BAT 16 ??? 1910 B. H Metropolitan Borough of Battersea. t REPORT on the HEALTH of the Metropolitan Borough of Battersea, For the YEAR 1910. by G. QUIN LENNANE, F.R.C.S., L.R.C.P., D.P.H, MEDICAL OFFICER OF HEALTH, BAT 16 3 Health Committe. Chairman, Alderman A. bridge. HIS WORSHIP THE MAYOR (Councillor J. E. Astill, J.P.) Alderman A. BRIDGE. Councillor P. BROLLY. Councillor Miss E. BROWN. Councillor Dr. S. H. CURRY. Councillor F. DUNMORE. Councillor Dr. J. M. EHRHARDT. Councillor G. T. KETTLEY. Councillor Dr. J. T. RICHARDS. Councillor J. B. TAYLOR. Councillor J. J. TAYLOR. Councillor S. J. THOMAS. Alderman W. WATTS, 4 Staff of the public Health Department. Chief Sanitary Inspector. I. Young, m.r.s.i. Women Sanitary Inspectors. Miss A. E. Moss, San. Insp. Board's Cert, Miss L. M. Fairbairn „ Health Visitor. Miss E. C. Peacock. 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 „ .. J. J. Burgess, San. Insp. Board's 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. Chief Clerk .. B. W. Sears. Second Class Clerk. F. H. Preston, Cert. San. Inst. E. Cole. Third Class Clerks J. H. Lloyd, San. Insp. Board's Cert. T. F. Davis. Office Youth .. W. Campbell. Manageress of Milk Depot. Miss A. Lowe. Superintendent of Disinfecting Station. C. H. Woodhouse. Mortuary Keeper. G. Streat. 5 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Battersea. I have the honour to submit my fifth Annual Report on the health and sanitary conditions of the Borough of Battersea. In doing so it is again my privilege to point to the satisfactory position which your Borough occupies in regard to its sickness and fatality statistics. Since the records for the year 1910 were compiled, the preliminary report of the enumeration of the population of the United Kingdom has been issued by the Registrar-General. As had been anticipated as regards the figures for the County of London, the estimate of the Registrar-General of the population of Battersea is proved by the Census figures to be considerably in excess of the actual population. The population, instead of increasing, has slightly declined, viz., to the extent of 0.66 per cent. as compared with the 1901 Census. Notwithstanding the error in the estimated population of the Borough, I have considered it advisable to retain this figure for purposes of this Report until the complete returns of the Census are available. It will, however, be found, despite the error as shown by the Census figures, that the results of the past year establish a record in the general health statistics of the Borough. There have been fewer deaths per 1,000 of the population in Battersea than in any previous year. There has also been a marked decrease in the infectious diseases figures. Moreover, infant mortality has declined in Battersea to a remarkable extent during the past 10 years. In 1901 there were registered 821 deaths of infants belonging to Battersea, as compared with 434 infant deaths in 1910, a decrease of 47 per cent., although numerically the population has remained practically the same. To the Members of the Council my thanks are due for the support extended to me. To my colleagues the Chief Officers of the Council and the Public Health Staff my thanks are also due for assistance always willingly rendered. G. Quin LENNANE. Town Hall, Lavender Hill, S.E. 6 CONTENTS. Births, Marriages and Deaths. page Births 9 Deaths 11 Deaths in Public Institutions 14 Infantile Mortality 14 Marriages 11 Notification of Births Act 17 Population 9 Senile Mortality 23 Infectious and other Diseases. Alcoholism 49 Bacteriological Examinations 49 Cancer 48 Diarrhœa 41 Diphtheria 33 Enteric Fever 35 Epidemic Cerebro-spinal Fever 39 Erysipelas 39 Measles 39 Notifiable Infectious Diseases 29 Puerperal Fever 38 Scarlet Fever 31 Small Pox 31 Tuberculosis 43 Whooping Cough 41 Zymotic Diseases 25 General Sanitary Administration. Ambulances 62 Block Dwellings 56 Cleansing of Persons Act, 1897 59 Common Lodging Houses 56 Customs and Inland Revenue Act 57 Disinfection 57 Effluvium Nuisance 62 7 General Sanitary Administration (Continued). PAGE House-to-house Inspection 52 Houses Let in Lodgings 53 Housing and Town Planning Act 53 Hygienic Street Paving 54 Midwives Act 60 Mortuary 60 Paving of Back yards and Forecourts 54 Sanitation of House Property 51 Sewer Ventilation 55 Shelter, Temporary 58 Smoke Nuisances 54 Van Dwellings 55 Water Supply 57 Protection of the Food Supply. Butchers' Shops 70 Cow-houses 67 Fish Shops 70 Ice Cream 67 Milk shops 69 Restaurants, &c 68 Sale of Food and Drugs Acts 71 Slaughter-houses 66 Unsound Food 64 Factory and Workshop Act, 1901. Bakehouses 82 Factories 77 Homework 84 Underground Workrooms 82 Workshops 78 Legal Proceedings 87 Infants' Milk Depôt 20 Appendices. Legal Proceedings 88 Tables 91 8 Summary of Vital Statistics for 1910. Area of Borough (excluding water) 2,139.9 acres Population (Census 1901) 168,907 „ Estimated to middle of 1910 188,222 Density 87.9 persons per acre Inhabited Houses (Census 1901) 23,462 Marriages 1,341 Births 4,489 Birth-rate 23.7 Deaths 2,124 Death-rate 11.3 Infantile Mortality 97 per 1,000 births 9 Births, Marriages and Deaths. Population. The population of the Metropolitan Borough of Battersea (created in November, 1900, under the provisions of the London Government Act, 1899, and formed from the old Parish of Battersea after some rearrangement between the two districts of Wandsworth and Battersea to define the boundary line) as estimated by the Registrar-General to the middle of 1910, was 188,222, made up as follows:— East Battersea 78,024 North-West Battersea 49,388 South-West Battersea 60,810 188,222 The estimate of the Registrar-General is based on the assumption that the rate of increase of population during the last intercensal period was maintained during the subsequent years. It will probably be found that when the new Census figures are to hand some time next year (1911) that this estimate is too high*; but it has been adopted in this report so that the Battersea statistics may be comparable with those of other districts. The numbers of the population of each sex, and at various age periods (at the Census of 1901) were as follows :— Totals at all ages. Under 5. 5- 14. 15—19. 20—49. 50—75. Above 75. Males 81,749 10,140 17,842 7,911 39,601 5,782 473 Females 85,158 10,207 17,974 8,239 42,646 7,107 985 168,907 20,347 35,816 16,150 82,247 12,889 1,458 Births. The total number of births belonging to the Borough of Battersea during 1910 was 4,489. Of the total births 2,304 were males and 2,185 females, showing an excess of 119 males. The number of births showed an increase of 39 over that of 1909, but was 321 below the decennial average 1900-1909, and 786 less than the number of births recorded in the old Parish of Battersea in 1884, when the * The Registrar General's figures (just published) are 167,793, showing a decrease of 0.66 per cent, as compared with the Census figures for 1901. 10 population was only 121,299. The births in the sub-districts were as follows:— Males. Females. Total. East Battersea 1,075 1,005 2,080 North-West Battersea 755 750 1,505 South-West Battersea 474 430 904 Borough 2,304 2,185 4,489 The birth-rate, i.e., the number of births per 1,000 of the population, was 23.7, and is 3.5 per 1,000 below the average for the previous ten years. This is the lowest birth-rate previously recorded in Battersea. The birth-rate in Battersea, in common with the rest of the country, has been steadily declining during the past two decades. As has been pointed out in previous Annual Reports, this is a matter for serious concern, and it is clear that before very many years have passed will be reflected in a decline of the population. The natural increase of population (i.e., excess of births over deaths), which, owing to the decreasing death-rate, is still being maintained, must at length become affected. The causes responsible for the decline in the birth-rate are largely the indifference and reluctance on the part of the more prosperous classes of the community to incur the responsibilities and sacrifices incidental to motherhood. There is, unfortunately, evidence pointing to the fact that this example is being followed by the artizan and labouring classes, and to those who, like myself, believe that a high birth-rate is a most important national asset, the outlook is not very promising. The decline in the birth-rate in Battersea as compared with that in England and Wales is shown in the following table :— Birth-rate per 1,000 Population. Years. England and Wales. London. Battersea. 1877-81 34.9 35 .3 40.5 1882-86 33.3 34.0 40.0 1887-91 33.2 33.9 36.1 1892-96 30.1 30.6 32.4 1897-1901 29.0 29.5 30.8 1902-06 27.8 27.7 27.5 1907 26.3 25.8 25.1 1908 26.5 25.2 25.1 1909 25.6 24.2 23.9 1910 24.8 23.6 23.7 11 The next table shows the birth rate in the Borough and in each of the sub-districts during the ten years 1900-1909 and in 1910:— Birth-rate per 1,000 Population. Year. The Borough. East Battersea. North-West Battersea. South-West Battersea. 1900 30.6 33.5 35.2 21.3 1901 29.7 32.6 33.3 21.3 1902 28.2 30.3 33.1 20.2 1903 28.6 31.3 34.1 19.4 1904 27.5 30.4 31.9 19.5 1905 27.3 30.5 32.7 17.7 1906 25.9 28.6 31.7 17.0 1907 25.1 28.2 31.3 15.6 1908 25.1 27.3 32.8 15.8 1909 23.9 26.5 31.9 13.9 Average 1900-1909 27.2 29.9 32.8 18.2 1910 23.7 26.6 30.5 14.8 Marriages. The marriages registered in Battersea during 1910 number 1,341, and are 58 less than the decennial average. The marriagerate, i.e., the number of persons married per 1,000 of the population was 14.2 or 1.6 below the decennial average. Deaths. The total number of deaths registered in the Borough of Battersea during the year 1910 was 2,165, as compared with 2,445 during 1909, and a yearly average of 2,849 in the old Parish of Battersea for the decennium 1891-1900. Of the total deaths 1,103 were males and 1,062 females, showing an excess of 41 males. The death-rate for Battersea is therefore 11.5 per 1,000 inhabitants, as compared with 12.8 for London. This rate is, however, uncorrected, and on analysing the 2,165 deaths registered in the Borough of Battersea it is found that 444 represent deaths occurring within the Borough amongst persons not belonging thereto. These deaths are to be deducted ; but on the other hand, there are 403 deaths of Battersea residents, and these must be 12 added, giving a corrected number of deaths for Battersea during 1910 of 2,124 (1,099 males and 1,025 females), an excess of 74 males, and a corrected death-rate of 11.3, as compared with 12.7 for London (the total corrected number of London deaths being 61,756). A further correction can be made according to age and sex distribution. This is a more reliable method for ascertaining the healthiness of a district. The death-rate for a district will vary according to the character of its population, e.g., a district containing a large number of very young or very old people will have a higher death-rate than a district where there is a large proportion of people of middle age. The Registrar-General has provided a factor by means of which the death-rate of each of the Metropolitan Boroughs in the County of London can be thus corrected and compared. The factor for Battersea is 1.0728, and the death-rate corrected by this factor is 11.3x 1. 0728= 12-1 per 1,000. Sub-dividing the death-rate amongst the three registration subdistricts, it will be noted that in all three, as compared with 1909, there have been a decrease in the death-rate, most marked in the north-west district. Taking the averages for the ten years 1900-1909, as shown in the following table, there has been a notable decrease in 1910 in the Borough and in the registration sub-districts. This is especially marked in North-West and East Battersea, districts inhabited by, on the whole, a less prosperous class than that living in South-West Battersea. Death:rate per 1,000 Population. Year. The Borough East Battersea. North-West Battersea. South-West Battersea. 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 17.1 10.3 1904 14.4 15.6 17.0 10.3 1905 14.4 15.5 17.6 9.9 1906 13.2 14.7 15.5 9.5 1907 13.2 14.8 16.0 8.6 1908 12.3 13.0 15.1 9.1 1909 13.0 14.0 16.5 8.7 Average 1900-1909 14.4 15.3 17.3 10.1 1910 11.3 11.9 13.9 8.3 13 In the following table is shown the number of deaths, and the death-rate, in the nine Wards into which the Borough is divided :— Ward. Population Estimated to middle of 1910. Number of Deaths. Death Rates. Nine Elms 32,252 366 11.0 Park 20,304 290 14.2 Latchmere 22,978 242 10.5 Shaftesbury 17,901 182 10.1 Church 21,840 260 11.9 Winstanley 22,954 302 13.1 St. John 9,248 91 9.8 Bolingbroke 20,909 194 9.2 Broomwood 19,836 197 9.9 The most gratifying feature of the Annual Report for 1910, and for which the Council are to be congratulated, is the remarkable decline in the mortality rates, both general and infantile. The general death-rate is the lowest ever previously recorded in the old Parish and Borough of Battersea. More gratifying still is the great decline in North-West and East Battersea districts. The steady and persistent efforts of the Council during the past few years in regard to the effective sanitary supervision of these districts, e.g., the appointment of female Sanitary Inspectors, Health Visitors, &c., has resulted in a decrease in the death-rate in North-West Battersea from 21.0 per 1,000 in 1900 to 13.9 per 1,000 in 1910, and in East Battersea during the same period from 18.9 per 1,000 to 11.9 per 1,000. Results such as these are indeed remarkable, and have more than justified the action of the Council in their efforts to maintain a high standard of health in the Borough. It is interesting to note the place the Borough takes during 1910 in the Registrar-General's corrected returns amongst the twenty-nine Metropolitan Boroughs. There are 21 Boroughs with a higher general death-rate, 13 with a higher zymotic death-rate, and 17 with a higher infantile mortality rate. Taking the ten South Metropolitan Boroughs, Lewisham has the lowest general deathrate, viz., 9.6, and Bermondsey the highest, viz., 17.7 ; only 3 of the ten Southern Boroughs having a lower death-rate than Battersea. London as a whole has a birth-rate of 23.6, a corrected deathrate of 13.4, a corrected zymotic (death) rate of 1.14 per 1,000 population, and an infantile mortality (corrected) rate of 103 per 1,000 births. For England and Wales the figures are: Birthrate, 24.8; death-rate, 13.4; infantile mortality, 106 per 1,000 births. 14 The corrected number of deaths of males and females registered in each quarter of the year is set out as follows :— Males. Females. Total. First quarter 321 270 591 Second quarter 214 200 414 Third quarter 248 221 469 Fourth quarter 316 334 650 Deaths in Public Institutions. During the year 1910 the deaths of Battersea residents occurring in Public Institutions numbered 735 as compared with 874 in 1909. Of this number 332 occurred within and 403 outside the Borough. Three hundred and seventy occurred in workhouses or union infirmaries as against 470 in 1909 and 383 in 1908. Infant Mortality. Infant Mortality has reference to the deaths of children under one year of age, i.e., the proportion which the deaths of such infants in any given year bears to every thousand children born in the same year. Infant mortality varies widely in different districts, and has come to be regarded as a sensitive index of the sanitary condition of a district. In recent years, owing to the attention devoted to this subject, there has been a general improvement throughout the country. Compared with the average for the ten years 1900-1909 there has been a decline of 26.0 per 1,000 in the infant mortality of England and Wales. Infant Mortality in Battersea in 1910. During the year 1910, 434 deaths of infants were registered in the Borough of Battersea. The total number of births recorded during the year was 4,489, an increase of 39 births over those of 1909, giving an infant mortality rate of 96.6 per 1,000. This was the lowest infant mortality rate ever previously recorded in Battersea, the previous lowest rate being that recorded in 1909 and 1908, viz., 107 per 1,000. CHART showing- the Infantile Mortality rate per 1,000 Births in the Borough of Battersea during- the last ten years. 15 Since the formation of the Borough and for the previous decennium, the infant mortality in Battersea and in London has been as follows :— Year. London. Battersea. 1891-00 158 162 1901 148 163 1902 139 136 1903 130 135 1904 144 147 1905 129 131 1906 129 126 1907 116 115 1908 113 107 1909 108 107 1910 103 97 In the above table, while the average rate in Battersea for the quinquennium 1901-1905 was 142.4 per 1,000, the average for the five subsequent years had fallen to 110 per 1,000. In the County of London during 1910 there was a total of 11,809 infant deaths, giving an infantile mortality rate of 103 per 1,000. In the next table is shewn the distribution of the 434 infant deaths in the sub-districts :— Registration Sub-Districts. Deaths of Infants under 1 year of age. Infantile Mortality per 1,000 births. East Battersea 197 94.7 North-West Battersea 174 115.6 South-West Battersea 63 69.6 The Borough 434 97 The next table shows the incidence of mortality from the chief diseases of infancy in the first and second trimesters and the last six months of the first year respectively :— 16 Certified Causes of Death. Months. 0-3. Months. 3-6. Months. 6-12. Total. Diarrhœa 21 23 28 72 Prematurity 82 1 ← 83 Marasmus and debility 19 1 5 25 Developmental disease 20 3 1 24 Bronchitis 20 12 11 43 Pneumonia 16 4 25 45 Convulsions 6 1 2 9 Suffocation 1 — 1 2 Measles — — 11 11 Whooping cough 8 3 15 26 Tuberculosis 2 4 8 14 Meningitis — — 3 3 Miscellaneous 47 10 20 77 242 62 130 434 A glance at the above table shows (a) that the mortality is heaviest in the first three months of life, more than half the deaths occurring during that age period ; (b) that three groups of diseases between them account for 292 (or 67.2 per cent.) of the total deaths of infants during 1910, viz., prematurity, respiratory diseases and diarrhoea. Looking more in detail into these figures it will be seen that of the 434 deaths of infants 132 (or 30 per cent.) were due to congenital or developmental diseases (which include prematurity, marasmus, atrophy, debility, &c.), such infants not having the necessary vitality to survive. The diarrhœal group of diseases again shows a decrease in infantile mortality as compared with the two preceding years, to some extent at least the result of the favourable meteorological conditions during the summer months. The respiratory group of diseases shows a slight decrease as compared with the previous year. The causes responsible for these 434 infant deaths were inquired into by the Health Department. The chief preventive measures for dealing with this important subject have been fully described in past annual reports, so that it will be unnecessary to do more than briefly recapitulate them, viz. :— 1. Notification of Births Act. 2. Health Visitors. 3. Milk Depot. 17 Notification of Births Act. This useful Act was passed to provide for early notification of births to the Medical Officer of Health, and thus avoid the delay which arose through late registration. In avoiding this delay, health authorities have been furnished with a valuable means for dealing with infant mortality. As will be seen on referring to the table on page 16, more than half the deaths of infants occur during the earlier weeks of life and as up to the passing of this Act of Parliament the period within which the birth of a child could be registered was 42 days, early information which might have been useful in preventing the deaths of many children in the early weeks of their existence, was not obtainable. The Act came into force in this Borough in March, 1908, and has consequently been in operation for nearly three years, and provides that the birth of every child shall be notified to the Medical Officer of Health within 36 hours. The notification is " in addition to and not in substitution for the requirements of any Act relating to the registration of births" and applies to any child born " after the expiration of the twenty-eighth week of pregnancy whether alive or dead." In default of notification a penalty of 20s. is imposed. The results of the working of the Act in Battersea during the past 3 years have shown that as a factor in the reduction of infant mortality it has fully justified its adoption. During 1910, 3,012 notifications of births were received. Of this number 1,094 (i.e., 36 per cent.) were notified by medical practitioners,899 (i.e. 30 per cent.) by mid-wives and 1,019 (i.e. 34 per cent) by other persons. The number of births notified from each of the registration sub-districts of the Borough was as follows :— East Battersea 467 North-West Battersea 972 South-West Battersea 573 The number of births registered during 1910 in Battersea was 4,288. The proportion of notified to registered births was therefore 70 per cent. Of the total number (3,012) of births notified during the year, 1,316 were visited by the Council's Health Visitors. In addition 1,396 revisits have been made and the Health Visitors of the Battersea Voluntary Health Society have also paid a large number of visits to notified births. Most of the latter have been revisits following on the first visit by the Council's Health Visitor, and in this way it has been possible to keep a considerable number of children under observation for the entire period of their first year of life. The value of this work is from the educational standpoint inestimable and forms in my opinion a most useful feature of the Council's Public Health work. 18 During the year those districts have been dealt with which, from the circumstances and status of the inhabitants most require the services of the Health Visitors in connection with the Notification of Births Act. These localities are situate mainly in NorthWest Battersea and East Battersea. The following is a summary of the results of the enquiries made into these 1,316 births. The enquiries made had reference— (a) As to the mothers : to health and occupation of; number of children ; whether attended in her confinement by a doctor or midwife ; condition of the house and number of rooms occupied, etc. (b) As to the child : condition of health at birth and nature of food given. As regards the Mothers of these 1,316 children visited by the Council's Health Visitors, the majority were found to be in good or fair health. Most of them were engaged in domestic work. In 640 instances a doctor had been in attendance at the birth ; in 528 cases the mother was attended by a midwife ; in 29 cases an un-certified nurse or person was in attendance, as compared with 65 cases attended by uncertified nurses in 1909. In the following table will be found summarised particulars relating to the previous family history of the mothers of these children and their circumstances as regards dwelling-house accommodation. No. of previous Children in family. