BER 26 Metropolitan Borough of Bermondsey. REPORT ON THE SANITARY CONDITION OF THE BOROUGH OF BERMONDSEY. For the Year 1905. BY R. K. BROWN, B.A., M.D., B.Ch., B.A.O. (R.U.I.), D.P.H. (Lond.) (Fellow of the Royal Institute of Public Health.) (Fellow of the Incorporated Society of Medical Officers of Health.) Medical Officer of Health for the Metropolitan Borough of Bermondsey London: Frederick Shaw & Co., Printers, Dockhead, S.E. 1906. TABLE OF CONTENTS. Page. Page. vITAL STATISTICS- SANITARY ADMINISTRATION— Population 3 Offensive Matter 26 Offensive Trades 27 Births 3 Marriages 4 Milk Premises 27 Cowsheds 27 Deaths 5 Slaughterhouses 27 Infantile Mortality 6 Senile Mortality 7 Ice Cream Premises 27 Sec. 48 Public Health (London) Act, 1891 27 Death Certification 7 Zymotic Diseases 7 Houses Let in Lodgings 27 Small-pox 8 Disinfection 29 Measles 8 Food Inspection 29 Whooping Cough 8 Food Premises 29 Typhus Fever 8 Unsound Food Seizures 29 Enteric Fever 8 Food Destroyed 30 Simple Continued Fever 8 Coffee Berries 30 Diarrhœa 8 Bacteriological Laboratory 31 Tubercular Diseases 9 Overcrowding 32 Phthisis 9 Hairdressers and Barbers 34 Alcoholism and Cirrhosis of Liver 10 Food and Drugs 36 Cancer and Malignant Disease 10 Smoke Nuisances 37 Heart Diseases 10 Customs and Inland Revenue Act 37 Suicides 10 House Refuse 37 Accidents 11 Cleansing of Persons Act, 1897 87 Other Violent Deaths 11 Alien Immigration 39 NOTIFICATION OF INFECTIOUS DISEASE— FACTORIES AND WORKSHOPS— Lead Poisoning 39 Small-pox 11 Outworkers 39 Typhus Fever 11 Female Sanitary Inspector 40 Diphtheria 11 Bakehouses 40 Scarlet Fever 12 APPENDIX—TABLES— Enteric Fever 13 Local Government Board Tables 42-45 Continued Fever 13 Population, etc., of Wards 46 Puerperal Fever 14 Meteorology 46 Measles 14 Marriages 46 Insanitary Area 48-49 Chicken-pox 15 Proceedings during Year 49 Membranous Croup 15 Factories and Workshops 50-51 Notification of Phthisis 15 Sanitary Work 52 Anthrax 17 Food and Drugs 53-54 School Closure 17 List of Bakehouses 55 Children excluded from School 19 Extended Table of Deaths 56 Metropolitan Borongh of Bermondsey. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH. 'To the Mayor, Aldermen, and Councillors of the Metropolitan Borough of Bermondsey. Gentlemen, I have the honour to submit my Fifth Annual Report on the sanitary condition of the Borough of Bermondsey during the year 1905. The report deals with the 52 weeks ending on December 30th, 1905. The death rate was 18.6 compared with 20.1 in 1904, the causes of this decrease being discussed on page 5. No serious outbreaks of notifiable disease occurred during the year, but a mild type of scarlet fever was very prevalent. The general plan of the Report is similar to that of previous years, the subjects being discussed under the following divisions, viz., I.—Vital Statistics; II.— Notification of Infectious Diseases; III.—Sanitary Administration; IV.—Factories and Workshops. In the appendix will be found the Local Government Board's tables along with those required to illustrate the subjects discussed in the Report. There is a new table on Infantile Mortality. Again I wish to record my thanks to the Chairman and members of the Public Health Committee, who throughout the year have shown themselves alive to the advances in sanitary science, and have with few exceptions approved of and carried out suggestions for the improvement of the Borough in a sanitary point of view. Thanks are due to the Chief Inspector and other members of the staff for their hearty co-operation in carrying out the various duties devolving on the Public Health Department, and also to the Surveyor for his assistance in connection with the plans of the Insanitary Area. I am, gentlemen, Your obedient servant, R. K. BROWN. I.—VITAL STATISTICS. Population. The populations of the Borough of Bermondsey and its registration sub-districts, as enumerated in the Census of 1891, 1896 and 1901, were as follow:- 1891. 1896. 1901. Estimate, 1905. Bermondsey 85,475 84,682 82,483 81,852 Rotherhithe 39,225 40,379 38,460 38,264 St. Olave's 11,731 9,817 8,614 12,723 130,760 Borough 136,660 137,585 128,730 As the interval between the last Census year and the year under report increases, so does the difficulty of arriving at a correct estimate of the population become greater. Houses have been pulled down and others rebuilt during the year 1905, but there has been no substantial change in this respect since the Report for 1904 was written. For various reasons I am inclined to think that the above estimates are rather under than over the mark, but the error is probably not very serious since an estimate published by the London County Council and based on the houses occupied and rated, gives a population for purposes of the equalisation of rates of 129,295. This is only 565 more than mine and does not appreciably affect the death and birth-rates which are calculated on the figures given in the table. Estimations of the ward areas and populations have been made for the first time. The populations have been reduced in the same proportion as the totals, and will be found in the Appendix. Births. The total number of births registered in the Borough for the 52 weeks ending December 30th, 1905, was 4,288, consisting of 2,185 males and 2,103 females. This is 294 below the average for the last 10 years and 95 above the figure for 1904. This total includes 2,894 for Bermondsey, being 146 above that for 1904, and 95 below the average for the last 10 years; 1,130 for Rotherhithe, being 47 above the number for 1904, and 94 below the average for the last 10 years, and 264 for St. Olave's, being 98 below 1904 and 104 below average for last 10 years. Note. -This reduction of births in St. Olave's is due to our being able to allocate births in Parish Street Workhouse to their proper districts. In Table II. of the Appendix will be seen the figures for the last 10 years in the three registration sub-districts, and in Table I. figures for the whole Borough. The birth rate for 1905 was 33.3 per thousand persons living, the highest since 1901, and is only 1.4 below the average for the last 10 years. Particulars of rates will be found in annexed Table A. London is concluded for comparison. Table A—Birth Rates. Year. Bermondsey. Rotherhithe. St. Olave's. Whole Borough. London. 1895 37.63 36.04 32.43 35.9 30.5 1896 37.53 33.41 36.2 36.03 30.2 1897 38.68 30.0 37.48 31.53 35.8 1898 36.73 32.85 32.97 35.3 29.5 1899 36.67 32.38 34.55 35.2 29.4 1900 34.07 30.56 39.67 33.5 28.6 32.73 1901 35.42 31.73 34.1 29.0 1902 34.70 30.47 33.92 33.4 28.5 1903 31.12 30.83 28.4 29.10 32.4 40.69 27.8 1904 33.52 28.27 32.4 Average for years 1895-1904 31.27 35.61 35.49 34.4 29.2 1905 35.35 27.1 29.53 30.64 33.3 From this it will be seen that there is a rise in the birth rate over the years 1903 and 1904. There is a larger proportional rise in Bermondsey than Rotherhithe, while St. Olave's shows a considerable fall. Marriages. The total number of marriages in the Borough in 1905 was 1,108, being 3 above the number for 1904, and 13 below the average for the last ten years. In Table VIII. of the Appendix will be found particulars of numbers and rates in the three registration sub-districts. The numbers have been supplied by the Superintendent Registrar. Deaths. In Table IV. of Appendix will be found the Local Government Board tables dealing with deaths in the Borough. A new one has been added by them to show the causes of death under one year of age, in weeks up to the end of the first month, and in months up to the end of the first year. The extended table of causes of death initiated last year will also be found in the Appendix. The total number of deaths registered in the Borough for the 52 weeks ending December 30th, 1905, was 1,911, which is 231 less than in 1904, and 541 less than the average for the last ten years. When this figure is corrected by exclusion of deaths of non-parishioners occurring in the district, and the inclusion of deaths of parishioners occurring outside the district, the number is raised to 2,399. This is 194 less than in 1904, and 434 less than the average for the last ten years. The annexed table shows the distribution of deaths in quarters, together with the correspending quarters of 1904. Contrary to the usual state of affairs, the largest number of deaths occurred in the fourth quarter, while the first quarter, which is almost invariably the heaviest, only takes third place. This is due to a falling off of deaths due to respiratory diseases, such as bronchitis, pneumonia, etc., and is no doubt due to the mild spring. The fourth quarter is high, and this may be partly explained by those lives which suffered from chronic respiratory diseases, such as bronchitis and phthisis, escaping the spring of 1905, and having passed this succumbing early in the following winter. Table B. Quarter. Bermondsey. Rotherhithe. St. Olave's. Whole Borongh. 1904. 1905. , 1904. 1905. 1904. 1905. 1904. 1905. First 423 196 144 70 689 399 58 601 401 161 Second 340 120 53 43 615 503 389 Third 396 163 165 67 41 619 602 421 Fourth 362 175 670 693 193 56 56 Total Deaths 246 198 2593 2399 1634 1597 713 604 The death rate of the Borough during 1905 was 18*6 per 1,000 living inhabitants, being 1*5 below that recorded for 1904, and 2*7 below the average for the last ten years. This is one of tbe lowest death rates recorded in Bermondsey, that for 1903, which was 18'4, being the lowest. If the census population of 1901 be taken as the basis of calculation of the rate, it works out at 18-35, which is '05 below that for 1903. Table D shows that Bermondsev and Botherhithe have both participated in the decrease, but St. Olave shows an increase. Table C.—Increase or Decrease of Diseases in 1905 Compared with 1904. Increase. Decrease. Amount. Amount. Amount. Amount. Smallpox 1 Venereal Diseases 2 Measles 77 Phthisis 34 Diphtheria 1 Premature Birth 5 Scarlet Fever 1 Bronchitis 31 Pneumonia 25 Puerperal Fever 2 Diseases & Accidents of Parturition 6 Whooping Cough 30 Other Septic Diseases 11 Enteric Fever 7 Alcoholism and Cirrhosis of Liver 7 Other Tubercular Diseases 9 Other Continued Fever 3 Accidents 10 Cancer 17 Heart Diseases 22 All other causes 20 Epidemic Influenza 4 Pleurisy 7 Diarrhœa 44 Enteritis 3 Other Diseases of Respiratory Organs 5 Erysipelas 2 By adding the above figures it will be seen that the increases amount to 96, and the decreases to 290, making a balance of 194 in favour of 1905. The most notable increase is that of cancer, while several diseases, notably measles, whooping, respiratory diseases, and diarrhœa show a considerable decrease. In column 1, foot of Table I. of the Appendix, will be found a list of places where deaths of non-parishioners occurred in the district. There were 83 such deaths in all, against 44 in 1904, and 40 in 1903. This number is rather below the average. 10 such deaths occurred in the Infirmary; 4 in the Surrey Commercial Docks; 2 in the Parish Street Workhouse; 1 in London County Council Sewer, Neptune Street; 1 in Nelson Dry Dock: 1 on City and South London Electric Railway, London Bridge; 1 at 93, Union Road ; 1 at 654, Rotherhithe Street; and 12 in River Thames. 521 person belonging to this Borough died in outlying institutions, against 495 in 1904, and 449 in 1903. The names of the various places where the deaths occurred will be found in columns 2 and 3 at foot of Table I. of Appendix. I have drawn attention to the slow but steady increase of these figures, which is probably due to more use being made of the various hospitals of the metropolis. Table D.— Death Rates. Year. Bermondsey. Rotherhithe. St. Olave's. Whole Borough. London. 21.89 1895 19.4 19.47 26.44 21.6 1896 20.70 22.44 21.6 18.2 21.95 1897 22.22 17.7 19.20 22.54 21.4 1898 21.05 19.56 21.42 20.6 18.3 24.70 19.3 1899 22.11 26.42 24.1 23.49 1900 22.79 22.91 23.2 18.3 1901 17.1 21.44 19.43 20.93 20.8 1902 21.66 19.30 24.62 21.2 17.2 1903 18.54 17.08 22.23 18.4 15.1 1904 19.91 18.59 27.65 20.1 16.0 Average for years 1895-1904 19.82 23.76 21.3 17.7 21.68 •I — 1905- 18.6 19.51 15.78 22.98 On estimated population 15.1 On Census population, 1901 19.36 20.17 18.35 15.70 The following extract, produced again from the Annual Report for 1903, explains Table E. below: — "Since the mortality per thousand living is much greater among children under 5 and old people, and is higher at practically all ages among men, it follows that a community which has a preponderance of these elements will have ceteris paribus a higher death rate than one which has not. "The age and sex distribution of the population of England and Wales being taken as a standard to all communities within their borders, the death rates of different localities can be calculated on the assumption that they have the same proportions of 6 children under 5, old people and women, as have the population of England and Wales. By thus eliminating this disturbing factor of age and sex distribution different communities can be brought into strict comparison with one another. "In 1883 the Registrar-General commenced a method of correcting the death rates of the great towns of England and Wales. Taking account of the differences of age and sex distribution between these and the latter, he has calculated a factor for each great town by which the recorded death rate must be multiplied so as to allow for the differences of age and sex, and thus places them as regards these matters on an equal footing. You thus get death rates, the differences in which can be put down to general sanitary conditions alone. In illustration of this I have taken the following rates for a table calculated on the Registrar's method by the Medical Officer of the London County Council, published in his Annual Report for 1902. "It will be seen from this that in London and the Boroughs the correction raises the death rate, showing that there is in them a preponderance of people living at ages when the death rate is low (viz. between 5 and 50), and also of women, sufficient to keep the recorded death rate down, notwithstanding the great number of children under 5." Table E. — Death Rates corrected for Age and Sex Constitution of the various Populations. District. Year. Factor for Correction of Age and Sex Distribution. Crude Death Rate. Corrected Death Rate. 1.05107 London 1902 17.2 18.1 Camberwell 1902 1.03788 16.3 16.9 17.3 Deptford 1902 1.05107 16.5 21.4 22.4 Southwark 1902 1.04684 BERMONDSEY 1902 1.03375 21.2 21.9 1.03375 18.4 19.0 1903 „ 1904 1.0244 20.1 20.6 „ 1.0244 18.6 19.0 1905 „ Infantile Mortality. This is calculated as the number of children dying under one year of age to every 1,000 births of the same year. This is done as the infantile population is difficult to get owing to the inaccuracy of the Census on this point. This is not so much due to enumeration as to the confusion in the minds of parents between a current and a completed year. The total number of infantile deaths in the Borough in 1905 was 631, viz., 422, 164 and 45 for the sub-division of Bermondsey, Rotherhithe, and St. Olave's respectively; the corresponding figures for 1904 being 723 for the whole Borough, and 477, 187 and 59 for its divisions. This gives an infantile mortality for 1905 of 147 for the Borough, the other figures being 146 for Bermondsey, 145 for Rotherhithe, and 170 St. Olave's. Table F.— Infantile Mortality. Bermondsey. Rotherhithe. Whole Borough. London. Year. St. Olave. No. of Deaths. Rate per 1000 Births. No. of Deaths. Rate per 1 1000 Births. No. of Deaths. Rate per 1 000 Births. No. of Deaths. Rate per 1000 Births. No. of Deaths. Rate per 1000 Births. 1895 162 193 148 205 801 162 22,013 165 520 88 160 214 64 153 159 160 1896 518 159 791 21,695 190 174 154 158 1897 605 219 67 891 183 21,106 220 169 1898 157 132 752 158 21,931 166 485 47 166 1899 215 169 842 180 22,129 574 187 53 147 186 243 205 120 185 1900 526 48 817 20,730 158 170 215 169 19,412 1901 497 176 42 132 754 148 174 153 18,478 1902 455 159 149 49 678 156 139 153 176 657 156 1903 428 179 160 50 16,978 130 173 187 172 1904 477 173 59 18,600 143 163 723 Average for years 1895 to 1904. 508 170 206 168 57 153 771 168 20,307 153 1905 422 146 164 145 631 147 129 16,324 45 170 This is a substantial and very satisfactory decrease as far as it goes, but the figure is still much too high and the decrease must remain permanent if one is to draw conclusions from it. The diseases which have principally contributed to this were the following—the figures in brackets referring to the number of deaths under 1 year in 1904, and the others to the number in 1905:- Measles, 12 (33); whooping cough, 16 (22); diarrhœa, 111 (148); bronchitis, 39 (55); pneumonia, 68 (84). According to these figures, measles, diarrhœa and respiratory diseases account for the largest part of the reduction, and the reduction in gastro-intestinal diseases is the more remarkable considering that the summer was a very warm one and judging by previous experience liable to produce much diarrhœa. While not wishing to draw hasty conclusions it is noteworthy that this is the first year in which any special attempt has been made to check the infantile mortality, and as reported in last year's Annual Report this was done by the systematic distribution of instructions on infantile feeding whenever a birth occurred. I firmly believe that this work has had some share in the reduction of infantile mortality, but how much it is quite impossible to say. Infantile mortality is only one branch of the larger subject of the preservation of child life and is intimately bound up with other branches of hygiene such as physical degeneration. In preserving the lives of infants you are at the same time improving the health of those which would not have died but would have gone into school life in a more or less unfit condition. The crusade against infantile mortality is comparatively recent and has been occupying more and more the attention of philanthropists in all civilised countries during the last 4 or 5 years. An enumeration of all the methods adopted would be difficult, but some of the principle ones may be mentioned taking them in chronological order. Presuming that the child belongs to healthy parents the first care should concern the pregnant mother, and efforts should be directed to such subjects as employment at this period, proper food and general hygiene. The next stage is the birth, which should be superintended by skilled persons who can see that no injury takes place which may be prejudicial to the child or mother later. The third stage which most immediately concerns us is the care of the child from birth up to the end of the first and second years. The important provisions here are healthy surroundings and suitable food. The former is deal t w ith under our every d a y hygiene measures, the latter rests principally on the mother. Mothers of the poorer classes, unfortunately, owing to industrial conditions, enter into marriage With a minimum of education, especially in household economy and the care of children. Their sole instructresses are as a rule elder relatives or neighbours of the same sex. The only way to get rid of this ignorance is to get the future mothers during their last year at school and teach them some general household economies and follow this up by evening or other classes for a few years longer, so that when they are married, their minds if not very largely stored will yet be receptive to such teaching as they may receive afterwards. When married, further instructions should be given during the period of pregnancy, and here one looks to the general practitioner and the midwife. On birth, a leaflet advising as to infant feeding, and emphasising the paramount importance of breast feeding, etc., should be sent, but the value of this measure would be quadrupled by verbal and practical instructions from a lady health visitor or lady sanitary inspector. I hope soon to see this followed up in the way I have mentioned. For mothers who cannot suckle their infants a pure milk is necessary, and as the trade do not seem inclined to supply this at present, many public bodies do it by starting Municipal Milk Depôts. This method I am in favour of, but within certain well-defined limits, and in combination with regular medical inspection of those partaking of the milk, and general supervision of its use in the home. In connection with the distribution of infant feeding cards, the following are particulars of cases in which the cards have been returned owing to wrong addresses being given to the Registrars of Births, or to the removal of the family between the time of registration and the posting of the card: — Total. False Addresses given. Removed since Registration. Name not known at Address given. No such number in Street. Removed. House unoccupied. 107 75 8 20 4 Senile Mortality. The number of deaths over 65 years of age in 1905 was 458, against 479 in 1904. There was a considerable decrease in respiratory and heart diseases, and an increase in cancer. Death Certification. There were no uncertified deaths in 1905. Deaths under this heading in 1904 and 1903 were 5. Zymotic Diseases. The following table gives the death rates for the principle zymotic diseases. Corresponding figures are given for London for comparison. Table G. Year. All Causes. Principal Zvmotic Liseases. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric Fever. Simple Continued Fever. Diarrhœa. No. Rate. No. Rate. No. Rate. No. Rate. No. Rate. No. Rate. No. Rate. No. Rate. No. Rate. No. Rate. No. Rate. 1895 2966 21.6 411 2.99 1 .00 .99 37 .27 - - 22 .16 - 136 24 .17 64 .46 - 127 92 129 .94 1.06 - 24 .17 .73 1896 2968 21.6 542 3.95 - .25 108 .79 146 - - 100 35 - - 537 1897 2902 21.4 3.95 103 .76 58 .43 85 .62 87 - 16 - - 188 1.38 - .64 - .12 - 1898 2776 20.6 375 2.79 97 .72 30 .22 58 .43 73 11 .08 106 1 .79 - .54 - - - - - 1899 3204 24.1 3.31 - 92 .69 23 .17 129 .97 43 .32 2 .01 31 - - .90 440 .23 120 - 1900 3062 23.2 437 3.32 - 87 .66 14 .11 .67 94 .71 - - 117 88 - 37 .28 - .89 - 1901 20.8 387 14 .10 76 .58 45 .34 .27 56 .42 22 .16 5 .03 133 2719 2.96 36 - 1.0 - 31 1902 2756 21.2 396 3.06 .24 154 1.19 18 .14 29 .22 64 12 .09 88 .49 - - - - .68 1903 2382 18.4 251 1.96 - 50 .39 25 .19 18 .14 41 .03 11 .09 .32 4 - - 103 .80 - 447 1904 2593 20.1 3.46 136 .13 68 - 16 3 .02 189 1.05 18 .14 17 .53 .13 1 .46 - - - 127 422 .03 .80 29 71 .53 .6 .00 20 .15 Average for years 1895-1904. 4.6 106 .47 .8 3.17 .22 63 0.00 2833 21.3 .95 2.23 59 .45 .13 - 1905 2399 .01 .14 .29 - .07 - 287 1 17 18 38 9 - 145 18.6 1.13 - London 1905 70442 1.68 1709 .36 546 234 .05 .00 3356 .72 10 .12 1487 .32 3 7894 .12 - 15.1 .00 549 There has been a great reduction in deaths from these diseases, the figures being 287 against 447 in 1904, and 422 the average for the last ten years. This gives a zymotic death rate of 2.23. The total deaths for notifiable diseases, viz., smallpox, scarlet fever, diphtheria and enteric fever were 45, compared with 54 in 1904, and for the non-notifiable, viz., measles, whooping cough, and diarrhœa, were 242, compared with 393 in 1904. The reduction is therefore solely in these. Smallpox. There was one death from this cause in 1905. It was of a sailor, unknown, aged 38, who was removed from his ship to the Seaman's Hospital, Greenwich, and from hers to the South Wharf. He was too ill to give particulars of his name, residence, etc., and died at the latter place. Measles. There were 59 deaths due to this disease, which is 47 below the average for the last ten years, and 77 below the number for 1904. The deaths occurred in quarters as follows, viz.:— 16, 18, 8, 17. The greatest number occurred in the second quarter similar to 1904. Whooping Cough. 38 deaths were due to this cause, against 68 in 1904; of these, 18 occurred in the first quarter, 7, 8 and 10 in the other quarters respectively. Typhus Fever. There were no deaths from this cause in 1904. Enteric Fever. 