Bat 11 Hol Metropolitan Borough of Battersea. REPORT on the HEALTH of the Metropolitan Borough of Battersea, for the year 1904. by G. F. McCLEARY, b.a., m.d.. d.p.h.. MEDICAL OFFICER OF HEALTH. Health Committee. Chairman: Councillor A. EMERY. HIS WORSHIP THE MAYOR (Alderman W. J. West, J.P.). Alderman H. BARNES. Councillor W. A. ANDREWS. Councillor J. C. CHOWN. Councillor P. P. HAYTHORNTHWAITE. Councillor L. S. McMANUS, M.D. Councillor W. J. MAY. Councillor A. MOUNCE. Councillor G. PEARCE. Councillor W. RAYMOND. Councillor E. G. TAYLOR. Councillor F. WILLIS. Staff of the Public Health Department. Medical Officer of Health. G. F. McClEARY, B.A., M.D., D.P.H. Chief Sanitary Inspector. I. Young, a.r.s.i. Lady Sanitary Inspectors. Miss E. Dawson, San. Insp. Board's Cert. Mrs. A. C. Young „ „ Food Inspector. A. Chuter, Cert. San. Inst., and Meat Insp. Cert. Workshop Inspector. W. E. Benjamin, Cert. San. Inst. District Sanitary Inspectors. No. 1 District J. Herrin, Cert. San. Inst. „ 2 „ A. Peverett, San. Insp. Board's Cert., and Meat Insp. Cert. ,, 3 ,, J. Lawrence, Cert. San. Inst. and Meat Insp. Cert. „ 4 „ A. E. Purnell, Cert. San. Inst. „ 5 „ J T. Baxter, „ ,, 6 ,, H. Marrable, „ „ ,, 7 ,, A. Odell, Cert. San. Inst. and Meat Insp. Cert. ,, 8 ,, H. H. May, Cert. San. Inst. Clerks. Senior Office Clerk B. W. Sears. Office Clerk F. H. Preston, Cert. San. Inst. E. Col.E. Junior Clerks H.E.Wright. Office Youth D. Robinson. Manageress of Milk Depot. Miss A. Lowe. Superintendent of Disinfecting Station. C. H. Woodhouse. Mortuary Keeper. G. Streat. To the Mayor, Aldermen, and Councillors of the Metropolitan Borough of Battersea. Mr. Mayor, and Gentlemen,— I have the honour to place before you my fourth Annual Report on the Health of the Metropolitan Borough of Battersea. In accordance with section 133 of the Factory and Workshop Act, 1901, a special report is included on the administration of the Act by the Borough Council. In the Appendix will be found the tables required by the Local Government Board and by the Secretary of State, and also certain tables suggested by the Medical Officer of Health of the County of London, in order to secure uniformity of tabulation in the Annual Reports of the Medical Officers of Health of the Metropolitan Boroughs. It is due to the Staff of the Health Department that I should take this opportunity of acknowledging their excellent work throughout the year. I have the honour to be, Mr. Mayor, and Gentlemen, Your obedient Servant, G. F. McCLEARY, Medical Officer of Health February 21st, 1905. CONTENTS. Page Births, Marriages and Deaths. Births 11 Deaths 14 Deaths in Public Institutions 16 Infantile Mortality 19 Marriages 13 Population 11 Senile Mortality 22 Infectious and other Diseases. Alcoholism 50 Cancer 48 Causes of Death 25 Diarrhœa 45 Diphtheria 36 Enteric Fever 40 Erysipelas 43 Measles 43 Notification, Table of 30 Notifications, Cost of 29 Puerperal Fever 42 Return Cases of Scarlet Fever and Diphtheria 39 Scarlet Fever 34 Small-pox 32 Tuberculosis 46 Whooping Cough 44 Zymotic Mortality 25 General Sanitary Administration. Ambulances 79 Block Dwellings 75 Chalêts 78 Common Lodging Houses 77 Cow-houses 83 Page General Sanitary Administration, continued. Customs and Inland Revenue Acts 78 Disinfection 67 Fish Shops 85 House-to-house Inspection 54 Houses Let in Lodgings 55 Hygienic Street Paving 65 Ice Cream 86 Lady Sanitary Inspectors 61 Legal Proceedings 90 Milkshops 83 Mortuary 73 Paving of Back-yards and Forecourts 66 Sale of Food and Drugs Acts 87 Sanitary Inspectors, Work of 53 Sewer Ventilation 66 Shelter, Temporary 72 Slaughter-houses 83 Smoke Nuisances 78 Stables 79 Unsound Food 84 Van Dwellings 76 Water Supply 81 Factory and Workshop Act, 1901. Bakehouses 115 Factories 124 Out-workers 121 Underground Workrooms 123 Workplaces 119 Workshops 113 Infants Milk Depot 129 Staff of the Health Department 4 Appendix. Tables 139-152 Summary of Vital Statistics for 1904. Area of Borough (excluding water) 2,13.9 acres. Population (Census 1901) 168,907 „ Estimated to middle of 1904 175,465 Density 81.8 persons per acre Inhabited Houses (Census 1901) 23,462 Marriages 1,465 Births 4,849 Birth-rate 27.5 Deaths 2,543 Death=rate 14.4 Infantile Mortality 147 per 1,000 births. Births, Marriages, Deaths. Births, Marriages and Deaths. Population. The population of Battersea at the middle of 1904, as estimated by the Registrar-General, was 175,465. This estimate is based on the assumption that the rate of increase of population during the last intercensal period was maintained during the subsequent years, and although it is probably too high, it has been adopted in this Report, so that the Battersea statistics may be comparable with those in other districts. Births. The births registered were 4,849 in number, of which 2,497 were males and 2,352 females, the proportion of male to female births being 1,061 to 1,000. The number of births was 276 below the decennial average, and 426 less than the number in 1884, when the population was only 121,299. The births in the sub-districts were as follows :— Males. Females. Total. The Borough 2,497 2,352 4.849 East Battersea 1,186 1,063 2,249 North-West Battersea 792 792 1,584 South-West Battersea 519 497 1,016 Table I. shows the birth-rate in each of the sub-districts and in London during the decennium 1894-1903, and in 1904. 12 TABLE I. Birth-rate per 1,000 Population. Year. The Borough. East Battersea. North-West Battersea. South-West Battersea. London. 1894 31.4 32.6 36.6 23.2 30.2 1895 32.3 34.3 37.9 22.2 30.6 1896 32.4 34.8 37.8 22.2 30.2 1897 31.7 33.8 36.6 22.7 30.2 1898 30.9 33.6 35.0 21.9 29.7 1899 30.9 33.6 36.0 21.0 29.6 1900 30.6 33.5 35.2 21.3 29.2 1901 29.7 32.6 33.3 21.3 29.0 1902 28.2 30.3 33.1 20.2 29.0 1903 28.6 31.3 34.1 19.4 28.4 Average 1894-1903 30.6 33.0 35.5 21.5 29.6 1904 27.5 30.4 31.9 19.5 27.8 The birth-rate in 1904 is the lowest ever recorded in Battersea. It will be seen from the above table that there has been a very considerable decline in the birth-rate in each of the sub-districts during the decennium, especially since the year 1900. The rate varies greatly in the three sub-districts, being lowest in South-West Battersea, where the standard of comfort is highest, and highest in North-West Battersea, the district in which there is the greatest poverty. The following table shows the birth-rate in England and Wales, in London and in Battersea since 1875:— 13 TABLE II. Birth-rate per 1,000 Population. Year. England and Wales. London. Battersea. 1875 35.4 35.4 40.3 1876 36.3 35.9 42.2 1877 36.0 35.6 39.9 1878 35.6 35.5 40.5 1879 34.7 35.5 40.8 1880 34.2 35.3 39.6 1881 33.9 34.7 41.8 1882 33.8 34.5 39.9 1883 33.5 34.5 40.2 1884 33.6 34.3 43.4 1885 32.9 33.4 37.0 1886 32.8 33.4 39.5 1887 31.9 32.9 38.6 1888 31.2 32.1 36.5 1889 31.1 31.9 36.1 1890 30.2 30.7 34.6 1891 31.4 31.8 34.7 1892 30.4 30.9 32.4 1893 30.7 31.0 33.3 1894 29.6 30.1 31.4 1895 30.3 30.6 32.3 1896 29.6 30.2 32.4 1897 29.6 30.1 31.7 1898 29.3 29.7 30.9 1899 29.1 29.7 30.9 1900 28.7 29.1 30.6 1901 28.5 29.0 29.7 1902 28.6 28.5 28.2 1903 28.4 28.4 28.6 1904 27.9 27.8 27.5 Marriages. The marriages registered during the year numbered 1,465, or 102 more than the decennial average, and 23 more than the number in 1903. The marriage-rate, i.e., the number of persons married per 1,000 population was i6.7, or .5 above the decennial average. It will be seen that although the birthrate has steadily declined, the marriage-rate is higher now than it was ten years ago. 14 TABLE III. Year. Battersea. London. No. of Marriages. Marriage-rate. Marriage-rate. 1894 1,158 14.4 17.0 1895 1,241 15.2 17.2 1896 1,334 16.1 18.0 1897 1,357 16.2 18.5 1898 1,441 17.2 18.8 1899 1,429 17.0 18.6 I900 1,451 17.2 18.0 1901 1,407 16.6 17.6 I902 1,372 16/0 17.8 1903 1,442 16.6 17.4 Average 1894-1903 1,363 16.2 17.8 1904 1,465 16.7 ... Deaths. During the year 2,517 deaths were registered. This number includes 372 deaths of non-residents occurring' in public institutions in the district. Deducting these and adding 398 deaths of Battersea residents registered in public institutions outside the district, a net total of 2,543 deaths (males 1,327, females 1,216) is obtained. This gives a death-rate of 14.4, the lowest death-rate, with the exception of the rate in 1903, viz., 14.2, ever recorded in Battersea. 1,158 deaths belong to East Battersea, 846 to North-West Battersea, and 539 to South-West Battersea. The number of deaths registered of males and females in each quarter of the year is set out as follows:— 15  Males. Females. Total. First quarter 357 359 716 Second quarter 297 266 563 Third quarter 364 305 669 Fourth quarter 309 286 595 The death-rates in the Borough and in the sub-districts in 1904 and in the preceding decennium are given in the subjoined table. TABLE IV. Death-Rate per 1,000 Population. Year. The Borough. East Battersea. North-West Battersea. South-West Battersea. 1894 16.1 16.6 19.5 10.8 1895 18.1 19.9 21.1 11.7 1896 18.1 20.5 21.3 10.4 1897 16.4 17.6 20.2 10.4 1898 17.3 19.4 20.4 10.5 1899 17.3 19.6 I9.1 11.7 1900 17.6 18.9 21.0 12.1 1901 16.3 16.4 18.7 11.9 1902 15.0 15.5 18.3 10.9 1903 14.2 15.0 i7.1 10.3 Average 1894-1903 16.6 17.9 19.6 11.0 1904 144 15.6 i7.0 10.3 16 The slight rise in the death-rate in 1904, as compared with the previous year, is due to the fact that the exceptionally hot weather in the summer of 1904 gave rise to an increase in the infantile mortality. Deaths in Public Institutions. The deaths of Battersea residents occurring in public institutions numbered 751. 353 occurred within, and 398 without the Borough. 415 deaths occurred in Workhouses or Workhouse Infirmaries, as against 348 in 1903, and 356 in 1902. Table VI. gives a list of the institutions in which the deaths occurred. Table V. shows the number of deaths of Battersea residents in public institutions in the years 1894-1904, and the proportion in each year of such deaths to the total number of deaths. TABLE V. Year. Total Deaths Deaths in Public Institutions. Proportion percent. of Deaths in Public Institutions to Total Deaths. 1894 2577 527 20.4 1895 2961 537 l6.1 1896 2994 560 18.7 1897 2737 576 20.6 1898 2892 625 21.6 1899 2905 644 22.1 1900 2978 625 20.9 19OI 2766 640 23.1 1902 2581 731 28.3 1903 2476 673 27.1 Average 1894-1903 2786 613 21.8 1904 2543 751 29.5 17 TABLE VI. Deaths of Battersea Residents in Public Institutions. Institution. Total. Group Totals. Infirmaries and Workhouses. 415 Holborn Workhouse, Mitcham 7 Islington Infirmary 1 Lambeth Infirmary 3 Lambeth Workhouse 1 Lewisham Infirmary 1 Paddington Infirmary 1 Shoreditch Infirmary 1 Tooting Home 62 Wandsworth and Clapham Union Infirmary 333 Wandsworth and Clapham Union Workhouse 5 Metropolitan Asylums Board's Hospitals 35 Grove Hospital 30 South-Western ,, 1 Western „ 4 General Hospitals. 227 Anti-Vivisection Hospital 3 Belgrave Hospital 3 Bolingbroke Hospital 17 Brompton Hospital 2 Cancer Hospital 2 Charing Cross Hospital 12 Chelsea Hospital for Women 1 Clapham Maternity Hospital 1 Evelina Hospital 3 Friedenheim Hospital 3 General Lying-in Hospital 1 Guy's Hospital 4 Home for Blind, Islington 1 Hospital of St. John and St. Elizabeth 1 Hostel of God 5 Kings College Hospital 7 London Hospital 3 Middlesex Hospital 1 National Hospital 1 Royal Chest Hospital 1 Royal Free Hospital 1 St. Bartholomew's Hospital 1 St. George's Hospital 41 St. Johns Hostel 1 St. Mary's Hospital 2 St. Peter's Home, Meadow Road 1 St. Thomas' Hospital 45 Salvation Army Maternity Home 1 Samaritan Free Hospital 1 Throat Hospital, Golden Square 1 University College Hospital 1 Victoria Hospital 25 West London Hospital 1 Westminster Hospital 16 Elsewhere 17 County and other Lunatic Asylums ... 74 751 All the above Institutions, except the Wandsworth and Clapham Union Infirmary, the Bolingbroke Hospital, and the Anti-Vivisection Hospital are outside the Borough. 18 TABLE VII. Comparative Statistics of Births, Mortality, &c. Year. Mean population for year. Births. Birth Rate. Deaths. Death Rate. Zymotic Deaths. Natural Increase. 1856 15,069 536 36.2 320 21.2 45 216 1857 I5,970 582 36.0 343 21.4 46 239 1858 16,872 562 33.3 380 22.5 100 182 1859 17,774 685 38.5 394 22.1 96 292 1860 18,676 680 36.4 399 21.3 62 281 1861 19,582 750 38.3 505 25.7 112 245 1862 23,108 784 33.9 491 21.2 106 293 1863 26,635 1,042 39.1 522 19.5 86 520 1864 30,161 1,140 37.7 669 22.1 129 471 1865 33,688 1,357 40.2 785 23.3 177 572 1866 37,145 1,386 37.3 1,002 26.9 244 384 1867 40,741 1,734 42.5 870 21.3 122 864 1868 44,267 1,975 44.6 1,046 23.6 194 929 1869 47,749 2,096 43,8 1,121 23.4 247 975 1870 51,320 2,170 42.2 1,375 26.7 404 795 1871 54.847 2,220 40.4 1,472 26.8 463 748 1872 60,244 2,349 38.9 1,202 19.9 220 1,147 1873 65,614 2,659 40.5 1,307 19.9 205 1,352 1874 70,984 2,865 40.3 1.387 19.5 238 1,478 1875 76,354 3,080 40.3 1,724 22.5 307 1,356 1876 81,704 3,455 42.2 1,745 21.3 340 1,710 1877 87,094 3,481 39.9 1,725 19.8 280 1,756 1878 92,464 3,748 40.5 1,803 19.4 322 1,945 1879 97,834 4,001 40.8 1,980 20.2 355 2,021 1880 103,204 4,095 39.6 2,040 19.7 383 2,055 1881 108,342 4,452 41.8 2,033 18.7 381 2,419 1882 112,661 4,504 39.9 2,214 19.6 353 2,190 1883 116,980 4,711 40.2 2,344 20.0 369 2,367 1884 121,299 5,275 43.4 2,569 21.1 568 2,706 1885 125,618 4,654 37.0 2,566 20.4 432 2,088 1886 129,937 5,140 39.5 2,477 19.0 398 2,663 1887 134,256 5,186 38.6 2,451 l8.2 502 2,735 1888 138,565 5,061 36.5 2,187 15.7 363 2,874 1889 142,884 5,161 36.1 2,240 15.6 366 2,921 1890 147,203 5,105 34.6 2,854 19.3 543 2,251 1891 150,880 5,237 34.7 2,697 17.9 398 2,540 1892 153,778 4,990 32.4 2,782 18.1 439 2,208 1893 156,719 5,225 33.3 2,974 18.9 614 2,251 1894 159,724 5,024 31.4 2,577 16.1 526 2,447 1895 162,787 5,264 32.3 2,961 18.1 460 2,303 1896 165,309 5,358 32.4 2,994 18.1 642 2,364 1897 166,059 5,266 31.7 2,737 16.4 486 2,529 1898 166,814 5,157 30.9 2,892 17.3 531 2,265 1899 167,570 5,179 30.9 2,905 17.3 418 2,274 1900 168,339 5,161 30.6 2,978 17.6 435 2,183 1901 169,100 5,025 29.7 2,766 16.3 491 2,259 1902 171,401 4,844 28.2 2,581 15.0 367 2,263 1903 !73,422 4,973 28.6 2,476 14.2 347 2,497 1904 175,465 4,849 27.5 2,543 14.4 353 2,306 The years marked thus ... were census years 19 Infantile Mortality. The deaths of infants under one year numbered 715, and formed 28.1 per cent, of the total deaths. The "infantile mortality,'' i.e., the number of deaths under one year per 1,000 births registered, was 147, being 10 below the decennial average. The infantile mortality was distinctly higher in 1904 than in the two previous years. This is due to the fact that the weather in the third quarter of 1904 was unusually hot and dry, whereas in the third quarters of 1902-3 the weather was unusually cold and wet. When the infantile mortality in 1904 is compared with that in previous years since 1894, it cannot be considered excessive, although it is, of course, far higher than it ought to be. The infantile mortality in the County of London was 146. The mortality in the Borough and in each of the sub-districts is given in the following table :— TABLE VIII. Year. The Borough. East Battersea. North-West Battersea. South-West Battersea. Deaths under 1 year. Deaths per 1,000 Births. Deaths under 1 year. Deaths per 1,000 Births. Deaths under 1 year. Deaths per 1,000 Births. Deaths under 1 year. Deaths per 1,000 Births.  1894 734 146 345 151 308 168 81 88 1895 930 176 435 178 365 192 130 139 1896 947 176 465 186 365 193 117 120 1897 853 161 411 169 326 178 116 114 1898 855 165 441 181 311 178 103 104 1899 837 161 437 180 299 166 101 104 1900 822 159 411 169 314 179 97 97 1901 821 163 407 172 296 178 118 116 1902 657 136 312 141 270 164 75 75 1903 671 135 316 137 268 158 87 88 Average 18941908 812 157 398 166 312 175 102 104 1904 715 147 365 162 248 157 102 100 20 The following table gives the age distribution of the deaths under one year in 1904. The mortality was high in the first week, and 333 deaths, or nearly one-half the total, occurred in the first three months:— district. Age in Months. Under 1 Month. Total Under 1 Month. 1- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- Total Under 1 Year. Under 1 week. 1 and under 2 weeks. 2 and under 3 weeks 3 and under 4 weeks. East Battersea 57 13 20 16 106 45 31 26 18 24 20 18 26 18 20 13 365 North-West Battersea 29 5 7 5 46 20 29 22 23 20 18 17 16 18 9 10 248 South-West Battersea 22 8 5 2 37 14 5 5 6 7 5 3 9 2 6 3 102 Borough of Battersea 108 26 32 23 189 79 65 53 47 51 43 38 51 38 35 26 715 The chief causes of infant deaths are set out as follows:— Cause of Death. No. of Deaths. Rate per 1,000 Births. Rate per 1,000 Births, 1903. Rate per 1,000 Births, 1902. Rate per 1,000 Births, 1901. Measles 20 4.1 5.6 5.0 5.5 Whooping Cough 30 6.3 6.4 6.3 7.5 Diarrhoea 159 32.7 15.7 17.3 35.2 Enteritis 28 5.7 4.6 4.7 3.7 Tuberculosis 26 5.3 5.0 5.8 6.9 Premature Birth 95 19.5 22.1 21.1 19.9 Debility, Marasmus 59 12.2 14.3 14.4 16.7 Convulsions 15 3.0 2.6 2.7 4.3 Bronchitis 71 14.6 11.5 13.6 12.9 Pneumonia 45 9.2 15.5 14.2 18.7 Suffocated in bed 5 1.0 0.2 1.9 3.3 All other causes 162 33.3 31.6 28.7 28.4 Total 715 147 135 136 163 21 It will be seen- that although in East and South-West Battersea, and in the Borough as a whole, the infantile mortality was higher in 1904 than in previous years, in North-West Battersea it was lower. There has been a great and progressive reduction in infantile mortality in North-West Battersea since 1901. The Council's Infants Milk Depot is situated in that sub-district, and most of the babies fed on the milk live there. This has been probably an important factor in the reduction. Five deaths were recorded as due to suffocation in bed or "over-lying." The following table gives the number of deaths from this cause, occurring on each day of the week in each year since 1896. The day refers to the morning on which the death was discovered, and it will be seen that by far the greater number of deaths were discovered on Sunday morning. This suggests that the over-lying takes place when the parents are under the influence of alcohol, and there are other facts which support this view. These deaths should be taken into account, therefore, in estimating the mortality due to alcohol. That this form of suffocation appears at all in our death returns is a great stain on this country, but until firmer measures are adopted in dealing with the parents, it is to be feared that it will continue to appear. TABLE IX. 1896. 1897. 1898. 1899. 1900 1901. 1902. 1903. 1904. Total Sunday 6 4 3 4 4 5 3 — 3 32 Monday 4 3 3 2 1 3 2 — — 18 Tuesday 4 4 2 1 1 1 1 — 1 15 Wednesday 1 5 4 4 1 1 — — — 16 Thursday 1 I 2 2 4 3 1 — 1 15 Friday 4 I 4 1 2 2 1 — — 15 Saturday — 3 — 3 2 2 1 1 — 12 Total 20 21 18 17 15 17 9 1 5 123 22 Senile Mortality. Five hundred and eight deaths of Battersea residents occurred at ages of sixty-five and upwards. The age distribution of these deaths in the sub-districts is given below:— District. 65 and under 75. 75 and under 85. 85 and upwards. Total over 63. East Battersea 123 73 11 207 North-West Battersea 79 51 13 143 South-West Battersea 71 66 21 158 Borough of Battersea 273 190 45 508 The deaths over sixty-five were 564, 434, 445 and 404 in the years 1900, 1901, 1902 and 1903 respectively. The 508 deaths over sixty-five in 1904 were equivalent to 20 per cent, of the deaths at all ages. Battersea Borrough Council. Chart indicating the prevalence of notifiable infectious disease during each week of the year 1904. Infectious and other Diseases. 25 Infectious and other Diseases. Causes of Death. The causes of death are tabulated in Table XXXI. (Table IV. of the Local Government Board Series), and are set out in greater detail in Table XXXII. Zymotic Mortality. Table X. shows the deaths from the chief zymotic diseases for the ten years 1894-1903, and the year 1904 respectively. The figures for the latter year show a marked reduction in the number of deaths from each of the diseases save diarrhoea. The reduction was greatest in measles and diphtheria. In only one year since 1881 has a lower number of deaths from measles been recorded in Battersea. This was the year 1891, in which year 37 deaths occurred; the population at that time, however, was only 150,880. It will be seen that there were no deaths from small-pox. The increased number of deaths from diarrhoea is to be attributed to the exceptionally hot weather, and also, to some extent, to changes in death certification and classification; many deaths now recorded under diarrhoea would formerly have been certified as due to enteritis or gastro-enteritis. TABLE X. Comparative Table of Deaths from Zymotic Diseases during the past ten years. 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 Decennial average 1904 Small Pox 2 1 ... ... ... ... ... 4 25 ... 3 ... Measles 151 99 185 76 119 103 81 126 99 107 115 58 Erysipelas 17 6 16 11 18 17 17 10 11 11 14 11 Scarlet Fever 30 28 32 47 28 14 13 9 23 7 23 11 Diphtheria 118 94 82 108 120 63 32 20 18 29 68 14 Enteric Fever, &c. 29 23 17 18 15 39 32 18 16 17 22 12 Puerperal Fever 9 6 4 3 6 7 3 8 14 5 6 2 Whooping Cough 77 52 137 82 71 52 108 79 63 79 80 61 Epidemic Diarrhœa 93 151 169 141 154 123 149 217 98 92 139 184 Totals 326 460 642 486 531 418 435 491 367 347 470 353 26 TABLE XI. Comparison of Prevalence of Sickness and Death from Infectious Diseases (Rates calculated per 1,000 persons on the population estimated to the middle of each year). Years. Small-pox. Erysipelas, Diphtheria and Membranous Croup. Scarlet Fever. Enteric and Continued Fever. Puerperal Fever. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. 1894 0.05 0.01 2.03 0.10 3.16 0.73 5.24 0.18 0.96 0.18 0.06 0.05 1895 0.12 0.00 1 .49 0.03 2.52 0.57 5.09 0.17 0.86 0.14 0.06 0.03 1896 0.02 0.00 1.59 0.09 2.57 0.49 6.72 0.19 0.67 0.10 0.06 0.02 1897 0.00 0.00 1.35 0.06 3.69 0.65 9.76 0.28 0.57 0.10 0.04 0.01 1898 0.00 0.00 1.06 0.10 4.74 0.71 4.84 0.16 0.56 0.08 0.05 0.03 1899 0.00 0.00 1.21 0.10 3.61 0.37 4.30 0.08 0.93 0.23 0.08 0.04 1900 0.00 0.00 0.98 0.10 1.81 0.19 3.25 0.07 1.22 0.19 0.03 0.01 1901 0.30 0.02 0.74 0.04 1.56 0.11 3.60 0.05 0.53 0.10 0.04 0.04 1902 0.98 0.14 1.14 0.06 1.60 0.10 4.98 0.13 0.51 0.09 0.08 0.08 1903 0.19 0.00 0.85 0.06 1 .62 0.16 2.58 0.04 0.49 0.09 0.04 0.02 Average 1894-1903 0.16 0.01 1.24 0.07 2.68 0.40 5.03 0.13 0.73 0.13 0.05 0.03 1904 0.03 0.00 0.90 0.06 1.13 0.07 2.13 0.06 0.29 0.06 0.04 0.01 This table is recommended for use by the Society of Medical Officers of Health, as a record of "the frequency and mortality of infectious diseases in the whole district for a series of years." 