Chapter III: Part 3

No progress in this matter has been made since my last report, a conference with a Committee of the Board of Guardians, with a view to the appropriation of a portion of the stone yard at the Dispensary Buildings, Mary Place, Potteries, having proved abortive. I cannot say I regret this result, as I do not consider the site a desirable one. The mortuary should be quite distinct from any association with pauperism, and though privacy of site is desirable, I hold that it should be placed in the most respectable and the most central locality that can be obtained, in order to ensure its being used. I am still of opinion that the

DISINFECTING CHAMBER

should, if possible, be so far associated with the mortuary as to enable one and the same person to have the charge of both establishments. Proceedings in respect of both are alike at a standstill, because we have not been able to procure a site. Fortunately, during a considerable portion of the year there has not been very much need of a chamber, so far as need depends on the prevalence of infectious disease; but I am of opinion that a great amount of good sanitary work might be done with an efficient chamber, if only in purifying by heat the often foul and otherwise offensive bedding and clothing of the poor. Latterly, owing to the increased prevalence of scarlet fever, and also during the latter period of 1874, a good deal of disinfection has been satisfactorily carried out for your Vestry by Messrs. Wellan & Co., of Manchester Mews, Walmer Road, Notting Hill, by chemical agents and heat combined. As to the value of disinfection properly done there can be no doubt and I am not acquainted with a single instance in which clothing, bedding, &c., that has been properly submitted to the process, has been the medium of contagion.

BATHS AND WASH-HOUSES.

No steps were taken during the year to supply the parish with these valuable institutions. I hope, however, that the subject will be taken up again before long, your Vestry having already expressed an opinion favourable to the principle. I have no doubt that in a few years, and at whatever reasonable cost, Baths and Wash-houses will be regarded as indispensable parts of a well-regulated system of sanitary administration.

SEWER VENTILATION.

The subject of sewer ventilation has made little or no progress during the year, and, as usual, numerous complaints have been received of noxious smells emanating from the gullies and ventilators. Each case has been dealt with as far as possible; and in many of the cases charcoal filters have been introduced, with the result of putting a stop to complaints. I am, nevertheless, somewhat sceptical as to the value of this plan, as I cannot divest my own mind of the suspicion that they impede ventilation, and may prove effectual only by preventing the escape of foul air. The subject was brought very prominently before your Vestry during the current year, in consequence of numerous complaints by inhabitants of Elsham-road of bad smells, not only in the roadway, but also in the houses. I made an exhaustive report on the locality, and advised measures for diminishing pressure in the sewers, by opening up blind ends, and so allowing the gas to circulate, or, at least, to escape innocuously into the open air, rather than into the houses. I described the sanitary defects which existed in the houses, and recommended ventilation of the house drains by independent pipes carried from the highest point of the drain to some distance above the parapets of the houses, and I pointed out that this remedy alone would go far to remove the cause of complaint. To what extent the plans have been carried out I have not yet ascertained, but it is certain that a long period had since elapsed without any communication on the subject having been received in my department.

With respect to the question of circulation of air in sewers, _plus_ ventilation, I may mention that a striking illustration of the value of this plan was afforded in the locality of Notting Hill Square. At one of the houses at the southern, or loftiest side of the square, there had been numerous cases of fever, and there was clear evidence of the escape of sewer gas into the house in question. Upon careful enquiry into the drainage of the locality, 1 ascertained that the sewer which received the house drainage originated in a dead or blind end, and that the ventilation was insufficient. Your Vestry directed a communication to be made between the blind end in question and another very near to it, thus setting up a free circulation in the system; and at the same time freely ventilated the sewer near the junction. The effect was everything that could be desired: for certain improvements in respect of the trapping and ventilation of the house drains having been carried out, the evil complained of was effectually removed, and no farther illness has been reported.

It is much to be wished that some effectual plan may be soon discovered for ventilating sewers; and, although I do not profess myself competent to decide what direction such a discovery is likely to take, the most promising idea I have yet heard proposes the extraction of foul air by the action of fans placed in suitable localities, the present ventilators being retained in the capacity of inlets for pure air, instead of outlets for foul air; acting, in fact, like the down draught in a mine. We all know, by reading, what great lengths of galleries in mines deep below the surface of the earth are ventilated, and very efficiently, in this manner, and it seems not unreasonable to hope that the system may be found applicable to the purpose under consideration. Certainly, there seems no reason to doubt the almost illimitable power of steam fans to induce currents in any direction; and leaving the question to be worked out by those who are making a practical study of it, I can but wish them every success, believing an effectual system of sewer ventilation to be one of the chief sanitary _desiderata_ of the present day.

WATER SUPPLY.

The Report, by Professor Frankland, on the analysis of the waters supplied by the Metropolitan Water Companies during the several months of the year, is, on the whole, somewhat more favourable than usual. As regards “temperature,” he notices the wide variation in the waters derived from riverian sources, as compared with the narrow range in the deep well water of the Kent Company, derived from the chalk. The temperature of the Thames water varied from 36° Fahr. in February to 68°–9 in June, a range of 34°; while the range in the water of the Kent Company was only 7°–9 Fahr., viz., from 51–l° in May to 59° in September and October. The total solid impurities—composed of a great variety of substances, some of which are organic and very objectionable, and at times eminently noxious, while others are either entirely or comparatively harmless—was rather less than in previous years, the progressive increase in the quantity which had been noticed during the years 1871–2–3 having apparently ceased. The maximum was observed in January, and the minimum in July. The character of the Thames water, in respect of organic impurity—as represented by its two most important constituents, carbon and nitrogen—was practically the same as in the previous years. The maximum pollution occurred in March, April, and December, when the river was in a very objectionable condition. In December the Chelsea Company supplied this foul water in an unfiltered condition, and contaminated with fœcal matter. The subjoined table shows the maximum, minimum, and average quantity of organic matter in the water, the amount of organic element (organic carbon and organic nitrogen) in the Kent Company’s water being taken as unity, or the standard of comparison:—

Name of Company. Maximum. Minimum. Average. Kent 1.0 1.0 1.0 West Middlesex 4.3 2.0 3.0 Grand Junction 4.9 2.4 3.3 Chelsea 7.1 2.3 3.7

Professor Frankland remarks that the water of the Thames is at its source as free from pollution as the chalk well water, but on its downward course becomes largely and progressively contaminated by sewage and the washings of cultivated land, especially during winter.

