesicular stage. There were fifteen inmates 19 in the house. Re-vaccination was at once performed on thirteen and primary vaccination on two of the inmates. Seven of these inmates developed the disease from ten to twelve days after the first case was removed, but they had it so mildly that it was only necessary to detain them in Hospital for a week or two. (2.) That it is possible to have Small Pox so modified that it is not recognised by the individual, his symptoms being so mild that he goes about his daily avocation as usual. Case to illustrate:—It came to my knowledge that a young woman at Southall developed Small Pox just twelve days after receiving a visit from an Acton man. |
0e723881-d0d6-4e90-b457-4f73095cc993 | I at once went and looked up this individual, and ascertained that he had had an attack of lumbago and one or two spots on his forehead. One was so typical that I had no hesitation in my own mind that he had had the disease and given it to the young woman at Southall. I therefore had the man, his clothing and house at once disinfected. Two days later a woman residing in the same house as the man developed typical Small Pox and was removed to the Hospital, thus confirming my diagnosis. These ambulatory cases are the most dangerous that the Medical Officer has to deal with. This man we know gave the disease to two persons, but how many others he infected I cannot say. (a.) That malignant or hemorrhagic Small Pox is invariably fatal. Two patients developed this terrible form—a man who died on the second day after removal, and a woman who had a few days previously been confined, on the third day. Neither had been re-vaccinated since infancy. |
cd791ab0-298b-4dc3-a09b-434bae18a706 | Unvaccinated infants also invariably die, and suffer from the confluent form. This was the case of an infant three months old in Bedford Park. (4.) That a considerable amount of re-vaccination must have exercised some influence in checking the spread of infection, but it is evident that a very large proportion of the working classes failed to avail themselves of this protection. (5.) That if we are to enjoy the immunity from Small Pox that falls to the lot of Germany, re-vaccination must be made compulsory about puberty. As the responsible officer for the measures that have to be taken in dealing with a Small Pox epidemic it is essential that the Medical 20 Officer of Health should have an efficient staff. I cannot speak too highly of the way in which I was seconded by Messrs Kinch and Fraser, the Sanitary Inspectors, and also by Mr King, who disinfected the premises. |
06717ffe-6cb5-46e6-ab63-f16cfff58a00 | They all cheerfully fell in with the work without a moment's delay on any day of the week, or at any time day or night. It was remarkable how much of the work in connection with the outbreak fell to our lot after ordinary office hours, and especially upon Sundays. Much of our success in dealing with the epidemic was also due to my brother practitioners, for they one and all informed me at once of any suspicious case, and kindly asked me to see the patient with them. In conclusion, I take this opportunity of gratefully acknowledging the good counsel and support which I received from the members of the Sanitary Committee and the Council. Mr Morris, Chairman of the Council, Mr Hunt, then Chairman of the Sanitary Committee, and our present Chairman of the Committee, Mr Monson, gave up much of their valuable time in assisting to tide us over a very anxious period. SCARLET FEVER. One hundred and nine cases were notified during the year. The following table shows the ages of those affected Age. No. |
388f86b3-6e48-4fb4-9fee-54e59d32e86c | of Cases. Age. No. of Cases. Under 1 year 1 12 years 3 1 „ 3 13 „ 3 2 ,, 6 14 „ 3 3 „ 10 15 „ 1 4 „ 10 16 „ 4 5 „ 8 18 „ 1 6 „ 8 19 „ 2 7 „ 13 20 „ 3 8 ,, 9 21 to 25 years 6 9 ,, 2 26 to 30 „ 5 10 „ 3 31 to 40 „ 3 11 ,, 2 Total 109 So far as these cases go they show that there is little liability to the illness under one year of age; that up to four years the liability increases, then gradually diminishing as years go on. The above figures also show that no age up to middle life is entirely exempt. |
6a2a89af-4482-4c32-bbca-0fc0bb038f49 | 21 It was ascertained that the following schools had been attended by children previous to their developing Scarlet Fever :— School. No. of Cases. All Saints, South Acton 4 Osborne Road, South Acton 5 Priory School, Acton Lane 11 Beaumont Park, Acton Green 13 East Acton 5 Churchfield Hall 6 St Mary's, Oldham Terrace 7 Willesden Junction 3 Haberdashers' 1 Private and other Schools 20 DIPHTHERIA. Thirty-three cases were notified. As I have repeatedly pointed out, it is impossible to say whether a suspicious case is true Diphtheria without a bacteriological examination, and medical practitioners err on the right side in notifying the same. I trust that when the new municipal buildings are erected, provision will be made for a small laboratory where such examinations can be conducted. In the meantime I beg to ask the Council to make arrangements with the Clinical Research Association to conduct these necessary examinations for us. |
f4819183-f2fe-421b-b4a9-8d6786f39359 | This course is followed by several other sanitary authorities, and the cost is very small. We have a striking example of the progress preventive medicine is making in the treatment of this disease. In Diphtheria Antitoxin we have a sure remedy if the treatment is applied before the poison has had time to do its work. The following figures of the Metropolitan Asylums Board are particularly instructive, showing the results of the antitoxic treatment of Diphtheria at the Brook Hospital, Shooters Hill, 1901:— Treated on Cases. Mortality per cent. |
1e6c1f05-8a96-4680-98bc-dd1c858a4c08 | First day of Disease 38 0.0 Second „ 170 4.1 Third ,, 192 11.9 Fourth „ 137 12.4 Fifth day and after 186 16.6 22 The importance of injecting the serum early is proved to the hilt in the above figures, and as no harm can accrue to the patients if ordinary antiseptic precautions are taken, a dose of the Antitoxin should be given at once in every suspicious case. I keep a supply of fresh serum from the Jenner Institute, and medical practitioners can have it by applying at my private residence any time of the day or night. The Prophylactic Use of Diphtheria Antitoxin is especially indicated where a case or cases of Diphtheria occur among susceptible individuals who are more or less closely associated, as, for example, in families, schools, and institutions. |