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 222 179 172 134 112 87 70 43 29 25 19 4 10 12 6 3 1 No. of previous Deaths of Children in Family. 1 2 3 4 5 6 7 8 9 13 198 159 43 33 19 7 2 5 2 1 No. of Rooms occupied by Family. 1 2 3 4 5 6 Caravans. 148 303 508 169 50 16 4 19 Sanitary condition of homes : — Thirty-two of these 1,316 homes were found to be very dirty and 230 showed evidence more or less of uncleanliness. These figures, it is satisfactory to note, show a very considerable improvement as compared with those of 1909 (vide Annual Report for 1909), when of 1,110 homes visited in connection with births notified to the Medical Officer of Health, 71 were found to be very dirty and 314 showed evidence more or less of neglect of cleanliness. As regards the child : health at birth :— Of the 1,316 infants visited at their homes the condition as regards health was ascertained to be as follows :— 231 were at the time they were visited more or less seriously ill. Of these 1,316 infants information as to the feeding was obtained with the following results :— Breast-fed only 1,130 Infants Milk Depot 63 Cows' Milk 66 Breast and other food 43 The above figures, it will be noted, appear to point to the satisfactory conclusion that the great majority of infants born in Battersea are breast-fed. As most of these children are visited by the Health Visitor within the first month, usually within the first 14 days of life, it is found that at the first time of visiting the great majority of them are being fed on the breast alone. Subsequently this breast-feeding was found to have been discontinued for various reasons, e.g., failure of breast milk, mother going out to work &c., or supplemented by artificial feeding. The form of artificial feeding employed has been found to be condensed milk, the brand most popular being Nestle's. The patent foods do not appear to have been much in evidence amongst the children visited by the Health Visitors, probably due to the cost. Owing to the attention given to the matter by the Health Visitors and to the printed cards of advice sent out, and probably also to some extent to the educational influence of the Milk Depot there is a growing tendency noticeable to use cows' milk in place of the condensed article. The visits of the Health Visitors continue to be much appreciated by the mothers, and their advice and kindly counsel acted upon as shewn by subsequent visits, to a most gratifying extent. 20 Even more satisfactory results would be achieved if it were possible to carry out a systematic system of re-visitation in connection with the births of infants notified, but this is not feasible with the staff available. Attention has therefore to be concentrated on those districts and cases where the indications point most clearly to the necessity for frequent and systematic re-visiting. Thus of one group of 290 children visited by Miss Moss, 74 were found to be in bad health suffering from various infantile maladies, e.g., congenital debility, malnutrition, tuberculosis, impetigo, respiratory diseases, convulsion, ophthalmia, rupture, hare-lip, cleft palate, &c., &c. The need and value of such systematic visitation will be fully appreciated from the above list, and I have no hesitation in stating that the lives of many more infants would be saved in industrial districts such as Battersea by an extension of the systematic visitation and revisitation of notified births. Infants' Milk Depôt. During the year 1910 the number of infants fed from the Council's Milk Depot was 492 as compared with 567 in 1909. Of this number 450 were resident in Battersea and the remaining 42 in adjoining districts. Of the 492 infants fed, 187 were already on the books of the Milk Depot at the beginning of the year, so that the number of children who were admitted during the year was 305. The age at which these children commenced taking the milk and the length of time fed are shown in the following table :— 21 MILK DEPOT.—Tables 1 & 2. Age Started. Period Fed. Totals. Under 1 wk. 1-2 wks. 2-3 wks. 3-4 wks. 1-2 mos. 2-3 mos. 3-4 mos. 4-5 mos. 5-6 mos. 6-7 mos. 7-8 mos. 8-9 mos. 9-10 mos. 10-11 mos. 11-12 mos. Over 1 year. Under 1 wk 2 1 3 3 4 6 7 3 3 5 1 .. 4 2 4 11 59 1-2 wks. 1 2 2 4 4 .. 1 1 1 3 4 .. 1 •• 1 5 30 2-3 „ 2 .. .. .. 1 2 2 2 .. .. 2 .. .. 2 .. 4 17 3-4 „ 2 .. .. 1 2 2 1 1 2 1 .. 2 1 1 .. 2 18 1-2 mos. 2 .. 6 3 12 9 5 7 10 3 7 2 4 4 4 21 99 2-3 „ 2 1 3 1 8 9 7 5 9 7 2 7 4 6 5 15 91 3-4 „ 3 3 4 1 7 8 4 4 2 1 5 3 4 2 5 3 59 4-5 „ 1 .. .. .. 2 2 4 .. 1 7 1 4 4 1 3 3 33 5-6 „ .. .. .. 2 6 3 2 3 2 6 2 .. 1 .. 1 1 29 6-7 „ 1 1 2 .. 5 1 2 .. .. 3 1 1 .. .. 1 1 20 7-8 „ .. 1 .. .. 1 1 2 2 1 .. 1 .. .. .. •• 1 11 8-9 „ .. .. .. .. .. 1 .. 2 1 1 •• .. .. .. .. .. 6 9-10 „ .. .. .. .. 1 .. .. .. .. 1 1 .. .. .. .. .. 3 10-11 „ .. .. 1 .. .. 1 1 .. .. .. .. .. .. •• .. 2 6 11-12 „ .. .. 1 .. .. .. 1 1 .. .. .. .. .. •• .. .. 3 Over 1 year. 1 1 .. .. 4 .. .. 1 .. 1 .. .. .. .. .. .. 8 Totals 17 10 22 18 57 45 39 32 32 39 27 19 24 18 24 69 492 22 Of the 492 infants fed from the Milk Depôt, 305 were admitted during 1910, the majority on the recommendation of medical practitioners, and the remainder were recommended by Hospitals, midwifes and the Council's Health Visitors, &c. Two hundred and thirty-seven of the 305 children admitted during the year were more or less seriously ill on admission, congenital and wasting diseases contributing the largest quota. The state of health on admission of the infants admitted during the year are classified in the Registers of the Milk Depot as follows :— Good health, 31 ; Immaturity and prematurity, 20; congenital syphilis, 12 ; indigestion, 24 ; diarrhoea, 8 ; malnutrition, 26 ; sickness, 2 ; wasting, marasmus, 33 ; rickets, 10 ; congenital debility, 30 ; improper feeding, 6; gastritis, 1 ; bronchitis and pneumonia, 12 ; tuberculosis, 4 ; jaundice, 3. It will be seen therefore that the majority of the children fed were not from a normal population and further a reference to the table on page 21 giving the age of these children and the length of time fed shows that as regards 68 per cent, of them, they were taking the milk for periods from one month to twelve months and over. The total number of deaths amongst the children fed from the Milk Depôt was 27. The death-rate was therefore equivalent to 54.8 per 1,000. as compared with 96.6, the general infantile mortality of the Borough. As pointed out in a previous Annual Report, the method of calculating the death-rate of the children fed from the Milk Depôt on the same basis as that of the general infant mortality is somewhat open to fallacy. To be strictly accurate, only those children who have been fed for continuous lengthened periods should be taken into account, allowance being made at the same time for deaths of children fed for shorter periods than one year; the assumption, found in practice to be justified, being that the rates that are ascertained to obtain for short periods would be maintained for longer periods. In this connection it should not be overlooked, as has already been mentioned, that the infants fed upon the Depôt milk are not a normal infant population, the majority having been admitted because of their more or less unhealthy condition. On the whole it may fairly be assumed that, taking all the factors into account, the estimate of the death-rate of depot-fed infants will be found to be approximately correct. In connection with the Infants Milk Depot there are two weighing-rooms, situate at the Latchmere and Nine Elms Baths, 23 respectively. The weighing-room at the Latchmere Baths, which is very centrally situate, is open on two afternoons a week, and that at the Nine Elms Baths one afternoon a week, the hours of attendance being from 3-5. This has proved a very useful method of exercising supervision over the majority of the infants fed from the Milk Depôt. The children are brought by their mothers to be weighed weekly or fortnightly, and in this way the effect of the milk is watched and any departure from the normal progress noted. The feeding of an abnormal infant population such as constitutes the larger proportion of those fed from the Milk Depôt, is one requiring constant watchfulness, and it is frequently necessary to substitute various additional modifications to those provided for the different age periods to meet the requirements of individual cases. It is largely due to the care taken in this direction that the continued success of the Council's Infants Milk Depot is, in my opinion, due, and much credit is due to Miss Moss for the able manner in which she has supervised this work under the direction of the Medical Officer of Health. The difficulty of providing an assimilable diet for many of these sickly infants is one requiring much care and thought, and it occasionally happens that one has to take a child off the milk for a time, and resort to some other method of feeding of which one's judgment would not, under ordinary conditions, approve, but which practical experience finds to be effective in overcoming the temporary difficulty. One is reminded in such cases of the dictum of a celebrated physician, that " you may give a baby anything as long as it is agreeing with it." The weighing-room procedure has the further great advantage of keeping the mothers in constant touch with the Health Visitors, thereby providing an opportunity of educating them in the proper methods of rearing their children. The following is a summary of the work carried out in connection with the Milk Depot during 1910 :— Visits paid by Health Visitors to homes of infants admitted to Milk Depot 1,288 Attendances of Health Visitors at Weighing-rooms 114 Number of infants attending Weighing-rooms 369 Weights registered 2,158 Number of infants under observation at home 117 Senile Mortality. During the year 1910 in the Borough of Battersea 510 deaths of persons aged 65 years and upwards were registered. The age distribution of these deaths is set out in the following table:- 24 District. 65 and under 75. 75 and under 85. 85 and upwards. Total over 65. East Battersea 130 78 12 220 North-West Battersea 57 49 9 115 South-West Battersea 78 72 25 175 Borough of Battersea 265 199 46 510 The 510 deaths over 65 were equivalent to 24 per cent. of the deaths at all ages. The deaths over 65 in each year during the eight years 19031910 were:- 1903 404 1904 508 1905 537 1906 495 1907 510 1908 564 1909 630 1910 510 25 Infectious and other Zymotic Diseases. Zymotic Diseases. The principal zymotic diseases are seven in number, viz., small pox, measles, scarlet fever, diphtheria (including membranous croup), whooping cough, "fever" (including typhus, enteric or typhoid, and simple or continued) and diarrhoea. The zymotic death-rate may be accepted, within certain limits, as an index of the sanitary condition of a community, and the statistics for the Borough of Battersea in 1910 will be found on inspection to establish a record low death-rate from these diseases during the year under report. In the Borough of Battersea during 1910 there were registered from the principal zymotic diseases 209 deaths, giving a corrected zymotic death-rate of 1.11 per 1,000, the corrected death-rate for the County of London being 1.14, varying in the different Metropolitan Boroughs from .46 in Hampstead to 2.44 in Bermondsey. The zymotic death-rate varies considerably for the three subdistricts into which for registration purposes the Borough is divided. Thus in the East District the rate was 1.26, in the North-West District 1.64, while in South-West Battersea the rate was only .47 per 1,000. This is in accordance with the rule that generally speaking the highest incidence and mortality from zymotic disease will be found in the less sanitary areas of the Borough, accounted for by the crowding and absence of facilities for home isolation in the two firstnamed districts as compared with the latter, in which the standard of living is, on the whole, much superior. Similar conclusions are to be drawn from a comparison of the death-rates from the chief zymotic diseases in the different Wards of the Borough, as shown in the table on page 26. The number of deaths registered from the chief zymotic diseases during 1910 was 180 fewer than the average for the ten years 1900-9. 26 The following table gives the death-rate from each of the chief zymotic diseases compared with the mean death-rate for the decennium 1900-9, the gain or loss in each case being also shown. Diseases. Mean Deathrate per 1,000 1900-1909. Death-rate per 1,000 1910. Gain in 1910. Loss in 1910. Small-pox 0.01 0.00 0.01 .. Measles 0.46 0.39 0.07 .. Erysipelas 0.05 0.04 0.01 .. Scarlet Fever 0.08 0.03 0.05 .. Diphtheria 0.12 0.06 0.06 .. Enteric Fever 0.06 0.03 0.03 .. Puerperal Fever 0.03 0.03 .. .. Whooping Cough 0.37 0.26 0.11 .. Diarrhœa 0.66 0.31 0.35 .. It will be noted from an inspection of the table that in the case of each disease mentioned there has been a gain as compared with decennial figure. In the next table is shown the death-rate from the chief zymotic diseases arranged in Wards :— Death Rate per 1,000 Population from the chief Zymotic Diseases arranged in Wards. Ward. Estimated Population. Small-pox. Measles. Erysipelas. Scarlet Fever. Diphtheria. Enteric, &c. Puerperal Fever. Whooping Cough. Epidemic Diarrhoea. All chief Zymotic diseases. 1. Nine Elms 32,252 .00 .68 .06 .06 .03 .06 .03 .21 .49 1.61 2. Park 20,304 .00 .44 .04 .00 .09 .04 .00 .34 .49 1.47 3. Latchmere 22,978 .00 .34 .04 .04 .00 .04 .08 .26 .17 1.00 4. Shaftesbury 17,901 .00 .50 .00 .00 .05 .00 .05 .44 .16 1.22 5. Church 21,840 .00 .45 .04 .04 .04 .04 .04 .13 .22 1.05 6. Winstanley 22,954 .00 .47 .04 .08 .04 .04 .00 .39 .78 1.87 7. St. John 9,248 .00 .10 .10 .10 .10 .00 .00 .32 .00 0.75 8. Bolingbroke 20,909 .00 .14 .00 .00 .19 .00 .00 .19 .09 0.62 9. Broomwood 19,836 .00 .05 .05 .00 .05 .05 .05 .15 .05 0.45 27 The Seasonal Mortality from the different important zymotic diseases is well shown by arranging the deaths quarterly, thus:- Quarter No. Small-pox. Measles. Whooping Cough. Scarlet Fever. Diphtheria. Fever. Diarrhoea. Erysipelas. Puerperal Fever. Cholera. Influenza. Total. Typhus. Typhoid. Continued. 1 - 17 17 2 3 - 1 - 5 - 1 - 8 54 2 - 22 19 1 2 - 2 - 3 3 2 - 1 55 3 - 2 7 1 4 - - - 37 1 2 - 4 58 4 - 33 7 3 3 - 4 - 14 4 1 - 6 75 Year - 74 50 7 12 - 7 - 59 8 6 - 19 242 Drains and sanitary fittings are tested as a routine procedure in all infected houses in cases of diphtheria, enteric and puerperal fever, and as regards other diseases in such instances as may be found necessary. It should of course be remembered in this connection that where defects are found, it does not follow that these are necessarily the cause of the disease. Indirectly, however, they may be so. The tests employed are usually the ordinary Smoke test and Chemical test (Kingzett's). The following table gives the drainage defects, &c., in houses in which cases of infectious disease were notified during 1910. DISEASE. No. of houses invaded. Number showing defects as to Percentage showing drainage defects. Percentage showing no drainage defects. Drains. Traps, fittings and appliances. Total. Diphtheria 173 16 39 55 32 68 Erysipelas 168 1 15 16 9 91 Scarlet Fever 359 15 51 66 18 82 Typhoid 29 4 7 11 34 66 Puerperal Fever 16 3 — 3 18 82 Total 745 39 112 151 20 80 28 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. Cerebro-spinal Fever. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. 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 — — 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 — — 1905 0.00 0.00 0.99 0.13 0.93 0.06 4.51 0.13 0.15 0.03 0.09 0.05 — — 1906 0.00 0.00 0.89 0.05 1.39 0.09 5.62 0.13 0.22 0.04 0.07 0.04 — — 1907 0.00 0.00 0.95 0.02 1.73 0.20 5.07 0.11 0.20 0.02 0.07 0.03 0.01 0.005 1908 0.00 0.00 0.82 0.02 1.84 0.11 5.97 0.13 0.19 0.03 0.03 0.02 0.01 0.01 1909 0.00 0.00 0.83 0.02 1.42 0.12 3.77 0.04 0.25 0.03 0.07 0.03 0.02 0.01 Average 1900-1909 0.15 0.01 0.90 0.05 1.50 0.12 4.14 0.08 0.30 0.06 0.05 0.03 — — 1910 0.00 0.00 0.90 0.04 1.10 0.06 2.33 0.03 0.21 0.03 0.08 0.03 0.02 0.02 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." 29 Notifiable Infectious Diseases. During 1910, under the Notification Clauses of the Public Health (London) Act, 1891, 880 cases of infectious diseases have been notified as compared with 1,189 cases notified in 1909. Of the 880 cases notified, 702 (i.e., 79 per cent.) were removed to Hospitals of the Metropolitan Asylums Board or to other hospitals and 178 (i.e., 21 per cent.) remained under treatment at their homes. As referred to in past Annual Reports it is satisfactory to note that the high percentage of removals to hospital for isolation purposes of cases of dangerous infectious diseases is being well maintained, a matter of great importance in a district such as Battersea where, owing to density of population and absence of means for adequate home isolation, the difficulty of checking the spread of epidemics is considerable. Examining the removals to hospital more in detail (e.g., nature of disease), it is seen that during 1910 in the Borough of Battersea the following are the percentages :— Scarlet fever 94.9 Diphtheria and membranous croup 92.3 Enteric fever 94.8 Erysipelas 26.4 Puerperal fever 50.0 The number of cases notified in the three sub-districts of the Borough and the proportion per 1,000 of the population are as follows:- Total number of cases notified. Notifications per 1,000 Population. The Borough 880 4.6 East Battersea 376 1.8 North-West Battersea 270 5.4 South-West Battersea 234 3.8 The total number of cases of notifiable diseases reported during 1910 shows a considerable decrease as compared with 1909, being 309 fewer in number. The total amount paid to medical practitioners as fees for notification of infectious diseases in Battersea during 1910 was £140 4s. 9d. This amount includes fees paid for notification of cases of phthisis, both for voluntary notification and notification under the Public Health (Tuberculosis) Regulations. 30 There was a great decrease in the number of notifications of scarlet fever during 1910, viz., 37 per cent., as compared with 1909, and 55 per cent. below the average for the past ten years 1891 1900. The 439 cases occurred in 359 houses and in 66 of these sanitary defects were found. A marked decrease has also to be recorded in the number of notifications of diphtheria received during 1910, as compared with 1909. The notifications were 58 per cent. below the average for the ten years 1891-1900. The 209 diphtheria cases occurred in 173 houses and in only 16 of them were the drains on testing found defective. The enteric fever or typhoid notifications received were 7 fewer in number than in 1909, and were 68 percent. below the average for the decennium 1891-1900. The 41 enteric fever cases occurred in 29 houses, in 4 of which the drains on testing were found to be defective. The following tables show the number of cases of infectious diseases received during 1910 arranged in wards, and the case-rate per 1,000 population in each ward respectively:- Ward. Diphtheria & Membranous Comp. Erysipelas. Scarlet Fever. Typhoid or Enteric Fever. Continued Fever. Puerperal Fever. Cerebrospinal Fever Totals. No. 1 (Nine Elms) 28 42 71 13 2 4 1 161 „ 2 (Park) 27 35 35 2 — 2 1 102 ,, 3 (Latchmere) 19 25 37 3 — 2 — 86 ,, 4 (Shaftesbury) 27 12 35 8 — — — 82 ,, 5 (Church) 28 17 53 2 — 2 — 102 ,, 6 (Winstanley) 20 17 77 3 — 1 1 119 „ 7 (St. John) 8 3 18 1 — 1 1 32 ,, 8 (Bolingbroke) 24 6 42 2 — 1 - 75 ,, 9 (Broomwood) 28 13 71 5 — 3 1 121 Totals 209 170 439 39 2 16 5 880 31 Ward. Estimated Population. Diphtheria & Membranous Croup. Erysipelas. Scarlet Fever. Enteric & Continued Fever. Puerperal Fever. Cerebrospinal fever. All Notifiable Infecti's diseases. No 1 (Nine Elms) 32,252 0.86 1.30 2.20 0.46 0.12 0.03 4.99 ,, 2 (Park) 20,304 1.32 1.71 1.71 0.09 0.09 0.04 5.02 ,, 3 (Latchmere) 22,978 0.82 1.08 1.61 0.13 0.08 0.00 3.74 ,, 4 (Shaftesbury) 17,901 1.50 0.67 1.95 0.44 0.00 0.00 4.57 ,, 5 (Church) 21,840 1.28 0.77 2.42 0.09 0.09 0.00 4.67 ,, 6 (Winstanley) 22,954 0.87 0.74 3.35 0.13 0.04 0.04 5.18 „ 7 (St. John) 9,248 0.86 0.32 1.94 0.10 0.10 0.10 3.44 ,, 8 (Bolingbroke) 20,909 1.14 0.28 2.08 0.09 0. 