9 deaths were due to this cause; 7 in Bermondsey, 1 in Rotherhithe, and 1 in St. Olave's. The corresponding figures for 1904 were 16 for the Borough, viz., 8 in Bermondsey and 8 in St. Olave's. Simple Continued Fever. No deaths were attributed to this cause in 1905. Diarrhœa. Under this head are included: — Epidemic enteritis. Zymotic „ Epidemic or summer diarrhœa. Dysentery or dysenteric diarrhœa. Choleraic diarrhœa, cholera, cholera nostras (in absence of Asiatic cholera). 145 deaths were due to diarrhoea, viz., 90 for Bermondsey, 37 for Rotherhithe, and 18 for St. Olave's. This is a considerable improvement on last year, the number for which was 189, but it is above the ten years' average of 127, which itself is high. 11l of these deaths occurred in the first year of life, 29 between one and two years, and sat older age periods. This reduction cannot be altogether explained by climatic influences, since the summer was up to the average as regards both heat and rain, and, as inspection of the annexed table shows, little, if at all, cooler or dryer than 1904. During the severe diarrhoea months, i.e., up to the end of the first week in September, the difference in the weekly deaths of the two years is more marked than after this date. In 1903, on the other hand, the heat was much less and the rainfall much more than in 1904, resulting in less diarrhoea. I should be inclined to attribute some part of the diminution to the various precautionary measures which have been taken by the Borough Council, how much it is impossible to say. Such measures have taken the form of instructions on infant feeding which were delivered to every family in the Borough to start with, and have been sent systematically to families where there have been births from April onwards. Besides there were various notices on this subject not only in the local press, which devoted a large space in one issue to the action of the Council, but notices have from time to time appeared in the other metropolitan papers on the action of the various sanitary bodies on the same subject. All education is necessarily slow, but signs are coming that the middle classes have taken the subject seriously, and that some of the information has begun to percolate into those classes for which it is intended. Table H. Rainfall. Deaths from Diarrhœa. Temperature of ground 3 feet below surface. Temperature of the Air. Weeks. 1904. 1905. 1904. 1905. 1904. 1905. 1904. 1905. ° 0 0 ins. ins. —- 0 63.58 67.1 65.2 63.59 0.04 0.02 10 4 July... ... ... | ( 64.23 1.83 0.53 66.3 64.21 10 8 65.4 0.08 68.1 62.2 64.53 64.19 0.65 25 14 0.06 64.62 August 61.0 60.3 63.04 0.16 20 16 0.47 62.1 62.62 59.5 63.26 0.03 29 17 0.22 0.48 57.6 60.2 61.58 62.37 23 13 61.37 61.33 1.21 17 61.0 56.7 1.01 13 September ... ... 60.57 60.97 0.36 0.68 8 57.0 61.0 7 56.4 54.2 59.29 59.96 0.24 0.33 5 4 58.13 53.6 54.3 58.47 0.20 0.01 9 8 56.72 57.43 1.27 52.1 53.0 0.14 5 8 56.03 50.3 48.8 56.10 0.86 0.16 1 October j 3 0.02 48.6 54.46 54.45 0.16 6 47.8 4 53.74 0.43 0.13 2 54.9 41.0 52.35 2 0.41 9 60.15 60.08 0.42 12 Weekly average 56.71 58.0 Table I.— Deaths from Diarrhœa. Year. Cases Inquired into. State of Premises. Family. Method of Feeding. Overcrowding Breast. Artificially. Partially by Both Methods. Dirty and Improvident. Good. Defective. Clean and Careful. Fair. 13 - 49 4 59 23 2 70 2 1901 74 6 21 18 1 37 3 33 1 1 1902 40 3 2 8 22 38 29 8 - 1903 40 15 115 54 6 14 82 55 101 16 17 - 1904 65 56 29 3 56 9 5 4 1 1905 33 32 2 173 15 302 48 259 27 Total 146 334 This table once again confirms the advantages of breast feeding. There is no doubt that artificial feeding is one of the great evils of the present day, and all efforts to improve the food of infants must be directed in the place to an endeavour to get mothers to suckle their infants. Artificial feeding should only be resorted to when a mother's milk cannot be got. Milk untreated by cooking or preservatives, i.e., fresh, is a living food. It contains ferments and organised substances, which come direct from the mother's body, and all cooking and doctoring take away from its nutritive value. The organic and chemical combinations of milk are so complex that we are as yet unable to get beyond anything but a very coarse analysis, and for this reason efforts should be directed to getting a pure supply which does not require cooking or preservatives to keep it. Tubercular Diseases. The number of deaths from all forms of tubercular diseases in 1905 was 325, against 350 in 1904. This figure comprises 217 for Bermondsey, 85 for Rotherhithe, and 23 for St. Olave's. Of this 825, 223 were due to phthisis, and 102 to the other tubercular diseases. By this there was a diminution of 34 on the year previous and of 38 on the ten years' average, There was a slight increase of 9 deaths in the tubercular diseases other than phthisis during 1905 —the actual numbers being 102 and 93 — but it is probably accidental. Phthisis. In Table J will be found particulars of deaths from phthisis since the year 1895. There were 223 deaths due to this cause, which is a diminution of 34 over 1904. There is no doubt 10 that deaths from this cause are diminishing all over the kingdom, and though the figures seem irregular in Bermondsey, still I think one may conclude that there are indications of a change for the better here. The subject will be considered later under "Notification." Table J. Phthisis. SUB- DIST. BERMONDSEY. ROTHERHITHE. ST. OLAVE'S. WHOLE BOROUGH. LONDON. Year. No. No. Rate. Rate. No. Rate. Rate. No. Rate. No. 76 298 1895 2.22 2.69 7742 1.89 2.16 32 190 1.77 2.24 176 2.06 90 2.23 26 292 7567 1896 2.13 1.68 1.60 2.94 174 2.05 64 33 271 7629 1897 1.99 1.71 74 1898 184 2.19 25 2.31 7746 1.87 283 2.10 1.72 1899 75 28 286 8275 183 2.19 1.92 2.68 2.15 1.82 169 2.04 47 2.88 235 7809 1900 1.21 29 1.78 1.71 19 1901 150 57 1.95 226 1.66 1.82 1.48 1.73 7514 55 1.43 21 239 7424 1902 163 1.98 2.22 1.83 1.62 1.46 1.79 18 221 7124 1903 147 56 1.96 1.70 1.54 1904 165 1.57 31 7526 2.02 60 3.48 257 1.99 1.62 26 261 Averages for years 1895-1904. 2.53 2.04 1.68 170 65 1.67 1.96 7636 1.81 55 1.73 6622 1905 223 1.44 20 2.32 148 1.42 Alcoholism and Cirrhosis of the Liver. 32 deaths were attributed to this cause in 1905, against 89 in 1904. As remarked in previous reports these deaths give a very small idea of the deaths caused by these diseases, since they are often the remote causes of death and are not always mentioned on the certificate for various reasons. Cancer and Malignant Disease. 109 deaths were attributed to this cause, 103 being due to carcinoma or cancer as ordinarily understood, and six to sarcoma. Unfortunately the figures from these diseases show an upward instead of a downward tendency as in phthisis. What the cause of this, is is still under investigation. One school hold that the increase is apparent and the other that it is real. Until the Cancer Research Committee issue their final report we will be obliged to remain in the dark. Particulars of the last three years combined will be found in annexed table. Table K. Cancer. Deaths during 1903, 1904 and 1905. Forms of the disease. Sex. All ages. 15 to 20. 20 to 25. 25 to 35. 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 85 and upwards Male. Female Male. Female Male. Female. Ma le. Female. Male. Female. Male. Female. Male. Female. Male. Female Male. Female. Cancer of rectum 33 ... ... ... 1 ... ... ... 1 4 7 6 4 4 3 ... 1 1 1 Cancer of stomach 47 ... 1 2 10 1 ... ... ... ... 3 8 ... 9 4 6 3 ... 1 ... Cancer of bowel 13 ... 2 1 2 1 1 1 ... ... ... ... ... 4 ... ... ... ... Cancer of liver 30 ... ... 3 1 2 6 3 ... ... ... ... 1 1 4 7 1 1 ... Cancer of breast 28 1 10 4 1 ... ... 5 1 7 ... ... ... ... ... ... ... ... ... ... Cancer of female pelvis and uterus, etc. ... 4 1 55 ... 7 17 19 ... ... 7 ... ... ... ... ... ... ... ... Cancer of œsophagus 16 3 1 1 ... ... ... 2 5 ... 4 ... ... ... ... ... ... ... ... Cancer of mouth, tongue and pharynx, cheek and lower jaw ... 1 1 ... ... ... 7 24 6 2 ... ... ... ... 3 ... ... ... Cancer of peritoneum 6 ... ... ... 1 1 2 1 1 ... ... ... ... ... ... ... ... ... ... 37 ... Cancer of other parts ... ... 2 2 5 3 8 ... 1 ... ... 7 6 3 ... ... ... ... Malignant disease, kind not stated 4 ... ... ... 1 1 ... 1 ... ... ... 1 ... ... ... ... ... ... ... Sarcoma 16 2 1 2 2 3 2 1 1 1 1 ... ... ... ... ... ... ... ... 2 2 1 2 8 13 24 31 44 44 52 35 2 13 1 3 Totals 309 2 30 Heart Diseases. 132 deaths were due to this cause, which is 22 below the figure for 1904. This table refers to organic or valvular disease of the heart. Suicides. 11 persons belonging to the Borough committed suicide in 1905, viz., 4 by poison, 2 by hanging or strangulation, and 5 by drowning. This total is exactly the same as that for 1904, bat in the latter year there was more variety in the methods employed. DIPHTHERIA Accidents. 113 deaths were due to accidents, against 103 in 1904. Particulars will be found in the extended table of the "Causes of Death." Other Violent Deaths. There was one death by homicide and was caused by enforced inhalation of ammonia. II- NOTIFICATION OF INFECTIOUS DISEASE. In Table III. of Appendix will be found particulars of infectious diseases notified in Bermondsey during the year 1905. During this year there was a considerable increase of notifiable disease, this increase being due to the greatly increased prevalence of scarlet fever. The number of cases notified in 1905 was 1139, against 926 in 1904, and 867 in 1903. The diseases which show an increase are scarlet fever (317), and puerperal fever (3); and those which show a decrease are small-pox (19), diphtheria (27), enteric fever (31), continued fever (1). The numbers in the registration sub-districts were: — Bermondsey 570 against 575 in 1904, Rotherhithe 508 against 306 in 1904, St. Olave's 61 against 69 in 1904. From these figures it is evident that while there has been a small increase in Bermondsey and St. Olave's, there has been a remarkable increase in Rotherhithe. This increase is due solely to a prevalence of scarlet fever, the figures of all the other diseases showing a considerable diminution, the numbers being 1905 (409), 1904 (163), 1903 (71). This subject is referred to again under "Scarlet Fever." The attack rate of these diseases per 1,000 inhabitants was 8.8 for the whole Borough, the rate for the sub-districts being, 6.9 Bermondsey, 13.3 Rotherhithe, and 7.1 for St. Olave's. The corresponding figures for 1904 were 7.2 whole Borough, 6.9 Bermondsey, 8.0 Rotherhithe, and 5.5 St. Olave's. The attack rate for Rotherhithe in 1908 was 4.8. The number of cases of scarlet fever are thus not only relatively greater than in Bermondsey, but absolutely, since the figures are 409 Rotherhithe and 329 Bermondsey. 40 cases were returned from hospital as not suffering from the diseases for which they were notified, but reasons have been given in previous reports for considering the total number of cases notified as representing more nearly the actual number occurring than the figure left after deduction of cases sent home again, the principal reason referred to being the number of mild cases which go unnotified. This argument is specially applicable to the present year. Small-pox. There was no case of small-pox notified in Bermondsey during 1905. A death occurred at the South Wharf from this disease, which was allocated to this Borough. For the explanation see among "Deaths." Typhus Fever. No cases of this disease occurred in Bermondsey during the year under report. Diphtheria. There were 165 cases of diphtheria notified in 1905, of which 113 occurred in Bermondsey, 40 in Rotherhithe, and 12 in St. Olave's. This is a decrease on 1904, for which the figures were Borough 191, Bermondsey 123, Rotherhithe 60, and St. Olave's 8. These numbers are very satisfactory, since this is the smallest number of diphtheria notifications since the formation of the Borough, the nearest approach being 1903 when the number was 174 (including two cases of membraneous croup). The attack rate per thousand persons living was 1.3, and as there were 18 deaths, the case mortality was 10.9 per cent, against 8.9 in 1904, and 10.5 in 1903. The accompanying chart shows an even distribution in time, and an examination of Table III. in the Appendix does not reveal a preponderance of cases in any particular Ward. 13 cases were returned from hospital not suffering from this disease. This is only about half the number returned last year. During 1905 more specimens were sent in by general practitioners than 1904, 108 against 91. Of the 108 examinations made, 20 were positive and only one was returned from hospital in which Klebs-Leoffler bacilli had been found. An isolated case of this sort does not necessarily prove either the hospital or me to be wrong. Diphtheria bacilli have a mysterious way of either disappearing quickly from some throats or else becoming hidden, so that when the throat of a child is examined at a few days' interval the bacilli which were evident on the first occasion fail to show themselves on the second one. The plan of examining all diphtheria contacts before permitting them to return to school inaugurated in 1903 has been continued unaltered. For the details the Annual Reports for 1903 and 1904 may be consulted. It has worked without friction and no school contact that we are aware of has escaped. The number of contacts examined for school attendance was 108, belonging to 41 families. Out of this number 8 had diphtheria bacilli in their throats or noses, and of these 4 subsequently developed clinical symptoms of diphtheria and were notified as such. Those contacts who did not develop symptoms were advised to get an antiseptic gargle from their medical Attendant, and did not return to school till their throats were free from infection as proved by a subsequent examination. One case deserves special mention to show the difficulty of getting rid of the bacilli. M. F. (F.) 10 years, of Abbey Buildings, was removed to hospital with diphtheria on September 2nd, 1905. An elder sister attending a school in the neighbourhood came for examination on September 8th. As she had a nasal discharge a swab was taken from her nostrils as well as the throat. Plentiful diphtheria bacilli were found in her nose but none in the throat. She was recommended to get the nose syringed by boric acid and permanganate solutions as well as carbolic acid, but subsequent examinations on September 21st and October 3rd still showed the presence of diphtheria bacilli. After the last examination I had the bacilli tested for virulence by Dr. Eyre, of Guy's Hospital, who stated they were genuine Klebs-Loeffler bacilli of low virulence and suggested syringing with formalin. She was therefore supplied with a solution of 1 in 1,000, and told to syringe four or five times daily. About October 17th two examinations were made, when the nose was found quite free as well as the throat. The points about this case were : —(1) The persistence of the infection in the nose alone, and (2) the resistence of the organisms to the ordinary antiseptics. Such cases as this are extremely likely to spread infection among school children without giving any indication of the source of infection. In 12 eases of diphtheria the source of infection was attributed as follows: — Previous cases in house or family 7 From friends (visiting) 1 t Patient picks up cigarette ends in street 1 Drains up in workplace of patient 1 "1 "Eetum"case 1 Patient previously had diphtheria, returned home, and renotified in 23 days 1 Scarlet Fever. There were 768 notifications of scarlet fever, 329 for Bermondsey, 409 for Rotherhithe, and 30 for St. Olave's. This is an increase of 317 for the Borough on the number for 1904. While, however, the increase in Bermondsey and St. Olave's might be considered normal, i.e., coincident and proportion, to a general rise of the disease in London during 1905, that in Rotherhithe is abnormal: thus Bermondsey shows an increase of 61 over 1904, while Rotherhithe, with just half the population, shows an increase of 246 over the year previous. As statistics in wards were not kept prior to 1905 it is impossible to say in which Wards the increase took place, but an examination of Table 111. of Appendix will show that the cases were very evenly distributed in Bermondsey, thus suggesting no more prevalent cause in one Ward over another, and that on the contrary Rotherhithe with Ward population of 15,000 in 1 and 2, and 8,000 in Ward 3, shows a great preponderance in the first named, not only over the other Wards in the same district, but over any Ward in Bermondsey, the actual numbers being 206. No. 1 Ward, Rotherhithe, has a density of population of 118 persons per acre, which is higher than the remaining Wards, but is considerably lower than most of the Bermondsey Wards, so that density of population as recorded on this basis will not account for it. An examination of the distribution in time, of the cases in Ward 1, Rotherhithe, reveals nothing striking, since they occurred fairly evenly throughout the year with the exception of some increased prevalence in the end of August and the beginning of September. Eighteen cases were returned from hospital as not suffering from scarlet fever, and considering the mildness of the type and the difficulty of diagnosis this may be considered a very small number. Even about these cases there must have been considerable difficulty, since they were retained varying periods, 2 to 4 weeks, before being sent home, the average before being sent home being 19 days, and in some of these I do not think that the diagnosis was finally set at rest by the certificate of the Medical Superintendent of the hospital where the case was sent. The accompanying chart tells a very different tale from 1904, when the weekly numbers were not so fluctuating. In 1905 there was a steady rise of notifications from July till the third week in November, when a maximum of 38 in one week was reached. This is in accordance with the normal curve of scarlet fever in London, which always show a maximum in the autumn and a minimum in the spring. Out of the 768 cases notified there were 17 deaths, making a case mortality of 2'2 per cent. This is very low and shows the mild type of the disease. The case mortality in 1903 was 6 - 25, in 1904, 3-9. The attack rate per 1,000 living inhabitants was 5*9, compared with 3'49 in 1904. In 120 cases the source of infection was attributed as follows : — Previous cases in house or family 47 From friends (visiting) 8 Cases contracted in hospitals where they were sent for other reasons 4 School infection 35 " Return" cases * 26 These include 4 cases in which the source of infection was attributed to cases returned to neighbouring houses. It will be seen from this in how large a number of cases the source of infection is unknown and this is quite in keeping with the mild character of the cases; and the view I have expressed in every annual report, that the source of infection of a very large number of cases of infectious disease is unrecognised cases, appears to find confirmation here. SCARLET FEVER. TYPHOID FEVER. The percentage of " return cases " was 3.38 of the total cases notified. This question was the subject of a short report to the Public Health Committee in September, owing to a communication from Wcolwich Borough Council on a report of their Medical Officer, Dr. Davies. The matter came before them a second time a little later, owing to the issue of Dr. A. G. R. Cameron's elaborate report on the subject. This was referred to me, and the following is my report on the subject:— " Return Cases." This subject has been before the Committee on several previous occasions and has given rise to severe criticism of the Metropolitan Asylums Board by public bodies and others interested in it. That the Board are anxious to put an end, if possible, to these so-called return cases is evident from the investigation which they have caused to be made. Professor Simpson was first appointed and his inquiry" extended from October, to March, 1899. Dr. A. G. R. Cameron was appointed in 1901 to continue prof. Simpson's work, and we received in September, 1905, his report the publication of which was delayed. " Th is cover s a period extending from July Ist, 1901, to July 31st, 1902, and his investigations were completed at the end of July, 1903. "The main object of the work was to ascertain the conditions under which 'return cases' arise, and to discover whether their incidence bears any relation to their period of detention in hospital. " The report is a very long one and consists of 224 foolscap pages. The total number of inquiries were about 900, 800 of which concerned 'return cases' of either scarlet fever or diphtheria. "Dr.Cameron defines a ' return case 'as one which is alleged to have contracted infectious disease from another case discharged from hospital, and the case which causes the infection as the 'infecting case.' "The volume consists of the report proper and the appendix. The former contains three parts, the first of which is devoted to scarlet fever, the second to diphtheria, and the third to cases of mixed infection. The appendix gives further particulars of return cases, and at the end 28 pages are devoted to observations and criticisms by the medical superintendents of the various hospitals under the Board, on the body of the report "The conclusions as regards scarlet fever are embodied in 34 paragraphs and for diphtheria in 13. Unfortunately they are not very definite on the main issues, and point to the necessity of still further investigation. "It would appear from this that there is no very constant relationship between length of stay in hospital and inactivity, and also that patients which have suffered from complications, especially nasal discharge, are more likely to infect others. "A number of recommendations and suggestions are made by Dr. Cameron and the Medical Superintendents, and these I am informed are now under the consideration of a special sub-committee. One of them has already been adopted, and is in the form of a circular which is handed to the parents or guardians of every child discharged after scarlet fever. It reads as follows:— "It is recommended— 1. That for three weeks after leaving hospital the patient should not sleep in the same bed (or, it possible, the same room) as children who have not had scarlet fever. 2. That during this period articles used by the patient (such as cup, plate, spoon, handkerchiefs, towels, toys) should be kept distinct from those used by other children. 3. That the patient should not attend school for three weeks. The above precautions are especially important in the case of those patients who suffer from discharge from either nose or ears. " I may add that I have sent out a somewhat similar circular to all discharged patients during the greater part of the past year, but have stopped it now that the Board have taken the matter up." Enteric Fever. 42 cases of this disease were notified in 1905, being 24 in Bermondsey, 11 in Rotherhithe Nine eases were returned as not suffering from enteric fever, making the actual total 33. This is a considerable diminution on 1904 and 1903, when the numbers were respectively 73 and 76 and is very satisfactory. On enquiries by the District Inspectors as to the sources of infection, the following information was received :— In 14 cases of enteric fever the source of infection was attributed as follows: — 7 patients were in the habit of eating watercress. „ „ mussels. „ cockles and whelks. 1 patient ate refuse picked up in the street. 1 patient washed dirty tins over sink. . ere has been a remarkable absence oi any of those localised outbreaks which occurred in previous years in families or groups of houses. ■ There were 9 deaths, which makes a case mortality 21'4. Continued Fever. The cases notified under this head are usually anomalous ones of enteric but none occurred in 1905. Puerperal Fever. 