27 The next table gives the death-rate from each of the chief zymotic diseases compared with the mean death-rate in the preceding decennium, and the gain or loss in each case is also given:— TABLE XII. Diseases. Mean Death rate per 1000 1894-1903. Death-rate per 1000 1904. Gain in 1904. Loss in 1904. Small-Pox 0.01 0.00 0.01 ... Measles 0.68 0.33 0.35 ... Erysipelas 0.07 0.06 0.01 ... Scarlet Fever 0.13 0.06 0.07 ... Diphtheria 0.40 0.07 0.33 ... Enteric Fever 0.13 0.06 0.07 ... Puerperal Fever 0.03 0.01 0.02 ... Whooping Cough 0.47 0.34 0.13 ... Diarrhoea 0.82 1.04 ... 0.22 It will be seen from the above table that in 1904 the death-rate in every disease except diarrhoea, was well below the mean death-rate for the preceding ten years. The reduction is most marked in the case of measles and diphtheria, but is also considerable in scarlet fever, enteric fever and puerperal fever. The death-rate from the seven principal zymotic diseases— viz., small-pox, scarlet fever, diphtheria, enteric fever, measles, whooping cough and diarrhœa was 1.93, the death-rate from these diseases in the County of London being 2.12. Notifiable Infectious Disease. Compulsory notification of certain infectious diseases came into force in Battersea in the year 1889 by the adoption of the Infectious Diseases (Notification) Act, 1889. 28 The diseases at present notifiable are Small-pox, scarlet fever, diphtheria and membranous croup, cholera, erysipelas, typhus, typhoid, continued, relapsing and puerperal fevers. By an Order of the Local Government Board, 19th September, 1900, bubonic plague was also made notifiable. On 29th March, 1904, the London County Council made an Order under section 56, sub-section 6, of the Public Health (London) Act, 1891, making chicken-pox a notifiable disease in the County of London for a period of four calendar months. The Order came into force on 7th April, and was subsequently renewed, finally expiring on 7th November, 1904. The number of cases notified during the year was 801, excluding chicken-pox cases. In East Battersea, 357 cases were notified; in North-West Battersea, 222; in South-West Battersea, 222. The number of cases notified and the proportion per 1,000 population are set out as follows :— Total number of cases notified. No. of cases notified excluding Chicken-pox. Notifications per 1,000 of the population excluding Chicken-pox. The Borough 1,367 801 4.5 East Battersea 545 357 4.8 North-West Battersea 427 222 4.4 South-West Battersea 395 222 4.2 The notifications included 7 cases of small-pox and 566 cases of chicken-pox. No cases of typhus fever, relapsing fever, cholera, or plague were notified. 29 TABLE XIII. Year. No. of Notifications received. Notifications per 1,000 of the population. Percentage of cases removed to hospital. 1894 1845 11.5 43.0 1895 1657 10.1 40.5 1896 1929 11.6 46.8 1897 2569 15.4 52.5 1898 1887 11.3 62.9 1899 1702 10.1 70.5 1900 1231 7.3 68.9 1901 1148 6.7 72.1 1902 1597 9.3 78.0 1903 1003 5.7 74.6 Average 1894-1903 1656 9.9 60.9 1904 801 4.5 71.6 In the above table the chicken-pox notifications are excluded. The cost of the notification of infectious disease in Battersea in each year since 1891 is given below:— Year. Amount paid to Medical Practitioners. Cost per 1,000 Population. ... ... £ s. d. £ s. d. 1891 ... ... 150 1 0 0 19 10 1892 ... ... 224 18 6 1 9 3 1893 ... ... 321 2 6 2 0 11 1894 ... ... 208 12 0 1 6 1 1895 ... ... 197 19 6 1 4 2 1896 ... ... 229 16 0 1 7 9 1897 ... ... 310 3 0 1 17 4 1898 ... ... 229 0 6 1 7 5 1899 ... ... 203 17 6 1 4 3 1900 ... ... 146 12 6 0 17 5 1901 ... ... 136 10 0 0 16 1 1902 (including Chicken-pox) 343 19 0 2 0 1 1903 ,, ,, 137 11 0 0 15 10 1904 ,, ,, 171 4 0 0 19 5 The amount paid to medical practitioners for notification certificates of cases of chicken-pox in 1904 was £67 6s. The notification fees are repaid to the Sanitary Authorities by the Metropolitan Asylums Board. Table XIV. gives the number of cases of each of the notifiable diseases in each week of the year, and the same information is recorded in a graphic form on the chart. 30 TABLE XIV. Weekly Summaries of Cases of Infectious Disease Notified During the Year 1904. (Cases of Chicken-pox are excluded). Month Week or Year. Cases of Infectious Disease Notified. Totals. Small-Pox. Diphtheria and Membranous Croup. Erysipelas. Scarlet Fever. Typhus Fever. Enteric Fever. Continued and Relapsing Fever Puerperal Fever. Cholera. 1904 1903 1902 January 1 ... 6 6 9 ... ... ... 1 ... 22 18 20 2 ... 4 3 6 ... 1 ... ... ... 14 20 45 3 ... 5 3 5 ... 1 ... ... ... 14 26 40 4 ... 4 5 4 ... 1 ... ... ... 14 35 39 February 5 ... 8 1 3 ... 2 ... ... ... 14 32 29 6 ... 5 5 7 ... 5 ... ... ... 22 20 29 7 4 6 4 4 ... ... ... ... ... 18 18 24 8 ... 9 1 12 ... 2 ... ... ... 34 30 40 March 9 2 4 ... 2 ... 1 ... ... ... 9 21 31 10 ... 2 4 3 ... 2 ... ... ... 11 15 42 11 ... 1 5 7 ... ... ... 1 ... 14 25 22 12 1 1 6 4 ... ... ... ... ... 12 26 22 13 ... 5 2 5 ... 2 ... ... ... 14 19 30 April 14 ... 4 3 6 ... ... ... ... ... 13 15 32 15 ... 6 4 3 ... 2 ... ... ... 15 13 32 16 ... ... 2 11 ... 1 ... 1 ... 15 15 28 17 ... 1 2 3 ... ... ... ... ... 6 17 35 May 18 ... 2 3 4 ... 1 ... ... ... 10 13 28 19 ... 1 2 6 ... ... ... ... ... 9 23 30 20 ... 4 3 6 ... 1 ... ... ... 14 16 30 21 ... 6 2 4 ... ... ... ... ... 12 18 29 June 22 ... 1 3 9 ... ... ... 1 ... 14 15 27 23 ... 3 ... 4 ... 1 ... 1 ... 9 12 22 24 ... 1 3 3 ... 1 ... ... ... 8 20 11 25 ... 1 5 6 ... ... ... ... ... 12 14 25 26 ... 5 1 2 ... ... ... ... ... 8 17 28 31 TABLE XIV.—continued. Month. Week of Year. Cases of Infectious Disease Notified. Totals. Small-Pox. Diphtheria and |Membranous Croup. Erysipelas. Scarlet Fever. Typhus Fever. Enteric Fever. Continued and Relapsing Fever Puerperal Fever. Cholera. 1904 1903 1902 July 27 ... 4 2 10 ... ... ... ... ... 16 16 24 28 ... 3 4 5 ... ... ... 2 ... 14 16 31 29 ... 3 4 10 ... ... ... ... ... 17 11 27 30 ... 4 3 6 ... ... ... ... ... 13 18 34 August 31 ... 3 2 11 ... 2 ... ... ... 18 22 30 32 ... 7 1 4 ... ... ... ... ... 12 18 32 33 ... 1 3 8 ... ... ... ... ... 12 9 21 34 ... 1 2 9 ... 1 ... 1 ... 14 19 21 September 35 ... 5 1 3 ... 1 ... ... ... 10 18 21 36 ... 2 4 ... ... ... ... ... ... 6 16 24 37 ... 3 2 11 ... 2 ... ... ... 18 10 26 38 ... 8 4 9 ... 3 ... ... ... 24 18 32 39 ... 6 2 9 ... 2 ... ... ... 19 16 36 October 40 ... 2 4 7 ... ... ... ... ... 13 20 51 41 ... 3 4 8 ... ... ... ... ... 15 18 50 42 ... 4 5 16 ... 1 2 ... ... 28 23 42 43 ... 2 5 20 ... 1 ... ... ... 28 31 35 November 44 ... 10 3 9 ... 3 ... ... ... 25 16 25 45 ... 3 4 6 ... ... ... ... ... 13 12 41 46 ... 3 5 11 ... 1 ... ... ... 20 22 42 47 ... 4 4 8 ... 2 ... ... ... 18 24 21 December 48 ... 3 2 9 ... 3 ... ... ... 17 23 32 49 ... 2 6 9 ... 2 ... ... ... 19 22 26 50 ... 4 1 8 ... 1 ... ... ... 14 22 24 51 ... 7 3 9 ... ... ... ... ... 19 17 38 52 ... 7 1 22 ... 2 ... ... ... 32 23 41 Whole Year ... 7 199 159 375 ... 51 2 8 ... 801 1003 1597 32 TABLE XV. Notifications of Infectious Disease received during the Year 1904 arranged in Wards. Ward. Small-pox, Chickenpox. Diphtheria & Membranous Croup. Erysipelas. Scarlet Fever. Typhoid or Enteric Fever. Simple Continued Fever Puerperal Fever. Totals No. 1 (Nine Elms) 4 85 19 22 102 7 — 1 240 „ 2 (Park) 2 50 15 37 54 7 — 2 167 „ 3 (Latchmere) 1 54 18 16 38 12 — — 139 „ 4 (Shaftesbury) — 36 12 11 16 4 — 2 81 „ 5 (Church) — 106 38 16 24 5 — — 189 „ 6 (Winstanley) — 66 37 26 28 6 — 1 164 „ 7 (St. John) — 17 15 6 24 — — 1 63 „ 8 (Bolingbroke) — 79 22 13 43 5 — - 162 „ 9 (Broomwood) — 73 23 12 46 5 2 1 162 Totals 7 566 199 159 375 51 2 8 1,367 Small-Pox. The following table gives the number of Small-pox cases and deaths in Battersea and in the County of London since 1891:— 33 Year. Battersea London. Cases. Deaths. Cases. Deaths. 1891 - 114 8 1892 2 1 425 41 1893 108 12 2,815 206 1894 8 2 1,193 89 1895 20 1 980 55 1896 4 — 225 9 1897 1 — 104 16 1898 1 — 33 1 1899 — — 29 3 1900 — — 86 4 1901 51 4 1,700 229 1902 169 25 7,797 1,314 1903 33 — 416 13 1904 7 — 491 25 The last of the 33 cases of small-pox that occurred in the year 1903 was notified on 7th September in that year. From that time until February 15th, 1904, no case was notified. On the latter date a case was notified from Culvert Road, and this was soon followed by other cases, the total number of cases occurring in the year being 7. The cases were all traced to one source of infection. A list of the cases is given below : — No of Case Initials of Patient. Street. Date of Notification. 1 H. W. Culvert Road 15 Feb. 2 M. W. Gonsalva Road 17 ,, 3 N. D. Gonsalva Road 17 ,, 4 W. W. Gonsalva Road 17 ,, 5 W. W. Gonsalva Road 1 March 6 R. S. Culvert Road 3 ,, 7 G. S. Culvert Road 25 ,, 34 The age-distribution of the cases is given below :— Age Periods— Years. Under 1 1-5 5-10 10-15 15 25 25-35 35-45 45-55 55- Cases — — 1 — 4 — 1 1 — The first case of small-pox to be actually notified in the year was notified from a house in Culvert Road on 15th February. On 30th January the patient had called on some friends in Gonsalva Road, and it was stated that one of these friends was unwell at the time, and had "spots" on his face. The house in Gonsalva Road was visited, and three of the inmates were found to be suffering from a mild form of small-pox. In two of these patients the rash had appeared on 31st January, and in the other patient on 16th January. It was then ascertained that another inmate of this house had been unwell about the end of December, and that a few spots had appeared on the face and arms on 1st January; but as the illness was slight, no doctor had been called in. There can be no doubt that this patient's illness was small-pox, and that she was the source of the infection in the other cases. On 1st March another case was removed to hospital from the house in Gonsalva Road, and on the following day a second case was removed from Culvert Road. Another case, the last in the year, subsequently occurred in Culvert Road. In all these cases the infection was derived, directly or indirectly, from the unrecognised case in Gonsalva Road. Scarlet Fever. The number of Scarlet Fever cases occurring in 1904 was 375, of which 11 were fatal. This is by far the smallest number of Scarlet Fever cases notified in Battersea since 1890. The Scarlet Fever case-rate, death-rate, and case-mortality in 1891 and the subsequent years are given on page 35. 35 Year. Cases. Case Rate per 1,000 population. Deaths. Death-rate per 1,000 population. Casemortality per cent. 1891 738 4.89 38 0.25 5.1 1892 1,171 7.61 42 0.27 3.5 1893 1,407 8.97 32 0.20 2.2 1894 837 5.24 30 0.18 3.5 1895 830 5.09 28 0.17 3.3 1896 1,111 6.72 32 0.19 2.8 1897 1,621 9.76 47 0.28 2.9 1898 809 4.84 28 0.16 3.4 1899 721 4.30 14 0.08 1.9 1900 548 3.25 13 0.07 2.3 1901 609 3.60 9 0.05 1.4 1902 854 4.98 23 0.13 2.6 1903 448 2.58 7 0.04 1.5 1904 375 2.13 11 0.06 2.9 In the sub-districts, the number of cases per 1,000 population was as follows:—East Battersea, 2.52; North-West Battersea, 1.49; South-West Battersea, 2.19. The number of cases per 1,000 population in the County of London was 2.89, and the death-rate 0.07. The following gives the age distribution of the cases notified, and of the fatal cases:— 36  Age Periods—Years. Total. Under1 1-2 2-3 3-4 4-5 5-10 10-15 15-25 25-65 Cases 4 8 18 22 38 162 80 28 15 375 Deaths 1 ... 2 1 1 4 2 ... ... 11 The number of cases removed to hospital was 325 or 86'6 per cent, of the cases notified. In 1903 83.9 per cent., and in 1902 87.7 per cent, of the cases notified were removed to hospital. In the sub-districts the percentage of cases removed to total cases was as follows:—East Battersea, 91.4; North-West Battersea, 97.2; South-West Battersea, 71.9. The high percentage of removals is an indication of the popular confidence in the Metropolitan Asylums Board's hospitals, for in no case was it found necessary to exercise compulsion to effect a removal. In 78 cases a history of direct personal contact with a previous case in the district was obtained, and 14 other cases were infected outside Battersea. In 20 cases the patients were infected after the return of an inmate of the same house who had been discharged from an isolation hospital after an attack of Scarlet Fever. In some of these "return" cases the infection was probably derived from the primary case. An outbreak of Scarlet Fever, comprising 6 cases, occurred in a boarding-school early in the year. The first patient (who infected, directly or indirectly, the five subsequent patients), was taken ill on 19th February. On the 16th she received a parcel of pancakes from her home in the country, and it was afterwards ascertained that on 18th February a case of Scarlet Fever was removed to hospital from her home. In 13 of the cases notified as suffering from Scarlet Fever, the diagnosis was found to be erroneous and the patients sent back from hospital. Diphtheria and Membranous Croup. The case-rate, death-rate and case-mortality from Diphtheria and Membranous Croup since 1891 are set out in the following table:— 37 Year. Cases Case-rate per 1,000 population. Deaths. Death-rate per 1,000 population. Casemortality per cent. 1891 260 1.72 68 0.45 26.1 1892 366 2.38 57 0.37 15.6 1893 682 4.35 176 1.12 25.8 1894 505 3.16 118 0.73 23.3 1895 411 2.52 94 0.57 22.8 1896 426 2.57 82 0.49 19.2 1897 614 3.69 108 0.65 17.6 1898 791 474 120 0.71 15.1 1899 606 3.61 63 0.37 10.4 1900 306 1.81 32 0.19 10.4 1901 264 1.56 20 0. 11 7.5 1902 275 1.60 18 0.10 6.5 1903 282 1.62 29 0.16 10.3 1904 199 1.13 14 0.07 7.0 The case-rate in the sub-districts in 1904 was as follows:— East Battersea, 0 78; North-West Battersea, 159; SouthWest Battersea, 1.19. In the County of London the case-rate was 1.55, the death-rate 0.15, and the case-mortality10.10 per cent. The number of cases removed to hospital was 155, or 77.8 per cent. of the total number of cases notified. In 1903 the percentage of cases removed to hospital was 81.9, and in 1902 73.4. The percentage of cases removed in the sub-districts was as follows:— East Battersea, 84.4; North-West Battersea, 82 2; South-West Battersea, 64.5. Ten deaths occurred in 38 hospital, and 4 at home, the case-mortality at hospital and at home being- 6.4 and 9. 1 respectively. The following table gives the age distribution of the cases notified, and of the fatal cases:— Age Periods—Years. Total. Under 1 1-2 2-3 3-4 4-5 5-10 10-15 15-25 25-65 Cases 6 8 12 19 28 79 19 13 15 199 Deaths 3 1 1 2 2 5 — — — 14 The total number of houses invaded by diphtheria was 156. In 30 houses the drainage was defective, and in 105 insanitary conditions other than drainage defects were found. In 20 cases a history of direct personal infection was obtained. In addition to these, 7 cases imported the disease from other districts, and 2 cases were possibly return cases. Thirty-five cases notified as suffering from diphtheria and removed to hospital were found not to be so suffering, and were returned home. On 31st October I was informed by the medical officer of one of the boarding schools in the district that he had found three cases of diphtheria amongst the scholars. I immediately accompanied him to the school, and specimens for bacteriological examination were taken from the throats of all the scholars and the members of the teaching staff. The Klebs-Loeffler bacillus was found to be present in two cases, in one of whom no clinical symptoms could be found. Two subsequent cases occurred, the last case being notified on 6th November. The total number of cases was 7. One patient, a girl aged eighteen months, had diphtheria twice during the year, the first attack beginning on 12th May, the second on 7th July. On both occasions the patient was removed to hospital. I was informed that the patient had had a previous attack on 21st February, when living at Tooting. Two hundred and forty-four bacteriological examinations were made, 39 of which gave a positive and 205 a negative result. 39 Return Cases of Scarlet Fever and Diphtheria. Twenty cases of Scarlet Fever occurred at periods varying from 4 to 39 days after the return of a previous Scarlet Fever patient from hospital. Two cases of Diphtheria occurred under similar circumstances. In 4 of the Scarlet Fever cases, however, there were other possible sources of infection, and although in the remaining 16 cases no other source of infection could be traced, it is probable that in some of them the return of the first case before the infection of the second was merely a coincidence. In some instances, however, there appeared to be a causal relationship between the two cases. It is not surprising that this should be so. It is impossible thoroughly to disinfect a human being as one disinfects a blanket, and in the present imperfect state of our knowledge of the sources of infection in Scarlet Fever, the absolute prevention of "return cases" appears hardly practicable. For some time past the London Medical Officers of Health have endeavoured to induce the Metropolitan Asylums Board to furnish them with the dates on which it was proposed to discharge from hospital recovered cases of Scarlet Fever and Diphtheria, and since early in 1903 this has been done. It is now one of Miss Dawson's duties to visit the homes to which recovered patients are to return, and to advise the mothers to take certain precautions; for instance, not to allow the child to sleep with other children soon after his return. She also ascertains to what school it is proposed to send the patient, and a letter is then addressed to the Head Teacher requesting that the child be excluded from school for a fortnight after his return home. This procedure appears to have been beneficial. The number of days occurring between the date on which the first patient was discharged, and the date on which the disease appeared in the second patient varied from 4 to 39. The following table shows the number of cases infected after each of the varying periods. 40 I. Scarlet Fever. No. of days between the discharge of the first patient and the onset of the disease in the second patient. No. of cases infected. 4 days 1 5 „ 2 6 „ 1 7 „ 3 8 ,, 1 10 ,, 1 11 ,, 1 12 ,, 2 13 ,, 1 14 ,, 2 15 „ 1 16 ,, 1 18 ,, 1 24 „ 1 39 „ 1 2. Diphtheria. 10 days 1 12 „ 1 Enteric Fever. The case-rate, death-rate and case-mortality from Enteric Fever since 1891 are set out in the following table:— 41 Year Cases. Case-rate per 1,000 population. Deaths. Death-rate per1,000 population. Casemortality per cent. 1891 118 0.78 23 0.15 19.5 1892 82 0.53 10 0.06 12.1 1893 138 0.88 22 0.14 16.0 1894 154 0.96 29 0.18 18.8 1895 140 0.86 23 0.14 16.4 1896 111 0.67 17 0.10 15.4 1897 95 0.57 18 0.10 19.0 1898 94 0.56 15 0.08 16.0 1899 157 0.93 39 0.23 24.9 1900 206 1.22 32 0.19 15.5 1901 90 0.53 18 0.10 20.0 1902 88 0.51 16 0.09 18.2 1903 85 0.49 17 0.09 20.0 1904 51 0.29 12 0.06 23.5 The reduction in enteric fever prevalence and mortality during the last few years, to which attention was called in previous annual reports, was maintained in 1904, both the case-rate and death-rate being exceptionally low. The death-rate and case-rate in the sub-districts are set out below:— Case-rate per 1,000 population. Death-rate per 1,000 population. East Battersea 0.28 0.10 North-West Battersea 0.38 0.06 South-West Battersea 0.21 0.01 42 In the County of London the case-rate was 0 40, and the death-rate o'o6. Forty-one cases, or 80.3 per cent, of the total were removed to hospital, compared with 69.4 per cent. in 1903, and 73.8 per cent. in 1902. In 7 instances the infection was found to have been derived from a previous case of the disease in the Borough, and in 7 other cases the patient was infected outside Battersea. One of these patients was infected in Madeira, and another at Emsworth. In 6 other cases there were reasons for suspecting shell-fish as carrying the infection. Oysters were suspected in 4 cases, cockles in one, and mussels in one. Two patients had eaten Emsworth oysters, and one patient mussels from Leigh-on-Sea. The number of houses invaded by the disease was 44. In 11 houses the drainage was found to be defective, and in 28 houses defects other than drainage defects were found to exist. Facilities for bacteriological diagnosis are supplied gratis by the Council to all medical practitioners in Battersea. Each practitioner is supplied with an outfit containing appliances for taking a specimen of blood for examination by the Widal test. The practitioner is apprised of the result of the examination by telegram, and the outfit is returned re-filled. 54 doubtful cases were examined, with a positive result in 12, and a negative result in 42 cases. Puerperal Fever. The number of cases notified was 8, that number being 1 below the decennial average. 7 cases were notified in 1903 and 15 cases in 1902. The case-rate was 04, or '01 below the mean case-rate for the preceding ten years, which was .05. 2 cases were fatal. The death-rate was .01, or '02 below the decennial average, '03. The death-rate for London was .04. 5 cases occurred in East Battersea, 1 in North-West Battersea, and 2 in South-West Battersea. 43 Erysipelas. One hundred and fifty-nine cases were notified, 11 of which were fatal. The case rate was .90, or .34 below the decennial average; and the death-rate .06, or .01 below the decennial average. 43 cases were removed to hospital, the majority going to Union infirmaries, and the remainder to general hospitals. Measles. The deaths from this disease numbered 58, or 57 below the decennial average. 