04 0.00 3.58 ,, 9 (Broomwood) 19,836 1.41 0.65 3.57 0.25 0.15 0.05 6.10 Small-pox. No case of this disease was notified in Battersea during 1910. In the County of London 7 cases were notified during the year. Contacts were watched on arrival within the Borough during 1910 in connection with small-pox cases that had occurred on board vessels arriving from abroad. All such cases were kept under observation for a period of sixteen days and no case of smallpox arose. Scarlet Fever. There was again a great decrease in the number of cases of scarlet fever reported in Battersea during 1910, 439 cases being notified and 7 deaths were registered from the disease. This is the lowest number of cases notified in any one year since 1891, with the exception of the year 1904, when 375 were notified—the lowest number of cases recorded in the old Parish or Borough of Battersea. In 1905 the epidemic wave which began to spread over London reached Battersea, 801 cases being notified in that year ; in 1906, 1,011 cases were notified, and in 1907, 922 cases. In 1908 the wave of epidemicity reached its height, 1,099 cases being registered in that year, and then began to subside, the number of cases notified in 1909 falling to 702, and in the year under report, as stated, to 439 cases. The death-rate per 1,000 of the population from scarlet fever in Battersea during 1910, i.e., .03 per 1,000, was the lowest ever recorded in the old Parish or Borough. This is a most gratifying fact to be able to record, and is largely, in my opinion, the result of 32 the prompt removal to the Metropolitan Asylums Board's hospitals of cases notified, and the rapid following up of contacts by the sanitary staff. In the following table are shown the number of cases and the case mortality per cent. in the Borough and sub-districts during 1910:— Sub Registration Districts. East Battersea. Nth.-West Battersea Sth.-West Battersea. Borough. No. of Cases 154 152 133 439 Case-rate per 1,000 population 1.97 3.07 2..18 2.33 No. of Deaths 3 3 1 7 Death-rate per 1,000 population .03 .06 .01 .03 Case-mortality per cent. 1.94 1.97 .75 1.59 Of the 439 cases of scarlet fever notified 265 {i.e., 60 per cent.) were of children of school age. Of the 7 deaths registered from the disease during 1910, 4 were of children under 5 years of age. In 55 of the houses invaded multiple cases occurred. In a majority of the cases notified the source of infection, there was reason to believe, was due to personal contact, the mild unrecognised case playing, as usual, an important part in spreading infection. So-called "return cases" were not so numerous during 1910 as in the preceding two or three years. It is always a difficult matter to definitely associate the discharged patient in crowded localities as being responsible for infecting healthy persons on their return home from hospital. Each such suspected case is exhaustively enquired into, and in a certain proportion of cases it is impossible to avoid the conclusion that the discharged patient is the cause of infection. Having regard to the more frequent channels of infection referred to in preceding Annual Reports, this as a source of infection cannot be considered a matter of great importance. Precautions are taken in the Health Department to reduce the risk to a minimum of such cases arising. CHART showing the number of cases of Scarlet Fever notified during each week of the year 1910. 33 Milk as a factor in the spread of infection did not in a single instance give rise to suspicion during 1910. The following are the number and percentages to total cases of "return cases" of scarlet fever since 1905:- Total cases. "Return" cases. Per cent. 1905 801 23 2.87 1906 1,011 34 3.36 1907 922 47 5.09 1908 1,099 52 4.73 1909 702 45 6.41 1910 439 20 4.55 The number of cases sent back from hospital notified as scarlet fever and in which the diagnosis was found to be erroneous was 47, or 10 per cent., as compared with 4.2 per cent. in 1909. No legal proceedings were taken for contravention of the infectious disease provisions of the Public Health (London) Act, 1891, in regard to scarlet fever. Diphtheria. The number of diphtheria cases notified during 1910 (including membranous croup) in the Borough of Battersea was 209, a considerable decrease as compared with the four preceding years, when the numbers were: In 1906, 251; in 1907, 315; in 1908, 340; in 1909, 265. Twelve deaths were registered from the disease in the Borough, giving a fatality rate of 0.06 per 1,000 population, which was equal to the lowest death-rate previously recorded in the old Parish or Borough of Battersea. The distribution of the disease in the three registration subdistricts of the Borough together with the number of deaths among both hospital and home-treated patients during 1910 is shown in the following table:— Registration Sub-Districts. No. of cases notified. Cases treated at home. Cases removed to hospital. No. of Deaths. Case-mortality per cent. Case-rate per 1,000 population. At home. At hospital. Total. East Battersea 93 4 89 - 4 4 4.3 1.19 North-West Battersea 53 1 52 - 2 2 3.7 1.07 South-West Battersea 63 11 52 - 6 6 9.5 1.03 34 In the above table it will he noted that the disease has been fairly uniformly distributed over the Borough, though on the whole East Battersea has suffered more than the other two divisions of the Borough, One hundred and ninety-three of the case notified were removed to hospital. or 92.3 per cent. In 1909 the percentage of case removed to hospital was 94.7, and in 1908 86.7 per cent. In the sub-districts the percentage of cases removed to hospital were as follows:— East Battersea, 95.7; North-West Battersea, 86.0; South-West Battersea, 82.0. The following table gives the age distribution of the case notified and of the fatal cases:— Age Periods-Years Boro Under 1 1-2 2-3 3-4 4-3 5-10 10-15 15-25 25-65 65- No. of Cases 4 8 10 24 22 90 33 13 5 .. 209 No. of Deaths .. .. 1 2 1 8 .. .. .. .. 12 Case Mortality per cent. .. .. 10 8.3 4.3 8.8 .. .. .. .. 5.7 The total number of houses invaded by diphtheria was 173. In 16 houses (in 9.2 per cent.) the drainage was found to be defective, and in 39 (i.e., 22 per cent.) insanitary conditions other than drainage defects were discovered. The source of infection in about 25 per cent, of the cases notified was due, there was reason to believe, to personal contact. In a few cases there was evidence strongly pointing to the patient having been infected at school. Four cases were post-scarlatinal cases, which developed in hospital while the patients were recovering from scarlet fever, and two patients were infected outside the Borough. No "return case" of diphtheria occurred during the year. With regard to the majority oil the cases notified the source of infection was merely conjectural. During the year 17 cases (i.e., 8.0 per cent.) notified as diphtheria, and removed to hospital, were found not to be suffering from the disease, and were discharged to their homes. Four hundred and ten bacteriological examinations of suspectcd cases of diphtheria were made during 1910, as compared with 628 in l909. and 2,319 in 1908. In 129 a positive and in 281 a negative result was obtained. CHART showing the number of cases of Diphtheria notified during each week of the year 1910. 35 Enteric Fever. During 1910, 41 cases of enteric fever were notified in the Borough of Battersea as compared with 48 in 1909 and 36 in 1908, and 7 deaths were registered from the disease, giving a case mortality of 17 per cent., and a death-rate per 1,000 population of 0.03. The number of deaths was the same as in 1909. In the following table are set out the case-rate, death-rate and mortality from enteric fever in the Borough of Battersea during the ten years 1900-09, and during 1910, respectively:- Year. Cases. Case-rate per 1,000 population. Deaths. Death-rate per 1,000 population. Case mortality per cent. 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 1905 27 0.15 6 0.03 22.2 1906 40 0.22 8 0.04 20.0 1907 37 0.20 4 0.02 10.8 1908 36 0.19 7 0.03 19.4 1909 48 0.25 7 0.03 14.5 1910 41 0.21 7 0.03 17.0 The age distribution of the cases during 1910 was as follows:- Ages. Under 5. 5-15. 15-30. Above 30. Totals. Males 5 15 1 5 26 Females - 3 4 8 15 Totals 5 18 5 13 41 The death-rate, case-rate and case mortality in the Borough and in the sub-districts are as follows:- Case-rate per 1,000 population. Death-rate per 1,000 population. Casemortality per cent. East Battersea 0.28 0.03 13 North-West Battersea 0.20 0.06 30 South-West Battersea 0.14 0.01 11 The Borough 0.21 0.03 17 36 In the County of London the case-rate was 0 04 and the deathrate 0.04 per 1,000 population. Of the 29 typhoid-infected houses, 11 (i.e., 34 per cent.) showed on inspection defective traps, fittings or appliances. In 4 of the houses the drains themselves were found to be defective. The source of infection in 15 cases was probably due to personal infection or to a so-called "carrier" case. In 2 cases the eating of mussels was suspected to have been the cause of the disease, and in 1 case it was ascertained that fried fish had been partaken of during the critical period, and may have been the cause of the disease. In the remainder of the cases it was impossible, notwithstanding a rigid investigation in each instance, to trace the probable source of infection. In my Annual Report for the year 1909, a somewhat remarkable local outbreak of enteric fever, which occurred in a street in East Battersea (Nine Elms Ward) was recorded. A similar outbreak, though not so serious as regards the number of cases or fatality, occurred in the same street during 1910, an interval of some four months separating the last case notified in 1909 from the first case occurring in 1910. Between the 11th February and 17th May I received the following notifications :— Date of Notification. Name. Age. Address. Date of Onset. 11th Feb. 9th March 3rd April 16th April 9th May 11th „ 17th „ George G. * Leslie C. Leonard C. Frank C. George G. Emily L. Cyril C. 68 11 13 8 14 14½ 11 18, L-Street 35, „ ,, „ „ v „ „ „ 76, „ „ 35, ,, ,, „ „ „ Dec., 09 3rd March 31st „ 8th April 24th „ 10th May No symptoms * This case was notified as continued fever. The history of the outbreak was as follows: George G. was notified as suffering from continued fever on the 11th February, his illness dated from early in December, but he was not seen by a doctor until the 2nd January. The nature of his illness was suspected to be enteric fever and a specimen of his blood was bacteriologically examined, with a negative result. When first seen by the doctor he was feverish temperature 101 deg. F. General malaise, no chest symptoms, no eruption was noticed, his skin was dry, harsh, tongue CHART showing the number of cases of Enteric Fever notified during each week of the year 1910. 37 dry and brown, slight diarrhoea before he was seen by the doctor, no abdominal tenderness and no enlargement of the spleen was noted. The symptoms and signs were generally indefinite. The case was eventually notified as continued fever on the 11th February and the patient died on the 3rd March. The house in which the patient resided was occupied by two families, but no other person in the house showed signs of illness. From the history of this case, it would appear to be doubtful that it was one of enteric fever—nor was there a far as could be ascertained any connection between this case and the subsequent cases of enteric fever notified. On the 9th March, the patient Leslie C., aged 11 years, was notified and was removed to Hospital on the same day. He was one of a family of 7 children, four other members of which were subsequently attacked. Every possible source of infection was investigated, but with very slender evidence resulting. The mother of the patient Leslie, the first case attacked, stated that the boy had been in the habit of playing with a child named C., who was one of the persons attacked in the previous outbreak in the autumn of 1909. On trying to find this child it was ascertained that she had left the district, so there was no opportunity of following up this clue. It is possible that this girl may have been still a "carrier" case, and so infected Leslie C. The subsequent cases were, there was every reason to believe, the result of infection by personal contact with Leslie C., and this view is strongly supported by the cases of Emily L., a domestic servant employed in this family, and George E. a playmate of Leslie C. who lived in the same street, and who had been frequently visiting him when the boy Leslie was first taken ill and before the nature of his illness was recognised. The outbreak, which was confined to the L. family and to one case in another family, that of George E., is of interest having regard to the previous outbreak in 1909 in the same street and which was of a much more serious and fatal character. This street is situate in one of the poorest quarters of the Borough and is mainly inhabited by persons earning a precarious livelihood. From the time the first case was notified every precaution was taken to prevent the spread of infection, and with satisfactory results, as with the exception of the boy George E. and excluding the doubtful case of George G. previously referred to, not another case occurred in the street or neighbourhood. Two other local outbreaks involving several members of the same family occurred. The subsequent cases being due to the nature of illness of the first case not having been recognised in time. In one case two persons were thus subsequently infected and in the other 4. In the latter case a mother and 2 of her children were removed to hospital within 3 or 4 days of each other with typhoid 38 fever, from a house in the Winstanley Ward. The mother had been ill for some 3 weeks suffering from what was thought to be influenza and was waited on by a married daughter who with her husband and one child age 4 resided in the Nine Elms Ward, at the other end of the Borough. Subsequently this daughter and her child developed (3 weeks later) typhoid fever and were removed to hospital. These multiple cases occurring in families help to swell the total of cases of enteric fever notified during the year. It is satisfactory, notwithstanding, as will be seen from a glance at the table, showing the incidence, case-rates and fatality-rates during the past 10 years in the Borough, that the disease is comparatively speaking rare in Battersea. Puerperal Fever. During 1910, in the Borough of Battersea, 16 cases of puerperal fever were notified and 6 deaths were registered from the disease, giving a case-mortality of 37 per cent. The case-rate was .08 or .02 above the mean case-rate for the preceding ten years. The death-rate was .03 per 1,000 and was equal to the decennial average. The death-rate for London was .03 per 1,000 population. Three deaths occurred in East Battersea, two in North-West and one in Southwest Battersea. In 1909, 14 cases of puerperal fever were notified in Battersea and 7 deaths were registered from the disease, giving a case-mortalitv of 50.0 per cent. and a death rate of .03 per 1,000 population. Puerperal fever is a preventable disease and is caused by want of care by those in attendance on the lying-in woman. During 1910, 4,489 births were registered in or belonging to Battersea. The mortality statistics therefore for the disease are on the whole satisfactory. In all cases of puerperal fever notified to the Medical Officer of Health, enquiries are at once made and the midwife or nurse in attendance are visited at their homes. Arrangements are immediately made for the personal attendance of the midwife at the Shelter, Sheepcote Lane, where she is provided with a sanitary bath and has her clothing, instruments, &c., sterilised by steam at the Disinfecting Station adjoining. Cases are at once reported to the London County Council, who are the local supervising authority under the Midwives Act, 1902. The duty of disinfection, however, devolves on the Borough Council as the local Sanitary Authority. Nurses and midwives who had been in attendance on puerperal fever cases during the year attended at the Shelter for purposes of disinfection. 39 Erysipelas. During 1910, in the Borough of Battersea, 170 cases of erysipelas were notified and 8 deaths were registered from the disease as compared with 156 cases and 4 deaths in 1909. The casemortality was 4.7 per cent. as compared with 2.7 per cent. in 1909, and 3.3 per cent. in 1908. The case-rate was .9 and the death-rate .04, being equal to and .01 below the decennial average respectively. Forty-five cases were removed to hospital, the majority going to Union Infirmaries and the remainder to general hospitals. In London during 1910, 3,982 cases of erysipelas were notified and 130 deaths registered from the disease, giving a case-mortality of 3.3 per cent. Epidemic Cerebro-spinal Meningitis. During 1910, five cases of cerebro-spinal meningitis were notified in Battersea as compared with four cases in 1909 and two in 1908, and five deaths were registered from the disease. In the County of London, 115 cases of epidemic cerebro-spinal meningitis were notified during 1910. Measles. During 1910, 74 deaths were registered within the Borough of Battersea from measles. The number of deaths was slightly lower than the average for the decennium 1900-1909. In 1909, 86 deaths and in 1908, 47 deaths were registered in Battersea from the disease. The death-rate was .39 per 1,000 population as compared with .46, the mean death-rate for the preceding ten years. The death-rate in East Battersea was .49, North-West Battersea .58, South-West Battersea .09 per 1,000. The London death-rate from measles was 0.41 per 1,000, there being 1,980 deaths from this cause registered during 1910. The number of deaths registered in each of the registration sub-districts in 1908, 1909 and 1910 is as follows:— 1910. 1909. 1908. East Battersea 39 50 22 North-West Battersea 29 31 21 South-West Battersea 6 5 4 40 Eleven deaths were of infants under one year and 59 of children aged one to five years. Only 4 of the deaths occurred amongst children over five years of age. The deaths in each of the four quarters of the year were as follows:— First quarter 17 Second quarter 22 Third quarter 2 Fourth quarter 33 Of the 33 deaths from measles during the fourth quarter of the year, no less than 20 occurred in the last month, and there is evidence pointing to a rising wave of epidemicity spreading throughout the Borough. Every precaution, that can be, is taken to prevent the spread of infection, but from the nature of the disease, together with the indifference shown by the parents in failing to recognise its fatal character, especially in the poorer and more crowded districts, it is a most difficult, one might add an impossible, task, to secure that proper precautions are observed to prevent the spread of measles, once it has got a start. The absence of any satisfactory system of notification, or of means of securing isolation, are further factors which give rise to difficulty in adequately dealing with this disease. The only information available as to the incidence of the disease is that obtained from the Public Elementary Schools. This, when received, is more often than not too late to be of any effective use, and it is clear that the time has arrived when more satisfactory preventive measures should be undertaken to prevent the heavy mortality which periodically has to be recorded from measles. The disease is accountable for more deaths annually, with the exception of tuberculosis, than all the other infectious diseases put together, and that it is, at least as regards fatality, amenable to proper treatment, when suitable measures are taken to secure this end, is shown by the fact that in the district of the Borough inhabited by the more prosperous and better housed class, the disease is rarely fatal. The infant departments of the Public Elementary Schools are, as pointed out in previous annual reports, largely responsible for the spread of measles, and it is to be regretted that steps are not taken to prevent the attendance of children under 5 years of age from attending school. It is amongst children under this age that practically all fatalities from measles occur, and were these young children excluded from attendance, a twofold object would in my opinion be attained, a decreased risk of infection and a diminished incidence of mortality. The preventive measures taken at present in the Borough are, when cases are notified to the Health Department, the homes of the 41 patients are visited and cards calling attention to the dangerous nature of the disease and the precautions to be taken are handed to the parents. Disinfection of the rooms is carried out when the patient has recovered. Whooping Cough. During 1910 in the Borough of Battersea, 50 deaths were registered from whooping-cough, as compared with 60 in 1909. The deaths were 18 below the average for the preceding ten years and were equivalent to a death-rate of .26 per 1,000 as compared with .37, the mean death-rate for the previous ten years. In the sub-districts, the number of deaths and the death-rate per 1,000 of the population were as follows:— No of. deaths. Death-rate per 1,000 of the population. East Battersea 22 .28 North-West Battersea 18 .36 South-West Battersea 10 .16 In this disease as in measles, the influence of environment is well shown in the above figures, North-West Battersea suffered most and South-West Battersea least from the disease. The death-rate under one year of age was 52 per cent. and from one to five years of age 48 per cent. the total percentage of deaths under 5 years of age being 100. The deaths in each of the four quarters of the year were as follows:— First quarter 17 Second quarter 19 Third quarter 7 Fourth quarter 7 Diarrhœa. During 1910, the number of deaths from diarrhœa registered in the Borough of Battersea was 59 as compared with 53 in 1909. Twenty-eight of these deaths were registered as being due to epidemic or zymotic enteritis. The death-rate was .31 per 1,000 or .35 below the decennial average .66. Of the 59 deaths, 57 (i.e., 96 per cent.) were of children under five years of age and 47 (i.e., 79 per cent.) were of children under one year of age. During 1909, of the 53 deaths from diarrhœa, 42 (i.e., 79 per cent.) were of infants under one year old. 42 The number of deaths and the death-rate in the subdistricts in 1910, 1909 and 1908 were as follows Registration Sub-District. No. of Deaths. Death-rate per 1,000 population. 