7 cases of puerperal fever were notified in 1905, and 4 of these died. Measles. This disease has been much less prevalent in Bermondsey during 1905 than the previous year. The number of deaths for 1905 was 59, against 136 in 1904. The annexed table gives the number of notifications received from the schools, the number of " contacts " excluded, and the number of deaths, in fortnightly intervals : — Fortnight ending Patients. "Contacts." Deaths. 3 January 14th 9 10 January 28th 11 8 1 February 11th 13 14 2 February 25th 29 35 2 March 11th 61 53 3 March 25th 63 45 5 April 8th 41 16 2 April 22nd 13 25 4 May 6th 3 12 14 31 May 20th 17 3 June 3rd 2 8 20 June 17th 30 56 - July 1st 17 48 - July 15th 48 22 2 July 29th 13 37 4 August 12th August 26th Schools I closed 1 ? 1 September 9th 9 1 September 23rd 1 13 2 1 October 7th 3 1 October 21st 9 21 2 November 4th 7 14 1 November 18th 7 14 - December 2nd 12 46 3 December 16th 6 30 3 December 30th 3 7 8 353 59 670 This table of school notification also shows a diminution of cases, and shows March as the period of greatest prevalence. The diminution is probably due to exhaustion of susceptible material during 1904, and is probably also on this account only temporary. The control of this disease is a constantly recurring question, and is a never ending source of controversy by public bodies interested in elementary education. An interesting experiment is being tried in Woolwich of treating a selected district specially. In one half of the district it is attempted to suppress measles by vigorous class closure, and in the other individual exclusion is the means adopted. A report on what has already been done has been incorporated in Dr. Kerr's report to the Education Committee of the London County Council, up to the end of March, 1905, but no final conclusion as to which is the best method has so far been arrived at, though a great deal of useful information on the subject has been collected. The general conclusion of the Medical Officer (Education Department) is that "probably, exclusion of non-protected individuals will be the ultimate solution of the attendance problem in face of a measles outbreak, and it is very doubtful whether exclusion of children, themselves unaffected but coming from affected households, is required in any except the infants' departments." On examining Table IV. in appendix it will be seen that 57 deaths of the 59 occurred under 5 years of age. In other words, that while older children may be equally susceptible to measles, it is not nearly so fatal to them. Any measure, therefore, which postpones the disease to a period subsequent to five years will be valuable, and lessen the mortality. The large majority of young children acquire infection at school, and it seems to me that the best method of preventing spread of this disease would be to prohibit children attending school till they are six years old. It is quite early enough to begin education, and anyone who goes into an infant department must be pained to see young children of from 3 to 5 sitting in constrained positions, many of them finding it very difficult to keep awake. No child in Germany attends school till between 6 and 7, and it would be much better for the health and eyesight of English children if they also were allowed to play in the open air till this age and discouraged engaging in near work. An endeavour is made to control measles in this district by excluding the patient for at least one month, and the contacts of the first case in the household for 3 weeks, at the end of which time the house and all infected articles are disinfected. When this is done a certificate is sent to the school stating that this has been done. There has been no reason for altering this plan during the year, but when the final report of the Medical Officer to the Education Department of the London County Council, and the Medical Officer of Health for Woolwich is issued it may be advisable in the light of fresh information as to its mode of spread and like matters, to reconsider some of the details regarding the length of time of exclusion of contacts, the value of disinfection, etc. The Public Health Committee made the following report to the Council on November 7th:- Measles —Exclusion of Scholars from School. We report the receipt of letter from London County Council adverting to this Council's letter of the 3rd July, 1905, and stating that the Committee have had under consideration the question of the exclusion from school of children coming from houses where there has been an outbreak of measles, and that they are desirous of minimising any risk of infection among the scholars in the schools. With that view they propose m respect of schools or class rooms closed on account of the prevalence of measles among the scholars to issue a notice to parents warning them of the possibly dangerous nature and very contagious character of the disease, and of the necessity of preventing children suffering from it going into public places or coming into contact with other children. The London County Council add that with regard to children coming from houses where measles exists, it is the practice of teachers to exclude them from school for a period of two weeks from the date of the occurrence of the last case. We have given instructions for a reply to be sent to the County Council stating that we still consider that the practice adopted by our Medical Officer, i.e., excluding patients for one month from commencement of the illness and contacts 3 weeks, subject to a certificate as to disinfection being produced, is preferable to the procedure adopted by the County Council, and we trust they will again consider the matter with a view to altering their regulations; farther, in regard to notices to parents.it has been the practice for some considerable time for this Council, to issue warning notices to parents. ° Chickenpox. ThiS disease was not notifiable durin S 1905, but 159 children were excluded from school as suffering from this disease against 156 in 1904. Membraneous Croup. There were no notifications of this disease. Notification of Phthisis. 54 cases of phthisis were voluntarily notified during 1905. These were notifications of fresh cases the corresponding number in 1904 being 128. This diminution is what might partly be anticipated since payment is not made for re-notification of same case. All these were visited by myself but regular disinfection was carried out in only 18 cases. The most which people could be prevailed upon to do was to wash floors, oilcloths, etc., with strong solution of carbolic, and cleanse the walls about the patient's bed and boil those articles in use which could be subjected to this process. The usual leaflet was also sent to each case and particulars obtained as to the illness. The total disinfections carried out in this disease were 57. The annexed table gives the occupation of all cases notified up to the end of 1905. I feel confident that voluntary notification is very useful, and that those patients who are thus rendered accessible to instruction have profited both personally and as to their families. I think in London that it should be universally adopted and followed later by compulsory notification. I hope also to see at no distant date accommodation provided for the poorer eases and suitable for cases that can be relieved or cured, and also for incurable cases. The latter accommodation is most urgently needed. Notification of Phthisis. Under 1 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards ALL AGES. OCCUPATION. Barmaid ... ... ... ... ... 1 ... ... 1 ... Book Keeper ... ... ... 1 ... ... ... ... 1 Builder's Labourer ... ... ... ... ... 1 ... ... 1 Butcher ... ... ... ... ... ... 1 ... 1 ... Book Folder 1 ... ... ... ... ... ... 1 ... 2 Book Binder ... 1 ... ... ... ... ... ... ... ... 1 ... Boot Repairer ... ... ... ... 1 ... ... ... 1 Buttonhole Maker 1 ... ... ... ... 1 ... ... 2 Card Maker ... ... 1 ... ... ... ... ... ... 1 ... Carman ... ... 1 ... ... ... ... Cashier ... ... 1 ... ... ... ... ... 1 ... 1 1 Charwoman ... ... ... ... ... ... ... 1 Clerk 1 ... ... ... 4 ... ... 2 ... ... ... ... ... ... 6 Collar Turner ... ... ... ... ... ... 1 ... 1 Compositor ... ... ... 1 2 ... 1 ... ... 4 Cook ... ... ... ... ... 1 ... 1 ... ... Carried forward - - 7 10 1 - 7 1 - 26 Under 1 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 _ 65 and upwards Brought forward 10 1 7 ... ... 7 26 ... 1 ... Cork Cutter ... ... ... ... ... ... ... 1 1 ... Cornchandler ... ... ... ... 1 ... 1 ... ... ... Domestic Servant and General Work ... ... 1 1 ... ... ... 1 2 5 Dressmaker ... ... ... 1 2 ... ... ... 3 .. Engine Driver ... ... 1 ... ... ... ... ... 1 ... Engineer's Labourer ... ... 1 ... ... ... ... 1 ... ... Envelope Maker ... 1 ... ... ... ... ... 1 ... ... Fitter ... 1 ... ... ... ... ... 1 ... ... Forewoman (wholesale grocers) ... ... ... 1 ... ... 1 ... ... ... Fur Dresser ... 1 ... ... ... ... 1 ... ... ... Fur Puller 1 ... ... ... ... 1 ... ... ... ... Gas Meter Manufacturer ... ... 1 ... ... ... ... 1 ... ... Grocer's Assistant ... 1 ... ... ... ... ... 1 ... ... Glove Maker ... ... ... ... ... ... 1 ... ... ... Hatter 1 ... ... ... ... ... 1 ... ... ... Housewife 4 21 20 11 4 2 ... ... 62 ... Indoor Porter ... 1 ... ... ... ... 1 ... ... ... insurance Agent ... ... ... ... 1 ... ... ... ... ... In Cold Store ... ... ... 1 ... I - 1 ... ... ... In Confectioner's Shop ... I ... 1 1 - ... I - ... ... I - Jam Factory hand ... ... 1 1 1... 1 ... ... ... I "■ ... Lambswool Cutter ... 1 1 ... 1 ... ... I ... ... ... ... I 1 1 Lace Tagger ... ... I I - ... ... ... ... ... "2 3 Laundry ... 1 I ... I ... ... ... ... Labourer (waterside) I 2 4 I 1 8 ... ... ... 1 ... ... Labourer (iron work) I ... I 1 ... 1 ... ... ... ... ... ... ... Labourer (general I 2 6 ... o tj 2 ... ... I - ... 1 ... Lighterman ... ... ... ... 1 ... ... ... Lead Worker ... ... ... I 1 ... 1 I ... ... ... 1 Leather Worker ... ... 2 1 ... 4 ... I - ... Lath Maker ... ... I 1 I o ... ( - ! i ... I - ... Machinist ... ... 1 I ... 1 ... I 5 -I ... 3 ... I 1 Manager of Cleaning Co. ... ... ... [ ... I ... ... 1 ... Mat Weaver 1 1 ... ... I - I ... ... ... ... ... Mantle Maker ... 1 1... ... ... ... I - I ... ... 1 Messenger ... ... j ... ,1 ... 1 ... ... ... ... I 1 Niglifc Watchman ... ... I ... ... 1 ... ... ... ... > I - Office Cleaner ... ... ... 1 ... ••• ... ... Paper Bag Maker ... 1 ... 1... ... 1 ... ... I - ... Park Labourer ... 1 - 1 ... ... I - ... I - ... 1 ... 1 Porter ... ... I ... ... I - ... ... 1 » 1 4 Printers ... I - ... ... ... ... Printing Machine Minder 1 ... ... 1 ... I ... ... I ::: ... ... I 1 1 Printer's Warehouseman ... ... ... ... ... ... ... I - [ 1 1 Spring Blind Maker ... ... ... ... ... I - ... ... i 1 1 Smelter ... ... ... ... ... ... ... ... i 1 Stevedore ... 2 ... ... ... ... ... ... 1 1 Sackmaker ... ... ... I ... ... ... ••• ... Seamstress ... I 1 2 ... ... 1 ... ... ... ... Chip's Steward I ... ! I 1 ... I I I - ... 1 ... I 1 ... ... ... 1 I - 1 Sail Maker ... ... ... ... ... ... ... ... 1 I ... 1 Sailor (H.M. Navy) ... ... ... " ... ... 1 ... i Soldier ... ... ... ... ••• ... ... 1 ... ... ... ... 1 ... Sawyer ... ... ... 1 i ... ... School Teacher ... ... ... ... ... ... I X 15 15 ... ... Scholar ... ... I - ... ... ... 1 ... 1 2 Tailor's Assistant ... ... ... ... ... ... j 1 2 ... 1 I - ... Tin Work ... ... ... ... ... ... 1 ... 1 I - Tie Workers ... ... ... ... JL 2 2 ... ... ... 1... ... ... Telegraphist ... ... ... 1 1 Tobacco Hand ... ... I - ... ... ... ... ... 1 "Watcher (Customs) ... ... ... I 1 ... ... ... ... ... I ... 1 1 ... ... Whitesmith ... ... ... ... ... 1 1 8 ... ... ... 1 ... ... Warehouseman ... 1 ... 1 I - ... ... Waitress ... ... ... ... 1 1 ... ... ... I - ... Woodcliopper ... ... ... 10 ... I r: ... No occupation 10 ... ... ... ... ... 6 55 ... 9 8 12 ... No information ... ... ... ... u 10 15 42 64 56 43 14 5 Totals 249 ALL AGES. Anthrax. The following is a list of the cases of anthrax which occurred in connection with the Borough in 1905. Date notified 1905. Name and Address of Patient. Part Affected. Result of Illness. Occupation. Source of Infection. Sept. 21 M. B. (female), 16, Goulston Buildings Employed at St. Olave's Wharf Right Cheek Handling wet and damaged China hides on Sept. 13 Died Nov. 16 J. H., 53, Yald- ing Road Labourer, Ellis & Co., Horney Lane Front of Neck Carrying hides Recovered Dec. 3 S. B. F., 3, Ban- try Place Employed at Messrs. Bevington & Son Right lower jaw Unhairing goat skins Recovered Dec. 5 J. C., 6, Crosby Row Tower Bridge Wharf Left side of neck Worked on piles of dry foreign hides Recovered On May 25th information was received that Messrs. Cheverton & Co., Tyer's Gateway Possession of 121 call hides which were alleged to have come in contact with a hide infected with anthrax during the journey from York. Information was received from another source that they had not been m actual contact although they had been in the same van, but as a matter of precaution they were all disinfected in a solution of chloride of mercury. Infectious Disease—School Closure. The following reports relating to infectious disease in schools have been made to the Public Health Committee during the year:— 28th March, 1905. There have been several cases of scarlet fever in connection with Alexis Street School. The following is a list of the recent notifications:— Date Notified. Name. Age. Sex. Address. Class-room. 12 Feb. 10, 1905 A. G. P. Male 47, Rouel (6) Boys. B & C Infants. „ 27, „ E. L. 4½ Female 107, Southwark Park Road Mar. 1, „ Male E. H. 4 4, Macks Road „ 6, „ M. D. 5½ Female „ „ 118, Lucey Road F „ „ 11, „ J. S. 4 Male 44, Rouel Road B & C „ „ 12, „ J. H. C. 4 Female 20, Lucey Road 4 „ 12, „ W. C. Male „ „ 96 „ „ „ „ 18, „ J. S. 6 Female 12, Yalding Road E „ „ 18, „ G. S. 8 Male 12, „ 2 Boys. „ 20, „ D. S. 4 Female B & C Infants. 12, „ B and C are two class-rooms situated close together and occupied by babies. The childrenare constantly interchanging and mixing with one another, so that these practically count as one room. It would seem from the dates that the cases up to March 12th became infected from one another in this class room. The last case on the list did not apparently receive infection from this source but from the other two cases in the same house, so that this class cannot be held responsible for any cases since March 12th.I am keeping a close watch for further developments. 11th March, 19o5. Owing to the prevalence of measles in Pages Walk (Infants') School, the Medical Officer (Education Department) of the London County Council decided to close Class-room B for two weeks. The room has been thoroughly disinfected with formalin spray. On March 29th, I received a communication from the Headmistress of Albion Street (Infants) School, drawing my attention to an outbreak of mumps among the children in Class-room G, 15 cases in all within three days. Acting under Article 57 of the Education have closed this room for a period of three weeks from March 30th, giving mv reasons as follows: — The prevalence of mumps in the class which occupies this room (15 cases occurring in a total of 54 on the roll) " ; " 2) Mumps is a highly infectious disease and liable to spread with great rapidity." On April I4ta Class-room A was closed, 27 cases occurring out of 62 on the roll. On April 17th the remainder of the Infants' Department was closed for a fortnight. May 30th, 1905. On May 8th I received four notifications of scarlet fever, viz.:—A. S., 5 vears female Paradise Street ; S. A. A., 4 years, female, Part Building,; A. H., 4 year, female, Staples Rents; and F. C. S., 5 years, Staples Rents. On inquiry it was ascertained that they all attended Christ Church Schools, Paradise Street, two of them being in Class-room V., and one in the next highest Class-room (No. IV.). On visiting the school the following day I found, on examining the children in the babies' class that a boy, G. M., 3 years, of Salisbury Street, was sitting in the class with a well-developed scarlet fever rash on him. He was immediately sent home and subsequently removed to hospital. As he had been mixing freely with the others I anticipated there might be an outbreak in this class, and recommended its closure for fourteen days—notice, of which the following is a copy, being sent to the Managers:— " To the Managers of Christ Church Schools, " Paradise Street. " May 9th, 1905. " We, the undersigned, being two members of the Sanitary Authority for the Metropolitan Borough of Bermondsey, acting on the advice of Dr. R. K. Brown, Medical Officer of Health of the said Borough, do hereby order and require the closure of Class-room V. of Christ Church Schools, Paradise Street, for a period of fourteen days from the date hereof, with a view to preventing the spread of scarlet fever and the danger to health likely to arise therefrom. " (Signed) J. H. Wilkinson, " Joseph Widdows." The names and addresses of the " contacts," which were 65 in number, were taken down and given to the District Inspectors to be kept under observation. Copies of this list were also sent to the neighbouring schools with the request that these children should not be admitted. in the course of the following week a number of suspicious cases of illness were brought to my notice, but on visiting the houses and examining the children they were found not to be suffering from scarlet fever. Two of the "contacts," A. W., 4 years, of Park Buildings, and G. C., 4 years, of Cherry Garden Street, subsequently developed the disease and were sent to hospital. No further cases have so far been discovered in connection with the school. June 27th, 1905. Four notifications of scarlet fever were received in connection with Midway Place School, two in connection with Class-room G, and two with Class-room C. In making local inquiries at the school, it seems that J. H., 6 years (male), Class-room C, probably became infected from the previous case in this class-room, viz., V. B., 5 years (female). There did not seem sufficient grounds to warrant the closure of the class, but a close watch is being kept on the school. No further cases have at present occurred. Aug. 30th, 1905. We report that between July 17th and August 10th, 11 cases of scarlet fever occurred in Rotherhithe within the radius from which St. Paul's Schools draw their scholars. These belong to 7 families. As 7 cases, 5 of whom were in Class 2, occurred before July 27th, the question of closing this class was considered, but since it was so close to the holidays this was not considered nefcessary. The last case occurred on August 10th, in Mistears Buildings, and so far there does not appear to be any tendency for the disease to spread. October 10th, 1905. There is a considerable increase in the number of cases of scarlet fever in the Borough, but this seems general all over London. I have had the milk supplies, both wholesale and retail, tabulated in Connection with the cases, also the schools, and any other common source of infection which has suggested itself to me, but am unable so far to trace any connection between these and the increase of the disease in the Borough. It is of a mild type, and therefore, if possible, more liable to spread, because from inquiries it would appear that unrecognised cases are playing an important role in the increase of the disease in this Borough. Children excluded from School on account of Infectious Diseases. Schools. Total Exclusions. Scarlet Fever. | Erysipelas. Measles. Diphtheria. Enteric I Fever. German Measles. Whooping Cough. Oliickenpox. Mumps. Patients. "Contacts." Patients. "Contacts.", 1 Patients. J i "Contacts." : Patients. i "Contacts."! ' Patients. "Contacts." I Patients. ■ ( l: Patients. < ! i "Contacts." } Patients. !_ "Contacts.'*! PatieDts. j "Contacts."! "Contacts." 483 i n <r* 1 71 1 2 | r 7 I 5 I 12 1 in 82 179 | I - 3 I 10 Albion Street SB 1 1 2 Alexis Street 162 j 21 I 19 57 5 | 5 12 2 1 1 ... ... j 2 All Sain Is, St. Ola ve's 2 I ''' -I ... ... I" ... I 183 29 -i f\ Alma, Soiithwark Park Road | 9'! .5 •••! 35 79 | 2 i • • ... 2 10 | 2 j 1° j 17 4 S Amicable, Adams' Gardens ... 10 1 ... ... I €> O j ... I ... i - I 2 J>acon, Grange Road 10 6 I 2 ... -! ... I ~ I .. , * v ' I - ... I i 59 15 12 I ' D Boutcber, Grange Road 1 2 ... 4 13 2 1 ... 6 j 2 j ... ... I I Bush Road 7 ! 2 j 5 I - ... ... ... 90 i 5 I 15 | I 1 I 7 7 Clarence Street ... ... I 21 1 j 19 14 ... 4 I J 2 Chaucer, Tabard Street I ~ 1 ... I - Q 82 17 Christ, Church, Paradise Street 39 | 6 ... 1 5 5 2 ... I ... 3 | KJ^I 14 2 Christ Church, Prospect Street 2 . ... I 5 2 2 | ... ... I ... Credon Road i 112 11 23 | 1 I 1° 1 ... ! u 28 ' 1 8 9 11 ... I ... I ... 7 5 Deptford Park i ... ... 2 ! ... ... Dockhead CatholicT 56 5 I 8 I 14 1 4 5 2 1 5 I ... I ... 2 ... ... j 93 I .7 ! 38 I 2 East Lane 1° 1 8 2 2 5 10 2 j ... I ... I 69 i 11 12 | 4 ! Fair Street 111_ _ di L 10 2 | ... 5 12 1 1 3 ... I 1 ... 4 114- 21 45 1 1 Farncombe Street 3 1 u 7 1 I ... I 1 ... 1 G 12 ... I 56 32 | 6 G alley wall Road 7 | 5 4 14 ! 2 ... ... ... 2 3 ... I Gomm Scliool3, Plough Eoad 10 2 5 I 1 2 ... I ... ... ... I ... I 1 I 27 L 3 Grange Walk 2 5 2 ... I ... I ... I ... 50 85 I Holy Trinity, Rothcrhithe 15 I ... ... I ... ... I ... 275 41 I ... Keetoris Road r Ci I 24 : 1 3 32 34 I 1 ... 35 i 1 1 23 39 I 5 ... 2f) j ]67 8 22 I 1 7 40 37 ! 11 1 1 16 j Laxon Street -ir 1 1 Ci l i ... 9 | 15 .. 41 2 i 11 12 15 Magdalen Street ... 1 j 2 4 4 ... . I ... ... j ... ... ... Mawbey Iload 24 2 1 8 ... I 4 2 | 1 1 1 I ... ... ... I ... 2 11 Melior Street ... ... 1 ... I ... ... •- ... 73 18 I 1 Midway Place 1 1 ... 3 1 I 5 3 ! ... ... 147 Monnow Road 7 16 5 8 2 24 55 18 6 5 | ... ... I 91 8 31 I Neckiiiger 2 1 j 21 5 3 41 1- 14 ... I ... I 2 3 1 Newcomen Street ... I m ••• ... 144 Page's Walk 4 26 J 1 3 13 9 9 2 - CO 13 3 ... I I 10 Purbrook Street I -1 5 1 ... I 2 I ... 1 ... ! ... I 3 I ... I ... | ... I ... I ... I ... I ... I ... I ... I ... I Children excluded from School on account of Infectious Diseases.—eontinued. German j' Measles. | j Eczema. Diphtheria. 1 Z Enteric Fever. nr 3 Erysipelas. Measles. Whooping 1 Cough. Chickenpox. i Mumps. I Schools. — i- Total Exclusions. Scarlet ! Fever. r~? i i "Contacts." Patients. ; "Oontacte."; Patients. "Contacts."' Patients. "Contacts." Patients. "Contacts." Patients. "Contacts." "Contacts.'' Patients. "Contacts.' Patients. "Contacts.' I Patients. "Contacts.' Patients. Patients. j 178 i ® 22 I 10 ! i 39 81 1 I 3 1 « ! ... I - Riley Street 4 7 11 I 16 6 ... I 1 I 3 ... I Rolls Koad 47 * 7 16 36 8 1 49 .... 4 i 6 4 I ... 222 98 Rotherkithe New Road 1 I 1 I 47 12 | ... 7 3 5 ... ... i 120 11 24 2 7 I ... Snowsfields 1 ... ... ... ... ... ... S 1 n Special School, Old Kent Road ... 2 3 ... 19 I": ... 7 7 ... r — 7 St. Barnabas j ... ... I 2 12 1 I 8 4 ! i 2 ... 83 26 2 5 I 1 1 ... 4 St. James', Spa lioad 13 1 I 11 23 ••• 2 1 I ... ... I ... St. Joseph's, Paradise Street 38 i "V j ... 1 ! 20 14 2 i 1 St. Mary's, Lower Road 42 ... 1 •• ! 5 ! 4 6 4 5 1 ! 19 27 1 2 ... St. Paul's Lane 74 ... ... ... ... ! ... 6 ! i 5 ... ! - ... St. Olave's 1 o 1 ... ... ... I St. Olave's (Girls) •" ... ... ... I - ... I ... 1 2 I ... i St. Saviour's* New Kent Road ■ ... A ... 1 ... ... I ... ... 3 5 I 2 St. Mary's, I'urbrook Street 7 ... ... ! - ... ... ... •" I 1 ... i ... Steplien-the-Yeoman, Marigold Strceb 11 1 c 3 ... ... I - i ... i V—— ' c Silwood Street ! 10 19 1 5 I •» ! s ... 35 ... 112 12 1 2 1 3 11 9 24 32 9 2 ! 8 ' ... ... Southwark Park Road 0 ... 5 i 3 ... I Sonthwark Park Iload (Private) 2 21 i lO j... 1 i ... 96 | 10 1 1 15 ... I; 8 Ct Webb Street 30 1 ... : 1 ... I . Q o o I 14 4 6 1 2 36 ... 