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f0aa4e53-761c-42c9-ae96-c77f2d899891 | I remain, Your obedient servant, D. J. THOMAS. 74 FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. INSPECTION. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances Premises. Inspections. Written Notices Workshops (Including Workshop Laundries) 77 31 Workplaces (Other than Outworkers' premises included in Part 3 of this Report). 4 —. Total 81 31 DEFECTS FOUND. Found Remedied Referred to H. M. Inspector. |
fcab10b5-d774-45b8-898c-c3a96f2918ff | Nuisances under the Public Health Acts:— Want of Cleanliness 18 18 _ Want of ventilation 2 2 — Overcrowding 1 1 — Want of drainage of floors 2 2 — Other nuisances 2 2 — Sanitary accommodation insufficient 1 1 — unsuitable or defective 1 1 — not separate for sexes 9 9 1 Offences under the Factory and Workshop Act:— Breach of special sanitary requirements for bakehouses (ss. 97 to 100). 1 1 - Total 37 37 — HOME WORK. OUTWORKERS' LISTS, SECTION 107. Twice Yearly Once Yearly Outworkers received from other Councils. Outworkers forwarded to other Councils. Inspection of Outworkers' Premises Infected Premises, Instances. NATURE OF WORK. Lists Outworkers Lists Outworkers Wearing Apparel— (1) making, etc. |
0a224dd2-4e65-47f8-bae9-1bf926169c69 | 30 40 4 8 17 2 60 — (2) cleaning and washing 102 208 12 19 - 7 306 4 Brush making 2 8 — — — 2 15 — Stuffed Toys 2 26 — — — 2 45 — Total 136 282 16 27 17 13 426 4 75 REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year:— Laundries 288 Dressmaking 43 Millinery 8 Tailoring 5 Bakehouses 27 Others 37 Total number of Workshops on Register 420 OTHER MATTERS. Matters notified to H.M. Inspector of Factories:— Action taken in matters referred Notified by H.M. Inspector 10 by H.M. |
5da4d740-d507-4820-b410-83e7c461b65c | Inspector as remediable under the Public Healthy Acts, but not under the FacReports (of action taken) sent to tory and Workshop Act (s.5) H.M. Inspec tor 10 Underground Bakehouses (s. 101):— In use at the end of the year 8 Your obedient servant, D J. THOMAS. March 1st, 1997 76 ANNUAL REPORT OF CHIEF SANITARY INSPECTOR FOR THE YEAR 1906. D. J. THOMAS, Esq., M.R.C.S., L.R.C.P., D.P.H., Medical Officer of Health. Sir, I herewith present my seventh annual statement, showing the particulars of the actions taken in the suppression of Nuisances, etc., and various improvements effected during the year 1906. NUMBER OF INSPECTIONS, etc. 483 Complaints received 1,452 Premises inspected 1,452 Premises re-inspected 4,403 times. |
be19e262-3d1b-4ae9-83f0-bf9cb121844f | 138 House to House inspections 1,236 Nuisances reported 1,645 Nuisances abated 1,200 Preliminary Notices served 692 Statutory Notices served 51 Drains opened up for examination upon written complaint. The Volatile or chemical test was applied in numerous instances 108 Plans of new drainage systems submitted and approved by the Council 35 Workshops inspected 54 times. |
ac5a706d-2d8c-4bfc-8b99-b8db16ca4942 | 78 Houses let in Lodgings inspected 236 „ 54 Furnished rooms inspected 218 „ 2 Common Lodging Houses inspected 112 „ 3 Cowsheds inspected 23 „ 69 Dairies and Milk Shops inspected 98 „ 28 Bakehouses inspected 189 „ 4 Slaughter Houses inspected 182 „ 6 Piggeries inspected 150 „ 3 Offensive Trades inspected 78 „ 4 Mews inspected 314 „ 7 Van Dwellings inspected 9 „ 179 Patients removed to Isolation Hospital 311 Rooms disinfected, also from which bedding, etc., was removed and steam disinfected 77 16 School rooms disinfected 12 Closets disinfected after Enteric Fever 54 Library Books removed from Infected Houses and dealt with 1,157 Letters received 1.060 Letters Written 4 Notices received from H.M. |
ad0aba05-6b86-4c5b-a900-3632cbdd6a4e | Inspector of Factories and satisfactorily dealt with 12 Notices to Water Company, re Waste of Water With regard to the Bakehouses, Dairies, Cowsheds and Milkshops, Common Lodging Houses, Houses Let in Lodgings, Mews, and Piggeries, I have no occasion to make special mention. Offensive Trades. There are 2 registered offensive trades in the district (fat extractors) and one licensed (Fertilizer Manufacturer). These premises have been frequently inspected during the year. In October serious complaints were received with regard to a nuisance emitted from the licensed premises, which complaints I can testify were not without foundation, and I understand the Council intend to take proceedings in the matter. Slaugnter Houses. I am pleased to be able to report that the number of slaughter houses (four) has diminished by one, viz., that of Mr. George Morris, 018 Enfield Road. The premises are now used as a carriers' depot. Public-house Urinals. |
0c04678a-98ea-473c-8bd1-048e46d4625c | In May, I presented a detailed report to the Council with regard to the offence against public decency caused by the situation of many of the urinals in connection with the Public-houses. You inspected all the premises with me upon a later occasion, and decided which should be dealt with. Circulars were sent to the Brewers, and in all but one instance our requirements were carried out. The Clerk, I understand, is at present dealing with the defaulter. 78 Cricket Pavilions. During the month of June, I visited all the Sanitary conveniences in connection with the cricket pavilions in the District, and am pleased to report that I found everything in a satisfactory condition. Dust Complaints. A complaint was lodged by the master of the County School with regard to the nuisance caused from the Carpet Beating Factory adjoining the ground. Upon investigation, I found that particles of fluff and hair were carried from the Works into the school hall and class rooms. |
0fbd5dbb-af58-457c-9dca-7db11f6192e4 | The Factory owners were very anxious to carry out anything we could suggest, as they did not wish to cause any nuisance. As you are aware, certain remedies were suggested, and these were at once complied with, and I have not received any complaints since . Smoke abatement. All factories' and works' chimneys have been observed at frequent intervals, and several cautionary Notices and Statutory Notices have been served upon owners for emitting black smoke in such quantities as to be a nuisance. No police court proceedings, however, have been necessary. During the year two petitions have been received by the Council with regard to smoke nuisances. One in May, relating to the chimney of the St. Mary's Laundry, and the other in December, relating to the London United Tramways chimney. With regard to the former, immediate steps were taken by the Council, and the nuisance was at once abated. In the case of the Tramway's chimney, it is situated in the Chiswick district. |
2731fa1b-f98e-4698-8ad5-33db07938535 | This Council was not asked to take any active steps in the matter, as a similar petition had been presented to the Chiswick authority. During December, in consequence of complaints having been received, special observations (from 8 a.m. to 4 p.m.) were kept upon the chimneys of Messrs. Eastman (2), Stratton, Napier, and Thompson and Norris. One chimney was found to be particularly bad, and steps were taken in the matter, since when very little nuisance has been observed. 79 Water Supplies. In August, Mr. Morris, of Wells Farm, complained of losing a cow, the death of which he attributed was due to poisoning, caused by drinking water in the water course which runs through his field. I took a sample of the water and submitted it to the County Analyst, who reported that it was unfit for drinking purposes. This result I communicated to Mr. Morris, and he removed his cattle from the field. In another instance, Dr. |
624eeb3f-21a3-4cb5-af78-d9627b53e3bc | Rudd complained of the well water which the occupiers were drinking at Heathfield Lodge, Gunnersbury Lane. I also took a sample of this water and had it analysed, and received a report that it was quite unfit for drinking purposes, and the necessary steps were taken to inform the occupiers concerned of the result of the analysis. Removal of Dead Body. In August, I received a complaint from an occupier in Hooper's Mews, stating that the dead body of his wife had been lying in the living room for some days awaiting the Poor Law undertaker. The weather being very hot, the smell from the body was unbearable, and I, therefore, had it removed to the Mortuary to await burial. Inspection of Meat and other Foods. |
9cf32a04-791e-4e5a-9b27-f6f785d2c162 | The butcher's shops, greengrocer's shops, and other places where food is sold or prepared, were frequently inspected during the year, and in very few cases did.I find any unsound food, or was it necessary for me to call the occupier's attenting to any insanitary conditions or want of cleanliness. The cutting out of pharyngeal glands of pigs by slaughtermen and butchers has practically ceased on account of the steps the Council took in the matter, and also, I think, by the stringent measures taken by the City Corporation. Messrs. T. Wall and Sons' sausage and potted meat works in Warple Way are visited twice every week, and I can only report that great care and cleanliness is observed. All the carcases of pigs are accompanied by a veterinary surgeon's certificate to the effect that they are free from disease. |
c99a4a9e-218a-49f7-b1e0-1d99c865edf5 | Extensive cold storage is provided, so that in 8o the hot weather there is very litle chance of finding any meat in a decomposing state or unfit for human food. In August, I had a pint of milk brought to me by a resident, which she had purchased from her milkman. She complained that she had been ill for some time past and thought probably that the milk had been the cause of her illness. I found the milk to be sour, and had a peculiar appearance. Under Section 28 of the Public Health Acts' Amendment Act, 1890, I took it before a Justice, who gave me a condemnation Order, but before having it destroyed, I had it Analysed by the County Analyst, and he reported that, beyond being sour and containing a small quantity of boracic acid, there was nothing to complain of. |
23872489-a275-4873-ae76-92b339a4b3aa | During the year, the following were seized, or surrendered and taken before a Justice:— 1 Box of apples, 8½ Stone of plaice, 4 Boxes of haddocks, 8 Pigs' heads, 1 Trunk of codlings, 357 Rabbits (wild), 7. Lungs, 4 Livers, 2 Spleen. Food and Drugs. During the year I procured:— 56 Samples of New Milk, 2 Samples of Butter, 1 Sample of Margarine, 3 Samples of Soda Water. In 7 cases the Analyst reported that the milk samples submitted were inferior in quality and probably adulterated. No action was taken with regard to these samples, but in another case, the vendor was prosecuted twice for selling butter containing 7 per cent, of Margarine. In the first case he was fined a sovereign, and in the second 40s. and costs. 8 Legal Proceedings. Date. Offence. |