1910. 1909. 1908. 1910. 1909. 1908. East Battersea 28 33 39 .35 .42 .51 North-West Battersea 26 16 40 .52 .32 .80 South-West Battersea 5 4 10 .08 .06 .17 In the next table are set out the deaths registered in each of the four quarterly periods in 1910, 1909 and 1908:— 1910. 1909. 1908. First quarter 5 4 12 Second quarter 3 6 7 Third quarter 37 27 53 Fourth quarter 14 16 17 Of the 47 deaths of infants under one year from diarrhœa or epidemic enteritis, 37 occurred in the third quarter of the year distributed as follows in the three sub-districts:—East Battersea, 20 ; North-West Battersea, 16 ; South-West Battersea, 1. The next table gives the age periods at which these 47 infants died during 1910:— Deaths of Infants under 1 year of age from Zymotic Diarrhœa and Epidemic Enteritis. 1-3 months. 3-6 months. 6-9 months. 9-12 months. Total. 14 17 13 3 47 A glance at the above table shows that of the total number of deaths under one year from diarrhœa 30 (i.e., 51 per cent.) were of infants between three and nine months old. The meteorological conditions, which are such an important factor in association with epidemic or summer diarrhœa, were as in 1909 favourable to a low incidence and mortality from the disease. It is probable also that, even allowing for this factor, the special measures undertaken by the Council during the past few years, in connection with their campaign against the high rate of 43 infant mortality which formerly prevailed in Battersea, have in no small degree been successful in checking this disease. These preventive measures are referred to in detail in the part of the report dealing with Infantile Mortality. Tuberculosis. During 1910, 252 deaths from tuberculosis were registered in the Borough of Battersea. Of this number 195 (i.e., 77 per cent.) were due to phthisis (tuberculosis of the lungs), 29 to tubercular meningitis, 18 to general tuberculosis, 4 to tubercular disease of the intestines and 6 to other forms of the disease. In 1909 the total number of deaths from tuberculosis was 289 and in 1908, 306. The following table shows the death-rate from phthisis and other tubercular diseases per 100,000 persons in each year since 1901:— Year. Deaths from Phthisis per 100,000 persons. Deaths from other Tubercular Diseases per 100,000 persons 1901 146 60 1902 129 44 1903 128 51 1904 139 41 1905 132 50 1906 122 48 1907 120 46 1908 119 46 1909 116 38 1910 103 30 The number of deaths from phthisis and other tubercular diseases, and the death-rate per 1,000 of the population in each of the sub-districts, and the Borough, are set out in the following table:— District. Phthisis. Other Tubercular Diseases. Total. No. of Deaths. Rate. No. of Deaths. Rate. No. of Deaths. Rate. East Battersea 79 1.01 29 0.37 108 1.38 Nth.-West Battersea 70 1 .41 21 0.32 91 1.84 Sth.-West Battersea 46 0.75 7 0.11 53 0.87 The Borough 195 1.03 57 0.30 252 1.33 44 The deaths from tuberculosis were 11.8 per cent. of the total deaths. It will be noted, however, that the death-rate from phthisis (the most common form of tubercular disease) was in 1910, 1 .03 or .13 lower than in 1909, and .16 lower than in 1908. There is thus apparent a slow but continuous decline in the death-rate from the pulmonary form of the disease in Battersea. PREVENTIVE MEASURES. Public Health (Tuberculosis) Regulations. At the beginning of 1909 a partial system of compulsory notification of pulmonary tuberculosis came into force by an Order of the Local Government Board. Later, in May 1909, the Council decided to adopt a system of Voluntary Notification of the disease in Battersea. Prior to these, there was practically no means of ascertaining the incidence of the disease in the Borough other than by an estimate based upon the mortality returns. The Public Health (Tuberculosis) Regulations provide for the compulsory notification (within 48 hours) to the Medical Officer of Health of cases of phthisis occurring amongst Poor Law patients. In this way a valuable source of information, which cannot fail to prove of real assistance in fighting the disease, has been placed at the disposal of Sanitary Authorities. During 1910, 434 notifications have been received relating to 166 cases. Table giving particulars of the notifications received under the Public Health (Tuberculosis) Regulations, 1908, Voluntary system:— Source. Cases. Duplicates. Total Notifications. Poor Law 166 268 434 Voluntary 103 24 127 Total 269 292 561 In addition to the notifications received under the Regulations under the system of Voluntary notification of Consumption adopted by the Council in 1909, 127 notifications referring to 103 cases of phthisis were received during 1910. 45 In the following tables are set out particulars as regards age periods and distribution in the sub-districts and wards of the notified cases, voluntary and compulsory, of pulmonary phthisis during 1910 :— Age Periods—Years. Notified under Under 1 l 2 3 4 5-10 10-15 15-25 25-65 65 Total. P.H. (T.) R.,'08 1 1 2 3 1 12 11 20 103 12 166 Voluntary 1 - — — — 4 2 26 68 2 103 Total 2 1 2 3 1 16 13 46 171 14 269 East Battersea N.-W. Battersea S.-W. Battersea. Borough. Poor Law 70 58 38 166 Voluntary 52 38 13 103 Total 122 96 51 269 Arranged in Wards. NotifieJ under 1 2 3 4 5 6 7 8 9 Total. P.H. (T.) R., 1908 33 21 16 11 24 24 28 4 5 166 Voluntary 18 20 9 10 15 18 1 8 4 103 Total 51 41 25 21 39 42 29 12 9 269 46 The next table gives the occupations of the 271 notified cases of Consumption received during 1910:— Occupation. Poor Law. Voluntary. Total. Potmen 1 1 2 Waiter 1 - 1 Billiard-room Marker - 1 1 Kitchen Porters 2 1 3 Menservants 1 - 1 Laundry Workers 2 4 6 Bottle Washers, Window Cleaners 2 - 2 Home, Charing and Domestic Work 31 31 62 Tailoring, Dressmaking, Millinery, Leather Stitcher 3 8 11 Mantle (Gas) Maker and Factory Hands 1 2 3 Packers 1 1 2 Labourer, Stonemasons, Gardeners, Asphalter 14 14 28 Blacksmith, Porters 2 2 4 Stokers 1 2 3 Carmen, Tram Conductors and Drivers 7 3 10 Costers, Hawkers, Organ-Grinders 5 - 5 Crucible Worker and Gas Burner Maker 1 1 2 Painters, Decorators, Plumbers, Joiners 9 3 12 Printers — 1 1 Bakers 1 - 1 Shop-keepers and Assistants 1 3 4 Clerks 1 3 4 Engineers 2 1 3 Musicians — 2 2 Messengers and Errand Boys 3 1 4 Navvy 1 — 1 Sorter (Paper works) — 1 1 Roadsweepers, Sewermen 1 1 2 Mortuary Attendant — 1 1 Commercial Traveller — 1 1 Vagrants 6 — 6 Children 32 8 40 Unknown & nil 34 6 40 Totals 166 103 269 The usual measures for dealing with notified cases of consumption were taken by the department during the year. These 47 measures include visits to the patient's home by the Sanitary Inspectors and Health Visitor for the purpose of inquiring into the history of the case, giving of advice, both oral and written, searching for contacts showing early symptoms of a suspicious nature and who are immediately advised to seek medical advice, provision of portable spittoons, inspection of the sanitary condition of the home, disinfection of rooms, bedding, &c. Each case is kept under observation, being re-visited periodically for this purpose, and where indicated efforts are made through the medium of the Battersea Voluntary Health Society to obtain material assistance or removal of suitable cases, into a sanatorium. A movement which promises to be successful is being made to start a Tuberculosis Dispensary on the lines of that established by Dr. Phillip of Edinburgh, and which he has shown has proved so successful in combating the scourge of consumption in that city. The movement was inaugurated by a large public meeting held in the Town Hall presided over by the Mayor (Mr. Councillor Haythornthwaite). The dispensary when established in Battersea will work in co-operation with the Borough Council, and it is hoped will prove as useful a factor in lighting the disease as is claimed for similar institutions started elsewhere in London. One of the most useful features of the Dispensary will be that the treatment will include Tuberculin as a remedial agent. There has in recent years been a recrudescence in favour of the tuberculin treatment, which when first employed by Koch yielded anything but satisfactory results. Very promising results are now shown from the use of this remedy, and it possesses this enormous advantage over the sanatorium and other forms of treatment, in that the patient may be treated without relinquishing his employment. One of the great difficulties met with in fighting consumption is that frequently the sufferer will not seek medical assistance at an early stage, because he fears that it will militate against his employment, nor is oftentimes he willing to enter a sanatorium if he has a family dependent on him. When he recognises, however, that a satisfactory treatment can be obtained without the necessity of giving up his work for a time, he will, there can be little doubt, be induced to seek medical aid at an earlier period. In this way a twofold advantage will be gained (a) earlier treatment yielding more satisfactory results and (b) less risk of spreading infection amongst members of his family. Already in one of the great towns of the kingdom, the Municipality have established a Tuberculin Dispensary, and the results will be watched with interest by other Sanitary Authorities. It is highly probable that eventually the Voluntary Institutions started as Tuberculosis Dispensaries will be taken over by the State or the Municipality. Great things are hoped from the Dispensary about to be started on voluntary lines in Battersea, and it is satisfactory to note that the public interest aroused in the war now being waged 48 against this dread scourge of civilisation has reached Battersea. Taken in conjunction with the figures shown in the table on page 43, which exhibit a progressive decline in the mortality from consumption during the past ten years in Battersea, the activity being displayed by the Council in fighting the disease and promising results already achieved are very encouraging. A Conference of Metropolitan City and Borough Councils was held at Caxton Hall, on May 25th, 1910, on the subject of Tuberculosis and was attended by two delegates (and the Medical Officer of Health) from the Battersea Borough Council. The following resolutions were adopted :— 1. That this conference is of opinion that the provision of Sanatoria for the educational and curative treatment of Tuberculosis is advisable. 2. (a) That in the opinion of this Conference it is desirable that a Sanatorium should be established for the accommodation of persons of the working classes of the Metropolis suffering from Tuberculosis, and that such Institution should be maintained by a charge upon the several Metropolitan Boroughs in accordance with their respective rateable values. (b) That in the opinion of this Conference the proposed Sanatorium should be under the direct control of the Metropolitan Asylums Board, and that such authority be asked to seek the necessary Parliamentary powers for that purpose (if necessary). (c) That copies of the above resolutions be forwarded to the Metropolitan Asylums Board and to the Local Government Board. 3. That pending the provision of a Sanatorium for the working classes it is desirable that each Municipal Authority should secure beds in some existing Sanatorium according to the provisions of Section 75 of the Public Health (London) Act, 1891. 4. That in the opinion of this Conference the establishment of Tuberculosis Dispensaries in each of the Metropolitan Boroughs would be a desirable adjunct to the prevention and treatment of tuberculosis. Cancer. The number of deaths from cancer registered of persons belonging to Battersea during the year 1910 was 141 (males 58, females 83) as compared with 180 in 1909 and 156 in 1908. 49 Taking the average annual number of deaths from cancer for the ten years 1900-1909, viz., 153.5, as compared with 141 deaths during 1910, there would appear to be a tendency towards a decrease in the mortality from this disease. The figures are, however, too small to provide any reliable data. Alcoholism. During 1910, in the Borough of Battersea, 5 deaths were registered from acute and chronic alcoholism (males 3, females 2). In addition to these, 17 deaths were registered from cirrhosis of the liver (males 7, females 10) a disease mainly due to alcohol. The total number of deaths therefore to be ascribed to alcohol is 22, as compared with 25 in each of the two preceding years. Bacteriological Examinations. During the year 1910, 626 bacteriological examinations of specimens sent in by medical practitioners, practising in the Borough of Battersea, have been made at the Clinical Research Association Laboratories at a cost of £111 9s. 9d., particulars of which are set out in the following table:— Suspected disease. Positive Results. Negative Results. Total. Diphtheria 129 281 410 Enteric fever 8 22 30 Tuberculosis 46 137 183 Cerebro-spinal fever — 1 1 Other specimens — 2 2 Total 183 443 626 50 General Sanitary Administration. The following table gives a summary of the work of the Sanitary Inspectors as far as the work admits of tabulation:— Summary of Sanitary Operations for the Year 1910. Total Sanitary Operations 77,888 Leaky house-roofs and gutters repaired 467 Number of house inspections 44,748 Bakehouse inspections 227 Houses supplied with water, and fittings repaired 159 Bakehouse nuisances abated 43 Urinals—inspections 197 Water closets provided, supplied with water or supply disconnected from drinking water cisterns 547 Do altered, repaired or water laid on 63 Intimations served under Sec. 3 4,318 Notices served under Sec. 4, &c. 1,317 Cisterns covered, cleansed and repaired 618 Notices served under Sec. 62 &65 2,039 Complaints received & attended to 3,763 Additional water supplies to upper floors 126 Number of houses disinfected 2,337 Houses supplied with disinfectants 5,278 Keeping of animals in unfit state discontinued 58 House drains flushed with disinfectants after infectious disease 2,337 Smoke observations 51 Overcrowding abated 79 Certificates of disinfectiongranted 1,847 Premises improved, cleansed and repaired 3,246 Houses inspected and certificates granted (Sec. 48) 83 Drains tested By smoke. 783 Proceedings ordered by Council and Health Committee 3,790 „ water. 3,180 Drains cleansed and repaired 419 Summonses issued 139 Drains relaid 452 Magisterial Orders obtained and enforced 79 Frontage drains constructed or re-constructed 51 Factories,Workshops,&c.,inspections 4,599 Soil-pipes and drains ventilated 132 Sink and rain water pipes disconnected or repaired 722 Sanitary conveniences provided or improvements effected in Factories&Workshops (Sec. 38) 386 Water Closets cleansed&repaired 488 Cesspools abolished — Mews & Stables drained & paved 8 Underground sleeping rooms disused 33 Yards and forecourts paved and repaired 498 Gipsy van inspections 78 Accumulations of manure and other obnoxious matter removed or proper receptacles provided 85 Drains laid to new houses and tenements 83 Samples taken under the Sale of Food and Drugs Acts 1,000 Dust receptacles provided 474 Miscellaneous 667 51 Sanitation of House Property. The systematic inspection of house property is carried out by eight district inspectors, the Borough being for this purpose divided into eight sanitary districts. During 1910 the total number of houses inspected in house-tohouse inspection was 3,441, as compared with 3,218 in 1909. The following is a summary of the number of houses inspected in each year since 1900:— 1900 3,009 1901 3,116 1902 1,740 1903 2,670 1904 3,020 1905 4,503 1906 3,609 1907 4,101 1908 3,609 1909 3,218 Average for the ten years 1900-1909 =3,259 1910 3,441 The number of houses inspected, it will be seen, has varied considerably in each year. This is accounted for by the increased prevalence of epidemic infectious disease in certain years. Thus the relatively small numbers of houses inspected in 1902 was due to the small-pox outbreak in that year, the time of the Inspectors being largely taken up with measures to prevent the spread of infection, e.g., isolation, removal to hospital, tracing contacts, &c. The work done in this direction during 1910 has been on the whole satisfactory and compares favourably with past years, being slightly higher than the average for the preceding decennium. The following summary shows the number of houses inspected and the number of defects found in each of the sanitary districts during 1910. 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 defectsexisted Acre Street 26 19 Alfred Place 13 3 Amies Street 40 37 Astbury Road 94 27 Ashton's Buildings 20 12 Ashness Road 25 19 Ashurst Street 17 5 Banbury Street 16 9 Battersea Rise 68 53 Beaufoy Road 1 1 Barmore Street 21 21 Bolingbroke Grove 56 26 Bognor Street 29 22 Benfield Street 39 37 Dorothy Road 84 31 Brighton Terrace 8 6 Bullen Street 59 28 Kyrle Road 86 22 Culvert Road 130 78 Colestown Street 25 12 Marjorie Grove 33 28 Doddington Grove 63 51 Crescent Place 20 11 Mayford Road 8 7 Etruria Street 42 23 Currie Road 22 14 Montholme Road 82 36 Eversleigh Road 217 53 Darien Road 15 11 Northcote Road 36 21 Haines Street 8 5 Edna Street 35 23 Plough Terrace 4 3 Hanbury Road 18 7 Ethelburga Street 39 14 Ravenslea Road 44 16 Havelock Terrace 13 11 Francis Street 59 29 St. Peters Place 11 10 Henley Street 91 62 Goslings Yard 8 4 Strath Terrace 8 4 Holden Street 56 13 Heaver Road 70 39 Usk Road 27 19 Lockington Road 49 38 Hope Street 74 65 Wexford Road 14 7 Morrison Street 72 14 John Street 23 15 Winifred Grove 27 22 Rolls Street 10 8 Knox Road 17 16 St. Andrews Street 25 12 Livingstone Road 3 2 Shaftesbury Park Chamkbers 20 3 Lombard Dwellings 27 15 Lubeck Street 25 22 Stewarts Road 208 102 Mantua Street 84 42 Tidbury Street 18 11 Mendip Place 4 4 Tidemore Street 30 12 Meyrick Road 26 17 Tipthorpe Road 29 12 Miles Cottages 7 16 Victoria Dwellings 140 43 Musjid Road 64 38 Watford Villas 19 11 Newcomen Road 14 9 Wickersley Road 35 22 Pearson Street 21 18 William Street 10 10 Sewell Road 40 25 Wycliffe Road 6 — Stillington Street 67 45 Yeovil Street 4 — Simpson Street 47 41 Trott Street 48 22 Usk Road 23 13 Winstanley Road 52 27 York Road 173 79 Totals 1,488 681 Totals 1,300 788 Totals 653 361 53 The above figures show that generally speaking much more activity has been exhibited in carrying out the important duty of house-to-house inspection in those districts of the Borough which from the character and status of the inhabitants most require inspection. In two or three of the sanitary districts in which extensive building operations were being carried on, the time of the Inspectors has further been largely taken up in supervising drainage operations, and consequently house-to-house inspections have suffered relatively to the other Inspectors' districts. The percentage of houses in which sanitary defects were on inspection found to exist was 53.2 as compared with 68.5 in 1909, and varied from 32 per cent. in No. 5 district to 70 per cent. in No. 7 district. Preliminary and Statutory notices were served to remedy these 1,830 defects. Housing and Town Planning Act, 1909. The Housing Act, 1909, imposes upon sanitary authorities duties of an important character in connection with the sanitation of house property. Under Section 17(1) the duty devolves upon the sanitary authority "to cause to be made from time to time inspection of their district with a view to ascertain whether any dwelling-house therein is in a state so dangerous or injurious to health as to be unfit for human habitation, and for that purpose it shall be the duty of the local authority and of every officer of the local authority to comply with such regulations and to keep such records as may be prescribed by the Local Government Board." The Board made an Order dated the 2nd September, 1910, prescribing regulations under Section 17 (1) of the Act, but action in connection with the regulations has been deferred by the Council until the beginning of 1911. Houses let in Lodgings. In the Borough of Battersea there are a small number of houses let in lodgings under circumstances which render it desirable in the interest of public health that they should be registered and inspected at regular intervals. By the end of 1909, 123 premises were on the register, and no additional house was registered during the year. 54 The sanitary supervision of these premises is governed by by-laws which were revised in 1904 and having been duly approved by the Local Government Board are now in force in the Borough. Smoke Nuisance. Emissions of black smoke were reported during the year 1910 on 51 occasions. In seven instances these were reported by the Coal Smoke Abatement Society, in sixteen by the Council's Sanitary Inspectors, and in 28 cases by the London County Council. Twenty-three preliminary and two statutory notices were served, but no legal proceedings were taken during the year. Paving of Yards and Forecourts. The following table shows the number of backyards and forecourts wholly or partly paved during 1910:— Sanitary District. Backyards. Forecourts. Wholly paved. Partly paved. Wholly paved. Partly paved. 