22 deaths occurred in East Battersea, 32 in North-VVest Battersea, and 4 in South-West Battersea. The death-rate was .33, as compared with 68, the mean death-rate for the preceding ten years, and .48, the death-rate in the County of London. The death-rate in the sub-districts was as follows:-East Battersea, .29; North-West Battersea, .64; South-West Battersea, '07. Twenty deaths were of infants under one year, 37 of children aged from one to five years, and 1 death occurred among children aged from five to ten years. The deaths in each of the four quarters of the year were as follows :— First quarter 18 Second ,, 26 Third ,, 7 Fourth ,, 7 The mortality from Measles in 1904 was lower than in any previous year except 1891, when the death-rate from this disease was .24. On 20th January, 1903, the London County Council made an order which had the effect of applying to Measles practically all the provisions of the Public Health (London) Act, 1891, relating to the prevention of infectious disease except notification. This order came in force on 1st April, 1903. Disinfection is now carried out in all cases coming to the 44 knowledge of the Medical Officer of Health. Although Measles is not a notifiable disease, a considerable number of cases are reported to the Medical Officer by the head teachers of elementary schools. Every case reported is now visited by one of the lady inspectors, who endeavours to secure such measures of isolation as are possible. A leaflet which sets out the main provisions of the law relating to the exposure of infected persons, etc., is handed to the person responsible for the care of the patient. Whooping Cough. Whooping Cough caused 61 deaths during the year, or 19 less than the decennial average. The deaths were equivalent to a death-rate of 33 per 1,000, or '35 lower than the mean death-rate for the preceding ten years, which was .68. The death-rate in the County of London was '32. The death-rate in the sub-districts was as follows:— East Battersea, 41; North-West Battersea, '52; South-West Battersea,.07. Thirty deaths were of infants under one year, and 30 of children from one to five. The deaths in each quarter of the year were as follows:— First quarter 40 Second ,, 13 Third ,, 7 Fourth ,, 1 Whooping Cough in 1904 caused more deaths than any of the notifiable diseases, but its fatality was rather less than in the previous year. Like measles, Whooping Cough is fatal chiefly from pulmonary complications, which could in a large measure be guarded against by proper care and attention. Like measles also, Whooping Cough too often leaves the respiratory organs so seriously impaired that they are rendered peculiarly susceptible to the bacillus of tuberculosis. 45 Diarrhœa. Diarrhoea was the cause of 184 deaths, including 95 registered as due to epidemic or zymotic enteritis. The death-rate was ro4 per 1,000, or .22 above the decennial average '82. The death-rate in the County of London was ro2. The number of deaths and the death-rate in the sub-districts are set out below :— No. of Deaths Death-rate per 1,000 East Battersea 90 1.21 North-West Battersea 76 1.53 South-West Battersea 18 0.34 One hundred and fifty-nine deaths, or 86.4 per cent. of the whole, were of infants under one year, and 21 deaths were of children aged from one to five years. The deaths in each quarter of the year were as follows:— First quarter 12 Second ,, 12 Third ,, 151 Fourth ,, 9 It will be seen that the exceptionally hot weather during the third quarter of the year was responsible for a heavy mortality from diarrhœa. Compared with former years, however, the mortality is not so heavy as it would appear, as many deaths are now certified as due to "epidemic enteritis" or "zymotic enteritis" (conditions which are classified as "diarrhœa") which would formerly have been certified as due to "gastro enteritis" or "enteritis," and would, therefore, have been classified under the heading " Enteritis." In the early part of July the following leaflet was delivered to every house in the borough:— 46 Battersea Borough Council. » HOW TO PREVENT DIARRHŒA. Diarrhœa is caused by eating food which has been contaminated by germs. The germs are carried by dust and dirt, and the way to prevent Diarrhœa is to keep your house and everything in it scrupulously clean. Do not allow dirt and dust to accumulate in the yard. Put the dust in the dust-bin, and see that the dust-bin is kept covered. Burn all animal and vegetable refuse. Boil all your milk as soon as it comes into the house. This will kill any germs that may be in the milk. Then keep it covered so as to prevent other germs from getting in. Do not eat tainted meat. Keep your cistern clean, and boil your drinking water. Thousands of hand-fed babies die from Diarrhœa every summer, but breast-fed babies are seldom attacked. It is, therefore, particularly important that babies should be fed from the mother's breast during the hot weather. By Order of the Health Committee, G. F. McCLEARY, M.D., Medical Officer of Health. Municipal Buildings, Lavender Hill. July, 1904. Tuberculosis. The following table shows the death-rate from Phthisis and other Tubercular Diseases per 100,000 persons in each year since 1892. 47 TABLE XVI. Year. Deaths from Phthisis per 100,000 persons. Deaths from other Tubercular Diseases per 100,000 persons. 1892 135 18 1893 143 82 1894 137 53 1895 151 65 1896 146 79 1897 151 62 1898 154 71 1899 162 56 1900 155 53 1901 146 60 1902 129 44 1903 128 51 1904 139 41 The total number of deaths from tuberculosis in 1904 was 317, as compared with 311 in 1903. The deaths from the various forms of the disease were as follows:- Tuberculosis of the Lungs (Consumption) 244 Tuberculosis of the Brain 23 Tuberculosis of the Larynx 1 Abdominal Tuberculosis 19 General Tuberculosis 24 Other forms of Tuberculosis 6 The number of deaths from Phthisis and other Tubercular diseases, and the death-rate per 1,000 in each of the subdistricts is set out in the following table:— 48 TABLE XVII. District. Phthisis Other Tubercular Diseases. Total. No. of Deaths. Rate. No of Deaths. Rate. No. of Deaths Rate. East ) Battersea) 112 1.51 29 .39 141 1.90 Nth.-West Battersea 74 1 .49 34 .68 108 2.17 Sth.-West Battersea 58 1.11 10 .19 68 1.30 The Borough 244 1.39 73 .41 317 1.8o The deaths from Tuberculosis formed 12 per cent. of the total deaths, and the disease caused a greater mortality than all the "zymotic" diseases, with the exception of diarrhoea, put together. Disinfection was carried out in 55 per cent. of the fatal cases occurring in private houses. Fifty-three specimens of sputum from doubtful cases of consumption were submitted to bacteriological examination, the result being positive in 16 and negative in 37 cases. Cancer. Table XVIII. gives the deaths and the death-rate from Cancer during the last ten years. The table appears to show an increased mortality from Cancer during the decennium, but the increase may possibly be due, to some extent, to improved diagnosis and certification. 49 TABLE XVIII. Year. Deaths. Deaths per 100,000 persons. 1894 110 62 1895 114 70 1896 105 63 1897 104 62 1898 122 73 1899 113 67 1900 130 77 1901 117 69 1902 151 88 1903 141 81 Average 1894-1903. 120 71 1904 164 93 The anatomical distribution of the disease in both sexes is set out in Table XIX. 7 deaths were certified as due to sarcoma, the remainder to cancer, carcinoma or malignant disease. 50 TABLE XIX. Situation. Males. Females. Total. Mouth and Jaw 5 1 6 Larynx 2 2 4 Stomach and (Esophagus 22 4 26 Liver 9 16 25 Bowels 4 7 11 Rectum 10 8 18 Bladder 4 — 4 Breast — 22 22 Uterus — 19 19 Abdomen 4 8 12 Other situations 11 6 17 Totals 71 93 164 Alcoholism. Sixteen deaths were returned as due to acute and chronic alcoholism, 13 of the cases being males, and 3 females. 15 deaths (males 6, females 9) were due to cirrhosis of the liver, a disease which, in practically every case, is caused by alcohol. This gives a total of 31 cases in which alcohol was the cause of death, as against 38 in 1903, but there is no doubt that this number greatly understates the real mortality from alcoholism. Deaths really due to this cause are usually certified under less invidious headings such as apoplexy, Bright's disease, heart disease, etc. The mortality from alcohol cannot, therefore, be even approximately estimated from the death returns. General Sanitary Administration. 53 General Sanitary Administration. Table XX. gives a summary of the work of the sanitary inspectors, so far as the work admits of tabulation. Table XX.—Summary of Sanitary Operations for the Year 1904. Total Sanitary Operations 80423 Dust receptacles provided 728 Number of house inspections 43456 Leaky house-roofs and gutters repaired 787 Bakehouse inspections 286 Bakehouse nuisances abated 186 Houses supplied with water, and fittings repaired 316 Urinal—inspections 579 Do. altered, repaired, or water laid on 92 Water closets supplied with water or supply disconnected from drinking water cisterns 818 Intimations served under Sec. 3 5366 Notices served under Sec. 4 1975 Cisterns covered, cleansed and repaired 629 Notices served under Sec. 62 & 65 1085 Complaints received & attended to 3424 Keeping of animals in unfit state discontinued 153 Number of houses disinfected 1215 Houses supplied with disinfectants 4171 Smoke observations 262 House drains flushed with disinfectants after infectious disease 1217 Certificates of disinfection granted 1333 Houses inspected and certificates granted (Sec. 48) 270 Overcrowding abated 58 Proceedings Ordered by Council and Health Committee 4593 Premises cleansed and repaired 1970 Drains tested ... By smoke 1209 Summonses issued 179 „ water 5142 Magisterial Orders obtained and enforced 119 Drains cleansed and repaired 460 Drains relaid 689 Factories & Workshops inspections 4701 Frontage drains constructed or re-constructed 152 Sanitary conveniences provided or improvements effected in Factories & Workshops (Sec. 38) 185 Soil-pipes and drains ventilated 561 Sink and rain water pipes disconnected or repaired 532 Water Closets cleansed & repaired 993 Underground sleeping rooms disused 39 Cesspools abolished 9 Mews & Stables drained & paved 132 Gipsy van inspections 229 Yards and forecourts paved 1389 Drains laid to new houses and tenements 270 Accumulations of manure and other obnoxious matter removed or proper receptacles provided 158 Samples taken under the Sale of Food and Drugs Acts 700 Other Sanitary operations 972 The following table gives particulars as to number of houses inspected in house-to-house inspection during the year:— 54 Table XXL—House-to-House Inspection. East battersea. north-west battersea. south-west battersea. Name of Road. No. of houses inspected. No. of houses in which defects existed. Name of Road. No. of houses inspected. No. of houses in which defects existed. Name of Road. No. of houses inspected. No. of houses in which defects existed. Aegis Grove 33 29 Alfred Place 15 9 Altenburg Gardens 33 28 Arthur Street 67 59 Althorpe Grove 5 4 Althorp Road 45 15 Ascalon Street 79 62 Banbury Street 16 14 Amies Street 40 37 Ashbury Road 18 1 Britannia Place 39 31 Bramfield Road 58 28 Belfour Street 37 37 Church Road 20 19 Burland Road 28 18 Birley Street 41 14 Colestown Street 27 23 Falcon Road 19 4 Brighton Terrace 8 4 Cottage Place 17 6 Grandison Road 32 19 Gideon Road 20 8 Edmund's Place 10 10 Hillier Road 70 27 Henley Street 94 85 Ford's Place 29 26 Lavender Hill 6 3 New Road 107 60 Green Lane 62 43 Longbeach Road 5i 35 Poyntz Road 43 29 Heaver Road 70 65 Mossbury Road 46 17 Prince of Wales Road 8 3 Henry Street 53 53 Northcote Mews 3 3 Savona Place 43 25 Ingrave Street 99 81 Nottingham Road 13 5 Savona Street 5 2 Kambala Road 91 76 Park Road (St. John's Hill) 65 13 Seldon Street 17 7 Lithgow Street 20 18 Shirley Grove 40 34 Little Europa Place 36 36 St. Ann's Road 10 6 Sleaford Street 56 26 Lombard Road 37 17 Sarsfeld Road 57 38 Spencer Street 65 36 Lothair Street 9 6 Sisters Avenue 115 75 Tidbury Street 18 8 Mantua Street 78 49 Spencer Road 30 11 Tidemore Street 35 27 Mendip Road 56 32 Sugden Road 21 19 Tyneham Road 24 14 Musjid Road 66 64 Taybridge Road 6 5 Victoria Dwellings 187 160 Orville Road 58 36 Thirsk Road 34 15 Warriner Gardens 82 48 Plough Road 8 4 Wandsworth Common (North Side) 28 6 Wellington Road 10 7 Stanmer Street 12 8 Stockwood Street 19 13 Weston Street 29 29 Thibet Street 13 10 Wroughton Road 79 22 Totals 1.137 785 Totals 965 753 Totals 918 477 55 Houses Let in Lodgings. The number of houses on the register is 121. These houses are kept under regular supervision. In March, 1903, the Council adopted new bye-laws as to houses let in lodgings. These differed from the existing bye-laws in several respects, the most important being that (1) the exemption clause was omitted, (2) the cubic air space was increased, and (3) by an alteration of the definition of the term " landlord," the responsibility for the structural condition of the premises was thrown upon the owner. The Local Government Board took exception to some of the proposed alterations, and after some correspondence the Council revised the bye-laws, which in their amended form were adopted by the Council on February 10th, 1904. In June, 1904, the Local Government Board informed the Council that owing to recent decisions in the High Court (which were to the effect that certain of the bye-laws were invalid, as they did not provide for notices to be served), they had caused their model bye-laws to be revised, and the Board asked the Council to consider the desirability of amending the proposed bye-laws in a corresponding manner. The Council accordingly amended the bye-laws so as to provide for the proper service of a notice before taking legal proceedings against the keeper or landlord for an offence against the bye-laws. The bye-laws as finally amended were adopted by the Council on 14th September, 1904, and are now being considered by the Local Government Board. The following are the chief provisions of the amended bye-laws as adopted on 14th September:— 1. In these bye-laws, unless the context otherwise requires, the following words and expressions have the meanings hereinafter respectively assigned to them; that is to say:— "Council" means the Mayor, Aldermen and Councillors of the Metropolitan Borough of Battersea. "Lodging-house" means a house or part of a house which is let in lodgings or occupied by members of more than one family. 56 "Landlord," in relation to a lodging-house, means the person (whatever may be the nature or extent of his interest in the premises) who receives, or is entitled to receive the rack rent of a lodging-house. "Keeper," in relation to a lodging-house, means the person (whatever may be the nature or extent of his interest in the premises) by whom or on whose behalf the lodging-house is let in lodgings or for occupation by members of more than one family, or who for the time being receives or is entitled to receive the profits arising from the said letting. "Lodger," in relation to a lodging-house, means a person to whom any room or rooms in the lodging-house may have been let as a lodging or for his use and occupation. 2. A lodging-house shall be exempt from the operation of these bye-laws where the keeper resides on the premises, and where in addition to such keeper and his family there are not more than two persons lodging in such house. 3. A lodger in a lodging-house and, subject to the provisions of these bye-laws the keeper of the lodging-house or, where there is no keeper and the landlord resides on the premises, the landlord of the lodging-house shall not knowingly cause or suffer a greater number of persons than will admit of the provision of four hundred cubic feet of free air space for each person of an age exceeding ten years, and of two hundred cubic feet of free air space for each person of an age not exceeding ten years to occupy, at any one time, as a sleeping apartment, a room which is used exclusively for that purpose, and which in the case of the lodger has been let to such lodger. 4. A lodger in a lodging-house and, subject to the provisions of these bye-laws the keeper of the lodging-house or, where there is no keeper and the landlord resides on the premises, the landlord of the lodging-house shall not knowingly cause or suffer a greater number of persons than will admit of 57 the provision of five hundred cubic feet of free air space for each person of an age exceeding ten years, and of two hundred and fifty cubic feet of free air space for each person of an age not exceeding ten years to occupy, at any one time, as a sleeping apartment, a room which is not used exclusively for that purpose, and which in the case of the lodger has been let to that lodger. 5. The keeper, or where there is no keeper, the landlord, of a lodging-house, within a period of fourteen days after he shall have been required by a notice in writing, signed by the Town Clerk and duly served upon or delivered to such keeper or landlord as the case may be, to supply the information necessary for the registration of the lodging-house by the Council, shall, himself, or by his agent duly authorised in that behalf, sign and furnish to the Council a true statement of the following particulars with respect to the lodging-house; that is to say— (a) The total number of rooms in the house : (b) The total number of rooms let in lodgings or occupied by members of more than one family : (c) The manner of use of each room : (d) The number, age, and sex of the occupants of each room used for sleeping : (e) The Christian name and surname of the lessee of each room ; and (/) The amount of rent or charge per week payable by each lessee. 6. In any case where the landlord of a lodging-house resides in any part of the premises, the landlord, and in any case where the landlord of a lodging-house does not reside in any part of the premises, every keeper or lodger who is entitled to have or to exercise the control of the outer door of the premises shall, at all times when required by the Medical Officer of Health, the Sanitary Inspector, or any other officer specially appointed or authorised by the Council in that behalf, afford any such officer free access to the interior of the premises for the purpose of inspection- 58 7. Every lodger in a lodging-house shall, at all times when required by the Medical Officer of Health, the Sanitary Inspector, or any other officer specially appointed or authorised by the Council in that behalf, afford any such officer free access for the purpose of inspection to the interior of any room or rooms which may have been let to the lodger. 8. Where the Medical Officer of Health, the Sanitary Inspector, or any other officer specially appointed or authorised by the Council in that behalf, has, for the purpose of inspection, obtained access to the interior of a lodging-house or to the interior of any room or rooms in a lodging-house, a person shall not wilfully obstruct any such officer in the inspection of any part of the premises, or, without reasonable excuse, neglect or refuse, when required by any such officer, to render him such assistance as is reasonably necessary for the purpose of his inspection. 9. In any case where a lodger in a lodging-house is entitled to the exclusive use of any court, courtyard, area, or other open space within the curtilage of the premises, the lodger, and in any case where two or more lodgers in a lodging-house are entitled to the use in common of any court, courtyard, area, or other open space within the curtilage of the premises, the keeper or where there is no keeper and the landlord resides on the premises the landlord shall, subject to the provisions of these bye-laws, cause the court, courtyard, area, or other open space to be thoroughly cleansed from time to time as often as is requisite for the purpose of keeping the same in a cleanly condition. 10. Subject to the provisions of these bye-laws, the landlord of a lodging-house shall cause every drain or means of drainage, with which any water-closet belonging to the lodging-house may communicate, to be maintained at all times in good order and efficient action. He shall also cause all such means of ventilation as are provided in or in connection therewith to be maintained at all times in good order. 59 11. Every lodger in a lodging-house shall cause all solid or liquid filth or refuse to be removed once at least in every day from every room which has been let to him, and shall once at least in every day cause every vessel, utensil, or other receptacle for such filth or refuse to be thoroughly cleansed. 12. In every case where a lodger in a lodging-house is entitled to the exclusive use of any staircase, landing, or passage in the lodging-house, the lodger shall cause every part of the staircase, landing, or passage to be thoroughly cleansed from time to time as often as is requisite. 13. A lodger in a lodging-house shall not cause or suffer any animal to be kept in any room which has been let to the lodger or elsewhere upon the premises in such a manner as to render the condition of the room or premises filthy. 14. Subject to the provisions of these bye-laws the keeper, or where there is no keeper and the landlord resides on the premises, the landlord of a lodging-house shall cause every common passage or staircase in the lodging-house to be thoroughly cleansed from time to time as often as is requisite. 15. Subject to the provisions of these bye-laws the landlord of a lodging-house shall, at least once, and when required by the Council, at a specified date in every year, cause every part of the premises to be cleansed. He shall, at the same time, when it is necessary for thorough cleansing, cause the walls of every area, the surface of every ceiling, and the interior surface of every wall of every room, staircase, and passage in the lodging-house, and of every water closet belonging to the premises to be thoroughly lime-washed. Provided that the foregoing requirement with respect to lime-washing shall not apply in any case where the internal surface of any such ceiling or wall is painted, or where the material of or with which that surface is constructed or covered is such as to render the lime-washing thereof unsuitable or inexpedient, and where the said surface is thoroughly cleansed, and the paint or other covering is renewed, if the renewal 60 thereof be necessary for the purpose of keeping the premises in a cleanly and wholesome condition. 16. Subject to the provisions of these bye-laws the landlord of a lodging-house shall provide adequate means of ventilation in or in connection with every common passage or staircase in the lodging-house, and shall cause the said means of ventilation to be maintained at all times in good order. 17. Subject to the provisions of these bye-laws the landlord of a lodging-house shall cause all such means of ventilation as are provided in or in connection with any room in the lodging-house to be maintained at all times in good order. 