d57a3f4e-8cd1-4d75-b182-dd611e963efa | Under such conditions, as soon as the primary case is recognised, all those who in any way may have come in contact with it, or better still, all the susceptible individuals in the institution, should without delay be injected with a dose of Diphtheria Antitoxin. Many records have now been published as to the efficacy of prophylactic injections as a preventive. The Health Department of Burton-upon-Trent have issued a circular to the medical men of the district, emphasising the value of Antitoxin as a preventive. In the combined rural districts of Chelmsford, and Maldon there were 24 families in which cases of Diphtheria antitoxon occurred. The remaining unaffected members of these families comprised 144 individuals, and to 136 of these prophylactic injections of Diphtheria were given, and among this number only a single doubtful case of Diphtheria occurred. Of the eight uninjected individuals, three subsequently developed Diphtheria. |
0e5a89a6-df9b-40d1-a75d-8e13c03daa2c | In a Convalescent Home containing 38 children, three consecutive cases of Diphtheria occurred. The remaining 35 children were each injected with Diphtheria Antitoxin (334 units each), and no further case developed. With regard to the amount of Diphtheria Antitoxin required for prophylactic purposes, probably, as a minimum, 300 units should be given to children, and 500 units to adults. Although the immunity induced by the injection is rapidly acquired, probably within a few hours it slowly passes off, and cannot be regarded as lasting for more than three weeks. 23 FACTORY AND WORKSHOP ACT, 1901. As required by Section 132 of the above Act, I beg to report on the administration of the same in this District during the year. There are 267 Workshops on the Register, but this I am of opinion is not all, as we are constantly finding out premises which come under the Act, the occupier having failed to report him or herself. |
bbbfc274-3b9a-4e49-8094-74e3845b4f0b | When classified, there are 182 Laundries, 24 Retail Bakehouses, and 61 other Workshops. These include tenement and domestic Workshops but not Domestic Factories or Workplaces. Personally I have made 64 inspections, and the Sanitary Inspectors 239. It will be noticed that the Laundry industry comprises the chief business of the Workshops. As to the sanitation of these premises, which embraces cleanliness, air space, ventilation, and drainage, I must say it is very good on the whole, very few Notices having to be served, and only one prosecution (in which we were successful) has been necessary. This was under Section 8, as to the wet state of the floor, and means of draining the same. Of the 24 Retail Bakehouses on the Register, 11 are underground. |
fca0cc85-a3d4-416e-bcb5-670084a2d4eb | It has not been necessary to serve Notices on the occupiers as to sanitary defects, and the premises have been regularly whitewashed twice yearly as prescribed by the Act, and visited 89 times by the Sanitary Inspectors. The following are the provisions of Section 101 of the Factory and Workshop Act, 1901, which relates to Bakehouses:— "1. An Underground Bakehouse shall not be used as a Bakehouse unless it is so used at the passing of this Act. "2. Subject to the foregoing provision, after the first day of January 1904, an Underground Bakehouse shall not be used unless certified by the District Council to be suitable for that purpose. "3. For the purpose of this section an Underground Bakehouse shall mean a Bakehouse, any baking room of which is so situate that the surface of the floor is more than three feet below the surface of the adjoining street or the ground adjoining or nearest to the room. |
b15bdb5b-f99d-4501-81bb-cfeeb2078719 | The expression ' baking room ' means any room used for baking or for any process incidental thereto. "4. An Underground Bakehouse shall not be certified as suitable unless the District Council is satisfied that it is suitable as regards construction, light, ventilation, and in all other respects. "6. If any place is used in contravention to this section, it shall be deemed to be a Workshop not kept in conformity with this Act." 24 During November and December of last year I visited all the Underground Bakehouses in company with the Sanitary Inspector, and on the 9th December I laid before the Sanitary Committee a full Report thereon, with the following model recommendations for making them absolutely sanitary :— Capacity.—The bakehouse must have a capacity of not less than 1,000 cubic feet. Floor Space.—The floor space must not be less than 125 square feet. Height.—The bakehouse should be in every part thereof 8 feet high, measured from the floor to the ceiling. Ceilings. |
b86db21c-0411-4d1c-9798-3548dfa91419 | —All ceilings, beams, and joists to be thoroughly scraped and cleansed, and to be match-boarded with tongued and grooved match-boarding, or lathed and rendered in Portland cement or similar damp-proof and impervious material, worked to an even and polished surface and limewashed. Walls.—All walls to be damp-proof, and to be maintained in such condition. All projections and irregularities in existing walls to be removed, and all hollows and crevices to be filled up with suitable material. The joints of all walls (except external walls) to be raked out, and the walls hacked over and rendered with Portland cement and sand, mixed in the proportions of one part Portland cement to three parts of clean, sharp sand, and such rendering to be left¾ inch thick at all points and finished to a smooth and polished surface. Note.—White glazed bricks, tiles, or opalite are preferred. |
fc5ae9b4-61e2-4112-a488-d00712cb6a96 | Floors.—The whole of the existing floors to be taken up and re-formed and re-laid, where necessary, 6 inches thick over the entire surface with Portland cement concrete, mixed in proportions one part Portland cement to five parts of broken stone or bricks and one part clean sharp sand. The surface to be finished with a ½-inch layer of Portland cement and granite chippings to pass a ¼-inch mesh, mixed in equal proportions, or of good flags 3 inches thick with cement joints. The floor should be laid to proper falls, and be drained by means of a suitable channel to a gully, over which, if practicable, a draw-off tap should be fixed, the gully being properly dished and placed outside the bakehouse. Yards.—Any yard or passage-way adjoining the entrance of the bakehouse to be paved with cement or other hard, durable, and impervious material at least 3 inches thick, and formed to fall towards a properly trapped drain inlet outside. |