The average hardness of the Thames water—or the weight of carbonate of lime, or its equivalent of other soap-destroying substances, found in 100,000 parts of water was 21° or parts in 1873, and 19.7° in 1874. Large quantities of soap or soda are required to soften the water before it is used for washing; but this process could be accomplished for a small portion of the expense by substituting lime for soap or soda, as practised on similar waters at Aylesbury, Canterbury, Caterham, and Tring. The following table exhibits the degree of efficiency of filtration of the waters:—

Name of Company. No. of occasions No. of occasions No. of occasions No. of occasions when clear and when slightly when turbid. when very transparent. turbid. turbid. Chelsea 6 5 0 2 West Middlesex 12 1 0 0 Grand Junction 7 5 1 0

The exceptional occasion on which the water supplied by the West Middlesex Company was slightly turbid was in December, when the condition of the Thames was bad for a lengthened time, so that even the large storage of the Company proved insufficient to render them independent of flood water; it being impossible, moreover, to separate by filtration the whole of the finely divided clay to which the turbidity of the water was due. The Kent Company’s deep well water, having already undergone natural filtration through an enormous thickness of chalk, is always clear and transparent, without artificial filtration. The appliances of the Companies supplying river water are, excepting in the case of the West Middlesex Company, unequal to the filtration work required of them. The microscope is called into use in the examination of potable water, and it always reveals numbers of living and moving organisms in the sediment deposited by turbid water on standing. The annexed table exhibits the results of such microscopic examinations during the past six years:—

Name of Company. Number of occasions when living organisms were found. 1869. 1870. 1871. 1872. 1873. 1874. Chelsea 3 2 2 3 2 5 West Middlesex 0 0 0 0 0 0 Grand Junction 4 1 1 2 3 5

To Professor Frankland’s valuable report, the main features of which I have thus summarised, are appended numerous tables setting forth, in detail, the various information condensed in the text. I subjoin, as of greatest general interest, Table M, which exhibits the

AVERAGES FOR 1874.
(The numbers in this Table relate to 100,000 parts of each Water.)

NAMES OF COMPANIES. Temperature in Total Solid Organic Carbon. Organic Ammonia. Nitrogen, as Total Combined Previous Sewage Chlorine. Total Hardness. Proportionate
Centigrade Impurity. Nitrogen. Nitrates and Nitrogen. or Animal Amount of
Degrees. Nitrites. Contamination. organic
(Estimated.) Elements, that
in the Kent
Company’s Water
being taken as
1.
THAMES.
Chelsea 11.8 26.46 .211 .039 .001 .155 .196 1250 1.87 19.3 3.7
West Middlesex 12 5 26.62 .176 .028 .001 .124 .153 930 1.83 19 4 3.0
Southwark 12.7 26.68 .192 .030 .001 .125 .155 940 1.83 20.0 3.3
Grand Junction 11. 4 27.00 .186 .033 .001 .129 .164 990 1.83 20 0 3.3
Lambeth 12.0 27.88 .196 .037 .001 .144 .181 1120 1.87 20.0 3.4
OTHER SOURCES.
New River 12.2 26.02 .087 .015 .001 .146 .162 1150 1.67 20.1 1.5
East London 11.8 27.13 .153 .027 .001 .076 .104 560 2.04 19.3 27
Kent 12.4 40.36 .057 .012 .000 .371 .383 3 40 2.48 28.1 1.0

But it is not to Professor Frankland alone that we are now indebted for information respecting the water we drink, many very interesting facts being supplied by Major Bolton, R.E., the water examiner appointed by the Board of Trade, under the provisions of the Metropolis Water Act, 1871. Major Bolton’s reports, which, by his courtesy, I receive every month, afford information on all points relative to the machinery for water supply, and to the provisions already made, or in progress, for giving a constant supply, the main object of the Act; and which, I suppose, we may, at some remote future, hope to obtain. As the information in question is not generally accessible, I make no apology for presenting a _resumé_ of it on this occasion. And, first, with respect to the constant service, we learn that the West Middlesex Company are giving constant supply to a number of houses, on the application of the owners, and are fully prepared to extend the supply when called upon. Extensive works and additional engine power of 120 horse power are in course of construction at Hampton.

The Grand Junction Company have formed a high service reservoir near Kilburn, to contain 6,000,000 gallons, for constant service, and are completing the line of main pipes to connect up this reservoir with the works at Campden-hill; they are likewise erecting boilers and works at Hampton, for which place an additional 70-inch engine of 125 horse power is being constructed, and an extra 30-inch main from Hampton to Kew has been ordered to be laid down. The Chelsea Company does not appear to have taken, as yet, any steps in this matter, having, as we shall see, other and more pressing work in hand. The Act of 1871 provides power to compel the companies to give a constant supply as and when the “public authority” may see fit to move. The authority (Metropolitan Board of Works) has not seen fit to move in respect of the companies supplying this parish, nor is it probable that any steps will be taken until the stringency of the water regulations, to which I have already referred, has been modified.