1 i 2 Weston Street 1 1 j 1 1 Westcott Street 4 1 3 ! ' I I " Totals 207 10 1 11 670 31 39 1 GO | 77 159 5 158 102 14 219 Insanitary Area. During the year under report, a good deal of correspondence was carried on between this Council, the London County Council, and the Local Government Board, as the result of representation made to the London County Council under Part I. of the Housing of the Working Classes Act, in November, 1904. The annexed map shows the exact position of the area in question, which is coloured red. On May 9th, 1905, the following report was made to the Public Health Committee : — "On the 11th of November, 1904, I made an official representation to the London County Council under Part I. of the Housing of the Working Classes Act, 1890, in respect of an area comprising Cusack Place, Gareth Place, and Porlock Place, in this Borough. This area contains 41 houses, viz.: 15, 17, 19, 21 and 22 to 40, Porlock Place, and the whole of Gareth and Cusack Places. The population, as the result of two enumerations during the year, was 230, and the total number of deaths for the six years 1898 to 1903, inclusive, was 55; 32 of these were children under 5, and 23 over 15. This makes a crude death rate for these years of 39.85, which when corrected for age distribution raises it to 42.17, compared with 21.4 for the whole Borough for the same years. The notifications for these years numbered 21, viz.: 2 small-pox, 10 scarlet fever, 2 diphtheria, 3 enteric fever, 4 erysipelas, making the attack rate 15 per thousand compared with ten per thousand for the whole Borough. During the period in question the phthisis death rate for the area was 2.9, that for the rest of the Borough being 1.9, and for London 1.7 per thousand living. The area is .38 acres in extent, and runs approximately north and south for about two-thirds of the length of Crosby Row. It is considerably below the level of Crosby Row, and has to be entered either by an incline, or, in the case of Gareth Place and one entrance to Porlock Place, by going down several steps. The ground level of the area is itself below Trinity high water mark. The houses are small two-storied cottages either with no back yards or very small ones, and they are overtopped on all sides by high buildings, viz.: on the west by Crosby Bow, on the north by Snowsfields, on the east by Hamilton Buildings and St. Paul's Church and Vicarage, and south by the Charterhouse Mission Building. It is thus situated in a kind of well, and this combined with the narrowness, closeness and bad arrangement of the courts and houses, causes them to suffer from a deficiency of light, air, and ventilation, which is injurious and prejudicial to the health of the inhabitants. The individual houses are old and some of them in bad repair, but the defects, in my opinion, are of such a nature that they can only be remedied by a proper reconstruction scheme, which would comprise the houses on the east side of Crosby Row and the two or three houses in Snowsfields bounding the north end. In answer to my letter and representation, I received a letter dated February 15th, 1905, in which the Clerk to the London County Council, after stating that the Housing Committee had had my letter and representation before them, goes on to say : — ' In reply I am directed to inform you that the Committee, after having given the matter the most careful consideration, are of opinion that any scheme which may become necessary for the reconstruction and rearrangement of the premises within the area should be undertaken by the Metropolitan Borough of Bermondsey under Part 11. of the Act of 1890. It appears, however, that 12 houses in Porlock Place, together with some houses in Crosby Row, are at present in the market, and it is anticipated that at no distant date the whole of the area will be redeveloped like other property in the neighbourhood. Pending such redevelopment, it is thought that any serious defects in the premises themselves can be adequately dealt with by the Borough Council under its existing powers. Under these circumstances the Committee do not see their way to advise the Council to prepare a scheme for dealing with the area under Part I. of the Act.' In this connection I have ascertained since that the site occupied by 22 to 33, Porlock Place and 12 to 22 (even numbers), Crosby Bow is being offered for building purposes. On March 3rd I wrote to the Housing Committee urging my reasons why the area should be dealt with by the London County Council. They replied on March 17th, reiterating their first opinion, and stating ' they are still of opinion that the area is one which cannot be deemed to be of general importance to the County of London, and should be dealt with by the Borough Council under Part 11. of the Housing of the Working Classes Act of 1890. If the conditions prevailing in the area are considered by the Borough Council to be such as to require a scheme of reconstruction, it would appear that the provisions of Sec. 39 (lb) of the Act would enable the Borough Council to prepare a scheme for the improvement of the area.' They also stated that they proposed asking the Council to pass a resolution on the 28th inst. in the form indicated by Sec. 73 (b) of the Act, and report same to the Local Government Board. This they did, and the Local Government Board have written asking that they may be furnished with the observations of the Borough Council on the resolution of the London County Council. The London County Council has apparently refused to deal with this area on two grounds ; first, that it was not of general importance to London, and secondly, that it was likely to be redeveloped like other property in the neighbourhood at no distant date. As regards the first reason it seems to me that in clearing this area we would be benefiting Ssouthwark as much as ourselves, and also South London generally by the widening of Crosby Row, and that for this reason alone the London County Council take the matter up. As regards the second reason, it is true that part of the site is in the market, but the date of development is somewhat uncertain, and in any case it refers to only about a third of the area. I understand the London County Council are in agreement with my representation that the area is an insanitary one." This report was finally considered by the Public Health Committee at their meeting on May 30th, and, reporting to the Council at their meeting on June 6th, they state " This matter has been before us on several occasions and we have viewed the area. The procedure is regulated by sec. 73 of the Housing of the Working Classes Act. 1890. Ihe Local Government Board upon having such a resolution (i.e. that of the London County Council) submitted to them may appoint an Arbitrator and direct him to hold a local inquiry and such Arbitrator shall hold such inquiry and report to the Local Government Board as to whether, having regard to the size of the area, to the number of houses to be dealt with, to the position, structure, and sanitary condition of such houses, and of the neighbourhood thereof, and to the provisions of Part I. of this Act, the case is either wholly or partially of any and what importance to the County of London with power to such Arbitrator to report that in the event of the case being dealt with under Part 11. of this Act, the London County Council ought to make a contribution in respect of the expense of dealing with the case. The Local Government Board, after considering the report of the Arbitrator, may, according as to the Board seems just, decide that the case shall be dealt with either under Part II of this Act, or under Part I. of this Act, and the Medical Officer of Health or other proper officer shall forthwith make the representation necessary for proceedings, in accordance with such decision." It appears to us that the attitude taken up by the London County Council is not the proper one contemplated by the Housing of the Working Classes Acts. We recommend— That the Local Government Board be informed that this Council is of opinion that the area in question is one of general importance to the County of London and should be dealt with by the London County Council. Our opinion is based upon the following reasons:— " (1) The insanitary area contains 41 houses, but in addition it would be necessary or advisable to acquire the houses in Crosby Row, together with three or four in Snowsfields, abutting upon the area, in order to obtain proper frontages and carry out a suitable rehousing scheme. These additional houses, although not unfit for human habitation, are in a more or less insanitary condition, and require constant supervision in order to prevent or remedy nuisances, etc. (2) Owing to the considerable amount of heavy through vehicular traffic which passes along Crosby Row from adjoining Boroughs, it would be necessary in any rehousing scheme at this point to widen a portion of Crosby Bow and Snowsfields. (3) The area in question is right on the border of this Borough and adjoining the Borough of Southwark, bo that the latter Borough would practically reap as much benefit as Bermondsey, if the area is dealt with under Part 11. of the Act, but without mating the smallest contribution towards the extremely heavy cost, which would fall upon Bermondsey. (4) That this area, both from its geographical position, the number of houses to be acquired, the necessity of purchasing additional property and the street improvement requirements involved by the scheme, is essentially one of general importance to the County of London within the meaning of the Statute. Although the London County Council in the past may only have dealt with large areas, or schemes, that, in itself, does not alter or modify what is the meaning and interpretation of the Act. Sec. 72, by expressly directing that an official representation to the London County Council under Part I. which relates to not more than 10 houses is to be dealt with under Part 11., impliedly justifies the representation made to the London County Council as to this particular area. (5) This Borough has already had to bear the very heavy expense of clearing one insanitary area and at the same time have had to contribute towards the cost of larger schemes in other parts of London undertaken by the London County Council. This hardship arises through a misconception as to the true meaning of the Act in applying the sole test of size or number of houses for the purpose of arriving at an opinion as to whether a representation is one of general importance to the County of London." This was followed by some further correspondence, of which the following is the Public Health Committee's report to the Council on September 19tb, 1905. " On the 13th June, 1905, we reported fully to the Council in reference to an official representation to the County Council made by this Council's Medical Officer with respect to an insanitary area comprising Cusack Place, Gareth Place and Porlock Place, and we also gave certain reasons in support of a recommendation that the Local Government Board be informed that the Council is of opinion that the area in question is one of general importance to this County of London, and should be dealt with by the County Council. Our recommendation was adopted by the Council, and the Local Government Board were accordingly informed of the views of the Council. A further letter has now been received from the Local Government Board asking to be furnished with the Council's observations upon the following letter from the London County Council:— ' I have laid before the Council your letter of the 27th ultimo (71,343 K, 1905), forwarding a copy of a letter received from the Bermondsey Metropolitan Borough Council with reference to the official representation made by its Medical Officer in relation to an area comprising Cusack Place, Gareth Place, and a part of Porlock Place within the Borough. With reference thereto I am directed to point out, for the information of the Local Government Board, that not only has a considerable amount of property in the immediate vicinity of the area been acquired in recent years and re-developed as a commercial speculation, but that 12 houses in Porlock Place, together with some houses in Crosby Row, are at present in the market. It is anticipated therefore that at no distant date the whole of the area comprised in the official representation will be re-developed for commercial purposes. Pending such redevelopment it is considered that any serious defects in the premises themselves can be adequately dealt with by the Borough Council under its existing powers, but if it should ultimately be found necessary to prepare a scheme for the reconstruction and rearrangement of the premises within the area, the Council is of opinion that such scheme should be undertaken by the Local Authority under Part 11. of the Housing of the Working Classes Act, 1890, especially as, generally speaking, schemes under that part of the Act can be carried into effect more economically than under Part I. of the Act. The Council observes that the Borough Council is of opinion that a number of houses in Crosby Row and Snowsfields which cannot be described as unfit for human habitation, should be acquired. In view, however, of the probable redevelopment of the area in the near future the acquisition of such property at its full commercial value would necessarily involve a large expenditure. The question of the desirability of widening a portion of Crosby Row and Snowsfields owing to the amount of through vehicular traffic is, of course, one which should be considered on its merits from a street improvement point of view, and does not appear to have a direct bearing on the necessity for the clearance of the insanitary area or the method of dealing with it under the Housing Act. The Council refers to the fact that the Borough has already had to bear the heavy expense of clearing one insanitary area and to contribute towards the cost of larger schemes undertaken by the London County Council. The area in question is, presumably, that comprised in the Fulford and Braddon Street, Rotherhithe, Scheme, 1897, with regard to which it may be pointed out that the Council has already contributed the sum of £13,500 towards the cost of clearance and has agreed to contribute a further sum of £1,060 on the understanding that the total amount does not exceed one-half of the nett cost. As the Board is aware, other local authorities in London have likewise undertaken schemes for the clearance of insanitary areas within their respective districts." We have given instructions for a reply to be forwarded to the Local Government Board to the following effect: — (1) That the latter portion of the second paragraph of the above letter appears to be a contradiction of the first part, because if the County Council seriously believe that the area will be re-developed for commercial purposes in the near future there was no need for the County Council to pass the resolution under Section 73 of the Housing of the Working Classes Act, 1890 —that the case is not one of general importance to the County of London, and should be dealt with under Part 11. of the Act —but rather they should have acted under Section 10 and passed a resolution to the effect that they would not proceed with the scheme. (2) With regard to the last two lines of the second paragraph the Council is not aware that a scheme under Part 11. of the Act could be carried out more economically by them than by the County Council and judging by their experience in a recent scheme, the Council very much doubt the correctness of the view expressed. (3) In reference to the acquisition of the additional property the Council believe that this would be necessary whether a scheme is prepared under Part 1. or Part 11. (4) The question of the street improvement suggested by the Council although not an absolute necessity now would become imperative if a proper rehousing scheme had to be prepared, and to that extent therefore it has a direct bearing upon the whole matter. (5) As the County Council advert to the amount contributed by them to the Fulford and Braddon Street, Rotherhithe, Scheme, 1897, undertaken by this Council and our predecessors, namely, £14,560, the Council beg to cite the following figures as another reason for not relieving the County Council from the onus of the proposed reconstruction scheme. The original estimate for purchasing the property, clearing the site, making new roads and sewers in connection with the Fulford Street and Braddon Street Scheme was £31,920 The value of the site remaining for building purposes was estimated at 2,800 £29,120 Towards which the County Council agreed to contribute one half £14,560 The actual cost of acquiring the property, clearing the site, together with the estimated cost of making new roads and sewers, was £37,848 The value of the site is estimated at 2,800 £35,048 The County Council declined to increase their contribution, so that, although originally the expense was to be shared between the County Council and the Sanitary Authority, this Council will expend £20,488 As against the County Council's expenditure of ±'14,560 and even this does not represent the actual difference because the Council had to pay large sums away and incur expenses for interest before receiving the grant from the County Council. In addition this Council has all the responsibility and expense of rehousing the persons displaced. (6) The Council observe that the County Council in their letter refrain from replying to two of the most important points raised by this Council, namely (a) that if this Council undertook the scheme under Part 11. the adjoining Borough of South war k would reap practically as much benefit as Bermondsey without making any contribution; {b) that the London County Council are and have been misconstruing the meaning and intention of the Act having regard to the limitation put upon the County Council by Section 72 that they shall not take any proceedings on a representation which relates to not more than 10 houses, with the result that the poorest Boroughs in the Metropolis have been saddled with responsibilities and heavy expenses which the legislature never contemplated, but which in fact it intended should be common to the whole of London and undertaken by the central body. In reply to this letter, the following letter was received from the Local GovernmentBoard :— " We report the receipt of a letter from the Local Government Board adverting to this Council's letter of the 20th September, 1905, with reference to the representation made by the Medical Officer of Health under Part I. of the Housing of the Working Classes Act, 1890, in respect of an area comprising Cusack Place, Gareth Place, and a part of Porlock Place; and stating that the Board do not propose at this stage to appoint an arbitrator under Section 73 (1) of the Act, but to direct a local inquiry by one of their Inspectors for the purpose of ascertaining the facts in regard to the area. The inquiry will take place as soon as the other engagements of the Inspectors will permit, and due notice of it will be given." This letter was followed by an advertisement of the Local Government Board, that an inquiry would be held by one of the inspectors of the Board, Mr. F. J. Willis, B.L., on November 20th, 1905, at 11 a.m. On November 28th the Public Health Committee further reported that the Local Government Board inquiry was duly held on the 20th inst., at 11 a.m., by F. .J. Willis, Esq., barrister - at-law, one of the Inspectors of the Board. Mr. Courthope Munro represented the Council, Mr. Hawes, of the Solicitor's Department, London County Council, represented the County Council. Dr. Brown, Medical Officer, Dr. Hamer, Assistant Medical Officer, London County Council, and Mr. Hunt, from the Valuer's Department of the County Council, gave evidence. The Inspector will make his report to the Board. At this inquiry evidence was taken as to the general insanitary condition of the area, the following points being agreed upon by the Medical Officer of the L.C.C., and myself, viz.:— General. The area, comprising Cusack Place, Gareth Place, and 15, 17, 19, 21 to 33 (odd), 20, to 40, Porlock Place, is '38 of an acre in extent, and situated at the London Bridge end of the Borough of Bermondsey. It is oblong in shape, the long diameter running approximately north and south. It is approached by four narrow passages from Crosby Row, and one at the back from Kipling Street. The surface of the area is below the level of the surrounding streets and spaces, the depth varying from 3 to 4 ft. in different parts, and to 3 ft. below Trinity high water mark. The houses, 41 in number, are mostly two-storied cottages from 14 to 20 ft. high (measuring from the roof top). They are surrounded by buildings ranging in height from 27 to 65 ft. above the ground level of the area in question. These are so close that they prevent the access of light and air to the area generally, causing it therefore to be situated in a kind of well. All the cottages are old, and the rooms on the upper floor, where they exist, are very lowpitched and generally deficient in light and ventilation. Cusack Place. This constitutes the North end of the area. There are 11 houses, two-stories high, 7 consisting of 4 rooms, and 4 of 3 rooms. The measurement from the ground level to the top of the roof is 20 ft. It is bounded on the North by Snowsfields, the houses of which are 30 to 35 ft. above the level of the court and therefore 10 to 15 ft. higher than the houses in Cusack Place. On the East the light and air are further restricted by the block dwellings in Hamilton Square, which are 65 ft. above the level of the court, or 45 ft. above the houses in question. These dwellings are situated on an average 27 ft. from the fronts of the houses in Cusack Place. The courtyard in front of the latter, and intervening between it and Hamilton Buildings, is 10 ft. 6 in. wide, and bounded by a wall 7 ft. 6 in. high. The cottages have small back yards, the areas of which in Nos. 1 to 4 are 90 to 103 square ft., in Nos. 5 to 8, 113 to 121 square ft., and in Nos. 9, 10 and 11, 41, 39 and 57 square ft. respectively, with a width of 3 ft. 6 in., inclusive of the area occupied by w.c.s and other erections. The houses are old, worn out, show some evidence of damp, and have no damp courses. The rooms are small, low-pitched, with deficient light and air, and the staircases mostly narrow, dark, and come direct out of the living room. The ground floors, in all but three cases, are below the level of the court, which itself is 3 ft. below Trinity high water mark. Gareth Place is approached from Crosby Row by a narrow covered passageway 3 ft. 2 in. wide and 8 ft. 7 in. high, followed by four steps. The courtyard, which is 4 ft. below Crosby Row and 3 ft. below Trinity high water mark, is only 9 ft. wide. The cottages consist of 4 rooms, and are 2 stories high. They are old and worn out, and the yards at their rear are very small, the average size of those on the North side being 47 square ft., inclusive of w.c.s and other erections thereon, with a uniform width of 4 ft. 3 in. Those on the South side, with the exception of No. 5 which abuts on a small piece of ground (vacant), have yards of an average area of 32 square ft. inclusive of w.c.'s and other erections thereon, and the width varying from 2 ft. 6 in. to 3 ft. 4 in. The rooms are low-pitched. The floors of the ground floor rooms are in some cases* below the level of the back yards adjoining, and the walls show signs of dampness. The staircases are narrow, dark, and ill-ventilated, and lead out of the living rooms. The end of the court is closed by a wall 13 ft. 6 in. high. Porlock Place Is approached from Crosby Row by two narrow passages, the northernmost one, which leads down three steps, being 3 ft. wide and covered in at a height of 8 ft. 2 in. The portion of Porlock Place included in the area consists of 5 groups of cottages badly arranged, with very narrow courtyards between them, varying in width from 4 ft. to 12 ft. Some of the houses, viz., 36, 38 and 40, are without back yards, and consist of two rooms with staircase leading out of living room. They show signs of dampness. The w.c.'s are at the end of the court. Numbers 22 to 32 have small yards which average 59 square ft., inclusive of w.c.'s and other erections thereon. Numbers 23 to 33, facing the cottages last mentioned, are only one-story high, and have back yards which vary from 77 to 102 square ft., inclusive of w.c.'s and other erections thereon. Numbers 15 and 17 have very small yards, that of 15 being quite covered in and of such small dimensions that it could scarcely be called a yard, while that of No. 17 is mostly closed in by high walls. Numbers 19 and 21 have no back yards, and the light and ventilation of these are very much restricted, principally owing to the buildings of the Charterhouse Mission, which is 64 ft. and 42 ft. above the highest point of these houses, which are themselves 16 ft. and 22 ft. high. The light and ventilation in No. 19 is further hindered by the close proximity of this high building which is only 4 ft. distant, and 13 ft. from No. 21. On the west side of No. 21, Porlock Place, in Crosby Row, the houses are only 13 ft. 6 in. distant and 30 ft. high, thus interfering with the light and ventilation in this direction. The cottages are old, No. 21 being largely constructed of wood, which is in a very dilapidated state. In the Appendix will be found Tables dealing with the statistics of the insanitary area. In addition to the above, evidence was brought supporting the various contentions of this Council as detailed in the correspondence, why this Borough should not be called upon to undertake the dealing with this area. On January 16th, the Public Health Committee reported:— We report the receipt of a letter from the Local Government Board stating that they have received the report made by their Inspector, Mr. Willis, after the Inquiry held by him with reference to the question of a scheme for the reconstruction of the premises within the area comprising Cusack Place, Gareth Place, and a part of Porlock Place; the Board gather that the case is one which clearly ought not to be dealt with under Part I. of the Housing of the Working Classes Act, 1890, and in these circumstances they do not feel justified, as matters stand, in putting the London County Council and the Borough Council to the expense which would be involved in a hearing before an Arbitrator to determine this point, and therefore they do not propose to take any further action upon the representation made to them under Section 73 (1) (b) of the Act. • Nos. 2, 3 and 8, and in Nos. 4 and 5 they are level. 