ab09e419-a0bc-49e3-b630-07e34e0ffd3d | Lighting.—All areas provided for the purpose of admitting light to be, if necessary, lined with white glazed tiles, bricks, or opalite, with splayed bottom for the purpose of cleansing, and fitted with pavement lights over the lighting area. To provide and fix hopper lights of an approved pattern above the pavement lights in the lighting area, and to make all the requisite alterations to the ceiling to permit of the proper working of the hopper lights. Permission to construct hopper lights in the street or passage must be obtained from the Council. All artificial lights are to be arranged in such a manner as will assist the ventilation of the bakehouse, as well as to enable any products of combustion to be drawn away. |
01ce4b5f-0c02-445a-bff3-6a7c0ddcaadf | Ventilation.—Fresh air is to be provided by means of three air inlets on the "Tobin" tube system, each of a sectional area as will be sufficient, and which size will be decided on the cubic contents of the bakehouse, the number of hands 25 employed, and the velocity of the passage of the air. The intakes for the same are to be fixed not less than 6 feet above the level of the adjoining street or yard in a position free from dust or dirt, and to be protected by grids of a clear ventilating area equal to that of the respective inlet tubes. The inlet tubes to discharge at a height of 5 feet 6 inches above the level of the bakehouse floor. Any existing air bricks and openings in walls are to be built up. |
847faf08-3e3f-42c7-81a1-6a98c3805882 | The foul air is to be drawn away by means of two extract ventilators at ceiling level, each of a total internal sectional area as is necessary, and calculated on the same basis as the inlets, and fitted with bell-mouth inlets 18 inches in diameter. The extract tubes to be carried over the oven and connected to an outside upright shaft of sufficient sectional area, terminating at a reasonable height above the intake inlets and fitted with a wire guard. All tubes are to be carried in direct lines and with few bends as possible. No right-angled or acute bends will be allowed. No perforated zinc is to be used, but fine gauged wire netting of not less than ½inch square mesh is to be fitted over the bell-mouth outlets and the air inlets. Flour Storage, &c. — Provision is to be made for the proper storage of flour, potatoes, salt, and all other constituents or ingredients used in the bakehouse elsewhere than in the underground bakehouse itself. |
f93ab723-b8a4-4190-a7d5-88e9143903ef | Such store places must be as strictly and properly kept as a bakehouse. Fittings.—All dough troughs, tables, and bins are to be provided with strong swivel castors or wheels, and arranged so as to be easily moved and allow for proper cleansing and inspection. Woodwork usually painted to have three coats of good oil paint, including the primary coat. Shelves, &c.—The joints of shelving or other woodwork joints at walls and other places to be filled in with suitable material, and left smooth, flush, and even. Staircase. —No outside staircase shall terminate within the bakehouse. I should like to advise the Council not to grant any certificates and thus close them all, but I feel that such a step would practically ruin several hard-working and deserving persons who have invested their little all in their business. |
9ad44b3e-c067-4f4a-84de-4daf1092bf04 | You have appointed a small Sub-Committee for the purpose of inspecting these premises, but it must be borne in mind that once these premises are passed they can be used for all time as Bakehouses, and that now is the golden opportunity for the Council to have them made healthy for the workers, and constructed so that the conditions under which bread, &c., is prepared are clean and wholesome. The chief difficulties arise in providing suitable ventilation, lighting, and the prevention of dampness and dust. There is no need for me to again discuss the ill effects of dust and the dust question generally, as I have repeatedly brought this important question before you, and I have seen from the Report of the Delegates who visited the Sanitary Congress at Manchester that you are fully alive to its injurious effects. 26 The Public Health Act Amendment Act, 1890, has been adopted for some time by the Council. Under Section 22, which relates to W.C. |
f8e6b70b-1945-4c6d-9500-f312ca9def7c | accommodation in Factories and Workshops, eight closets for persons of either sex have been provided, and no prosecutions have been necessary to enforce the provisions of this section. As to the means of escape in case of Fire from premises coming under this Act I am not called upon to report. With reference to Sections 107 to 115, which deal with Homework, I beg to report that the total number of lists received during the year were 32, representing 30 employers, 2 contractors, and 87 out-workers. Under the Act, employers or contractors giving out Home-Work are required to send a list of all persons employed by them to do such Home-Work to the District Council twice a year, viz., on or before the 1st of February and on or before the 1st of August. No such lists were received up to February—the 32 being received between then and 1st August. |
2103ea7b-ea7b-4f90-b096-69f1e087b425 | I do not think these would have come in then had it not been for the Council's action in inserting the requirements of this section for two weeks in May in the local newspapers. The sending in of these lists only refers to persons giving out work connected with the following trades, viz.— The making, cleaning, washing, altering, ornamenting, finishing, repairing of wearing apparel, and any work incidental thereto. The making, ornamenting, mending, and finishing of lace curtains and nets. Cabinet and furniture making and upholstery work. The making of electro-plate. The making of files. Fur pulling. Thirty-two is a very small number of lists for a District like Acton, and I should recommend the Council to take proceedings against persons whom we find are contravening this section, not for the sake of recovering the penalty, but because I know of no other effective way of making the requirements of the section known. |