The number of miles of streets in the Metropolis which contain mains constantly charged, and upon which hydrants could at once be fixed, is 666—including 67 in the West Middlesex, 41½ in the Grand Junction, and 50 in the Chelsea Company’s district. The companies are prepared to affix hydrants thereon when required by the authorities; but, in fact—although hydrants might be used for street watering—of 2,531 hydrants already erected, 1,996 are for private purposes, and only 535 for public purposes, including 267 for street watering, in the entire Metropolis.

The companies supplying this parish obtain water exclusively from the Thames, viz., the West Middlesex and Grand Junction Companies at Hampton, and the Chelsea Company at Ditton. The bad state of the water supplied by the last-named company in December appears to have been caused by the intake being “below the filthy outflow of the rivers Mole and Rye.” The total volume which may be supplied daily by each company is 20,000,000 gallons. The average daily supply during the month of December was—West Middlesex, 8,600,000; Grand Junction, 10,200,000; and Chelsea, 7,200,000 gallons—eleven to fourteen per cent. of the water (exclusive of waste, an enormous but unknown quantity!) being delivered for other than domestic purposes. The number of houses supplied in the several districts is—West Middlesex, 46,404; Grand Junction, 35,144; and Chelsea, 28,395. Only 401 houses in the West Middlesex district have a constant supply. The estimated population supplied is—West Middlesex, 348,000; Grand Junction, 316,000; Chelsea, 210,000. The West Middlesex Company possess eleven engines of 1,341 horse power; the Grand Junction, eleven of 1,820 horse power; and Chelsea, eight of 1,025 horse power. The number of miles of mains possessed by these companies in the Metropolis is—West Middlesex, 248; Grand Junction, 200; Chelsea, 170. The West Middlesex Company have three subsiding and storage reservoirs for unfiltered water—area, 20½ acres; available capacity, 57,000,000 gallons: and three covered reservoirs for storing filtered water, of an aggregate capacity of 10,922,000 gallons. This company, by means of its large reservoir capacity, avoids taking in water during floods. The Grand Junction Company have four subsiding and storage reservoirs for unfiltered water—area, 7 acres; available capacity, 19,500,000 gallons: the number of covered reservoirs for filtered water being three, their capacity 18,000,000 gallons. This company requires additional impounding and subsiding reservoirs. The Chelsea Company have no reservoirs for unfiltered water, and only two (capacity, 11,000,000 gallons) for storing filtered water. The filter beds of the several companies are as follows:—West Middlesex, five in number, area 8 acres, depth 5 feet, viz., Harwich sand 1ft. 9in., Barnes sand 1ft., and gravel (screened to different sizes and arranged in layers) 2ft. 3in. The average rate of filtration per square foot of area was, during December, 1½ gallons per hour. (It may be here observed that the quality of the water is improved by a slow rate of filtration—the rate should not exceeded 2½ gallons per square foot of filter bed per hour: this will give 540 gallons per square yard each 24 hours, and at this rate filtration should be effectual.) Grand Junction: Number of filter beds, 4; area in acres, 7¾; depth, 5ft. 6in.—viz., Harwich sand, 2ft. 6in.: Hoggin, 6in.: fine gravel, 9in.: coarse gravel, 9in.: boulders, 1ft.: average rate of filtration, 1⅓ gallons per square foot of area per hour. Chelsea: Filter beds, 7; area, 6¾ acres; depth, 8ft.—viz., Thames sand, 3ft. 3in.: shells, &c., 3in.: gravel, 4ft. 6in.; rate of filtration, 2⅓ gallons per square foot per hour. It will be observed that notwithstanding the greater depth of the filter beds of the Chelsea Company, the water supplied by the Company in all times of difficulty arising from a flooded state of the river is unfit for drinking, although the rate of filtration is slower than that deemed sufficient by the water examiner. This is due to the total absence of impounding and storage reservoirs for unfiltered water, to the exceptionally bad quality of the water taken in by the Company, owing to the improper situation of the intake at Ditton, and to the impossibility of filter beds removing suspended matter when in any large quantity; that, moreover, being a principal object of the subsiding reservoirs. The disgusting condition in which the water of the Company was sent out during parts of the months of November and December formed the subject of many complaints, both in the public press and in communications addressed to myself, and was referred to in my reports, dated December 16th, 1874, and January 13th, 1875. I had, on former occasions, reported specially on the subject, and particularly in February, 1872. The dissatisfaction which the condition of the water at the latter date gave rise to induced the Company to take steps to improve their means of supply by enlarging their storage. The scheme submitted to Parliament in the Session of 1873 included the embanking of the Thames at Hampton Court, and was defeated by a strong public opposition, on what I described at the time as æsthetical grounds. No further attempt appears to have been made by the Company to put their supply on a proper footing until the great outcry referred to arose. On the 18th December, however, at a special meeting of the proprietors, a resolution to the following effect was passed:—

“That the directors be authorised to take such steps as in their
judgment may be necessary or expedient to obtain a fresh intake, with
reservoirs and other works connected therewith, and lay the necessary
main pipes from the site of such proposed intake to the works at
Seething Wells, with the least possible delay.”

The measures taken by the directors to secure the land—an area of 50 acres, near Molesey—for the construction of impounding reservoirs, were approved and adopted, and the directors were authorised to apply to Parliament in the now current Session for the necessary powers. This they have done, and there is every probability that their Bill will pass, and that with the completion of the contemplated additions to their works this Company will be able, at no distant time, to supply its customers with water as clear and transparent as any derived from the River Thames.

GAS.

