Acton Urban District Council. ANNUAL REPORT on the SANITARY CONDITION, &c., of the URBAN DISTRICT OF ACTON, For the Year, 1903 by G. A. GARRY SIMPSON, M.R.C.S., L.S.A., Fellow of the Royal Institute of Public Health. MEDICAL OFFICER OF HEALTH. Printed by Order of the Sanitary Authority. Act 11 Acton Urban District Council. on the SANITARY CONDITION, &c., of the URBAN DISTRICT OF ACTON, For the Year, 1903 by G. A. GARRY SIMPSON, M.R.C.S., L.S.A., Fellow of the Royal Institute of Public Health. MEDICAL OFFICER OF HEALTH. Printed by Order of the Sanitary Authority. CONTENTS. MEDICAL OFFICER OF HEALTH'S REPORT. Pages Acreage of District 8, 9 Abstract in Workshops 28 Birth Rate 8, 10 Bakehouses 26, 28 Bakehouses (Underground) 26 Causes and Ages at Death (Table giving) 12 Consumption or Phthisis 18 Cock and Crown Yard 29 Death Rate. 8, 9, 11, 13 Death Rates (General and Zymotic, Comparative Table) 13 Diphtheria 15, 19 Disinfection 19 Disinfector, Regulations as to 19, 20 Disinfector, (Steam) Regulations as to 21, 22, 23 Drainage 25 Dust Collection 25, 26 Enteric Fever 13, 15, 16, 17, 18 East Row 29 Employment of Children Act 33, 34 Factory and Workshop Act 26,27,28 Factory Inspectors Notices 27 General Remarks 4, 5 Golden Meadow Cottages 30 Homework 27 Housing of the Working Classes Acts 29, 30 Infantile Mortality 8, 9 Infectious Diseases Notified (Comparative Table) 15 Infectious Diseases Notified (Table Showing) 16 Laundries 26 Measles 12, 13, 18, 19 Mortuary 23 Narrow street 29 Office 7 Population 8, 9, 10 Phthisis or Consumption 18 Sanitary Committee 6 Sanitary Staff 7 Small Pox 15. 16, 17 Sick Nursing 23 Schools 23, 24, 25 Sewage 25 Scavenging of Roads 25 Steyne Road 29 Steyne, Plan showing 31 Table shewing Birth Rate, Death Rate, & Zymotic Death Hate in 14 Towns 11 Vital Statistics (Summary) 8 Vital Statistics (Table showing) 9 Ward Boundaries 7 Whooping Cough 18 Workshops 26, 27 28 Workshops (Closet accommodation) 26 27 Zymotic Diseases 15 SANITARY INSPECTOR'S REPORT. Pages Bakehouses 40 Common Lodging Houses 41 Cowsheds 40 Drainage Examinations 39 Dairies 40 Food and Drugs Acts 40 General Remarks 35, 36 Inspections, &c 37 Meat and other Foods (inspection of) 30, 40 Milkshops 40 Notices 39 Prosecutions 39 Piggeries 41 Sanitary Improvements (List of) 37, 38, 39 Slaughterhouses 40 Smoke Abatement 41 Acton Urban District Council. Annual Report of the Medical Officer. For the year ending just December, 1903. To the Chairman and Members of the Urban District Council. Gentlemen, I beg to submit my tenth Annual Report, concerning the health and Sanitary Conditions of your town. During July and August we experienced a succession of severe rainstorms, which not only cooled the air and prevented the dissemination of dust, but scoured the streets and sewers. It is unfortunate that a wet Summer—which to most people is a source of sorrow and regret—should to Medical Officers of Health, be the occasion for rejoicing, for with a cool Summer the Infantile mortality is lowered. In consequence I have to report a marked decrease in the General Death Rate, the Infantile Death Rate and the Zymotic Death Rate. I think we are exceptionally fortunate with such a large number of children to have a Zymotic Death Rate of 1 per 1000 and I question whether any district with a population comparable to our own could shew such figures. I would also draw your attention to the fact that there has not been a single death from measles. The Acton Improvement Bill which will shortly be submitted 5 to Parliament contains many sanitary reforms which will be of lasting benefit to the Town. The building of the Isolation Hospital is progressing, and will probably be finished during the present year; the same remarks apply to the Baths. The Board Schools are now under your supervision, and I have made some very important suggestions in the report which I trust will receive your earnest consideration. Certain changes in the Staff of my department have taken place. Mr. Fraser whose work was most satisfactory has been appointed Sanitary Inspector to the Northfleet Urban District Council, Kent, and Mr. Ernest J. Gough, has taken his place. The appointment of Miss L. Bulkeley Williams, as a Lady Health Visitor, will be of the greatest help and benefit to the Town. In the tables, dealing with the Vital Statistics you will notice the great increase in the number of inhabited houses and the population. The work of my department has been carried out to my complete satisfaction and I take this opportunity of thanking the Council for their kind help and advice in many important matters. I am greatly indebted to Mr. Kinch for his able assistance and support; and from his report which I append it will be seen that he has done good service in the Town. I am Gentlemen, Your obedient Servant, G. A. GARRY SIMPSON. 6 Public Health Committee. Mr. R. AINSLEY (Chairman) „ E. B. ATHAWES. „ F. A. BALDWIN. „ R. BARNES. „ J. W. BULLEN. „ J. DE LARA COHEN. „ D. P. CRONIN. „ S. GOODHALL. „ E. F. HUNT. „ J. W. JARRATT, J.P. „ A. W. W. KING, J.P. „ F. T. W. MILLER. „ T. H. MORRIS. „ E. MONSON. „ R. POULTON. 7 SANITARY STAFF. G. A. Garry Simpson, Medical Officer of Health M. R. C. S., F. R. I. P. H. M. W. Kinch, Cert. San. Inst. Chief Sanitary Inspector (London.) Assistant Sanitary Inspector Ernest J. Gough, Cert. San. Inst. Miss L. Bulkeley Williams. Lady Health Visitor Cert. San. Insp. (London) Clerk Lewis Bradford. Disinfector F. King. E. Bevan, 4 New Court, County Analyst Lincoln's Inn, W.C. County Inspector under Food and W. Tyler, Town Hall, Drugs Acts Brentford. County Dr. Gordon Hogg South Parada, Bedford Park. The Office of the Health Department is at Gothic Villa, Mill Hill Grove. I attend daily at 9.30 a.m., and may be consulted on all matters connected with the health of the District. Should an urgent matter require immediate attention after office hours, or on Sundays, I can be interviewed at my private residence— Bardon House, East Acton. WARD BOUNDARIES. North Ward.—All north of centre of High Street. West Ward.—South of centre of High Street from Birch Grove to Railway Bridge, High Street, and west of centre of North London Railway, from Railway Bridge, High Street, to Bollo Lane. East Ward.—South of centre of Uxbridge Road, from Railway Bridge, High Street, to Wilton Road, and East of North London Railway from Railway Bridge, High Street, to Bollo Lane. 8 VITAL STATISTICS. SUMMARY. Area of District 2,304 acres Rateable Value £277,153 Net Value of a Penny Rate £856.11s Population at middle of last year 49,680 Population in 1901 Census 37,744 Persons per acre in the District 21.5 Average number of persons per house 1901 census 6.. Death Rate 1903 8.6 Average Death Rate for previous ten years 14.7 Zymotic Death Rate 1903 1.0 Average Death Rate for previous ten years 2.6 Biith Rate 1903 28.6 Average Birth Rate for previous ten years 30.4 Infant Death Rate (under one year old) per thousand births 1903 105.4 Infant Death Rate Average for previous ten years per 1,000 births 174.3 VITAL STATISTICS. The Following Table gives the Vital Statistics of the whole District during 1903 and previous years:— 9 VITAL STATISTICS OF WHOLE DISTRICT DURING 1903 AND PREVIOUS YEARS. Year Population estimated to Middle of each Year. Births. Total Deaths Registered in tub District. Total Deaths in Public Institutions in the District. Deaths of Nonresidents Registered in Public Institutions in the District. Deaths of Residents Registered in Public Institutions beyond the District. Next Deaths at all Ages belonging to the District. Number Rate* Under 1 Year of Age. At All Ages Number Rate per 1,000 Births registered Number Rate* Number Rate* 1893 26,000 831 31.9 160 192.0 451 17. 