933bda08-ce47-4934-941c-1345d40b73fb | These lists are of great assistance, and are always referred to upon the receipt of a notification of Infectious Disease. They also enable us to inspect 27 the out-workers' home and to see that the premises are wholesome and fit for the purpose used. I am pleased to say no Prohibition Order as to infected houses has been necessary. Forty-six notices have been received from H.M. Inspectors of Factories, dealing principally with defective closets, insufficient closet accommodation for persons of either sex, defective wash-house floors, dirty walls, and inefficient ventilation to work rooms. Immediately on receipt of these notices the Sanitary Inspectors visit the premises to which they relate, and make a thorough inspection of the drains and sanitary appliances. Notices are served on the Owner or Occupier to abate the nuisance complained of, and when this has been done the Factory Inspector is at once informed, as required by Section 5. |
afebe9c9-3780-4159-a9d5-9507ecafb101 | Under this section also one month is allowed to abate the nuisance, and if the Council do not take action to enforce abatement, the Home Office may take proceedings, and any expense incurred in so doing shall be charged to the Council. Twelve notices were sent to H.M. Factory Inspector re workshops not having the prescribed Abstract affixed, under Section 133. Each year there is an improvement in the condition of the Laundries, but I hope for still further improvement. Much good work is being done under this new Act. SICK-NURSING. The nurses in connection with our Cottage Hospital have had under treatment 305 patients, and paid 7,753 visits, an average of 25 to each patient. Excellent work is done by these ladies, whose skill and sympathy is greatly appreciated. Nurse Dawkins has paid 1,078 visits, and nursed patients when necessary. She has also given out 606 bottles of disinfectant and accompanied eight patients to Hospital. |
cad07eaa-9546-445c-9c8d-89a466f048ff | She has also distributed various leaflets. MORTUARY. During the year 36 bodies were received into the Mortuary, viz., 21 Males and 15 Females. Post-Mortems were made in 30 cases. 28 Annual Report of tbe Sanitary Inspector for the Dear 1902. To Dr G. A. Garry Simpson, Medical Officer of Health. Sir,—I herewith present my Annual Statement, showing the particulars of the action taken in the suppression of Nuisances, &c., and various improvements effected by this Department during the year 1902. |
6c370ad1-368c-49f7-b2c2-5daf016a55de | It will be seen from the tables which I have compiled that a great deal of sanitary work has been done through the medium of this Department, although the Small Pox outbreak during the year interrupted our work to no small degree, as my own time and that of my Assistant was for many days taken up with removing Cases to Hospital and following up contacts, &c. I am pleased to state that now we have a separate office, the work is done in a more systematic manner than was possible when we were hampered through lack of office accommodation. The provision of a Typewriter at the beginning of the year has proved invaluable, for we are now able to write our letters, notices, reports, &c., in far less time than was possible before, thus saving much valuable time. The new Factory and Workshop Act which came into force on 1st January has added considerably to the work of your Inspectors. |
7da3b5c1-9d86-487b-b8c1-6b64910fa24d | Mr Fraser, my Assistant, has now been with me eighteen months, and I can only speak in the highest terms of his abilities, and the manner in which he has discharged his duties. I only hope that I shall be able to retain his services for some years. I am, Dear Sir, obediently yours, Maurice W. Kinch. Public Health Department, Gothic Villa, Mill Hill Grove. 29 Number of Inspections, &c. 1,754 Premises inspected. 3,091 Re-inspections to premises where Nuisances were in course of abatement. 2,809 Nuisances were reported. 2,628 „ „ abated. 1,108 Letters written. 1,206 „ received. 64 Notices received from H.M. Factory Inspector. 10 Library Books removed from Infected Houses and destroyed. 15 Van Dwellings inspected. 335 Visits paid to Infected Houses. 40 Infectious Patients removed to Hospitals. 356 Rooms fumigated. |
083bbe95-948a-401e-b29b-14b393638dfc | 18 tons 12 cwt. Bedding disinfected. 25 Closets disinfected after Enteric Fever Cases. The following Tabulated List gives particulars of the sanitary improvements effected during the year :— House drains taken up and reconstructed 48 , repaired 15 „ unstopped and cleansed 102 „ provided with intercepting traps 95 „ manholes provided to 109 „ ventilated 106 „ manholes to, cleansed 12 „ „ repaired 14 „ fresh-air inlets repaired 12 Water-closets repaired 36 „ new pans provided to 94 , unstopped and cleansed 38 „ pan closets and containers replaced by efficient pans 19 „ provided with flushing cisterns 40 „ flushing cisterns repaired 103 „ flush, disconnected from drinking water cistern 11 „ additional or separate, provided in Factories and Workshops 8 Soil-pipes repaired 9 „ ventilated 18 „ increased ventilation provided 37 , |
666aab7c-e999-4efd-a7f2-a54314585a30 | Norman Shaw system abolished - 2 30 Ventilating shafts repaired 27 „ provided 6 Waste-pipes, sink waste-pipes disconnected from drain 39 „ bath and lavatory waste-pipes 5 „ bath and lavatory waste-pipes disconnected from soil-pipes - 4 „ repaired 33 „ trapped with lead traps 5 Rainwater-pipes disconnected from drain 220 „ repaired 41 „ provided 10 Eaves guttering provided 27 „ repaired 35 Gully traps replaced with stoneware gullies 184 „ unstopped 25 „ provided 48 „ cement work around, repaired 20 Yards, |
1c4323cb-439c-4fc2-a596-ee9f07091d95 | paving repaired 116 „ paved and drained 58 „ cleansed 10 Dust-bins provided 215 Cisterns repaired and covered 24 „ cleansed 15 Houses cleansed and whitewashed 180 „ plastering of walls and ceilings repaired 52 Workshops cleansed and limewashed 26 Roofs of houses repaired 42 Floors of houses repaired or relaid 73 „ workshops repaired or relaid 24 „ stables repaired or relaid 9 Dampness of house walls remedied 6 Accumulations of refuse removed 17 „ manure removed 25 , water in cellars removed 5 Manure receptacles provided 21 Animals, fowls, &c. nuisances from, abated 31 Overcrowding, number of cases abated 9 Smoke nuisances, number of cases dealt with 7 Privies abolished and earth-closets provided 3 Water supply provided to houses 4 Miscellaneous nuisances abated 42 Notices. |