During the first half of the year the parish was supplied with cannel gas of 20 candle lighting power, and at the increased price of six shillings and threepence per thousand cubic feet. Since July common coal gas of 16 candles has been exclusively supplied at a charge of five shillings per thousand. The subjoined table, taken from the quarterly returns of the chief gas examiner, shows the results of the daily testings of the gas supplied by the Gas Light and Coke Company, at the testing station at 123, Ladbroke Grove, Notting Hill:—

Month. Illuminating AMOUNT OF IMPURITY. Number of power in Examinations. Sperm Candles. Sulphuretted Ammonia per Sulphur per Hydrogen. 100 feet 100 feet Grains. Grains. January 21.28 4.11 21.92 25 February 21.76 1.15 18.46 23 March 21.47 0.86 15.63 26 April 22.04 0.56 17.37 22 May 21.53 0.39 17.97 23 June 21.28 0.48 17.93 20 July 17.13 0.50 18.76 26 August 16 70 0.37 17.79 23 September 16.83 0.15 17.17 25 October 16.53 (Present 3 0.19 16.44 26 times) November 16.67 0.19 17.02 24 December 16.68 (Present 3 19.01 25 times)

The next table shows the maxima, minima, and averages of lighting power stated quarterly:—

Period. Maximum. Minimum. Average. 1st Quarter (Cannel 22.9 19.6 {49a} 21.50 Gas) 2nd do. do. 23.0 20.3 21.62 3rd do. (Common Gas) 17.6 16.1 16.89 4th do. do. 18.2 15.5 {49b} 16.63

As regards sulphur impurity, the amount was in excess of the permitted quantity (25 grains in 100 cubic feet of gas), on one occasion only during the year, viz., 26.4 grains on 30th July. Sulphuretted hydrogen was found on three occasions—in the months of October and December respectively.

Ammonia was in excess on 19 occasions in the month of January, but of a total of 25 testings: the average for the entire month being 4.11 grains (maximum 7.5.) This excess above the maximum allowance (2.5 grains in 100 feet of gas) was due to unavoidable causes, in connection with alterations being then made in the purifying machinery, which, having since been perfected, the ammonia has sunk to an almost infinitesimal quantity.

In the Appendix I have given the quarterly returns of the chief examiner, showing the results of the _daily_ testings—for which I am indebted to the courtesy of Mr. Wakefield, the Clerk to the Metropolitan Board of Works. These returns show in detail the facts above stated, and prove that the gas has been up to the Parliamentary standard, as estimated by the prescribed tests. Nevertheless, complaints have been made by persons living in various parts of the parish, of the deficient lighting power of the gas. It must be assumed, therefore, that in some cases the burners in use have been in fault. There can, indeed, be no doubt that many consumers fail to obtain a proper light, owing to the habitual use of bad burners, or to the neglect to cleanse good ones. Burners that were of sufficient capacity for the cannel gas, with which the parish was supplied during the first half of the year, are inadequate, and are not adapted to burn common gas so as to produce a good light. Some consumers who have reported the sufficiency of the light when proper burners have been employed, have complained of the great increase in the amount of their gas bills, and in a few instances, I understand, the dissatisfaction has been so great as to lead to a discontinuance of the use of gas. It is a remarkable fact, often observed—a fact that makes us almost despair of ever getting “cheap gas”—that the bills seem always to increase when the price is lowered! How this is brought about I do not pretend to explain; but, so far as my experience goes, it would seem that gas bills never were lower than when the price per thousand feet was at its highest. I do not think that extravagance in consumption—as a result of decrease in price—can be admitted to be a sufficient explanation of the phenomenon. There are mysteries in gas manufacture and supply, which may be revealed hereafter, and the discovery may both enlighten us on the point now mentioned, and also explain the occurrence of complaints of bad light, concurrently with the satisfactory results of the nightly examinations of the gas at the appointed testing station.

During some portion of the year the supply was scarce. The Company, when applied to for an explanation, attributed the scarcity to the refusal of a “sister Vestry” to allow the roads in their parish to be broken up for the purpose of laying down a larger main from the works at Horseferry Road, to supplement the supply from the Kensal Works, which are inadequate for the large district hitherto dependent on that source. I am not without hope that when the new 24-inch main is completed some of the causes of dissatisfaction to which I have adverted may be removed, and that a sufficient and well-regulated pressure, with a full supply of gas, will be obtained.

The dissatisfaction with the gas led your Vestry to adopt a curious experiment during the current year, viz., that of burning mineral oil with the Silber light in a certain number of street lamps in the Kensington Road. I offer no opinion at present on the comparative value of the two sources of light; but I may mention the fact already well known, and referred to in my monthly reports, that the lighting of the streets in this parish is very unsatisfactory, inasmuch as we are still using burners adapted to consume three feet per hour, as in the days of cannel gas, whereas 4½ feet burners, at the least, should be employed. A suggestion has been made that the average meter system should be adopted in this parish, and it has my cordial approval—already expressed in my monthly reports—as it is only fair and proper that public bodies should pay for the gas they consume and no more. The average meter system has been adopted in the parishes of Paddington and St. Pancras. It has given entire satisfaction, and in a very short space of time the first cost of applying the meters to every twelfth lamp will have been defrayed by the saving in expenditure on gas. In Paddington the Vestry have undertaken all the necessary work of lighting and repairing the lamps. The gas has been burned for a somewhat shorter average period nightly, and a further large saving in expenditure has thus been effected. With reference to the cost of gas in this parish, I may be permitted to mention that during the year the revenue of the Company was many thousand pounds more than necessary to pay the ten per cent. dividend—which, in fact, might have been paid without the increase in the price of the gas, sanctioned by the Commissioners appointed by the Board of Trade, in the month of January. If, however, the price had not been raised during 1874, it is probable that the price charged in 1873 would have been maintained. But, in the face of the enormous over-taxation of gas consumers in 1874, and the reduced cost of coal, the Company could not apply to the Board of Trade for a revision of the price in 1875, the result being that the charge reverted on the 1st of January to the Parliamentary price of three shillings and ninepence per 1,000 cubic feet.