3 ... ... 35 486 18.6 1894 27,600 834 30.2 133 159.0 368 13.3 ... ... 25 393 14. 2 1895 27,648 874 31.6 147 168.1 445 16.1 ... ... 33 478 17.2 1896 29.454 894 30.3 151 168.9 435 14.7 ... ... 29 464 15. 7 1897 31,632 973 30.7 193 198.3 470 14.8 ... ... 33 503 15.9 1898 32,562 995 30.5 181 181.9 507 15.5 ... ... 10 517 15.8 1899 33,684 1,068 31.7 200 187.2 509 15.1 ... ... ... 509 15.1 1900 38,406 1,080 28.1 182 168.5 528 13.7 15 ... ... 528 13.7 1901 37,744 1,211 32.0 206 170.1 519 13.7 6 ... ... 519 13.7 1902 44,565 1,242 27.8 186 149.8 593 13.3 12 ... 6 599 13.4 Averages for years 1893-1902 32,929 1,000 30.4 173 174.3 482 14.7 ... ... 17 499 15.3 1903 49,680 1,422 28.6 150 105.4 430 8.6 8 ... ... 430 8.6 *Calculated per 1,000 of estimated population. Total population as per Census 1901—All ages 37,744. Number of inhabited houses 6,114. Average Number of persons per house, 61. Area of District in acres (exclusive of area covered by water), 2,304. 10 Population.—The population calculated to the middle of 1903 was 49,680, an increase of 5,115 in twelve months. The number of inhabited houses was 8,240 and uninhabited 240 The following table shews the population and the number of the inhabited houses at the five preceding censuses. Year Inhabited Houses Population 1861 610 3,151 1871 1,568 8,306 1881 2,844 17,110 1891 4,084 24,207 1901 6,114 37,744 In making my calculations I allow six persons to each occupied house, and one for each unoccupied house. The census of 1901 shewed the average to be 6., per house. This method of calculating the population is the one adopted by previous Medical Officers for the District. Birth Rate.—During the year 1903 there were 1,422 births registered. The birth rate per 1,000 persons living was 28,6. The London birth rate was 28,5 The following table shews the births since 1893:— Year. Number of Births. 1893 831 1894 834 1895 874 1896 894 1897 973 1898 995 1899 1,068 1900 1,080 1901 1,211 1902 1,242 1903 1,422 11 DEATH RATE. General mortality.—There were 430 deaths registered. The recorded general death rate was 8.6 per 1,000 of the population. The London death rate was 15.2 The death rates since 1893 are as follows:— 1893 18.6 1894 14.2 1895 17.2 1896 15.7 1897 15.9 1898 15.8 1899 15.1 1900 13.7 1901 13.7 1902 13.4 1903 8.6 This is the lowest death rate on record and is highly satisfactory. It will be noticed that the recorded general death rate has been gradually falling for the last seven years. The following Table gives the Birth rate, Death rate, and Zymotic death rate per 1,000 per annum in the undermentioned 14 towns. Birth Rate Death Rate Zymotic Death Rate ACTON 28.6 8.6 1.0 Ealing 23.07 10.2 1.46 Chiswick 28.90 10.45 1.4 Brentford 31.6 12.9 1.5 Willesden 32.0 12.1 1.97 Reading 27.0 12.7 0.94 Ipswich 28.3 15.2 1.41 Hornsey 20.3 7.9 0.68 Tottenham 32.3 13.0 1.90 West Ham 33.7 15.3 2.65 East Ham 34.5 11.0 1.62 Leyton 30.6 10.8 1.64 Walthamstow 33.2 11.2 1.91 Croydon 46.3 11.8 1.08 12 The following table gives the causes of and ages at deathduring the year 1903. CAUSES OF, AND AGES AT DEATH DURING YEAR 1903. Causes or Death Deaths in or belonging to whole District at subjoined Ages. Deaths in or belonging to localities at all ages Total Deaths in Public Institutions in the District All Ages Under 1 year. 1 and under 6 6 and under 15 15 and under 25 25 and under 65 65 and upwards North Ward West Ward East Ward Small Pox ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 2 1 ... 1 ... ... ... 1 1 ... ... Whooping Cough 20 14 5 1 ... ... ... 2 5 13 ... Diphtheria & Membranous Croup 2 ... 1 1 ... ... ... 2 ... ... ... Croup 1 ... 1 ... ... ... ... ... 1 ... ... Fever— Typhus ... ... ... ... ... ... ... ... ... ... ... Enteric 5 1 ... ... 2 2 ... 2 2 1 1 Other continued ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 5 ... 1 1 ... 2 1 1 4 ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... Diarrhoea 21 16 4 ... ... ... 1 ... 11 .10 ... Enteritis 14 10 3 ... ... 1 ... 2 4 8 ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... Erysipelas 3 1 ... ... ... 1 1 1 1 1 ... Other Septic Diseases ... ... ... ... ... ... ... ... ... ... ... Phthisis 18 .. 1 I 4 11 I 2 13 3 ... Other Tubercular Diseases 14 4 4 ... 2 4 ... .1 3 10 ... Cancer, Malignant Disease 18 1 ... ... ... l6 I 8 2 8 ... Bronchitis 35 10 5 .. .. 7 11 4 21 10 1 Pneumonia 30 13 8 3 ... 5 1 5 16 9 2 Pleurisy 1 ... ... ... ... 1 ... ... 1 ... ... Other Diseases of Respiratory Organs 3 1 ... ... ... 1 1 2 ... 1 ... Alcoholism — Cirrhosis of Liver 9 ... ... ... ... 9 ... 1 4 2 ... Venereal Diseases ... ... ... ... ... ... ... ... ... ... ... Premature Birth 21 21 ... ... ... ... ... 2 11 8 ... Diseases and Accidents of Parturition ... ... ... ... ... ... ... ... ... ... ... Heart Diseases 55 1 1 3 ... 29 21 21 13 21 4 Accidents 6 2 ... ... 1 3 ... 2 ... 4 ... Suicides 1 ... ... ... ... 1 ... ... ... 1 ... All other causes 146 54 9 3 8 31 41 14 58 48 •• All causes 430 150 43 14 17 IS4 82 101 171 158 8 13 In the following table the death rate and Zymotic death rate are so arranged that comparison can be made for the preceding ten years:— 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 Small Pox ... ... ... ... ... ... ... ... ... 6 ... Measles a 15 6 24 2 6 ... 16 ... 32 ... Scarlet Fever 10 3 3 1 ... 3 2 6 2 1 2 Diphtheria 2 5 5 8 28 8 7 4 6 4 2 Whooping Cough 5 17 5 21 ... 10 14 4 16 13 20 Typhoid Fever 4 2 2 2 2 ... 7 4 1 4 5 Diarrhoea and Dysentery 60 17 44 37 80 50 56 50 69 23 21 Puerperal Fever 6 4 2 ... ... 1 ... 1 ... ... ... Total Number of Deaths from seven Zymotic Diseases 89 63 67 93 130 78 86 85 94 83 50 Deaths from other Causes 396 330 411 371 373 439 423 443 425 516 380 Total Deaths 486 393 478 464 503 517 509 528 519 599 430 Death Rate from seven Zymotic Diseases per 1,000 3.4 2.2 2.4 3.1 4.1 2.3 2.5 2.2 2.4 1.8 1.0 Death Rate from other causes per 1,000 15.2 12.0 14.8 12.6 11.8 13.5 12.6 11.5 11.3 11.6 7.6 General Death Rate per 1,000 186 14.2 17.2 15.7 15.9 15.8 15.1 13.7 13.7 13.4 8.6 The London Zymotic death rate for 1903 was 176 14 INFANTILE MORTALITY. There were 150 deaths registered of Infants under one year of age, as against 1,422 births ; the proportion which the deaths under one year of age bear to 1,000 births is therefore 105.4 as against 149.8 in the preceding year. The following table compares the death rate of children under one year per 1,000 registered births, and the birth-rate for the preceding ten years:— Year. Birth Rate per 1,000 Deaths of Children under one year per 1,000 Registered Births 1893 31.9 192.5 1894 30.2 160.6 1895 31.6 168.1 1896 30.3 168.9 1897 30.7 198.3 1898 30.5 181.9 1899 31.7 187.2 1900 28.1 168.5 1901 32.0 170.1 1902 27.8 149.8 1903 28.6 105.4 This low Infant Mortality is due to the diminished number of deaths from Zymotic Diarrhoea. The heavy rainfall during the summer months washed and purified the air, and laid the dust of the streets. This dust frequently contains micro-organisms, which cause Zymotic or Infantile Diarrhcea. It shows how important it is to keep the roads well watered during hot and dry weather, and the food properly protected from dust and germs. In the bill which will be presently before Parliament, provision is made for the establishment of a Creche, such an institution will materially help to diminish the Infant Mortality. I also look for great help from Miss Williams, our Lady Help Visitor, who will instruct the mothers as to the care and feeding of their offspring. 