66334e97-4ac2-416f-9c98-ad6183695073 | Fine. Jan. 10th. Depositing for the purpose of sale a Tubercular Cow's carcase. Fine £5 and costs. Jan. 10th. „ „ „ Fine £5 and costs. May 2nd. Butter adulterated with 70 per cent. Fined 20s., Analyst's of Margarine fee 10/6, and costs. May 30. Butter adulterated with 60 per cent. Fined 40s., Analyst's of Margarine. fees, and costs. The following Tabulated List gives particulars of the Sanitary Improvements effected during the year:— F. J. Fearns North J. J. Jenkins South District. District. .TI. |
038f2dfe-b013-4d22-9106-a5b929ab3f0d | House Drains taken up and reconstructed 91 45 136 „ repaired 15 26 41 unstopped and cleansed 28 66 94 „ provided with intercepting traps 69 49 118 „ manholes provided to 77 78 155 , ventilated 36 70 106 „ manholes to, cleansed — 22 22 „ manholes to, repaired 6 26 32 „ fresh air inlets repaired 3 14 17 fresh air inlets provided 68 45 133 Water Closets repaired 12 12 24 „ new, provided 103 73 176 „ new, pans provided to 1 17 18 „ unstopped and cleansed 11 11 22 , pan closets and containers replaced by efficient plans - 4 4 „ provided with new flushing cisterns 3 47 50 „ flushing cisterns repaired 19 33 52 „ flush, |
1a24c7b8-90c7-4846-967d-6a1434147ef1 | disconnected from drinking water cistern 2 10 12 „ additional provided to houses — 8 8 „ additional or separate, provide in Factories and Workshops - 9 9 apartments, foul and dilapidated 3 10 13 Soil Pipes repaired 18 6 24 „ ventilated 17 7 24 „ increased ventilation provided to 5 5 10 , reconstructed 24 9 33 Interceptors, want of stoppers to 3 10 13 Ventilating Shafts repaired 34 5 39 Waste Pipes disconnected from drain 4 4 8 „ stopped or repaired 11 8 19 82 Waste Pipes: sinks, baths ami lavatories trapped with lead traps 34 21 55 „ new, provided — 13 13 Rain Water Pipes disconnected from drain 28 48 76 „ repaired 4 2 6 „ provided 2 6 8 Eaves guttering provided 2 7 9 , |
2485fc9c-91fc-42e1-83d3-a9009fbbb7d6 | repaired 7 11 18 Gully Traps replaced with stoneware gullies 2 10 12 „ removed from improper situation 4 12 16 „ unstopped — 31 31 „ provided — 10 10 „ grids provided to 1 7 8 „ cement work around, repaired 3 28 31 Yards or Passages, paving repaired 1 26 27 „ paved and drained 69 84 153 „ cleansed — 36 36 Bust Bins provided 21 50 71 Ashpits, foul arid defective, remedied 1 18 19 Cisterns repaired and covered 22 15 37 „ cleansed 14 14 28 „ removed from improper positions — 12 12 Cleansing, |
e19609ec-d9af-49b4-816f-017796406bb5 | houses cleansed and whitewashed 221 127 348 „ plastering of walls and ceilings repaired — 7 7 „ houses dealt with under Housing Acts — — — Workshops cleansed and lime washed — 18 18 „ excessive steam in — 1 1 roofs repaired — 2 2 „ floors repaired - 4 4 „ overcrowding 1 — 1 Roofs of houses repaired 12 5 17 Floors of houses repaired or relaid 27 9 36 „ workshops repaired or relaid — 4 4 „ stables repaired or relaid — 3 3 Stables provided with drainage 12 4 16 „ ventilation — 1 1 Coachhouse floors repaired — — — „ ceilings repaired — — — Dampness of house walls remedied 45 4 49 Air space under floors of houses ventilated 31 2 33 Accumulations, |
dc865751-11b0-4dbe-8059-5bb26efe01b9 | refuse removed 18 10 28 manure removed 37 5 42 „ water in cellars removed 2 1 3 „ in ditches — — — Cess pools cleansed 1 — 1 Manure receptacles provided 2 2 4 Animals, fowls, etc. nuisances from, abated 5 6 11 Urinals cleansed — 8 8 „ reconstructed — 7 7 Smoke, nuisances abated 7 9 16 83 Overcrowding, number of cases abated — 11 11 Water, supply provided to houses 6 3 9 „ taps provided on Main — 15 15 Miscellaneous, nuisances abated 16 3 19 Inspections.—Number of premises inspected on complaint 483 „ Number of premises inspected in connection with infectious Diseases 276 „ Number of Premises under Periodical Inspection 286 „ Houses inspected from House-to-house 138 , Total number of inspections and re-inspections made 5,855 Notices. |
0180108c-1f14-4f6c-8178-337a79545b41 | —Cautionary notices given 1,200 Statutory orders issued 692 , Summonses served 4 , Convictions obtained 4 Dwelling Houses.—Houses, premises, etc. cleansed, repaired, etc. |
c1642c18-d0c5-4734-b8dd-80915463faf2 | 355 „ Illegal underground dwellings vacated 1 Houses let in separate dwellings or lodgings.—Number registered under Bye-Laws 132 Common lodging houses—Number registered under Bye-Laws 2 Movable dwellings, caravans, tents, etc.—Number observed during the year 7 ,, Number removed from district 7 Workshops and workplaces—Number in district 420 „ Contraventions of Factory Acts 37 Laundries.—Number in district 288 Bakehouses.—Number in district 28 „ Contraventions of Factory Acts 1 Slaughterhouses.—Number on Register 4 Cow-sheds.—Number on Register 3 Dairies and Milkshops.—Number on Register 69 Unsound Food.—Articles or Parcels seized and articles or Parcels surrendered 388 Adulterated Food.—Samples taken 62 ,, Found adulterated 9 Offensive Trades.—Number of premises in district 8 Contraventions of Bye-Laws 3 WATER SUPPLY AND WATER SERVICE. |
bfb378ed-89ab-42e0-86ba-92996e62b78c | Wells.—Closed as polluted 1 Percentage of Houses supplied from Public Water Service 100 per cent. Cisterns.—New, provided 9 „ Cleansed, repaired, covered, etc 45 „ Overflow pipes disconnected from drains 1 Draw-taps removed from Cisterns to Mains 15 Percentage of houses supplied on constant system 100 per cent. Water Closets—New constructed 176 „ „ Repaired, supplied with water or otherwise improved 212 „ „ Percentage of houses provided with water closets 100 84 DRAINAGE AND SEWERAGE. Drains.—Examined, tested, exposed, etc. 187 , Unstopped, repaired, etc. 339 „ Waste pipes, rain water pipes disconnected, repaired, etc. 293 „ Soiled pipes and drains ventilated 164 „ Disconnecting traps or chambers inserted 273 „ Reconstructed 136 Cesspools—Rendered impervious, emptied, cleansed, etc. |
456d8684-5a06-4bcc-9b45-53caac570e58 | 1 Percentage of houses draining into sewers 100 Disinfection—Rooms disinfected 377 Dust—New bins provided 90 „ Periodical frequency of dust removal weekly Sundry nuisances abated—Overcrowding 12 „ „ „ Smoke 16 „ „ „ Accumulations of refuse 73 „ ,, „ Foul pigs and other animals 15 „ „ „ Dampness 49 „ „ „ Other nuisances 698 I am, Sir, yours obediently, MAURICE W. KINCH, A. R. San. I., (Chief Sanitary Inspector,) Public Health Dept., 130 Churchfield Road, Acton, W. |
7460140c-212f-4b41-b1c2-5e4218d0eb4f | ACT 15 Urban District of Acton. Annual Report OF THE Medical Officer of Health FOR 1907. ACT 15 Urban District of Acton. Annual Report OF THE Medical Officer of Health FOR 1907. Public Health and Isolation Hospital Commitee. Mr. Councillor E. F. HUNT (Chairman). „ „ H. S. SCHULTESS-YOUNG, M.A., J.P. „ „ E. MONSON, J.P. „ „ G. W. PAGE. „ „ H. L. STORY. „ „ J. F. SHILLAKER. „ „ C. PEAT. „ „ G. R. PARKINSON. |
0a7fbe59-f31f-4e61-8c8f-14c1bc60ae2d | 2 By the Order of the Local Government Board, dated March 23rd, 1891, article 18, section 14, it is prescribed that the Medical Officer of Health shall make an Annual Report to the Sanitary Authority, up to the end of December in each year, comprising a summary of the action taken, or which he has advised the Sanitary Authority to take, during the year, for preventing the spread of disease, and an account of the sanitary state of his district generally at the end of the year. |
31fc73c4-a720-4030-8814-a8381f57041c | The report shall also contain an account of the inquiries which he has made as to conditions injurious to health existing in the district, and of the proceedings in which he has taken part or advised under any Statute, so far as such proceedings relate to those conditions; and also an account of the supervision exercised by him, or on his advice, for sanitary purposes, over places and houses that the sanitary authority have power to regulate, with the nature and results of any proceedings which may have been so required and taken in respect of the same during the year. The report shall also record the action taken by him, or on his advice during the year, in regard to offensive trades, to dairies, cowsheds and milk shops. The report shall also contain tabular statements (on Forms to be supplied by us, or to the like effect) of the sickness and mortality within the district, classified according to diseases, ages and localities. |
253ebe58-e6c6-446e-bd5e-ee77b33bacba | In a memorandum issued by the Local Government Board in November, 1906, it is recommended that the report shall deal with the extent, distribution and causes of disease within the district; and should give an account of any noteworthy outbreak of epidemic diseases during the year under review, stating the result of investigations into their origin and propagation, and the steps taken to check their spread. As these reports are for the information of the Local Government, and of the County Council, as well as of the Council of the District, a statement of the local circumstances and a history of local sanitary questions, which may seem superfluous for the latter, may often be needed by the former bodies. Under section 132 of the Factory and Workshop Act, 1901, the Medical Officer of Health is also required in his Annual Report to report specifically on the administration of the Act in workshops and workplaces, and to send a copy of his Annual Report, or so much of it as deals with this subject, to the Secretary of State. |
7b4b1833-a319-49e5-9ece-37e5990eedd3 | ANNUAL REPORT of the Medical Officer of Health for the year 1907. 130 Churchfield Road, Acton, W. April, 1908. To the Chairman and Members 0/ the Acton District Council. Gentlemen, I have the honour to submit to the Council a report on the sanitary conditions of the district, together with the vital and other statistics for the year 1907. The death-rate was slightly higher in 1907 than in 1906. The increased mortality was entirely confined to the first quarter of the year, and was due to the large number of deaths from diseases of the lung. Some of these deaths were due to complications of Measles, an epidemic of which prevailed in the district during the earlier months of the year. The number of deaths under 12 months of age was one less than that of 1906. This cannot be considered satisfactory, in view of the favourable meteorological conditions which prevailed during the fourth quarter. |