* * * * *

I cannot conclude my report without special acknowledgment of the assistance rendered to me by the sub-district registrars of births, deaths, &c., during the past year, which has been one of crisis. For many years the Registrar-General had presented to the several Medical Officers of Health of the Metropolis the original manuscript returns of the causes of all deaths registered within their districts during the previous week, these returns being forwarded by the sub-district registrars to Somerset House, and forming the basis of the Registrar-General’s “Weekly Return.” For this duty the sub-district registrars received no remuneration. The necessity of similar information being supplied to Provincial Medical Officers of Health arose out of the passing of the Public Health Act, 1872, but no such returns being in existence, the information was not forthcoming. Hence many difficulties, into which I need not enter. Suffice it to say that in the Public Health Amendment Act provision was made for the payment of the sub-district registrars by Provincial Sanitary Authorities for information of a precisely similar character to that which had hitherto reached the Metropolitan Medical Officers without expense to the Local Boards. On the passing of the last-named Act, the London registrars, feeling themselves entitled to remuneration for the “secondary use,” by the Medical Officers of their manuscript returns, applied to the Registrar-General on the subject, and he, in turn, requested the Society of Medical Officers of Health to bring the question of payment on a proposed scale before the several Vestries and District Boards. The Society, however, declining the somewhat invidious task, the Registrar-General addressed a similar application to the Local Boards. In the result very few of them consented to the requisition of the Registrar-General, who thereupon gave notice to the Medical Officers that after an appointed day in October he should no longer forward the weekly returns; and he was as good as his word. Greatly to their credit, Messrs. Barnes and Hume spontaneously put themselves in communication with me, promising to send me a duplicate copy of the returns as before; and this they did, until, some time afterwards, a fair and mutually satisfactory arrangement was completed between your Vestry and these gentlemen. The upshot is that I obtain the returns early on Monday morning instead of on Wednesday evening, and I am thus enabled to tabulate the vital statistics up to a period within four days of the date of my monthly reports, instead of eleven days, as under the former arrangement. Additional information of value is also supplied by the registrars, and they continue to forward from day to day, on special forms, notice of any deaths that may have been registered from small-pox, scarlet fever, diphtheria, typhus, enteric, and simple continued fevers, and puerperal fever, &c., so that no time is lost in taking the necessary steps after _fatal_ cases of these infectious diseases.

I have to express my obligations to the officers of the Board of Guardians for information of cases of infectious diseases, &c.; and I am happy to testify my sense of the cordial support I invariably receive from the Sanitary Inspectors, and of the efficient manner in which their onerous, often delicate, and always important duties have been performed. Some portion of the time of Messrs. Wood and Langman has been taken up in attending to the new duties imposed on them under the Adulteration of Food, &c., Act—especially in attending the police court to conduct prosecutions. Much of the work of general inspection is still done in a desultory way, owing to the magnitude and inconvenient configuration of the parish, and to the necessity of attending to complaints as they arise from day to day—a necessity that impedes, more or less, the important duty of systematic inspection of the houses in streets, &c., inhabited by the poorer classes of the population. It is desirable that the 35th clause of the Sanitary Act, 1866, should be adopted, in order to the registration and regular inspection of all houses which are let out in tenements. No doubt this would involve much additional work for a time, but the benefits would be commensurate, for the risk of overcrowding would be diminished, ventilation would be improved, and the cleansing of the rooms, staircases, &c., would be systematically carried out. It seems to me that this is the direction sanitary improvement should take in the future; and the staff having been increased by the appointment of an additional officer, I am not without hope of being able to bring the subject under the notice of your Vestry at an early date, with reasonable prospect of success. A principal difficulty in connection with sanitary administration is that of securing an efficient record of work done—a difficulty which has been much lessened in this parish by the conspicuous care and ability with which Mr. Rudman has performed the clerical duties of the department.

I am, Gentlemen,

Your very obedient Servant,

T. ORME DUDFIELD, M.D.,
_Medical Officer of Health_.

VESTRY HALL, KENSINGTON,
_August_, 1875.

APPENDIX.

NOTE—The forms for Tables I.–VI. have been settled by the Society of Medical Officers of Health to ensure uniformity of Statistical returns.

TABLE I.

Estimated population 1874, at the middle of the year, and in 10 previous years; number of inhabited houses; Births, Deaths and Marriages (gross numbers).

Year. Estimated Number of Registered Deaths. Marriages. Population. Houses. Births. {57b} {57a} 1874. 138,000. 17,667. 4,356. 2,696. 1,311. 1873 133,000 16,920 4,182 2,436 1,243 1872 127,400 16,206 4,041 2,171 1,132 1871 121,500 15,394 3,804 2,328 1,131 1870 116,350 15,279 3,705 2,473 892 1869 111,350 14,654 3,625 2,249 891 1868 106,350 14,029 3,522 2,232 984 1867 101,350 13,404 3,158 1,938 974 1866 96,350 12,779 3,080 1,966 984 1865 91,350 12,154 2,619 1,733 920 1864 86,350 11,529 2,494 1,849 No Information Average of 10 109,135 14,234 3,423 2,137 „ years, 1864–1873

Notes.

Population at Census, 1871, 120,234.

Area in Statute Acres, 2,190.

Average number of persons in each house at Census, 1871, 7.8.

TABLE II.

Showing Birth and Death Rate: Deaths of Children, and Deaths in Public Institutions 1874, and 10 previous years.