15 Any poor mothers who are not in a position to pay for medical attendance, and require advice as to suitable food to give their Infants, can apply at the Health Office any morning at 9.30 a.m., when every assistance will be given. Miss Williams will also visit the case and personally superintend the preparation of the food. I shall be greatly obliged if the Medical Practitioners in the district will kindly inform me of any case of improper feeding where Miss Williams' supervision will be of use. ZYMOTIC DISEASES. The number of cases notified during the year, excluding Chicken Pox, was 167 against 215 in the preceding year. Cne hundred and forty four cases of Chicken Pox were notified, against one hundred and eighty three in 1902. The following table gives the number reported during the preceding ten years:— 1893 1894 1895 1896 1897 1898 1899 1900 1901 1903 1908 Small Pox 7 a ... ... ... ... ... 2 1 31 1 Scarlet Fever 192 86 67 193 93 167 111 243 82 109 76 Diphtheria 41 22 32 23 89 35 49 28 34 33 22 Membranous Croup 1 ... ... ... 4 ... ... 1 1 3 1 Typhoid Fever 19 15 28 14 10 9 ... 19 27 14 40 Continued „ 1 ... ... ... ... ... ... 2 ... ... ... Puerperal ,, 2 1 3 3 ... 1 ... ... 1 1 ... Erysipelas 77 41 31 16 15 21 31 28 26 24 27 Totals 340 167 161 259 221 234 239 333 172 215 168 I personally visited all cases of Chicken Pox immediately on receipt of notifications. 16 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1903. Notifiable Disease. Cases Notified in Whole District, Total Cases notified in each Locality. At all Ages At Ages—Years. North Ward West Ward East Ward Under 1 1 to 6. 6 to 16 15 to 25 25 to 66 66 and upwards Small Pox 1 ... ... 1 ... ... ... ... 1 ... Cholera ... ... ... ... ... ... ... ... ... ... Diphtheria 22 ... 7 9 2 4 .. 9 5 8 Membranous Croup 2 ... 2 ... ... ... ... ... 2 ... Erysipelas 27 1 1 2 1 19 3 10 10 7 Scarlet Fever 76 1 21 41 8 5 ... 16 26 34 Typhus Fever ... ... ... ... ... ... ... ... ... ... Enteric Fever 40 ... 2 12 14 12 ... 11 8 21 Relapsing Fever ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... Chicken Pox 144 11 67 63 2 1 ... 9 66 69 Totals 312 13 100 128 27 41 3 55 118 139 17 Small Post.—One case of Small Pox occurred in July, a young girl residing in Shaftesbury Road. She was removed to South Mimms Hospital, and all contacts vaccinated and kept under observation with satisfactory results, as the disease did not spread. The difficulty of dealing with contacts and the great necessity of keeping a close observation of their movements may be gathered from the fact that after the premises in Shaftesbury Road had been disinfected, some of the inmates again visited a case of Small Pox in Ealing, and the disinfection had to be done over again. Enteric Fever.—Forty cases were notified during the year, and five of these proved fatal. At one time a serious outbreak was threatened, for no less than eleven cases were notified in two days, eight of the eleven patients had consumed the milk of a certain dairy. In one case a patient had taken two glasses from the suspected milk some fourteen days before being attacked, at home she and her relatives were supplied from another dairy. Although it was impossible to prove absolutely that the suspected dairy was at fault, yet the inference was very suspicous and I immediately stopped the supply of milk from this source in my district, except in a pasteurized form, viz., heated to 150° Far. The result of my action proved successful in arresting what would probably have been a severe epidemic. I take this opportunity of laying stress on the importance of always boiling or pasteurizing milk for dangers of contamination are very numerous, however stringent the regulations may be. One case of Enteric was probably caused by sewage contaminated shell fish. Probably shellfish, viz., oysters, cockles, mussels and whelks have played a very large, if not a leading part in the general incidence of enteric fever in this country. In sea coast towns they are probably the main source of Typhoid Fever, though this is not even yet generally acknowledged. Enteric Fever shows a slight tendency to increase all over the country, and this regardless of the fact that more care than ever is taken to guard our water and milk supplies. The reason in my opinion is that in this country we have not 18 given the same attention to the maxims of cleanliness as regards other forms of food as we have given to preserving our water and milk supplies from pollution. PHTHISIS OR CONSUMPTION. There were eighteen deaths due to phthisis and 14 to other tubercular diseases, as against 43 and 15 respectively in 1902. I have examined the sputum in 15 suspicious cases, the tubercular bacillus was found in 3 specimens. The movement on foot to provide an open air sanatorium for Middlesex should receive the {support of every ratepayer. If the disease is recognised in the early stages, which can be done by a bacteriological examination of the sputum," and the patient sent to undergo the open air treatment at a sanatorium, a cure is invariably brought about. WHOOPING COUGH. There were 20 deaths from this disease, mostly children under one year of age. Lung complications in nearly every case was the immediate cause of death. I trust that the leaflet which is now freely circulated will assist in educating the poorer classes as to the necessity of isolation, and taking better care of their children. At present many poor people have all sorts of absurd ideas as to how to treat a child suffering from Whooping Cough. MEASLES. As a contrast to the above disease there was not a single death from measles. I fully believe that the poor classes in my district at last understand the importance of taking proper care of their children when suffering from this complaint. Measles is rarely fatal if lung complications are avoided, this is to be done by keeping the child warm and avoiding chills. A leaflet has now been in circulation for some years and I 19 believe it has had something to do with this satisfactory result. With so many children in the district it is very satisfactory to be able to submit such a favourable report, DIPHTHERIA. There were two deaths from this disease. Unfortunately medical advice was sought too late for the Diphtheria Antitoxin to be of service. Parents should send at once for medical advice, if any of their children are suffering from sore throats, and not wait for developments. If injected early Antitoxin will cut short this terrible disease and save the patient's life, and