12 ft. or more from back addition. Less than 12 ft. from back addition. 1 — - 48 6 14 2 13 3 29 10 7 3 — 14 27 — - 4 — — 7 1 - 5 1 — 177 1 2 6 1 2 23 11 - 7 1 3 3 5 — 8 — — 1 — — Totals 16 22 315 34 23 Legal proceedings were taken for breaches of By-laws in four instances, results of which will be found set out on page 90. Hygienic Street Paving. This important and useful hygienic work has been referred to fully in past annual reports. It will only be necessary, therefore, to advert to the remarkable decline in the death rate, both general and infantile, and to the equally remarkable decrease in the incidence of dangerous infectious disease, which has taken place in recent years in the Borough, coincident with such hygienic improvements as the impervious paving of many of the side streets of the Borough. 55 During 1910, the following street was paved with impervious material:— Square yards. Parma Crescent 1792 It is to be hoped that this useful method of paving will be continued by the Council in suitable localities. Sewer Ventilation. During 1910, seven ventilating columns were erected by the Borough Council to ventilate their sewers in the following situations:— Altenburg Gardens. Meteor Street. Eccles Road. Sisters Avenue Elspeth Road. Wix's Lane Forthbridge Road. During the year, complaints were fairly frequent as to the nuisance arising from sewer ventilation on the surface of the roadway, and in one or two instances from the upcast columns, which have been erected by the Council to prevent nuisance arising. These complaints were fully enquired into and dealt with by the Council. Van Dwellings. The number of van dwellings in Battersea during 1910 was 78, as compared with 71 in 1909. In the following table are set out the situation and number of occupants:— Situation of Vans. No. of Vans. No. of Occupants. Males. Females. Mill's Yard, 88 Sheepcote Lane 5* 6 5 ,, 80 ,, 4* 4 4 Land rear of 383 Battersea Park Road 1 1 1 Manley's Yard, Falcon Road 5 8 6 Manley's Yard, Cabul Road 22 24 27 Donovan's Ground, Cabul Road 23† 41 24 Rear of 55 Cabul Road 1 1 — Mill's Yard, Culvert Road 13‡ 17 22 "Gray's Fair," Lavender Hill 4 5 7 Total 78 107 96 * Including one shed. † Including one cottage. ‡ Including 1 shed and 2 tramcars. 56 These vans are frequently inspected by night as well as day. During the year twenty-four vans were found to be overcrowded and notices were served where necessary to abate. No case of infectious disease was notified from van dwellings during 1910. Common Lodging Houses. The following table gives a list of the Common Lodging Houses in the Borough:— Premises. Authorised Number of Lodgers. Whether Males or Females Date registered 75 Falcon Road 78 Males March, 1900 53 Surrey Lane 39 Females May, 1885 55 „ ,, 36 Females „ „ 57,, ,, 22 Males and Females July, 1895 59 „ ,, 24 Males and Females June, 1903 89 „ ,, 28 Males August, 1885 91 „ ,, 30 Males Nov., 1887 6 Orville Road 18 Males June, 1902 Under the Common Lodging Houses Act, 1853-5, the London County Council has control of all the Common Lodging Houses situate within the Metropolis. All Common Lodging Houses must be licensed annually by the London County Council (General Powers) Act, 1902, Part IX., Sec. 46. The Common Lodging Houses in Battersea are visited from time to time by the Borough Council's Officers in connection with drainage defects, infectious disease, etc. Block Dwelling's. The following is a list of the artisans' dwellings of the "block" type in the Borough of Battersea, with the number of tenements in each:— 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 Dwelings Asso., Ltd. 189 Lombard Dwellings Lombard Road Exors. of Francis Ravenscroft 36 Shaftesbury Chambers Ashbury Road Artizans, &c., Dwellings Co. 22 57 Customs and Inland Revenue Act, 1903. During 1910, five applications were received for the certificate of the Medical Officer of Health under the Revenue Act, 1903, in connection with tenements (or dwellings) so constructed as to afford suitable accommodation for each of the families inhabiting such tenements. After inspection one certificate was granted in respect of two tenements, the remainder having been refused or postponed. The object which the Legislature had in view in connection with these certificates was to induce owners of tenement property to provide a higher standard of accommodation for tenants of this class of property by offering in such cases as were certified as suitable an abatement in the inhabited house duty. In the new Housing and Town Planning Act, a further extension has been made by exempting from inhabited house duty any house occupied for the sole purpose of letting lodgings to persons of the working class, at a charge not exceeding 6 pence a night for each person, if certified by the Medical Officer of Health to have due provision made for the sanitary requirements of the lodgers using such lodging houses. No applications were made for certificates in respect of this class of lodging house during 1910. Water Supply. During the year 1910, 83 applications were received for certificates of water supply in accordance with Section 48 of the Public Health (London) Act, 1891 and granted in each instance. Twenty-eight notices of withdrawal of supply for various reasons were received from the Metropolitan Water Board, and in 5 instances the supply was reinstated under notice. Under the provisions of Sec. 78 of the London County Council (General Powers) Act, 1907, additional supplies to the upper floors of tenement houses were provided in 126 instances. Disinfecting Department. During the year 1910, 3,834 rooms and 48,205 infected articles were disinfected as compared with 4,192 rooms and 58,474 infected articles in 1909. A total number of 880 cases of notifiable infectious diseases were reported during the year, but in addition to these a large amount of disinfection was carried out in connection with measles, tuberculosis, cancer, verminous houses, &c. In seventy-six instances Schools or departments of schools were disinfected in connection with outbreaks of infectious disease. 58 The following table gives particulars of the work carried out at the Disinfecting Station since it was opened in 1902:— 1902. 1903. 1904. 1905. 1906. 1907 1908. 1909. 1910. Premises 1,161 1,187 1,215 2,589 1,991 2,995 2,418 2,656 2,337 Rooms 1,771 1,616 1,637 3,308 2,848 5,085 4,583 4,192 3,834 Articles disinfected 92,368 67,001 54,626 64,052 72,531 72,220 85,117 58,474 48,205 Articles destroyed 984 847 1,288 929 1,244 1,084 778 607 720 Books disinfected — 271 215 332 337 399 387 331 230 Persons admitted to shelter — — — 33 31 33 28 4 — The Disinfecting Station has been improved by the new laundry opened in 1907. During 1910, 23,862 articles were after disinfection laundered before being returned to their owners. The total weight of articles removed for disinfection during 1910, was 116 tons 17 cwts. 3 qrs. In addition to the work carried out in the disinfection of rooms, clothing, &c., bedding belonging to the Council was lent out during 1910 to persons whose bedding had been removed for disinfection. As soon as this has been effected it is returned and the Council's bedding collected and brought back to the station, where after being disinfected it is returned to the Store-room. The total weight of bedding belonging to the Council dealt with in this way, and not included in the table on this page, amounted to 5 tons 9 cwts. Verminous clothing belonging to persons who attended the personal cleansing station adjoining the Disinfection Station, weighing 7 tons 19cwts. 0 qrs. l0lbs. was disinfected, and this also is not included in the returns shown in the table. Temporary Shelter or House Accommodation. During 1910, at the Reception Shelter situate at Sheepcote Lane, three midwives and fourteen nurses, who had been in attendance on cases of puerperal fever or in contact with other forms of dangerous infectious disease, had the use of one of the tenements at the Shelter for purposes of personal disinfection. Two hundred 59 and seventy-one persons, including laundry hands, milk vendors, dressmakers, &c., whose occupation rendered it desirable, attended for personal disinfection at the shelter on account of exposure to infectious disease. Cleansing: of Persons Act, 1897. The use of the Personal Cleansing Station (established by the Council under the provisions of the Cleansing of Persons Act, 1897), was largely availed of during 1910 by persons requiring the facilities therein provided, and 1,924 persons who were infested with vermin attended the station and were cleansed and had their clothing disinfected at the Disinfecting Station adjoining. Of the total number cleansed, 1,554 were men, 29 women and 341 children, the latter coming mainly from the public elementary schools. In connection with the cleansing of these 1,924 persons, clothing belonging to them weighing nearly seven tons was disinfected in the steam disinfecting machines. The arrangements for the cleansing at the Borough Council's Personal Cleansing Station, of verminous school children, and which the London County Council are under statutory obligation to carry out (vide Secs. 36 and 37 of the London County Council (General Powers), Act, 1907), are not yet completed. A letter was received from the education authority, dated 4th May, 1910, agreeing provisionally upon the general outlines of a scheme for the treatment of verminous children throughout London as follows:— 1. That the Cleansing Stations provided by the various politan Borough Councils should as far as possible be utilised by agreement with the Borough Councils. 2. That the treatment of children should be entirely distinct from any establishment used for the isolation of suspected cases of infectious disease contacts. 3. That the exclusive use of the baths for the cleansing of children should be allowed on certain days. 4. That the Cleansing Station should be in a convenient position and that the children should be efficiently supervised with female attendants for the treatment of girls. 5. That a uniform payment to the Borough Councils at the rate of 2 shillings per child, irrespective of the number of baths required before a child can be regarded as cleansed, should be arranged throughout London. 6. That this scheme should be subject to the Borough Councils undertaking, where necessary, to deal with the homes of the children cleansed. 60 The Council decided to accept this scheme subject to the payment being 2 shillings per child for each time cleansed, and the London County Council were accordingly informed, but at the end of the year negotiations were still pending, and some modifications with regard to the above scheme were then under consideration. It will be noted on reference to previous Annual Reports that there has been in each year a progressive increase in the numbers of persons cleansed at the Personal Cleansing Station. The total for 1910 is the largest since the Station was opened and was 200 in excess of that for 1909. I have again to draw the attention of the Council to the difficulty of dealing with this increasing use of the Station, owing to the limited and in other respects unsuitable character of the accommodation. The Midwives Act, 1902. The Midwives Act in London is administered by the London County Council as the Local Supervising Authority. The important duty of disinfection, however, devolves upon the Borough Councils, Rule V. of the rules framed by the Central Midwives Board, states :— "Whenever a midwife has been in attendance upon a patient suffering from puerperal fever or from any other illness supposed to be infectious, she must disinfect herself and all her instruments and other appliances to the satisfaction of the Local Authority, and must have her clothing thoroughly disinfected before going to another labour. Unless otherwise directed by the Local Supervising Authority, all washable clothing should be sent to be stoved (by the Local Authority) and then exposed to the open air for several days." In Battersea one of the tenements at the Reception Shelter is used for this purpose. The midwife or monthly nurse who has been in attendance on a patient suffering from puerperal fever or other infectious illness is required to attend at the Shelter and is given a disinfectant bath, her instruments, clothing, &c. being at the same time disinfected at the Disinfecting Station adjoining in one of the Steam disinfectors. Mortuary. The total number of bodies received at the Mortuary in Sheepcote Lane during 1910 was 234 as compared with 269 in 1909 and 258 in 1908, and an annual average for the Parish of Battersea for the five years 1896-1900 of 288. On 222 of these bodies inquests were held, and twelve bodies were received at the mortuary for sanitary or other reasons. 61 The following table gives the number of bodies received at the Mortuary in each year since 1900:— Year. Number of bodies received in the Mortuary. Number of bodies upon which postmortem examinations were held. Number of bodies upon which Coroners' Inquests were held. 1900 291 234 273 1901 321 271 304 1902 239 198 224 1903 223 207 213 1904 221 161 204 1905 253 176 236 1906 244 167 239 1907 302 204 288 1908 259 174 247 1909 269 170 258 1910 234 137 222 Inquests. During the year 1910, inquests were held in 222 cases, with the following results:— Natural Causes 139 Open Verdict— Found dead 3 Found drowned 5 — 8 Accidental Causes— Burns and Scalds 9 Poisoning 4 Falls, etc. 18 Run over (in street and on railway) 8 Suffocation 4 Other injuries 7 — 50 Suicide— Cut throat 6 Drowning 2 Hanging and Strangulation 7 Poison 6 Gun shot 3 — 24 Homicide— Gun shot 1 — 1 Total 222 62 Ambulances. The Council have for some years past provided a wheeled ambulance at each of the following six points in the Borough:— Queens Road (at Queens Circus). Clapham Junction (at Junction of Falcon Road and Lavender Hill). Bridge Road (at Junction of Cambridge Road and Bridge Road). York Road (at Junction of York Road and Plough Road). Battersea Park Road (outside Christ Church). Nightingale Lane (Wandsworth Common End). These ambulances are freely accessible to the Public. They are frequently availed of by the police and have proved of valuable service in connection with street accidents, &c. Each ambulance is provided with the necessary appliances, dressings for rendering " first aid " to the injured. Effluvium Nuisance. During 1910, on the 13th August, a complaint was received from 12 inhabitants residing in Park Road, of an effluvium nuisance from the "drains or elsewhere." On enquiry it was reported by the Council's Inspector that on certain dates in August, an effluvium nuisance was observed by him to be emitted from the sewer manhole in Park Road. It was alleged by several of the complainants that the nuisance was noticed coincidentally with the starting of the Food Specialists' Factory adjoining. The premises of this Company were visited and inspected, and it was found that waste products were allowed to pass into the drains and that these were in the Inspector's opinion responsible at times for the nuisance from the sewer manhole. The firm's attention was drawn to the matter and I subsequently received a letter expressing regret that, owing to the inexperience of their workmen at starting and to certain defects in the material and machinery, a nuisance had inadvertently resulted, and that steps had been taken to prevent any further nuisance arising. I visited the premises on the 7th September, in which, briefly, the processes carried on are the manufacture of a fluid peptonoid from dried meat by digestion with an acid in a steam digester. No nuisance was observable in the factory itself, which was large, airy, and well constructed, but in the yard adjoining, waste liquors and 63 washings had been allowed to flow, causing an accummulation of foul-smelling water and debris, which in warm weather would be likely to give rise to a nuisance of an offensive character, and which in my opinion may have been responsible, to some extent at least, for the nuisance complained of. Representations were accordingly made to the firm calling their attention to the necessity, having regard to the nature of the business carried on, to exercise greater care in the disposal of residual and other matters likely to give rise to nuisances. To this a reply was received that the firm were prepared to at once carry out the Council's requirements, to obviate the risk of any further nuisance arising. In view of this assurance, the Council decided to take no further action. No further complaint was received during 1910. 64 Protection of Food Supply. During 1910, as in past years, the food supply was carefully supervised. The work has comprised meat inspection and seizure, registration and strict supervision of milk shops. Attention has also been given to the sanitation of bakehouses (vide section dealing with administration of Factory and Workshops Act) and to premises wherein food is prepared, e.g., sausages, potted meat, &c. Other premises in which the sale of and preparation of food in various ways is carried on, such as ice-cream shops, butchers' shops, restaurant-kitchens, &c., have been visited and inspected systematically by the Council's Officers. Unsound Food. During 1910, two seizures of unsound food were made from premises situate in the Borough. On April 26th, a quantity of sausages, weighing 501bs., were seized by the Food Inspector, part of which were reported by him to have been found in a box in the shop and part in the ice-safe on the premises, at 38 Lavender Hill. They were condemned by the Magistrate at the South-Western Police Court on the same day, and the Magistrate ordered them to be destroyed. Legal proceedings followed, and the defendant was fined £2 and 6s. costs for exposing and depositing for sale sausages which were unsound and unfit for human food. In the other case, as the result of a complaint, the Food Inspector proceeded, on the 14th June, to the premises, 260 Battersea Park Road, and found a quantity of pieces of unsound meat in the ice-safe, and in the shop a small quantity of sausages unfit for human food. The unsound meat and sausages were seized by the Inspector and taken to the South-Western Police Court, where they were condemned by the Magistrate and ordered to be destroyed. Summonses were taken out against the proprietors and their manager. At the hearing of the case the proprietors proved to the satisfaction of the Magistrate that they were not responsible, in respect of the unsound meat, the meat having been withheld from their Inspector. The manager was held by the Court to be the seller and he was convicted for selling and for depositing and exposing for sale, unsound meat and sausages, and fined £5 and 18s. costs. The Proprietors were ordered to pay £1 10s. costs for exposing for sale unsound sausages. 65 The following is a tabulated return of unsound food inspected, condemned and destroyed under the supervision of the Council's Sanitary Inspectors during 1910, having been brought to the Health Department by the respective owners for the purpose:— Food. Quantity. Where Purchased. Bananas 2 crates Covent Garden Market Cherries 83 lbs. Pudding Lane Coalfish 1 box Billingsgate Market Cod 1 barrel „ „ „ 1 trunk „ „ Codling (mixed) 1 „ „ „ Dabs 1 box „ „ „ ½ case „ „ Grapes 1 box Spitalfields „ „ 1 barrel „ „ Haddock 1 trunk Billingsgate „ „ 1 „ „ „ „ 1 „ „ „ Halibut 1 case St. Mary-at Hill Herrings 1 „ Billingsgate Market „ 1 barrel Monument Street Kippers 2 boxes Billingsgate Market Lamb 38½ lbs. Central Market Mustard (German) 11 glasses Whitechapel Road Pears 1 box Covent Garden Market Plaice 1 trunk Billingsgate „ „ 1 „ „ „ „ 1 box „ „ „ 2 boxes „ „ Skate 6 stone „ „ Tomatoes .. 