The Year. Births per 1000 Death rate per Deaths of Deaths of Deaths of Deaths in Public of the 1000 living. Children under 1 Children under 1 Children under 5 Institutions.{58} Population. year per cent. to year per cent. to years per cent. Total Deaths. Registered to Total Deaths. Births. 1874. 31.7 19.5 28.5 17.5 45.4 352 1873 31.4 18.3 27.0 15.9 40.0 272 1872 32.1 17.0 28.9 15.6 44.2 264 1871 31.3 19.1 25.0 15.0 41.6 252 1870 32.1 21.2 24.4 16.4 42.9 330 1869 32.5 20.2 † † † 318 1868 33.1 21.0 † † † 303 1867 31.2 19.0 † † 40.6 221 1866 32.0 20.4 † † 41.6 248 1865 28.7 19.0 † † † 250 1864 28.9 21.4 † † 41.6 281 Average of 10 31.3 19.6 † † 41.8 273 Years, 1864–1878.

† = No information.

TABLE III. Deaths Registered from all causes during the year 1874.

(The Deaths in Public Institutions of non-residents being excluded.)

CAUSES OF DEATH. AGES. Total deaths Grand Total. SUB-DISTRICT. under Five. Under 1. 1 to 2. 2 to 5. 5 to 15. 15 to 25. 25 to 35. 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 85 to 95. 95 and Kensington Brompton. upwards. Town. (CLASSES). I. ZYMOTIC 187 89 95 40 24 26 13 13 10 8 3 1 ... 371 509 424 85 DISEASES II. CONSTITUTIONAL 69 46 44 40 49 60 58 56 32 29 8 ... ... 159 491 399 92 III. LOCAL 242 66 52 21 27 54 75 121 152 180 129 22 4 360 1145 921 224 IV. DEVELOPMENTAL 228 16 4 ... 4 6 4 1 1 14 43 31 4 248 356 296 60 V. VIOLENT DEATHS 28 ... 2 4 1 2 1 7 4 1 ... ... ... 30 50 44 6 (Not specified.) 8 6 6 ... ... ... ... ... ... ... ... ... ... 20 20 18 2 _Total_ 762 223 203 105 105 148 151 198 199 232 183 54 8 1188 2571 2102 469 I. ZYMOTIC DISEASES. _Order_ 1.—MIASMATIC. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 37 47 35 2 ... ... ... ... ... ... ... ... ... 119 121 115 6 Scarlet Fever 1 8 12 11 ... ... ... ... ... ... ... ... ... 21 32 28 4 (Scarlatina) Diphtheria 3 2 9 7 ... 2 1 1 1 ... ... ... ... 14 26 24 2 Quinsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Croup 7 4 14 1 ... ... ... ... ... ... ... ... ... 25 26 25 1 Whooping-cough 14 17 13 1 ... ... ... ... ... ... ... ... ... 44 45 36 9 Typhus ... ... 1 2 ... ... ... 3 1 1 1 ... ... 1 9 9 ... Enteric or Typhoid ... 3 2 7 6 1 4 3 ... 2 ... ... ... 5 28 19 9 Fever Simple continued 3 1 4 1 ... 1 ... ... 2 2 1 ... ... 8 15 11 4 Fever Erysipelas 3 ... 1 2 4 3 2 3 2 1 ... ... ... 4 21 13 8 Puerperal Fever ... ... ... ... 9 12 3 ... ... ... ... ... ... ... 24 18 6 (Metria) Carbuncle ... ... ... ... ... 1 ... 1 1 ... ... ... ... ... 3 2 1 Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Dysentery ... ... ... ... ... ... ... ... 2 ... ... ... ... ... 2 2 ... Diarrhœa 100 6 2 ... ... ... ... ... ... 2 1 1 ... 108 112 90 22 Simple Cholera 5 ... ... ... ... ... ... ... ... ... ... ... ... 5 5 3 2 Ague ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 ... Remittent Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rheumatism 1 ... 2 5 5 3 1 ... ... ... ... ... ... 3 17 13 4 Other _Zymotic_ ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diseases _Order_ 2.—ENTHETIC. Syphilis 11 1 ... ... ... ... ... ... ... ... ... ... ... 12 12 10 2 Stricture of ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Urethra Hydrophobia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Glanders ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... _Order_ 3.—DIETIC. Privation ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Want of Breast-milk ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Purpura and Scurvy ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 Alcoholism: Del. ... ... ... ... ... 2 ... ... 1 ... ... ... ... ... 5 3 2 Tremens Alcoholism: ... ... ... ... ... ... 1 1 ... ... ... ... ... ... Intemperance _Order_ 4.—PARASITIC. Thrush 2 ... ... 1 ... 1 ... ... ... ... ... ... ... 2 4 2 2 Worms, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 187 89 95 40 24 26 13 13 10 8 3 1 ... 371 509 424 85 II. CONSTITUTIONAL DISEASES. _Order_ 1.—DIATHETIC. Gout ... ... ... ... ... ... ... ... 1 2 ... ... ... ... 3 3 ... Dropsy ... ... 1 1 ... 1 1 2 ... 1 2 ... ... 1 9 7 2 Cancer ... ... ... ... 1 1 6 17 18 19 5 ... ... ... 67 51 16 Cancrum Oris (Noma) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Mortification ... ... 1 ... ... ... ... ... 1 1 1 ... ... 1 4 3 1 _Order_ 2.—TUBERCULAR. Scrofula 11 6 4 2 1 ... 1 2 ... ... ... ... ... 21 27 23 4 Tabes Mesenterica 33 15 5 ... ... ... ... ... ... ... ... ... ... 53 53 45 8 Phthisis 1 7 8 25 46 56 50 35 12 6 ... ... ... 16 246 200 46 Hydrocephalus and 24 18 25 12 1 2 ... ... ... ... ... ... ... 67 82 67 15 Tubercular Meningitis 69 46 44 40 49 60 58 56 32 29 8 ... ... 159 491 399 92 III. LOCAL DISEASES. _Order_ 1.—NERVOUS SYSTEM. Cephalitis 1 ... ... 3 ... 1 ... 1 ... ... ... ... ... 1 6 6 ... Apoplexy 2 1 1 ... 1 1 2 15 16 18 7 ... ... 4 64 45 19 Paralysis ... 1 ... 1 ... 1 3 6 7 15 13 ... ... 1 47 32 15 Insanity ... ... ... ... 1 1 ... ... ... 2 ... ... ... ... 4 4 ... Chorea ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 1 Epilepsy 1 ... 1 ... ... 2 4 2 2 1 ... ... ... 2 13 9 4 Convulsions 47 8 4 ... ... ... ... ... ... ... ... ... ... 59 59 50 9 _Brain Disease_, 9 4 5 2 2 1 6 7 9 11 6 ... ... 18 62 53 9 &c. _Order_ 2.—ORGANS OF CIRCULATION. Pericarditis ... ... 