18. In every case where, in pursuance of any statutory provision in that behalf, an order of a justice has been obtained for the removal from a lodging-house to a hospital of a person who is suffering from any dangerous infectious disease and is without proper lodging or accommodation, the keeper, or where there is no keeper and the landlord resides on the premises the landlord of the lodging-house, and the lodger to whom any room whereof the person aforesaid may be an occupant has been let shall, on being informed of the order, forthwith take all such steps as are requisite on the part of the keeper or landlord and of the lodger respectively, to secure the safe and prompt removal of the said person in compliance with the order, and shall, in and about the removal adopt all such precautions as, in accordance with any instructions which such keeper or landlord and such lodger, respectively, may receive from the Medical Officer of Health of the Council, are most suitable for the circumstances of the case. 19. Where a duty imposed upon or a prohibition applied to the keeper or landlord of a lodging-house, as the case may be, is by any bye-law expressly imposed or applied subject to the provisions of these bye-laws, proceedings shall not be taken against the keeper or landlord, as the case may be, for an offence against the bye-law unless and until the keeper or landlord, as the case may be, after service upon him of a notice in writing by the Council requiring him within such 61 reasonable time as is specified in the notice to comply with the bye-law has failed to comply with the bye-law within the time so specified. The Work of the Lady Sanitary Inspectors. The work of each of the two lady sanitary inspectors, so far as it admits of tabulation, is set out in the following tables. Miss Dawson, who entered upon her duties in June, 1902, is chiefly concerned in the supervision of workshops, etc., where female labour is employed, but, as will be seen from the following table, she does much important work in other directions. The following is a summary of Miss Dawson's operations :— New workshops inspected and registered 59 Workshop re-inspections 606 New workshops notified to H.M. Inspector 53 Cards distributed showing number of persons legally employed in workrooms 91 Houses visited which on enquiry were found not to be workshops 50 Workplace inspections 165 Inspections of out-workers' premises 343 Visits to consumers of Council's milk 584 Premises inspected after infantile deaths 219 Premises re-inspected after infantile deaths 184 Visits to premises to which children recovered from infectious disease returned 297 Cases of puerperal fever investigated 4 Other inspections 6 Written intimations issued 420 Statutory notices issued 240 Inspections of houses let in lodgings 77 Re-inspections of houses let in lodgings 227 Houses visited during house-to-house inspection 103 Re-inspection of such houses 144 62 Mrs. Young, who entered the service of the Council in May, 1904, is chiefly occupied with work having for its object the prevention of infantile mortality in the poorer districts of the borough. Mrs. Young's operations are set out in tabular form below. No. of houses inspected during house-to-house inspection 110 No. of premises inspected after infantile deaths 436 No. of inspections of sanitary works in progress 347 No. of visits to cases of non-notifiable infectious disease 95 No. of visits to consumers of Council's milk 429 No. of visits to verminous and exceptionally dirty houses 18 No. of addresses given at mothers' meetings, etc. 35 No. of premises visited where births had occurred 72 No. of visits re neglected children 44 No. of houses visited on complaint 35 No. of other visits 25 No. of intimations issued 253 No. of statutory notices served 54 In the early autumn a circular letter was addressed, by order of the Health Committee, to the clergy of all denominations in Battersea, stating that the Committee were prepared to arrange for Mrs. Young to give short practical addresses on the feeding and care of infants at mothers' meetings and similar gatherings. The Committee's offer was accepted by a good number of clergymen, and 35 addresses were given before the end of the year. The addresses met with great success. Large audiences (in some cases exceeding 100 women) were obtained, and the mothers appeared to be interested, and anxious to profit by the instruction given. Similar addresses are being arranged for the present year. One of Mrs. Young's duties is to visit homes where births have occurred, and to give practical advice to the mothers as 63 to the feeding and care of the infant. Some delay was experienced before this work could be begun, owing to the inability of the local Registrars to furnish the Council with lists of homes from which births were registered. In April, the Council addressed a communication to the Local Government Board, asking the Board to take steps to empower the Registrars to give this information, and in November a letter was received from the Board to the effect that the Board had arranged with the Registrar-General to permit the local Registrars to give the desired information. Weekly lists containing certain specified particulars of each birth registered in Battersea are now received from the Registrars, and suitable cases are visited by Mrs. Young. Particulars of each case visited are reported in writing to the Medical Officer of Health, and the information is recorded in a card register. Mrs. Young supplements her oral instructions by leaving a card containing advice as to the feeding of infants. This card, which was drawn up by the Medical Officer of Health, by order of the Health Committee, is in the following terms :— Battersea Borough Council. ADVICE ON THE FEEDING OF INFANTS. The baby should be fed at the breast for at least nine months. MOTHER'S MILK IS BY FAR THE BEST FOOD FOR BABIES. THE BABY SHOULD BE FED REGULARLY. During the first two months give the breast every two hours in the day, and every four hours at night. After two months gradually increase the time between each meal to three hours in the day, and let the baby sleep from 11 at night to 5 in the morning without a meal. If the mother has not enough milk, give cow's milk as well. The two milks will not disagree. Never take stout or other stimulants when suckling; drink plenty of milk instead. WEAN YOUR BABY GRADUALLY. Never wean during July, August or September if you can possibly help it. If you do your baby may die from summer diarrhœa. 64 If you cannot feed your baby at the breast, feed the baby on cow's milk. Never give solid food, such as bread, biscuits, tops and bottoms, or anything but milk until the baby is twelve months old, unless your doctor orders it. The milk should be given in a bottle with a short teat, or in a spoon. ON NO ACCOUNT WHATEVER SHOULD YOU USE THE BOTTLE WITH THE LONG TUBE. Carefully wash the bottle and teat with hot water after each meal. Turn the teat inside out and hold it under the tap, and then keep it in clean water. Cow's milk must be prepared with great care, or it will not agree with the baby. Prepare the milk in the following way :— Boil all the milk when you receive it from the milkman. Then keep it in a jug or can closely covered so as to keep out dust and flies. Place the jug or can in cold water, and store it in the coolest place you have. Make up each meal in the following way:— For a Baby under Two Weeks Old. Milk, 1 table-spoonful; water, 2 table-spoonfuls. Mix and then warm. Give this to the baby every two hours in the day and every four hours at night. For a Baby from a Fortnight to Two Months Old. Milk, 1½ table-spoonfuls, gradually increasing to 3 ; water, 3 table-spoonfuls. Mix and warm. Feed as before. For o Baby between Two and Four Months Old. Milk, 3 table-spoonfuls, gradually increasing to 4; water, 3 table-spoonfuls, gradually increasing to 4. Mix and warm. Give this every three hours during the day and once at night. For a Baby between Four and Six Months Old. Milk, 5 table-spoonfuls, gradually increasing to 8; water 5 table-spoonfuls, gradually decreasing to 4. Mix and warm. Give this every three hours during the day and once at night. For a Baby between Six and Nine Months Old. Milk, 9 table-spoonfuls, gradually increasing to 11; water, 3 table-spoonfuls. Mix and warm. Give this every three hours in the day and once at night. A tea-spoonful of cream and a tea-spoonful of sugar must be put into each meal before warming. 65 When the baby is nine months old the milk may be given without anything being added, and the number of table-spoonfuls in each meal may be increased from 14 to 16. In the summer, instead of warming the milk for each meal, after mixing with the cream and sugar, boil it; then let it cool until the baby can take it. The food must be freshly prepared for each meal, and if any of the meal is left it must not be given again to the baby. But it need not be wasted ; give it to the older children. Keep the bottle, teat, and all the things for holding the milk, cream and sugar perfectly clean. UNLESS ORDERED BY A DOCTOR, NEVER GIVE YOUR BABY SKIMMED OR SEPARATED MILK, CONDENSED MILK, PATENT FOODS, OR MEDICINES OF ANY KIND. N.B.—These directions are not intended to apply to those babies who are ordered a special diet by a doctor. In April, 1904, the Health Committee addressed a communication to the Highways Committee, asking that Committee to take into consideration the question of paving the carriage ways of certain side streets with an impervious paving such as asphalt. The Highways Committee decided to give this form of paving a trial, and during the year the carriageways of 14 streets were paved with tarred slag macadam. This material gives a smooth impervious surface, and is much less expensive than asphalt. Impervious paving of carriageways is an important feature of urban sanitation. Such paving is especially needed in side streets. In many districts side streets are the chief playgrounds of the children. The following is a list of the streets paved with tarred slag macadam during the year :— G. F. McCleary, M.D., Medical Officer of Health. hygienic Street Paving. Austin Road Balfern Street Balham Park Road Britannia Place Elspeth Road Estcourt Road Gonsalva Road Kennard Street Latchmere Street Montholme Road Motley Street Mysore Road Northcote Road Parkside Street 66 On 23rd November the Council decided to apply to the London County Council for a loan of £10.000, to pave some 40 streets with tarred slag macadam. Sewer Ventilation. During the year twenty-five ventilating shafts were erected, three of which were erected by the London County Council in connection with their sewers in Battersea Park Road, Thurleigh Road, and York Road, and the remaining twenty-two were erected by Borough Council to ventilate their sewers situated as follows :— Andoe Road High Street Lombard Road Lavender Sweep Lithgow Street Longhedge Street New Road Poyntz Road Phoenix Wharf Lane Prairie Street Power Street Queens Road Ravenslea Road (2 shafts) Tennyson Street (3 shafts) Totteridge Road Usk Road Winstanley Road Wycliffe Road (2 shafts) In most of these streets surface ventilators in the roadway were closed after the erection of the tall shafts. During the hot weather many of the surface ventilators gave rise to nuisance, and it is to be hoped that these openings may soon give place to better methods of sewer ventilation. Paving of Back-yards and Forecourts. The following table shows the number of back-yards and forecourts wholly or partly paved during 1904. It will be seen that the work done in this connection was considerable, especially in the Winstanley Ward, where owing to the energy and tact of Inspector Purnell there has been a great improvement in back-yard sanitation. 67 Ward. Back-yards. Forecourts. Wholly paved. Partly paved. Wholly paved. Partly paved. Paved as far as 12 feet or more from end of house. Paved for a lesser distance than 12 feet. Nine Elms 53 10 126 13 36 Park 138 2 6l — - Latchmere 20 — 67 6 10 Shaftesbury 47 15 49 12 1 Church 134 28 142 35 27 Winstanley 178 50 147 101 24 St. John's 4 — 15 — 3 Bolingbroke 22 23 30 8 44 Broomwood 2 27 9 2 29 Totals 588 155 646 177 174 It should be said that no attempt was made to enforce the paving of any yard which was being really cultivated as a garden. The yards which were paved were merely pieces of waste land, usually in a dirty and untidy condition. The paving of the ground round dwelling-houses is a very important feature in urban sanitation. By preventing the pollution of the soil it tends to prevent diarrhoea and other filth diseases. Also, it has a good effect upon the tenants ; a paved yard is usually kept in a better condition than an unpaved yard. Disinfection. The total number of rooms disinfected during the year was 1,637. In most cases the disinfectant used was formic aldehyde, either volatised in an Alformant lamp or applied in 68 solution as "formalin" by means of a spray. In verminous rooms sulphur dioxide was used. After small-pox cases the rooms were first disinfected by formic aldehyde and then the walls were stripped of paper and washed down before and after stripping with a solution of formalin. In the case of every disease but measles, the process of disinfection included the removal of all bedding, clothing, and fabrics generally from the infected rooms, and the disinfection of these articles by steam in the Equifex machines at the Council's Disinfecting Station. Infected articles which would be destroyed by steam, such as boots, furs, etc., were disinfected by formic aldehyde in a specially constructed zinc-lined chamber. The following table shows the number of premises and rooms disinfected during each month of 1904. 69 TABLE XXII. month. Smallpox. Scarlet Fever. Diphtheria Enteric Fever. Erysipelas. Puerperal Fever. Phthisis. Measles. Other Diseases. Total. Premises. Rooms. Premises. Rooms. Premises. Rooms. Premises. Rooms. Premises. Rooms. Premises. Rooms. Premises Rooms. Premises. Rooms. Premises. Rooms. Premises. Rooms. January ... ... 18 20 18 23 8 8 13 13 1 1 20 22 1 i 4 4 83 92 February 2 21 21 31 34 41 11 11 8 9 ... ... l6 20 6 7 5 5 103 145 March 3 33 19 30 15 24 3 3 9 11 I I l6 20 47 48 3 3 116 173 April ... ... 17 23 16 23 4 4 11 13 I 2 12 14 35 40 7 7 103 126 May ... ... 27 46 15 17 3 3 8 8 ... ... 2 2 56 60 4 7 115 143 June ... ... 19 24 8 9 1 1 7 7 I I 12 12 63 67 3 6 114 127 July ... ... 31 40 21 21 2 2 9 10 2 2 11 11 18 20 7 7 101 113 August ... ... 30 39 15 18 4 4 7 8 1 1 8 14 3 3 7 9 75 96 September ... ... 23 24 18 26 6 6 11 11 ... ... 9 11 2 2 5 8 74 88 October ... ... 54 73 14 31 4 5 8 9 ... ... 17 20 13 15 3 3 113 156 November ... ... 39 93 21 82 7 8 17 18 ... ... 10 21 7 10 7 12 108 244 December 43 46 20 37 5 5 7 7 ... ... 18 22 14 14 3 3 110 134 Totals 5 54 341 489 215 352 58 60 115 124 7 8 151 189 265 287 58 74 1,215 1,637 70 Table XXIII. shows the number of articles removed and disinfected by steam at the Disinfecting Station. TABLE XXIII. Articles. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total for year 1904. Beds 250 206 232 253 941 Blankets 690 520 526 921 2.657 Bolsters 239 195 200 337 971 Carpets 274 199 207 313 993 Cushions 362 252 215 379 1,208 Mattresses 199 179 151 289 818 Palliasses 267 200 245 265 977 Pillows 626 447 524 647 2,244 Quilts 415 353 322 501 1.591 Sheets 584 448 485 744 1,291 Wearing Apparel, &c. 11,323 6,844 7,066 10,163 35.396 Totals 15,229 9.843 10,173 14,842 50,087 In addition to those set out in the above list, 3,819 articles were removed and subjected to chemical disinfection, the total number removed and disinfected being 53,906. The following articles were removed and destroyed at the request of the owners:— 71 Beds 30 Blankets 16 Bolsters 14 Carpets 18 Cushions 33 Mattresses 23 Palliasses 47 Pillows 29 Quilts 8 Sheets 28 Articles of wearing apparel 1,042 Total 1,288 The whole work of disinfection was carried out under the immediate supervision of Mr. Woodhouse, the Disinfection Superintendent, and was very well done. The Station, which was opened on March 25th, 1902, has a separate staff on either side, the infected side is completely separated from the noninfected portion of the building and no interchange of duties is allowed to occur between the workers on opposite sides. The total number of articles of clothing, etc., removed and disinfected was 53,906, and in only one case was any complaint made of damage during disinfection. In this case a claim was made for the sum of £5 for alleged damage to some articles which had been disinfected. Upon enquiry, however, it was found that no damage had been sustained by the articles while they were in the custody of the Council's officers, and when it became evident that the claim would be contested by the Council, it was promptly withdrawn. Many complaints were, however, received that soiled clothing had been sent home after disinfection unwashed, and until means for washing such articles are provided similar complaints will continue to be made. A steeping-tank and a wringer have been provided lately, and the utility of the Station would be greatly increased if a small laundry were added to it so that the infected articles could, where necessary, be 72 thoroughly washed and returned home cleansed as well as disinfected. It is to be hoped that during the present year steps will be taken to provide this much-needed addition to what is otherwise an admirably planned and well equipped Disinfecting Station. The total weight of the articles removed and disinfected at the Disinfecting Station during the year 1904 was 105 tons 15 cwt. 17 lbs. The disinfection of this weight of articles at the charges made by the contractor formerly employed by the Council would have cost the Council ;£1,586 7s. 3d. The actual cost is set out in detail below:— £ s. d. Wages 691 6 0 Hire of Council's horses 200 15 0 Fuel 43 0 0 Water and electric light 7 1 6 Rates and taxes 61 18 9 Insurance 2 11 0 Stores 4 10 0 Interest on loan 97 9 4 Repairs (including repairs to vans) 66 15 6 Depreciation— Buildings (at 3 per cent.) 77 16 5 Machinery (at 10 per cent.) 63 12 0 Vans (at 10 per cent.) 12 18 0 Van shed (at 3 per cent.) 3 15 0 Total £1, 333 8 6 Temporary Shelter or House Accommodation. The Public Health (London) Act, 1891 (section 60, subsection 4) imposes an obligation upon Sanitary Authorities to provide accommodation for persons who have been compelled to leave their dwellings on account of disinfection being carried on therein. Interior of Shelter, Sheepcote Lane. 73 The sub-section is as follows:— "The Sanitary Authority shall provide, free of charge, "temporary shelter or house accommodation with any "necessary attendants for the members of any family "in which any dangerous infectious disease has "appeared, who have been compelled to leave their "dwellings for the purpose of enabling such dwellings "to be disinfected by the Sanitary Authority." The Council's Shelter in Sheepcote Lane (adjoining the Public Mortuary and Coroner's Court) was ready for occupation by the end of the year. The Shelter comprises two tenements, each containing two rooms and a scullery, and one tenement containing three rooms and a scullery. The arrangement of the rooms is shewn on the accompanying plan. Each tenement is fitted with the combined kitchen-range, copper and bath, invented by Mr. Councillor J. Cornes, of Leek. In the same building, but quite separate from the Shelter, is the residence of the Mortuary Keeper. The total cost of the building was £900 and the cost of the furniture, bedding, etc., in the shelter £56. Mortuary. The number of bodies removed to the Mortuary in Sheepcote Lane was 221. 204 were inquest cases, 6 bodies of patients dying from infectious disease, and 15 bodies removed for sanitary reasons from crowded homes. The following table gives the number of bodies removed to the Mortuary in each year since 1892:— 74 Year. Number of bodies received in the Mortuary. Number of bodies upon which postmortem examinations were held. Number of bodies upon which Coroner's inquests were held. 1892 193 163 187 1893 243 200 237 1894 224 197 208 1895 259 210 232 1896 293 242 278 1897 289 246 273 1898 294 238 267 1899 274 221 260 1900 291 234 273 1901 321 271 304 1902 239 198 224 1903 223 207 213 1904 221 161 204 The largest number of bodies received during any one day of the year was on the 28th January and 6th July, when four bodies were admitted. Inquests were held in 204 cases, and verdicts were returned as follows :— Natural Causes 101 Open Verdict— Found dead 7 Found drowned 9 — 16 T.H.AHAYWARD AMJnsrCE. BOROUGH SURVEYOR. 75 Accidental— Misadventure 2 Suffocation in bed with parents 5 Falls, &c. 19 Run over in streets and on railway 10 Burns and scalds 8 Poisoning 1 Asphyxia 2 Improper feeding 9 Drowning 3 Other injuries, &c. 6 —65 Suicide— Cut throat 3 Poisoning 9 Hanging 4 Drowning 4 — 20 Homicide— Fall 1 Stabbing 1 — 2 Total 204 Block Dwellings. The following is a list of the artizans' dwellings of the " block " type in Battersea with the number of tenements in each:— 76 Name of Buildings. Situation. Owner. No. of tenements Battersea Bridge Buildings Bridge Road London County Council 69 Durham Buildings York Road „ 108 Victoria Dwellings Battersea Park Road Victoria Dwellings Asso.,Ltd. 185 Lombard Dwellings Lombard Road Exors.of Francis Ravenscroft 36 Shaftesbury Chambers Ashbury Road Artizans, &c., Dwellings Co. 22 Van Dwellings. There were 78 dwellings of this description in Battersea in 1904, situated as follows:- Situation of Vans. No. of Vans. No. of Occupants. Males. Females. Mill's Yard, 88 Sheepcote Lane 3 3 5 „ 80 „ 4 4 4 Gurling's Yard, High Street 10 21 15 Barnett's Yard, York Road 10 17 19 Manley's Yard, Falcon Road 4 5 5 ,, Cabul Road 20 17 27 Donovan's Ground, „ 13 20 16 Mill's Yard, Culvert Road 14 16 24 Total 78 103 115 77 During the year the Local Government Board gave their sanction to a new set of bye-laws relating to these structures. These bye-laws give the Council more adequate powers to secure the sanitary condition of the vans and of the ground upon which they stand, than were given by the provisions contained in the old bye-laws, which were made by the Board of Works for the Wandsworth District in 1887. Common Lodging Houses. The Following is a list of the common lodging houses in Battersea:- Premises. Authorised number of lodgers. Whether males or females. Date registered. 75 Falcon Road 78 Males March, 1890 5 Sheepcote Lane 11 Males July, 1901 7 „ „ 10 Males „ „ 53 Surrey Lane 39 Females May, 1885 55 „ „ 36 Females „ „ 57 „ „ 22 Males and Females July, 1895 59 „ „ 24 Males and Females Opened since June, 1903 89 „ „ 28 Males August, 1885 91 „ „ 30 Males Nov., 1887 6 Orville Road 18 Males June, 1902 The common lodging houses are under the control of the London County Council, but they are visited from time to time by the officers of the Sanitary Authority in connection with drainage defects, cases of infectious disease, etc. By the London County Council (General Powers) Act, 1902, the County Council has become a licensing authority for the common lodging houses within the county. Licences may be granted, or refused, annually. 78 Smoke Nuisance. Emission of black smoke was reported on 72 occasions. 63 reports were made by the Council's inspectors, 1 by the London County Council, and 8 by the Coal Smoke Abatement Society. 