26 III.—SANITARY ADMINISTRATION. In Table XYI. of Appendix will be found particulars of the general sanitary work by the District Inspectors for 1905, and in Table XIII. the number of premises on the register to which special attention has been paid. The house to house inspections number 5,629. This is about 600 more than last year, and is an average of 625 per Inspector. Taking the number of houses at the last census as 15,817, at this rate of inspection it would take 2f years to inspect the whole Borough once. The number of re-inspections was 27,580, against 24,707 in 1904. The number of intimations served was 3,647, against 3,670 in the previous year. The number of statutories was 1,249, against 899 in 1904. Offensive Matter. 30 summonses were taken out under the London County Council bye-laws for carrying offensive matter through the streets at improper hours and in improper receptacles. This is a great increase on the previous year, when the summonses were five. This shows great vigilance on the pari of the Chief and other Inspectors. Date of Offence. Names and Address. I Offence. Result of Prosecution. July Is , J. F. Johnstone, Belvedere Fish & Guano Co., 196, Crisp Street, Poplar Carriage of offensive matter in unsuitable receptacle Tl m I I T £2 and 2s. costs, summons against carman withdrawn, 2s. costs n r\ \ i June 30th S Messrs. Squires & Son, 59, | Tobin Street, Netting Hill Ditto do. £2 and 2s. costs, summons against carman withdrawn, 2s. costs Aug. 1-ith I J. T. Hunt & Son, Bow Bridge, Stratford Prohibited hours : £1 and 2s. costs „ Unsuitable vessel j Withdrawn, 2s. costs i Ditto do. ' Joseph Rock, 129, St. Leonard Street, Bromley-by-Bow j Carriage of offensive matter during prohibited hours I ss. and 2s. costs Ditto do. Unsuitable vessel Withdrawn, 2s. costs >> JJ Albert Wilier, 29, Empress ; Street, Walworth Unsuitable vessel Withdrawn, wrong name and address given " ! Henry Rivett, 12, Brooks Road, Plaistow, E. Unsuitable vessel ! ! ss. and 2s. costs I TTT.,, Ditto do. ; Prohibited hours I "Withdrawn, 2s. costs fj Unsuitable vessel I Withdrawn, 2s. costs "William James, Eglantine Farm, Stanwell, Middlesex Sept. 2nd Prockter & Bevington, 124, Grange Road Prohibited hours j ; £3 and 4s. cost 3, summons against carman withdrawn, costs included above Sept. Bth Messrs. Freeland & Smith, 13, Almond Eoad Unsuitable vessel ss. and 2s. costs Ditto do. Prohibited hours | Withdrawn, 2s. costs, summonses against carman withdrawn, 2s. costs in ( each case » Sept 29th , . George Johnson & Son, Car- I I penters Road, Stratford | I Prohibited hours I £2 and 2s. costs - ! I Ditto do. 1 Unsuitable vessel 1 £2 and 2s. costs Benj. Head (carman in above) j I Unsuitable vessel 10s. and 2s. costs I Ditto do. Prohibited hours 10s. and 2s. costs I fj Oct. 19th Frederick Hornett, 51, Temple, Mill Lane, E. Prohibited hours j£l and 2s. costs ! Ditto do. Unsuitable vessel Withdrawn, 2s. costs Nov. 2let : Messrs. Freeland & Smith, 7-8, Railway Approach Unsuitable vessel £3 and 2s. costs >> Ditto do. Prohibited hours ... Withdrawn, 2s. costs, summonses against carman withdrawn, 2s. costs in each case Nov. 24th Messrs. Freeland & Smith, 7-8, Railway Approach Unsuitable vessel Withdrawn, 2s. costs, summons against carman ! withdrawn, 2s. costs Offensive Trades. The same number of offensive trades, viz., 13, are on the register as during 1904. They consist of the following : — Glue and size makers 4 Tripe boiler 1 Fellmongers 3 Fat melters 4 Manure manufacturer 1 225 inspections were made, against 118 in 1904, and 4 notices were served. Several minor defects were remedied without notice being served. I have so far found the occupiers of these premises ready and willing to carry out any reasonable suggestion for the prevention of nuisances. There was a prosecution at the instigation of the London County Council against the fat melting premises known as Brown's Yard, Tooley Street, for extending their business without a license. The occupiers had rebuilt their premises, which were very old, and it was alleged by the London County Council that the shed which is at present used for storing fat was not so used prior to the rebuilding, and that they had therefore enlarged their premises within the meaning of the Act and required a fresh license. The plaintiffs brought evidence that this shed had been used for storage of fat prior to the rebuilding, so that the magistrate found they had not extended their business of fat melting so as to render a fresh license necessary and dismissed the summons. Milk Premises. There were 301 milk premises on the register at the end of 1904, 121 were added and 159 removed in 1905, making a total of 263 on the register at the end of the year under report. The number of inspections was 861, and 65 notices were served. Cowsheds. There are 7 cowsheds in the Borough. These were regularly inspected. The number of inspections was 103, and 4 notices were served. Slaughterhouses. The number of slaughterhouses in this Borough has been gradually decreasing since by far the greater portion of the meat sold has already been killed in Smithfield or other markets. I hope that the time is not distant when private slaughterhouses will be abolished, for it is impossible to examine all the animals slaughtered in these places, especially if there happen to be a great number as in some Boroughs. All animals throughout the country should be slaughtered in public slaughterhouses, which are under the supervision of a special staff, who should examine all flesh before it goes out. Many diseases cannot be detected unless the internal organs are examined at the time of slaughter along with the whole carcase, so that no matter how skilled the Inspector may be in the examination of meat he is liable to miss many slight cases of illness which would render the meat unfit for human food without producing any obvious naked eye appearances which would render its soundness open to suspicion. There are now two slaughterhouses in the Borough. The number of inspections made was 76, and two notices were served. Ice Cream Premises. There were 69 premises where ice cream is manufactured on the register at the end of 1904, and during 1905 one was added and one taken off, making the same total at the end of the year under report. There were 295 inspections of these premises, and 36 notices were served. Sec. 48 Public Health (London) Act, 1891 Certificates were granted to the owners of the following premises for a proper and sufficient water supply:— 12,13,14, Bethel Place. Park Buildings, Blocks A, B and C. 41, 42, Willow Walk. 9, Cathay Street. 3, Cathay Street. Women's Shelter, Decima Street, attached to Central Hall. No summonses were taken out for occupation without a certificate under the above Section. Houses Let in Lodgings. In 1904 there were 218 "houses let in lodgings, or occupied by members of more than one family" on the register, and during 1905 four more were added and one removed, bringing the total up to 221. These, according to the instructions of the Public Health Committee, were visited quarterly, the total number of inspections being 596. 204 notices were served, and 10 of these were for overcrowding. One summons was taken out for overcrowding, but was withdrawn on same being abated. The following is a list of the houses let in lodgings:— 5, Aberdour Street 11, „ 13, „ 14, „ 17, „ 56, Arnolds Place 82, Abbey Street 86, „ 95, „ 98, „ 100, „ 10, Alice Street 26, Bermondsey Street 84, „ 117, „ 131, „ 136, „ 50, Bermondsey Wall 52, „ 6, Bell Court 8, „ 9, „ 12, „ 15, „ 18, „ 24, Bermondsey New Road 7, Cloyne Road 1, Curlew Street 2, „ 10, Crosby Row 19, Debnam's Road 21, „ 23, „ 13, Decima Street 42, „ 28, Enid Street 2, Emba Street 4, „ 28, East Lane 29, „ 3, Elim Street 7, „ 9, „ 18, „ 19, „ 21, „ 40, „ 41, „ 45, „ 24, Freda Street 1A, Flockton Street 5, Foxlow Street 7, „ 8, „ 15, „ 16, „ 17, „ 19, „ 20, „ 21 , „ 22, „ 23, „ 25, „ 23, Faustin Place 31, „ 35, „ 4, Fendall Street 30, Ferrand Street 31, „ 16, Fulford Street 18, „ 12, Gedling Street 14, „ 60, Gainsford Street 9, Grange Walk 76, „ 81, „ 87, „ 91, „ 5A, Green Walk 6, Hatteraick Street 9, Kenning Street 10, „ 11, „ 19, Kipling Street 31, „ 6, Lamb Alley 7, „ 8, „ 46, Larnaca Street 47, „ 54, Leroy Street 58, „ 62, „ 72, „ 74, „ 76, „ 78, „ 82, „ 86, „ 22, Litlington Street 11, London Street 12, „ 13, „ 14, „ 15, „ 16, „ 17, „ 18, „ 19, „ 20, „ 31, Lafone Street 230, Long Lane 201, Lower Road 35, Mellicks Place 39, „ 41, „ 43, „ 63, „ 4, Maze Pond 6, „ 8, „ 10, „ 12, „ 14, „ 16, „ 18, „ 7, Morris Court 8, „ 9, „ 10, „ 11, „ 12, „ 19, Manor Lane 6, Marigold Street 10, „ 12, „ 1, Marshall's Place 21, „ 9, Maynard Road 9, Marcia Road 13, „ 2, Oldfield Road 3, „ 1A, Osborne Buildings 10, Pages Walk 9, Porlock Place 19, „ 21, Porlock Place 21, Paulin Street 2, Parkers Buildings 4, „ 6, „ 8, „ 9, „ 10, „ 13, „ 15, „ 20, „ 28, „ 28, „ 11, Reed Street 9, Riley Street 350, Rotherhithe Street 352, „ 556, „ 1, Suffolk Street 42, „ 1, Salisbury Place 4, „ 10, „ 14, „ 16, „ 20, „ 8, Salisbury Street 24, „ 27, „ 29, „ 55, „ 57, „ 58, „ 59, „ 66, „ 14, Snowsfields 43, „ 16, St. Helena Road 78, St. Marychurch Street 80, „ 19, The Grange 21, „ 51, „ 86, Tanner Street 23, Trident Street 26, „ 13, Turners Retreat 40, Vauban Street 41, „ 3, Warford Place 4, „ 14, Wilds Rents 1, William Square 29, West Lane 40, „ 43, „ 45, „ 48, „ 50, „ 20, Westlake Road 22, „ 52, Weston Street 54, „ 199, „ 247, „ 253, „ 4, Woods Place 11, „ 14, „ 15, „ 16, „ 1, Woolf Street 2, „ 29 Disinfection. Early in the year, the old Neckinger Disinfector, the makers of which were Messrs. Ooddard, Massey & Warner, was condemned by the Boiler Insurance Co. It had been in use some 15 or 16 years and required such extensive repairs that the Committee decided to do away with it. Accordingly a more modern machine which was situated at Bull Head Dock was brought up to the Neckinger Depot, and reinstated on the piece of land between the Baths and Wash-houses and the Dust Destructor. This situation was considered more convenient because there was an existing shed attached which could be adopted for the Cleansing of Persons Act should the Council decide to adopt it, and it was in a convenient position for receiving steam from the Dust Destructor. These advantages have so far proved true. The following table shows the number of articles passed through the steam disinfector during the year : — Beds 1158 Palliasses 136 Blankets 1173 Pillows 1966 Bolsters 604 Quilts 1119 Carpets 277 Shirts 1239 Cushions 315 Wearing Apparel, etc. 6431 Mattresses 954 Total 15372 Food Inspection. The food coming into or manufactured in the Borough has been systematically inspected during the year, after the manner detailed in the Annual Report for 1904. The following table gives the number of inspections, and an approximate idea of the amount of food examined during the year : — Food Examined during the Year 1908. Inspectors. ! Fish. I J \_ Fruit. I Tinned Goods. ( Dairy I Produce. | I Meat. Vegetables. I Cereals. Inspections. Tons. ! inspections. Toils. Inspections. Tons. fnspections. Tons. Inspections. Tons. Inspections. Tons. ' inspections. Tons. Mr. Thomas 1826 : 590 I 258| | ;! 944 15994' ! 148} s| 24fj ! 92 80 | 303ij 1195| ! 658 <J i-l 139 IlsBo| „ Ashdown. I 254 ! 713 66 j 64|j I 3255 i r i 8180.1, j 213| 81C !* 7289 I - | 55 „ Oockburn ... T* ill, I 81 221} ; 56 94"; 92 f 53 232-}; 2|i - I 1 ! »3j „ Barfcletfc !« 63 42 t 3 1 39 ; 11l I _ I - _ Z' I "I ill 14 l c\ J 106 „ Toogood 232 ; 2121 ; 3i7 | 147-g 1443}| 34 — * 528 j ! 21 721 2 40 „ Scott ! :531 125§ ! 167 1064; 1 38 874 1 i ! 16 | 26j 59 I S H - Hoskins 79 124? 59 22|| | 138 i 44 ■ 37|S i | 6 ■; 85 4' I I 98 j 70]- ! 78 81! I - 1 I „ Harris :| & 2* 15 59 180 j I 24 l 149 240 i; 98 ! 871 I 16* i 13 I 20 , 1 ~ Jones | 134 I 61 16 1 2907 |: 781i| ! 2043 L i 6816 !' 1165 196765': 1630 ) 7397 1 18 1 100 1436 '•291 8159 | 484 Note.—2'he inspections refer to the number of separate lots, and the weights are only approximate. The total number of inspections of wharves, factories and shops where food stuffs are stored or made was 2,289 during the year 1905. Register of Places where Food is Prepared for Sale. The following table gives the number and kind of the various places where food is prepared (exclusive of the warehouses and wharves on the riverside) at present on our register. A special register was started towards the end of 1903 for such places, and a considerable number were added during 1904 and 1905 : — Batchers 21 Pork butchers 4 Confectioners (wholesale) s Picklers 2 Restaurants 10 Coffee and eating houses 117 Eel pie shops 7 Tinned provision merchants 4 Fried fish shops 29 Tea rooms 2 Fish shops 16 Various 9 Fish curers TT 11 * 1 7 n Ham and beef shops 3 Total 236 Oyster rooms 2 Unsound Food Seizures The following are particulars of unsound food seized during 1905: — January 18th 72 tons of coffee berries Magistrate refused to grant order for destruction. 19th 18 „ „ „ ~ 20ih 29 ~ „ Destroyed on magistrates' order. March 24th 14 lbs. herrings Pined 10s. and ss. costs. July 10th B*l4 half sieves of black currants Order for destruction. Costs paid bv consignees. August 14th 101 boxes of greengages ~ Unsound Food. The following articles were brought to the notice of the Department, found to be unfit for human food, and destroyed as trade refuse : — 7 tons 15 cwt. 56 lbs. bananas 15½ pigs' livers 1½ crates „ 27¼ cwt. eggs 81 lbs. rabbits 3 cwt. 8 lbs. pears 80 lbs. currants 1 cwt. soles 2 trunks soles 92 lbs. cherries 1 cwt. sprats 6 cwt. 14 lbs. tomatoes 3¼ cwt. various fish 12 half sieves „ 3¾ cwt. haddock 4½ cwt. plums 1½ cwt. mackerel 26 half sieves plums 3½ cwt. skate 344 half sieves black currants 1¼ cwt. periwinkles 276 „ red „ 2 cwt. 14 lbs. catfish ½ ton onions 6 cwt. apples 1½ cwt. roker 4 ton 7 cwt. 42 lbs. dried plums 28 lbs. herrings 3 cwt. plaice. 4 ton 8 cwt. 76 lbs. various tinned foods Coffee Berries. The following is the report of the Chief Inspector to the Public Health Committee regarding the seizure of coffee berries which he made at Globe Wharf: — "On the 18th January, accompanied by the Medical Officer of Health, I went to Upper Globe Wharf, 199, Rotherhithe Street, occupied by the Desiccated Grains Company, and found a large quantity of raw coffee berries on the wharf, some in the process of drying and the remainder waiting to be dried, as well as a quantity in two barges, altogether about 66 tons. We also visited Fisher's Wharf, Rotherhithe Street, and found 6 tons in the same condition and going through the same process. The berries were damp, slimy, nearly all of them black, smelling strongly of sewage water, in a state of fermentation, some partially decomposed, and in our opinion quite unfit for the food of man. I seized them and requested the presiding magistrate at the Southwark Police Court to visit the wharves as the bulk was too great to be removed to the Court. After viewing the same he said he would give his decision the following morning, when he expressed his opinion that the coffee was unfit for the food of man; but on the application of the owner's solicitors the case was adjourned until the 24th inst., as they had given a bond to the Customs for a very large amount that the coffee when dried should be returned to the Customs, and if an Order was granted they were afraid they would not be able to fulfil their bond by returning the coffee. "On the 19th we went to Dudin's Wharf in Shad Thames and found 10 tons in the same condition, part of it being dried. We also went to Messrs. Gardiner & Tidy's at Farrand's Wharf, Bermondsey Wall, and found 8 tons in the same condition, evidently the whole of the same cargo. I seized the whole and got the magistrate to view the same, but he adjourned his decision until the 24th so as take the whole together. "On the 20th we again visited Upper Globe Wharf and found that 29 tons of coffee had been delivered and part was being dried. In our opinion this was also quite unfit for the food of man, and the same afternoon the presiding magistrate, after viewing the same, made an Order for its destruction. I served a copy of the Order on His Majesty's Customs and also on the owner of the wharf as the coffee was in bond. "On the 24th inst. Mr. Chapman gave his decision in the case of 90 tons; but at the request of the court, we did not proceed with the destruction of the 29 tons, as the owners intended to apply to Mr.Rose to prevent his Order being executed. Evidence was given by the Medical Officer of Health, the Public Analyst, Dr. Eyre, the Bacteriologist of Guy's Hospital, who also made a complete bacteriological examination, and myself. The owners of the coffee were represented by counsel, and produced a number of analytical chemists, doctors and coffee experts to prove that when roasted the coffee was made innocuous. The magistrate refused the application, holding that the coffee (although rightly seized, as in its then condition it was unfit for the food of man) was in course of preparation, and when that preparation was complete the coffee berries would be harmless. "On the 27th inst., application was made for the magistrate to rescind his Order as to the 29 tons, but he refused to do so. The coffee is still in charge of His Majesty's Customs." This was the most important food seizure during the year under report, since it concerned part of a large consignment of coffee which was damaged, owing to the sinking of the s.s. "Caravellas" in the Thames, near Gravesend. It had been submerged by at least two tides, and after this thorough soaking it remained in the hold some two or three weeks, where it underwent fermentation and presented a most unsightly mass. During the adjournment, after the first proceedings were taken the owners of the property occupied their time in collecting evidence that the coffee was wholesome, and obtained the services of several chemists and one doctor. There was no doubt that when roasted it had the smell of coffee, and produced a beverage having some resemblance to that article, but it had not the genuine taste, and it was entirely a stretch of imagination to describe it as wholesome. The Medical Officer gave evidence that a heat of 300° to 400° Fahr. would kill bacteria, and moulds but would not necessarily destroy their products of putrefaction, which were equivalent to various poisonous alkaloids. The coffee would be so altered in character that it would lose its good properties and be no longer wholesome. It would be likely to set up gastro-intestinal disturbances, and might convey typhoid germs in the same way as boiled sewage. Bacterial products could not be given in chemical formula, but they included various toxines. Alcohol was a bacterial product. Caffeine, the active principle of coffee, was not destroyed in the roasting, and it might, therefore, be presumed that toxic alkaloids would survive the process. Coffee itself was not an antiseptic, and people handling dirty, filthy coffee like this might impregnate good coffee. Dr. Eyre, bacteriologist for Guy's Hospital, examined the berries bacteriologically, and found there was evidence of at least 250 to 500 of the bacillus coli, also the bacillus of sewage and various other organisms were present. In other words the coffee acted as a cultivating medium, and the bacilli multiplied in it, so that its actual condition was worse than Thames water. He thought that drinking this coffee would be likely to produce gastro-intestinal trouble. Dr. Hugh Candy, Analyst to the London Hospital; Mr. E. J. Friswell, President to the Institute of Chemistry; and Dr.F.J.Smith, of Harley Street, gave evidence for the defence. The following comments on the case appeared in the "Lancet" of February 4th, 1905: — Coffee and Sewage. "A rather strange decision seems to have been arrived at in a case which was concluded at the Southwark police court on January 24th after an adjournment from the preceding week. The application made by the Chief Sanitary Inspector of the Borough of Bermondsey was for the destruction of 60 tons of coffee salvaged from a ship which had been sunk in the Thames and the summons was taken out in order to prevent the berries from being dried and sold for human consumption. The evidence of Dr.R.K.Brown, Medical Officer of Health for Bermondsey, of Dr.J.W.H.Byre, and of Mr. Bodmer was to the effect that the coffee was moist, sodden, permeated with sewage, and unfit for food purposes. Although they admitted that the necessary roasting might modify the dangerous conditions they declined to say that the subsequent decoction would thereby be rendered a wholesome beverage. On the other side, Mr. Friswell, of Great Tower Street, said that he had drunk coffee made from the sewage-laden berries without untoward results. Dr.F.J.Smith also gave evidence that he was prepared to do the same, but that he "would not do so for choice." The magistrate, Mr.C.Chapman, appears to have been satisfied that the usual roasting process was sufficient to render the coffee fit for the food of man and dismissed the application. If he could have ordered that the stuff when sold retail should be labelled "coffee and sewage," so that the purchaser would have the same choice in purchasing that the law gives him in the case of admixture with chicory, the matter might have passed without comment. Few, even when tempted by a cheaper price, would be likely to buy coffee if they knew that it had undergone soaking in the diluted products of the metropolitan drainage system, although the decision of the learned magistrate would seem to be a certificate that 60 tons possibly saturated in varying degrees will make a safe and wholesome drink for those who will partake of it. According to the "Standard" it now appears that Mr.Rose, at Southwark police court, refused to revoke his Order for the destruction of the coffee in spite of Mr.Chapman holding with regard to a portion of it that it was fit for human consumption. If this be so, we congratulate Mr. Rose on his attitude." The rest of the coffee was subsequently destroyed to the satisfaction of the customs, by mixing with quicklime, with the intention, it is stated, of it being used for manure. This was permitted on the Desiccated Grain Co. giving a guarantee that it was not intended for human food. Bacteriological Laboratory. The total number of specimens examined during 1905 was 402, against 432 in 1904. There is somewhat more advantage taken by medical practitioners in sending in diphtheria swabs, 108 being sent in against 91 in the previous year. Number Examined. Result of Examination. Positive Result. Negative Result. Nature of Specimen. Diphtheria (specimens taken by Medical 119 14 105 Officer of Health) Ditto (taken by medical practitioners) 108 20 88 Diphtheria (total specimens taken) ... 