1b823873-d20f-425e-8cd4-6d0e632330fd | There was an extensive outbreak of Scarlet Fever in the autumn, but the majority of the cases were mild in character. The incidence of Diphtheria and Enteric Fever remains very low. 4 In addition to the routine work of the Sanitary Department, at the request of the Local Government Board, a systematic inspection was made by the Inspectors of nearly 2,000 intercepting traps. The results of this inspection are embodied in the report. The year has been an exceptionally busy one for the Hospital staff, and 50 patients from outside districts were admitted. The following is a summary of the vital statistics for the year: Estimated population: 53,000. Birth-rate: 29 per 1,000 inhabitants. Death-rate: 13.9 per 1000 inhabitants. Infantile mortality: 130 per 1000 births. Zymotic Death-rate: 1.3 per 1000 inhabitants. |
fd5e054e-4ff0-4f40-8de3-b789ba98d970 | Respiratory Death-rate (including Phthisis): 13 per 1,000 inhabitants. Phthisis Death-rate: 1.2 per 1.ooo inhabitants. Death-rate from other forms of Tuberculosis: 4 per 1000 inhabitants. POPULATION. Of the various methods of estimating the population of a district in any particular year, the most reliable in the case of Acton is based upon the number of new houses erected during the year. But even this method is liable to considerable error. The number of inhabitants in each house rose from 5.9 at the census of 1891 to 6.2 at the census of 1901. This increase was due to the fact that houses formerly occupied by one family were converted into flats. This process is still going on, and an average of 6.2 persons per house is probably below that which obtains at the present time. |
c16170c1-ed54-4a48-8bd4-9ade116986b0 | Between July 1st, 1906, and June 30th, 1907, 245 new buildings were completed and occupied. Of these 218 were dwelling houses, and distributed amongst the wards as follows:— 5 North-East 69 North-West 63 South-East 45 South-West 41 An average of 6.2 per house would represent 1,351 inhabitants, which, added to the estimated population of 1906, would give a population of 53,351. The figures in this report have been based upon an estimated population of 53,000. Seven years have now elapsed since the official census was made, and the further we are removed in time from that census until the next, the more inexact our estimates become, and the less reliable are all vital statistics. It is to be regretted that there is not undertaken by the Government a census every 5 years. |
28e1d04a-dda9-4a77-8614-b367045fd2d8 | There are other methods by which an estimate of the population can be made, but, as explained in previous reports, for Acton these are more unreliable than the one given above. The method adopted by the Registrar-General is based on the assumption that the rate of increase which prevailed in the last completed intercensal period has since been maintained. According to this method, the increase is geometrical, but how fallacious the results obtained by such means are, may be easily understood from the following figures. Between June, 1901, and June, 1905, the average yearly amount of dwelling houses erected exceeded 440, but between June, 1906, and June, 1907, the number was less than one-half. Ver recently the population has not been increasing to the same extent as it did immediately after the census. The results obtained by this method are vitiated by the introduction of factors which formerly were not in existence. |
e9ebbd96-c176-4168-89c7-634e33751e33 | In Acton, since 1901, the development of large industries and the introduction of the electric tramway, have rendered the Registrar-General's method of calculation almost valueless, and one is justified in discarding it. Another method is based upon the extent of the excess of the number of births over the number of deaths in any particular year. 6 The excess of births over deaths is known as the "natural increase" in the population, but the accuracy of this method obviously rests upon the absence of any marked difference between the immigration and emigration associated with the district concerned. In Acton, emigration and immigration profoundly affect the population, and any estimate based upon the natural increase of the population would be entirely worthless. It will thus be observed that after a certain period has elapsed since the census was taken all methods of estimating the population are liable to error. On the whole, for this district, the most reliable is the one based upon the number of houses built in each year. |
d790cf7b-6100-44ea-b08d-617fb024b803 | As a rule, the birth-rate serves as a means of checking the estimated population. Though the birth-rate is steadily declining throughout the kingdom, it rarely shows any sudden deviation from the normal. Based on an estimated population of 53,000, the birth-rate last year was 29 per 1,000 inhabitants. BIRTHS. There were 1,535 births registered as having occurred within the district. This number corresponds to a birth-rate of 29 per 1,000 ihabitants. Although the aggregate number of births exceeds that recorded in any previous year, the birth-rate last year was 4 per 1,000 inhabitants less than that of 1906, and 1.6 per 1,000 less than the average for the 10 years 1897—1906. On table I. the birth-rates for the last 10 years are given, and it will be seen that the rate for 1907 is the lowest recorded in that period. |
88b27c2d-0350-4b8e-a9e3-634923f2bba6 | In spite of this fact; last year the birth-rate in Acton was 2.7 per 1,000 higher than that of England and Wales, 2 per 1,000 higher than that of the 76 large towns, and 3.3 per 1,000 higher than that of the 142 smaller towns. Usually, the number of male children born exceed the number of female ones, but last year the difference was very small—772 males and 763 females. 7 The second quarter contributed the largest number and the third quarter the smallest number of births, the number for the four successive quarters being 386, 420, 362 and 367 respectively. There was a great disparity in the birth-rate of the several wards. In the South-West Ward the rate reached 39.5 per 1,000, whilst in the North-West Ward it was only 18.5. |
36496c2d-c3da-42da-ae86-ebf044973a41 | In the North-East Ward the rate was 24.5, and in the South-East Ward 28.2. The infants registered as having been born out of wedlock numbered 37, which figures correspond to a rate of 24 per 1.000 births or .7 1,000 living. This is slightly lower than the illegitimate birth-rate of 1906, and considerably lower than that of the whole of England and Wales. DEATHS. Number 737 Rate per 1,000 13.9 Rate per 1,000 in England and Wales 15 Rate per 1,000 in 76 large towns 15.4 Rate per 1,000 in 142 smaller towns 14.5 There were 605 deaths registered as having taken place within the district; of these 8 were deaths of non-residents. 140 deaths of residents occurred in public institutions outside the district, and this number has to be added. |
dd234cb8-b951-4d0f-86f1-b3f32fbd78b5 | The actual number of deaths, therefore, which has to be regarded in estimating the death-rate is 737. This gives a recorded death-rate of 13.9 per 1,000 inhabitants. It was explained in last year's report that in order to compare the death-rate of one district with that of another it is necessary to make an allowance for the difference in age and sex constitution of the different districts. The method by which this correction is made is based upon the death-rate of each sex at different ages throughout England and Wales. Series of factors are thus obtained by which the recorded death-rates of different towns can be multiplied. The figures by which the recorded death-rate should be multiplied in order to make a correction for variations of sex 8 and age distributions is called the factor for correction for the particular district; when the recorded death-rate is multiplied by the factor for correction, the result is the corrected death-rate for that district. The factor for correction for Acton is 1.04240. |
21e97acd-db82-43d5-93ab-20df0ee57e68 | There is an increased number of deaths of residents in outside institutions. The increase was most marked in the case of Isleworth Infirmary. The following list gives the names of the institutions, together with the number of deaths in each:— Isleworth Infirmary 82 West London Hospital 18 Middlesex County Asylum 10 St. Mary's Hospital 6 St. George's Hospital 4 St. Bartholomew's Hospital 2 University College Hospital 2 Great Ormond Street Hospital 2 St. Luke's House 2 Brompton Hospital 1 Royal Free Hospital 1 German Hospital 1 King's College Hospital 1 Chelsea Cancer Hospital 1 Paddington Children's Hospital 1 Victoria Children's Hospital 1 St. Pancras Workhouse 1 Hammersmith Infirmary 1 All Saints' House 1 Camberwell House Asylum 1 Marshall Aster's Works, Hammersmith 1 Ward Distribution. |
f13a37d8-d1bf-44c0-83b7-55996996372d | Of the 82 deaths that occurred in Isleworth Infirmary, it was impossible to trace the address from which 12 of the patients were removed into the Infirmary. These persons had been in the 9 house or Infirmary for many years. The remaining deaths were distributed as follows:— North-East. North-West. South-East. South-West. 153 105 120 347 Based upon the estimated population, the death-rate of each ward would be:— North-East. North-West. South-East. South-West. 11.3 9.1 10.9 20.4 The death-rate in the North-East and South-West Wards is higher than that of 1906; in the North-West Ward it is lower, and the rate in the South-East Ward is practically the same as that of 1906. In last year's report some of the factors operating towards a high death-rate in the South-West Ward were mentioned. |
5d854fa7-3299-491b-9510-b55f70c4c0bd | Some of the causes are not dependent upon sanitary conditions. The death-rate of a population is profoundly affected by its age constitution. The tendency to death is greater among persons living at the extremes of life—among infants and old people. The birthrate in the South-West Ward is much higher than in the rest of the district. 44 per cent. of the births registered in the district occurred in the South West Ward. The age distribution of the population, though, is not sufficient to account for the marked difference in the death-rate of this Ward as compared with the rest of the districtNor is the cause a transient one, as a higher death-rate has to be recorded here year after year. We are reticent to recognise that the public health is affected by other causes than sanitary defects. Everyone knows that a defective soil pipe is dangerous. Its effects are immediate. For a similar reason the effects caused by overcrowding, exposure to infection, and unsound food are appreciated by all. |