15561828-bbde-4711-9049-93baa29d6471 | —776 Preliminary Notices and 153 Statutory Notices have been served for the abatement of Nuisances, and the necessary 31 works asked for were carried out in nearly all cases. Police Court Proceedings were taken in two instances where owners had failed to comply with Notices served. One case was withdrawn on payment of costs, the work having been done, and in the other an Order was made by the Magistrate for the work to be done in fourteen days. I beg to call your attention to the very few Police Court Proceedings and the number of Statutory Notices compared with the Preliminary ones, which shows that Statutory Notices are not asked for, unless owners absolutely refuse to comply with what I consider is a reasonable request and necessary in the interests of Public Health. Drainage Examinations.—The smoke test has been applied to Drains 153 times, and in addition 19 Drains were opened up for examination after formal written complaints had been made, and authority given for that purpose. |
fc5f86a6-b903-4a1b-a887-19478dbaa09e | The volatile or chemical test has also been applied to Drains in numerous instances. Inspection of Meat and other Foods- -The various Butchers' Shops, Greengrocers' Shops, and other places where food is sold were frequently inspected during the year, and on one occasion in July I found unwholesome meat exposed for sale at three Butchers' Shops. I reported the facts to the Council, and they decided to take Proceedings against the Offenders, with the result that in each case they were fined 10s. and costs. They all pleaded that the hot weather was the cause of the meat turning bad, and had they not impressed the Magistrate with this fact, I am confident that much heavier fines would have been imposed. On the 24th April I visited a Butcher's Shop in Acton Lane, and found the whole carcase of a cow which I considered unfit for human food, and no doubt you will remember that you came and looked at this carcase yourself, and agreed that the same was unfit. |
d5f3a61c-fcde-4937-8304-6e5c45a143d2 | It was removed from the premises and condemned by a Justice and destroyed. During the year the following were seized and taken before a Justice:— 1 box Skate. 1 box Plaice. 1 carcase of Beef. Quantity of pieces of Meat. 1 box Dabs. 32 Food and Drugs Acts.—Samples under these Acts are taken by Mr W. Tyler, the County Council Inspector. No returns are supplied to our Council as to the number of samples taken in the District and the result of the analysis. Dairies, Cowsheds, and Milkshops.—There are at present 79 Dairies and Milkshops, and 7 Cowkeepers on the Register. Every quarter I forward to the occupier of every Dairy and Cowshed a Notice reminding him of his duty to have the premises limewashed, as required by the Regulations. 140 visits were paid to the Dairies and Milkshops and 21 visits to the Cowsheds, and they were found to be in good order. |
16b2f9cc-761e-4a70-8440-9f70d68f76b0 | In one case a Cowshed was found to be inefficiently ventilated, but this was rectified on a representation being made to the occupier. Bakehouses.—The number of Bakehouses on the Register is 24, of which 11 are underground. A circular letter is sent to the occupiers every six months reminding them of the time to limewash and cleanse, as prescribed by the Factory and Workshop Act, 1901. All these premises have been visited, 51 inspections having been made. Slaughterhouses. -There are 4 Slaughterhouses in the District, 2 Licensed and 2 Registered. 48 visits were paid to these premises, and upon each occasion the Bye-Laws were found to be complied with. Piggeries. -The 13 Piggeries have been inspected from time to time. |
03fc363b-5bce-4ce0-9533-5192362b5eda | Several complaints have been received with regard to the smell from the Piggeries in Old Oak Lane from persons frequenting this road, and it will be a good thing when this part of the Parish is developed for building purposes, so that we can deal with them under our Bye-Laws as we successfully did with the South Acton Piggeries. Common Lodging Houses.—Only one Common Lodging House exists in the District. This has been regularly inspected, and on all occasions was found to be in a satisfactory condition. Smoke Abatement. -All Factory and Works chimneys have been observed at frequent intervals, and in two cases Proceedings were taken against the owners for emitting dense black smoke so as to be a nuisance. In one case a conviction was obtained, and in the other an order was made to abate the nuisance, the owner having decided to erect an additional shaft and provide mechanical stokers to each of the furnaces. This work is now nearing completion. |
1ee89c10-4ec7-4d83-81d1-fda71852aa74 | Acton Urban District Council. ANNUAL REPORT on the SANITARY CONDITION, &c., of the URBAN DISTRICT OF ACTON, For the Year, 1903 by G. A. GARRY SIMPSON, M.R.C.S., L.S.A., Fellow of the Royal Institute of Public Health. MEDICAL OFFICER OF HEALTH. Printed by Order of the Sanitary Authority. Act 11 Acton Urban District Council. on the SANITARY CONDITION, &c., of the URBAN DISTRICT OF ACTON, For the Year, 1903 by G. A. GARRY SIMPSON, M.R.C.S., L.S.A., Fellow of the Royal Institute of Public Health. MEDICAL OFFICER OF HEALTH. Printed by Order of the Sanitary Authority. CONTENTS. MEDICAL OFFICER OF HEALTH'S REPORT. |
9e03fe58-d4d1-4950-a311-46c78db50b14 | Pages Acreage of District 8, 9 Abstract in Workshops 28 Birth Rate 8, 10 Bakehouses 26, 28 Bakehouses (Underground) 26 Causes and Ages at Death (Table giving) 12 Consumption or Phthisis 18 Cock and Crown Yard 29 Death Rate. 8, 9, 11, 13 Death Rates (General and Zymotic, Comparative Table) 13 Diphtheria 15, 19 Disinfection 19 Disinfector, Regulations as to 19, 20 Disinfector, (Steam) Regulations as to 21, 22, 23 Drainage 25 Dust Collection 25, 26 Enteric Fever 13, 15, 16, 17, 18 East Row 29 Employment of Children Act 33, 34 Factory and Workshop Act 26,27,28 Factory Inspectors Notices 27 General Remarks 4, |
27881b18-454b-47cd-9012-db778f796d4f | 5 Golden Meadow Cottages 30 Homework 27 Housing of the Working Classes Acts 29, 30 Infantile Mortality 8, 9 Infectious Diseases Notified (Comparative Table) 15 Infectious Diseases Notified (Table Showing) 16 Laundries 26 Measles 12, 13, 18, 19 Mortuary 23 Narrow street 29 Office 7 Population 8, 9, 10 Phthisis or Consumption 18 Sanitary Committee 6 Sanitary Staff 7 Small Pox 15. |
500426b7-0e06-4268-9112-421383b97750 | 16, 17 Sick Nursing 23 Schools 23, 24, 25 Sewage 25 Scavenging of Roads 25 Steyne Road 29 Steyne, Plan showing 31 Table shewing Birth Rate, Death Rate, & Zymotic Death Hate in 14 Towns 11 Vital Statistics (Summary) 8 Vital Statistics (Table showing) 9 Ward Boundaries 7 Whooping Cough 18 Workshops 26, 27 28 Workshops (Closet accommodation) 26 27 Zymotic Diseases 15 SANITARY INSPECTOR'S REPORT. |