2 ... 1 ... 1 ... 1 ... ... ... ... 2 5 5 ... Aneurism ... ... ... ... ... 1 3 2 ... 1 ... ... ... ... 7 6 1 _Heart Disease_, 2 2 3 3 5 5 6 13 23 29 31 12 3 7 137 104 33 &c. _Order_ 3.—RESPIRATORY ORGANS. Laryngitis 2 ... 2 ... 1 ... ... 1 ... ... ... ... ... 4 6 6 ... Bronchitis 91 25 10 3 3 6 13 19 32 53 48 5 1 126 309 258 51 Pleurisy ... 1 1 ... 2 ... 2 2 1 ... 1 ... ... 2 10 9 1 Pneumonia 55 20 19 3 4 14 13 18 11 13 5 1 ... 94 176 150 26 Asthma ... ... ... ... ... 2 ... 1 4 3 2 ... ... ... 12 7 5 _Lung disease_, &c. 14 2 2 ... ... 2 1 1 11 3 4 1 ... 18 41 32 9 _Order_ 4.—DIGESTIVE ORGANS. Gastritis ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... 2 1 1 Enteritis 7 1 ... 1 1 3 1 1 2 2 ... ... ... 8 19 16 3 Peritonitis 3 ... ... 4 1 4 2 1 2 2 1 ... ... 3 20 18 2 Ascites ... ... ... ... ... ... ... 1 2 ... ... ... ... ... 2 1 1 Ulceration of ... 1 ... ... ... ... 2 3 3 ... ... 1 ... 8 19 16 3 Intestines Hernia ... ... ... ... ... ... ... ... ... 1 ... ... ... 3 20 18 2 Ileus ... ... ... ... ... ... ... ... 2 1 ... ... ... ... 3 3 ... Intussusception 1 ... ... ... ... 1 ... ... ... ... ... ... ... 1 8 5 3 Stricture of ... ... ... ... ... ... ... ... ... ... 2 ... ... ... 2 1 1 Intestines Fistula ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... _Stomach Disease_, ... ... ... ... ... 1 ... ... 5 2 ... ... ... ... 8 6 2 &c. _Pancreas Disease_, ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... &c. Hepatitis ... ... ... 1 ... 1 1 1 ... ... ... ... ... ... 5 4 1 Jaundice 3 ... ... ... ... ... ... 3 ... ... ... ... ... 3 7 6 1 _Liver Disease_, 2 ... ... ... 2 1 6 9 6 7 2 2 ... 2 37 30 7 &c. _Spleen Disease_, ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 &c. _Order_ 5.—URINARY DISEASES. Nephritis ... ... 1 ... ... 1 1 ... ... ... ... ... ... 1 3 2 1 Ischuria ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... 1 Blight’s Disease ... ... ... ... 1 2 3 5 4 5 2 ... ... ... 22 14 8 (Nephria) Diabetes ... ... ... ... ... ... ... 2 1 1 1 ... ... ... 5 4 1 Calculus (Stone) ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 1 ... Cystitis ... ... ... ... ... ... ... ... 1 5 1 ... ... ... 7 6 1 _Kidney disease_, ... ... ... ... 1 ... 3 3 3 1 1 ... ... ... 12 10 2 &c. _Order_ 6.—ORGANS OF GENERATION. Ovarian Dropsy ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 1 ... _Uterus Disease_, ... ... ... ... ... 1 ... 3 2 ... ... ... ... ... 6 4 2 &c. _Order_ 7.—ORGAN OF LOCOMOTION. Synovitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (Arthritis) _Joint Disease_, ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 ... &c. _Order_ 8.—INTEGUMENTARY SYSTEM. Phlegmon 2 ... 1 ... ... 1 ... 1 1 1 ... ... ... 3 7 7 ... Ulcer ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... 2 2 ... _Skin Disease_, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 242 66 52 21 27 54 75 121 152 180 129 22 4 360 1145 921 224 IV. DEVELOPMENTAL DISEASES. _Order_ 1.—DISEASES OF CHILDREN. Premature Birth 46 ... ... ... ... ... ... ... ... ... ... ... ... 46 46 35 11 Cyanosis 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 ... Spina Bifida ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Malformations 3 ... ... ... ... ... ... ... ... ... ... ... ... 3 3 1 2 Teething 25 19 ... ... ... ... ... ... ... ... ... ... ... 35 35 26 9 _Order_ 2.—DISEASES OF ADULTS. Paramenia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Childbirth (_see_ ... ... ... ... 4 6 4 ... ... ... ... ... ... ... 14 11 3 Puerperal fever) _Order_ 3.—DISEASES OF OLD PEOPLE. Old Age ... ... ... ... ... ... ... 1 1 14 43 31 4 ... 94 79 15 _Order_ 4.—DISEASES OF NUTRITION. Atrophy and 153 6 4 ... ... ... ... ... ... ... ... ... ... 163 163 143 20 Debility 228 16 4 „, 4 6 4 1 1 14 43 31 4 248 356 296 60 V. VIOLENT DEATHS, &c. _Order_ 1.—ACCIDENT OR NEGLIGENCE. Fractures and 1 ... ... 1 1 2 ... 2 2 1 ... ... ... 1 10 10 ... Contusions Wounds ... ... ... ... ... ... 1 1 ... ... ... ... ... ... 2 2 ... Burns and Scalds ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 1 1 ... Poison ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Drowning 1 ... 1 2 ... ... ... ... ... ... ... ... ... 2 4 3 1 Suffocation 17 ... ... ... ... ... ... ... ... ... ... ... ... 17 17 15 2 Otherwise ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... 1 _Order_ 3.—HOMICIDE. Murder and 4 ... ... ... ... ... ... ... ... ... ... ... ... 4 4 2 2 Manslaughter _Order_ 4.—SUICIDE. Wounds: Gunshot, 1 ... ... ... ... ... ... 2 1 ... ... ... ... 1 4 4 ... Cut, Stab Poison ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Drowning ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 ... Hanging ... ... ... ... ... ... ... 1 1 ... ... ... ... ... 2 2 ... Otherwise ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... _Order_ 5.—EXECUTION. Hanging ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Violent Deaths (not 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 2 2 ... classed) Sudden deaths 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 2 2 ... (cause unascertained) 28 ... 2 4 1 2 1 7 4 1 ... ... ... 30 50 44 6 _Causes not 8 6 6 ... ... ... ... ... ... ... ... ... ... 20 20 18 2 specified or ill defined_