60 intimations and 19 statutory notices were served, and 5 summonses were taken out. As a result of the proceeding's arising out of these summonses, penalties amounting with costs to £5 17s. were imposed. Customs and Inland Revenue Acts. The following is a list of certificates for exemption from inhabited house duty granted by the Medical Officer of Health in Each year since 1890:- Year. No. of Certificates Granted. Year. No. of Certificates Granted. 1890 243 1898 82 1891 113 1899 68 1892 165 1900 93 1893 201 1901 32 1894 91 1902 28 1895 91 1903 97 1896 120 1904 232 1897 27 The total number of houses inspected by the Medical Officer of Health during 1904 was 232, all of which, except 4 were houses erected by the Council on the Latchmere Estate. Châlets. The following chalets are now in use, under the control of the Health Committee:— (1) Lavender Hill, at junction with Falcon Road. (2) Battersea Park Road, at corner of Cabul Road. (3) Queen's Road, by Victoria Suspension Bridge. (4) Queen's Road, corner of Prince of Wales' Road (opened 1899). (5) York Road, at corner of Plough Road (opened 1900). (6) Bridge Road, at corner of Cambridge Road (opened 1902). 79 Each of the châlets is provided with free accommodation for both sexes, and has two lavatories, one for each sex, attached. There are also 9 public urinals maintained by the Borough Council at:— Town Hall Road. Nine Elms Lane (near steam-boat pier). Do. (by Rifleman public-house). Battersea Park Road (near S.E. &C.D. Railway Station). Do. (near L.B. & S.C. Railway Station). Forfar Road. Church Dock, Church Road. Wye Street. Vicarage Road. Urinal accommodation, accessible to the general public, is also provided at 97 public-houses. The number of public conveniences in Battersea is therefore 112, and these are all kept under close supervision by the sanitary staff. Ambulances. The Council has for some years provided a wheeled handambulance at the châlets in Battersea Park Road, Queen's Road (2), York Road and Lavender Hill, and one is stationed at the corner of Nightingale Lane and Bolingbroke Grove, there being six ambulances in all. The ambulances are freely accessible to the public, and each is provided with splints and surgical dressings. The ambulances are not infrequently used, particularly by the police, to convey injured persons to hospital, and they are undoubtedly of considerable service to the district. Stables. During the year a systematic inspection was made of all the stables in Battersea. The total number of stables was 570, and in these were kept 3,065 horses and 18 donkeys. In 213 stables only one animal was kept on the premises, in 296 80 instances the number of animals varied from 1 to 10, in 53 instances the number varied from 10 to 50, and there were 8 stables in each of which over 50 horses were kept. In 223 instances the stables were in connection with dwellings and in 63 of these the dwelling was situated above the stable. There were 9 cases in which a pony or donkey was stabled in the yard of a dwelling-house, the only outlet from the yard being through the passage of the house. The arrangements for the removal of manure from the stables were as follows:— Frequency of Removal. No. of Stables. Daily 78 Three times a week 52 Twice a week 148 Weekly 267 Fortnightly 17 Monthly 8 The defects discovered and remedied in the course of this inspection were as follows:— Defects. No. of Stables. Manure receptacle absent or defective 231 Defective paving of stable or yard 122 Defective drainage 38 Defective gutters and roofs 12 Defective lighting and ventilation 48 Dirty stables 41 Other defects 28 The number of horses stabled in Battersea in 1904 was 3,065, and the population of Battersea was 175,465. Assuming the same proportion of horses to population to obtain in the whole County of London, it follows that the number of horses stabled in London was 81,207. According to VeterinaryCaptain Smith's "Manual of Veterinary Hygiene," the average amount of excreta passed by a horse in twenty-four hours is about 30 lbs. of solid, and about 5 quarts of liquid matter, and one-half of the solid and one-fourth of the liquid matter is deposited in the streets. Assuming, however, that the amount of excremental matter deposited in the streets is equal to 81 one-third of the solid and one-fourth of the liquid matter, we arrive at the conclusion that over 362 tons of solid, and over 23,377 gallons of liquid horse manure are deposited in the streets of London every day, while the daily amount of manure deposited in stables is over 725 tons of solid matter, and 76,131 gallons of liquid matter. Future generations of Londoners will find it difficult to believe that such a disgusting state of things was tolerated in London at the beginning of the twentieth century. The disappearance of the horse from the streets of London would be a sanitary reform of the first magnitude, and anything, therefore, which tends to improve and cheapen mechanical traction tends to improve public health. Water Supply. At the beginning of the year 1904 the water supply of Battersea was derived from the Lambeth and the Southwark and Vauxhall Water Companies, the latter supplying the whole of the Borough except the southern part of the South-Western sub-district. In June, 1904, the property of these Companies was transferred to the Metropolitan Water Board, who are now responsible for the water-supply of Battersea, except the houses on the Latchmere Estate, which are supplied with water from the wells sunk by the Council in the vicinity. During the year monthly samples from the rising mains were taken in the areas formerly supplied by the two Water Companies, and submitted to the Public Analyst for analysis. The houses, from the mains of which the samples were taken are given in the following table:— 82 Table XXIV. Date taken. Water Company. Lambeth. Southwark & Vauxhall. Jan. 20 43 Broomwood Road 15 Rush Hill Road Feb. 25 55 Hillier Road 57 Taybridge Road March 11 55 Bolingbroke Grove 2 Amies Street April 30 12 Ballingdon Road 84 Latchmere Road May 30 106 Balham Park Road 4 Britannia Place June 29 127 Broomwood Road 2 St. Philip Street July 19 10 Wroughton Road 84 Latchmere Road Aug. 16 4 Dents Road 78 Shillington Street Sept. 27 "Meadowside," Thurleigh Road 2 Altenburg Gardens Oct. 25 28 Broomwood Road 34 Lindore Road Nov. 22 32 Winsham Grove 25 Knowsley Road Dec. 29 15 Althorp Road 5 Amies Street According to the reports of the Public Analyst, the water supplied in the districts in Battersea, formerly served by these Companies, was during the greater part of the year of "fair" quality. Both the February samples, however, and the sample of the Lambeth Company's supply in March were reported as being of from "fair to tolerably fair" quality. The Council's dwellings on the Latchmere Estate are supplied with water from deep wells sunk near the Latchmere Baths. The water from these wells has been several times analysed and found to be of exceptionally good quality. 83 Slaughter Houses. Under the London Government Act, 1899, the duty of inspecting slaughter-houses, cow-houses and milk-shops was transferred from the London County Council to the Borough Councils. The slaughter-houses are frequently inspected by the Food Inspector. They are generally kept in a clean condition, and very little slaughtering is done therein, most of the meat being imported from outside Battersea. The following is a list of the premises licensed as slaughter-houses:— 205 St. John's Hill. 345 Battersea Park Road. 163 St. John's Hill. 235 Battersea Park Road 351 York Road. 49 York Road. 96 Falcon Road. The number of slaughter-houses in Battersea is now 7, as against 9 in 1901. The private slaughter-houses in London generally are being gradually reduced to make way, it is to be hoped for public abattoirs. Cow-houses. A list of the cow-houses in the Borough is given below:— 14 Belle Vue Road. 122 Usk Road. 17 Wiseton Road. The cow-houses and slaughter-houses were visited by a sub-committee of the Health Committee before the annual licensing meeting, and it was decided not to oppose the renewal of any of the licences. Milk-Shops. In 1904 the Milk-shops were supervised by Inspector Benjamin. The number of milk-shops on the register at the end of 1903 was 225; during 1904, 43 new milk-shops were added and the use of 22 discontinued, the total number at the end of 1904 being 246. In 150 instances milk was sold in general shops; in 74, in shops where only dairy produce was 84 sold; in 14, in confectioners' shops, and in 8 cases milk was found to be sold from a dwelling house. Only 16 milk sellers in Battersea obtain milk direct from the farmer; 132 are supplied by wholesale dealers, 87 by other retail purveyors of milk in Battersea, and 11 from retail dealers outside Battersea. In 104 instances less than 1 gallon of milk is sold daily, in 51 shops between 1 and 10 gallons are sold daily per shop, and in 87 shops the daily quantity of milk sold per shop is over 10 gallons. 79 intimations were served for offences under the Public Health Act discovered in milk-shops, and 235 special letters were sent calling upon defaulting purveyors of milk to comply with the Regulations of the London County Council. In 25 milk-shops the utensils were washed in the same copper as was used for washing the family linen, &c.; in 8 cases the milk was found to be stored in the lobby of a dwelling-house, and in very many cases the milk was found to be stored in the shop in uncovered vessels. In all the latter cases the milk seller was called upon to keep his milk in covered vessels, and in this respect a great improvement has taken place. The Regulations relating to milk-shops now in force were made by the Metropolitan Board of Works in 1885 and the powers these Regulations confer are inadequate to deal with many of the improper conditions under which milk is stored and distributed in London. For sixteen years the London County Council have had the power to make new Regulations and it is much to be regretted that this power has not been exercised. Unsound Food. In cases where the retail vendor has unknowingly purchased articles of food unfit for human consumption, and has made no attempt to sell the articles, it is the practice, when the latter are brought to the Health Office, to grant a certificate, which enables the retailer to claim the return of the money paid for the articles to the wholesale dealer. The food is destroyed at the Council's destructor. During the year certificates were granted in respect to the following articles of food, all of which were first covered with disinfectant and then taken to the destructor and destroyed. 85 Food. Quantity. Where purchased. Hake 1 box Billingsgate Market. „ 1¼ cwt. Cod's Roes ¾ cwt. ,, ,, Mixed Fish 6 stone ,, ,, Beef 116 lbs. Central Meat Market Potatoes ½-ton Midland Railway Depot, J Wandsworth Road Mackerel 80 lbs. Billingsgate Market Strawberries 55 punnets Covent Garden Market Roker 100 lbs. Billingsgate Market Haddocks 5 boxes „ „,, 1 cwt. „ „ Herrings 1 barrel „ „ 1¾ cwt. „ „ Bananas 4½ tons (Condemned at Nine Elms Goods Yard) Herrings ... 1 box Billingsgate Market Fish Shops. These premises were closely supervised during the year. There are 62 premises in Battersea where fish is sold. In 43 of these places fried fish only is sold, in 15, wet and dried fish only is sold, and 4 shops sell wet, dried and fried fish. At the first inspection the offal at these premises was found to be collected as follows:— Number of premises where a daily collection was made ... ... ... ... 36 Number of premises where four collections weekly were made ... ... ... 3 Number of premises where three collections weekly were made ... ... ... 13 Number of premises where two collections weekly were made ... ... ... 6 At three shops the offal was collected at irregular intervals, and at one place it was burnt nightly. 86 The total amount of fish offal produced at these shops daily is about 2 tons 11 cwt. After the first inspection steps were taken to secure a daily removal of offal from all the fish shops. Various defects were found and remedied during the year. In four shops a w.c. was found within the place where the fish was stored. Ice Cream. During the year ice-cream was sold on 116 premises in Battersea, the number in 1903 being 115. These premises were supervised by Inspector Benjamin. Various offences against the Public Health Act were discovered, and in 30 instances there was failure to comply with the provisions relating to ice-cream in the London County Council (General Powers) Act, 1902. In all these cases, however, the defects were remedied without any recourse to legal proceedings. In the early part of July a serious outbreak of food poisoning occurred, which there was reason to attribute to the consumption of contaminated ice-cream. The persons affected had all eaten ice-cream from a certain shop; a few ate the ice-cream on the evening of 8th July, and the greater number on 9th July. Particulars were obtained from 54 patients, but there were others affected of whom no particulars could be obtained. In all the known cases the symptoms were similar, and appeared within twenty-four hours after eating the ice-cream, the usual period being from eight to fourteen hours. The symptoms began with violent abdominal pain, followed by severe diarrhoea and sickness. The temperature was raised in most cases, varying from 101° to 103° F. The pulse was rapid and feeble, and in most of the cases the patient soon became collapsed. No case was fatal. Unfortunately, the ice-cream which gave rise to this outbreak was all consumed by the evening of Saturday, the 9th, and no sample, therefore, could be taken for analysis. When the first cases were reported to me early on the following Monday morning, I at once visited the shop, and seized all the ice-cream on the premises. A 87 sample was submitted for bacteriological examination. This examination showed that "the specimen contains at least 10,000 coliform organisms per cubic centimetre of the sample, that the typical Bacillus Coli Communis is apparently only present in very small numbers, and that the Bacillus Sporogenes Enteritidis is probably entirely absent." The examination of the ice-cream which caused the outbreak would, of course, have given very different results. The premises on which this ice-cream was sold were clean and well kept, comparing very favourably with the conditions which are usually found in such places. From my investigations of this outbreak I have no doubt that one of the receptacles used for storing the ice-cream was contaminated by bacteria-containing dust from a dust-bin on premises in the neighbourhood, that the ice-cream stored in this receptacle also became contaminated, and that the consumption of this ice-cream gave rise to the outbreak. The outbreak well illustrates the dangers which may arise from the contamination of milk foods, and it emphasises the necessity for taking precautions against such contaminations. It also throws light on the dangers of the present primitive methods of dust collection in London. The practice of keeping refuse in close proximity to human beings for a week in crowded districts cannot be defended on sanitary grounds. In hot weather such a practice is especially dangerous. A daily collection of dust is much needed. Sale of Food and Drugs Acts. Early in the year the number of samples taken under these Acts was raised from 500 to 700, and Inspector Chuter was appointed to take the whole of the samples. It was thought that the Acts could be administered more efficiently if a special inspector were appointed for the work, and this expectation has been, amply fulfilled. Inspector Chuter has displayed exceptional ability in detecting and bringing to justice the adultering traders in the district, and his operations 88 have had the effect of inducing some of the worse of these scoundrels to practise their dishonest methods elsewhere than in Battersea. Although the number of samples taken has been considerably increased, Inspector Chuter's detective skill has exposed a much higher percentage of adulterated samples than was secured in any previous year. The following is a statement of the adulteration detected in the last seven years. The whole of the samples in 1904, and about one-half of those in 1903, were taken by Inspector Chuter. Year. No. of Samples taken. No. of Adulterated Samples. Percentage of Adulterated Samples. 1898 357 44 12-32 1899 506 56 ii-O6 1900 514 46 8-92 1901 474 35 7-38 1902 500 52 10-40 1903 500 67 13-40 1904 700 107 15-28 89 TABLE XXV. Description of Article. Total No. of Samples taken. Genuine. Adulterated. Inferior. Ale 1 1 ... ... Arrowroot 11 10 1 ... Bread & Butter 9 6 2 1 Butter 103 71 15 17 Camphorated Oil 13 6 7 ... Cheese 3 3 ... ... Cocoa (flake) 3 3 ... ... Cod Liver Oil 3 2 ... 1 Coffee 16 15 1 ... Cream 2 1 1 ... Cream of Tartar 3 3 ... ... Gin 7 6 1 ... Ginger (ground) 4 4 ... ... Glycerine 4 4 ... ... Honey 3 3 ... ... Lard 8 8 ... ... Margarine 3 3 ... ... Milk 438 345 71 22 ,, (separated) 10 5 4 1 „ (skim) 2 1 1 ... Mustard 10 9 1 ... Oatmeal 3 3 ... ... Olive Oil 4 4 ... ... Pepper (white) 6 6 ... ... Rum 5 5 ... ... Sweets 1 ... ... 1 Tomatoes (tinned) 4 4 ... ... Vinegar 12 10 1 1 Whisky 9 8 1 ... Totals 700 549 107 44 Totals (1903) 500 386 67 47 90 Summary of Legal Proceedings. The facts relating to the legal proceedings instituted by the Council in connection with the work of the Health Department are set out on pages 92-110, and are summarised below:- No. of Prosecutions. No. of Convictions. Fines. Coats. £ s. d. £ s. d. Sale of Food and Drugs Acts 143 86 163 15 0 66 0 0 Smoke nuisances 5 5 5 0 0 0 17 0 Unsound Food 11 10 59 0 0 9 12 0 Contravention of Byelaws 14 13 1 1 0 1 6 0 Other proceedings 6 5 6 0 0 2 2 6 Total 179 119 234 16 0 79 17 6 91 TABLE XXVI. Legal Proceedings under the Public Health (London) Act, 1891, Metropolis Management Act, 1855, and Railway Clauses Consolidation Act, 1845. Date of Hearing. Name of Magistrate. Initials and Address of Defendant. Nature of Offence. Result of Proceedings. 1904. Jan. 20 Mr. Francis C.H., 46 New Road Deposit of unsound meat for sale or preparation for sale Fined £10 and 4s. costs „ „ „ B.S., 132 Lower Marsh, Lambeth, S.E. No water supply at No. 31 York Road Closing Order unless supply put on within 14 days, and 5s. costs Feb. 3 „ „ N. & Sons, 73 Clapham Road, S.W. Default in depositing drainage plans Fined 5s. and 2s. costs „ „ „ W. S., 2 Lebanon Gardens, Wandsworth, S.W. Do. do. The plans been having deposited and 2s. the costs of the summons paid before the hearing the summons was withdrawn „ „ „ W.H.M.P., 33 Union Road, Clapham, S.W. Default in complying with notice to abate nuisance at No. 38 Sterndal Road Fined £4 and 4s. costs „ „ „ Do. do. Ditto to provide fittings to w.c., at ditto Feb. 3 & 17 Mar. 2 & 16 „ „ G.C., 191 Fleet Street, E.C. Default in complying with notice to abate nuisance at 90 Stewarts Road Defendant having abated nuisance, the summons was withdrawn on payment by him of £1 11s. 6d. costs 92 Legal Proceedings under the Public Health (London) Act, 1891; Metropolis Management Act, 1855, and Railway Clauses Consolidation Act, 1845—(continued.) Date of Hearing Name of Magistrate Initials and Address of Defendant. Nature of Offence. Result of Proceedings. 1904. Mar. 30 Mr. Francis A.S., 187 York Road Default in complying with notice to abate black smoke nuisance Fined £2 and 2s. costs „ „ „ Do. do. Do. do. Defendant ordered to pay 2s. costs „ „ „ Do. do. Black smoke nuisance Prohibition Order with 5s. costs April 13 „ „ W.K., 332 Balham High Road, S.W. Breach of London County Council Bye-law Fined 3s. and 2s. costs „ „ „ Do. do. Breach of London County Council Bye-law Fined 3s. and 2s. costs Mar. 30 & April 19 Mr. Garrett J.W.G., 140 Northcote Road (Employer) Exposing unsound bananas for sale Fined £1 and £3 3s. costs „ „ „ A.J.R., 140 Northcote Road (Employe) Do. do. Ordered to pay 2s. costs „ „ „ H.E.S., 42 Falcon Road Do. do. Fined £1 and 4s. costs April 13 & 27 Mr. Fenwick E.H., 280 Battersea Park Road Having deposited on his premises for the purpose of preparation for sale diseased meat intended for the food of man Fined £20 and £3 3s. costs 93 Date of Hearing. Name of Magistrate. Initials and Address of Defendant. Nature of Offence. Result of Proceedings. Mar. 30, April 27, & May 6 Mr. Garrett W.W., 68 York Road Deposit for sale of unsound meat Fined £5 and £2 2s. costs April 13 & 27, May 11 & 25 Mr. Lane P., 26 Benfield Street Overcrowding at No. 26 Benfield Street Nuisance having been abated, summonses withdrawn June 8 Mr. Garrett F.R., 50 Plough Road Exposing unsound meat for sale Fined £5 and 4s. costs, or one month June 22 „ „ J.W.G., 150 Northcote Road Exposing unwholesome meat for sale Fined £10 and 4s. costs „ „ „ G.S., 150 Northcote Road Obstructing Inspector in execution of his duty Fined £2 and 2s. costs June 22 & July 6 „ „ S , 4 Ægis Grove Breach of London County Council Bye-law re removal of offensive matter Fined 10s. and 2s. costs July 6 „ „ G.H. & Co., York Road Black smoke nuisance Fined £2 and 4s. costs July 20 „ „ E.S., 187 York Road Breach of prohibition order against smoke nuisance Fined £1 and 4s. costs July 20 „ „ G., 22 Lebanon Gardens Defective paving at Nos. 8, 10, 12 and 14 Lithgow Street Work having been done, defendant ordered to pay 8s. costs 94 Legal Proceedings under the Public Health (London) Act, 1891; Metropolis Management Act, 1855, and Railway Clauses Consolidation Act, 1845—(continued). Date of Hearing Name of Magistrate. Initials and Address of Defendant. Nature of Offence. Result of Proceedings. Sept. 28 & Oct. 26 Mr. Garrett T.J., 7 Bedford Row, W.C. Default in paving of yards at 39 Harroway Road, 2 Urswick Road and 8, 9 and 11 Totteridge Road Work having been done, defendant ordered to pay 10s. costs Oct 25 Mr. Horace Smith A.D., 13 York Road Depositing for sale, six unsound turkeys Fined £3 and 4s. costs „ „ „ Do. Exposing for sale unsound pig's head and rabbit Fined £3 and 2s. costs 95 Summary of Legal Proceedings in connection with the Seizure of Unsound Food. Date of Seizure. Initials and Address of Defendant. Nature and Quantity of Food Seized. Name of Inspector. Result of Proceedings. 