442f8af0-83a1-4a88-8b7d-1f8ca2da224d | Pages Bakehouses 40 Common Lodging Houses 41 Cowsheds 40 Drainage Examinations 39 Dairies 40 Food and Drugs Acts 40 General Remarks 35, 36 Inspections, &c 37 Meat and other Foods (inspection of) 30, 40 Milkshops 40 Notices 39 Prosecutions 39 Piggeries 41 Sanitary Improvements (List of) 37, 38, 39 Slaughterhouses 40 Smoke Abatement 41 Acton Urban District Council. Annual Report of the Medical Officer. For the year ending just December, 1903. To the Chairman and Members of the Urban District Council. Gentlemen, I beg to submit my tenth Annual Report, concerning the health and Sanitary Conditions of your town. During July and August we experienced a succession of severe rainstorms, which not only cooled the air and prevented the dissemination of dust, but scoured the streets and sewers. |
c508ec2a-8374-4394-9b82-71d870e76b97 | It is unfortunate that a wet Summer—which to most people is a source of sorrow and regret—should to Medical Officers of Health, be the occasion for rejoicing, for with a cool Summer the Infantile mortality is lowered. In consequence I have to report a marked decrease in the General Death Rate, the Infantile Death Rate and the Zymotic Death Rate. I think we are exceptionally fortunate with such a large number of children to have a Zymotic Death Rate of 1 per 1000 and I question whether any district with a population comparable to our own could shew such figures. I would also draw your attention to the fact that there has not been a single death from measles. The Acton Improvement Bill which will shortly be submitted 5 to Parliament contains many sanitary reforms which will be of lasting benefit to the Town. The building of the Isolation Hospital is progressing, and will probably be finished during the present year; the same remarks apply to the Baths. |
1fce2eee-95f3-4d74-a508-89c0becbd822 | The Board Schools are now under your supervision, and I have made some very important suggestions in the report which I trust will receive your earnest consideration. Certain changes in the Staff of my department have taken place. Mr. Fraser whose work was most satisfactory has been appointed Sanitary Inspector to the Northfleet Urban District Council, Kent, and Mr. Ernest J. Gough, has taken his place. The appointment of Miss L. Bulkeley Williams, as a Lady Health Visitor, will be of the greatest help and benefit to the Town. In the tables, dealing with the Vital Statistics you will notice the great increase in the number of inhabited houses and the population. The work of my department has been carried out to my complete satisfaction and I take this opportunity of thanking the Council for their kind help and advice in many important matters. I am greatly indebted to Mr. Kinch for his able assistance and support; and from his report which I append it will be seen that he has done good service in the Town. |
1dd9be7a-5af4-4ebb-a766-9f8b7f738d10 | I am Gentlemen, Your obedient Servant, G. A. GARRY SIMPSON. 6 Public Health Committee. Mr. R. AINSLEY (Chairman) „ E. B. ATHAWES. „ F. A. BALDWIN. „ R. BARNES. „ J. W. BULLEN. „ J. DE LARA COHEN. „ D. P. CRONIN. „ S. GOODHALL. „ E. F. HUNT. „ J. W. JARRATT, J.P. „ A. W. W. KING, J.P. „ F. T. W. MILLER. „ T. H. MORRIS. „ E. MONSON. „ R. POULTON. 7 SANITARY STAFF. |
cc4a075f-54aa-40f6-8588-1b1abadac250 | G. A. Garry Simpson, Medical Officer of Health M. R. C. S., F. R. I. P. H. M. W. Kinch, Cert. San. Inst. Chief Sanitary Inspector (London.) Assistant Sanitary Inspector Ernest J. Gough, Cert. San. Inst. Miss L. Bulkeley Williams. Lady Health Visitor Cert. San. Insp. (London) Clerk Lewis Bradford. Disinfector F. King. E. Bevan, 4 New Court, County Analyst Lincoln's Inn, W.C. County Inspector under Food and W. Tyler, Town Hall, Drugs Acts Brentford. County Dr. Gordon Hogg South Parada, Bedford Park. The Office of the Health Department is at Gothic Villa, Mill Hill Grove. I attend daily at 9.30 a.m., and may be consulted on all matters connected with the health of the District. |
d6f9cc24-63d7-42c9-a59d-8299507eefb3 | Should an urgent matter require immediate attention after office hours, or on Sundays, I can be interviewed at my private residence— Bardon House, East Acton. WARD BOUNDARIES. North Ward.—All north of centre of High Street. West Ward.—South of centre of High Street from Birch Grove to Railway Bridge, High Street, and west of centre of North London Railway, from Railway Bridge, High Street, to Bollo Lane. East Ward.—South of centre of Uxbridge Road, from Railway Bridge, High Street, to Wilton Road, and East of North London Railway from Railway Bridge, High Street, to Bollo Lane. 8 VITAL STATISTICS. SUMMARY. |
b18de71e-73b9-4d4b-abaa-6f48cceb3132 | Area of District 2,304 acres Rateable Value £277,153 Net Value of a Penny Rate £856.11s Population at middle of last year 49,680 Population in 1901 Census 37,744 Persons per acre in the District 21.5 Average number of persons per house 1901 census 6.. Death Rate 1903 8.6 Average Death Rate for previous ten years 14.7 Zymotic Death Rate 1903 1.0 Average Death Rate for previous ten years 2.6 Biith Rate 1903 28.6 Average Birth Rate for previous ten years 30.4 Infant Death Rate (under one year old) per thousand births 1903 105.4 Infant Death Rate Average for previous ten years per 1,000 births 174.3 VITAL STATISTICS. |
801203b5-2ccb-45af-9ded-1fe16b847610 | The Following Table gives the Vital Statistics of the whole District during 1903 and previous years:— 9 VITAL STATISTICS OF WHOLE DISTRICT DURING 1903 AND PREVIOUS YEARS. Year Population estimated to Middle of each Year. Births. Total Deaths Registered in tub 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. Next Deaths at all Ages belonging to the District. Number Rate* Under 1 Year of Age. At All Ages Number Rate per 1,000 Births registered Number Rate* Number Rate* 1893 26,000 831 31.9 160 192.0 451 17. 3 ... ... 35 486 18.6 1894 27,600 834 30.2 133 159.0 368 13.3 ... ... 25 393 14. |
465e5c94-07e2-4345-a56a-8a6fe31a07c1 | 2 1895 27,648 874 31.6 147 168.1 445 16.1 ... ... 33 478 17.2 1896 29.454 894 30.3 151 168.9 435 14.7 ... ... 29 464 15. 7 1897 31,632 973 30.7 193 198.3 470 14.8 . . 33 503 15.9 1898 32,562 995 30.5 181 181.9 507 15.5 . . 10 517 15.8 1899 33,684 1,068 31.7 200 187.2 509 15.1 . . . 509 15.1 1900 38,406 1,080 28.1 182 168.5 528 13.7 15 . . 528 13. |