56f8d375-43e9-42c5-b133-6f343327f49d | But the part played by social conditions is not so readily admitted, either because the effect is more remote, or there may be an immediate as well as an ultimate cause. The diseases which were responsible for the high death-rate in the South-West Ward were Measles, Whooping Cough, Diarrhoeal Diseases, Bronchitis 10 and Pneumonia in children under 5 years of age, and Tubercular Diseases. In all of these social as well as sanitary conditions played a part. We know that in Consumption the immediate cause was exposure to infection by the Tubercle Bacillus, but in addition there was a predisposing cause in the shape of Heredity, Poverty, Intemperance, &c. Defective sanitary conditions were not the only factors in the high death-rate amongst children from the other diseases mentioned. Some of the deaths from diseases of the lungs were due to the exposure which some of the children have to undergo. |
bf8340a9-abb8-4631-9d2f-8c939654adcd | The mothers go out to work and place their young children under the charge of persons who undertake this duty. On some days of the week the children are not taken home before 9 p.m. The conditions under which some of these children are cared for leave much to be desired. The rooms are badly ventilated, and the vitiated atmosphere undoubtedly tends to lower the resistance of the children to respiratory diseases. Age-Constitution. The ages at death were as follows:— Under 1 year. 1—5. 5—15. 15—25. 25—65. over 65. 200 94 38 28 217 160 Compared with 1906, the increased number of deaths is uniformly distributed over all the age-periods with the exception of that under 1 year of age. ZYMOTIC DISEASES. Deaths, 70. Death-rate, 1.3. |
69b2bf12-ebfa-4108-a308-153e0e055a9f | The so-called Zymotic death-rate includes deaths from seven Zymotic diseases, namely, Small-pox, Measles, Whooping Cough, Scarlet Fever, Diphtheria, Fever and Diarrhoea. 11 It will be observed that all the preventable diseases are not included in this list, and though the Zymotic death-rate is retained and regarded in some quarters with some degree of importance, it forms no index of the sanitary conditions of a district. As the incidence of each disease varies in its relative importance, most of them will be dealt with separately. SCARLET FEVER. 267 cases of Scarlet Fever were notified, and 6 deaths were caused by the disease. Although there was an increase of 97 in the number of cases notified, there were only 6 deaths in 1907, as compared with 7 in the previous year. |
64b7d7e2-c242-4905-8d0a-4d074b2026c1 | It was this mildness of the symptoms in a large number of the cases which was one of the principal factors in the spread of the infection, and whenever a rise in the number of notifications occurred, a search usually resulted in the finding of a missed case. Instances of "missed" cases have been repeatedly brought to the notice of the Health Committee, and it is a significant fact that whenever a missed case was found attending school, the notification of cases from that school ceased on his exclusion. In this connection, too much value cannot be attached to the cooperation received from, and the great care exercised by, the teachers; without their assistance the detection of these mild cases would be impossible. Most authorities are agreed that the missed case plays the most important role in the spread of the infection. Other factors probably enter, and on one occasion last year suspicion was attached to the milk supply. It is only fair to add that no evidence whatever was forthcoming by which the milk could be reasonably condemned. |
32ed322d-6ec6-4284-9bb4-a5ec2b490df7 | The circumstances were so peculiar as to merit recital. During the fortnight ended October 12th, 26 cases were notified. Of these, 11 occurred in families supplied by one dairyman, and in 12 9 of them the onset occurred either on October Ist or 2nd (Tuesday and Wednesday). The dairyman resided outside the district, and on inquiries, it was found that in Hammersmith and Chiswick about 30 cases had occurred in families supplied by the same milk vendor. The onset of the symptoms in all these cases coincided in point of time with that of the 9 cases in Acton. An examination of the employees was made, but no illness resembling scarlet fever had occurred amongst them. Inquiries were then directed to the milk supply, and it was ascertained that the dairyman distributed about 500 gallons each week day and about 800 gallons on a Sunday. |
e0870f6c-8d21-4484-b9ba-0361047ec271 | The 500 gallons were obtained from two farms, but the extra 300 gallons were obtained from a large distributing company in Paddington. The Medical Officer of Health for the district in which the two farms were situated was communicated with, but the milk supply from these two farms was free from suspicion. It will be observed, though, from the dates given above, that Sunday, September 29th, would be the most probable day on which the infection occurred, and on that day some of the milk was obtained from the distributing company. The latter company obtains its milk supply from a large number of farms. The milk was mixed, and inquiries had to be made at all the farms. These inquiries were made by the officials of the London County Council with negative results. As far as Acton was concerned, I believe that the milk had absolutely nothing to do with the infection, and that the high percentage of cases which occurred amongst the customers of this particular dairyman was a mere coincidence. |
3d61d1a7-0d09-4e1f-bcf5-a8829b66a012 | Of the 9 cases whose onset of symptoms dated from October Ist or 2nd, 4 attended Southfield-road School, 3 attended Central School, and 2 were not of school age. On October IIth, a case was notified from The Avenue. The skin of the hands and body 13 was peeling, and the child had been suffering from the disease since September 20th. He had attended the Central School from September 28th to October nth. A pupil of Southfield Road School was notified as suffering from Scarlet Fever on September 30th. The child had been ill since September 15th, but the illness was not diagnosed until peeling had commenced. It is true that the patient had not attended school since September 13th, but two other children attended school, and mixed freely with the patient, and in view of the possibility of "carrier" cases of Scarlet Fever, this element could not be excluded as a possible factor in the spread of infection. |
b8cd34c6-dc75-45db-8fa4-3f970c2fe01a | The disease was distributed almost uniformly throughout the wards. 48 cases occurred in the North-East Ward, 37 in the North-West, 44 in the South-East and 107 in the South-West Ward. The School distribution was as follows:— Beaumont Park 40 South Acton 22 Central 22 Southfield Road 18 Priory 12 Roman Catholic II Rothschild Road 9 St. Mary's 6 Willesden Junction 2 Outside Schools 19 More than one-half of the cases occurred in the last quarter of the year. During the earlier part of the year the district was comparatively free of the disease, but following an increase which occurred in London towards the end of the summer, the notifications increased in number here at the beginning of October. The wave seemed to extend from East to West. The eastern districts of the Metropolis were the earliest ones to experience the increased prevalence, and a rise was noticed in these boroughs about the beginning 14 of August. |
d6ed9c76-0998-475b-92b1-846b160c2fa9 | The increase in Acton did not become abnormal until the first week in October, when the number of notifications increased from 4 in the week ended September 28th to 15 in the week ended October 5th. DIPHTHERIA. 63 Cases of Diphtheria were notified, and 5 deaths resulted from the disease. There is a slight increase both in the number of cases and deaths. The spread of Diphtheria seems to be more intimately connected with school attendance than that of the other infectious diseases. Out of 32 cases that occurred amongst children attending school, 22 of these were in 4 schools, and the history of a limited outbreak in Rothschild Road School will show how easily the disease can be spread. A notification was received on January 30th. The child lived in Kingswood Road and attended Rothschild Road School. The child had been ill since January 13th, and had attended school on January 14th—17th. |
4987cf33-5c05-45e0-b982-6f430f3dca95 | The children attending the school were examined and a list of those absent on account of illness was obtained. I examined all the children unattended by a doctor and obtained the consent of the parents to swarb all suspicious throats. As a result 3 children were found suffering from the disease. ENTERIC FEVER. 13 Notifications were received, and 3 deaths were registered. In 2 of the cases the disease was contracted outside the district, and in one of these the patient had exhibited symptoms before he arrived in Acton. He was a steward on a steamship and left Southampton for New York on April 25th. He returned to Southampton on May 17th, and came here on a visit to friends on May 18th. He first exhibited symptoms of the disease on May 15th. 15 3 Other cases were proved to have been in contact with a previous case of Typhoid, and in all probability this was the source of the infection. |
cfbe4525-8945-4461-ac25-9ce40a3a2ba1 | In the 8 other cases the source of the infection was not definitely traced, but recent bacteriological research has thrown a new light on one of the ways hitherto little suspected whereby Typhoid Fever may be disseminated. Several instances have been recorded of outbreaks due to chronic typhoid carriers, and in one instance a typhoid carrier of 29 years' standing was discovered. The discovery of the chronic typhoid carrier and of the mischief which such a person may produce is certainly disquieting, particularly when we reflect that, though the bacillus probably persists in only a very small percentage of enteric fever cases, there must be a considerable number of these dangerous individuals whose condition is unknown, unsuspected, and not likely to be discovered. It is especially disconcerting to realise that some of these unknown carriers may be engaged in occupations which involve the constant handling of food. |