3 boxes Borough „ „ 1 box „ „ „ 1 bundle Covent Garden Whiting 2 trunks Billingsgate „ „ 1 trunk „ „ „ 1 „ „ „ „ 1 „ „ „ Winkles about 3 bushels „ „ 7 Certificates were also granted in respect of carcases and plucks of pigs condemned at Brown's slaughter-house in Usk Road. In relation to the above-mentioned articles of food, it is the practice in cases where the retail vendor has unknowingly purchased 66 articles which are unfit for human food and where he has made no attempt to sell them to grant a certificate, which enables him to claim the return of his money. The food is destroyed under the supervision of the Council's Officers. During 1910, 33 certificates were granted in respect of the articles shown in the table. During 1910, the carcases of 1,715 pigs slaughtered at Brown's Slaughter-house, Usk Road, were inspected by the Council's Meat Inspector. Of this number, five whole carcases and the heads of 50 pigs which showed slight evidence of Tuberculosis in the neck (pharyngeal) glands, were surrendered and destroyed under the supervision of the Council's Officers. It is the practice to carefully inspect each carcase, and in cases where only slight evidence of incipient disease, confined to the neck glands, is found to be present, and there is no lesion elsewhere in the carcase, to require only the surrender of the head. In any doubtful case the matter is referred to the Medical Officer of Health. The duty of inspecting this large number of carcases by Inspector Chuter, has been of an exacting character, and has necessitated no less than 234 visits being paid to the slaughter-house during 1910. Owing to the irregular times at which slaughtering is carried out, visits have had to be paid at all hours of the day and on Sundays. Of the 234 visits paid to the slaughter-house, 42 were on Sundays, and 67 visits were paid out of office hours. Having regard to the fact that Inspector Chuter is also Food and Drugs Inspector under the Sale of Food and Drugs Acts, his work during the past year has been of an arduous character and credit is due to this Officer for the efficient manner, notwithstanding, in which he has performed his duties. Slaughter-houses. There are five slaughter-houses in the Borough, in only three of which is any regular business done. One of the latter is licensed for the slaughter of small animals only. The following is a list of these premises licensed in the Borough of Battersea, during 1910:— 345 Battersea Park Road. Falcon Road. 235 Battersea Park Road. St. John's Hill. Usk Road (small animals only). The license of 235 Battersea Park Road was transferred to a new occupier during the year. 67 These premises are frequently and systematically inspected by the Officers of the Borough Council, who are responsible for the enforcement of all By-laws and Regulations. This duty was formerly carried out by the Officers of the London County Council, but was transferred to the Borough Councils under the provisions of the London Government Act, 1899. This is a very important duty, consisting as it does of the enforcement of all by-laws and regulations made for the sanitation of these premises. During 1910, 295 inspections of slaughter-houses were made in connection with the inspection of food, &c. Owing to the large number of animals slaughtered weekly in one of these premises, special arrangements have had to be made for the inspection of the carcases. The details of this inspection are referred to in the chapter dealing with unsound food. Cowhouses. There are only three licensed cowsheds remaining in the Borough of Battersea, situate as under:— Bellevue Road. Usk Road. Wiseton Road. Very few cows are kept in these sheds, which appear to be kept for advertisement purposes or with the object of retaining the animal license. These premises require to be annually licensed by the London County Council, the enforcement of the by-laws and regulations devolving on the Borough Councils as the Sanitary Authority. The premises were systematically inspected during the year, and may be said to be (sanitarily) in a fairly satisfactory condition. Ice Cream. During the year, the number of premises in which this article of food is manufactured or sold, considerably increased, 185 premises being registered, as compared with 156 in 1909 and 108 in 1908. Systematic supervision and inspection is exercised over these premises by Inspector Benjamin. Of these 185 premises, nine are occupied by Italians, who employ 25 barrows in the sale of the article. The number of these alien manufacturers and vendors of ice-cream appears to be diminishing in the Borough, while on the other hand the industry is increasing amongst the native population, with, on the whole, desirable results in the matter of cleanliness. 68 It was found necessary during the year to take proceedings for infringement of the regulations made under the provisions of the London County Council (General Powers) Act, 1902, governing the manufacture, sale, &c., of this article, against the occupier of an ice cream shop at 375, Battersea Park Road, on October 5th, for using dirty utensils. A conviction was obtained and the defendant was fined £1 and 2s. costs. On the same date an itinerant Italian ice-cream vendor was summoned for using a dirty towel in the cleansing of the glasses used for holding the ice-cream. He was convicted and fined £1 and 2s. costs. During the year the Council, on the recommendation of the Health Committee, drew the attention of the London County Council to the need for an amendment in the Act governing the manufacture and sale of ice-cream, and suggested that the wording of sec. 42 (a) should be extended so as to include the words " materials or ingredients used in the manufacture thereof." It was found in the course of inspection of these premises that materials used for the manufacture of ice-cream, e.g., milk, was sometimes stored under insanitary conditions. The Council also concurred with the suggestion of Greenwich Borough Council to amend the Act so as to include "stalls" from which ice-cream is sold, within the meaning of sec. 42 (a). These suggestions have been embodied by the London County Council in their (General Powers) Bill now before Parliament. The importance of safeguarding this article of food from the risk of contamination is considerable. As numerous outbreaks of dangerous diseases have been traceable to contaminated ice-cream, the proceedings which the Council have found it necessary to take for contravention of the ice-cream regulations have acted as salutary lessons so far as the sale and manufacture of this article in Battersea is concerned. Restaurants and Eating Houses. The annual inspection of these premises was systematically commenced in 1902, and since then a general sanitary supervision has been exercised over them by Inspector Benjamin. The total number on the register at the end of 1910, was 103, as compared with 95 in 1909 and 90 in 1908. During the year it was found necessary to serve 17 preliminary and three statutory notices in connection with sanitary defects. In the majority of instances, these defects were not of a serious character, and had reference mainly to dirty condition of premises (walls, floors and ceilings), defective sanitary appliances, &c. 69 On the whole it may be said that restaurants and eatinghouses in Battersea are in a (sanitarily) satisfactory condition, and that this has been brought about by the systematic inspection, which during the last 9 years has been carried on in connection with premises where food is prepared and sold. The powers of sanitary authorities in controlling the sanitary condition of premises wherein food for human consumption is prepared, stored and sold, are considerably augmented by the London County Council (General Powers) Act, 1908. Milk Shops. The milk supply of Battersea has, during 1910, as in past years, been carefully supervised by the Council's Officers. A revision of the register of these premises was carried out by direction of the Health Committee in 1909, in connection with the additional powers provided in the London County Council (General Powers) Act, 1908, and as a result, a large number of general shops, which on sanitary grounds were deemed unsuitable for the sale and storage of milk, were removed from the register, while at the same time, those milk shops remaining on the register were required to comply with additional requirements with a view to reducing to a minimum, conditions likely to give rise to the risk of contamination. The Committee's action in this respect has resulted in a decrease in the number of the premises, wherein milk is sold, and furthermore has been followed by a distinct improvement as regards the sanitary state of the milkshops remaining on the register, a matter of great importance having regard to the sensitiveness of this article of human food to contamination and to the fact that it constitutes the main diet of infants and invalids. The number of registered milk shops in Battersea at the end of 1909, was 178. During 1910, 41 new milkshops were added, and 34 removed from the register, the total number on the register at the end of 1910, being 185. The character of the business carried on in premises in which milk was sold in Battersea during 1910 as compared with the two preceding years is as follows:— 1908. 1909. 1910. Dairy produce only 70 72 88 General shops 131 78 70 Confectioners 13 11 16 Dwelling-houses 22 14 9 Wholesale 5 3 2 241 178 185 70 The decrease which is shown in the number of general shops and of dwelling-houses is a satisfactory result of the revision of the Council's register. These premises are on sanitary grounds most unsuitable for the sale of milk. It is most desirable in the interest of the public health that milk should only be sold from premises in which dairy produce alone is sold. Although this desirable end has not yet been reached in Battersea, the action of the Council in reducing the number of unsuitable premises and their refusal to register any new applications for the sale of milk from general shops must necessarily result in a considerable improvement in the conditions under which the milk traffic is carried on in their district. All premises wherein milk is sold and stored for purposes of sale were systematically visited and inspected during the year by Inspector Benjamin. It was found necessary to send a few cautionary letters for neglect in complying with the Regulations for the protection of milk from contamination. These offences were not of a serious character, and in no case was it necessary to resort to more drastic measures. On the whole there has been a marked improvement as regards the sanitary conditions under which milk is sold in the Borough. Fish Shops. The fish shops in the Borough are 79 in number, an increase of 4 as compared with 1909. In 49 of these places fried fish is sold, in 20 wet and dried fish is sold, and 4 sell wet, dried and fried fish. These premises are frequently inspected, and during the year notices were served in 9 instances for various insanitary conditions, all of which were complied with. In addition 64 inspections were made by the Food Inspector at these premises. Butchers' Shops. There are 92 butchers' shops in Battersea, all of which are regularly and systematically inspected by Inspector Chuter. In 52 of these premises sausage-making or meat chopping is carried on, the work being done by hand in 37 instances and by machinery in 15 cases. Ninety of the shops are provided with ice safes. The trade refuse is, in most cases, moved bi-weekly or oftener from these premises, and they are well kept and, on the whole, in a satisfactory condition. During 1910, 901 inspections of butchers' shops were made. 71 Sale of Food and Drugs Acts. The object of these Acts is two-fold in character: (a) to protect the honest trader from fraudulent competition, and (b) to safeguard the public from fraud, imposition and dangers to health in regard to food and drugs. During 1910, 1,000 samples were purchased within the Borough of Battersea and submitted to the Public Analyst for analysis. Of these 1,000 samples 87 (i.e., 8.7 per cent.) were reported by the Analyst to be adulterated, and in addition 24 samples were reported by him to be inferior. The following table gives the details of the number of samples purchased during the year, and the numbers found to be genuine or otherwise:- Description of Article. Total No. of Samples taken. Genuine. Adulterated. Inferior. Arrowroot 5 5 — — Bread 5 5 — — Butter 173 141 14 18 Camphorated Oil 6 4 1 1 Cheese 10 7 — 3 Cocoa 15 13 — 2 Coffee 25 24 1 — Cream 9 4 5 — Fish (preserved) 4 4 — — Flour 4 4 — — Gin 3 3 — — Honey 5 5 — — Jam 4 4 — — Lard 16 15 1 — Margarine 13 13 — — Meat (preserved) 8 6 2 — Milk 642 588 54 — Mustard 4 4 — — Oatmeal 6 6 — — Olive Oil 5 5 — — Pepper 4 4 — — Rice 4 4 — — Rum 4 3 1 — Sausages 13 6 7 — Vinegar 5 4 1 — Whisky 8 8 — — Totals 1,000 889 87 24 72 The next table shows the percentage of adulteration during the ten years 1900-1909 and during 1910:— Year. No. of Samples taken. Adulterated. Percentage of Adulteration. 1900 514 46 8.9 1901 474 35 7.4 1902 500 52 10.4 1903 500 67 13.4 1904* 700 107 15.3 1905 700 90 12.8 1906 925 129 13.9 1907 1,000 105 10.5 1908 1,000 115 11.5 1909 1,000 91 9.1 1910 1,000 87 8.7 *Since 1004 a new system has been adopted, a special inspector being appointed to carry out the duties under the Sale of Food and Drugs Act, instead of, as formerly, several of the district inspectors doing this work. It wil be noted that the results shown in the above table during the last few years are of a satisfactory character, having regard to the increased number of samples taken since 1906, and there is little doubt but that this is largely due to the Council's activity in the administration of these important statutes. Of the total number of samples purchased under the provisions of these Acts, during 1910, 642 (i.e., 64.2 per cent.) were milk samples. Of this number 54 (i.e., 8.4 per cent.) were reported by the Analyst to be adulterated. During 1909, 672 of the samples purchased referred to milk, of which 70 (i.e., 8.9 per cent.) were found to be adulterated. The nature of the adulteration in the adulterated samples of milk was as follows:— 1. Extraneous water (29), varying from a miminum of 1 per cent, to a maximum of 19.5 per cent., viz., 1, 1.5, 2, 2, 3.5, 3.5, 4, 4.47, 5.5, 6, 6, 6.3, 7, 7, 7.3, 7.5, 7.5, 8, 8.3, 9, 9.4, 9.4, 9.5, 10, 11, 12, 12, 13, 19.5. 2. Deficiency in milk fat (17), varying from a minimum of 2 per cent. to a maximum of 27 per cent., viz., 2, 3,4, 4.3, 5, 5, 5, 5, 6, 7, 7, 7, 7, 9, 10, 25, 27. 3. Extraneous water and fat deficiency (2), viz., 5.5 and 6.5, 8 and 5. 73 4. Added preservatives (1), viz., 9.56 grains per pint of Boric Acid. 5. Separated milk (5), viz., 12, 32, 4118, percent. of extraneous water, 2.713, 3.56 grains per pint of boric acid. Of the total number of milk samples taken during the year, under report, 533 were taken on week days, and 109 on Sundays. Samples were taken on 21 Sundays in the year. Of the 533 week-day samples 42 (i.e., 8.7 per cent.) were found to be adulterated, while out of 109 samples taken on Sundays, 12 (i.e., 11 per cent.) were adulterated. Butter. One hundred and seventy-three samples of butter were taken, and of these, 14 (i.e., 81 per cent.) were reported by the Analyst to be adulterated. This percentage of adulteration was higher than in 1909, but lower than 1907, the percentage figures of adulterated samples in those years being 6.1 and 12.7 respectively. The form of adulteration found to be present in all these fourteen samples was in each instance added foreign fat. The added foreign-fat (margarine) ranged from a minimum of 27 per cent. to a maximum of 82 per cent., viz., 27, 32, 40, 43, 45, 60, 64, 65, 66, 66, 67, 70, 77, 82. In respect of these fourteen adulterated samples, proceedings were taken, and in 10 cases convictions were obtained, while as regards the remaining 4 cases, the proceedings at the end of the year were still pending. Fines and costs amounting to £26 5s. Od. were imposed. In connection with one of these samples, summonses were in addition taken against the vendor for obstructing the Inspector and selling margarine in a plain wrapper, and for these offences, fines and costs amounting to 9 shillings were imposed. Sausages. Thirteen samples of sausages were taken and submitted to the Public Analyst. Of these 13 samples, 7 (i.e., 54 per cent.) were reported by the Analyst to contain added preservative (Boric Acid) in varying proportions from 7.42 grains per lb. to 29.794 grains per lb. Proceedings were taken in respect of one of these adulterated samples, which are still pending. In the remaining cases the adulteration was not considered serious enough to take out a summons against the vendors who were, however, cautioned, 74 It would be more satisfactory if some authoritative pronouncement were made with regard to the use of so-called preservatives. In the present state of the law there is considerable uncertainty as to the result of taking legal action and unless the amount of the drug found to be present on analysis is more than 17 J grains per lb. (i.e., 25 per cent.) it is not usually considered advisable to risk taking the case into court. The consensus of medical opinion is that the use of these preservatives is a danger to the public health. Apart from the injurious effect of the drug itself, one of the most unsatisfactory features of its use as a food preservative is that it enables materials to beused in the manufacture of sausages, potted meats, &c., that are unfit for human consumption from incipient decomposition. The use of this drug masks the effects of such early putrefaction and does not prevent the ill-effects which may follow the ingestion of such unsound food. As a proof of the needlessness of the use of this drug in sausages, one of the principal firms in the sausage trade in London does not use any preservative. Where the materials used are sound and of good quality, and where regard is had to scrupulous cleanliness, sausages made under these conditions will keep for two or three days, even in warm weather, if reasonable care is taken in storing them. Coffee and Cocoa. Twenty-five samples of coffee were taken and submitted for analysis, of which one was reported to be adulterated, and fifteen samples of cocoa were taken and similarly dealt with, all of which were reported to be genuine. Other Articles. Arrowroot, 5 ; bread, 5 ; cheese, 10 ; cream, 9 (of which 5 were adulterated to an extent varying from 11 to 18.5 grains per lb.) ; fish (preserved), 4 ; flour, 4 ; jam, 4 ; lard, 16 (1 adulterated, vide page 71) ; margarine, 13 ; meat (preserved), 8 (2 containing preservatives) ; mustard, 4 ; oatmeal, 6 ; olive oil, 5 ; pepper, 4 ; rice, 4 ; vinegar, 5 (1 adulterated). Gin, 3 ; rum, 4 ; whisky, 8 ; camphorated oil, 6 (one of which was 83.39 per cent. deficient in camphor; proceedings taken, defendant fined £2 and 12s. 6d. costs). Cheese deficient in Fat. The Council, on 24th December, 1909, in a letter addressed by them to the Board of Agriculture and Fisheries, drew their attention to the fact that Dutch cheese deficient in fat to a considerable extent is sold in their district, but that, owing to the absence of an 75 official standard for cheese it was difficult to take legal proceedings against the vendors of such cheese, and asking the Board to issue regulations under the Sale of Food and Drugs Act, 1899, fixing a minimum standard as to the fat content of cheese. A reply, dated 12th April, 1910, was received from the Board expressing the opinion that no advantage would accrue from such regulations, and pointing out the practical difficulties in the way of framing suitable regulations owing to the many different kinds of cheese on the market, each varying in character and composition. Further, the fact that all high-class cheeses contain a relatively high percentage of fat, and that the proportion of moisture in cheese decreases and the proportion of fat pari passu increases during the time the article is kept in storage, a change that is very marked in some cheeses; that the risk of cheese being adulterated is much less than the adulteration of milk and butter. The commercial value of cheese stands in no precise relation to its alimentary value nor, except in a very broad sense, is there any connection between its commercial value and its composition. It is the characteristic flavour of a cheese which is generally taken into account by consumers without regard to its nutritive quality. There are whole milk cheeses and skim milk cheeses, and many variations between these two extremes. Lard and Lard Substitutes. In May, 1910, a memorandum was received from the Local Government Board dealing with the following matters:— (a) Sale of lard substitutes as lard, the great increase in the sale and the necessity of taking samples; (b) Presence of water in lard substitutes—the necessity of testing lards for percentages of water ; (c) Presence of paraffin in lard, lard substitutes and garine ; solid paraffin (2.5 per cent.) found in lard and 2.10 per cent. in margarine ; and convictions obtained under the Sale of Food and Drugs Acts. During 1910, 16 samples of lard were taken in Battersea, and only one of these was reported on analysis to be adulterated. This case was of considerable interest. On the 21st July a sample of lard was purchased at a provision shop in Plough Road, under the provisions of the Sale of Food and Drugs Acts. The Food and Drugs Inspector reported that the agent employed by him to make the purchase asked for "half a pound of 7d. lard," and she was served from a block of material lying on the counter in full view the purchaser and labelled "Prepared lard," the vendor saying at the same time, "It is prepared lard." The sum of 3id. was paid for the article supplied. The Inspector then entered the shop and took charge of the purchase and told the vendor, to whom he was 76 known, the purpose for which it was required. On opening the package in order to divide it into three parts, as required by the Act, he discovered on the underneath side of the parcel and inside the wrapper a small label bearing the words "McDoddie's Prepared Lard "(large type)—"A Pure Vegetable Product" (small type). The Inspector reported that this disclosure, if such it were, could not be seen until the packet was opened and the lard turned upside down, and that on his asking the agent if anything had been said to her, she replied, " No, only that it was prepared lard, nor did I see the label he placed inside. That must have been put on the scales and the sample placed on top of it, and then all wrapped up together. I certainly did not see it until you opened it and cut the lard." The Inspector then informed the vendor that the words "Prepared Lard " on the bulk from which the sample was purchased did not, in his opinion, constitute a disclosure. The sample was subsequently reported by the Public Analyst to contain 100 per cent. of cocoanut oil. When the case was heard at the South-Western Police Court evidence to the above effect was given, but the Magistrate, Mr. De Grey, dismissed the case, but on an application by the defendant's solicitor he refused to give costs against the Council. The decision of the Magistrate was considered by the Health Committee to be of such importance from the public health standpoint and the administration of the Food and Drugs Acts that they decided to recommend the Council to appeal. An appeal has, therefore, been entered. 