99d37129-4e57-4d6e-9482-76fd125edba5 | 7 1901 37,744 1,211 32.0 206 170.1 519 13.7 6 . . 519 13.7 1902 44,565 1,242 27.8 186 149.8 593 13.3 12 . 6 599 13.4 Averages for years 1893-1902 32,929 1,000 30.4 173 174.3 482 14.7 . . 17 499 15.3 1903 49,680 1,422 28.6 150 105.4 430 8.6 8 . . 430 8.6 *Calculated per 1,000 of estimated population. Total population as per Census 1901—All ages 37,744. Number of inhabited houses 6,114. Average Number of persons per house, 61. |
5c9694ba-58f8-4c48-9284-fbac5199a375 | Area of District in acres (exclusive of area covered by water), 2,304. 10 Population.—The population calculated to the middle of 1903 was 49,680, an increase of 5,115 in twelve months. The number of inhabited houses was 8,240 and uninhabited 240 The following table shews the population and the number of the inhabited houses at the five preceding censuses. Year Inhabited Houses Population 1861 610 3,151 1871 1,568 8,306 1881 2,844 17,110 1891 4,084 24,207 1901 6,114 37,744 In making my calculations I allow six persons to each occupied house, and one for each unoccupied house. The census of 1901 shewed the average to be 6., per house. This method of calculating the population is the one adopted by previous Medical Officers for the District. |
70e6234e-8a6e-4f66-b86f-8e5dccdd49de | Birth Rate.—During the year 1903 there were 1,422 births registered. The birth rate per 1,000 persons living was 28,6. The London birth rate was 28,5 The following table shews the births since 1893:— Year. Number of Births. 1893 831 1894 834 1895 874 1896 894 1897 973 1898 995 1899 1,068 1900 1,080 1901 1,211 1902 1,242 1903 1,422 11 DEATH RATE. General mortality.—There were 430 deaths registered. The recorded general death rate was 8.6 per 1,000 of the population. |
c1b35a29-df2c-43a6-945e-ab257df83279 | The London death rate was 15.2 The death rates since 1893 are as follows:— 1893 18.6 1894 14.2 1895 17.2 1896 15.7 1897 15.9 1898 15.8 1899 15.1 1900 13.7 1901 13.7 1902 13.4 1903 8.6 This is the lowest death rate on record and is highly satisfactory. It will be noticed that the recorded general death rate has been gradually falling for the last seven years. The following Table gives the Birth rate, Death rate, and Zymotic death rate per 1,000 per annum in the undermentioned 14 towns. Birth Rate Death Rate Zymotic Death Rate ACTON 28.6 8.6 1.0 Ealing 23.07 10.2 1.46 Chiswick 28.90 10. |
ec57830a-cec4-449c-a2b0-56fac01bc0a2 | 45 1.4 Brentford 31.6 12.9 1.5 Willesden 32.0 12.1 1.97 Reading 27.0 12.7 0.94 Ipswich 28.3 15.2 1.41 Hornsey 20.3 7.9 0.68 Tottenham 32.3 13.0 1.90 West Ham 33.7 15.3 2.65 East Ham 34.5 11.0 1.62 Leyton 30.6 10.8 1.64 Walthamstow 33.2 11.2 1.91 Croydon 46.3 11.8 1.08 12 The following table gives the causes of and ages at deathduring the year 1903. CAUSES OF, AND AGES AT DEATH DURING YEAR 1903. |
235dfa52-c3fc-4c05-a423-ca42ebaa7312 | Causes or 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 6 6 and under 15 15 and under 25 25 and under 65 65 and upwards North Ward West Ward East Ward Small Pox . . . . . . . . . . . Measles . . . . . . . . . . . Scarlet Fever 2 1 . 1 . . . 1 1 . . Whooping Cough 20 14 5 1 . . . 2 5 13 . Diphtheria & Membranous Croup 2 . 1 1 . . . 2 . . . Croup 1 . 1 . . . . . 1 . . Fever— Typhus . . . . . . . . . . . Enteric 5 1 . . 2 2 . |
3ef6f2df-e023-4452-9a1e-1f26ef2fe4bc | 2 2 1 1 Other continued . . . . . . . . . . . Epidemic Influenza 5 . 1 1 . 2 1 1 4 . . Cholera . . . . . . . . . . . Plague . . . . . . . . . . . Diarrhoea 21 16 4 . . . 1 . 11 .10 . Enteritis 14 10 3 . . 1 . 2 4 8 . Puerperal Fever . . . . . . . . . . . Erysipelas 3 1 . . . 1 1 1 1 1 . Other Septic Diseases . . . . . . . . . . . Phthisis 18 . 1 I 4 11 I 2 13 3 . Other Tubercular Diseases 14 4 4 . 2 4 . .1 3 10 . Cancer, |
f69db75a-a8b6-48cf-93ba-44df8db86d1b | Malignant Disease 18 1 . . . l6 I 8 2 8 . Bronchitis 35 10 5 . . 7 11 4 21 10 1 Pneumonia 30 13 8 3 . 5 1 5 16 9 2 Pleurisy 1 . . . . 1 . . 1 . . Other Diseases of Respiratory Organs 3 1 . . . 1 1 2 . 1 . Alcoholism — Cirrhosis of Liver 9 . . . . 9 . 1 4 2 . Venereal Diseases . . . . . . . . . . . Premature Birth 21 21 . . . . . 2 11 8 . Diseases and Accidents of Parturition . . . . . . . . . . . Heart Diseases 55 1 1 3 . |
aa2c1d68-f9a9-4fa2-b608-c97fcc937735 | 29 21 21 13 21 4 Accidents 6 2 . . 1 3 . 2 . 4 . Suicides 1 . . . . 1 . . . 1 . All other causes 146 54 9 3 8 31 41 14 58 48 •• All causes 430 150 43 14 17 IS4 82 101 171 158 8 13 In the following table the death rate and Zymotic death rate are so arranged that comparison can be made for the preceding ten years:— 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 Small Pox . . . . . . . . . 6 . Measles a 15 6 24 2 6 . 16 . 32 . Scarlet Fever 10 3 3 1 . |
6a97c405-746d-40d3-96a8-ab1af4e2aac7 | 3 2 6 2 1 2 Diphtheria 2 5 5 8 28 8 7 4 6 4 2 Whooping Cough 5 17 5 21 . 10 14 4 16 13 20 Typhoid Fever 4 2 2 2 2 . 7 4 1 4 5 Diarrhoea and Dysentery 60 17 44 37 80 50 56 50 69 23 21 Puerperal Fever 6 4 2 . . 1 . 1 . . . |
15efb4b8-44cb-4e10-87c4-d8d9e9a4a9de | Total Number of Deaths from seven Zymotic Diseases 89 63 67 93 130 78 86 85 94 83 50 Deaths from other Causes 396 330 411 371 373 439 423 443 425 516 380 Total Deaths 486 393 478 464 503 517 509 528 519 599 430 Death Rate from seven Zymotic Diseases per 1,000 3.4 2.2 2.4 3.1 4.1 2.3 2.5 2.2 2.4 1.8 1.0 Death Rate from other causes per 1,000 15.2 12.0 14.8 12.6 11.8 13.5 12.6 11.5 11.3 11.6 7.6 General Death Rate per 1,000 186 14.2 17.2 15. |
92a529de-621a-45dd-9172-27a9af83099f | 7 15.9 15.8 15.1 13.7 13.7 13.4 8.6 The London Zymotic death rate for 1903 was 176 14 INFANTILE MORTALITY. There were 150 deaths registered of Infants under one year of age, as against 1,422 births ; the proportion which the deaths under one year of age bear to 1,000 births is therefore 105.4 as against 149.8 in the preceding year. The following table compares the death rate of children under one year per 1,000 registered births, and the birth-rate for the preceding ten years:— Year. |
b3cd8648-baad-4619-ae92-1c4391c4561f | Birth Rate per 1,000 Deaths of Children under one year per 1,000 Registered Births 1893 31.9 192.5 1894 30.2 160.6 1895 31.6 168.1 1896 30.3 168.9 1897 30.7 198.3 1898 30.5 181.9 1899 31.7 187.2 1900 28.1 168.5 1901 32.0 170.1 1902 27.8 149.8 1903 28.6 105.4 This low Infant Mortality is due to the diminished number of deaths from Zymotic Diarrhoea. The heavy rainfall during the summer months washed and purified the air, and laid the dust of the streets. This dust frequently contains micro-organisms, which cause Zymotic or Infantile Diarrhcea. |
