BER 30 Metropolitan Borough of Bermondsey. REPORT ON THE Sanitary Condition OF THE BOROUGH OF BERMONDSEY For the Year 1910. BY R. K. BROWN, B.A., M.D., B.Ch.,B.A.O. (R.U.I.), D.P.H. (Loud.), Medical Officer of Health. LONDON: HENDERSON & SPALDING, PRINTERS, SYLVAN GROVE, OLD KENT ROAD, S.E. 1911. metropolitan Borough of Bcrmondsey. REPORT ON THE Sanitary Condition OF THE BOROUGH OF BERMONDSEY For the Year 1910. BY R. K. BROWN, B.A., M.D., B.Ch., B.A.O. (R.U.I.), D.P.H. (Lond.), Medical Officer of Health. LONDON: HENDERSON & SPALDING, PRINTERS, SYLVAN GROVE, OLD KENT ROAD, S.E. 1911. TABLE OF CONTENTS. PAGE VITAL STATISTICS— Population 4 Births 5 Marriages 5 Deaths 5 Infantile Mortality 8 Zymotic Diseases 8 Senile Mortality 8 Death Certification 9 Small-pox 9 Measles 9 Diarrhœa 9 Whooping Cough 9 Typhus Fever 9 Enteric Fever 9 Other Allied Diseases 9 Tubercular Diseases 10 Phthisis 10 Alcoholism and Cirrhosis of Liver 10 Cancer and Malignant Disease 10 Heart Diseases 11 Suicides 11 Accidents 11 Other Violent Deaths 11 NOTIFICATION OF INFECTIOUS DISEASE— Small-pox 11 Typhus Fever 11 Diphtheria 11 Scarlet Fever 12 Measles 13 Enteric Fever 13 Puerperal Fever 13 Membranous Croup 13 Phthisis 13 Cerebro-spinal Meningitis 19 Anthrax 19 Consultations 19 Children excluded from School 20 SANITARY ADMINISTRATION— Offensive Matter 22 Offensive Trades 22 PAGE SANITARY ADMINISTRATION—continued. Unsound Food 22 Food Places 23 Unsound Food Seizures 23 Bacteriological Laboratory 23 Unsound Food and Foreign Meat Regulations 24 Hairdressers and Barbers 27 Inspections 27 Housing, Town Planning, &c., Act, 1909 27 Milk Premises 29 Cowsheds 29 Slaughterhouses 29 Ice Cream Premises 29 Houses Let in Lodgings 29 Food Examined 30 Food Inspector's Work 31 Housing of the Working Classes Acts 31 Food and Drugs 31 Sec. 48 Public Health (London) Act, 1891 31 Disinfection 32 Cleansing of Persons Act, 1897 32 Smoke Nuisances 32 House Refuse 32 Overcrowding 33 Health Visitor's Work 37 FACTORIES AND WORKSHOP- Outworkers 37 APPENDIX—TABLES— Local Government Board Tables 38-42 Population, &c., of' Wards 43 Meteorology 43 Marriages 0 43 Proceedings during Year 44 Factories and Workshops 45-47 Sanitary Work 48 Food and Drugs 49-52 List of Bakehouses 53 Extended Table of Deaths 54 PUBLIC HEALTH DEPARTMENT. COMMITTEE, 1910: Chairman—Councillor VEZEY. Alderman Parkinson, Councillor Guerin, „ Peeke, „ Hooton, Councillor Bevington, „ Markwick. „ Brenner, „ Oake, „ Brown, „ Pridmore, „ Clark, „ Renwick, „ Davies, „ Richmond, M.D. „ Delderfield, „ Salter, „ Dhonau, „ Saunders. „ Gardiner, Ex-officio : Councillor ARTHUR LAYMAN, J. P. - - Mayor of Bermondsey. STAFF: Medical Officer of Health—R. K. BROWN, B.A., M.D., D.P.H. Sanitary Inspectors. No. 1 District Mr. M. Grice. No. 5 District Mr. E. C. Freeman. No. 2 „ „ J. W. Wood. No. 6 „ „ J. Bartlett. No. 3 „ „ A. H. Merryman. No. 7 „ „ A. C. Townsend. No. 4 „ „ H. J. Toogood. No. 8 „ „ H. M. Cockburn. Food Inspectors—Mr. T. Ashdown, Mr. G. A. Hoskins, and Mr. G. L. Scott. Health Visitor—Miss E. M. Clibbens. Clerical Staff. Mr. C. A. Chapman, Sanitary Clerk, Mr. J. Francksen, Fourth Clerk, „ J. Pitts, Second Clerk, „ F. C. Shaw, Office Lad. „ H. Bush, Third Clerk, PUBLIC HEALTH DEPARTMENT, TOWN HALL, SPA ROAD, S.E. Metropolitan Brough of Bermonday 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 Tenth Annual Report on the sanitary condition of the Borough of Bermondsey during the year 1910. The report deals with the 52 weeks beginning January 2nd, and ending December 31st, 1910. The death-rate was 17.6, compared with 18.8 in 1909, and 18·8 in 1908. This is the lowest yet recorded in the Borough. No serious outbreaks of infectious disease occurred during the year, but the mild type of scarlet fever mentioned in the last three reports is less prevalent. There was a slight ncrease in diphtheria and a considerable decrease in measles. The sections of the report are, as usual, divided into:— 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 Tables, including a special Table on Infantile Mortality. Again, I may record my thanks to the Chairman and Members of the Public Health Committee for their cordiality and co-operation throughout the year. Thanks are also due to the members of the staff for their hearty co-operation in carrying out the various duties devolving on the Public Health Department. I am, Gentlemen, Your obedient servant, E. 