other inmates will be saved from catching the complaint if they are given a prophylactic dose. I beg to remind the general practitioners in this district that I keep a supply of Antitoxin from the Jenner Institute, which can be had at any time of the day or night by applying at my private residence free of charge to necessitous cases. The Prophylactic dose is I.c.c. or about 16 mims. We have had ample proof of the extreme value of this means of prevention. All those who have come in contact with a patient should be given a dose; no harm can result. I gave further evidence of the value of the prophylactic dose in my annual report of 1902. DISINFECTION. The exceptionally low zymotic death rate, and the diminished number of notifications received testify, to the satisfactory manner in which disinfection has been carried out; but one cannot be too strict in this important work, and I have drawn up the following instructions to be observed by the Disinfectors. FUMIGATION, &c., OF INFECTED ROOMS & PREMISES. Regulations to be observed by Disinfector. Disinfeetor to caear Overall—Before going into an infected room the Disinfector shall put on the mackintosh overall provided for the purpose. This must be kept on during the whole time he is disinfecting the room or rooms. Upon leaving an infected room the overall must be removed, sponged off, and he must wash his 20 hands in disinfectant. He must do everything possible to avoid bringing the infection from an infected room to other parts of the house. This applies also to any helper that may be employed to assist in the work. Sealing ap of rooms—All windows, crevices, fireplaces and doors (except exit door) must be sealed up with gummed strips provided for the purpose. Note :—Before proceeding to do this he must at once if he finds any textile articles that have not been removed as required by the regulations for the Steam Disinfector Attendant, report the facts to the Sanitary Inspector, and take his instructions thereon. Spraying.—After sealing up (exit door excepted), the ceiling walls, floor and all articles must be sprayed with the sprayer provided for the purpose with a solution of formalin as directed. Fumigation.—The fumigating lamps, candles or cylinders, containing the fumigating gases are to be placed on the floor of the room in such a position as to avoid any possible chance of causing damage to any articles near by, or so as to cause fire. He must use the number of lamps, candles or cylinders as directed for each room. Lieai/lng Infected room.—After lighting the lamps, candles or cylinders, and being satisfied as to their safety, he must immediately leave the room and lock and seal up the door upon the outside and leave a Notice with the occupier, also the key, (or in the event of no one being in the house, affix same to the door of infected room) setting forth the time when it may be opened &c. Such Notice must not be timed so as to allow any room to be opened until four hours have elapsed after sealing ; but a longer time must be allowed when possible. Persons objecting to Disinfection—Should the person in charge of the premises object to disinfection being carried out, the Disinfector shall not proceed with the work, or use any threats to such person with a view to getting their consent to disinfect, but shall at once report the facts to the Sanitary Inspector and take his instructions thereon. 21 Care to be taken.—Every care must be taken not to damage or injure any articles or break any windows, on the premises. The Disinfector will be held liable to replace the same if the damage is caused by him. Aets of Negligence op Carelessness—These instructions must be strictly adhered to, as the Disinfector will be answerable to the Council for all complaints of negligence or carelessness. The Council may dismiss him if satisfied that all due care has not been exercised in carrying out this work. By order, G. A. Garry Simpson, June, 1903. Medical Officer of Health. STEAM DISINFECTION OF TEXTILE ARTICLES. Regulations to be observed by Steam Disinfector Attendant. Attendant to wear Overall—Before going into an infected room the attendant shall put on the mackintosh overall provided for the purpose. He shall also put it on at the disinfector before taking the bedding &c., out of the van. Before going into No. 2 side to remove the articles from the disinfector it must be removed, sponged off, and he must wash his hands in disinfectant. He must do everything possible to avoid re-infecting the articles after being steamed. This applies also to any helper who may be employed to assist him in the work. Removal of Bedding, &c.—The Disinfector Attendant upon receiving an Order from the Health Department to remove and Steam Disinfect all Textile Articles, &c., must proceed to the house named in the Order at once, with the necessary bags and van and remove and Steam Disinfect the following articles—all Bedding, viz., Quilts, Counterpanes, Sheets, Blankets, Pillows, Pillow Cases, Bolsters, Bolster Cases, Feather or Flock Beds, Paliassesand all Bed Hangings; Carpets, Mats, Curtains, Valances, Cushions, Shawls, Towels, Table and Toilet Covers, Box Coverings, Drapings all Wearing Apparel, Books, Toys, &c., and any other textile articles that may have become infected. 22 Every care must be exercised in their removal so as not to damage any of the articles. Removal of Clothing—Any articles of Wearing Apparel must not be put into the bags containing Bedding, but must be put into a separate bag or bags. Valuable and clean articles must not be mixed with dirty ones. Disinfection of Bedding— Upon arrival at the Disinfector No. 1 side the Bedding can be passed through the Apparatus in the bags, but must be taken out of the bags after being disinfected and spread out or hung on lines for at least half an hour to air. Every precaution must be taken to keep the things clean. All articles capable of being folded such as sheets and blankets, must be carefully folded after being thoroughly aired. These must not be returned in the bags but laid carefully into the baskets provided for the purpose and taken back in same. Disinfection of Clothing.—Articles of clothing must not be disinfected in the bags, but must be taken out and hung up on hooks provided to the cradle for the purpose. Care must be taken to see that they are not put in creased. After passing through the apparatus they must be shaken out and carefully hung up until thoroughly aired (half an hour must be allowed for this), then they are to be folded up and returned in the baskets provided for the purpose. Returning Articles.—Upon returning to the house with the disinfected articles, they must be taken to any room where directed, carefully taken out, and a receipt signed by the person receiving same. This receipt must be left at the Health Department as early as practical. Persons objecting to the removal of Articles.— Should the person in charge of the premises object to the removal of any Bedding, &c., the Attendant shall not use any threats to such person with a view to getting their consent to remove same, but shall at once report the facts to the Sanitary Inspector and take his instructions thereon. 