ae5ce778-69fc-47c3-a627-bce4f270cd52 | It shows how important it is to keep the roads well watered during hot and dry weather, and the food properly protected from dust and germs. In the bill which will be presently before Parliament, provision is made for the establishment of a Creche, such an institution will materially help to diminish the Infant Mortality. I also look for great help from Miss Williams, our Lady Help Visitor, who will instruct the mothers as to the care and feeding of their offspring. 15 Any poor mothers who are not in a position to pay for medical attendance, and require advice as to suitable food to give their Infants, can apply at the Health Office any morning at 9.30 a.m., when every assistance will be given. Miss Williams will also visit the case and personally superintend the preparation of the food. I shall be greatly obliged if the Medical Practitioners in the district will kindly inform me of any case of improper feeding where Miss Williams' supervision will be of use. ZYMOTIC DISEASES. |
acc7314b-033d-4354-9644-7e17c8dcb733 | The number of cases notified during the year, excluding Chicken Pox, was 167 against 215 in the preceding year. Cne hundred and forty four cases of Chicken Pox were notified, against one hundred and eighty three in 1902. The following table gives the number reported during the preceding ten years:— 1893 1894 1895 1896 1897 1898 1899 1900 1901 1903 1908 Small Pox 7 a . . . . . 2 1 31 1 Scarlet Fever 192 86 67 193 93 167 111 243 82 109 76 Diphtheria 41 22 32 23 89 35 49 28 34 33 22 Membranous Croup 1 . . . 4 . . 1 1 3 1 Typhoid Fever 19 15 28 14 10 9 . |
21c0a1fb-ecd8-437f-8602-17787cb78dde | 19 27 14 40 Continued „ 1 . . . . . . 2 . . . Puerperal , 2 1 3 3 . 1 . . 1 1 . Erysipelas 77 41 31 16 15 21 31 28 26 24 27 Totals 340 167 161 259 221 234 239 333 172 215 168 I personally visited all cases of Chicken Pox immediately on receipt of notifications. 16 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1903. Notifiable Disease. Cases Notified in Whole District, Total Cases notified in each Locality. At all Ages At Ages—Years. North Ward West Ward East Ward Under 1 1 to 6. 6 to 16 15 to 25 25 to 66 66 and upwards Small Pox 1 . . 1 . . . . 1 . |
23a33b6d-1016-494e-a333-f14e6089af83 | Cholera . . . . . . . . . . Diphtheria 22 . 7 9 2 4 . 9 5 8 Membranous Croup 2 . 2 . . . . . 2 . Erysipelas 27 1 1 2 1 19 3 10 10 7 Scarlet Fever 76 1 21 41 8 5 . 16 26 34 Typhus Fever . . . . . . . . . . Enteric Fever 40 . 2 12 14 12 . 11 8 21 Relapsing Fever . . . . . . . . . . Continued Fever . . . . . . . . . . Puerperal Fever . . . . . . . . . . Plague . . . . . . . . . . Chicken Pox 144 11 67 63 2 1 . |
e6148388-4714-4502-8887-9247f4cd4b98 | 9 66 69 Totals 312 13 100 128 27 41 3 55 118 139 17 Small Post.—One case of Small Pox occurred in July, a young girl residing in Shaftesbury Road. She was removed to South Mimms Hospital, and all contacts vaccinated and kept under observation with satisfactory results, as the disease did not spread. The difficulty of dealing with contacts and the great necessity of keeping a close observation of their movements may be gathered from the fact that after the premises in Shaftesbury Road had been disinfected, some of the inmates again visited a case of Small Pox in Ealing, and the disinfection had to be done over again. Enteric Fever.—Forty cases were notified during the year, and five of these proved fatal. At one time a serious outbreak was threatened, for no less than eleven cases were notified in two days, eight of the eleven patients had consumed the milk of a certain dairy. |
28c4f1d3-fc93-4e91-aa82-0c89461d5548 | In one case a patient had taken two glasses from the suspected milk some fourteen days before being attacked, at home she and her relatives were supplied from another dairy. Although it was impossible to prove absolutely that the suspected dairy was at fault, yet the inference was very suspicous and I immediately stopped the supply of milk from this source in my district, except in a pasteurized form, viz., heated to 150° Far. The result of my action proved successful in arresting what would probably have been a severe epidemic. I take this opportunity of laying stress on the importance of always boiling or pasteurizing milk for dangers of contamination are very numerous, however stringent the regulations may be. One case of Enteric was probably caused by sewage contaminated shell fish. Probably shellfish, viz., oysters, cockles, mussels and whelks have played a very large, if not a leading part in the general incidence of enteric fever in this country. |
523335a8-0b6e-4f74-9ebc-caefea66c373 | In sea coast towns they are probably the main source of Typhoid Fever, though this is not even yet generally acknowledged. Enteric Fever shows a slight tendency to increase all over the country, and this regardless of the fact that more care than ever is taken to guard our water and milk supplies. The reason in my opinion is that in this country we have not 18 given the same attention to the maxims of cleanliness as regards other forms of food as we have given to preserving our water and milk supplies from pollution. PHTHISIS OR CONSUMPTION. There were eighteen deaths due to phthisis and 14 to other tubercular diseases, as against 43 and 15 respectively in 1902. I have examined the sputum in 15 suspicious cases, the tubercular bacillus was found in 3 specimens. The movement on foot to provide an open air sanatorium for Middlesex should receive the {support of every ratepayer. |
addbd7ae-f2da-429d-9866-edfb5014dae7 | If the disease is recognised in the early stages, which can be done by a bacteriological examination of the sputum," and the patient sent to undergo the open air treatment at a sanatorium, a cure is invariably brought about. WHOOPING COUGH. There were 20 deaths from this disease, mostly children under one year of age. Lung complications in nearly every case was the immediate cause of death. I trust that the leaflet which is now freely circulated will assist in educating the poorer classes as to the necessity of isolation, and taking better care of their children. At present many poor people have all sorts of absurd ideas as to how to treat a child suffering from Whooping Cough. MEASLES. As a contrast to the above disease there was not a single death from measles. I fully believe that the poor classes in my district at last understand the importance of taking proper care of their children when suffering from this complaint. |