0c96e056-cee2-4310-9a12-df398de946ee | But however unpleasant this contingency may be, we cannot afford to close our eyes to its possibility; and it therefore seems desirable that special precautions should be taken when persons ascertained to have previously suffered from typhoid fever are employed in work of this nature. PUERPERAL FEVER. Only one case of Puerperal Fever was notified, and the illness resulted in death. ERYSIPELAS. 29 Cases were notified, but there was no fatal case. CANCER. There were 46 deaths from Cancer. 16 The Ward distribution- was as follows:— North-East 14 North-West 9 South-East 5 South-West 16 The previous addresses of two persons who died in Isleworth Infirmary were not ascertained. It is impossible to state accurately the relative prevalence of the disease in the different wards unless we know the age constitution of the population in each ward. |
054a414e-d5be-4e58-9a5b-5145f71c0969 | The area and the figures are too limited to draw any conclusions, but it is a curious fact that the South-Eastern portion of the district year after year shows a lower death-rate from the disease than that of the rest of the district, inasmuch as it is generally held that cancer is more prevalent in low-lying districts. 13 Deaths were of males and 33 of females. Deducting 16 of the deaths in females, which were due to cancer of the reproductive and generative organs, the preponderance of females is not very marked. The seat of the disease was as follows:— Uterus 10 Breast 5 Stomach 8 Bowels 5 Liver 7 Throat and Neck 4 Panereas 2 Hip, Larynx, Kidney, Ovary, Cerebellum, 1 each. MEASLES AND WHOOPING COUHH. |
c8f66154-5c55-4940-b2df-29d67b560ce9 | The only knowledge possessed of the cases of Measles and Whooping Cough is that derived from the school notification cards, and from the inquiries made upon the receipt of these cards. Measles. 17 There were 20 deaths from Measles as compared with 27 in 1906. The Ward distribution of the fatal cases was as follows North-East 2 North-West 6 South-East 4 South-West 8 The information we received as to the distribution of the disease is necessarily incomplete, but the fatality from the disease is no index of its distribution. The mortality is in a large degree determined by the social conditions of the population. Out of the 307 cases notified, 113 lived in the North-East Ward, 54 in the North-West, 83 in the South-East and 57 in the SouthWest. There is no doubt that the disease was least prevalent in the South-West Ward, and a glance at the schools affected will bear out this view. |
32c70dcf-b6a5-45bb-a216-ac2020caca4c | Central Infants was closed from Jan. 21st to Feb. 15th. Priory Infants was closed from Jan. 21st to Feb. 15th. South Acton Infants was closed from Jan. 28th to Feb. 22nd. St. Mary's Infants was closed from Mar. 4th to Mar. 28th. Beaumont Park Infants was closed from Mar. IIth to Mar. 28th. From inquiries made, it was found that the majority of the deaths occurred from lung complications, and many lives would doubtless be saved if all cases of Measles which were seriously ill could have skilled nursing. Under Section 21 of the Acton Improvement Act, 1904, the Council may provide or contract with any person or persons to provide nurses for attendance upon any person suffering from infectious disease within the district and may charge a reasonable sum for the service of any nurse so provided. |
5da7c7f3-0bd3-460b-90d6-39574c8a3bbc | It is probable that this section applies to Measles and Whooping Cough as well as the diseases scheduled in the Infectious Disease Notification Act, but in Acton it is difficult to suggest means by which 18 the provisions of the section can be effectually carried out. Epidemics of Measles are of an explosive character, and the difficulty is to cope with the work during an epidemic with the staff required in interepidemic periods. As far as possible, visits are being paid to the houses where a case is notified, and when necessary, instructions are given, but in many instances, these instructions could be usefully supplemented. There is no doubt but that the visits which are now being paid prove of great educational value. Parents appreciate to a greater extent than formerly the seriousness of the illness. Out of the 307 cases investigated, 191 were attended by a doctor. |
ac317644-2bd6-440f-b756-4d24faf4c7b7 | In last year's report the influence of school attendance, and the question of disinfection were entered into, and it is unnecessary to dwell on these matters. Whooping Cough. Apart from the tendency of both Measles and Whooping Cough to appear epidemically at certain periods, there seems to be some other connection between the diseases. It is commonly found that an outbreak of one of the diseases follows upon the subsidence of the other. The order in which they follow each other is not constant. Sometimes an outbreak of Measles occurs amongst children convalescent of Whooping cough but more frequently Whooping Cough follows Measles. Last year in Acton the usual course of events was noticed, and Whooping Cough made its appearance in the early part of the year in that part of the district which had suffered from Measles during the latter part of the previous year. |
05b646f6-0fcd-4d80-80e1-54fd46cd2579 | Altogether 17 deaths were attributable to this disease, and of these 14 belonged to the South-West Ward. But of the 236 cases notified, 155 lived in the South-West Ward, 57 in the SouthEast, 13 in the North-East, and n in the North-West. 119 Cases, or slightly over 50 per cent., were attended by a doctor. 19 TUBERCULAR DISEASES. There were 66 deaths from Phthisis or Consumption, and 22 deaths from other tubercular diseases. The deaths from Phthisis were equally distributed between the two sexes, but of the deaths over 15 years of age 30 were of males and 28 of females. Prior to their attack of illness the 58 persons were employed as follows :— Males. |
08c347f8-0b8e-40e6-8a72-46c52135cc5a | Labourer 4 Traveller 3 Baker 2 Confectioner 2 Groom 2 Painter 2 Cattle Drover 2 Tailor 2 Teacher 1 Clerk 1 Laundryman 1 Plumber 1 Blacksmith 1 Barman 1 Portmanteau Maker 1 Brush Finisher 1 Porter 1 General Dealer 1 Carman 1 Females. Household 19 Laundress 4 Nurse 1 Shop Assistant 1 No Occupation 3 20 18 of the deaths from Consumption occurred at the Isleworth Infirmary, and of the many factors influencing the prevalence of tuberculosis, poverty stands out prominently above all others. Though it is a matter for dispute which elements of poverty are mainly operative, there is no doubt that poverty as a whole, with all that it comprises and implies acts as one of the most potent predisposing causes of the malady. The ward distribution of the deaths would also suggest this view. |
8cefb1e3-04c7-4c25-8ae9-64fd9bfce483 | 33 of the deaths, or exactly one-half belonged to the South-West Ward. It is this aspect of the question which constitutes the chief difficulty in obtaining information Of early cases. Of the number investigated during the year, only 10 were considered likely to derive any permanent benefit from sanatorium treatment, and results proved that some of these were not suitable cases ; two died within a few months of their discharge from the sanatorium. In the report on Sanatoria presented to the Local Government Board, it is pointed out " that Germany seems to be in advance of this country in securing early cases for sanatorium treatment ; a circumstance due, no doubt, in no small degree to the farreaching system of compulsory insurance of work people against sickness and incapacity which is in force in the German Empire. By means of this system the workman, when attacked by tuberculosis, has a legal claim on insurance funds for medical treatment and maintenance in his own case, and for the support also of his own family. |
b9c7aab0-8298-4e16-a2e0-862a99b534df | Thus it comes about that he can, without social disqualification, such as is associated with Poor Law relief or charity —without, that is, forfeiting in any degree, his sense of self-respectprocure at once at the very onset of his malady treatment requisite for himself, and at the same time maintenance of those belonging to him. Although residence at the sanitorium has not resulted in "curing" the disease of the persons sent there from Acton, the effects from an educational point of view have been considerable. The patients have learnt by what means the disease is spread and what 21 precautions should be taken to prevent the infection of those living in the same house. The example set by one patient is worth all the leaflets which can be distributed. Voluntary notification has been in force for 5 years, and last year 6 cases were notified. INFANTILE MORTALITY. 183 Deaths under 1 year of age were registered in the district. |
d42c4dc4-367c-439c-ae9e-10e3b0e4a224 | and 17 infants under 1 year of age died in public institutions beyond the district, making a total of 200. This latter figure corresponds to an infantile mortality of 130 per 1,000 births, or a deathrate of 3.8 per 1,000 inhabitants. In 1906 the infantile mortality in England and Wales was 118 in the 76 large towns it amounted to 127; and in the 142 smaller towns it was 122. The deaths were distributed as follows:— North-East Ward 31 North-West Ward 23 South-East Ward 32 South-West Ward 114 The infantile mortality in each ward would be:— North-East 94 per 1,000 births. North-West 108 per 1,000 births. South-East 100 per 1,000 births. South-West 170 per 1,000 births. |
014173f7-4440-4e1c-8ed8-38a5e9d0f5ef | At the January meeting of the Health Committee, I was requested to report upon the milk supply of the district in so far as it affects directly or indirectly the infantile mortality. Although the question resolves itself to a consideration of the conditions under which children are handfed, it is not advisable that our survey should be limited to this aspect alone, but should also include some of the factors which render hand-feeding inevitable. 22 This is essential for more than one reason. It must be clearly realised that human milk is not only the best food, but that no other milk can be made into a perfect food for infants. In infant feeding, nature is superior to art, and any artificial food should approximate as closely as possible to this ideal. The milk of any species of animal is a highly specialized product, specialized mechanically, chemically and physiologically to suit the digestive system, nutrition, rate of growth, and mode of life of the animals of that species, and it cannot with impunity be displaced by a foreign milk. |