227 34 193 yiu UOjl UCUiXVA-iy •" I iJiJI «•*■ ' Tubercle| 156 48 108 Enteric i 15 j 3 12 I 1 r% Various 4 2 2 ~~ — ; 7~ ~~ i Total specimens taken 402 j 87 j 315 Addrs ss. Occupants of overcrowded part of house. Rooms occupied and cubic feet space. Deficiency. State of Premises and Family. Space Required. J I "Cubicfeet 360 Second floor, back room, 840 cubic feet The husband is a leather dresser by trade, but is now working as a waterside labourer, earning from 6s. to 12s. per week. Tbey have lived here 9 months. The room is dirty, and the light and ventilation fair. Tower Bridge Ed. 2 adults and girl (9), boy (6) Living and sleeping, 1200 cubic feet The following cases of overcrowding were visited by the Medical Officer of Health during 1905. West Lane ! Living and sleeping, 1200 cubic feet Second floor front room, 1053 cubic feet 147 The husband is a labourer, out of work, and the wife earns 12s. to 14s. per week at Southwell's. The room is clean, but the bedding is very scanty and dirty. The light and ventilation are fair. 2 adults, and girls (2 J and 9 months) Blaekman's Court Man, wife, son (17), daughter (15) Living and sleeping, IGOO cubic feet Ground floor front room, 727 cubic feet 873 The husband is a calf kid dresser, but has not followed his occupation for some j'ears. lie now earns a precarious living as a casual labourer, earning from ss. to 10s. weekly. The son is a van boy and earns 7s. per week. The wife and daughter are not earning anything. This i 3 a bad case of overcrowding and indecent occupation. The room is fairly clean, but the light and ventilation were indifferent on the day I visited it. Man, wife, 2 girls (15 and 11) Tarkers Buildings Sleeping, 1200 cubic feet Ground floor front room, 792 cubic feet 408 The husband is a purveyor of calves' feet and makes a precarious living, the gross receipts, he states, being 30s. per week, out of which he pays his son ss. or 65., besides feeding him. He is an epileptic. The other members of the family assist him in the business, The rooms generally are dirty and untidy, and the bedclothes scanty and dirty. The light and ventilation are not very good. Overcrowding. 82 Living and sleeping, 1600 cubic feet Do. Woman, 2 boys (13 and 10), and girl (14) first floor front room, 968 cubic feet 632 The woman earns about ss. per week by washing, receives parish relief, about 3s. per week, and the girl earns about ss. per week. The light and ventilation are good but the room is damp and out of repair ; it is fairly clean. She stateß that the boy (age 3 13) now sleeps at 18, Hargrave Square. Man and wife Living and sleeping, 800 cubic feet Do. First floor back room, 590 cubic feet 210 The husband is a casual labourer at present out of employment, but when in work, states, he earns about 15s. per week. The room itself is dirty and dilapidated The bedclothes are clean, but the people are evidently very poor. The light and ventilation are passable. Ciarka Orchard Man, wife, and 2 children, 11 (male), and 8 (female) Living and sleeping, 1-100 cubic feet Ground floor right hand room, 1012 cubic feet 388 *1— — * The husband is a waterside labourer earning a precarious living. The wife works at a jam factory, and is stated to earn or S)s. per week. The light is indifferent, and the ventilation fair. The room is fairly clean but untidy, and the bedclothes aro scanty. They are evidently very poor, but could, I think, afford another room. Kocherhitho Street Man, wife, girls (1| and 9), and boys (8 and G) Living and sleeping, IGOO cubic feet | First floor, 2 back rooms, 1305 cubic r . < 295 | i I The husband, a casual dock labourer, is stated to earn 15s. per week. The rent is 4s. Gd. per week. The room is clean and the bedclothes fair. The light and ventilation were good at the time of visit. <• (Xcupair.s of ov< rcrowJed part of house. ltooms occupied and cubic feet space. Deficiency. Space Required. State of Premises and Family. •2 adults and 4 children, girls (3 and 5), boys (4, and 11 months) Sleeping, 1200 cubic feet Ground floor, front room and scullery, 1072 cubic feet ' ! Cubic feet 123 The husband is a casual labourer earning a precarious living. The rent for the house is 9s. per week, and they let off two rooms for ss. per week. The light and ventilation are very indifferent, and the bedclothes scanty and dirty. They are evidently very poor. Living and sleeping, 1600 cubic feet Front room, first floor, 1169 cubic feet 431 ~ j • ~ j r The room is clean and tidy. The ventilation is good, and the light proceeds from two windows, one at the side and one at the end. The occupier informs me she is a brush drawer by trade but has had no work for nearly two years. She earns from 4s. to ss. per week at washing. Her daughter earns on an average 7s. per week at a tin manufactory in Eiley Street, and the boy earns about 2s. 6d. to 3s. per week selling muffins on Sunday. The rent is 4s. per week. She says she cannot afford any more room at present, but as soon as her son obtains some better employment, which is expected every day, she is prepared to take another small room on the same landing. Woman, boys (14 and 11), and girl (16) Man, wife, boys and 3 years) Living and sleeping, 1400 cubic feet Front room, second floor, 914 cubic feet 486 x x t •-» The husband is a waterside labourer at present out of work, but expects to have a fortnight's work at Christmas for the Post Office. For the last few weeks he has earned 10s. per week. His wife earns up to lis. per week at Southwell's. The room is fairly clean, but the bedclothes are scanty and dirty, and the light and ventilation bad. The rent is 2s. 6d. per week, and this is regularly paid. Man, wife, boy (9), girl (4 and 7 months) Living and sleeping, 1400 cubic feet Front room, first floor, 1173 cubic feet 227 The husband has been a casual carman and labourer since he left the Field Artillery in 1898. He has not done any work for a fortnight. The wife earns from 7s. to 10s. per week at jam factories. The rent is 7s. per week. The liiiht and ventilation are fair. They are trying to find another place, and in my opinion they can obtain much better accommodation in other parts of the Borough for the same rent. Man, wife, girls (4 and 3 weeks) Living and sleeping, 1200 cubic feet Back room, first floor, 954 cubic feet 216 The husband, a leather dresser, has been doing casual work for the past five years. He is out o! work at present. The wife makes a little money by minding her sister's children while the latter is at work. The light and ventilation are fair. The rent is 6s. per week. Much better accommodation could, in my opinion, be obtained for the same money. This is the class of house which should be put on the register of houses let in lodgings, and I would suggest that it be measured up with a view to placing it on the register as soon as it becomes re-occupied. Hairdressers and Barbers. The following report was submitted to the Public Health Committee on February 13th: — The question of the advisability of framing regulations for the conduct of the businesses of hairdressers and barbers was raised by Dr. Collingridge, Medical Officer of Health for the City of London, in a valuable report made to the Sanitary Committee of the Corporation last year. In this he gives the result of inquiries made in practically all civilised countries as to their action in the matter. Sixty replies were received, 46 from foreign countries and 14 from our colonies abroad. He says, "Speaking generally, it may be said that sanitary regulations, or statutes specially controlling barbers and hairdressers, exist in but few of the civilized countries of the world. There are none in force in any of the British Colonies, but the Board of Health of the Province of Ontario, Canada, have the matter under consideration." Regulations, as far as can be ascertained, are in operation in the following countries, viz.:—America (New York State), Bolivia, Germany (Anhalt, Waldeck, Hamburg and Danzic), .Japan, Salvador, Servia, Sweden, Switzerland (Lausanne, Vevey, and Rolle), Turkey and Uruguay. The only English-speaking country which has adopted regulations is America, and this is the State of New York. Here barbers require to pass an examination before plying their trade, must then register and conform to certain antiseptic regulations. They are regularly inspected to see that they are carried out. The law empowering the making of such regulations met with little opposition. There are said to be 15,000 hairdressers and barbers on the register there at present. The remainder of the report is taken up mainly with an account of the regulations adopted in the various countries. They are all very similar and aim at two objects, viz.:—general cleanliness and antiseptic precautions in various degrees. The following regulations and recommendations for the conduct of hairdressers' saloons have been drawn up by the Incorporated Guild of Hairdressers, Wigmakers and Perfumers in conjunction with the Medical Officer of Health for the City of London : — 1. All shelves, fittings and tables on which instruments are placed, to be of glass, marble, slate, or other similar material. 2. Clean towel, etc., to be used for each customer, and a fresh piece of paper or clean linen to be placed on the back of chair or head rest. 3. No general powder puffs to be used, and powder pulverizers or cotton wool to be substituted. No sponges to be used. 4. All hairclippers, razors, scissors, combs or other tools, after use, to be placed in a disinfection solution. 5. Razors to be wiped on paper. 6. Perfectly clean hairbrushes only may be used. 7. Shaving brushes, after use, to be placed in a disinfection solution. 8. Liquid or powdered soap or shaving cream only to be used. 9. Cut hair falling on the floor to be immediately swept up and removed, and floors to be cleansed daily. 10. No general alum crystals or blocks to be used as a styptic, but a liquid or powder applied on towel or cotton wool or by spray. 11. The most scrupulous cleanliness to be observed in all that pertains to the business. The foregoing regulations give a very fair idea of the kind which have been adopted elsewhere. As there are no members of the above Guild in this Borough or of any other Association with which we can deal, I have approached the subject from a general point of view, and directed my inquiries first into the conditions of the business of the hairdressers and barbers of the Borough as to cleanliness, and secondly from the doctors practising in the district as to the prevalence of diseases communicated by the processes of shaving and hair-cutting. Taking the last question first, I wrote to practitioners practising in the Borough and received twenty-six replies. The questions I put were:- (1) The disease most commonly transmitted; (2) Average number of cases per annum which come under their personal observation, and (3) Implements which in their opinion are most likely to be spreaders of infection. The replies varied somewhat on all these points, but principally as to the number of cases annually treated by them. All agree that the most common disease transmitted by shaving is tinea sycosis (tinea barbae-barbers' itch) which is highly infectious, difficult to cure, and frequently leaves permanent effects behind. Other diseases transmitted in a similar manner are ringworm and impetigo contagiosa (a species of eczema). These diseases might be termed local. I have been unable to trace an example of the transmission of any constitutional disease by shaving, though I inquired of one of the highest authorities in London; still there is an obvious possibility, and I am somewhat surprised that there is not more evidence on this head. It is very difficult to come to a conclusion as to what implements are most to blame in conveying these infections, but I should be inclined to place them in the following order, beginning with the most likely : —Brush, razor, powder puff, sponges, styptic, and towel. I should think that it is probable that the brush harbours infection in the largest amount, but the razor, by producing a slight breach of skin, is responsible for the actual inoculation. As to the number of cases treated annually by these practitioners, 2 state the cases have been numerous, 4 that they have ranged from 10 to 12 per annum, 2 an average of about 6 per annum, 8 estimate the number at 2 to 4 per annum, 3 state they have a few, and 5 do not give any estimate. These estimates principally relate to contagion produced by shaving. One must of course be cautious in receiving estimates of this sort since there is a tendency on the part of patients to attribute a large part of the troubles which attack this part of the face to the barber, if they happen recently to have been shaved by one. However, one can gather from these estimates, making allowance for possible exaggeration, that there is a considerable amount of skin disease attributable to this source. As to the danger of inoculation during the process of hair-cutting it is most difficult to form an opinion. The diseases most likely to be transmitted here are the different forms of ringworm of the scalp, and also eczema (impetigo), and various parasites which use the human hair and skin as their hosts. These could be transmitted by the clippers, brushes, combs, etc. I do not doubt that many of the cases of ringworm of the scalp, pediculi, etc., occurring in clean children, and often erroneously attributed to "school," acquire their infection during the fortnightly or three weekly Saturday morning hair-clipping which most of them undergo. _ To come to the second aspect of the inquiry, viz, the hairdressers' and barbers' establishments. I have had them all enumerated and inspected. After this was done I visited personally most of them so as to get some uniformity as to the general estimation of cleanliness. There are at present 88 hairdressers and barbers in this Borough, 43 of which are kept by Englishmen, and 45 by foreigners. This latter fact, however, has not much bearing on the subject, since there is little to choose between the two as regards cleanliness. Of these some 13 or 14 might be designated as "very clean" and leaving little room for improvement. (I am not here referring to antiseptic precautions.) Fifty-eight I would call fairly clean, and by this I mean that their premises were kept as pure as their condition, in the matter of repair, suitability of the fittings, tools, etc., would permit. The remaining 17 I would classify as dirty, i.e., the walls, floors, shelves, brushes, and persons of the barbers themselves might be called dirty and untidy. That cleanliness is inexpensive is proved by the fact that those classified among the very clean did not all live in the neighbourhood of London Bridge, but one or two could be found in the poor parts of the Borough, where the prices charged were among the lowest. Among some of the better class hairdressers I found all the precautions advised in vogue, viz., clean paper for head rests, clean towels for each customer, etc., except the use of any antiseptics. I only came across one barber in ope of the poorer neighbourhoods who adopted the precaution of dipping his razor in an antiseptic before shaving. The principal defects in the large majority of places visited were, want of some impervious material on the floor which could be frequently washed or cleaned, unsuitability of the shelves, etc., where instruments were placed (in many of the poorest shops these consist of marble, showing that it was not. an unobtainable luxury), want of waste pipes to the basins, insufficiency of the water supply, especially of hot water, which in many cases was kept in very small urns. In about a dozen or so the water was kept simmering all day in a common pot over a small gas jet. Into this pot the brush for shaving was -dipped direct. One barber informed me that the contents resembled a- jelly at the end of the day as it became so impregnated with soap. They say this cannot convey infection because it is boiling, but this is not so for I did not see it boiling once, and in a few cases in which I took the temperature it varied from 60° to 80° C., a temperature which is not guaranteed to get rid of all germs. The head rests were frequently broken and dirty, and the towels, brushes, etc., dirty. Other defects were a want of personal cleanliness of the operators themselves, deficiency of light and ventilation in the workshops. As to the general results of my inquiries and visits, I came to the conclusion that there were many possible and even probable sources of infection to be found in this business. Having come to these conclusions the next point is to consider the remedies. I inquired in each the charge for shaving and haircutting, my reason for doing this being that the regulations suggested should not press too heavily on the humbler members of the trade. With the exception of a few hairdressers in the neighbourhood of the railway station, the charges for shaving and haircutting are fairly uniform throughout the Borough, that for the former being three-half-pence and twopence, and for haircutting threepence. There are a certain number charge one penny for shaving, but they are comparatively few, and in scarcely one is it the exclusive charge. Taking general cleanliness first, I do not think it would be the least hardship to insist on a general raising of the standard. Some of the poorest shops were above reproach in this respect, and for this purpose certain regulations as to the structure of the premises would bo advisable. The floor should be covered with some impervious material, such as good linoleum, and all shelves, fittings and tables made as directed in regulation lof the City. All basins should have a properly trapped waste pipe, and there should be a plentiful supply of hot and cold water. The common hot water pot should be done away with and a large urn put in its place. Head rests should be made of impervious material and wiped after every customer with a damp cloth and some disinfectant. The barber himself should keep his hands clean and wear some sort of linen overall. Passing on to special regulations all razors should be dipped into some disinfectant solution before shaving, and then into hot water. There is a great difference of opinion among barbers as to the effect of hot water on the razor, but I have it from one of the foremost manufacturers that it does the edge good, and from another that it does no harm. The brush is more difficult to deal with. It should be dipped in boiling water and cleansed after each customer and boiled at night for the next day. There are cheap brushes made with the hair right through and bound with cord, which will stand boiling without doing any harm. I do not know, at present, of any cheap effective disinfectant which would be likely not to irritate the skin of the face. The best solution for regular customers would be for them all to provide themselves with shaving pot, brush and soap. This is done in most of the places at a charge of twopence per shave, but one man at least, who charged one penny, said he could do it just as well for this fee if his customers would have it, as the only expense was the initial outlay. Clean towels should be used to dry the face with afterwards, but I do not insist on the necessity for a clean one for every customer as the price paid would not admit of it. The only styptic should be a little powdered alum and not a common piece for all. The powder puff should be done away with and in its stead a spray for powder or liquid used. This is already being done in many of the small places. In haircutting and dressing the brushes used should be washed daily, the combs dipped frequently in some disinfectant, and the clippers run through the bunsen flame before using, and scrupulous cleanliness observed in every operation of the business. There is not a single regulation suggested here which could not be carried out in the poorest shop, and, as pointed out, is carried out already in some with the exception of the antiseptics. As to how this could be done is another matter. The City of London are effecting this in conjunction with the Guild of Hairdressers, by giving a certificate to those who carry the regulations out. As the regulations are printed and posted up in the shop the customers are a check on the barbers and can demand the precautions. Some similar method could be adopted here, and there is no doubt that those who did not have a certificate would soon find that it would be to their interest to comply with the regulations as their cleaner and more aseptic brethren would tend to draw the custom. The second method would be legislation empowering the Borough Councils to make regulations to the like effect as those sketched above, and I do not doubt that something of this kind will take place in the future. Your obedient servant, R. K. BROWN, M.D. In connection with the 17 shops which were found in a dirty condition, the following action was taken: — Notices given— Verbal 3 Written 2 Premises found cleaner on reinspection 8 No improvement found 4 17 The proprietors promised to he more careful in the future in five cases. In the tour in which no improvement was found, the premises were not sufficiently dirty to serve a notice. Food and Drugs. In Tables XVII. and XVIII. of Appendix will be found a list of the samples taken in 1905, and the action taken. There were 990 samples taken compared with 844 in 1904. Of these 8.7 per cent. were found adulterated compared with 8.2 per cent. in 1904. During the past year an alteration has been made in the administration of the Food and Drugs Acts. For the purpose of administering these, the District Inspectors' districts have been changed so that they do not at present take samples on their own districts. It was thought by the Committee that the Inspectors were too well known on their own districts to discover adulteration efficiently, so the Medical Officer of Health and the Chief Sanitary Inspector were given instructions to see that some alteration was made. Accordingly we arranged that the Inspectors should have different districts and these be changed every six months. This arrangement has been found advantageous since a larger number of offences committed under these Acts have been brought to light, especially as regards the commoner articles of food. For instance, the percentage of adulteration in milk has increased. This is satisfactory as far as it goes, and shows that toe mere fact of a small percentage of adulteration discovered does not necessarily mean that the articles in the district are less adulterated than previously, but indicates that the amount of adulteration discovered depends largely on the methods used to discover it. I am still of opinion that one capable Inspector could administer these Acts more uniformly, and by specialising, could adopt more efficient methods of discovering adulteration. I purpose bringing this matter up again as soon as a favourable opportunity occurs, and after the present system has had a fair trial. The following table gives particulars of the genuine samples of milk taken. On the whole they are of poorer quality than those taken in the previous year, but are slightly better than the 1903 samples: — Of the samples taken in 1905 — Milk fat — Under 3 per cent. 9 1"7 per cent, of total 3 per cent. and under 3.5 per cent 216 42.77 „ 3.5 „ 4 „ 168 33.26 4 per cent. and over 112 22-17 505 100 1904— Under 3 per cent 5 I' 2 per cent, of total 3 per cent, and under 3'5 per cent 147 35*1 ~ 3'5 „ 4 ~ 1«4 89-1 Ci A .r* 4 per ccnt. and over 103 24-6 419 100-0 1903— Under 3 per cent. _ 32 8'63 per cent, of total XIVHJL *-» 3 per cent, and under 3*5 per cent 134 36-12 3*5 „ 4 „ 135 36-38 4 per cent, and over 70 18-87 S7T 100 Smoke Nuisance. 