23 Rets of Negligence of Carelessness—These instructions must be strictly adhered to, as the Attendant will be responsible for any damage, and answerable to the Council, for all complaints of negligence or carelessness. The Council may dismiss him if satisfied that all due care has not been exercised in carrying out this work. By order, G. A. Garry Simpson, June 1903. Medical Officer of Health. SICK NURSING. The Nurses in connection with our Cottage Hospital have had under treatment 1213 patients, and paid 9674 visits, an average of 7.9 to each patient. Excellent work is done by these ladies, whose skill and sympathy is greatly appreciated. MORTUARY. During the year 29 bodies were received into the Mortuary, viz., 16 Males and 13 Females. Post-Mortems were made in 23 cases. The following list gives number received each month— January 4 cases March 2 „ April 2 ,, May 5 ,, July 2 ,, August 1 „ September 2 ,, October 2 „ November 8 „ December 1 ,, THE COUNCIL'S SCHOOLS. As the Schools are now under your supervision, I beg to draw your attention to the following very important facts. Amongst the large number of children attending the various 24 schools, a certain proportion if examined will be found to be suffering from myopia or short sight. If this condition is allowed to continue without proper treatment, subsequent changes take place in the eye which leads to destruction of the sight, children so suffering are frequently supposed to be stupid, when in reality they cannot see properly, Moreover they constantly suffer from headache. Again a certain proportion of children will be found to be deaf; these scholars are frequently accused of inattention and punished wrongfully. This deafness in many cases is due to throat and nose troubles. If these cases are taken in hand and suitably treated, the hearing power is restored, and permanent damage prevented. In Germany the schools are periodically visited by the Medical Officer of Health with the object of detecting the above serious defects, and also weeding out children which for other reasons are not in a fit state of health to attend school. I will ask you in considering this report to give this matter your very serious consideration, and I am prepared to make a suggestion which I think will be agreeable to you. The following cards I have supplied to each Teacher and School Attendance Officer for them to fill in whenever a child is kept away from school for 'personal illness, or illness of others in the house. Upon receiving these cards Miss Williams our Health Visitor will call at the house and obtain full particulars. SCHOOL NOTIFICATION CARD To be filled in by school authorities. School Dept. Disease Name Age Sex Address Class Child Excluded Date For Personal Illness For Illness of others in House Teacher Attendance Officer. Date 25 HEALTH VISITOR'S OBSERVATIONS. Disease No. Date of Visit Card left Is disease being treated ? Dr. Milk If boiled Date of Onset Date of Rash Isolation attempted Sep. Room Suspected Cause Probable date Sunday School Disinfection Actual Other schools by inmates School notified (Signed' SEWERAGE AND DRAINAGE. The bacterial treatment at the Sewage Works, Warple Way, is proceeding satisfactorily, and is carried out with a minimum amount of nuisance considering that 900,000 gallons are treated every day. The presence of sulphuretted hydrogen is apparent in the immediate vicinity of the filters, but it is rarely noticeable outside the works. A nuisance was caused by the burning of slag in a field east of the works, and this gave rise to an erroneous opinion that the smell came from the works. The Surveyor has modified the filters, so as to diminish to the utmost any rippling in the effluent and in consequence far less Sulphuretted Hydrogen is set free than was the case a year ago. Considering the rapid growth of the district, provision will probably have to be made for larger septic tanks and filters in the near future ; and for the same reason our main sewers will have to be enlarged or new ones laid. DUST COLLECTION AND SCAVENGING OF ROADS. The dust collection is now carried out promptly, and there are fewer complaints as to the non-removal of dustbin refuse. The roads are well kept and swept. I think, however there should be less delay in the making up of new roads. Creffield Road has been in a deplorable state for a long time, and it is very inconvenient to those residing in the immediate neighbourhood. 26 It is just ten years since I first drew attention to the need of a Refuse Destructor and I must respectfully beg that the Council will lose no further time in having one erected. Although probably the organic matter in the dust bin refuse is rendered inert in 3 or 4 years, yet during the process of nitrification noxious fumes and gasses are given off, and moreover in the hot weather the residents in the immediate neighbourhood of the shoot are pestered with flies. FACTORY AND WORKSHOP ACT, 1901. As required by Section 132 of the above Act, I beg to report on or the administration of the same in this District during the year. There are 338 Workshops on the Register, but this as I mentioned last year is not all, as we are constantly finding out premises which come under the Act, the occupier having failed to report himself or herself. When Classified, there are 250 Laundries, 26 Bakehouses, and 62 other Workshops. These include tenement and domestic Workshops but not Domestic Factories or Workplaces. Personally I have made 73 inspections, and the Sanitary Inspectors 305. It will be noticed that the Laundry Industry comprises the chief business of the Workshops. As to the sanitation of these premises, which embraces cleanliness, air space, ventilation, and drainage, I must say it is very good on the whole, very few Notices having to be served, and no prosecutions have been necessary. Of the 26 Bakehouses on the Register 8 are underground. It has been necessary to serve Notices on the occupiers of some of these premises as to sanitary defects, all the premises have been regularly whitewashed twice yearly as prescribed by the Act, and visited 95 times by the Sanitary Inspectors. Under Section 22 of the Public Health Act AmendmentAct, 1890 which relates to W.C. accommodation in Factories and Workshops, one closet for persons of either sex has been provided, and no prosecutions have been necessary to enforce the provisions of this section. 27 As to the means of escape in case of Fire from premises coming under this Act I am not called upon to report. With reference to Sections 107 to 115, which deal with Homework, I beg to report that the total number of lists received during the year were 88 as against 32 last year, representing 86 employers, 24 contractors, and 131 out-workers. Under the Act, employers or contractors giving out Home-Work are required to send a list of all persons employed by them to do such Home-Work to the District Council twice a year, viz., on or before the 1st of February and on or before the 1st of August. The sending in of these lists only refers to persons giving out work connected with the following trades, viz.