a2049ccb-0c76-4692-ab30-ab8689a15c5e | The so called " humanized " milk, is not humanized in the true sense of the term. It is true that other milks can be modified so as to resemble in chemical composition human milk, but milk is not an inert liquid, depending for its nutritious qualities on the chemical substances it contains ; it is a living liquid with important biological properties. A discussion of these properties would introduce subjects of too technical a character for a report of this kind, but one aspect of the question may be mentioned. There is evidence that human milk contains substances derived from the mother, and that these substances carried by the milk into the infant's body protect it from the attacks of disease-producing bacteria. These facts are in accord with clinical experience. It is extremely rare for infants on the breast to suffer from Measles, Scarlet Fever, or any of the infectious diseases. |
fffe337f-bd89-4bd5-9972-5028e77afa0e | These observations are made not for the purpose of discouraging any improvement in the conditions under which children are being artificially fed, but in order to show that extreme care is necessary lest an inducement be given to mothers to wean their offspring unnecessarily and prematurely. Premature weaning is a pathological process, and always a regrettable event. Nevertheless, it is often inevitable and Professor Bunge, of Basle, made an inquiry into this subject, and found that only 519 women out of 1,912 were capable of nursing their offspring for nine months. Inquiry into their family history showed that the daughter of a mother who could not nurse her own children is also commonly incapable 23 of suckling. If this function is once lost in a family, it is not likely to be regained in subsequent generations. Fortunately, the human organism is eminently capable of adapting itself to circumstances, and in spite of the above facts, in a majority of instances, healthy children can be brought up on the bottle. |
90162d49-214c-48a2-8dc4-487d46223cbd | We have to consider what are the factors which compel artificial feeding, to what extent they can be obviated, and when artificial feeding becomes inevitable, can the conditions under which the artificial food is handled be improved. At the Census of 1901, there were 2,488 women employed in the laundries of the district. The number has considerably increased since then. There are at the present time 93 factory laundries registered, and 230 workshop laundries. In addition, about 300 women are employed as homeworkers. It is probably no exaggeration to state that 3,500 women are employed in the laundry industry alone, and of these about 1,500 are married women or widows. From inquiries made, it may be stated that one-third of the married women in the South-West Ward are employed in laundry work. |
b33fe96a-a663-4d04-87f8-b294e9741507 | In 1906, 724 births were registered in this ward, and in 1907, 671, so that in this ward alone there are over 200 children under one year of age who are, at any rate, +.o some extent, artifically fed, as a result of this one factor. These women are occupied in this employment, not from choice, but from necessity. But whatever may be the cause, whether it be physical or economic, we are face to face with this fact, that a large number of children are brought up, either wholly or partially on the bottle. For practical purposes, the only substitute for human milk is cow's milk, and we have to consider to what extent a cleaner and more pure supply of the latter can be brought within the reach of these children who are brought up on the bottle without at the same time offering an inducement to abandon suckling prematurely. |
1ea22b0f-8a4c-49a2-9289-7c7363e1149b | 24 The question of contamination is by far the most important one we have to face when dealing with cow's milk. It is not the only difficulty in its bearing on the infantile mortality. It has been pointed out that cow's milk differs in its chemical composition from human milk. In the vast majority of cases, this difficulty is overcome by a suitable dilution, together with the addition of a little fat and sugar. But after all the modification the question of contamination remains. Human milk is sterile, and is transferred directly from the breast to the infant, but this is far from true of cow's milk. There is no other food so exposed to contamination, or so easily contaminated as milk. The contamination may start with the cow (through unhealthy or unclean udders) supplemented by the milker, and added to in the cowshed. Opportunities for further contamination occur in its transit. It is well known that warm transit means impure decomposing milk. |
ac5dd8e9-de1a-41b9-83c8-c9a03e1096c1 | The railway companies do not provide different vehicles for the summer from those used in the winter, and none provide refrigerating vans for milk in this country. 24 Samples were recently taken on delivery at Liverpool Street Station, and examined by Dr. Klein. 13 were found to be fairly clean, 2 were tuberculous, and 9 were dirty and unsatisfactory. To anyone acquainted with dairy farming as carried on in some parts of the country, these results are not surprising. The Dairies and Cowsheds Order is more honoured in the breach than in the observance by many rural authorities. Cattle and cowsheds, if inspected at all, are inspected in a very perfunctory manner. The cowsheds are far from sanitary, and the grooming of the cattle is seldom if ever done. Conditions have so changed in Acton that we have to depend for a large part of our supply on outside sources. |
da013f05-8a0f-443a-8935-6475ab11a1b8 | 64 Persons are registered to sell milk in the district, and of these only 2 are eowkeepers. The others obtain their milk from sources of supply which are not under the supervision of the officials of our Council. 25 I have not dwelt upon the role of milk as a carrier of infectious disease, but it is well known that some of these diseases are carried by contaminated milk. Outbreaks of Typhoid Fever have been traced to infected milk; these outbreaks are usually due to the pollution of the water used for washing the cans. The germs of consumption are also generally supposed to be transmitted in milk. Outbreaks of Scarlet Fever, and Diphtheria, are said to have originated in a contaminated milk supply. But the influence of bacteria-laden milk on health is not fully understood nor definitely settled. |
1864d7e7-3b84-4763-9614-c1214d8a92a4 | It is possible that our list of milk-borne diseases is far from complete, and that fuller knowledge may add to the dangers we now know to exist in the present state of our milk supply But the possibility of contamination of the milk does not stop with its delivery in the district. Of the premises registered, 25 are dairies or shops selling dairy produce only and the other 37 are general shops, where milk is sold in addition to a variety of articles, including, in some instances, soap, firewood, and other things liable to create a dusty atmosphere. It is a difficult matter to keep the milk clean in these general shops, but there is no power conferred on local authorities to refuse the registration of unsuitable shops. Clause 6 of the Dairy Order of 1885 enacts that every local authority shall keep a correct register of all milk sellers and purveyors in their district, and they shall register every person who applies. |
532ca9cb-98eb-47b3-82ed-a5c8f7824eed | Under the regulations, the Council has power to insist upon certain conditions of cleanliness to be observed. In most instances, the counter-pan is covered with muslin, but this only prevents the grosser forms of contamination To what extent can these be obviated, and how can the dangers attendant on them be avoided? On theoritical lines, our obvious duty would be to insist on regulations which would ensure the milk to be absolutely free from contamination, the cows healthy, the 26 udders groomed and milked by clean hands into sterile pails, and all the subsequent processes carried out with a rigid regard to cleanliness. This is, of course, the counsel of perfection, and probably these conditions will some day be accomplished facts, but in order to meet circumstances as they exist, various methods have been adopted by sanitary authorities and others. |
f41234ab-c7c6-4582-b18a-0a7d1d21820b | The question of sterilization and pasteurization has been much discussed of late, both in the medical and lay Press, and the ex perience of those who have tried these methods have been recorded. But the process, as carried out by sanitary authorities, means much more than the mere treatment of the milk. If nothing else be done to the milk but heating it, the same results could be obtained by the use of condensed milk. But the practice of using condensed milk should not be countenanced. It has been pointed out that one of the characteristics of human milk is its high percentage of fat. This fat serves as a fuel and maintains the body heat of the child, and if the percentage is reduced there is a liability of the child to catarrhs of the lungs and bowels. It is true of most of the condensed milks on the market, if the directions for dilution are carried out, there is a large deficit of fat in the prepared mixture. Drs. |
6d6a9e93-bdd5-4c6a-8e8a-f529d05ab120 | Park and Holt, of New York, found that children fed on condensed milk, though often apparently in good condition, when attacked with acute disease, offered but little resistence, and seemed to succumb more quickly than any other class of patients. Fuller knowledge will probably reveal further serious disadvantages of patent foods and condensed milk. Nor is condensed milk a "safe" food during the diarrhoea season. Although it may be sterile on opening, a tin usually lasts two or three days, and during that time it is open to contamination in the house. The avoidance of contamination in the house is one of the features of the schemes for the supply of sterilized milk. The milk may be sterilized by simply boiling it, that is, the milk may be raised to a temperature of 212 F° and kept at that temperature 27 for a few minutes. This process effectually kills all the germs in the milk, but it has certain disadvantages. |
66dd374c-fd57-4e46-bfb0-1955a2c27d03 | It alters the taste and colour of the milk, it destroys the fine emulsification of the fat and probably makes the milk less digestible. A great deal has been written that boiled milk causes scurvy, but there is no positive evidence of this, and opinions seem to be very much divided on the question. In spite of the drawback, it certainly seems better to drink boiled milk under present conditions, even if it be slightly less digestible than raw milk. Efforts have been made to overcome the drawbacks of boiled milk by pasteurization. By pasteurization is meant the heating of the milk at 165° F for 20 or 30 minutes. It has been claimed for the process that it kills 997 out of every 1,000 germs in the milk. |