TABLE IV.

Showing Mortality from certain classes of Diseases, and proportions to Population, and to 1,000 Deaths, 1874, viz.—

Diseases. Total Deaths. Deaths per 1000 Proportion of of Population. Deaths to 1000 Deaths. 1. Seven 388 2.8 144 Principal Zymotic Diseases 2. Pulmonary 554 4.0 208 (_other than Phthisis_) 3. Tubercular 326 2.3 121 4. Wasting 209 1.5 77 Diseases of Infants (_under_ 5). 5. Convulsive 161 1.1 59 Diseases of Infants (_under_ 5).

NOTES.

1. Includes Small Pox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Fever and Diarrhœa.

3. Includes Phthisis, Scrofula, Rickets, and Tabes.

4. Includes Marasmus, Atrophy, Debility, want of Breast Milk, and Premature Birth.

5. Includes Hydrocephalus, Infantile Meningitis, Convulsions and Teething.

TABLE V.

Showing the number of Deaths in the 10 years 1864–1873, from the seven principal Zymotic Diseases, and the number in 1874, &c.

Disease. 1864 1865 1866 1867 1868 1869 1870 1871 1872 1873 Annual Proportion 1874 Proportion Average 10 of Deaths of Deaths years, to 1000 to 1000 1864–1873. Deaths in Deaths in 10 years, 1874. 1864–1873. Smallpox 5 18 10 29 4 6 8 120 68 1 26.9 12.5 121 45 Measles 100 52 40 19 84 27 70 64 43 38 53.7 25.3 32 11.8 Scarlet 90 31 28 35 170 106 198 95 29 10 79.2 37.1 26 9.6 Fever Diphtheria Not separately registered. 9 14 11 14 11 5.9 2.7 Whooping 56 37 28 68 34 71 55 72 77 44 54.2 25.3 45 16.7 Cough Fever 60 77 33 46 52 42 46 48 42 41 48.7 22.8 52 19.3 Diarrhœa 63 104 112 78 113 108 154 129 110 145 111.6 52.3 112 41.6 TOTAL, 374 319 251 275 457 369 545 539 383 290 380.2 178.0 388 144 KENSINGTON TOTAL, 16,029 14,272 14,761 11,660 14,925 17,413 16,476 19,455 12,699 11,385 14,907 198 11,230 147 London. TOTAL. 1862 1863 1864 1865 1866 1867 1868 1869 1870 1871 1862–71 1872 1872 1872 England & Wales 1862–1871 {60} 73,220 98,490 96,279 92,030 82,692 72,587 97,352 90,380 100,497 103,801 90,732 188 91,743 188

TABLE VI.

Inspectors’ Report of the Sanitary Work completed in the year ended March 25th, 1875.

Sub-Districts. No. of No. of Houses Results of Inspection. House Drains. Privies and W.C.’s. Dust Bins. Water Supply. Miscellaneous.
Complaints and Premises,
received during &c., inspected.
the year.
Orders issued Houses and Houses Repaired, Trapped or Repaired, Supplied with New provided. New provided. Repaired, Cisterns (new) Cisterns No. of Lodging No. of Dust Removal of Removal of Regularly Inspected Other
for Sanitary Premises, &c., Disinfected Cleansed, &c. Ventilated. Cleansed, &c. Water. Covered, &c. erected. Cleansed, Houses Complaints accumulations of Animals Proceedings,
Amendments of Cleansed, after Infectious Repaired and registered under received and Dung, Stagnant improperly kept. _e.g._ Legal
Houses and Repaired and Diseases. Covered. 35th Clause of attended to. Water, Animal Proceedings.
Premises. Whitewashed. Sanitary Acts, and other
1866. {62} Refuse.
Bakehouses. Licensed Licensed
Cowhouses. Slaughterhouses.
North. 820 3229 818 567 40 207 76 163 69 .4 20 25 5 38 ... 2560 64 46 60 18 32 82
South. 662 4057 664 496 28 235 59 178 53 2 11 19 3 37 ... 3331 51 12 48 18 22 18
Total. 1482 7286 1477 1063 68 442 135 341 122 6 31 44 8 75 ... 5891 115 58 108 36 54 100

TABLE VIa.

Summary of Monthly Returns of Sanitary Work performed by the Inspectors.