— The making, cleaning, washing, altering, ornamenting, finishing, repairing of wearing apparel, and any work incidental thereto. The making, ornamenting, mending and finishing of lace curtains and nets. Cabinet and furniture making and upholstery work. The making of electro plate. The making of files. Fur pulling. These lists are of great assistance, and are always referred to upon the receipt of a notification of Infectious Disease. They also enable us to inspect the out workers home and to see that the premises are wholesome and fit for the purpose used. Nine notices have been received from H.M. Inspectors of Factories, dealing principally with defective closets, insufficient closet accommodation for persons of either sex, defective wash-house floors, dirty walls, and inefficient ventilation to work rooms. Immediately on receipt of these notices the Sanitary Inspectors visit the premises to which they relate, and make a thorough inspection of the drains and sanitary appliances. Notices are served on the Owner or Occupier to abate the nuisance complained of, and when this has been done the Factory Inspector is at once informed, as required by Section 5. Under this section also one month is allowed to abate the nuisance, and if the Council do not take action to enforce abatement, the Home Office may take 28 ceedings, and any expense incurred in so doing shall be charged to the Council. Twelve notices were sent to H.M. Factory Inspector re Workshops not having the prescribed Abstract affixed, under Section 133. Each year there is an improvement in the condition of the Laundries, but I hope for still further improvement. Section 101 of the above Act states that after the first of January 1904, an underground Bakehouse shall not be used unless certified by the District Council to be suitable for that purpose. In my Annual Report of 1902 I drew up certain model recommendations for making them sanitary. A sub-committee was appointed, and after visiting the bakehouses it was recognised that important alterations were necessary. At a subsequent meeting of the Council, it was left to me to press for such alterations as I thought necessary. I am pleased to state that in every case the work has been carried out entirely to my satisfaction and I take this opportunity of informing the ratepayers that they can rest assured that their bread is now made under the most perfect sanitary surroundings. The work naturally necessitated frequent visits and inspections and some difficulty in securing efficient ventilation, but finally all obstacles were overcome to my complete satisfaction. I beg to thank the Sanitary Committee, the Surveyor, and Assistant Surveyor for their kind help, and also the owners themselves for their hearty co-operation. Certificates have been given to the following:— Mr. Beauchamp, 160, High Street. Mr. Banham, 9, Market Place. Mr. Weitzell, 43, Churchfield Road. Mr. Clogg, 26, Churchfield Road. Mr. Bennett, 41, High Street. Mrs. Eastham, 7, Leamington Terrace. Mr. Jones, 49, Park Road North. Mr. Wissemann, 23, Bollo Bridge Road. 29 HOUSING OF THE WORKING CLASSES ACTS. During the year I made several inspections of the houses in the Steyne and finally made representation to you that the premises marked on the accompanying plan were unfit for human habitation. The premises so marked are:— 6, 8, 18, 20, 22, 24, 49, 51, 53, 80, 84, Steyne Road. 1. 2, 3, 4, 5, 6, 7, East Row. 1, 2, 3, 4, 5, 6, 7, 8, 9, Narrow Street. With reference to Nos, 6 and 8, Steyne Road, the Owners have decided to demolish the premises, and at Nos. 18, 20, 22, 24 49, 51, 53, 80 and 84, Steyne Road, the Owners are carrying out such work as will render the premises dry and habitable for a few years at any rate. Nos. 2 to 7 East Row have also been treated in a similar manner by the Owners. As to the houses in Narrow Street I do not think that they can be made fit for habitation and it would be a waste of money to spend anything on the present buildings, and I therefore trust that we shall be successful in obtaining a Closing Order, and also No. 1 East Row as it is decidedly the worst property in the Steyne. I think it would be a great benefit to the Town if the Council could see their way to acquire and clear the whole of this area in the centre of the Steyne as it would get rid of all this old property and could be turned into an open space with much advantage. The housing of the Working Classes Act of 1903 gives the Council many additional powers, such as the longer periods for the repayments of Loans, &c. I have also made representation under Section 8 of the Housing of the Working Classes Act, 1903 as to the unfitness for human habitation of Nos. 1, 2, 3, 4, 5, 6, 7, and 12 Cock and Crown Yard, in my opinion their occupation should be immediately discontinued, as the premises are not reasonably capable of being made fit for human habitation. The first case under this new Housing Act which gives power to Local Authorities to close slum dwellings without giving notice to the owners to put them in repair has been heard and decided at 30 Reading. Under the old Act the owner of a house unfit for human habitation was warned and ordered to put them into repair and fit for living in. Now, when a local body decides that the houses are uninhabitable, it can apply, without warning the houseowner, for a closing order, and, satisfactory evidence of their condition being forthcoming, the magistrates are bound to make the order. The new law is giving slum owners considerable uneasiness. Golden Meadow Cottages are now pulled down. These premises were voluntarily closed 4 years ago, but as no closing order was applied for, it was impossible to obtain a demolition order. Acton District Council Plan showing houses with respect to which the Medical Officer of Health has made representation under the Housing of the working Class act s 31 32 Action District council cocli and Crown Yard Plan showing houses with respect to which the Medical Officer of Health has made representation s under the Housing of the working Class act s 33 EMPLOYMENT OF CHILDREN ACT 1903. This Act which came into force on the 1st of January provides that the Local Authority may make Bye-Laws for— (i) prescribing for all children, or for boys and girls separately, and with respect to all occupations or to any specified occupation,— (a) the age below which employment is illegal; and (b) the hours between which employment is legal ; and (c) the number of daily and weekly hours beyond which employment is illegal. (ii) prohibiting absolutely or permitting, subject to conditions, the employment of children in any specified occupation. POWER TO MAKE BYE-LAWS FOR THE REGULATION OF STREET TRADING BY PERSONS UNDER SIXTEEN. 2. Any Local Authority may make bye-laws with respect to street trading by persons under the age of sixteen, and may by such bye-laws— (a) prohibit such street trading, except subject to such conditions as to age, sex, or otherwise, as may be specified in the bye-law, or subject to the holding of a licence to trade to be granted by the Local authority ; (b) regulate the conditions on which such licences may be granted, suspended and revoked; (c) determine the days and hours during which, and the places at which, such street trading may be carried on ; (d) require such street traders to wear badges, (e) regulate generally the conduct of such street traders: Provided as follows :— (1) The grant of a licence or the right to trade shall not be made subject to any conditions having reference to the poverty or general bad character of the person applying for a licence or claiming to trade; (2) The local authority, in making bye-laws under this section, shall have special regard to the desirability of preventing the employment of girls under sixteen in the streets or in public places. GENERAL RESTRICTIONS ON EMPLOYMENT OF CHILDREN. 