77 Factory and Workshop Act, 1901. The Factory and Workshop Act came into force at the beginning of 1902, and in consequence a number of additional duties devolved on the local authority. Section 32 of the Act directs that the Medical Officer of Health shall every year report specifically on the administration of the Act in workshops and workplaces in the district under his supervision, and transmit a copy to the Secretary of State for the Home Department. In this part of the annual report will be found everything which has concerned the Health Department in relation to factories, workshops and workplaces. The only exceptions are milkshops and restaurant kitchens, which are more appropriately included in the section dealing with the protection of the food supply. In the following table is shown a summary of the various premises in the Borough where work is done which are now registered in the Health Department:— Workshops and Workplaces 981 Factories 189 Bakehouses 88 Restaurant Kitchens, &c. 103 Ice Cream Premises 185 Home Workers 270 Stables 2 548 Factories. Factories include all places in which mechanical power is used in aid of the manufacturing processes. There are 189 of these premises registered in the Health Department, employing 7,866 persons (males 6,114, females 1,752) as follows:— 78 Trade. Number of Factories on Register. Males. Females. Adults. Young Persons. Adults. Young Persons. Barge builder 1 10 3 - - Baker 8 136 33 33 33 Bootmaker 6 18 1 - - Builder 4 29 - - - Butter blender 3 31 49 2 - Carpenter 10 73 10 - - Chemical works 3 115 8 34 3 Chaff cutter and Forage 7 84 1 - - Cycle maker 2 5 2 - - Dyer 2 37 1 35 5 Engineer 23 618 51 - - Flour Mills 2 145 - - - Firewood cutter 7 48 14 31 2 Founder 3 46 4 - - Lift maker 2 78 31 - - Mason 6 161 1 - - Mineral Water 2 27 - 15 - Printer 21 101 24 8 1 Steam Laundry 32 67 4 596 65 Other Trades 45 3,619 409 732 157 Totals 189 5,468 646 1,486 266 The duties of sanitary authorities in relation to factories are few and limited mainly to the enforcement of suitable and sufficient sanitary accommodation for factory employees. The Factory Act contains a code which is administered by the Factory Inspectors. There is no statutory obligation upon the sanitary authority to register factories, but for the purpose of the health department a register is kept of all factory premises in the Borough of Battersea. During 1910, 55 defects were found on factory premises in Battersea, for the most part relating to unsuitable or insufficient sanitary accommodation or to defects in sanitary fittings and appliances. Forty-six preliminary and six statutory notices were served to remedy these defects. Workshops. Workshops include any premises (not being factories) in which manual labour is exercised by way of trade or for purposes of gain 79 in or incidental to the making, altering, repairing, finishing or adapting for sale of any article and to or over which the employer of the persons there has the right of access or control. The workshops in Battersea are under the supervision of two workshops inspectors, one male and one female, who deal with premises where male and female labour is employed respectively. The following is a list of the workshops on the register at the end of 1910:— Trade. No. of Workshops. No. of Workrooms. Persons Employed. Males. Females. Adults. Young Persons. Adults. Persons. Baker 80 118 169 7 - - Billiard Table maker 2 5 21 3 - - Blind maker 4 9 16 1 - - Bootmaker 81 85 161 17 2 Carpenter 11 12 26 5 - - Coach builder 10 19 55 5 - - Cycle maker 13 18 19 7 - - Dressmaker 114 157 - - 297 93 Embroiderer 3 8 - - 45 27 Farrier and Smith 28 31 63 7 - - Firewood cutter 11 11 23 1 4 - Laundry 55 132 17 - 199 4 Mason 5 5 56 - - - Millinery 26 30 - - 47 29 Musical instrument 2 4 37 - - - Photographer 5 12 13 2 16 8 Picture framer 5 5 9 - - - Ragsorter 11 11 33 1 - - Saddler 8 8 17 1 - - Tailor 41 56 61 6 56 19 Upholsterer 5 10 22 - 6 - Other Trades 80 99 219 23 106 53 Totals 600 845 1037 86 778 233 At the beginning of 1910, the number of workshops on the register was 530. During the year the occupation of 53 of these premises was discontinued, while on the other hand, 123 new 80 workshops were added to the register, so that at the end of 1910, the total number of these premises was 600, in which were employed 2,134 persons (1,123 males, 1,011 females). Of the 123 new workshops added to the register during 1910, 64 were notified to H.M. Inspector, in pursuance of Sec. 133 of the Factory and Workshop Act, 1901, which directs that " when any woman, young person or child is employed in a workshop in which no abstract of the Act is affixed, as by this Act required, and the Medical Officer of Health becomes aware thereof, he shall forthwith give written notice thereof to the Inspector for the district." The following table gives particulars relating to new workshops in which "protected persons" were employed, notices of which were duly sent to H.M. Inspector during 1910— Trade. No. of Work shops. Protected Persons employed Women Young Persons. Total. Bootmaking 6 - 6 6 Dressmaking 22 53 22 75 Laundry 5 7 - 7 Millinery 3 7 3 10 Tailoring 6 2 4 6 Miscellaneous 22 6 18 24 Totals 64 75 53 128 Sanitary Condition of Workshops. The local authority is the authority responsible for the sanitary condition of workshops and workplaces in its district. Sanitary conditions include (a) cleanliness, (b) air space, (c) ventilation, (d) drainage of floors, (e) provision of sanitary accommodation. During the year 1910, 3,645 visits of inspection (2,714 by the male and 931 by the female workshops inspectors) to factories, workshops and workplaces, exclusive of visits to home workers, have been made by the workshops inspectors. The following is a tabulated statement of the work carried out in connection with workshop inspection during 1910, so far as it admits of tabulation— 81 Workshops inspections and re-inspections 1,947 Workrooms measured 136 Workshops notified to H.M. Inspector 64 Cards distributed showing number of persons legally employed in workrooms 183 Written intimations issued 168 Statutory notices served 7 Defects discovered in Workshops and remedied:— Workrooms in a dirty condition 62 „ overcrowded 1 „ badly ventilated 2 „ with defective walls or ceilings 9 „ with defective floors 4 Workshops with defective yard paving 9 ,, with defective drains — „ with blocked drains 7 „ without proper dustbins 14 „ with defective w.c. apparatus 18 ,, with sanitary conveniences insufficient in number or absent 4 ,, with sanitary conveniences opening into workrooms 1 ,, with sanitary conveniences without proper doors or fastenings 2 „ with sanitary conveniences in dirty condition 18 Coal bins provided in bakehouses — Accumulation of refuse removed 13 Other defects remedied 45 The following notices of defects were received from H.M. Inspector of Factories during 1910 and received attention :— Premises. Trade. Nature of Complaint. 24 Chatto Road Dressmaking Workshop in dirty condition. 128 Bridge Road West Laundry Door of W.C. off its hinges. Gideon Road Laundry Effluvia from sanitary conveniences. Battersea Park Road Laundry No fastenings on W.C. doors. 62 Underground Workrooms. Excluding the underground bakehouses, there are 29 underground workshops and workplaces in Battersea, as compared with 37 in 1909. The number of such premises and the business carried on, is shown below :— Workshops. Workplaces Laundries 8 Restaurant kitchens 4 Picture-frame making 2 Meat chopping 6 Cycle making 3 Small exempted laundries 4 Fitters 2 Bakehouses. Bakehouses are either factories or workshops within the meaning of the Act, according as mechanical power is, or is not, used in aid of the processes carried on. They are therefore subject to the provisions of the Act, and although in the main the factory bake houses in the Borough are supervised by the Factory Inspector, by far the greater part of the work connected with the sanitary super vision of bakehouses in Battersea devolves upon the Council as the Sanitary Authority. In the Borough of Battersea during 1910, there were on the register 88 bakehouses, eight of which were factory bakehouses, with regard to which the duties of the Council are few, and 80 workshop bakehouses. Of the latter, 49 are above ground and 31 underground, according to the definition given in the Factory Act. The following is a list of the workshop bakehouses :— 49 Bakehouses Above Ground. Addresses. Addresses. 257 Battersea Park Road 88 Grayshott Road 292 ,, ,, ,, 45 Harroway Road 343 ,, ,, ,, 11 Hanbury Road 1 Battersea Rise 49 High Street 78 ,, ,, 80 ,, ,, 31 Bridge Road 173 „ ,, 84 „ ,, 137 Lavender Hill 64 Castle Street 213 ,, ,, 83 Culvert Road 64 Latchmere Road 139 Chatham Road 93 ,, ,, 47 Este Road 29 Meyrick Road 29 Falcon Road 48 New Road 83 Addresses. Addresses. 89 New Road 38 Rowena Crescent 148 ,, ,, 10 St. Phillip Street 205 ,, ,, 93 Stewarts Road 10 Northcote Road 29 Stockdale Road 23 ,, ,, 90 St. John's Hill 64 ,, ,, 32 Tyneham Road 94 ,, ,, 47 ,, ,, 175 ,, ,, 102 Usk Road 62 Plough Road 70 York Road 76 ,, ,, 187 ,, ,, 112 ,, ,, 198 „ ,, 41 Queen's Road 287 „ ,, 121 ,, ,, 31 Bakehouses Under Ground. Addresses. Addresses. 163 Battersea Park Road 103 Falcon Road 189 ,, ,, ,, 46 Francis Street 200 ,, ,, ,, 30 Lavender Hill 219 ,, ,, ,, 123 Maysoule Road 265 ,, ,, ,, 36 Orkney Street 310 ,, ,, ,, 23 Plough Road 373 ,, ,, ,, 34 ,, ,, 501 ,, ,, ,, 109 Salcott Road 525 ,, ,, ,, 140 St. John's Hill 48 Broomwood Road 8 Tyneham Road 2 Burland Road 23 Webbs Road 35 Castle Street 47 Winstanley Road 83 Chatham Road 79 ,, ,, 83 Church Road 6 York Road 4 Currie Street 345 ,, „ 43 Falcon Road The bakehouses in the Borough have been systematically inspected during the year, and on the whole, may be said to be in a (sanitarily) satisfactory condition. The following summary of the work done during the year in connection with the supervision of the bakehouses in the Borough of Battersea, may for convenience of reference be set down here. It should, of course, be remembered that these are all included in the tables giving the results of general factory and workshop inspection. 84 Above-ground bakehouses :—22 intimation notices were served for defects, all of which were complied with without requiring a statutory notice being served. Underground bakehouses :—15 intimation notices were served for various defects and the service of two statutory notices was found necessary before the defects complained of were remedied. The defects for which these notices were served had reference mainly to want of cleanliness, defective sanitary fittings, paving, &c. Factory Bakehouses. The following is a list of the Factory bakehouses in the Borough :— Altenburg Gardens Bread and Confectionery. Park Road ,, ,, ,, 381, Battersea Park Road ,, ,, ,, Broughton Street Biscuits only. 37, Grayshott Road Bread. 465, Battersea Park Road ,, 465, Battersea Park Road ,, — Sugden Road ,, It was found necessary to serve one intimation in respect of a nuisance on a factory bakehouse premises, which was duly com plied with. Homework. This term has reference to persons who carry on certain classes of work in their own homes. Under the Factory and Workshop Act very important powers are given to District Councils for controlling the (sanitary) conditions under which the work is done. These powers aim at the prevention of homework (1) in dwellings which are injurious to the health of the workers themselves, viz., through overcrowding, inadequate ventilation, &c. ; (2) in premises where there is dangerous infectious disease. The home-workers residing in Battersea are employed by firms established in the Borough and by firms belonging to other Boroughs. The list of trades specified by the Home Secretary, to which sections 107-110 apply, are set out in orders made by the Secretary of State (vide previous Annual Reports). During 1910, the names and addresses of 842 outworkers were received as compared with 832 in 1909, 814 in 1908, and 787 in 1907. I.ists were sent in by employers and by Medical Officers 85 of Health for the following Metropolitan Boroughs and District Councils:— District. Lists. Outworkers District. Lists. Outworkers Bromley 2 2 Paddington 1 1 Camberwell 1 1 Poplar 1 1 Chelsea 8 63 St. Marylebone 2 25 City of London 10 18 Shoreditch 2 5 Finsbury 2 12 Southwark 2 11 Fulham 1 1 Walthamstow 1 1 Hackney 2 2 Wandsworth 18 77 Hammersmith 2 2 Westminster 5 88 Islington 1 1 Wimbledon 3 3 Kensington 3 24 Totals 75 358 Lambeth 8 20 The names and addresses of 209 outworkers, which were sent in by employers were found to refer to other districts, and were forwarded to the Medical Officers of these districts accordingly. The premises occupied by outworkers are systematically inspected, and any insanitary conditions found remedied. The premises generally were in fair condition, and comparatively few notices were required. The following table shows the number of outworkers' premises registered in the Borough, together with the trades and number of persons employed. Trade. Number on Register. Persons Employed. Premises Work rooms. Males. Females. Blousemaking 15 15 19 Bootmaking 45 45 50 2 Boxmaking 9 9 — 11 Dressmaking 7 7 — 8 Embroidery 34 34 - 34 Glovemaking 54 57 1 63 Tailoring 57 57 36 35 Underclothing 25 27 1 31 Other trades 24 24 2 25 Totals 270 275 90 228 86 The systematic inspection of outworkers' premises is carried out by the male and female Workshop Inspectors. The former deals with male outworkers and the latter with female. The lists which are required to be kept under the provisions of the Act by Battersea firms, of outworkers employed by them, are regularly inspected by the Council's Officers, and care taken that these lists are properly kept and in the manner prescribed by the Act. The lists are required to be sent in twice yearly, February and August, but at times difficulty is experienced in getting some employers to recognise their obligation in this respect, but it has not been found necessary to resort to legal proceedings to enforce the requirement. During 1910, 954 inspections were made, and 55 notices were served in connection with homework inspection, the results of which are summarised as follows:— Male Outworkers (Inspector Benjamin). Number of male outworkers on register 71 Total number of inspections 175 Number of notices served 10 Five outworkers removed during the year, and 7 new outworkers were registered. Female Outworkers (Miss Fairbairn). Number of female outworkers on register 199 Total number of inspections 779 Number of notices served 45 During 1910, 82 female outworkers had removed or discontinued for various reasons. The defects found in outworkers' premises were mainly those referring to want of cleanliness of rooms, defective sanitary fittings, &c. Two cases of scarlet fever occurred in two outworkers' homes during the year. It was not found necessary in either instance to stop the work or to take other proceedings under the Act. The patients were immediately removed to hospital, and special precautions were taken to prevent the spread of infection. 87 Legal Proceedings. 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 in Appendix No. 1, pages 88 to 90, and are summarised below— No. of Prosecutions. No of Convictions. Fines. Costs. £ s. d. £ s. d. Sale of Food and Drugs Acts 121 67 83 7 6 48 8 0 Smoke Nuisances — — — — Unsound Food 4 4 7 0 0 2 14 0 Contravention of Bye- Laws 5 3 2 0 0 0 16 6 Other proceedings 9 5 4 5 0 2 5 0 Total 139 79 £96 12 6 £54 3 6 88 APPENDIX No. 1. Legal Proceeding's under Sale of Food and Drug's and Margarine Acts. Number of Sample. Article. Nature of Offence or Adulteration, &c. Result of Proceedings. 649 Cream 32.2 grains per 1b. boric acid Fined 5s. and 14s. 6d. costs. 648 ,, 23.548 ,, ,, ,, ,, Fined 5s. and 14s. 6d. costs. 650 ,, 17.353 ,, ,, ,, ,, Fined 5s. and 14s. 6d. costs. 647 ,, 22.309 ,, ,, ,, ,, Fined 5s. and 14s. 6d. costs. 643 Butter 70.5 per cent. foreign fat Fined £1 and 14s. 6d. costs. — ,, Selling Margarine in a plain wrapper Fined 2s. 6d. and 4s. costs. 685 Coffee 34 per cent. chicory Fined 10s. and 14s. 6d. costs. 669 Milk 35 per cent of fat abstracted Withdrawn (warranty). 663 ,, 6 „ ,, „ ,, ,, 704 Separated milk 6 per cent. extraneous water. and less than 9 per cent. of milk solids. Fined 10s. and 12s. 6d. costs — — No name on barrow Fined 10s. and 2s. costs. 743 Butter 70 per cent. foreign fat, and selling margarine in a plain wrapper Fined £5 and 18s. 6d. costs. 770 Milk 8 per cent. added water, and 5 per cent. devoid of fat Dismissed (warranty). 805 ,, 3.5 per cent. added water ,, ,, — ,, Giving false warranty Fined £1 and £2 2s. costs. — ,, ,, ,, ,, Fined £1 and £3 3s. costs. 822 ,, 6 per cent. added water Fined 10s. and 14s. 6d. costs 827 ,, 5.5 per cent. added water, and 6.5 per cent. devoid of fat. Fined £1 and 14s. 6d. costs. 808 ,, 9.4 per cent. added water Fined 10s. and 12s. 6d. costs 826 ,, 7 per cent. of fat abstracted Fined £1 and 14s. 6d. costs. 840 Butter 70 per cent. foreign fat Fined £2 and 12s. 6d. costs. — „ Selling margarine in a plain wrapper Fined 5s. and 2s. costs. - — Obstructing Inspector Ordered to pay 2s. costs. 861 Milk 12 per cent. added water Fined £2 and 14s. 6d. costs. 848 Separated milk 32 per cent. added water Fined £5 and 14s. 6d. costs. 802 Milk 6 per cent. added water Dismissed (warranty). — „ Giving false warranty Fined £1 and 12s. 6d. costs. 872 Camphorated oil 83.39 per cent. deficient in camphor Fined £2 and 12s. 6d. costs. 878 Butter 65 per cent. foreign fat Fined£l 10s.& 14s.6d. costs. — ,, Selling margarine in a plain wrapper Withdrawn. 920 Milk 12 per cent. added water Fined £3 and 14s. 6d. costs. 940 Butter 43 per cent. foreign fat, and selling margarine in a plain wrapper Fined £3 and 14s. 6d. costs. 938 ,, 45 per cent. foreign fat, and selling margarine in a plain wrapper Fined £2 and 14s. 6d. costs. 89 APPENDIX No. 1, continued— Number of Sample. Article. Nature of Offence or Adulteration, &c. Result of Proceedings. 939 Margarine Selling margarine in a plain wrapper Fined 10s.and 12s.6d. costs. 600 Sausages 18·59 grains per lb. of boric acid Ordered to pay £1 11s. 6d. costs. 604 ,, 22·435 grains per lb. boric acid 606 ,, 22·309 grains per lb. boric acid Ordered to pay £1 1s. costs. 601 ,, 16·10 grains per lb. boric acid Ordered to pay £2 2s. costs. 971 Milk 8 per cent, added water Fined £1 and 14s. 6d. costs. 991 Butter 64 per cent. foreign fat, and selling margarine in a plain wrapper Fined £2 and 18s. 6d. costs. 21 Vinegar 6 per cent. added water Ordered to pay 12s. 6d. costs. 34 Milk 9 per cent. of fat abstracted Fined £1 and 12s. 6d. costs. 35 ,, 6 per cent. of fat abstracted Dismissed (warranty). 3 ,, 5·5 per cent. added water ,, ,, — Giving false warranty Dismissed. 39 Butter 77 per cent. foreign fat. and selling margarine in a plain wrapper Fined £3 and 14s. 6d. costs 71 Milk 10 per cent. of fat abstracted Fined £1 and 14s. 6d. costs. 84 Butter 32 per cent. foreign fat, and selling margarine in a plain wrapper Fined £1 and 14s. 6d. costs. 147 Milk 4·47 per cent. added water Withdrawn, 10s. 6d. costs. 56 ,, 7 per cent. of fat abstracted Summons adjourned sine die, defendants having left the neighbourhood. 135 ,, 8·3 per cent. added water Fined 10s. and 16s.6d. costs — ,, Giving false warranty Withdrawn, £1 1s. costs. 227 ,, 9·56 grains per pint boric acid Fined £1 and 14s. 6d. costs. 229 ,, 13 per cent. added water Dismissed (warranty). 201 ,, 11 per cent. added water ,, ,, 298 ,, 7·3 per cent. added water Fined £1 and 14s 6d. costs. 354 ,, 5 per cent. of fat abstracted Fined 10s. and 14s. 6d. costs. 365 Rum 27·78 degrees under proof Ordered to pay 12s.6d.costs. 319 Lard 100 per cent. of cocoa nut oil Dismissed without costs. Milk Giving false warranty Dismissed. 196 ,, 10 per cent. added water Fined £1 and 14s. 6d costs. — Refusal to sell to Inspector Withdrawn, £1 1s costs. 277 Milk 6·3 per cent. added water Dismissed (warranty) 302 ,, 7 per cent. of fat abstracted Fined £2 and 16s. 6d. costs 268 ,, 9·4 per cent. added water Fined £2 and 12s. 6d. costs 446 Coffee 50 per cent. chicory Fined £2 and 12s. 6d. costs 460 Milk 7·5 per cent. added water Dismissed (warranty). — ,, Giving false warranty Fined £2 and 4s. costs. — ,, ,, ,, ,, ,, Dismissed. 488 ,, 7·5 per cent. added water Dismissed (warranty). — ,, Giving false warranty Dismissed. 90 APPENDIX NO. 1, continued— Number of Sample. Article. Nature of Offence or Adulteration, &c. Result of Proceedings. 238 Separated milk 41·18 per cent. extraneous water and less than 9 per cent. of milk solids, also no name and address on barrow Fined £12 and £1 0s. 6d. costs. 285 ,, ,, 21·70 grains per gallon boric acid. Ordered to pay 14s. 6d. costs. 