395 observations were made, and 100 nuisances reported to the Committee. On October 6th Messrs. Enthoven, Rotherhithe Street, were summoned for a nuisance of 10 minutes at their premises on July 3rd ; a fine of £10, and 2s. costs were inflicted. On January 30th, 1906, the London Brighton & South Coast Railway were fined £2, and £2 2s costs for a nuisance in connection with their locomotive No. 468, on November 16th. On September 20th Messrs. W.P.Hartley were fined £5, and 2s. costs, for a nuisance at their premises in Green Walk on August 15th. Customs and Revenue Inland Act. A certificate under section 26 of the above Act was granted to the following premises:- Seaford Buildings, Swan Lane —40 tenements. House Refuse. The following table shows the amount of house and trade refuse disposed of during the year finding December, 1905:— Loads. Tons. Cvvt. Quarters. 9815 19507 6 3 Bermondsey Destructor 0 East Lane Wharf 614 1166 12 299½ 569 1 0 Bull Head Dock 21242 3 Total 10728½ 19 Cleansing of Persons Act, 1897. On March 28th, 1905, the following report was submitted to the Public Health Committee:- This is a short Act which gives the local authority discretionary power to permit any person who shall apply to the said authority, on the ground that he is infested with vermin, to have the use, free of charge, of the apparatus (if any) which the authority possess for cleansing the person and his clothing from vermin." This is not to be considered parochial relief with its disabilities. "Local authorities may expend any reasonable sum on buildings, appliances, and attendants that may be required," and "any expenses for these purposes may be defrayed out of any rate or fund applicable by the authority for general sanitary purposes or for the relief of the poor." Nothing has been done in Bermondsey towards administration of this Act. The Guardians, to whom the matter was referred in 1897, decided to take no action. I have made inquiries in St. Marylebone, St. Pancras, Woolwich, and Westminster, which seem to be the only Boroughs which have taken steps in the matter, and received the following information in reply:- St. Marylebone.—Four Baths (2 for females and 2 for males) were provided in 1898 at a cost of .£364, and for a small disinfector connected therewith, £126 10s. was paid. The following number of persons have used the Baths since they were constructed: — Males. Females. Total. 1898—from March 2nd to Dec. 31st 3301 5 3306 1899— „ Jan. 1st to Dec. 31st 4340 4340 - 1900— „ „ „ 31 3401 3432 1901— „ „ „ 4140 142 4282 1902- „ „ „ 4250 278 4528 1903— „ „ „ 5515 655 6170 1904— „ „ „ 7089 1376 8465 The cost of the annual upkeep, including attendants' wages, etc., and laundry work, is about £280. St. Pancras. —This Borough provided four baths (2 for males and 2 for females) in 1904. Part of an existing building was adapted for the purpose at a cost of about £80. The number of persons infested with vermin or in an unwholesome condition who were cleansed and whose clothing was'disinfected during the last three quarters was as follows:- Quarters Males. Females. Children. Total. Second 266 127 79 472 Third 395 217 168 780 Fourth 291 170 83 544 952 514 330 1796 The cost of the upkeep has not yet been worked out, but at present £1 per week is paid to a female attendant for the women and children, and in addition, cost of water, gas for geysers, soap, brushes, towels, etc., and a small part of wage of the attendant at the steam disinfecting apparatus will have to be recovered. Westminster.—When the Act came into force the late Strand Board resolved that the disinfecting chamber which is provided with baths should be utilised as far as possible without interference with the ordinary disinfecting work. Since the incorporation of the City the same practice has been followed, but as the building has been pulled down for a new street, they are considering as to the provision of new premises. They find the Guardians deal with a number of cases. Woolwich.—An estimate has been made for carrying out the Cleansing of Persons Act for £150 for the ensuing financial year, and plans are under consideration. It is proposed to start in the first instance with one bath, and enlarge later to two, one for each sex. The establishment will adjoin the disinfecting station. Judging from the St. Marylebone figures it would seem as if the number of bathers increased as the baths became more known. At present there is no accommodation for carrying out the Act in Bermondsey except the part connected with disinfecting the clothes. The existing bathroom accommodation in the baths and wash-houses and the shelter is unsuitable for the purpose, since this Act is intended to benefit the verminous and very dirtiest of the population, and to put these baths to such a use, especially if the numbers should be anything like those in St. Marylebone and St. Pancras, would destroy their reputation as regards their present use. It would therefore seem necessary to erect one or two baths, with waiting rooms, to be used for this purpose alone. The most suitable place I can suggest is the building known as the pump-house situated in the Spa Road entrance to the Depot, along the side of the Baths and Wash-houses. It is at present occupied by a disused pump, and seems to be mainly used for lumber. It is 6 ft. wide and 44 ft. long. The Surveyor states there would be ample accommodation for two baths with waiting rooms adjoining each, and that the cost of adapting the building for this purpose would not exceed £75. The water, etc., would be readily obtained from the present Baths, and a suitable entrance could be made at each end, one for males and one for females. This report came before the Council on May 16th, when it was decided not to take any action in the matter. The following report was made on February 13th, 1906: — In accordance with the instructions of the Public Health Committee I beg to submit the report of the Surveyor accompanied by plans. Facts were brought forward in a previous report to show that those Boroughs which had adopted the Cleansing of Persons Act, and had taken means to make its advantages known to those members of the community who might require the same, had found the establishment of them a success. The plans and estimate submitted by the Surveyor are of the very simplest kind, and I would suggest that, as the adoption would be in the nature of an experiment, the system of upkeep should also be of the simplest nature. For the male bath, one of the hands employed at the Disinfector would be available, and for the female side one of the hands at present on the premises, such as the wife of the keeper of the Shelter, could be asked to act as attendant, payment being made according to the time occupied. Ido not think any other arrangement is necessary to begin with. If this is adopted I think a sum of £50 per annum would cover the expenses, and include such things as hot water, light and soap. The following is the Surveyor's estimate: — " Men's and Women's Baths in a portion of the Office situated on the old Depot, and adjoining the Public Baths, Neckinger. " The scheme provides for dividing a portion of the building with brick walls in order to form two separate bath rooms, and fitting each up with baths and laying the hot and cold water supply on from the laundry section of the Public Baths adjoining. "The walls and ceilings will be plastered with Keen's or other approved cement, in order to render same impervious to vermin and capable of being washed down with a hose pipe if necessary. " The specification includes for removing the whole of the present internal fittings including fireplace and chimney, and the outside gantry, the estimate for the work being approximately £100." When the estimates were brought up in March of the present year, the Council agreed to include an estimate for the above. Alien Immigration. The following report was made to the Public Health Committee at their meeting on September 26th. " I received information in the early part of last week that a number or aliens were being landed by ships from Russia at Hay's Wharf. I immediately wrote to the Port Sanitary Authority requesting them to be good enough to advise me as to the arrival of vessels carrying them. Accordingly on September 20th I received word of the arrival of the s.s. Micail from Riga at the above wharf at 5.60 p.m. On arriving at the wharf I found the ship contained 325 aliens, mostly from Russian Poland. They seemed to be very poor, ill fed, badly clothed, and some of them not very clean. About three-fourths were passing through to the Argentine, Canada and the United States, the rest remaining in London. The Port Medical Officer and his assistants examined them all carefully at Gravesend, and took the names and addresses of those who were to remain in London. These addresses are forwarded to the respective sanitary authorities. Those who were on their way to America were conveyed across London to St. Paneras in the private omnibuses of the Midland Railway Company. It seemed to me a somewhat objectionable use to put these vehicles to, so I have written to the Railway Company suggesting that if they do not already take precautions against the possible spread of infection or vermin before these omnibuses are hired out again to the public, they ought to do so. Those aliens who were destined to various parts of London were conveyed in open brakes. The wharf owners as well as the ship owners are in the habit of cleansing and disinfecting the places occupied by these people, so that I think the omnibuses at least should be subjected to similar treatment. I also wrote to the owners of the brakes. The Midland Railway Company replied stating that every possible precaution was taken in respect to their vehicles, but I received no reply from the owners of the brakes. IV.—FACTORIES AND WORKSHOPS. In Table XIV. of the Appendix will be found particulars of inspections of factories and workshops, and the action taken, and in the following table some particulars regarding the number of workshops on the register and the persons employed. In 1905 there were 527 workshops on the register, against 476 in 1904, and in 1903. Including bakehouses, of which there are 105, the total is 632. Lead Poisoning. One case of lead poisoning occurred during the year. The following report was made to the Public Health Committee on October 31st:- "On the 17th inst. I received information from Guy's Hospital that A.W., of 26, Wood's Place, was suffering from chronic lead poisoning, which has taken the form of wrist drop. The patient works in the white-lead department of Messrs. Brandram Bros., Neptune Street. I have sent a communication to the Home Office on the subject." Outworkers. There were 555 outworkers on the register at the end of 1905. Several of these are on the register of workshops. 42 lists were sent in by firms in the Borough giving out work. In spite of the warning notice there is still difficulty in getting these lists regularly. The following firms were reported for not sending in their lists, but proceedings were not taken, as the majority complied with the Act immediately afterwards, and the remainder after receipt of a warning letter from the Town Clerk: — Evans, G. & Co.99, Tower Bridge Road. Hobbs, W.H. Southwark Park Road. Gosling, Miss 4, Slippers Place. Martin, Martha 51, Linsey Street. Peachey, Elizabeth 48, Grange Road. Schimel, Sophia Jamaica Road. *Ennis, Mrs.26A, Trothy Road. *Chave, Mr. Galleywall Road. Faulls, S. 124, Jamaica Road. *Goulding & Son 140, Abbey Street. *Nottingham, H.N202, Jamaica Road. Templeman, M. 185, Bermondsey Street. Turnbull, Elizabeth 137, Galleywall Road. Warwick, C. 2, Reverdy Road. *Williams, T. & S. Abbeyfield Road. Note.-Those starred were written to by the Town Clerk. The Secretary of State, by a special Order of August 15th, 1905, added certain trades to the list, in which the firms are required to send in lists of outworkers, so that the total now coming under the requirements for home work are : — I. Section 107 (relating to lists of out-workers) and Section 108 (relating to employment in unwholesome premises) shall apply to the following classes of work:- The making, cleaning, washing, altering, ornamenting, finishing, and repairing of wearing apparel and any work incidental thereto; The making, ornamenting, mending, and finishing of lace and of lace curtains and nets; Cabinet and furniture making and upholstery work; The making of electro-plate; The making of files; Fur-pulling; The making of iron and steel cables and chains; The making of iron and steel anchors and grapnels; The making of cart gear, including swivels, rings, loops, gear buckles, mullin bits, hooks, and attachments of all kinds ; The making of locks, latches, and keys; The making of covers for, and the covering, finishing, altering or repairing of, umbrellas, sunshades, parasols, and articles of a similar character, and any work incidental thereto; The making of paper bags and of paper boxes; Brushmaking; and The making of staffed toys. In five cases of scarlet fever which occurred in the homes of outworkers, the work was stopped until the premises were disinfected. In one of these cases the patient was kept at home, thus necessitating the stoppage of homework for eight weeks. Female Sanitary Inspector. The Council had no special report to consider on the advisability of employing a female Sanitary Inspector, since their refusal to entertain the proposal when it was brought up on several previous occasions rendered it probable that a similar fate would befall any such proposal if it were brought up during the year under report. The increasing employment of female labour and its connection with infantile mortality are bringing the subject of factories and workshops where such labour is employed every day into greater prominence, and from the reports of those public bodies who employ female Inspectors I hope the Council will not continue its present attitude, but sanction the appointment of one in the Borough. The sanitary condition of factories and workshops where women are employed is essentially a question for investigation by women, since to obtain all the facts the employers and employed must both be interrogated, a thing which for obvious reasons cannot be effectually done by the ordinary male Inspector. Bakehouses. There are at present 105 retail bakehouses in the Borough, viz., 41 underground and 64 above. Of the underground 33 are in use and 8 not. Six of these were not in use at the time the Factory and Workshop Act came into force and two were not granted certificates as the owners did not comply with the requirements of the Council. Of the 64 overground bakehouses 55 are in use and 9 not. The bakehouses were all visited twice during the year, and the usual requirements as to limewashing were complied with. APPENDIX. 42 APPENDIX. Table I.—Vital Statistics of Whole District during 1905 and Previous Years. Year. 1 Population estimated to Middle of each Year. 2 Births. Total Deaths Registered in the District. Net Deaths at all Ages belonging to the District. Deaths of Nonresidents registered in Public Institutions in the District. 10 Total Deaths in Public Institu-tions in the District. 9 Deaths of Residents registered in Public Institutions beyond the District. 11 Number. 3 Rate.* 4 Under 1 Year of Age. At all Ages. Number. 12 Rate.* 13 Number. 5 Rate per 1000 Births registered. 6 Rate.* 8 Number. 7 137,438 4944 35.9 818 165 19.3 387 41 2966 21.6 1895 2650 357 1896 137,231 4968 30.2 807 162 2646 19.3 385 57 2968 379 21.6 1897 135,827 4868 35.8 903 185 2540 18.7 404 35 2902 21.4 397 1898 134,446 4745 35.3 779 164 18.0 438 81 2776 20.6 2422 435 1899 133,085 4690 35.2 855 182 21.2 515 48 3204 24.1 2817 435 1900 131,748 4410 33.5 837 190 20.4 540 99 3062 2684 477 23.3 1901 130,633 4459 34.1 711 159 17.8 423 52 2719 20.8 2320 451 1902 130,137 4346 33.4 636 146 460 63 21.2 2323 17.8 496 2756 1903 129,654 4200 32.4 596 142 414 40 1973 15.2 449 2382 18.4 1904 129,187 4193 32.4 654 156 16.6 44 2593 2142 440 495 20.1 Averages for years 1895-1904 132,939 34.4 760 2452 18.4 56 2833 21.3 4582 165 441 437 128,730 4288 33.3 1911 14.8 439 33 2399 18.6 1905 547 127 521 Rates in columns 4, 8, and 13 calculated per 1,000 of estimated population. Area of District in acres (exclusive of area covered by water), 1336.1. At Census of 1901—Total population of all ages, 130,760. „ „ Number of inhabited houses, 15,817. „ „ Average number of persons per house, 8.26. I. Institutions within the District receiving sick and infirm persons from outside the District. II. Institutions outside the District receiving sick and infirm persons from the District. III. Other Institutions, the deaths in which have been distributed among the several localities in the District. No. of Deaths. No. of Deaths. Guy's Hospital Bermondsey Infirmary, Lower Road BermondseY Workhouse, Ladywell—61 deaths 228 10 Bermondsey Workhouse, Ladywell 61 „ Children's Home, Peckham Rye Bermondsey Workhouse, Parish Street 15 2 Brook Hospital 23 Park „ 10 Deaths in River Thames, Surrey Commercial Docks, etc. 21 Gore Farm Hospital 1 St. Bartholomew's Hospital 9 Evelina Hospital 21 Seamen's Hospital, Greenwich. 2 33 Total King's College Hospital 6 London Hospital 6 St. Thomas' Hospital 8 Charing Cross Hospital 2 East London Hospital 8 Middlesex Hospital 2 Hostel of God 1 Mount Vernon Hospital 2 Homoeopathic Hospital 1 Chelsea Cancer Hospital 1 Children's Hospital, Great Ormond Street 2 London Fever Hospital 1 German Hospital 1 Chest Hospital, Victoria Park 1 Brompton Hospital 2 Chelsea Hospital for Women 1 Westminster Hospital 1 Royal Chest Hospital 1 Royal Free Hospital 1 St. George's Hospital 1 Cottage Hospital, Eltham 1 Belgrave Children's Hospital 2 43 I. Institutions within the District receiving sick and infirm persons from outside the District. II. Institutions outside the District receiving sick and infirm persons from the District. II. Other Institutions, the deaths in which have been distributed among the several localities in the District. No of Deaths General Lying-in Hospital, York Road 2 Friedenheim Hospital 1 Grove Hospital 1 Banstead Asylum 6 Cane Hill Asylum 9 Caterham Asylum 16 Claybury Asylum 6 Camberwell House Asylum 1 Darenth Asylum 2 Dartford Asylum 6 Horton Asylum 7 Leavesden Asylum 1 Norwood Asylum 2 Tooting Bee Asylum 12 St. Peter's House 5 Infirmary, Camberwell 1 „ Lewisham 1 „ Whitechapel 1 „ Greenwich 1 Workhouse, Newington 1 „ Southwark 1 Wandsworth Prison 1 Orphan Schools, Mildmay Park 1 Miscellaneous 14 Total 521 Table II.—Vital Statistics of separate Localities in 1905 and previous Years. BERMONDSEY. ROTHERHITHE. ST. OLAVE'S. 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 mid dle of each year. Births registered. Deaths under 1 year. Deaths at all ages. Year. 1895 85,356 3212 1869 520 1304 783 11,874 428 314 40,208 193 88 1346 834 11,627 419 1896 85,323 3203 513 40,281 214 261 1873 64 1897 84,717 3176 605 39,890 1258 766 11,220 434 253 1883 219 67 485 84,116 39,504 1298 773 232 1898 3090 1771 220 10,826 357 47 1899 3063 574 1266 865 10,446 361 276 83,518 2063 39,121 215 53 2826 1184 883 243 10,081 231 1900 82,925 1948 526 38,742 400 48 1901 82,441 2920 1768 497 38,446 1220 747 9,746 319 204 215 42 1782 1902 82,281 2855 455 1170 741 9,462 321 233 38,394 174 49 1903 82,129 2801 1523 453 1116 655 9,178 283 204 38,347 168 36 477 246 1904 2748 1083 713 8,897 81,986 1634 38,304 187 362 59 Averages of years 1895 to 1904. 83,479 2989 510 39,124 205 10,336 368 245 55 1224 1811 776 81,852 2894 422 164 8,614 264 1905 Table III.—Cases of Infectious Disease Notified During the Year 1905. Total Cases Notified in Each Locality. No. of Cases Removed to Hospital from Each Locality. Cases Notify in Whole District. Rotherhithe. Wards. St. Olave. Wards. Bermondsey. Rotherhithe. St. Olave. At ages—Years. Bermondsey. Wards. At all Ages. Notifiable Disease. 1 2 3 Total. St. John. St. Olave. St. Thomas Total. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards 1 2 3 5 6 Total. 4 - - - - - - - - - - - - - - - - - - - - - - Small-pox - - - - - - - - - - - - - - - - - - - - - - - - - - Cholera - - 108 68 7 3 19 113 20 7 2 165 8 9 25 25 18 18 8 29 69 11 - 40 12 12 13 Diphtheria - - - - - - - - - - - - - - - - - - - - - - - - Membranous croup - 7 - 16 16 4 1 157 10 15 25 18 16 12 99 17 8 5 91 12 20 12 21 46 - Erysipelas - 46 6 297 90 3 30 274 438 9 46 329 206 21 768 34 - 49 62 30 365 65 61 113 409 Scarlet fever 13 - - - - - - - - - - - - - - - - - - - - - Typhus fever - - - - - 6 4 3 1 1 7 16 9 Enteric fever 2 6 24 6 42 12 - 3 - - 14 11 16 3 2 5 Relapsing fever - - - - - - - - - - - - - - - - - - - - - - - - - - Continued fever - - - - - - - - - - - - - - - - - - - - - - - - 1 1 - - Puerperal fever - - 7 - 5 5 2 - - - - 1 - 2 1 2 1 - - - - Plague - - - - - - - - - - - - - - - - - - - - - - - - Totals 26 352 543 75 128 15 102 96 99 99 86 88 570 251 149 108 40 11 10 61 421 403 508 42 1139 45 Table IV.—Births and Corrected Deaths, for the Year 1905. Cause of Death. All Ages. Under 1 1 and under 5 5 and under 15 15 and under 25 25 and under 65 65 and upwards. Corrected deaths all ages. Outlying Institutions. Institutions in Borough. Deaths of Non-Parishioners in Boro.' Rotherhithe. St. Olave's. Bermondsey. 1 - - - 1 - 1 - - - - - Small-pox - Measles 12 - 8 17 7 2 59 45 1 1 42 9 - Scarlet Fever 17 2 11 3 1 15 - 10 6 1 - - - 16 7 1 2 Whooping Cough 38 22 - - 30 5 - - - Diphtheria and Membranous Croup 3 16 18 14 1 - 14 1 3 - - - - - - - - - - - - - Croup - - - - Typhus - - - - Fever. - - - - - - - - - 1 2 1 Enteric 9 3 3 1 - 7 1 5 - - - - - Other Continued - - - - - - - - - - Epidemic Influenza. 4 - - 1 9 3 15 - 5 9 4 2 - Cholera - - - - - - - - - - - - - - Plague - - - - - - - — - - - - Diarrhœa 2 90 18 111 29 - 3 37 145 — 17 7 - Enteritis 8 1 - - 8 2 10 - 1 — 2 - - Puerperal Fever 4 - - 2 2 3 - 2 - 1 - - - 3 6 Erysipelas 6 2 - - - - 1 1 - - - 7 4 3 18 Other Septic Diseases 34 8 4 5 6 27 7 4 - 10 35 20 23 223 5 10 163 148 55 90 Phthisis 4 - 3 3 21 Other Tubercular diseases 102 47 38 12 2 69 30 27 2 - - - 71 23 - 3 9 34 Cancer and Malignant disease 109 35 73 27 - 2 18 39 21 15 1 54 71 Bronchitis 225 138 97 66 - 20 Pneumonia 68 72 6 66 28 248 5 31 165 63 58 2 Pleurisy 3 3 - 3 1 9 6 2 - - - - - - - 11 10 Other diseases of Respiratory Organs 16 5 12 4 - 2 - - - - 3 - 1 5 _ I Alcoholism and Cirrhosis of Liver 21 32 25 7 10 - 3 6 - 7 1 3 - - 1 Venereal diseases 9 - - - 1 95 - 56 6 7 1 Premature birth 96 - 34 - - - 5 2 Diseases and accidents of Parturition 7 - - - 1 6 2 - - - - - 42 84 37 23 13 12 11 1 Heart diseases 132 75 31 1 15 67 30 16 4 Accidents 113 24 9 10 51 4 51 15 1 6 2 6 1 Suicides 11 - - - 8 2 3 2 53 494 171 124 All other Causes 711 184 16 199 235 50 5 24 167 2399 631 342 84 105 779 458 1597 604 198 521 439 All Causes 33 ST. OLAVE'S. WHOLE BOROUGH. BERMONDSEY. ROTHERHITHE. BIRTHS. M. F. M. & F. M. F. M. & F. M. F. M. & F. M. F. M. & F. 1435 2894 595 535 1130 131 133 2185 4288 264 Table V.—Infantile Mortality during the year 1905. Deaths from stated Causes in Weeks and Months under One Year of Age. 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. 