3.—(1) A child shall not be employed between the hours of nine in the evening and six in the morning : Provided that any local authority, may by bye-law, vary these hours either generally or for any specified occupation. (2) A child under the age of eleven years shall not be employed in street trading. (3) No child who is employed half-time under the Factory and Workshop Act, 1901, shall be employed in any other occupation. (4) A child shall not be employed to lift, carry, or move anything so heavy as to be likely to cause injury to the child. 34 (5) A child shall not be employed in any occupation likely to be injurious to his life, limb, health, or education, regard being had to his physical condition. (6) If the local authority send to the employer of any child a certificate signed by a registered medical practitioner that the lifting, carrying, or moving of any specified weight is likely to cause injury to the child, or that any specified occupation is likely to be injurous to the life, limb health or education of the child, the certificate shall be admissible as evidence in any subsequent proceedings against the employer in respect of the employment of the child. Section 5. (1) Provides that any person employing a child under the age of 16 in contravention of this Act shall be liable to a fine of 40/- and £5 for a second offence. Parents or guardians who have conduced to the commission of the alleged offence by wilful default are also liable to the like fine. The person under sixteen years of age is also liable to a penalty for contravening the Bye-Laws made under this Act. Under Section 8 any Justice of the Peace on complaint may empower any Officer of the Local Authority acting under this act to enter any place whether a building or not for the purpose of examining the place and any person therein. Bye-Laws made under this Act will not apply to any child above 12 employed in pursuance of the Factory and Workshop Act 1901. Section 13 defines certain expressions used in the Act as follows— The expression "child " means a person under the age of fourteen years. The expression "guardian," used in reference to a child, inciudes any person who is liable to maintain or has the actual custody of the child. The expressions "employ" and " employment" used in reference to a child, include employment in any labour exercised by way of trade or for the purposes of gain, whether the gain be to the child or to any other person. The expression "local authority" means, in the case of the City of London, the mayor, alderman, and commons of that city in common council assembled in the case of a municipal borough with a population according to the census of nineteen hundred and one of over ten thousand, the borough council, and in the case of any other urban district with a population according to the census of nineteen hundred and one cf over twenty thousand, the district council, and elsewhere the county council: The expression " street trading " includes the hawking of newspapers, matches, flowers, and other articles, playing, singing, or performing for profit, shoeblacking, and any other like occupation carried on in streets or public places. 35 Annual Report of the Sanitary Inspector, FOR THE YEAR 1903. To Dr. G. A. Garry Simpson, Medical Officer of Health. Sir, I herewith present my Fourth Annual Statement, showing the particulars of the action taken in the suppression of Nuisances &c., and various improvements effected by this Department during the year 1903. The amount of sanitary work which has been done through the medium of this Department will be seen from the tables which I have compiled. The class of work executed in the abatement of nuisances arising from defective drains, &c., is on the whole very good, but I am sorry to say we still come across Owners who will not employ skilled tradesmen, consequently the workmanship in these cases is most inferior, though they always manage to execute the work sufficiently well as to prevent my taking any action. To illustrate this I can state that in one instance I found a broken down photographer doing sanitary work for an Owner, and I have frequently come across painters and odd men relaying drains, &c. There is no remedy for this and Legislation does not give the power to specify the weights of materials to be used, nor to prescribe the manner in which the work shall be carried out, which is obviously unsatisfactory. In July the Council appointed me a delegate to attend the Sanitary Institute Congress at Bradford, the proceedings being of a valuable and instructive nature. The Presidential address was delivered by the Right Hon. the Earl of Stamford, and should be read by everyone interested in sanitation as it will be found to be both interesting and instructive. I am pleased that the Infectious Hopital will shortly be completed. The removal of infectious cases to Islington and other Hospitals takes up much of our time which could otherwise be more profitably employed During the year I have had no applications from persons desiring to avail themselves of the Cleansing of Persons Act, 1897. I frequently disinfect verminous premises when I find same. On one occasion a woman who called to make a complaint with 36 reference to the verminous state of the house, informed me that at night she was unable to sleep as the bugs fell from the ceiling on her bed like a shower of rain. There is no doubt that if people would avail themselves of the provisions of this Act, it would be a great protective agent against the spread of disease. Possibly as time goes on the Council will see their way clear to provide a bath room at the Hospital at the Friars for the use of persons who wish to have a hot bath while their wearing apparel is being disinfected, and who are inadmissible to the Public Baths. If a Notice concerning these arrangements was at the same time placarded in all Public places in the District it would bring it to the knowledge of the Public and I think many would avail themselves of the offer of the Council. In Marylebone since 1898, 19,888 baths have been supplied, and the clothing of the same number of persons disinfected. A new Common Lodging House has been established in Osborne Road, on most up to date lines. It is for persons of the male sex only, and the two sleeping wards provide beds for 147 persons. Mr. Fraser, my late Assistant, left me early in November, after being in the service of the Council just over two years, to take up the duties of Inspector to the Northfleet Urban District Council, Kent, and from this time to the end of the year I had to work singlehanded. I wish to record my thanks to Mr. Fraser for his assistance during the year, I cannot speak too highly of his abilities, and the manner in which he discharged his duties. Mr. Gough, his successor, refilled the position on the 9th January. The appointment of Mr. Bradford as Clerk has greatly facilitated the work, Mr. Gough and myself can now devote more time to District Inspection, which it was impossible to do before, owing to the ever increasing amount of clerical work. I also beg to tender to you on behalf of the Department, many thanks for your kind consideration. I am, Dear Sir, obediently yours, Maurice W. Kinch, Public Health Department, Gothic Villa, Mill Hill Grove. 