430afeb2-575f-4cfc-8ed5-5cbfd9b475b1 | At any rate, it probably kills all the germs that produce specific disease, But pasteurization in practice does more, it necessitates a better method of delivering milk than that employed in most places, and avoids the danger of contamination in the house. Dr. Dufour set the example in 1894, at Fecamp, in France, and the " Goutte de Lait " may be regarded as the precursor and to some extent the prototype of the Infants' Milk Depots in this country. The first depot in this country was instituted in St. Helens, and the example has been followed by many other places, such as Liverpool, Battersea, Lambeth, Finsbury, &c., and one of the most recent ones was opened in 1906, at Woolwich. Most of these are under the control of the Sanitary Authority, but some are the results of philanthropic action. In principle, the system adopted by Mr. |
e6c5d270-03e5-46fd-a399-fc1d80c1b92e | Nathan Straus, in New York, is very similar to that of the Infants' Milk Depots of this country. The milk is obtained from a farm where the cows are periodically examined. The cowsheds are frequently inspected, the cattle are groomed, and every precaution is taken that strict cleanliness is observed. The milk is strained and cooled immediately it is drawn from the cow. It will thus be seen that every care is 28 taken to safeguard the milk from pollution before it reaches the depot. It is true that the process of pasteurization destroys the bacteria in milk, but it is important that no poison is manufactured in the milk before its sterilization. The milk, after being cooled, is placed in sealed churns, and conveyed in these churns to the depot. The milk is prepared at the depot by mixing it with a suitable proportion of water, &c., for children under six months, but those over that age receive unmodified milk. |
31943d22-3dd1-46ee-a195-9df09d5c14bc | After modification, the milk is bottled, and sterilized. The milk is distributed in bottles sufficiently large to contain enough food for one meal. The bottles are supplied in wire baskets, each basket holding from 6 to 9 bottles, and containing a twenty-four hours' supply. The next day the basket of empty bottles is returned, and a fresh supply obtained. Each bottle represents one meal, and is not to be opened until required for use, thereby preventing home contamination of milk by storage in an insanitary pantry or kitchen. Teats are provided for use with each bottle The charge is usually from 1/6 to 1/9 a week, according to the age of the child. In the Straus Milk Charity, two kinds of milk are supplied, pure pasteurized milk in 8 ounce bottles, and modified milk for infants. Dr. |
d65f2a5a-79e1-4d5a-9274-a42d9bfa1441 | Straus endeavours to obtain milk as pure as possible, and it is certified by the New York Milk Commissioners and visited by the veterinarian of the New York Board of Health. It will thus be observed that whatever the agency is, the supply of pasteurized milk means much more than the simple heat of the milk. It involves the supervision of the supply. But in most instances, it goes further than this, and includes a supervision of the infants fed. For instance, in Battersea, care is taken to admit to the depot only those infants for whom satisfactory breast-feeding is impossible to obtain. Domiciliary visits are paid by Health Visitors, and in some places it is claimed that breast feeding has increased through the establishment of a milk depot. It is often true that many women 29 give up suckling and deliver up their babies to the bottle on the advice of ignorant friends and relatives, because the milk appears to disagree with the baby. What results have followed the establishment of these depots? |
fe379c93-eded-4136-b7c0-768fbd1749be | Various figures have been given containing the mortality of depotfed children with the general infantile mortality of a district. This method is so beset with fallacies as to be almost useless. The first year of life is not one period, but a collection of age periods, and the mortality during the first week is higher than that of any subsequent week. The mortality falls gradually from the first day of birth to the eighth month. Naturally, very few children under one month would attend a depot, so that the comparative figures lose their value. There is no doubt, as to the value of these depots in this country, though the period of observation is too short to attach too much importance to the figures. In this connection, the New York figures are of interest. The Straus Milk Charity was established in 1892, and has since steadily increased its area of operation. The infantile mortality has been reduced from 96 per 1,000 to 55 in 1906. |
8c4dd1ab-52e9-4e90-ae47-a3a464e1c613 | But it must be remembered that the Straus Milk Charity was not the only ameliorative influence which came into operation after 1892. But there is one method of comparison which is not vitiated by outside factors. In 1896, Mr. Straus installed in the Infant Asylum at Randall's Island, New York City a complete plant for the pasteurization of milk. The following figures give the death-rate per cent, in the years before and after the installation of the plant:— 1895 42 1896 39 1897 44 1898 19 1899 24 1900 27 1901 18 30 This appears to be a really valuable statistical result, and certainly justifies the expense which the reform of the milk supply entailed. Although feeding is only one of the factors in the mortality amongst infants, it is not one that can be ignored by sanitary authorities. |
ad22bb1a-8634-433f-b96b-42775b65a3c3 | It is, of course, not the only one, and other methods must be adopted, but if it be within the range of possibility, no method should be left untried. The establishment of a Day Nursery in South Acton may also be mentioned as one of the agencies which it is hoped will be instrumental in reducing the infantile mortality in the South-West Ward. Although the Council is precluded from supporting a Creche, the initiation of the movement is due to the advocacy of the Chairman of the Health Committee. As far back as 1904, Councillor Hunt read a paper at the Congress of the Royal Institute of Public Healthpointing out the conditions under which the children of women employed during the day are being cared for. It will be remembered also that a clause was proposed in the Acton Improvement Act empowering the Council to establish and maintain one or more creches. The Parliamentary Committee, though professing sympathy, refused the application. |
afaae2d0-0335-48ba-bb8d-53779c29ceaa | Philanthropic agencies took the matter up, and the Day Nursery was opened in J anuary, 1908. It is too soon to estimate the value of the institution, but it caused no surprise when it was known, that within a few weeks of its establishment, children had to be refused because all the cots and beds were occupied. The nursery can only accommodate about 24 children, but in the South-West Ward there are probably 200 babies under 12 months of age placed out with neighbours, &c.( during the day. The conditions under which most of these children are cared for in these houses are extremely unsatisfactory. The women who take in these children are often old, and the standard of cleanliness observed amongst them is below that of the average for South Acton. It will be observed that no less than 20 infants died from Bronchitis and 42 from Broncho-pneumonia. |
aa2595bb-7076-4e48-87b1-1397f7f03aac | In the case of a large number of these, 31 the mothers went out to work, and there is reason to believe that the excessive mortality from disease of the lungs is partly due to the injurious effects of the stuffy rooms and the sudden changes of temperature to which the children are exposed. As usual the mortality amongst illegitimate children was excessive. Out of 37 children born out of wedlock, 17 died before reaching the age of 12 months. These figures represent an infantile mortality of 480 per 1,000 births. In 1906 the infantile mortality, amongst illegitimate children was 564 per 1,000 births, so that in the last two years not one illegitimate child in two survives twelve months. ISOLATION HOSPITAL. During the year 342 patients were admitted. On January xst 1907, there were 19 patients under treatment, and on January 1st, 1908, 48. |
1bfc2b68-9911-464c-9712-156b22a76a59 | During the year 301 patients were discharged, and there were 12 deaths. Diphtheria. 88 Cases of Diphtheria were admitted; 52 of these were from Acton and 36 from outside districts. There were 5 deaths from this disease ; four of these deaths were of Acton patients. Scarlet Fever. 246 Cases of Scarlet Fever were admitted—232 from Acton and 14 from outside districts. There were 6 deaths, 5 of Acton patients. The following were probably " return " cases :— 1. G.W. Notified on March 23rd, first taken ill on March 20th. The " infecting " case (aged 4 years) was admitted into Hospital on January 29th and discharged on March 12th. |
fa6deb8b-e43e-4ab5-877c-7ec508b863a7 | The " infecting " case had suffered from no complications whilst in Hospital, and on examination subsequently to her return home, nothing could be detected, which would give rise to a suspicion of the case being still infectious. 32 2. N W. Notified May 10th, ill since May 8th. The "infecting" case (aged 6 years) was admitted to Hospital on March 1st, and discharged on May 2nd. It will be observed that the "infecting" case was detained in the Hospital for 9 weeksIt was a very mild case, but the peeling was protracted. There were no complications, and his stay in the Hospital was prolonged owing to an operation which was performed on him prior to his admission. There could be no suspicion that any infected articles had been left behind in the house as the child was admitted from the Cottage Hospital, where he had been an inpatient for over a week. 3. |
44f8279d-b939-4257-bbf8-0dc496647288 | W. V. Notified on November 28th, ill since November 26th. The "infecting" case (aged 5 years) was admitted on October nth, and discharged on November 21st. The child suffered no complications, but tonsils were enlarged. 4. (a) L. H. Notified December 5th, ill since November 30th. (b) E H. Notified December 5th, ill since December 4th. The "infecting" case (aged 7 years) was admitted to Hospital on October 27th, and discharged November 23rd. She had been ill for over a week before admission. She had no complications. and when discharged had finished peeling. Two days after she went home, she had a slight discharge from the ears. 5. E. R. Notified December 25th, ill on December 24th. |