36 37 20 189 63 54 49 34 36 35 35 34 27 29 631 Certified 96 46 Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Common Infectious Diseases Small-pox ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... 3 ... ... ... ... 2 2 1 3 11 ... ... ... ... ... ... Scarlet Fever ... ... ... 2 2 ... ... ... ... ... ... ... ... Diptheria : Croup 1 ... ... ... ... ... 1 ... 2 ... ... ... ... ... 1 ... ... ... 1 1 1 ... ... ... 1 2 5 2 17 Whooping Cough ... ... ... 3 ... 15 9 12 Diarrhœa, all forms 2 2 4 11 12 14 5 7 10 8 111 ... ... 4 Diarrjœal Diseases 1 2 10 ... 1 2 1 ... 2 ... Enteritis, (not Tuberculous) ... 1 1 1 ... ... ... ... 1 1 ... ... ... 1 Gastritis, Gastro-intestinal Catarrh ... ... ... ... ... ... 8 2 .. ... 66 7 11 3 87 ... 1 ... 98 Premature Birth I ... ... ... 2 ... ... 9 4 3 18 2 1 2 ... 1 Congenital Defects ... 1 .. 25 ... ... Wasting Diseases ... .. ... ... ... ... ... .. ... Injury at Birth ... ... ... ... ... ... ... ... ... ... ... ... ... ... Want of Breast-milk ... ... ... ... ... ... ... ... ... ... ... ... 11 6 42 17 13 9 2 ... 111 Atrophy, Debility, Marasmus 14 11 12 4 3 6 3 3 ... ... ... 2 2 1 3 13 Tuberculous Meningitis ... ... 1 1 2 1 ... ... ... Tuberculous Diseases 4 Tuberculous Peritonitis : Tabes Mesenterica ... 3 1 1 2 2 ... ... ... ... 2 1 1 ... 17 ... 1 2 4 2 1 Other Tuberculous Diseases ... ... 1 3 ... ... 14 ... ... ... ... ... 1 1 4 ... ... 1 ... ... ... ... 2 Erysipelas ... ... ... ... ... ... ... ... 1 1 3 Syphilis ... 6 ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... .. ... 2 Rickets ... ... 1 ... ... ... ... 2 1 ... ... ... ... 10 Meningitis (not Tuberculous) ... ... .. ... 1 1 1 ... 2 2 ... 1 1 1 1 ... 5 1 10 1 2 2 22 Convulsions 3 1 2 1 ... 7 6 2 1 1 2 1 5 4 4 1 3 3 40 Bronchitis 3 2 ... ... ... ... ... Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... 9 ... 1 6 10 Pneumonia 1 2 4 4 5 2 4 7 7 5 8 71 ... ... 1 5 Suffocation, overlaying 2 ... ... 3 7 1. ... 1 1 ... ... ... 18 3 ... 4 3 1 1 1 2 Other causes 4 1 12 3 1 1 25 ... ... 63 ... 36 49 189 631 47 Table VI.—Populations, &c., of Wards. Wards. Population at Census, 1901. Deaths, 1906. Death rate. Deaths under 1 year of age. Estimated population, 1906. Births, 1906. Infantile mortality per thousand births. Birth rate. # I j t I 1 Bermondsey— 36.3 295 14323 516 Ward 1 20.7 83 161 14213 14405 530 37.1 302 21.1 88 166 „ 2 14295 17.8 73 „ 3 15633 546 35.2 268 134 15514 47 16336 511 31.5 14.9 92 16211 241 „ 4 34.1 399 223 19.0 62 155 „ 5 11804 11714 213 66 392 39.6 21.5 168 „ 6 9982 9905 15.6 58 Roth0rhithe — Ward 1 429 27.8 241 15508 135 15429 223 30.7 14.9 63 137 „ 2 15046 14969 459 30.7 43 142 18.0 178 7906 7866 242 „ 3 20 .2 26 "St. Olave's — St. John 148 5986 175 33.3 106 5253 17 60 30.4 66 283 33.4 St. Olave 2250 1974 29 14.4 1 34 1387 20.9 20 St. Thomas 1581 4,288 147 Whole Borough Totals 128,730 33.3 130,760 2399 631 18.6 Note. —*59 deaths in outlying Institutions could not be allocated to any particular Ward, but are included in the total for the whole Borough. 4 deaths of infants under one year could not be allocated to any particular Ward, but are included in the total for the whole Borough. Table VII.— Meteorology of the Year, 1905 (Greenwich Record). 1905. MONTH. TEMPERATURE OF THE AIR. RAIN. Mean Reading of the Barometer. A Minimum. B Maximum. Number of days it fell. Mean of A and B. Amount collected. ins. 1.00 ° 38.0 8 ins. 30.101 ° 32.4 January ° 43.6 13 February 42.3 0.72 29.992 37.9 46.8 22 52.6 45.4 3.56 March 29.594 38.2 17 54.7 47.3 1.70 April 29.675 39.8 29.950 43.4 64.5 53.9 8 1.33 May 18 4.32 68.8 60.2 29.773 51.7 June 15 38.2 52.4 45.3 0.91 July 29.882 18 47.2 41.2 3.12 29.721 35.3 August 44.6 40.1 8 35.7 0.60 29.790 September 66.9 8 56.4 77.5 0.92 29.848 October 61.5 13 52.0 71.0 2.54 29.529 November 49.2 56.6 13 64.0 2.31 December 30.072 57.3 29.827 Means 42.5 49.9 13 Sum 161 1.92 Sum 23.03 Table VIII.—Marriages. ROTHERHITHE. ST. OLAVE'S. WHOLE BOROUGH. Year. BERMONDSEY. No. Rate. No. No. Rate. No. Rate. Rate. 12.12 13.34 1895 14.18 240 11.94 72 917 605 1027 14.96 16.08 268 13.30 73 1896 686 12.56 14.04 1197 86 15.32 17.62 1897 831 19.62 280 14.96 1216 302 81 18.06 1898 833 19.80 15.28 19.78 288 13.02 1182 17.70 826 14.72 68 1899 13.68 1186 18.00 17.24 69 18.88 334 1900 783 15.42 58 11.92 1154 17.70 800 19.44 296 1901 11.50 17.39 799 19.55 270 14.22 1123 54 1902 1101 17.22 1903 794 19.56 238 12.65 69 15.23 17.11 18.71 280 14.62 58 13.04 1105 1904 767 69 1121 280 14.34 13.33 Average for years 1895-1904 772 18.56 16.92 11.81 1108 256 13.38 51 1905 801 19.57 17.21 48 Statistics of Porlock Place Area. Table IX.—Deaths in Special Area during Seven Years ending 1004. Total. Under 1. Ito 5. 5 to 15. 15 to 25. 25 to 65. 65 and up. Population of Borougn (Census 1901) 13,036 29,206 4,715 130,760 25,393 54,675 3,735 Population Special Area 230 28 83 79 8 28 4 412 106 888 2719 753 1901 111 449 678 1902 2756 431 97 113 964 473 Deaths in Borough 307 1903 2382 657 87 110 825 396 723 396 1904 81 829 2593 85 479 2,612 386 Average, 4 years 703 94 876 449 104 Deaths in Special Area (7 years) 14 - 22 54 - 16 2 Correction for Age Distribution. 703x8 Under one year Estimated number of deaths = 1.5057 3735 386x28 1 to 5 years „ „ „ = .8290 13036 94x83 5 to 15 years „ „ „ = .2671 29206 104x28 15 to 25 years „ „ „ = .1146 25393 876x79 25 to 65 years „ „ „ = 1.2657 54675 449x4 65 and upwards „ „ „ = .3809 4715 Total 4.3630 4.363x1000 Standard death rate = 18.97. 230 2612x1000 But death rate for Borough is = 19.97. 130760 19.97 Therefore factor for correction = 1.0527. 18.97 35.54 x 1-0527=35.31 Death rate for Area corrected for age distribution = Note.—Correction for sex distribution unnecessary, as the numbers in the whole Borough correspond with the Area in question in this respect. Table X—Deaths in Special Area during Seven Years ending 1904. Year. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and up. Total. Female Male Female Male Female Male Female Male Female Male Female Male Female Male 4 — 2 - - - 1 - 1 2 - - 8 1898 2 - - - 1899 - - - - - - - 3 - 3 6 1 1900 2 ... - - - 2 3 3 - - 1 - - 1901 1 2 1 - - - 1 3 - 4 4 - - - 1902 3 1 1 - - - - 1 - 7 3 4 - - 1 - 1903 2 1 2 - - - - - 3 5 - 2 - 1 1 - - - 1 2 1 1904 - - - - - 11 5 9 5 - - 2 - 8 14 - - 30 24 Totals 22 - 54 2 16 14 - 49 Table XI.—Crude Death Rates for Special Area. Total. Males. Females. 17.4 43.5 69.6 1898 52.2 39.1 26.1 1899 26.1 26.1 26.1 1900 34.8 34.8 34.8 1901 43.5 60.8 26.1 1902 26.1 34.8 43.5 1903 17.4 8.7 1904 13.0 33.54 37.27 Average, 7 years 29.83 Deaths under 1 year per thousand of population under 1 year ... 286 for Special Area. „ „188 Whole Borough. Table XII. —Infectious Diseases Notified. Scarlet Fever. Diphtheria. Enteric Fever. Erysipelas. Total. Years. Smallpox. - - - - - 1898 - 1 - 3 2 1899 - - 2 1 3 1900 - - - 1 - 5 1901 4 - - - 2 - 3 7 1902 2 1 3 1 1 1903 - - - - 1904 - - - - 3 2 10 4 21 Totals 2 Incidence in Area 13 per thousand of population. „ Whole Borough 9 „ (4 years 1901-2-3-4). Porlock Place Area. Whole Borough. London. 1.67 3.10 1.90 Death rate for Phthisis „ other Respiratory Diseases 9.94 4.52* 3.35 Total Lung Diseases 13.04 6.42 5.02 1.46 5.59 2.05 Zymotic Diseases (Exclusive of Diarrhœa) 2.29 6.83 2.98 (Total) Table XIII. —Proceedings during 1905. Number of inspections, 1905. Number of notices, 1905. Number of prosecutions, 1 905. PREMISES. NUMBER OF PLACES. On register at end of 1904. Added in 1905. Removed in 1905. On register at end of 1905. 861 2 Milk premises 301 121 159 263 65 103 - 7 4 Cowsheds 7 - - 2 2 - - 2 76 - Slaughter-houses 4 13 - - 13 225 - Other offensive trade premises 36 - 1 1 69 295 Ice cream premises 69 (a)*10 (a)* 1 with drawn 4 1 596 218 221 Registered houses let in lodgings (b)*194 (b)*— * (a) For overcrowding. * (b) For other conditions. Total number of Intimation Notices served for all purposes - - 3647 Overcrowding, 1905— Number of dwelling rooms overcrowded 38 Number remedied 38 Number of prosecutions 1 (Summons withdrawn Overcrowding abated. Underground rooms — Illegal occupation dealt with during year Number of rooms closed Insanitary houses — Number closed under the Public Health (London) Act, 1891 Number closed under the Housing of the Working Classes Act Number of premises cleansed under Section 20 of the L.C.C. (General Powers) Act, 1904 50 Shelters provided under sec. 60 (4) of the Public Health (London) Act, 1891 — (Families - 21 Number of persons accommodated during the year - Adults - 38 Children - 52 Revenue Acts — Number of houses for which applications were received during year - 3 Number of tenements for which certificates were granted - 40 Number of tenements for which certificates were deferred - 2 Number of prosecutions under By-laws under Public Health Act, 1891— (a) For prevention of nuisance arising from snow, ice, salt, filth, etc. - — (b) For prevention of nuisance arising from offensive matter running out of any manufactory, etc. - (c) For the prevention of keeping of animals m such a manner as to be injurious to health - (d) As to paving of yards, etc., of dwelling houses (e) In connection with the removal of offensive matter, etc. (f) As to cesspools and privies, removal and disposal of refuse, etc. (g) For securing the cleanliness of tanks, cisterns, etc. (h) With respect to water closets, earth closets, etc. (i) With respect to sufficiency of water supply to water closets (J) With respect to drainage, etc. (Metropolis Management Act, section 202) 2 (k) With respect to deposit of plans as to drainage, etc. (Metropolis Management Acts Amendment (By-laws) Act, 1899) Mortuaries — Total number of bodies removed 225 Total number of infectious bodies removed 4 Table XIV. —Factories, Workshops, Laundries, Workplaces and Homework. (1) Inspection. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (including Factory Laundries) 159 24 - 251 62 Workshops (including Workshop Laundries) - 461 66 Workplaces 1 754 94 Homeworkers' Premises - 1625 246 1 Total (2) Defects Found. Number of Defects. Number of Prosecutions. Particulars. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts: — - 141 - 141 Want of Cleanliness 6 6 - Want of Ventilation - - Overcrowding - - - 3 Want of Drainage of Floors 3 - - 115 115 Other Nuisances - - 10 - Insufficient 10 1 Sanitary Accommodation Unsuitable or Defective 29 29 - - Not Separate for Sexes 1 - - 1 Offences under the Factory and Workshop Act: — Illegal Occupation of Underground Bakehouse (s. 101) - - - - Breach of Special Sanitary Requirements for Bakehouses (ss. 97 to 100) - - - - Failure as regard Lists of Outworkers (s. 107) 15 15 - - Giving out work to be done in premises which are Unwholesome (s. 108) - - - - Infected (s. 110) - - - - Allowing Wearing Apparel to be made in Premises infected by Scarlet Fever or Small Pox (s. 109) - - - - Other Offences - - - - 320 320 - Total 1 51 Table XIV. —continued. (3) Other Matters. Class. Number. Matters notified to ELM. Inspectors of Factories:- Failure to affix Abstract of the Factory and Workshop Act (s. 133) - 2 Action taken in matters referred by H.M. Inspectors as remediable under the Public Health Acts, but not under the Factory Act (s. 5) Notified by H.M. Inspectors 2 Reports (of action taken) sent to H.M. Inspectors - Other Underground Bakehouses (s. 101): — - Certificates granted during 1905 33 In use at the end of 1905 Number of Homework: — Lists. Outworkers. List of Outworkers (s. 107): — 42 531 Lists received 234 forwarded to other Authorities Addresses of outworkers 660 received from other Authorities Wearing Apparel. Homework in unwholesome or injected premises:— Other. Notices prohibiting homework in unwholesome premises (s. 108) - - 5 Cases of infectious disease notified in homeworkers' premises - - Orders prohibiting homework in infected premises (s. 110) - Workshops on the Register (s. 131) at the end of 1905 527 105 Workshop Bakehouses 632 Total number of workshop on Register Table XV. —Workshops. No. of Workshops on Register. No. of Workrooms. Persons Employed. Trade. Young Persons. Females. Males. - 44 76 42 - Boot Makers and Repairers 7 12 Bottle Washers 2 4 - 11 26 Brushmakers 18 22 - 13 Buttonhole Makers 3 5 - - 1 1 1 Cabinet Makers - - 190 Carmen, Stables 26 - - - 10 10 23 Carpenters' Shops (builders) - - 3 5 25 Collar Workers - - 3 6 Chair Makers 2 3 - 12 12 42 - - Coopers 6 3 3 Cork Cutters - - 3 5 8 - Curriers - 5 2 4 6 Cycle Makers - 27 34 5 73 17 Dressmakers 27 2 Engineers and Smiths 11 11 - 12 4 Farriers 4 - - 1 1 20 Fishcuring - - 158 4 Hairdressers 88 88 - 22 2 Harness and Strap Makers 8 9 - 79 - - 15 Hop Warehouses - 185 31 64 5 - Laundries 6 21 186 Leather Works - - 3 2 23 3 - Mantle Makers 4 11 4 Milliners - - - 3 3 3 Paper Bag Makers - 22 8 24 Picture Frame Makers 3 - 1 2 Rag Sorters 2 2 - 4 2 Sack Makers and Menders 5 5 6 4 11 Shirt Makers 4 — - 12 7 Tailors 9 9 - 15 4 4 Tie Makers - - 3 6 9 2 Tin Workers - 2 12 4 Tobacco Pipe Makers 4 - 5 8 - 18 Underclothing - - 3 2 2 Waistcoat Work - Wharves and Warehouses 26 303 8 - - 7 30 Wheelwrights - - - 2 2 7 Whip Makers - - 1 1 9 Wire Workers - - 24 Wood Choppers 17 47 18 - 1 Wood Turners 5 6 8 - 299 Various 85 95 36 50 98 527 496 1650 Totals Table XVI. —Sanitary Work, 1905. Totals. Mr. Thomas. Mr. Ashdown Mr. ockburn Mr. Bartlett. Mr. Toogood. Mr. Scott. Mr. Hoskins. Mr. Harris. Mr. Jones. Houses and other places inspected ; — 712 390 741 479 841 648 748 543 527 5629 House to house 594 70 2 414 735 915 764 680 864 802 6468 Various 2771 3153 3366 Re-inspections 2818 3447 3215 2252 3814 2744 27580 549 342 437 289 395 445 Notices and intimations served; — Intimations 376 448 366 3647 267 Statutories 158 148 71 116 107 139 137 106 1249 229 128 Houses or parts of houses cleansed or repaired 380 332 68 180 154 170 1721 80 16 58 W.C. accommodation provided or reconstructed 17 5 2 2 9 1 6 - W.C.s repaired, ventilated, or whitewashed 143 129 18 28 5 3 34 21 438 57 Closets panned or trapped, old pans cleansed or new ones fixed 47 145 99 43 23 77 511 12 46 19 101 Closets supplied with water or defective supplies remedied 29 35 4 120 40 129 38 556 60 20 Defective drains reconstructed, repaired, ventilated or trapped 19 143 221 17 41 133 43 692 55 32 Stopped drains and W.C.s cleared 57 26 80 69 38 41 36 53 432 68 60 94 20 Yards and forecourts paved or paving repaired 84 34 79 20 75 534 42 1 - 12 7 5 10 Houses supplied with water 3 4 - 84 70 34 44 107 72 90 88 64 659 Defective roofs repaired Defective rainshoots and gutters repaired, unstopped, or disconnected from drain 138 96 45 27 35 49 113 54 72 629 42 4 3 15 Offensive accumulations removed 2 2 6 7 8 89 Defective water apparatus in W.C.s repaired 76 17 14 39 - 36 5 - 235 48 Animals kept so as to be a nuisance, removed 1 7 3 - 2 2 2 1 5 23 3 10 Urinals cleansed, supplied with water and doors 12 9 6 10 10 83 9 14 17 7 - 2 10 5 42 Stables and other places drained and paved 17 - 1 Waste water pipes disconnected from drains and made to discharge in open air, and new waste pipes provided 9 44 25 3 14 15 16 1 28 155 6 11 - - 1 19 Providing means of ventilation beneath ground floor 2 - - 39 4 20 - 1 5 3 Dung receptacles provided or repaired - 6 2 41 3 5 2 7 Accumulations of manure removed 1 - 1 5 - 24 - 2 Separating W.C. and domestic water supplies 2 - - 3 - 1 7 15 11 81 6 4 Effective means taken to prevent dampness 17 5 19 17 25 185 38 43 - Yards cleansed - 1 1 12 4 - 99 65 26 16 16 31 Means of ventilation provided or improved 2 - 1 29 1 186 1 Cisterns cleansed or covers provided 51 3 - - 14 2 3 74 - - 1 - 2 Cowsheds cleansed 1 - - - - - 241 21 120 137 13 42 18 27 62 681 Miscellaneous 500 273 4 293 48 62 366 1702 Drains tested 45 111 Inquests held 174 Rooms disinfected 1489 Articles disinfected 15372 Post-mortem examinations 129 Bodies removed to Mortuary 225 Houses disinfected to satisfaction of Medical Attendant 21 53 Table XVII.—Food and Drugs. Articles submitted for analysis. Total samples taken. Number genuine. Number adulterated. Percentage of articles adulterated. Milk 562 505 57 10.1 nil Separated Milk 5 5 ... Skimmed Milk 4 4 nil ... 1 Milk and Water 1 nil ... Condensed Milk 1 1 nil ... 16 Butter 217 201 7.4 nil Margarine 22 22 ... Pepper 27 27 nil ... 3 nil White Pepper 3 25.0 4 1 Cayenne Pepper 3 25.0 9 Vinegar (Malt) 24 15 37.5 nil 5 Vinegar 5 ... 3 nil Lard 3 ... nil Ginger Wine 1 1 ... nil Coffee 21 21 ... Liquid Coffee 1 1 nil ... 1 6 5 16.7 Cocoa 5 5 nil Cheese ... nil Coffee and Chicory 1 1 5 ... nil Arrowroot 5 ... Mustard 8 8 nil ... nil 1 1 Ice Cream ... nil Oatmeal 1 1 ... 14 14 nil Rice ... Ground Rice 2 2 nil 1 1 nil Flaked Rice ... Sago 2 2 nil ... 7 7 nil Jam (Plum) ... nil „ (Raspberry) 4 4 ... 2 2 nil „ (Black Currant) ... 2 2 nil „ (Strawberry) ... 1 1 „ (Apricot) nil ... 1 1 nil „ (Greengage) ... 1 „ (Mixed Fruit) nil 1 ... nil Golden Syrup 1 1 ... 1 nil Milk Chocolate 1 ... 1 1 nil Burnt Almondas ... nil Sweetstuff Cigarettes 1 1 ... 1 1 nil Greengage Balls ... 1 nil Coltsfoot Rock 1 ... 2 1 Camphorated. Oil 1 50.0 2 2 Glycerine nil ... 2 2 nil Saffron ... Milk of Sulphur 3 3 nil ... 1 nil 1 Vaseline ... Cod Liver Oil 4 4 nil ... nil 1 1 Compound Liquorice Powder ... 4 3 1 25.0 Olive Oil 990 904 86 8.7 Totals Table XVIII. —Prosecutions in connection with Samples taken during 1905. Adulteration or Infringement. Result. No. Sample. First Quarter. Fined £1 and £3 3s. costs Malt Vinegar 313a Other than malt vinegar 50 per cent. Margarine 100 per cent. Fined £2 and 12/6. costs 261J Butter „ wrapper not marked Withdrawn, 2/- costs - Obstructing or impeding Inspector in the execution of his duty Fined £5 and 12/6 costs - Margarine 100 per cent. Fined £5 and 12/6 costs 100D Butter „ wrapper not marked Withdrawn, 2/- costs Margarine 100 per cent. Dismissed. Defendant proved business had been sold. Wrong name given by occupier 272J Butter - „ wrapper not marked Ditto Obstruction of Inspector Fined £1 and 2/- costs - Second Quarter. 305s Added water 6 per cent. Fined £5 and 12/6 costs Milk Added water 11 per cent. Fined £10 and 12/6 costs Mik 277H Other than malt vinegar 40 per cent. Fined the costs, 12/6 450c Malt Vinegar * Defendant went to prison for one month in default. 54 Table XVIII.—Prosecutions in connection with Samples taken during 1905. —continued. No. Sample. Adulteration or Infringement. Result. Milk Deficient in milk fat 18 per cent. Dismissed ; warranty proved 308s 452c Contained 0.11 per cent, or 9.6 grains of boracic acid per pint Fined the costs, 12/6 Milk Milk 320S Deficient in milk fat 17 per cent. Fined 10/- and 12/- costs 131D Milk Deficient in milk fat 15 per cent. Dismissed ; warranty proved Milk 558B Fined 1/- and 12/6 costs for deficient in fat. Added water withdrawn, 2/- costs Added water 20 per cent. Deficient in milk fat 16 per cent. Milk Deficient, in fat 8 per cent. Added water 15 per cent. 561B Fined £1 and 12/6 costs for deficient in fat. Added water withdrawn, 2/- costs Malt Vinegar 308J At least 80 per cent, other than malt vinegar Fined £1, and £1 12s. 6d. costs 309J Margarine Bulk not marked Fined £ 1 and 12/6 costs 301H Milk Deficient in fab 18 per cent. Dismissed ; warranty proved 322J Milk Third Quarter. Fined £5 and 12/6 costs for added water. Fined the costs, 2/-, for deficient in fat Deficient, in milk fat 10 per cent. Added water 15 per cent. Malt Vinegar 323J Chiefly, if not entirely, other than malt vinegar Fined 1/- and 12/6 costs Margarine 324J Fined 10/- and 12/6 costs Bulk not marked 325J Butter Margarine 100 per cent. Fined. £5 and 12/6 costs „ wrapper not marked Fined £1 and 2/- costs Milk Fined £1 and 12/6 coats 579B Added water 7 per cent. 587B Milk Fined. £1 and 12/6 costs Deficient in milk fab 15 per cent. Butter 331J Fat other than butter fat 13 per cent. „ wrapper not marked Fined £8 and 14/6 costs Withdrawn Butter 332J Margarine 100 per cent. „ wrapper not marked Fined £5 and 14/6 costs Withdrawn Milk 332H Contained formaldehyde 0.01 percent. Dismissed 337H Milk Contained formaldehyde 0.01 per cent. Dismissed Butter Fourth Quarter. 342H Margarine 100 per cent. Fined £1 and 14/6 costs Withdrawn „ wrapper not marked Added water 20 per cent. Milk 501C Fined £3 and 12/6 costs Other than malt vinegar 75 per cent. 342J Malt Vinegar Fined £1 and 12/6 costs 352J Malt Vinegar Other than malt vinegar 75 per cent. Dismissed; magistrate not being satisfied that Defendant heard agent use the word "Malt" Milk 627B Added water 28 per cent. Fined £10 and 12/6 costs Butter Fined £2 and 12/6 costs 442T Fats other than butter fat 76 per cent. (Margarine) Withdrawn, 2/- costs „ wrapper not marked Two summonses taken out against manager of shop withdrawn, 4/- costs „ Butter 443t Fats other than butter fat, 82.8 per cent. (Margarine) Fined £2 and 12/6 costs Withdrawn, 2/- costs „ wrapper not marked „ Two summonses taken out against manager of shop withdrawn, 4/- costs Balk not marked Margarine Withdrawn, 2/- costs 397h Summons against assistant withdrawn, 2/- costs „ Butter 400h Margarine 100 per cent. Fined £1 and 12/6 costs „ wrapper not marked Withdrawn, 2/- costs Summonses against assistant withdrawn, 4/- costs „ Butter 448t Margarine sold as butter Fined £] and 12/6 costs „ „ Fined £1 and 2s. costs Butter 377j Margarine 100 percent Fined £3 and 12/6 costs Butter „ wrapper not marked Withdrawn, 2/- costs 380j Margarine 100 per cent. Fined £3 and 12/6 costs Milk wrapper not marked Withdrawn, 2/- costs 532c Added water 5 per cent. Fined £1 and 12/6 costs Margarine 379H Bulk not marked Fined £1 and 12/6 costs 454T Contained 10 per cent, cocoa-nut fat Butter Costs, 12/6 Summons against servant withdrawn, 2/- costs „ „ „ „ SUMMARY. Fines £84 2 0 Costs27 5 0 £111 7 0 55 Table XIX.—List of Bakehouses in the Borough. Address. Situation of Bakehouse, Address. Situation of Bakehouse. Underground 49, Abbey Street 333, Old Kent Road Above ground 157, „ 91, „ „ „ 20, Alice Street (closed) 69, „ „ „ 2, Alscot Road 7, Paradise Street „ Underground 246, Rotherhithe New Road 126, „ (closed) „ „ 186, Abbey Street Above ground 365, „ 66, Abbeyfield Road „ „ 218, Bermondsey Street Underground 173, „ „ Above ground 88, Bermondsey Wall 25, Parkers Row „ 20, Bracton Road (not in use) 49, „ „ „ 25, Paradise Street „ 209, Bermondsey Street (not in use) 3, Plough Road „ „ 1, Rosebery Street „ 101, Bermondsey Street Above ground 79, Rouel Road „ 111, „ 270, RotherhitheStreet „ „ 34, Rotherhithe New Road 31, Charlotte Street „ „ 48, Cherry Garden Street „ 37, Rolls Road (not in use) „ 31, Crimscott Street (not in use) „ 574, Rotherhithe Street (not in use) „ 145, Drummond Road Underground 51, Dockhead 39, St. James' Road Underground Above ground 27, Derrick Street 239, Southwark Park Road „ „ *30-36, Denman Street 20, Dockhead (not in use) 351, Southwark Park Road „ „ 51, Esmeralda Road 415, Southwark Park Road (not in use) „ „ 49, Frean Street (not in use) „ 479, Southwark Park Road „ 77, Grange Road Underground 31, George Row 3, Spa Mansions (never been used) „ „ 68, Galley wall Road „ 49, Southwark Park Road 163, Grange Road (not in use) Above ground „ 119, Southwark Park Road 55, „ (not in use) „ „ 33, „ Above ground 158, Southwark Park Road „ 125, „ „ 198, Southwark Park Road 2, Galleywall Road „ „ 36, Gedling Street (not in use) „ 319, Southwark Park Road „ Underground 1a, Ilderton Road 1 355, Southwark Park Road 16, „ „ „ 170, Jamaica Road „ 53, „ 208, Southwark Park Road „ „ 140, „ „ 92, Snowsfields 75, „ Above ground „ 92, Spa Road 203, „ „ „ 61, Salisbury Street. 227, „ „ „ 29, Kipling Street 5, St. Marychurch Street „ „ Underground 82, Keetons Road Underground 142, Long Lane 96, Tooley Street „ 2, Lucey Road 157, „ „ „ 97, Lynton Road 167, „ „ „ 132, Lower Road 95, Tower Bridge Road „ „ 93B, „ „ 87, „ (not used) Above ground 43, Tanner Street 184, Long Lane Above ground „ 49, Lucey Road „ 144, „ „ 25, Lower Road „ 245, Tooley Street „ 160, „ 53, Tower Bridge Road „ „ 182, „ 26, „ „ „ „ 204, „ 65, „ „ „ 47, Maltby Street 22, The Grange Underground „ 17, Neckinger Street 106, Union Road (not used) Above ground „ 16, Neptune Street „ 69, New Church Street (not in use) 22, Union Road „ „ 94, „ „ Factory Bakehouse.