1903. Dec. 18 C. H., 46 New Road 2½ lbs. of pigs' lungs J. Herrin Fined £10 and 4s. costs 3 lbs. of calves' lungs 4 lbs. of pork and beef 1904. Feb 18 W. W., 68 York Road 24 lbs. of meat A. Chuter Fined £5 and £2 2s. costs „ 26 H. E. S., 42 Falcon Road 5 lbs. of bananas J. T. Baxter Fined £1 and 4s. costs March 3 J. W. G., 140 Northcote Road „ „ A. Odell Fined £1 and £3 3s. costs „ 3 A. J. R., 140 Northcote Road (employé) „ „ „ Ordered to pay 2s. costs . „ 25 E. H., 280 Battersea Park Road 14½ ozs. of pig's liver A. Chuter Fined £20 and £3 3s. costs 8 lbs. 1½ ozs. of beef May 16 F. R., 50 Plough Road 27 lbs. of beef „ Fined £5 and 4s. costs, or one month June 11 J. W. G., 150 Northcote Road 4 lbs. of pork „ Fined £10 and 4s. costs „ 11 G. S., 150 Northcote Road Obstructing the Inspector while making the seizure „ Fined £2 and 2s. costs Sept. 26 A. D., 13 York Road 6 turkeys „ Fined £5 and 4s. costs „ 26 „ „ 1 pig's head and 1 rabbit „ Fined £3 and 2s. costs 96 TABLE xxvii. Legal Proceedings under sale of Food and Drugs and Margarine Acts. No. of Sample. Date of Hearing. Name of Magistrate. Initials and Address of Defendant. Nature of Offence. Result of Proceedings. 307 1904. Jan. 6 Mr. Francis A. D., 64 Plough Road Selling Irish whiskey 26.57 degrees under proof Fined £5 and 12s. 6d. costs 302 „ 20 „ „ W. W., 62 and 64 St. John's Hill Selling preserved peas containing 0.01083 per cent, of copper Fined £2 and £1 13s. 6d. costs 301 „ „ „ F. & S., Ltd., 450 Brixton Road, S.W. Selling preserved peas containing 0.00637 Per cent, of copper Fined £1 and £1 13s. 6d. costs 303 „ „ „ A. M., 242 Battersea Park Road Selling preserved peas containing 0.00702 per cent, of copper Fined £1 and £1 13s. 6d. costs 298 „ „ „ W. H. M., 143 Lavender Hill Selling preserved peas containing 0.00777 Per cent, of copper Fined £1 and £1 13s. 6d. costs 299 „ „ „ S. S. N., 171 Lavender Hill Selling preserved peas containing 0.00536 per cent, of copper Fined 10s. and £1 13s. 6d. costs 97 No. of Sample. Date of Hearing. Name of Magistrate. Initials and Address of Defendant. Nature of Offence. Result of Proceedings. 300 Jan. 6 Mr. Francis W. T. P., 161 St. John's Hill Selling preserved peas containing 0.00443 per cent, of copper Fined 10s. and £1 13s 6d. costs. 305 Jan. 6and Feb. 17 „ „ W. B.. Plough Hotel, St. John's Hill Selling Irish whiskey 35.24 degrees under proof Fined £5 and 12s. 6d. costs 309 „ „ „ Do. do. Selling Scotch whiskey 26.38 degrees under proof Ordered to pay 12s. 6d. costs 332 Jan. 6 and 20 and Feb. 17 „ „ H. N., Hope Dairy, Hope Street Selling milk containing 7.8 per cent, of extraneous water Fined £2 and 12s. 6d. costs 333 „ „ „ Do. do. Selling milk containing 7.4 per cent. of extraneous water Ordered to pay 12s. 6d. costs 376 Feb. 17 „ „ T. S., 20 Castle Street Selling milk containing 13.4 per cent. of extraneous water Summons dismissed without costs (Warranty defence) 383 „ „ „ G. T. E., 14 Poyntz Road Selling milk containing 11.7 per cent. of extraneous water Fined £1 and 12s. 6d. costs 404 March 2 „ „ F. C., 221B Eversleigh Road Selling milk containing 6 per cent. of extraneous water Fined 10s. and 12s. 6d. costs 391 „ „ „ W. B., 4 Simpson Street Selling milk containing 10.5 per cent. of extraneous water Fined £1 and 12s. 6d. costs 98 Legal Proceedings under Sale of Food and Drugs and Margarine Acts—{continued). No. of Sample. Date of Hearing. Name of Magistrate. Initials and Address of Defendant. Nature of Offence. Result of Proceedings. 401 1904. Mar. 2 Mr. Francis A. L., 16 Miles Street, Wandsworth Road, S.W. Selling milk containing 16 per cent. of extraneous water Fined £1 and 12s. 6d. costs 407 „ „ „ A. A., 123 York Road Selling butter containing 82 per cent, of foreign fat Fined £1 and 12s. 6d. costs 393 „ „ „ J. P. D., 11 York Road Selling camphorated oil 55.7 per cent, deficient in camphor Fined £1 and 12s. 6d. costs 394 „ „ „ G. B. & Co., 77 Walworth Road, S.E. Selling camphorated oil devoid of camphor Fined £1 and 12s. 6d. costs 408 „ „ „ D. J., 121 Maysoule Road Selling butter containing 85 per cent. of foreign fat Fined £1 and 12s. 6s. costs 431 „ 16 „ „ B. L. Q., 36 Prairie Street Selling vinegar containing 6 per cent, of extraneous water Fined £1 and 12s. 6d. costs 420 „ „ „ S. B., 35 Grayshott Road Selling camphorated oil containing an oil not having the characters of olive oil Withdrawn—Analyst's certificate insufficient 99 No. of Sample. Date of Hearing. Name of Magistrate. Initials and Address of Defendant. Nature of Offence. Result of Proceedings. 392 Mar. 2 and 16 Mr. Francis W. F., 33 Queens Road Selling camphorated oil 41.3 per cent, deficient in camphor Withdrawn by instructions of Health Committee, defendant paying 12s. 6d. costs 435 „ 16 „ „ W. G., 17 The Parade, Earlsfield Selling separated milk containing 12 per cent, of extraneous water Fined £10 and 12s. 6d. costs or, in default, 1 month's imprisonment 462 „ 30 „ „ G. G. & Co., 7 Northcote Road Selling milk containing 3 per cent. of extraneous water Summons dismissed without costs (Warranty defence) 412 ,, 2 and 30 „ „ E. W. E. (trading as E. & Sons), 75 Northcote Road Selling milk containing 3 per cent. of extraneous water Summons withdrawn (warranty defence). Defendant paying ing 12s. 6d. costs 458 „ 30 „ „ A. M. & Co., 55 Stewarts Road Selling milk containing 5 per cent. of extraneous water Fined 10s. and 12s. 6d. costs 398 „ „ „ A. L. J., 28 Crichton Street Selling butter containing 84 per cent. of foreign fat Defendant ordered to pay 12s. 6d. costs 449 „ „ „ Do. do. Exposing for sale margarine without having the prescribed label attached Fined £3 and 12s. 6d. costs 465 „ „ „ G H. P., 46 Winstanley Road Selling mustard containing 10 per cent, of starch Fined £1 and 12s. 6d. costs 100 Legal Proceedings under the Sale of Food and Drugs and Margarine Acts—(continued). No. of Sample. Date of Hearing. Name of Magistrate. Initials and Address of Defendant. Nature of Offence. Result or Proceedings. 432 1904. Mar. 16 Mr. Francis A. H., 2 Tennyson Street Selling milk containing 27 per cent of extraneous water Summons adjourned sine die for service. Defendant stated to have left address 506 April 13 „ „ G. K J., Field Farm, Minety, Wilts Selling milk containing 12 per cent, of extraneous water (sample taken at Clapham Junction Railway Station in course of delivery) Fined £3 and 12s. 6d. costs 534 „ 27 Mr. Fenwick W. H., Braddenstoke Abbey, Chippenham, Wilts Selling milk containing 5 per cent, of extraneous water Fined £5 and 12s. 6d. costs 528 „ „ „ J. P., 101 Meyrick Road Selling milk containing 28 per cent of extraneous water Fined £5 and 12s. 6d. costs 477 „ 13 and 27 „ „ F. J., 3 Culvert Road Selling milk containing 8.5 per cent. of extraneous water Fined £3 and 12s. 6d. costs 531 „ 27 „ „ C. D. S., 64A Winstanley Road Selling milk containing 4 per cent. of extraneous water and 12 per cent, of which was devoid of fat Fined £2 and 12s. 6d. costs 101 No. of Sample. Date of Hearing. Name of Magistrate. Initials and Address of Defendant. Nature of Offence. Result of Proceedings. 521 April 27 Mr. Fenwick S. L., 11 Everett Street Selling margarine by retail in a plain wrapper Fined £2 and 12s. 6d. costs 9 May 25 Mr. Lane W. E., 99 Latchmere Road Selling milk containing 8 per cent. of extraneous water Fined £1 and 12s. 6d. costs 17 „ „ „ C. G., 48 Bridge Road Selling milk containing 26 per cent. of extraneous water Fined £3 and 12s. 6d. costs 16 „ „ „ M. S., 14 Howie Street Selling milk containing 9 per cent. of extraneous water Fined £3 and 12s. 6d. costs 21 „ „ „ O. O., 27 Plough Road Selling milk containing 12 per cent. of extraneous water Fined £10 and 12s. 6d. costs 11 „ „ „ J. R., 42 Battersea Park Road Selling milk containing 8 per cent. of extraneous water Summons dismissed (Warranty defence) 22 „ „ „ D. P., 111 York Road Selling milk containing 7 per cent. of extraneous water Summons dismissed (warranty defence) 5 „ 11 and 25 „ „ G. T., 1 Tennyson Street Selling milk containing 6 per cent. of extraneous water Summons withdrawn at Magistrate's suggestion.* (See note below) * In this case Defendant's Analyst analysed the milk two days after the sample was taken by the Inspector, and his analysis showed extraneous water to the extent of 3.52 per cent. and deficiency in fat to the extent of 8 per cent. He, however, stated that the milk was too sour to make an exact analysis, and having regard to this the Magistrate considered it was useless to send the third sample to the Government Analysts, and intimated that under all the circumstances, if the summons were not withdrawn he should have to dismiss it. 102 Legal Proceedings under the Sale of Food and Drugs and Margarine Acts—(continued). No. of Sample. Date of Hearing. Name of Magistrate. Initials and Address of Defendant. Nature of Offence. Result of Proceedings. 34 1904. June 8 Mr. Garrett T. R., 28 Silverthorne Road Selling milk containing 12 per cent. of added water Fined £2 and 12s. 6d. costs 29 „ „ „ H. J. A., 18 Newman Street Selling separated milk containing 6.5 per cent, of added water Fined £5 and 12s. 6d. costs 41 „ „ „ C. E. P., 44 New Road Selling milk containing 11.5 per cent. of added water Fined £2 and 12s. 6d. costs 495 „ „ „ F. O., Lake Farm, Draycott, Chippenham Selling without disclosure milk with 4 per cent. of fat abstracted Ordered to pay 14s. 6d. costs 64 „ 22 „ „ W. R. J., Whitnell House, Binegan, Somerset Selling milk 12 per cent. devoid of fat Fined £1 and 12s. 6d. costs 83 „ „ „ J. G., 33 High Street Selling milk containing 11 per cent. of extraneous water Fined £5 and 12s. 6d. costs — „ „ „ Do. do. Refusal to sell Fined £1 and 2s. costs 27 June 8 and July 6 „ „ A.M. & Co., 55 Stewarts Road Selling milk containing 4 per cent. of extraneous water Fined £1 and 12s. 6d. costs 103 No. of Sample. Date of Hearing. Name of Magistrate. Initials and Address of Defendant. Nature of Offence. Result of Proceedings. 51 June 8 and July 6 Mr. Garrett D. J., 121 Maysoule Road Selling milk containing 15 per cent. of extraneous water Fined £2 and 12s. 6d. costs 62 June 22 and July 6 „ „ B. B., 2 Ashness Road Selling milk containing 16.5 per cent. of extraneous water Summons dismissed (warranty defence) 77 „ „ „ T. R., 21 Pearson Street Selling milk containing 5 per cent. of extraneous water and 36 per cent. devoid of fat Fined £1 and 12s. 6d. costs 104 „ 6 „ „ W. S., 42 Lockington Road Selling milk containing 12 per cent. of extraneous water Fined £2. and 12s. 6d. costs 106 „ „ „ A. G., 38 Orkney Street Selling milk containing 0.0313 per cent. of boron trioxide equal to 4.99 grains per pint of boracic acid Fined £2 and 12s. 6d. costs 97 „ „ „ E. J. H., 31 Falcon Road Selling camphorated oil 22.82 per cent. deficient in camphor Summons dismissed (warranty defence) 100 „ „ „ H. W. J., 67 Wye Street Selling butter containing 44 per cent. foreign fat Fined £1 and 12s. 6d. costs 144 „ 20 „ „ J. T., 57 Wayford Street Selling milk 76 per cent. devoid of fat Fined £3 and 12s. 6d. costs 104 Legal Proceedings under the Sale of Food and Drugs and Margarine Acts—(continued). No. of Sample. Date of Hearing. Name of Magistrate. Initials and Address of Defendant. Nature of Offence. Result of Proceedings. 105 1904. July 20 Mr. Garrett M. A. G., 32 Carpenter Street Selling milk 76 per cent. devoid of fat Ordered to pay 12s. 6d. costs 126 „ ,, ,, C. C., 62 Henley Street Selling arrowroot containing 20 per cent. of wheat flour Fined £1 and 12s. 6d. costs 114 „ ,, ,, H. T., 2 Pearson Street Selling milk 83 per cent. devoid of fat Ordered to pay 12s. 6d. costs 110 „ ,, ,, A. W., 30 Falcon Grove Selling milk containing 12 per cent. of added water Fined £1 and 12s. 6d. costs 130 „ „ ,, D. L. R., 78 Taybridge Road Selling coffee containing 50 per cent. of vegetable matter other than coffee and having the characters of chicory Fined £2 and 12s. 6d. costs 146 ,, 26 Mr. Francis W. P., 51 Gwynne Road Selling butter containing 87.6 per cent. of foreign fat Fined £2 and 17s. 6d. costs 165 „ ,, ,, A. P., 52 Surrey Lane Selling milk containing 8.5 per cent. of extraneous water Fined £1 and 17s. 6d. costs 105 No. of Sample. Date of Hearing. Name of Magistrate. Initials and Address of Defendant. Nature of Offence. Result of Proceedings. 164 July 26 Mr. Francis W. H., 1 Simpson Street Selling milk containing 14 per cent. of extraneous water Summons dismissed (warranty defence) 174 „ „ „ D. J., 3 Cabul Road Selling butter containing 77.9 per cent. of foreign fat Summons adjourned for service, defendant having left address 246 Aug. 31 Mr. Lane J. Bros., 85 Falcon Road Selling milk from a vehicle without their name and address conspicuously inscribed thereon Fined £1 and 2s. costs 238 „ „ „ F. C., 29 Cross Street, Clapham Selling milk containing 13 per cent. of extraneous water Summons dismissed (warranty defence) 231 „ „ „ C. S.,301 York Road Selling milk from which 20 per cent. of the original fat had been abstracted Fined £1 and 12s. 6d. costs 249 „ „ „ W. H., 145 Stewarts Road Selling milk containing 9 per cent. of extraneous water Fined 7s. 6d. and 12s. 6d. costs 221 „ „ „ G. H. P., 46 Winstanley Road Selling margarine by retail in a plain wrapper Fined 10s. and 17s. 6d. costs - „ „ „ G. E. F., 62 High Street Selling milk from a can without his name and address conspicuously inscribed thereon Fined 5s. and 2S. costs 106 Legal Proceedings under the Sale of Food and Drugs and Margarine Acts-(continued). No. of Sample. Date of Hearing. Name of Magistrate. Initials and Address of Defendant. Nature of Offence. Result of Proceedings. 237 1904. Aug. 31 Mr. Lane G. E. F., 62 High Street Selling milk containing 7.5 per cent. of extraneous water Fined 12s. 6d. and 17s. 6d. costs 206 Oct. 12 „ „ M. A. P., 14 Currie Street Selling milk containing 5.7 per cent. of extraneous water Fined 10s. and 12s. 6d. costs 197 „ „ „ J. R., 76 Park Grove Selling milk containing 6 per cent. of extraneous water Fined 10s. and 12s. 6d. costs 202 „ „ „ A. L., 16 Miles Street, Wandsworth Road Selling milk containing 0.025 per cent. of boron trioxide and 8 per cent. of extraneous water Fined 10s. and 12s. 6d. costs 184 „ „ „ H. W. B., 491 Battersea Park Road Selling bread and butter containing 44.5 per cent. of foreign fat in the butter on the bread Fined 10s. and 12s. 6d. costs. 187 „ „ „ A. R., 42 York Road The like containing 76.5 per cent. of foreign fat in the butter on the bread Summons withdrawn by instructions of the Health Committee 107 No. of Sample. Date of Hearing. Name of Magistrate. Initials and Address of Defendant. Nature of Offence. Result of Proceedings. 311 Oct. 26 Mr. Garrett D. J., 121 Maysoule Road Selling butter containing 85.6 per cent. of foreign fat Fined £5 and 12s. 6d. costs 269 „ „ „ J. J., 437 Battersea Park Road Selling milk containing 11 per cent. of extraneous water Fined £2 and 12s. 6d. costs 283 „ „ „ C. E. F., 114 Meyrick Road Selling milk containing 5 per cent. of extraneous water Fined £1 and 12s. 6d. costs 314 „ „ „ L. E., 38 Chatham Street Selling milk containing 27 per cent. of extraneous water Fined £3 and 12s. 6d. costs 301 „ „ „ J. M., 117 Clapham Park Road Selling milk containing 7 per cent. of extraneous water Summons dismissed (warranty defence) 95 July 6 and 20, Oct 26 and Nov.4 „ „ B. & B., 145 Northcote Road Selling camphorated oil 18.61 per cent. deficient in camphor Fined £1 and £2 12s. 6d. costs 157 Sept. 14, Oct. 26 and Nov. 4 „ „ F. T., 298 Battersea Park Road Selling camphorated oil 11.8 per cent. deficient in camphor Fined 10s. and £1 12s. 6d. costs. 344 Nov. 9 Mr. Plowden G. E. T., 24 Falcon Road Selling butter containing 77 per cent. of foreign fat Fined £1 and 12s. 6d. costs 346 „ „ „ A. A., 123 York Road Selling butter containing 86 per cent. of foreign fat Fined £5 and 12s. 6d. costs 108 Legal Proceedings under the Sale of Food and Drugs and Margarine Acts—(continued). No. of Sample. Date of Hearing. Name of Magistrate. Initials and Address of Defendant. Nature of Offence. Result of Proceedings. 245 1904. Nov. 9 Mr. Plowden W. C. & Sons, 56 Bridge Road West Selling milk containing 0.00333 per cent of formaldehyde Fined £1 and 12s. 6d. costs 265 „ „ „ J. B., 17 Bridge Road Selling milk containing 0.00285 per cent. of formaldehyde and 0.03984 per cent. of boracic acid Fined £1 and 12s. 6d. costs 379 ,, 23 „ „ C. S., 55 Bridge Road West Selling milk containing 10 per cent. of extraneous water Fined £1 and 12s. 6d. costs 279 „ „ „ G. M., 50 Battersea Rise Selling milk containing 5 per cent. of extraneous water Fined £2 and 12s. 6d. costs 369 „ „ „ G. E. F., 62 High Street Selling milk from which 12 per cent. of the original fat had been abstracted Summons dismissed (warranty defence) 368 „ „ „ W. J., 46 St. Andrew's Street Selling milk containing 14.5 per cent. of extraneous water Summons dismissed (warranty defence) 109 No. of Sample. Date of Hearing. Name of Magistrate. Initials and Address of Defendant. Nature of Offence. Result of Proceedings. 299 Dec. 21 Mr. Kennedy W. J. J., late of 54 Winstead Street, and now of 49 Pembroke Road, Seven Kings, Ilford Selling milk containing 12 per cent. of extraneous water Fined £2 and £1 1s. costs or 21 days in default of distress 414 „ „ „ W. P., 51 Gwynne Road Selling butter containing 78 per cent. of foreign fat Fined £4 and 12s. 6d. costs 410 „ „ „ F. J., 3 Culvert Road Selling butter containing 84 per cent. of foreign fat Fined £4 and 12s. 6d. costs 416 „ „ „ B. B., 2 Ashness Road Selling milk containing 4 per cent. of extraneous water Summons dismissed (warranty defence) 423 „ „ „ J. B., 53 Lavender Hill Selling butter containing 82 per cent. of foreign fat Fined £10 and 12s. 6d. costs 401 „ „ „ E. B., 39 Inman Road, Earlsfield Selling separated milk containing 10 per cent. extraneous water Fined £1 and 12s. 6d. costs Factory and Workshop Act, 1901. 113 Factory and Workshop Act 1901. Factory and Workshop Act, 1901. The following part of this report is made pursuant to section 132 of the Factory and Workshop Act, 1901, which provides as follows :—"The Medical Officer of Health of every District Council shall in his Annual Report to them report specifically on the administration of this Act in workshops and workplaces, and he shall send a copy of his Annual Report, or so much of it as deals with this subject, to the Secretary of State." The report, however, is not limited to an account of the administration of the above Act in workshops and workplaces; it contains in addition a statement of the work done by the Council in carrying out their duties in relation to factories under the public Health (London) Act, 1891. Workshops. The workshops in Battersea are supervised by the two Workshop Inspectors, Miss Dawson and Mr. Benjamin. Workshops in which women only are employed are inspected by Miss Dawson. Mr. Benjamin has charge of the men's workshops, while those in which both sexes are employed are supervised by both Inspectors. Pursuant to section 131 of the Factory Act, a register of workshops is kept, and it has been found that the card register, which has now been in use nearly three years, has many advantages over the ordinary book register. Each workshop has a special dossier, in which are filed all the reports, plans, letters, and other papers relating to that particular workshop. At the beginning of the year 1904, there were 541 workshops on the register. During the year the occupation of 108 of these premises as workshops was discontinued, while 60 new workshops were registered, so that at the end of the year the number on the register was 493, in which were employed 1,920 persons, 877 males and 1,043 females. 114 The following is a list of the workshops on the register at the end of 1904:— WORKSHOPS. Trade. No. of Workshops on Register. No. of Workrooms. Persons Employed. Males. Females. Adults. Young Persons. Adults. Young Persons. Bakers 89 140 220 9 - Billiard Table Makers 2 6 19 2 - - Blindmakers 2 6 16 — — — Bootmakers 6l 63 139 14 — — Carpenters 8 9 27 6 — — Coach Builders 7 11 41 5 - - Coffin Makers 3 3 6 - — — Crayon Makers 2 5 5 1 3 — Cycle Makers 19 27 36 13 - — Dressmakers 107 123 - - 205 132 Embroiderers 3 8 1 1 15 33 Farriers 8 8 26 — - - Firewood Cutters 6 6 13 2 2 — Florists 3 3 - — 3 2 Furniture Makers 3 3 10 — — — Glaziers 2 3 15 — — — Ironmongers 3 3 7 2 — — Jewellers 4 4 9 — — — Laundries 41 105 2 — 385 18 Masons 4 4 24 3 — — Milliners 32 34 — — 52 40 Musical Instrument Makers 4 5 12 - - - Photographers 6 9 2 7 5 — Picture Frame Makers 3 3 6 3 - - Plumbers 2 3 8 — — — Rag Sorters 4 4 17 — — — Saddlers 5 6 12 — — - Sculptors 3 3 10 — — — Tailors 32 34 31 3 28 14 Trunk and Hat-case Makers 3 10 15 6 2 1 Underclothing Makers 3 3 - - 15 2 Upholsterers 5 9 26 — 9 1 Other Trades 14 32 34 11 69 7 Totals 493 695 789 88 793 250 115 Section 133 of the Act provides that "When any woman, young person, or child is employed in a workshop in which no abstract of this Act is affixed as by this Act required, and the Medical Officer of Health of the District Council becomes aware thereof, he shall forthwith give written notice thereof to the inspector for the district." This section is important, as it provides the procedure by which most workshops become known to the factory inspectors, who, upon receiving the notice, enter the workshop in the Home Office register and send an abstract of the Act to the occupier. Workshops notified to H.M. Inspector during 1904 in pursuance of section 133 of the factory and Workshop Act, 1901. Trade. Number of Workshops. Protected Persons employed. Women Young Persons Children. Total. Bakers 3 - 3 - 3 Barge Builder 1 — 3 — 3 Blouse Maker 1 5 - — 5 Bootmakers 6 — 5 — 5 Boot Polish Maker 1 1 — — 1 Carpet Maker 1 2 — — 2 Carriage Builder 1 — 1 — 1 Crayon Maker 1 4 — — 4 Cycle Maker 1 - 1 — 1 Dressmakers 32 121 9 — 130 Farrier 1 — 1 — 1 Firewood Cutters 2 2 - - 2 Hat Maker 1 - 1 - 1 Laundries 3 14 — — 14 Motor Car Maker 1 - 2 — 2 Rag Sorter 1 — 1 — 1 Smiths 2 — 2 — 2 Tailors 10 21 2 — 23 Totals 69 170 31 — 201 Bakehouses. There are 89 workshop bakehouses and 5 factory bakehouses in Battersea. The former are supervised by the Council's Inspectors, the latter mainly by the Factory Inspectors. The 116 factory bakehouses are all above ground, while of the workshop bakehouses, 56 are above ground and 33 underground, according to the definition given in the Factory Act. When the Factory Act of 1901 was passed, there were 49 underground bakehouses in Battersea; 16 of these have been closed, and the remaining 33 greatly improved and certified as suitable by the Sanitary Authority. In 9 of the 16 cases in which the use of the bakehouse was discontinued, the occupier removed to a newly-built bakehouse in or near the same premises. In 6 cases the shop was closed or used for another business, and in one case the occupier continues to sell bread, but has it baked by another baker. A list of the workshop bakehouses is given below:— Above Ground. Address. Address. 