37 Number of Inspections, &e. 1423 Premises inspected. 3324 Re-inspections to premises where Nuisances were in course of abatement. 2129 Nuisances were reported. 2273 „ „ abated. 1499 Letters written. 1071 „ received. 9 Notices received from H.M. Factory Inspector. 8 Library books removed from Infected Houses and destroyed 104 Notices to Librarian re Infectious Cases. 104 ,, ,, Head Teachers of schools re Infectious cases 4000 Leaflets distributed. 320 Pints disinfectants supplied. 26 Notifications of Waste of Water sent to Grand Junction Co. 8 Van Dwellings inspected. 167 Visits paid to Infected Houses. 18 Infectious Patients removed to Hospitals. 149 Rooms fumigated. 30 tons 4 cwt. Bedding disinfected. 48 Closets disinfected after Enteric Fever Cases. The following Tabulated List gives particulars of the Sanitary improvements effected during the year:— House drains taken up and reconstructed 45 „ repaired 33 ,, unstopped and cleansed 130 ,, provided with intercepting traps 128 „ manholes provided to 106 „ ventilated 167 „ manholes to, cleansed 22 ,, „ repaired 17 „ fresh-air inlets repaired 38 „ cesspools abolished 6 Water-closets repaired 19 ,, new pans provided to 153 „ unstopped and cleansed 222 38 Water Closets Pan closets and containers replaced by efficient pans 7 „ provided with flushing cisterns 29 ,, flushing cisterns repaired 81 ,, flush, disconnected from drinking water cistern 20 ,, additional or separate, provided in Factories and Workshops 1 „ apartments ventilated or lighted 2 Soil-pipes repaired 18 „ ventilated 16 ,, increased ventilation provided 13 ,, reconstructed 6 Ventilating shaft repaired 39 „ provided 16 Defective sink structures abolished 4 Waste-pipes, sink waste-pipes disconnected from drain 39 ,, bath and lavatory waste pipes ,, ,, ,, 8 „ provided to sinks 5 ,, repaired 35 „ trapped with lead traps 2 Rainwater pipes disconnected from drain 218 „ repaired 42 „ provided 12 Eaves guttering provided 12 ,, repaired 100 Gully traps replaced with stoneware gullies 106 „ unstopped 12 ,, provided 18 ,, cement work around, repaired 11 Yards, paving repaired 46 „ paved and drained 94 „ provided with drainage 9 ., cleansed 5 Dust bins provided 153 Cisterns repaired and covered 52 „ cleansed 4 Houses cleansed and whitewashed 102 „ dry areas provided 4 39 Houses plastering of walls and ceilings repaired 34 Workshops cleansed and limewashed 5 Roofs of houses repaired 59 Floors of houses repaired or re-laid 46 ,, airspaces under provided 6 ,, workshops repaired or relaid 10 ,, stables repaired or relaid 12 Stables provided with drainage 1 Dampness of house walls remedied 33 Accumulations of refuse removed 19 „ manure removed 21 ,, water in cellars removed 20 Manuie receptacles provided 11 Animals, fowls, &c., nuisances from, abated 18 Overcrowding, number of cases abated 1 Smoke nuisances, number of cases dealt with 6 Privies abolished and earth closets provided 1 Water supply provided to houses 10 Miscellaneous nuisances abated 91 flotiees.—650 Preliminary Notices and 70 Statutory Notices have been served for the abatement of Nuisances, and the necessary works asked for were carried out in nearly all cases. No Police Court proceedings being necessary. As I pointed out last year the very few Police Court proceedings and the number of Statutory Notices compared with the Preliminary ones show that the Statutory Notices are not asked for unless the Owners absolutely refuse to comply with what I consider a reasonable request, and necessary in the interests of Public Health. Drainage Examinations.—The smoke test has been applied to drains 160 times, and in addition 26 drains were opened up for examination after formal written complaints had been made and authority given for that purpose. The volatile or chemical test has also been applied to drains in numerous instances. Inspection of meat and other poods.—The various Butchers' Shops, Greengrocers' Shops, and other places 40 where food is sold were frequently inspected during the year, but I did not find any cause for complaint. During the year the following were seized and taken before a Justice:— 1 box of bloaters. 1 box frozen rabbits. 1 barrel of dog fish. 1 basket of cherries. 5 barrels of potatoes. 1 box of skate. Food and Drugs Hets.—Samples under these Acts are taken by Mr. W. Tyler, the County Council Inspector. No returns are supplied to our Council as to the number of samples taken in the District and the result of the analysis. Dairies, Cocusheds and Milk Shops.—There are at present 66 Dairies and Milkshops and 5 Cowkeepers on the Register. Every quarter I forward a Notice to the occupier of every Dairy and Cowshed reminding him of his duty to have the premises limewashed, as required by the Regulations, 132 visits were paid to the Dairies and Milkshops, and 20 to the Cowsheds, and they were found to be in good order with the exception of one which was found to be getting into a bad state. I served a notice upon the Owner to remedy the defects and he has given the tenant notice to leave, and proposes putting up some houses on the site. Bakehouses.—The number of Bakehouses on the Register is 25 of which 8 are underground. A circular letter is sent to the occupiers every six months reminding them of the time to lime-wash and cleanse, as prescribed by the Factory and Workshop Act, 1901. All these premises have been visited, 70 inspections having been made. Slaughterhouses.—There are 4 Slaughterhouses in the District 2 Licensed and 2 Registered. 42 visits were paid to these premises and upon each occasion the Bye-Laws were found to be complied with. 41 Piggeries.—With reference to the Piggeries I have to report that they have been frequently inspected, but I have never received any complaints as to the smell from same. In Old Oak Lane Nos 1 to 4, I have persuaded the Owner to make the tenants abolish keeping Pigs in the Back Yards so that we now only have three Piggeries in Old Oak Lane. Common Liodging Houses—Only 2 Common Lodging Houses exist in the District. These have been regularly inspected, and on all occasions found to be in a satisfactory condition. Smoke Abatement.—All Factory and Works chimneys have been observed at frequent intervals. No proceedings have been taken against the Owners for emitting black smoke so as to be a nuisance. I received complaints from the Coal Smoke Abatement Society during the year and immediately served Notices with reference to same. The observations kept by myself and Assistant numbered 23. I have to record the valuable assistance in the suppression of Smoke nuisances which I have received from the Inspector to the Coal Smoke Abatement Society. Woodgates, Printer, South Acton.