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83 Public Bealth and Poor Law. LOCAL GOVERNMENT DEPARTMENT. REPORTS OF MEDICAL OFFICERS OF HEALTH. South Shields Urban District.-In commencing his report in 1886, Dr. Campbell Munro states that the mean death-rate for the borough during the decade which has just closed indicated an annual saving of lifa amounting to 31 per - 10,000 living, as compared with that of the previous decade. During 1886 the death-rate was 20’5 per 1000, and the deaths under one year only amounted to 134 on each 1000 ’registered births. As regards infectious diseases, the borough isolation hospital did excellent work, no less than 137 cases being admitted, and of these 120 were scarlatina patients. The deaths were only as 1 to every 17’1 cases admitted, a result which is especially satisfactory to Dr. Munro, who has taken upon himself the administrative charge of the institution without remuneration. A con- siderable part of the year has been devoted to improving the houses of the poor, and Dr. Munro says that the red- tapeism connected with action under McCullagh-Torrens’ Acts is such that he will never again resort to them, pre- ferring procedure under Section 97 of the Public Health Act. Satisfactory proceedings were taken in connexion with some Tyne alkali works; and as to milk pollution, such measures as were adopted were aimed, not against retailers, but against the more culpable wholesale dealers, and in every case the action was successful. Maidstone Urban District.—Mr. -Al. A. Adams, F.R.C,S., .gives the death-rate for the borough as 17’5 per 1000 during 1886. Scarlet fever was somewhat prevalent. Eighty-eight cases came under notice, and of these no less than fifty-eight were received into the new isolation hospital, as to which the report has only praise and satisfaction to record. In like manner 4795 articles were disinfected, this being done free of cost. The need for extending the public water service is shown by the fact that of three samples of well water analysed not one was fit for use, and it is stated that many remain which are highly dangerous. Amongst other improvements effected, we are glad to note the paving of courts and alleys, a proceeding sadly wanted in a vast number of our towns and cities. The year was one with- out special sanitary incident, but it was marked by steady progress in regard to hygiene. Marylebone.—Under the name of "Sanitary Chronicles" Mr. Wynter Blyth issues a monthly record of work in this parish, and these supply much of the information which ,goes to make up the annual record. During 1886 the birth- - rate was 25’6, and the death-rate 19 7 per 1000; the mean ’duration of life for the whole parish being 44’5 years. Con- siderable improvements as to dwelling accommodation are steadily in progress, artisans’ dwellings taking the place of insanitary property. So, also, the leases of great estates are falling in, and this involves extensive repairs or re-erections. Under the Sanitary Acts 2048 orders were issued during the year, and only sixteen owners were summoned for neglect. Amongst tenemented houses, 901 have now been put on the register, and it is believed that but few of the class of houses intended to be dealt with under the law as to houses let in lodgings now remain which are not under control. In 1200 instances extensive improvements in house drainage were effected during the year, and, speaking generally, a itarge amount of good work was done as the result of ] nuisance inspection. Liverpool Urban District.-One of the most satisfactory records contained in Dr. Stopford Taylor’s recent annual ( report is that relating to the mortality from "fever," which i since 1866, when typhus was largely prevalent, has fallen i ,,with fair annual regularity from 1523 deaths to 198. It is a .great pity that the deaths thus tabulated all appear under 1 the meaningless bead "fever," except as regards an epidemic f of relapsing fever in 1870-72; but this is, perhaps, to some 1 extent, brought about by the terms used in registering ( deaths. Thus, of the 198 "fever" deaths in 1886, 7 were said to be from gastric fever, 85 from typhoid, 48 from t enteric fever, 3 from continued fever, 1 from low fever, 47 c from typhus, 3 from fever, and 1 from relapsing fever. As a to typhus fever, the disease still clings to Liverpool, and we t regret to notice the continued practice of occupying cellar dwellings. Typhus will never be eradicated from Liverpool until much more has been done in improving the dwelling accommodation of the lower classes, and in securing ample means for isolating the disease. The beginning made in the latter direction is excellent in its way, but when we compare Liverpool and its present proposals, and Glasgow with hospital grounds of thirty acres in extent, we have greater hopes for Glasgow in the matter of typhus than we have for Liverpool. Peterborough Urban District.-Dr. Paley reports that of the cases of enteric fever which were not imported there was a definite local cause ascertainable in nearly every case. Such an experience should lead to increased energy in the matter of inspection, for the value of true sanitary work is mainly shown in the removal of these conditions before, and not after, preventable disease has been brought about. Privy nuisances are especially adverted to, and we have already commented on the question of refuse removal in connexion with the report of the inspector of nuisances. The annual death-rate for 1886 was 17 8 on the population for 1881 and 16 4 on the estimated present population. Peterborough Rural District.-In this rural area Dr. Paley records a death-rate of 14’5 per 1000, and be strongly endorses the advice given by Mr. Spear of the Local Government Board as to the need for scavenging and refuse removal by the authority themselves in the more populous parts of the district. He says that the question is rather one of organisation than of expense, and only needs the in- struction of the authority to carry it into effect. VITAL STATISTICS. HEALTH OF ENGLISH TOWNS. IN twenty-eight of the largest English towns 6114 births and 3207 deaths were registered during the week ending July 2nd. The annual rate of mortality in these towns, which had steadily declined in the preceding five weeks from 20’4 to 17’6, rose again last week to 18’1. During the thirteen weeks ending on the 2nd inst., the death-rate in these towns averaged 19’8 per 1000, and was 1’4 below the mean rate in the corresponding periods of the ten years 1877-86. The lowest rates in these towns last week were 9’4 in Derby, 12.5 in Portsmouth, 12’5 in Halifax, and 12. 9 in Sunderland. The rates in the other towns ranged upwards to 24 6 in Blackburn, 27 in Newcastle-upon-Tyne, 28’1 in Preston, and 29 2 in Manchester, The deaths referred to the principal zymotic diseases in the twenty-eight towns, which had been 489, 501, and 512 in the preceding three weeks, declined again last week to 486, notwith- standing the greater fatality of diarrhoea ; they included 156 from measles, 136 from whooping-cough, 110 from diarrhoea, 38 from scarlet fever, 22 from 11 fever" (principally enteric), 22 from diphtheria, and only two from small-pox. No death from any of these zymotic diseases was registered during the week in Derby or in Halifax; while they caused the greatest mortality in Manchester, Norwich, Birkenhead, and New- castle-upon-Tyne. The highest death-rates from measles occurred in Oldham, Huddersfield, Manchester, Norwich, Birkenhead, and Newcastle-upon-Tyne; from whooping- cough in Norwicb, Sheffield, Liverpool, Blackburn, and Nottingham ; and from scarlet fever in Bristol, Birken- head, and Blackburn. The 22 deaths from diphtheria in the twenty-eight towns included 13 in London and 2 in Manchester. Small-pox caused two deaths in Cardiff, but not one in Greater London or in any of the twenty-six other large provincial towns. The mortality from diarrhoea somewhat exceeded the average for the season. Only one case of small-pox was under treatment on Saturday last in the metropolitan hospitals receiving cases of this disease, no new case having been admitted during the week. The deaths referred to diseases of the respiratory organs in London, which had declined in the preceding five weeks from 333 to 184, rose again last week to 199, but were 21 below the corrected average. The causes of 65, or 2’1 per cent., of the deaths in the twenty-eight towns last week were not certified either by a registered medical prac- titioner or by a coroner. All the causes of death were duly certified in Portsmouth, Plymouth, Wolverhampton, and Derby. The largest proportions of uncertified deaths were registered in Salford, Sheffield, and Leicester.