25 Battersea Park Road 29 Meyrick Road 257 „ „ 48 New Road 292 „ „ 89 „ „ 343 „ „ 148 „ „ 465 „ „ †205 „ „ †† The Parade, Battersea Rise 10 Northcote Road 23 „ „ 78 Battersea Rise †64 „ „ 31 Bridge Road †94 „ „ 84 „ „ †62 Plough Road 64 Castle Street 76 „ „ 45 Culvert Road 112 „ „ 83 „ „ 41 Queens Road 139 Chatham Road 121 „ „ 47 Este Road 38 Rowena Crescent 29 Falcon Road 93 Stewarts Road 88 „ „ 29 Stockdale Road †37 Grayshott Road 10 St. Philip Street 88 „ „ 90 St. John's Hill 45 Harroway Road † Sugden Road 11 Hanbury Road 32 Tyneham Road †49 High Street 47 „ „ 80 „ „ 102 Usk Road 173 „ „ 46 York Road 40 Lavender Hill 70 „ „ 137 „ „ 187 „ „ 313 „ „ †198 „ „ 64 Latchmere Road 287 „ „ 93 „ „ † Newly built during 1903-4. 117 Underground. Address. Address. 163 Battersea Park Road 103 Falcon Road 189 „ „ 46 Frances Street 200 „ „ 30 Lavender Hill 219 „ „ 291 „ „ 265 „ „ 123 Maysoule Road 310 „ „ 36 Orkney Street 373 „ „ 23 Plough Road 501 „ „ 34 „ „ 525 „ „ 109 Salcott Road 48 Broom wood Road 140 St. John's Hill 2 Burland Road 8 Tyneham Road 35 Castle Street 23 Webbs Road 83 Chatham Road 47 Winstanley Road 83 Church Road 79 „ „ 4 Currie Street 6 York Road 28 „ „ 345 „ „ 43 Falcon Road During the year the bakehouses were kept under close supervision. In many of the premises above ground, improvements were made on the lines of the alterations carried out in the underground bakehouses. The following is a tabulated statement of the work carried out in connection with workshop inspection during the year, so far as it admits of tabulation:— Workshop inspections and re-inspections 3,008 Workrooms measured 133 Workshops notified to H.M. Inspector 69 Cards distributed showing number of persons legally employed in workrooms 914 Written intimations issued 366 Statutory notices served 44 118 Defects discovered in Workshops and remedied:— Workrooms in a dirty condition 141 ,, overcrowded 12 ,, badly lighted 2 ,, badly ventilated 22 ,, with defective walls or ceilings 23 ,, with defective floors 20 ,, floors not properly constructed to drain off wet 10 Workshops with defective yard paving 15 ,, with defective drains 4 ,, with blocked drains 9 ,, without proper dustbins 29 ,, with defective w.c. apparatus 29 ,, with sanitary conveniences insufficient in number or absent 8 ,, with sanitary conveniences badly ventilated 4 ,, with sanitary conveniences opening into workrooms 8 ,, with sanitary conveniences without proper doors or fastenings 11 ,, with sanitary conveniences in dirty condition 24 Gullies removed from bakehouses 7 Coal bins provided in bakehouses 27 Accumulations of refuse removed 8 Other defects remedied 36 The following notices of defects in workshops were received from H.M. Inspectors of Factories. In each case a notice was served on the person responsible, and the defects remedied. 119 Premises. Trade. Nature of Complaint. 100 Battersea Rise Laundry Defective wash-house floor. 23a Bridge Road Smith Dirty and defective condition of water-closet. 220 „ „ Crayon maker Premises require limewashing. Printing Factory, Stormont Road Printer Defective flush to watercloset. Surrey House Laundry, Surrey Lane South Laundry Water leaking over approach to sanitary accommodation for women. 72 York Road Carpenter Dirty condition of watercloset. Workplaces. Although the term "workplace" occurs in both the Factory Act and the Public Health (London) Act, in neither Act is it defined; but in the case of Bennett v. Harding, under section 38 of the latter Act, it was held that the term "workplace" includes any "place where work is done permanently and where people assemble together to do work permanently of some kind or other." In this case a stable and stable-yard, where men were employed as cab-cleaners and horse-keepers, was held to be a workplace. The Home Secretary has been advised that kitchens of restaurants, etc., are workplaces. In 1902, the first systematic inspection of the restaurant and coffee-house kitchens was made by Inspector Benjamin. The kitchens then numbered 83. In 1903, the use of two of these places was discontinued, while two new kitchens were opened, leaving the same number on the register as in 1902. In 1904, thirteen new kitchens were opened, and the use of four discontinued, so that the total number on the register at the end of 1904 was 92. A list of the kitchens is given on the following page. 120 Restaurant and Coffee-House Kitchens. Premises. Premises. 4 Abercrombie Street 291 Lavender Hill 16 Battersea Park Road 23 New Road 17 „ „ 64 „ „ 34 „ „ 10 Nine Elms Lane 35 „ „ 93 „ „ 24 „ „ 4 Northcote Road 126 „ „ 8 „ „ 141C „ „ 14 „ „ 157 „ „ 63 „ „ 160 „ „ 151 „ „ 178 „ „ 13 Park Road 183 „ „ 30 Plough Road 231 „ „ 96 „ „ 262 „ „ 138 „ „ 295 „ „ 35 Queen's Road 335 „ „ 38 „ „ 431 „ „ 174 „ „ 491 „ „ 218 „ „ 503 „ „ 35 St. Andrew's Street 509 „ „ 10 St. John's Hill 575 „ „ 17 „ „ 583 „ „ 26 „ „ 64 Battersea Rise 39 „ „ 94 „ „ 64b „ „ 21 Bridge Road 73 „ „ 41 „ „ 85 „ „ 42 „ „ 93 „ „ 68 „ „ 146 „ „ 70 Chatham Road 45 St. John's Road 50 Church Road 62 „ „ 114 Culvert Road 73 Stewarts Road 23 Falcon Road 159 Usk Road 101 „ „ 45 Webbs Road 125 „ „ 24 Winstanley Road 135 „ „ 10 York Road 166 „ „ 42 „ „ 184 „ „ 73 „ „ 19 High Street 76 „ „ 22 „ „ 139 „ „ 86 „ „ 159 „ „ 130 „ „ 167 „ „ 150 „ „ 183 „ „ 93 Latchmere Road 201 „ „ 233 Lavender Hill 216 „ „ 235 „ „ 329A „ „ 266 „ „ 357 „ „ 121 Since the kitchens have been regularly inspected there has been a marked improvement in their condition, but, as was pointed out in the Annual Report for 1903, there is need for bye-laws to deal with the structural conditions of the premises, the way in which they are kept, and the way in which the food is stored and prepared. The restaurant is becoming more and more prominent a feature in modern life, as the tendency of the workers to live at a distance away from their work increases with the growth of large towns; and it is important that the food should be stored and prepared under the best conditions, which is certainly not the case at the present time. The following is a statement of the work done in connection with restaurant kitchens during 1904:- Inspections 252 Intimations issued 37 Statutory notices served — No. of premises licensed to sell intoxicants 4 No. of premises where gas only is used for cooking 29 No. of premises where sanitary conveniences are provided for customers 4 Defects found and remedied— Refuse receptacles absent or defective 3 Dirty walls and ceilings 20 Dirty and defective yards 7 Drainage defects 6 Defective sanitary conveniences 5 Other defects 7 Out-Workers. The Factory Act of 1901 provides that in certain trades to be specified by the Home Secretary, the employers shall twice a year send to the Sanitary Authority lists of the outworkers employed by them. The trades so far specified by the Home Secretary are as follows:— The making, cleaning, washing, altering, ornamenting, finishing and repairing of wearing apparel and any work incidental thereto; 122 The making-, ornamenting and finishing of lace and of lace curtains and nets; Cabinet and furniture making and upholstery work; The making of electro-plate; The making of files; Fur-pulling; The making of iron and steel cables and chains; The making of iron and steel anchors and grapnels; The making of cart gear, including swivels, rings, loops, gear buckles, mullin bits, hooks, and attachments of all kinds; The making of locks, latches and keys. The names and addresses of 349 out-workers were received during the year. Lists were sent in by employers and by the Medical Officers of Health of the following Metropolitan Boroughs:— Borough. No. of Lists. Borough. No. of Lists Camberwell 2 Hammersmith 1 Chelsea 4 Kensington 8 City of London 1 St. Marylebone 1 Deptford 1 Southwark 3 Finsbury 9 Wandsworth 17 Guildford 1 Westminster 4 Hackney 1 Thirty-seven out-workers whose names were sent in by employers were found to live outside Battersea, and their names and addresses were sent to the Medical Officers of Health of the respective districts. 123 The premises occupied by the out-workers are registered and regularly inspected. The following table shows the number of such places which have been registered, together with the trades and the number of persons employed:— Trade. Number on Register. Persons Employed. Males. Females. Blouse makers 7 — 9 Cleaners and Dyers 2 1 2 Dressmakers 10 — 10 Embroiderers 54 — 58 Florists 1 — 1 Glove makers 46 — 53 Hosiers 4 — 4 Milliners 4 — 4 Shoemakers 9 10 - Tailors 22 9 19 Underclothing makers 10 - 10 Upholsterers 2 — 5 Other trades 6 - 6 Total 177 20 181 Underground Workrooms. There are 30 underground workrooms in the Battersea workshops and workplaces, not counting underground bakehouses, and the number in each trade is given on the following page. 124 workshops. Laundries 5 Dressmaking 2 Embroidery 1 Picture frame making 3 Cycle making 1 Tailoring 1 workplaces. Restaurant kitchens 7 Meat-chopping 2 Small exempted laundries 8 Factories. The Factory Act contains a special sanitary code for factories, which is administered by the Factory Inspectors; but for the most part this code supplements, not displaces, the provisions of the Public Health (London) Act, which are administered by the Sanitary Authorities. The definition of the word "house" in the latter Act includes a factory, and where there is no express statutory provision to the contrary, the sections of that Act apply to factories as to dwelling houses. Moreover, section 38 of the Public Health Act lays upon the Sanitary Authorities the duty of securing for the workers "sufficient and suitable accommodation in the way of sanitary conveniences " in all factories. 125 The following is a list of the factories in Battersea:— Trade. Number of Factories on Register Persons Employed. Males. Females. Adults Young Persons Adults Young Persons Barge and Boat builders 2 39 2 ... ... Bakers 5 158 10 62 10 Builders 7 123 15 ... ... Brewers 2 78 ... ... ... Chemical manufacturers 3 129 11 30 14 Chaff Cutters 3 30 ... ... ... Dyers 2 30 ... 21 6 Engineers 12 599 50 ... ... Flour Mills 2 133 11 ... ... Firewood cutters 2 21 10 ... 4 Founders 4 63 7 ... ... Masons 7 532 21 ... ... Printers 10 74 3 2 ... Steam Laundries 25 79 .. 687 117 Other trades 32 3,461 362 368 227 Totals 118 5,549 502 1,184 378 The following is a list of the defects discovered and remedied in factories during 1904:— Defects in sanitary conveniences:— Defective w.c. apparatus 4 Sanitary conveniences inside workrooms 11 Want of proper flush in w.c.'s 7 Want of proper flush in urinals 7 Dirty condition of w.c.'s 12 Dirty condition of urinals 8 Defective condition of urinals 4 126 Defects in sanitary conveniences—continued. Want of doors to w.c.'s 6 ,, light to w.c.'s 1 ,, screens to w.c.'s 4 ,, fastenings to w.c.'s 8 ,, partitions in w.c.'s 4 ,, ventilation in w.c.'s 1 ,, separate accommodation for two sexes 1 ,, proper and sufficient number of w.c.'s 1 Stoppage of drains 3 Defects in drains 1 Want of drainage of wet floors 3 Defective condition of roof 1 Accumulations of refuse 3 Defective condition of yard paving 1 Dilapidations 2 Infants Milk Depot. 129 Infants Milk Depot. Many requests for information as to the methods upon which the Depot is conducted were received during the year from the officers and members of other authorities, and from other persons at home and abroad who were interested in the subject. In order to supply such information in a convenient form, the following memorandum was prepared by the Medical Officer of Health, by order of the Health Committee:— MEMORANDUM. In June, 1902, the Battersea Borough Council opened a depot for the supply of specially prepared milk for infants whose mothers are unable to suckle them. The milk is obtained from a herd of tuberculin-tested cows on a farm which is from time to time inspected by the Medical Officer of Health. Shortly after being drawn from the cow, the milk is strained and cooled down to 40°F., and it is sent direct to the depot in sealed churns. The following is a list of the conditions under which the milk is supplied by the contractor:— The Contractor shall supply milk which must contain not less than 3.25 per cent. of butter fat and 8.75 per cent. of solids not fat, and cream which must contain not less than 50 per cent. of butter fat; and the milk and cream must be free from chemical preservatives or colouring matter, and be drawn from healthy cows only. The Contractor shall deliver the milk and cream in sealed churns or cans to the Council's Depot, No. 28 York Road, before 8 a.m. every morning, Sunday excepted. 130 The Contractor must be prepared to increase or diminish the supply within reasonable limits, at one day's notice from the Medical Officer of Health. A warranty ticket must be attached to every churn and can guaranteeing its contents to be in accordance with the specification. No charge is to be made for the use of churns or cans, which when empty are to be removed by the Contractor from the Council's Depot free of charge. All pails, strainers, railway churns, refrigerators, fittings and other vessels and implements brought into contact with the milk shall be thoroughly inspected before being used, be properly cleansed, scalded and dried immediately after being used, and exposed to the air in a clean place, without lids or covers. The farms, water supply, drainage system, farm buildings, dairy and cattle shall be open at any reasonable time to the inspection of the Council's Medical Officer of Health, or any person duly authorised by him, and no milk or cream shall be supplied from any farm which has been certified by the said Medical Officer of Health to be in an insanitary condition. The cows shall be subject, if required, to a periodical veterinary inspection by a Veterinary Surgeon duly appointed by the Council, and the Contractor shall undertake not to supply milk or cream from any cow which is diseased, newly calved or under physic. The cows shall during the summer be pastured, and during winter so fed that no taint is imparted to the milk. The Contractor undertakes to use no brewers' grains (wet or dry), turnip-tops or vetches. 131 The udders of the cows shall be carefully cleansed before milking, and the utmost possible cleanliness observed at every point connected with the cows, cowhouse, utensils and attendants. The milk shall be carefully strained and cooled to at least 56° F., immediately after milking, over a Lawrence, or other cooler of approved design, and shall be delivered at the Council's Milk Depot at a temperature not higher than 56° F. The Contractor shall undertake that the refrigerators and the in-fiow and out-flow pipes, etc., are examined daily in order to see that everything is in thorough repair, and that there is no leakage. No milk or cream shall be supplied from any farm on which there is a case of infectious disease. The Council shall have the right to take samples of the milk or cream at any time, either at the farm or at any point in course of delivery. From June to September inclusive, the Contractor, when required by the Medical Officer of Health, shall pasteurise the milk before delivery. Should any breach of any one or more of these clauses be at any time proved, the Contractor shall pay to the Council the sum of twenty pounds, or any lesser sum the Council may think fit, as and for liquidated damages, for each and every time such breach of any clause shall have been committed, and the Council shall deduct the same from any amount which may be due to the Contractoi Upon arrival at the depot the milk, after being strained, is modified and bottled. The modifications and quantities are as follows:— Upon arrival at the depot the milk, after being strained, is modified and bottled. The modifications and quantities are as follows:— 132 Age of Child. Modifications. No. of Bottles per Day. Amount per Bottle. Amount per Day. During first fortnight Milk 1 part, water 2 parts 9 1½ oz. 13½ oz. ,, second „ „ „ 9 2½ oz. 22½ oz. ,, second month ,, ,, 9 2½ oz. 22½ oz. ,, third Milk 1 part, water 1 part 9 3 oz. 27 oz. „ fourth ,, ,, ,, 8 4 oz. 32 oz. „ fifth „ Milk 2 parts, water 1 part 7 5 oz. 35 oz. ,, sixth ,, ,, ,, 7 5 oz. 35 oz. ,, seventh ,, Milk practically unmodified 6 6 oz. 36 oz. „ eighth „ ,, ,, 6 6 oz. 36 oz. Over eight months ,, ,, 6 7 oz. 42 oz. 133 To each modification, cream, sugar and salt are added in proper quantities ; cane sugar is used in all the modifications, except the first, which contains milk sugar. The bottled milk is placed in the sterilising chamber, steam is injected into the chamber, and the temperature raised to 212° F., and maintained there for about ten minutes. The milk is then removed from the steriliser and cooled down in a cooling tank. It is then ready for distribution. In addition to the central depot at 28 York Road, distributing stations have been opened at the Town Hall, and at Lurline Gardens Library. The demand for the milk has always been good, and in the summer of 1904 it was so great that the resources of the depôt were unable to cope with it. As many as 400 infants have been supplied daily with the milk. The following leaflet is given to the mothers of infants fed from the dep6t:— INSTRUCTIONS FOR THE USE OF HUMANISED MILK. 1. The charge for the full weekly supply of Humanised Milk for infants under six months is 1s. 6d., payable in advance. If a day's supply only is taken, the charge is 3d. The charge for the full weekly supply for infants aged from six to twelve months is 2s., or 4d. per day. Children above one year old will be charged 2s. 6d. per week, or 5d. per day. The scale of charges for children living outside the Borough is as follows: — Under six months - - - 2s. 3d. per week, or 4d. per day. Six months to twelve months - 2s. 9d. „ 5d. „ Over one year old - - - 3s. 3d. „ 6d. ,, 2. The Depôt is open from 11 a.m. to 6 p.m. on wees-days, and is closed on Sundays. 134 3. The milk will be supplied in bottles in a basket, each bottle containing sufficient milk for one meal, the amount varying with the age of the child. Infants under two months receive nine bottles per day; older children receive fewer bottles, as they should be fed less frequently. 4. If children are sent for the milk, they must be warned not to tamper with the stoppers of the bottles. On no account must a bottle be opened until the infant is ready to be fed. 5. Just before using, each bottle should be placed unopened in a basin, or jug of hot water, and warmed to the proper temperature. The bottle should then be opened and the teat put on. The child should be fed at regular intervals, and fed from these bottles only. On no account should any other feeding-bottle be used. The teat should be kept scrupulously clean. 6. When all the milk in one bottle is not used, the remainder must not be warmed up again, but a fresh bottle opened for the next meal. Where there are other children this milk need not be wasted. 7. On no account should any other food be given unless ordered by a doctor. 8. After using, the bottles should be thoroughly rinsed in cold water. 9. Breakages will be charged for at the rate of 1d. per bottle, and damage to baskets must be made good. All bottles, baskets, and rubber rings not returned to the Depot will be charged full value. 10. It is important that the child should be brought once a week to be weighed. The Depot is open for this purpose on Tuesdays and Wednesdays from 2.30 to 4 p.m. 135 11. The presence of Infectious Disease in a house must be at once notified to the Medical Officer of Health. N.B.— The milk should never be used in preference to mothers' milk, which is the best of all foods for young infants. The homes of the infants fed on the milk are visited by a lady sanitary inspector, who endeavours to secure that the instructions are properly carried out. The staff employed at the depot consists of a manageress and five female assistants. The appliances in use are as follows :— One i-h.p. boiler. ,, sterilising chamber with trolleys. ,, cooling tank. ,, cold storage chamber. ,, bottle-washing machine, with three soaking tanks and sets of rinsing jets. ,, weighing machine. ,, Ulax strainer. Two bottle-filling machines. ,, churns, with pails, measures and stirrer. Wire baskets, bottles and rubber teats. The initial cost of the depôt was £400; the sum of £250 was spent in alterations to premises, and £150 in appliances. Since the dep6t was opened, additional alterations have been carried out on the premises, and the appliances have been considerably increased. Appendix. TABLES. 139 TABLE XXVIII. (Required by the Local Government Board to be used in the Annual Report of the Medical Officer cf Health). Vital Statistics of Whole District during 1904 and previous Years. Year Population estimated to middle of each year. Births. total deaths registered in the 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. Nett Deaths at all Ages belonging to the District. Under 1 Year of Age. At all Ages. Number. Rate* Number. Rate per 1,000 Births registered Number. Rate* Number. Rate* 1 2 3 4 5 6 7 8 9 10 11 12 13 1894 159,724 5,024 31.4 718 142 2,404 15.6 354 204 377 2,577 16.1 1895 162,787 5,264 32.3 907 172 2,901 17.8 477 247 307 2,961 18.1 1896 165,309 5.358 32. 4 937 174 2,941 17.7 507 266 319 2,994 18.1 1897 166,059 5,266 31. 7 845 160 2,620 15.7 459 270 387 2.737 16 .4 1898 166,814 5,157 30.9 840 162 2,762 I6.5 495 258 388 2,892 17.3 1899 167,570 5,179 30.9 838 161 2,858 17.0 597 301 348 2,905 17. 3 1900 168,339 5,161 30.6 826 157 2,951 17.5 598 293 320 2,978 17.6 1901 l69,ioo 5,025 29.7 828 164 2,729 16.1 603 311 348 2,766 16 .3 1902 171,401 4,844 28.2 654 135 2,451 14.2 601 298 428 2,581 15.0 1903 173,422 4,973 28.6 688 138 2.425 13.9 622 299 350 2,476 14. 2 Averages for years 1894-03. 167,052 5,125 30.6 808 156 2,704 16.2 531 274 357 2,786 166 1904 175,465 4,849 27.5 706 146 2,517 14.3 725 372 398 2,543 14.4 * Rates calculated per 1,000 of estimated population. Note.—The deaths included in Column 7 of this table are the whole of those registered during the year as having actually occurred within the Borough The deaths included in Column 12 are the number in Column 7 corrected by the subtraction of the number in Column 10 and the addition of the number in Column 11. By the term "Non-residents" is meant persons brought into the Borough on account of sickness and infirmity, and dying in public institutions there; and by the term 11 residents " is meant persons who have been taken out of the Borough on account of sickness or infirmity and have died in public institutions elsewhere. The "Public Institutions" taken into account for the purpose of these Tables are those into which persons are habitually received on account of sickness or infirmity, such as hospitals, workhouses and lunatic asylums. Area of District in acres (exclusive of area covered by water), 2139.9 acres. Total population at all agec, 168,907; number of inhabited houses, 23,462; average number of persons per house, 7-19—at Census of 1901. 