286 Milk 25 per cent. of fat abstracted Ordered to pay 14s. 6d. costs. 427 ,, 9·5 per cent. added water Withdrawn, .£1 1s. costs. 498 ,, 27 per cent of fat abstracted Fined 10s. and 12s.6d. costs. 494 Butter 60 per cent. foreign fat Fined £1 and 14s. 6d. costs. 508 ,, 27 per cent. foreign fat and selling margarine in a plain wrapper Fined 10s. and 14s. 6d. costs — Milk Giving false warranty Withdrawn, £1 1s. costs. 579 ,, 9 per cent. added water Dismissed (warranty). 627 Butter 40 per cent. foreign fat, and selling margarine in a plain wrapper. Fined £3 and 14s. 6d. costs. Legal Proceedings under the Public Health (London) Act, 1891, London County Council (General Powers) Act, 1890, and Metropolis Management Act, 1855. Nature of Offence. Result of Proceedings. Breach of by-law re yard paving at No. 18 Acanthus Road Fined £1 and 2s. costs. Breach of by-law re yard paving at No. 16 Acanthus Road Fined £1 and 2s. costs. Breach of by-law re yard paving at No.17 Acanthus Road Ordered to pay 2s. costs. Nuisances at Nos. 2, 4 and 6 Lithgow Street Nuisance at No. 232 York Road Fined 30s. and 12s. costs. Nuisance abated, ordered to pay 2s. costs. Non-compliance with abatement order Fined 10s. and 2s. costs. Insufficient ash-pit at No. 29 Bognor Street Fined 5s. and 4s. costs. Exposing and depositing for sale unsound sausages Fined £2 and 6s. costs. Nuisance at No. 14 Duffield Street Summonses withdrawn, work done, £1 1s. costs. Defective yard paving at No. 14 Duffield Street Selling unsound meat Fined £5 and 6s. costs. Depositing for sale unsound mutton Ordered to pay 6s. costs. Exposing for sale unsound sausages Ordered to pay £ 1 16s. costs. Manufacture of ice cream under improper conditions Fined £1 and 2s. costs. Manufacture of ice cream under improper conditions Fined £1 and 2s. costs. Non-deposit of drainage plans Summons withdrawn, plans deposited, 10s. 6d. costs. 91 APPENDIX No. 2. TABLE I. (Required by the Local Government Board to be used in the Annual Report of the Medical Officer of Health.) Vital Statistics of Whole District during 1910 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 Instituter. xin the District. Deaths of Residents registered in Public Instituv xbeyond 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 1900 168,339 5,161 30·6 826 157 2,951 17·5 598 293 320 2,978 17·6 1901 169,100 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 2,541 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 1904 175,465 4,849 27·5 706 146 2,517 14·3 725 372 398 2,543 14·4 1905 177,532 4,843 27·3 550 114 2,542 14·3 741 399 418 2,561 14·4 1906 179,622 4,654 25·9 611 131 2,425 13·5 786 444 403 2,384 13·2 1907 181,736 4,574 25·1 534 117 2,431 13·4 817 446 421 2,406 13·2 1908 183,873 4,629 25·1 495 116 2,265 12·4 740 408 415 2,272 12·3 1909 186,036 4,450 23·9 483 113 2,445 13·1 902 502 474 2,417 13·0 Averages for years 1900-09 176,652 4,800 27·2 637 133 2,527 14·3 713 367 397 2,538 14·4 1910 188,222 4,489 23·7 451 100 2,165 11·5 776 444 403 2,124 11·3 * 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 or infirmity, and dying in public institutions there: and by the term "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 ages, 168,907 ; number of inhabited houses, 23, 462; average number of persons per house, 7.19—at Census of 1901. 92 APPENDIX No. 2, continued.— TABLE II. 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 1910 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 it 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. 1900 168,339 5,161 2,978 822 72,119 2,418 1,370 411 49,691 1,749 1,044 314 46,529 994 564 97 1901 169,100 5,025 2,766 821 72,226 2,357 1,271 407 49,663 1,658 932 296 47,211 1,010 563 118 1902 171,401 4,844 2,581 657 72,797 2,208 1,133 312 49,631 1,643 911 270 48,973 993 537 75 1903 173,422 4,973 2,476 671 73,310 2,298 1,101 316 49,593 1,692 851 268 50,519 983 524 87 1904 175,465 4,849 2,543 715 73,931 2,249 1,159 365 49,564 1,584 845 248 51,970 1,016 539 102 1905 177,532 4,843 2,561 636 74,589 2,278 1,159 305 49,536 1,622 873 256 53,407 943 529 72 1906 179,622 4,654 2,384 588 75,169 2,150 1,100 316 49,520 1,570 759 198 54,933 934 525 74 1907 181,736 4,574 2,406 526 75,740 2,139 1,125 257 49,481 1,552 793 211 56,515 883 488 58 1908 183,873 4,629 2,272 494 76,321 2,087 993 217 49,453 1,624 748 198 58,099 918 531 79 1909 186,036 4,450 2,417 478 77,469 2,051 1,088 231 49,417 1,578 815 191 59,150 821 514 56 Averages of years 1900 to 1909 176,652 4,800 2,538 641 74,367 2,224 1,150 314 49,555 1,627 857 245 52,731 949 531 82 1910 188,222 4,489 2,124 434 78,024 2,080 929 197 49,388 1,505 690 174 60,810 904 504 63 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 deceased. 93 APPENDIX No. 2, continued— TABLE III. (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 1910. 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 to 65. 65 and upwards. Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 204 3 61 122 13 5 .. 89 52 63 86 51 52 Membranous croup 5 1 3 1 .. .. .. 4 1 .. 3 1 .. Erysipelas 170 6 4 14 21 109 16 97 51 22 26 13 6 Scarlet fever 439 2 134 265 25 13 .. 154 152 133 152 149 116 Typhus fever .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric fever 39 1 4 17 2 15 .. 20 10 9 20 9 8 Relapsing fever .. .. .. .. .. .. .. .. .. .. .. .. .. Continued fever 2 .. .. 1 .. .. 1 2 • • .. .. .. .. Puerperal fever 16 .. .. •• 5 11 .. 8 3 5 3 2 3 Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Cerebro-spinal fever 5 1 3 1 .. .. .. 2 1 2 .. 1 1 Glanders .. .. .. .. .. .. .. .. .. .. .. .. .. Anthrax .. .. .. .. .. .. .. .. .. .. .. .. .. Hydrophobia .. •• .. •• .. .. .. •• •• .. .. .. .. Totals 880 14 209 421 66 153 17 376 270 234 290 226 186 94 APPENDIX NO. 2, continued— TABLE IV. (Required by the Local Government Board to be used in the Annual Report of the Medical Officer of Health.) Causes of, and Ages at, Death during the Year 1910. 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. 1 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 74 11 59 4 .. .. .. 39 29 6 31 Scarlet Fever 7 .. 4 3 .. .. .. 3 3 1 .. Whooping Cough 50 26 24 .. .. .. .. 22 18 10 17 Diphtheria and Membranous Croup 12 .. 4 8 .. .. .. 4 2 6 .. Croup .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. Enteric 7 .. .. 3 .. 4 .. 3 3 1 .. Other Continued 3 .. 2 .. .. .. 1 2 .. 1 .. Epidemic Influenza 19 .. .. .. .. 10 9 10 5 4 2 Cholera .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 59 47 10 1 .. 1 .. 28 26 5 2 Enteritis 28 22 3 .. .. 2 1 14 6 8 28 Gastritis 6 3 1 .. .. 1 1 2 2 2 1 Puerperal Fever 6 .. .. .. 1 5 .. 3 2 1 1 Erysipelas 8 2 1 .. 1 4 .. 3 3 2 4 Phthisis 195 .. 2 10 39 135 9 79 70 46 102 Other Tuberculous Diseases 57 14 23 11 1 8 .. 29 21 7 12 Cancer, Malignant Disease 141 .. .. 1 1 92 47 57 39 45 66 Bronchitis 220 43 16 1 1 61 98 102 68 50 62 Pneumonia 205 45 47 9 9 59 36 92 72 41 40 Pleurisy 8 .. .. 1 1 5 1 5 3 .. 4 Other Diseases of Respiratory Organs 10 1 1 1 1 6 .. 4 3 3 .. Alcoholism Cirrhosis of Liver 22 .. .. .. .. 15 7 6 8 8 7 Venereal Diseases 14 9 2 .. .. 2 1 10 4 .. 18 Premature Birth 83 83 .. .. .. .. .. 38 32 13 6 Diseases and Accidents of Parturition 3 .. .. .. .. 3 .. 1 1 1 1 Heart Diseases 80 .. 2 6 5 45 22 28 29 23 35 Accidents 57 4 5 4 3 31 10 24 13 20 38 Suicides 27 .. .. .. 2 25 .. 13 9 5 9 All other causes 723 124 27 28 18 259 267 308 219 196 290 All causes 2124 434 233 91 83 773 510 929 690 505 776 95 APPENDIX No. 2, Continued— Table V. Required by the Local Government Board to be used in the Annual Reports of the Medical Officer of Health. Borough of Battersea. Infantile Mortality during the Year 1910. CAUSE OF DEATH Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under One Year. All Causes.—Certified 92 12 19 24 147 51 44 21 27 14 27 18 25 25 15 20 434 Common Infectious Diseases. Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. 1 3 2 2 .. 3 11 Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria : Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. 1 1 2 3 3 .. 1 2 1 1 1 5 4 3 26 Diarrhœal Diseases. Diarrhœa, all forms .. .. 1 2 3 6 5 8 8 1 7 3 3 1 .. 2 47 MucoEnteritis Gastro- .. 1 l 1 3 2 .. .. 3 3 2 • • 3 3 2 1 22 Gastritis, Gastrointestinal Catarrh .. 1 .. .. 1 .. 1 .. .. .. .. .. 1 .. .. .. 3 Wasting Diseases. Premature Birth 56 4 7 7 74 4 4 1 .. .. .. .. .. .. .. .. 83 Congenital Defects 12 1 2 1 16 2 2 1 1 1 .. .. .. 1 .. .. 24 Injury at Birth 3 .. .. .. 3 .. .. .. .. .. .. .. .. .. .. .. 3 Want of Breast Milk .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 2 Atrophy, Debility, Marasmus 1 .. 2 6 9 5 5 .. 1 .. 2 2 .. .. 1 .. 25 Tuberculous Diseases. Tuberculous Meningitis .. .. .. .. .. 1 1 1 1 .. 1 1 1 1 .. 1 9 Tuberculous Peritonitis: Tabes Mesenterica . .. .. • • .. .. .. .. .. 1 .. .. .. 1 .. .. .. 2 Other Tuberculous Diseases .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. 1 .. 3 Other Causes Erysipelas .. .. .. .. .. .. 1 .. 1 .. .. .. .. • • .. • • 2 Syphilis 1 .. 1 1 3 1 .. .. .. 2 2 .. .. 1 .. .. 9 Rickets .. .. .. .. .. .. .. .. .. .. 1 .. .. 2 1 .. 4 Meningitis (not Tuberculous) .. .. •• .. .. .. .. .. .. .. .. 1 1 .. .. 1 3 Convulsions 2 .. 1 3 .. 3 .. 1 .. 1 .. .. .. 1 .. 9 Bronchitis 2 .. 2 1 5 10 5 7 3 2 1 .. 4 2 2 2 43 Laryngitis 1 .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 Pneumonia 1 .. .. 1 2 7 7 2 1 1 6 2 4 4 2 7 45 Suffocation, overlying .. .. .. .. .. .. .. .. .. .. • • .. • • .. .. • • .. Other Causes 13 5 2 2 22 10 6 1 4 2 1 5 3 3 1 .. 58 92 12 19 24 147 51 44 21 27 14 27 18 25 25 15 20 434 Borough of Battersea. Population (estimated to middle of 1910).—188,222. Births in the year :—Legitimate, 4,380 ; Illegitimate, 109. Deaths in the year of Legitimate Infants, 393 ; Illegitimate Infants, 41. Deaths from all Causes at all Ages—2,124. 96 APPENDIX No. 2, continued— TABLE V.—(continued). East Battersea. Infantile Mortality during the Year 1910. cause OF death. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months. 2-3 Months. • 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under One Year. All Causes.—Certified 33 4 10 10 57 23 18 11 11 11 13 7 11 13 11 11 197 Common Infectious Diseases. Small-pox .. .. .. .. .. .. .. .. • • .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. 2 2 2 .. 1 7 Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria : Croup .. .. .. .. .. .. .. .. .. .. .. • • .. .. .. .. .. Whooping Cough .. .. 1 .. 1 2 3 .. 1 1 1 .. .. 3 2 .. 14 Diarrhœal Diseases. Diarrhœa, all forms .. .. 1 1 2 .. 2 5 6 .. 2 1 1 .. .. 2 21 Enteritis Muco- Gastro- .. •• l .. 1 1 .. .. l 2 2 .. .. 1 2 1 11 Gastritis, Gastrointestinal Catarrh .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Wasting Diseases. Premature Birth 23 3 5 2 33 3 2 .. .. .. .. .. .. .. .. .. 38 Congenital Defects 3 .. 1 1 5 1 1 .. .. 1 .. .. .. 1 .. .. 9 Injury at Birth 1 .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 Want of Breast Milk .. .. .. .. .. .. 1 .. .. .. 1 • • .. .. .. .. 2 Atrophy, Debility, Marasmus .. .. • • 4 4 3 2 .. .. .. l .. .. .. 1 .. 11 Tuberculous Diseases. Tuberculous Meningitis .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 Tuberculous Peritonitis: Tabes Mesenterica .. .. .. .. .. .. .. .. .. .. .. .. l .. .. .. 1 Other Tuberculous Diseases .. •• .. .. .. .. .. .. l .. .. .. .. .. 1 .. 2 Other Causes. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. . . .. Syphilis 1 .. .. .. 1 1 .. • • .. 2 1 .. .. 1 .. .. 6 Rickets .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 Meningitis (not Tuberculous) .. .. .. .. .. .. .. .. .. .. .. .. l .. .. 1 2 Convulsions 1 .. .. .. 1 .. 1 .. .. .. .. .. .. .. 1 .. 3 Bronchitis 1. .. .. .. 1 4 1 4 1 2 .. .. .. 1 1 2 17 Laryngitis l .. .. .. l .. .. .. .. .. .. .. .. .. .. .. 1 Pneumonia .. .. .. 1 l 5 5 1 .. 1 4 1 4 2 1 4 29 Suffocation, overlying .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Causes 2 1 1 1 5 3 .. .. 1 2 1 3 2 2 1 •• 20 33 4 10 10 57 23 18 11 11 11 13 7 11 13 11 11 197 Sub-Division of East "Battersea. Population (estimated to middle of 1910)—78,024. Births in the year—Legitimate, 2,038; Illegitimate, 42. Deaths in the year of Legitimate Infants, 183; Illegitimate Infants, 14. Deaths from all Causes at all ages—929. 97 APPENDIX NO. 2, continued— TABLE V.—(continued). North-West Battersea. Infantile Mortality during the Year 1910. CAUSE OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under One Year. All Causes.—Certified 41 5 7 61 22 20 7 12 3 14 10 11 9 3 2 174 Common Infectious Diseases. Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles . . .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 2 Scarlet Fever .. .. .. .. .. .. .. .. .. .. • • .. .. .. .. .. .. Diphtheria : Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. 1 1 1 .. .. .. 1 .. 1 .. 2 1 .. 7 Diarrhceal Diseases. Diarrhoea, all forms .. .. .. .. .. 4 2 3 2 1 5 2 2 .. .. .. 21 .. .. .. .. •• .. .. .. 2 1 .. •• 1 1 .. .. 5 Gastritis, Gastrintestinal Catarrh .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 Wasting Diseases. Premature Birth 23 .. 2 3 28 1 2 1 .. .. .. .. • • .. .. .. 32 Congenital Defects 7 1 .. .. 8 1 .. .. 1 .. .. .. •• .. •• .. 10 Injury at Birth 1 .. .. .. 1 .. •• .. .. .. .. .. .. .. •• .. 1 Want of Breast Milk .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Atrophy, Debility, Marasmus .. .. 1 1 2 2 1 .. 1 .. 1 2 .. .. .. .. 9 "uberculous Diseases. Tuberculous Meningitis .. .. .. .. .. .. 1 .. .. .. 1 1 1 1 .. .. 5 Tuberculous Peritonitis: Tabes Mesenterica .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 Other Tuberculous Diseases .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 Other Causes. Erysipelas .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. .. 2 Syphilis .. .. 1 1 2 .. .. .. .. .. 1 .. .. .. .. .. 3 Rickets .. .. .. .. .. .. .. .. • • • • 1 .. .. 2 .. .. 3 Meningitis (not Tuberculous) .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 Convulsions 1 .. .. .. 1 .. 2 .. .. .. 1 .. .. .. .. .. 4 Bronchitis 1 .. 2 1 4 6 4 2 1 .. l .. 4 .. 1 .. 23 Laryngitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. • • Pneumonia 1 .. .. .. 1 1 2 1 1 .. 2 .. .. 2 1 2 13 Suffocation, overlying.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Causes 7 4 1 1 13 6 5 .. 2 .. .. 2 1 1 .. .. 30 41 5 7 8 61 22 20 7 12 3 14 10 11 9 3 2 174 Sub-Division of North-West Battersea. Population (estimated to middle of 1910)—49,388. Births in the year—Legitimate, 1,464 ; Illegitimate, 41. Deaths in the year of Legitimate Infants. 155 ; Illegitimate Infants, 19. Deaths from all Causes at all ages—690. 98 APPENDIX No. 2, continued-— TABLE V,—(continued). South-West Battersea. Infantile Mortality during Year 1910. CAUSE OF DEATH. Under l week. 1-2 Week. 2-3 Weeks. Total under 1 Month. 1-2 Month. 2-3 Month. 3-4 Month. 4-5 Month. 5-6 Month. 6-7 Month. 7-8 Month 8-9 Month. 9-l0 Month. 10-11 Month. 11-12 Month. Total Deaths under One Year All Causes.—Certified 18 2 3 6 29 6 6 3 4 .. .. 1 3 3 1 7 63 Common Infectious Diseases. Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 2 Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria : Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 3 5 Diarrhœal Diseases. Diarrhœa, all forms .. .. .. 1 1 2 1 .. .. .. .. .. .. 1 .. .. 5 Enteritis Muco- Gastro- •• 1 .. 1 2 1 .. .. .. .. .. .. 2 1 1 .. 6 Gastritis, Gastrointestinal Catarrh .. .. 1 .. 1 .. 1 .. .. .. .. .. .. .. .. .. 2 Wasting Diseases. Premature Birth 10 1 .. 2 13 .. .. .. .. .. .. .. .. .. .. .. 13 Congenital Defects 2 .. 1 .. 3 .. 1 1 .. .. .. .. .. .. .. .. 5 Injury at Birth 1 .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 Want of Breast Milk .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Atrophy, Debility, Marasmus 1 .. 1 1 3 .. 2 .. .. .. .. .. .. .. .. .. 5 Tuberculous Diseases. Tuberculous Meningitis .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. 1 3 Tuberculous Peritonitis: Tabes Mesenterica .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Tuberculous Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Causes. Syphilis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rickets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Meningitis (not Tuberculous) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Convulsions .. .. .. 1 1 .. .. .. 1 .. .. .. .. .. .. .. 2 Bronchitis .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 .. .. 3 Laryngitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pneumonia .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. 1 3 Suffocation, overlying .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Causes 4 .. .. .. 4 1 1 1 1 .. .. .. .. .. .. .. 8 18 2 3 6 29 6 6 3 4 .. .. 1 3 3 1 7 63 Sub-Division of South-West Battersea. Population (estimated to middle of 1910)—60,810. Births in the year- Legitimate. 878 ; Illegitimate. 26. Deaths in the year of Legitimate Infants, 55; Illegitimate Infants, 8. Deaths from all Causes at all ages, 505. 99 Factories, Workshops, Laundries, Workplace! and Homework, 1.—Inspection (including Inspection made by Sanitary Inspectors or Inspectors of Nuisances). Premises. Number of Inspections. Written Notice. Prosecutions. Factories (including Factory Laundries) 702 52 — Workshops (including Workshop Laundries) 1,947 175 — Workplaces (other than Outworkers' premises included in Part 3 of this Report 996 100 2 Total 3,645 327 2 2.—Defects Found. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts :— NIL. Want of Cleanliness 89 89 — Want of Ventilation 3 3 — Overcrowding 1 1 — Want of drainage of floors 4 4 - Other nuisances 196 196 Sanitary accommodation Insufficient 6 6 Unsuitable or defective 62 62 Not separate for sexes — — - 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) 25 25 - Other Offences (excluding Offences relating to Outwork which are included in Part 3 of this report) - Total 386 386 — 100 3.—Home Work. NATURE OF WORK. OUTWORKERS' LISTS, SECTION 107. Inspections of Outworkers' premises. Outwork in Unwholesome Premises. Section 108. Outwork in Infected Premises, Sections 109.110. Lists received from Employers. Addresses of Outworkers. Instances. Notices served. Instances. Orders made (S. 110). Sending twice in the year. Sending once in the year. Received from other Councils. Forwarded to other Councils. Lists.- Outworkers. Lists. Outworkers. Contractors Workmen. Contractors. Workmen. Wearing Apparel— (1) Making, &c. 69 50 394 4 2 5 331 185 916 51 54 2 — (2) Cleaning & washing 8 15 11 — — — 3 20 2 — — — — Lace,lace curtains and nets — — — — — — 2 — 3 — — — — Sacks 2 — 2 1 — 1 — 2 3 — — — — Furniture and upholstery 2 — 4 — — — — — 2 — — — — Fur pulling — — — — — — — — — — — — — Paper bags and boxes — — — — — — 20 2 27 1 1 — — Brush making — — — — — — 2 — 1 — — — — Total 81 65 411 5 2 6 358 209 954 52 55 2 — 101 4.—Registered Workshops. Workshops on the Register (Sec. 131) at the end of 1910:— Bakehouses 80 Bootmakers 81 Dressmakers 114 Laundries 55 Milliners 26 Tailors 41 Other Trades 203 600 5.—Other Matters. Matters notified to H.M. Inspectors of Factories :— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 64 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5) :— Notified by H.M. Inspector 4 Recorts (of action taken) sent to H.M. Inspector — Other — Underground Bakehouses (s. 101) :— Certificates granted during the ye — In use at the end of the year 31 102 Proceeding's during 1910. (The following tables 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. No. of Inspections, 1910. No. of Intimation Notices 1910 No of Prosecutions 1910. On Register at end of 1909. Added in 1910. Removed in 1910. On Register at end of 1910. Milk premises 178 41 34 185 836 35 — Cowsheds 3 — — 3 * — — Slaughterhouses 5 — — 5 295 — — Other offensive trade premises 2 — — 2 16 — — Ice-cream premises 156 57 28 185 403 50 2 Registered houses let in lodgings 123 — — 123 305 154 — * These premises are subject to frequent inspection. Total number of intimation notices served for all purposes 4,318 Overcrowding— Number of dwelling-rooms overcrowded 79 Number remedied 79 Number of prosecutions — Underground rooms— Illegal occupation dealt with during the year 33 Number of rooms closed 33 Insanitary houses— Number closed under the Public Health (London) Act — Number closed under the Housing of the Working Classes Act — Number of verminous premises cleansed under Section 20 of the L.C.C. (General Powers) Act, 1904 — 103 Shelters provided under Section 60 (4) of the Public Health (London) Act— Number of persons accommodated during the year Revenue Acts— Number of houses for which applications were received during year 5 Number of tenements comprised therein 11 Number of tenements for which certificates were :—(a) Granted 2 (b) Refused 3 (c) Deferred 6 Number of prosecutions under bye-laws under Public Health Act, 1891— (a) For prevention of nuisance arising from snow, ice, salt, filth, &c— (b) For prevention of nuisance arising from offensive matter running out of any manufactory, &c. — (c) For prevention of keeping of animals in such a manner as to be injurious to health — (d) As to paving of yards, &c., of dwelling houses 4 (e) In connection with the removal of offensive matter, &c. — (f) As to cesspools and privies, removal and disposal of refuse, &c. — (g) For securing the cleanliness of tanks, cisterns, &c. — (h) With respect to water-closets, &c. — (i) With respect to sufficiency of water supply to water closets — (j) With respect to drainage, &c. (Metropolis Management Act, Section 202) — (k) With respect to deposit of plans as to drainage, &c. (Metropolis Management Acts Amendment (Bye-laws) Act, 1899) 1 Mortuary— Total number of bodies removed 234 Total number of infectious bodies removed 12