59ec8b40-9a2c-4666-a878-bfae09887c55 | J. R. Notified December 30th, ill on December 23rd. The " infecting " case (aged 8 years) was admitted to Hospital on October 31st. and discharged on December 18th. There are features in connection with these "return" cases which are of interest. We may divide the year into 3 periods. 1. From January 1st to May 5th—2 "infecting" and 2 " return " cases. 33 2. From May 5th to November 23rd—no " return " cases, 3. From November 23rd to December 31st—3 "infecting" and 5 " return " cases. In the First Period 45 Scarlet Fever patients were discharged. |
b5901da0-9fec-4391-bbcb-c3f39cb0f340 | The average number of patients in the Hospital was 31.4, varying from 18.5 in the week ending January 5th to 51 in the week ending February 9th. The average number of Scarlet Fever patients in the Hospital was 17.6, varying from 13 in the weeks ending March 9th and January 5th, to 22 in the week ending April 20th In the Second Period 126 Scarlet Fever patients were discharged. The average number of patients in the Hospital was 37, varying from 17 in the week ending June 1st to 62 in the week ending November 16th. The average number of Scarlet Fever patients was 30, varying from 14 in the week ending June 1st to 61 in the week ending November 16th. In the Third Period * 45 Scarlet Fever patients were discharged. The average number of patients in the Hospital was 55, varying from 45 to 60. |
65419119-4e59-4cfe-8806-9879e2e5ccbb | The average number of Scarlet Fever patients was 52, varying from 41 to 59. The age distribution of the cases was almost similar in the 3 periods, about 70 per cent of the patients being under 10 years of age. It will be observed that as far as the average number of all patients and the average number of scarlet fever patients are concerned, the second period stands between the first and third periods, but in one respect it differed from both. In the second period the patients were able to be out of doors throughout the latter part of their convalescence. It is possible that this had some effect on the freedom of the patients from infection at the 34 time of their discharge. Whenever possible, the patients are kept in a " clean " ward for about a week prior to their discharge, but occasionally it is not practicable to carry out this arrangement. |
a8be9176-ee80-4e1f-bf48-101159f46004 | Not one of the " infecting " cases was over 10 years of age, and it is extremely rare to find adults or very young children giving rise to " return" cases. Enteric Fever. 7 Cases were removed to Hospital, and one patient died. INQUESTS. 46 Inquests were held, the cause of death being:— Overlaying 5 Accidentally killed by railway engine 4 Accidental burns 3 Suicide 4 Accidental contact with live conductor 2 Accidental fall 3. Fracture of skull 1 Pistol shot wound 1 Want of attention at birth 1 Neglect of mother 1 Natural causes 21 MORTUARY, 39 bodies were removed to the Mortuary, and 25 postmortem examinations were made. OFFENSIVE TRADES. There are two offensive trades registered in the district, This is one less than there were in 1906. The business of fat-extraction which was formerly carried on in Osborne-road has been discontinued. |
efe6f18c-a730-4d76-ba46-3662daf9df1d | It was pointed out that these premises were entirely unsuitable for the purpose it was used, and in addition, they were badly kept. 35 The other premises where fat extraction is carried on are situated in Hanbury-road. In this place also it was pointed out that the whole process was not carried out under cover, but every care is taken so as to reduce the nuisance to a minimum. Although a nuisance cannot be entirely obviated in the summer, the Council decided, in view of the precautions taken by the occupier, not to insist upon such alterations in the premises as would necessitate the whole of the process to be carried on under cover. The other offensive trade is that of the manufacture of a chemical fertilizer. The premises are situated on the canal bank near Willesden Junction. It was mentioned in the report of 1906 that owing to accidents to the machinery complaints had been received as to a nuisance, but in 1907, no source of complaint was observed. SEWAGE DISPOSAL. |
f11bfd11-5a9b-40ea-84f9-d9e719d55a4a | A description of the sewage works was given in the report of 1906, and it was stated that the works authorized in the Acton Sewage Act of 1905 were in hand. The work is not yet completed, but before the end of the summer, the whole of the sewage of the district will be emptied into the metropolitan sewers. SLAUGHTER HOUSES. There were 3 registered, and one licensed slaughter house in the district. One registered slaughter house was given up by the occupier during the year. DAIRIES AND COWSHEDS. There are two cowkeepers and 62 purveyors of milk on the register. COMMON LODGING HOUSES. There are two on the register, and both are licensed annually. 36 REFUSE DISPOSAL. The erection of a refuse destructor is in hand, but pending its completion, arrangements were made during the year with the Willesden and Acton Brick Company, whereby most of the refuse is burnt. |
c897c569-5390-4220-8bce-cfdef1ef4e0b | The process has not been carried out entirely without a nuisance, but it is a vast improvement on the practice formerly in vogue of tipping the refuse on land near the cemetery. INTERCEPTING TRAPS. The following letter, dated March 5th, 1907, from the architect to the Local Government Board, was submitted to the meeting of the Health Committee held in March : "The Local Government Board have recently had occasion to order an investigation to be made of the use of modern intercepting traps, whether in combination or not with inspection chambers, such as are required to be provided in many places by building bye-laws. In the course of this investigation, which has been entrusted to Dr. Mair, of the Medical Department, Mr. |
ab80e416-a61e-432b-b13d-34f904bb304d | Malet, of the Engineering Department, and me, a semi-metropolitan district has come under review, in which it has been shown that in a large number of instances a serious blocking of the house drain had taken place at the intercepting trap, and that, although this had usually resulted in a considerable accumulation of sewage, both in the drain and in the inspection chamber, no obstruction had been apparent to the occupier in the use of the drain. In these circumstances, it is obviously desirable that we should obtain further information for the Board from local authorities in whose districts similar drainage arrangements exist, with a view to seeing whether the use of intercepting traps is commonly found liable to lead to these results, and the board have, therefore, instructed us to invite assistance from your Council, amongst others, in the matter. |
9521bd76-e2b5-4f13-a5c1-99a4320cf5e4 | 37 We would suggest that your Council should allow their officers to undertake, under the supervision of the Medical Officer of Health, the systematic inspection of as large a number as may be practicable of easily assessible insertion chambers at intercepting traps, in order to ascertain facts as to their condition, and that these fact should l>e recorded so as to show formarily:— 1. The number of traps examined. 2. The number of cases in which :— (a) the intercepting trap is blocked, (b) an accumulation of sewage in the chamber, (c) though no accumulation at present exists, appearance of the chamber shows that there has been accumulation, (d) the " cap " of the raking or cleansing arm is displaced. It might be useful also, if in a few selected cases of obstruction of the trap, steps were taken to ascertain the exact cause of the obstruction. |
b61fa3f2-f01a-42e5-91f3-e4161f3d5aa9 | It is important for the purpose of the present investigation to exclude from examination the traps of any drains which may be liable to backwatering of sewage from the sewer. Although it is not expected that the above inquiries should be made by your Council's officers in a very short time, especially as their value will largely depend on the total number of chambers examined, it is hoped that they may not take very long, since it would seem that they may be made in the course of ordinary inspectional work. We should also be glad if your Council's technical officers would submit any observations on the subject which their experience of it may suggest, and which they may desire to make. Will you kindly inform me whether your Council will be good enough to assist in the investigation in any way proposed? It will be understood that the use of any information supplied in response to this letter will not involve disclosure of the district to which it relates." |
40cc6a36-a4c8-4fcf-b26f-d98f5dd3ba84 | 38 The Council accepted the suggestions made, and an examination of the intercepting traps was carried out, but a few remarks may be necessary in order to explain the conditions under which it was deemed advisable that the house drains should be intercepted from the sewer. In No. 65 of the bye-laws made by the Council with respect to new streets and buildings provides that every person who shall erect a new building shall provide, within the curtilage thereof, in every main drain or other drain of such building which may directly communicate with any sewer or other means of drainage into which such drain may lawfully empty, a suitable trap at a point as distant as may be practicable from such building and as near as may be practicable to the point at which such drain may be connected with such sewer, and with convenient means of access from the surface of the ground or paving under which it is placed. |
433674c8-89ad-4ad5-a340-79e0416b4d3b | The primary object of the bye-law is the prevention of the escape of gas in the sewer into the house drains, but there is reason to believe that in the absence of an intercepting trap, specific bacteria can pass from the sewer into the air in the house drains. Major Horrocks carried out a series of experiments for the purpose of determining the conditions under which specific bacteria derived from Sewage may be present in the air of ventilation pipes, drains, inspection chambers and sewers, and his experiments showed that : (1) Specific bacteria present in sewage may be ejected into the air of ventilation pipes, inspection chambers, drains and sewers by (a) the bursting of bubbles at the surface of the sewage, (b) the separation of dried particles from the walls of pipes, chambers, and sewers, and probably by (c) the ejection of minute droplets from flowing sewage. (2) A disconnecting trap undoubtedly prevents the passage of bacteria, present in the air of a sewer, into the house drainage system. |