140 TABLE XXIX. (Required by the Local Government Board to be used in the Annual Report of the Medical Officer of Health). Vital Statistics of Separate Localities in 1904 and Previous Years. Names of Localities. 1. Borough of Battersea. 2. East Battersea. 3. North-West Battersea. 4. South-West Battersea. Year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages Deaths under 1 year. Population estimated to middle of each year. Births registered. , Deaths at all ages. Deaths under 1 year. 1894 159,724 5°24 2577 734 69,995 2284 1168 345 49,861 1825 975 308 39,868 915 434 81 1895 162,787 5264 2961 930 70,981 2439 1418 435 49,832 1892 1052 365 41,974 933 491 130 1896 165,309 5358 2994 947 71,753 2500 1472 465 49,804 1886 1064 365 43, 752 972 458 117 1897 166,059 5266 2737 853 71,848 2431 1265 411 49,775 1824 1007 326 44,436 1011 465 116 1898 166,814 5r57 2892 855 71.942 2424 1400 441 49,747 1744 1017 3" 45,125 989 475 103 1899 167,570 5179 2905 837 72,020 2424 1412 437 49,719 1791 954 299 45,831 964 539 101 1900 168,339 5161 2978 822 72,119 2418 1370 411 49,691 1749 1044 314 46,529 994 564 97 1901 169,100 5025 2766 821 72,226 2357 1271 407 49,663 1658 932 296 47,211 1010 563 118 1902 171,401 4844 2581 657 72,797 2208 1133 312 49,631 1643 911 270 48,973 993 537 75 1903 173,422 4973 2476 671 73,310 2298 HOI 316 49,593 1692 851 168 50,519 983 524 87 Averages of years 1894 to 1903 167,052 5125 2786 812 71,899 2378 1401 398 49,731 1770 980 312 45,421 976 505 102 1904 ... 175,465 4849 2543 715 73,931 2249 1159 365 49,564 1584 845 248 51,970 1016 539 102 Note.— Deaths of residents occurring in public institutions, whether within or without the Borough, are allotted to the respective localities according to the addresses of the deeeasad. 141 TABLE XXX. (Required by the Local Government Board to be used in the Annual Report of the Medical Officer of Health). Cases of Infectious Disease notified during the Year 1904. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Locality. No. of Cases Removed to Hospital from each Locality. At all Ages. At Ages—Years. East Battersea. N.-West Battersea. S.-West Battersea. East Battersea. N.-West Battersea S.-West Battersea. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to65. 65 and upwards. Small-pox 7 ... ... ... 4 2 ... 7 ... ... 7 ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 193 5 63 97 13 15 ... 54 79 60 47 66 39 Membranous croup 6 1 4 1 ... 4 ... 2 2 ... 1 Erysipelas 159 11 5 9 18 97 19 79 49 31 26 13 4 Scarlet fever 375 4 86 242 28 15 ... 187 74 114 171 72 82 Typhus fever ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric fever 51 ... 2 11 11 27 ... 21 19 11 15 17 9 Relapsing fever . . . ... ... ... ... ... ... ... ... ... ... ... ... Continued fever 2 ... 2 ... ... ... ... ... ... 2 ... ... . ... Puerperal fever 8 ... ... ... 3 5 ... 5 i 2 2 I ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 801 21 162 361 77 161 19 357 222 222 270 I69 135 I42 143 TABLE XXXI. (Required by the Local Govnnmtnt Board to be used in the Annual Report of the Medical Officer of Health.) Causes of, and Ages at, Death during the Year 1904. causes of death. deaths in or belonging to whole district at subjoined ages. deaths in or belonging to localities (at all ages). total deaths in public institutions in the district. All Ages. Under 1 year. and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 65 years. 65 years and upwards. East Battersea. North-West Battersea. South-West Battersea. Small-pox ... ... ... ... ... ... ... ... ... ... ... Measles 58 20 37 1 ... ... ... 22 32 4 27 Scarlet Fever 11 1 4 6 ... ... ... 4 7 ... ... Whooping Cough 61 30 30 1 ... ... ... 31 26 4 6 Diphtheria and Membranous Croup 14 3 6 5 ... ... ... 4 6 4 ... Croup ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... Enteric 12 ... ... ... 3 9 ... 8 3 1 ... Other Continued ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 21 ... ... ... 2 9 10 3 8 10 1 Cholera ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... Diarrhœa 184 159 21 ... 1 1 2 90 76 18 2 Enteritis 45 28 7 3 ... 2 5 25 16 4 15 Puerperal Fever 2 ... ... ... ... 2 ... 1 1 ... 1 Erysipelas 11 5 ... ... 1 4 1 7 2 2 12 Other Septic Diseases 17 4 1 ... 1 8 3 11 5 1 9 Phthisis 244 ... 4 10 44 179 7 112 74 58 89 Other Tubercular Diseases 73 26 20 5 7 14 1 29 34 10 11 Cancer, Malignant Disease 164 ... 1 1 2 102 58 66 45 53 61 Bronchitis 260 71 17 2 1 68 101 124 101 35 68 Pneumonia 189 45 46 7 4 64 23 88 67 34 41 Pleurisy 6 ... ... ... 2 2 2 4 2 ... 3 Other Diseases of Respiratory,Organs 17 ... ... 1 ... 11 5 5 3 9 4 Alcoholism Cirrhosis of Liver 31 ... ... ... ... 28 3 13 8 10 10 Venereal Diseases 16 14 ... ... ... ... 1 7 7 2 15 Premature Birth 95 95 ... ... ... ... ... 51 25 19 4 Diseases and Accidents of Parturition 8 ... ... ... 1 7 ... 4 a 2 2 Heart Diseases 111 ... ... 8 5 58 40 56 34 21 7° Accidents 50 6 7 3 5 25 4 27 16 7 28 Suicides !5 ... ... ... ... 14 1 7 2 6 4 All other causes 828 208 41 32 30 276 241 359 244 225 242 All causes 2543 715 242 85 109 884 508 1158 846 539 725 144 The tables on pages 144-146 have been drawn up by the Secretary of State, "for the guidance and convenience of Medical Officers of Health in preparing that part of their annual report which relates to factories, workshops, workplaces and home work." It is intended "to provide for uniformity in the presentation of such particulars as lend themselves to statistical treatment." Factories, Workshops, Laundries, Workplaces and Homework. 1.— Inspection (including Inspections made by Sanitary Inspectors or Inspectors of Nuisances). Premises. Number of Inspections. Written Notices. Prosecutions. Factories (including Factory Laundries) 705 78 Nil Workshops (including Workshop Laundries) 3,008 410 Workplaces 645 83 Homeworkers' Premises 343 98 Total 4,701 669 — 145 2.—Defects Found. Particulars. Number of Difects. Number of Prosecutions. Found. Remedied. Referred to h.m. Inspector. Nuisances under the Public Health Acts:—* Nil. Nil. Want of Cleanliness 192 192 Want of Ventilation 17 17 Overcrowding 9 9 Want of drainage of floors 31 31 Other Nuisances 350 350 Sanitary accommodations Insufficient 9 9 Unsuitable or defective 175 175 Not Separate for Sexes 3 3 Offences under the Factory and Workshop Act:— Illegal Occupation of Underground Bakehouse (sec. 101) — — Breach of Special Sanitary Requirements for Bakehouses (secs. 97 to 100) 68 68 Failure as regard Lists of Outworkers (sec. 107) — — Giving out work to to be done in premises which are Unwholesome (sec. 108) — — Infected (sec. 110) — — Allowing Wearing Apparel to be made in premises infected by Scarlet Fever or Smallpox (sec. 109) — — Other Offences 3 — 3 — Total 857 854 3 — * Including those specified in sections 2, 3 7 and 8 of the Factory Act as remediable under the Public Health Acts. 146 3.— Other Matters. Matters notified to H.M. Inspectors of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 69 Action taken in matters referred by H.M. Inspectors, as remediable under the Public Health Acts, but not under the Factory Act (s. 5):— Notified by H.M. Inspector 6 Reports (of action taken) sent to H.M. Inspectors 6 Other 3 Underground Bakehouses (s. 101):— In use during 1903 49 Certificates granted:— In 1903 29 In 1904 4 In use at the end of 1904 33 Homework :— Lists of Outworkers (s. 107)— Lists received 10 No. of outworkers to which lists referred 174 Addresses of outworkers forwarded to other Authorities 37 Addresses of outworkers received from other Authorities 175 Homework in unwholesome or infected premises:— Notices prohibiting homework in unwholesome premises (s. 108) ... — — Cases of infectious disease notified in homeworkers' premises — — Orders prohibiting homework in infected premises (s. 110) — — 147 Workshops on the Register (s. 131) at the end of 1904:— Bakehouses 89 Bootmakers 61 Dressmakers 107 Laundries 41 Milliners 32 Tailors 32 Other trades 131 Total 493 Proceedings during 1904. (The tables on pages 147-151 are suggested by the Medical Officer of Health to the County of London in order to secure uniformity of tabulation in the annual reports of the Medical Officers of Health of the Metropolitan Boroughs). Premises. Number of Places. Number of inspections, 1904. Number of Intimation notices, 1904. Number of prosecutions, 1904. On register at end of 1903. Added in 1904. Removed in 1904. On register at end of 1904. Milk premises 225 43 22 246 583 79 Nil. Cowsheds 3 — — 3 † — Slaughter-houses 7 — — 7 † — Other offensive trade premises 3 — — 3 † — Ice-cream premises 115 13 4 116 267 22 Registered houses let in lodgings 121 — — 121 † (a)*- (b)* 79 (a)* For overcrowding. (b)* For other conditions. † These premises are subject to frequent inspection. 148 Class of Homework. Number of Lists Received. 1904. Number of Addresses of Out-workers. Due Feb. 1st. Due Aug. 1st. Forwarded to other Authorities. Received from other Authorities, No. of Lists. No. of Outworkers. No. of Lists. No. of Out workers. Due Feb. 1st. Due Aug. 1st. Due Feb. 1st. Due Aug. 1st. Blouse making — — — — 1 — 15 10 Dressmaking — — — — — — 5 2 Glove making 1 60 1 57 18 13 — — Hosiery — — — — — — 3 4 Millinery — — — — — 5 — Shoemaking — — 1 1 — — 12 8 Tailoring — — 2 8 1 — 19 4 Underclothing 1 1 — — 1 1 12 7 Other 1 21 3 24 1 1 52 17 Total 3 84 7 90 22 15 123 52 factories. workshops. workplaces. total. Number of out-workers (persons) on register at end of year 1904 — 65 136 201 Number of out-workers premises on register at end of year 1904 — 43 134 177 Total number of out-workers (persons) dealt with during the year 1904 — 165 172 337 Total number of out-workers premises dealt with during the year 1904 — 51 202 253 149 Number of Notices prohibiting homework in unwholesome premises (s. 108) — Number of Cases of infectious disease notified in homeworkers' premises — Number of Orders prohibiting homework in infected premises (s. no) — Number of Cases reported to H.M. Inspector:— Failure to affix Abstract 69 Replies as to action taken in cases notified by H.M. Inspector 6 Other matters 3 Number of underground bakehouses in use at the end of 1904 33 Certificates granted during the year (s. 101) 4 Number of workshop rooms measured 133 Overcrowding, 1903. Number of dwelling rooms overcrowded 58 Number remedied 58 Number of prosecutions 1 Underground Rooms. Illegal occupation dealt with during year 5 Number of rooms closed 5 Insanitary Houses. Number closed under the Public Health (London) Act, 1891 — Number closed under the Housing of the Working Classes Act — Shelters provided under sec. 60 (4) of the Public Health (London) Act, 1891. Number of persons accommodated during the year — Revenue Acts. Number of houses for which applications were received during the year 232 Number of tenements comprised therein 244 Number of tenements for which certificates were— (a) granted 244 (b)refused — (c) deferred — 150 Number of Prosecutions under Bye-laws under Public Health Act, 1891. (a) For prevention of nuisance arising from snow, ice, salt, filth, etc. — (b) For prevention of nuisance arising from offensive matter running out of any manufactory, etc. — (c) For the prevention of keeping of animals in such a manner as to be injurious to health — (d) As to paving of yards, etc., of dwelling houses 9 (e) In connection with the removal of offensive matter, etc. 1 (/) As to cesspools and privies, removal and disposal of refuse, etc. — (g) For securing the cleanliness of tanks, cisterns, etc. — (h) With respect to water closets, earth closets, etc. 1 (i) With respect to sufficiency of water supply to water closets — (j) With respect to drainage, etc. (Metropolis Management Act, sec. 202) 1 (k) With respect to deposit of plans as to drainage, etc. (Metropolis Management Acts Amendment (Bye-laws) Act, 1889) 2 Mortuaries. Total number of bodies removed 221 Total number of infectious bodies removed 6 151 Inspection of Factories, Workshops and Workplaces. Class of Works Number of Places. Number of Inspections, 1904. Number of Notices, 1904. Number of Prosecutions, 1904. On Register at end of 1903. Added in 1904. Removed in 1904. On Register at end of 1904. Premises Rooms. Factories Factory Laundries 24 2 1 25 70 92 21 Nil. Factory Bakehouses 4 1 — 5 13 19 3 Other Factories 65 34 11 88 340 594 54 Workshops Workshop Laundries 67 26 41 105 3,008 410 Workshop Bakehouses 91 I 3 89 140 Other Workshops 383 59 79 363 450 Outworkers' Premises 178 9 10 177 177 343 98 Workplaces Places where Food is prepared for Sale* 149 5 — 154 170 480 47 Other Workplaces 66 8 15 59 117 165 36 Total 1,027 119 145 1,001 1,582 4,701 669 * Under this head are included the kitchens of hotels, restaurants, eating-houses of all sorts, tripe, fried fish and eel shops and other places where food is prepared. TABLE XXXII. Causes of, and Ages at Death, during the Year 1904. (Exclusive of the deaths of Non-Residents in Public Institutions within the Borough, but inclusive of the deaths of Residents in Public Institutions without the Borough. Causes of Death. Ages. All Ages. Sub-Districts. Under 1. 1 and under 5. 5 and under 10. 10 and under 15. 15 and under 20. 20 and under 25. 25 and under 35. 35 and under 45. 45 and under 55. '55 and under 65. 65 and under 75 75 and under 85. 85 and upwards. Males Females Total East Battersea Nth.West Battersea. Sth.West Battersea. Measles 20 37 1 ... ... ... ... ... ... ... ... ... ... 32 26 58 22 32 4 Scarlet Fever 1 4 4 2 ... ... ... ... ... ... ... ... ... 6 5 n 4 7 ... Epidemic Influenza ... ... ... ... ... 2 ... 1 4 4 6 4 ... 12 9 21 3 8 10 Whooping Cough 30 30 1 ... ... ... ... ... ... ... ... ... ... 31 30 61 31 26 4 Diphtheria 3 6 5 ... ... ... ... ... ... ... ... ... ... 9 5 14 4 0 4 Enteric Fever ... ... ... ... 1 2 2 6 ... 1 ... ... ... 9 3 12 8 3 1 Diarrhœa, Dysentery 79 9 ... ... ... 1 ... ... ... ... ... ... ... 48 41 89 46 31 12 Epidemic Enteritis 80 12 ... ... ... ... ... 1 ... ... ... 2 ... 53 42 95 44 45 6 Syphilis 14 ... ... ... ... ... ... ... 1 ... 1 ... ... 7 9 16 7 7 2 Erysipelas 5 ... ... ... 1 ... 2 1 ... 1 ... 1 ... 2 9 11 7 2 2 Puerperal Fever ... ... ... ... ... ... 1 1 ... ... ... ... ... ... 2 2 1 1 ... Pyaemia 1 1 ... ... 1 ... 1 1 ... ... ... ... ... 1 4 5 3 2 ... Infective Endocarditis ... ... ... ... ... ... 1 ... ... 1 ... ... ... 2 ... 2 1 1 ... Other Allied Diseases ... ... ... ... ... ... ... 2 2 1 2 ... 9 1 10 7 2 1 Malarial Fever ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 ... ... 1 Rheumatic Fever 1 ... 2 5 1 4 1 2 ... 3 ... ... ... 5 14 19 5 8 6 Tuberculosis of Brain 8 11 ... 1 1 1 1 ... ... ... ... ... ... 12 11 23 11 8 4 Tuberculosis of Larynx ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... 1 ... 1 ... Phthisis ... 4 3 7 14 3o 57 49 47 26 6 1 ... 153 91 244 112 74 58 Abdominal Tuberculosis 10 4 ... 1 1 ... 1 1 1 ... ... ... ... 10 9 19 7 9 3 General Tuberculosis 5 4 2 1 2 2 4 ... 3 1 ... ... ... 11 13 24 8 13 3 Other forms Tuberculosis 3 1 ... ... ... ... ... 1 1 ... ... ... ... 3 3 6 3 3 ... Acute Alcoholism ... ... ... ... ... ... ... 2 1 ... ... ... ... 3 ... 3 ... 3 ... Chronic Alcoholism ... ... ... ... ... ... 3 1 5 2 2 ... ... 10 3 13 7 2 4 Lead Poisoning ... ... ... ... ... ... ... 1 1 ... ... ... ... 2 ... 2 ... 2 ... Osteo-arthritis ... ... ... ... ... 1 1 ... ... 1 4 ... i 2 6 8 2 3 3 Gout ... ... ... ... ... ... ... ... 2 ... ... ... ... 2 ... 2 1 1 ... Cancer ... 1 1 ... ... 2 4 15 34 49 43 14 1 71 93 164 66 45 53 Diabetes Mellitus ... ... ... ... ... 1 ... ... 1 2 ... 1 ... 4 1 5 1 1 3 Haemophilia 1 ... ... ... ... ... ... ... ... ... ... ... ... ... i 1 1 ... ... Anaemia ... 1 1 ... ... 1 ... 1 ... ... ... ... ... 1 3 4 2 1 1 Lymphadenoma ... ... ... ... ... 1 1 ... 1 ... ... ... ... 1 2 3 1 2 Premature Birth 95 ... ... ... ... ... ... ... ... ... ... ... ... 60 35 95 5i 25 19 Injury at Birth 5 ... ... ... ... ... ... ... ... ... ... ... ... 2 3 5 3 ... 2 Debility at Birth 15 ... ... ... ... ... ... ... ... ... ... ... ... 11 4 15 8 5 2 Atelectasis 5 ... ... ... ... ... ... ... ... ... ... ... ... 1 4 5 2 1 2 Congenital Defects 26 1 ... ... ... ... ... ... ... ... ... ... ... 15 12 27 19 5 3 Improper feeding 15 2 ... ... ... ... ... ... ... ... ... ... ... 11 6 17 6 10 1 Atrophy, Debility, Marasmus 59 4 ... ... ... ... ... ... ... ... ... ... ... 37 26 63 33 20 10 Dentition 4 1 ... ... ... ... ... ... ... ... ... ... ... 5 ... 5 2 1 2 Rickets 13 5 ... ... ... ... ... ... ... ... ... ... ... 9 9 18 11 4 3 Old Age, Senile Decay ... ... ... ... ... ... ... ... ... ... 27 41 13 27 54 81 40 16 25 Convulsions 15 3 ... ... ... ... ... ... ... ... ... ... ... 9 9 18 8 5 5 Meningitis 16 13 6 1 2 ... ... ... 1 1 1 ... ... 21 20 41 20 14 7 Encephalitis ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 1 ... ... 1 Apoplexy ... ... ... ... ... ... 1 1 2 9 5 6 2 7 19 26 8 11 7 Softening of Brain ... ... ... ... ... ... ... 1 ... ... ... 2 1 1 3 4 1 2 1 Hemiplegia ... ... ... ... 1 ... ... ... 2 3 7 5 2 9 11 20 8 4 8 General Paralysis of Insane ... ... ... ... ... ... 5 7 3 2 ... 1 ... 12 6 18 9 4 5 Other forms of Insanity ... ... ... ... ... ... ... ... 1 1 2 ... ... 2 2 4 ... 1 3 Cerebral Tumour ... ... 1 ... ... ... 1 1 1 ... 2 ... ... 4 2 6 2 ... 4 Epilepsy ... 1 ... 2 ... ... ... 2 3 ... ... ... 1 3 6 9 1 6 2 Laryngismus Stridulus 1 1 ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 ... 1 1 Locomotor Ataxy ... ... ... ... ... ... ... ... ... 2 2 ... ... 4 ... 4 1 1 2 Paraplegia 1 ... ... ... ... ... ... ... ... 3 ... 1 ... 2 3 5 3 1 1 Other forms, Brain Diseases 2 ... ... 1 1 ... ... 1 3 1 5 1 ... 5 10 15 5 6 4 Otitis 2 4 1 ... 1 ... ... 1 ... ... ... ... ... 3 6 9 6 3 ... Pericarditis ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 ... Endocarditis ... ... 3 4 2 3 7 10 15 26 25 12 3 51 59 110 56 33 21 Angina Pectoris ... ... ... ... ... ... ... 2 1 1 ... 1 ... 3 2 5 ... 1 4 Aneurism ... ... ... ... ... ... 1 1 5 1 1 ... ... 8 1 9 2 5 2 Senile Gangrene ... ... ... ... ... ... ... ... ... ... ... 1 2 1 2 3 ... ... 3 Embolism, Thrombosis ... ... ... ... ... 1 ... 1 ... 2 4 2 ... 5 5 10 5 1 4 Phlebitis ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... 2 2 1 1 ... Other Diseases, Heart and Vessels ... ... 3 1 3 1 6 10 26 35 29 21 7 55 87 142 58 49 35 Laryngitis 2 2 ... ... ... ... ... ... ... ... ... ... ... 2 2 4 4 ... ... Acute Bronchitis 68 17 1 ... ... ... ... 4 3 7 8 6 1 59 56 115 67 35 13 Chronic Bronchitis 3 ... 1 ... ... 1 2 7 !7 28 44 37 5 67 78 145 57 66 22 Lobar Pneumonia 4 5 1 ... ... 2 4 5 11 7 2 2 1 28 16 44 22 14 8 Lobular Pneumonia 33 34 2 2 ... ... 2 2 3 4 3 2 1 49 39 88 41 32 15 Pneumonia 8 7 ... 2 ... 2 4 4 10 8 4 7 1 3i 26 57 25 21 11 Emphysema, Asthma ... ... ... ... ... ... ... 2 3 2 1 2 ... 6 4 10 2 1 7 Pleurisy ... ... ... ... 1 1 ... 1 ... 1 1 1 ... 2 4 6 4 2 ... Other Diseases, Respiratory System ... ... ... 1 ... ... ... ... 3 1 2 ... ... 3 4 7 3 2 2 Diseases of Mouth and Annexa 3 1 ... ... ... ... ... ... 1 ... ... ... ... 3 2 5 3 1 1 Ulcer of Stomach and Duodenum ... ... ... ... ... ... 1 2 2 4 2 ... ... 7 4 11 5 ... 6 Other Diseases of Stomach 8 ... ... ... ... 1 ... 1 2 ... ... ... ... 8 4 12 3 3 6 Enteritis 28 7 3 ... ... ... ... ... 1 1 4 1 ... 24 21 45 25 16 4 Appendicitis ... ... 1 2 2 1 ... ... 1 2 ... ... ... 8 1 9 3 3 3 Obstruction of Intestine 3 1 ... ... 1 ... 1 1 3 3 5 3 ... 10 11 21 8 5 8 Other diseases of Intestine ... ... ... ... ... ... ... ... 1 ... ... 1 ... 1 1 2 2 ... ... Cirrhosis of Liver ... ... ... ... ... ... ... 2 6 6 1 ... ... 6 9 15 6 3 6 Other Diseases of Liver ... ... ... 1 ... ... 2 ... 2 2 2 1 ... 5 5 10 3 3 4 Peritonitis 2 ... 2 ... ... ... ... ... ... 2 1 ... ... 2 5 7 3 2 2 Other Diseases, Digestive System 2 ... ... ... ... ... 1 ... 1 1 ... ... 1 2 4 6 2 2 2 Diseases, Lymphatic System and Gland: ... ... ... ... ... ... 1 1 2 ... ... ... ... 2 2 4 2 ... 2 Acute Nephritis ... 1 ... ... ... ... 2 1 3 2 ... ... ... 7 2 9 5 2 2 Bright's Disease. ... ... ... ... ... 2 6 3 15 13 15 3 ... 26 31 57 20 20 17 Calculus ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 1 1 ... ... Diseases of Bladder and Prostate ... ... ... ... ... ... ... ... 1 2 ... 3 ... 6 ... 6 2 1 3 Other Diseases, Urinary System ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 ... ... 1 Diseases of Testis and Penis 1 ... ... ... ... ... ... ... ... ... ... 1 ... 2 ... 2 1 ... 1 Diseases of Ovaries ... ... ... ... ... 1 1 ... ... ... ... ... ... ... 2 2 2 ... ... Diseases of Uterus and Appendages ... ... ... ... ... ... ... 4 2 ... ... ... 1 ... 7 7 4 3 Puerperal Convulsions ... ... ... ... ... 1 1 1 ... ... ... ... ... ... 3 3 ... 1 2 Placenta Praevia, Flooding ... ... ... ... ... ... ... 2 ... ... ... ... ... ... 2 2 2 ... ... Other Diseases, Pregnancy & Childbirth ... ... ... ... ... ... 1 2 ... ... ... ... ... ... 3 3 2 1 ... Arthritis, Ostitis, Periostitis ... ... ... 1 ... ... ... 1 ... ... ... ... ... 1 2 3 3 ... ... Pemphigus .... 2 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 2 2 ... ... Accidents and Negligence. In Vehicular Traffic ... ... ... ... 1 ... 1 2 1 ... ... ... ... 4 1 5 2 2 1 On Railways ... ... ... ... 1 1 2 2 3 1 ... ... ... 9 1 10 6 4 ... In Building Operations ... ... ... ... ... ... ... ... 3 1 ... ... ... 4 ... 4 4 ... ... By Machinery ... ... ... ... ... 1 ... ... 1 ... ... ... ... 2 ... 2 2 ... ... By Weapons and Implements ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... 1 1 ... ... Burns and Scalds ... 4 2 ... ... ... 1 ... 1 ... 1 ... ... 4 5 9 3 4 2 Poisons, Poisonous Vapours ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 ... Drowning ... ... ... 1 ... 1 1 ... ... ... ... ... ... 3 .. 3 2 1 ... Suffocation, Overlaid in Bed 5 ... ... ... ... ... ... ... ... ... ... ... ... 3 2 5 3 2 ... Falls not specified ... 2 ... ... ... ... ... ... ... 2 2 1 ... 5 2 7 3 1 3 Otherwise, not stated ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 1 ... 1 ... Homicide 1 ... ... ... ... ... ... ... ... 1 ... ... ... 1 1 2 1 ... 1 Suicides. By Poison ... ... ... ... ... ... ... 3 ... 1 1 ... ... 4 1 5 4 1 ... By Hanging and Strangulation ... ... ... ... ... ... ... 1 3 ... ... ... ... 3 1 4 1 ... 3 By Drowning ... ... ... ... ... ... 1 1 ... 1 ... ... ... 3 ... 3 1 ... 2 By Cut or Stab ... ... ... ... ... ... 2 1 ... ... ... ... ... 3 ... 3 1 1 1 Ill-defined and Unspecified Causes. (a) Found Drowned ... ... ... ... 1 1 2 3 1 ... ... ... ... 8 ... 8 5 3 ... (b) Found Dead 4 ... ... ... ... ... ... ... ... ... ... ... ... ... 4 4 ... 3 1 (c) Other Causes ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 1 1 ... ... Totals 715 242 49 36 40 69 142 184 275 283 273 190 45 1327 1216 2543 1158 846 539 .