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, and the estimate for the year under report, are as follows:— 1901. 1891. 1896. Estimate, 1910. 81,304 Bermondsey 84,682 85,475 82,483 Rotkerhithe 39,225 40,379 38,460 38,125 11,731 9,817 7,205 St. Olave 12,723 Borough 136,660 137,585 130,760 126,634 The estimate of the population in Bermondsey for 1910 shows a still further decrease from the Census of 1901. At this distance from the last Census it is very difficult to give an accurate estimate, but, apart from the replacing of small houses by warehouses, the number of empty houses would seem to point to a decrease. The latter circumstance is probably entirely due to the increased facilities of transit, leading to a tendency on the part of the population of this, as well as other central boroughs, to seek residence further out. The same method of estimating has been adopted as that employod in former years. Births. The total number of births registered in the Borough for the 52 weeks ended December 31st 1910, was 3,957, consisting of 2,017 males and 1,940 females. This is 260 below the average for the last 10 years, and 98 below the figure for 1909. This total includes 2,661 for Bermondsey, being 78 below that for 1909, and 131 below the average for the last 10 years; 1,040 for Rotherhithe, being 29 below the number for 1909, and 90 below the average for the last 10 years; and 256 for St. Olave, being 9 above the number for 1909, and 38 below the average for the last 10 years. In Table 11. 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 1910 was 31.2 per thousand persons living, which is 1.4 below the average for the last 10 years. Particulars of rates will be found in annexed Table A. London is included for comparison. A new departure with regard to births was made by the Registrar-General in 1906. The births are corrected by distributing those which occurred in the chief lying-in hospitals of the Metropolis to the Boroughs in which the mothers had resided previous to admission. Those allocated to Bermondsey in 1910 number 49, and if they are added to the above total the rate would be 31·6. Table A—Birth-rates. Whole Borough. Year. Bermondsey. Rotherhithe. St. Olave. London. 1900 34·07 30·56 39·67 33·5 28·6 1901 35·42 31·73 32·73 34·1 29·0 1902 34·70 30·47 33·92 33·4 28·5 1903 31·12 29·10 30·83 32·4 28·4 1904 33·52 28·27 40·69 32·4 27·8 1905 35·35 29·53 30·64 33·3 27·1 32·83 1906 28·48 31·08 31·4 26·5 1907 32·76 29·06 28·45 31·4 25·6 1908 33·53 29·02 32·58 32·1 25·2 33·65 1909 28·02 32·99 31·9 24·2 Average for years 1900-1909 } 33·69 33·36 27·1 29·42 32·6 35·5 31·2 23·6 1910 32·7 27·3 From this table it will be seen that there is a reduction of the birth-rate for the Borough which is shared by the three Registration Sub-Districts. ' Marriages. The total number of marriages in the Borough in 1910 was 1,149, being 111 above the number for 1909, and 35 above the average for the last 10 years. In Table VIII. of the Appendix will be found particulars of numbers and rates in the three Registration Hub-districts. The numbers have been supplied by the Superintendent Registrar. Deaths. In Table IV. of , A PP endix found the Local Government Board tables dealing with deaths in the Borough. The extended table of causes of death initiated in 1904 will also be found in the Appendix. The totle number of deaths registered in the Borough for the 52 weeks ended December 31st, 19lO, was 1, 717 which is 230 less than in 1909, and 392 less than the average for the last 10 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 nuber is raised to2,229.This is 158 less than in 1909, and 332 less than the average for the last 10 years. The annexed table shows the distribution of deaths in quarters, together with the corresponding quarters of 1909. The largest number of deaths occurred in the fourth quarter of the year. Table B.—Deaths. Bermondsey. Rotherhithe. St. Olave. Whole Borough. Quarter. 1910. 1909. 1910. 1909. 1910. 1909. 1910. 1909. 233 155 57 51 816 528 First 526 322 44 35 563 528 360 354 159 139 Second 499 299 337 111 119 35 43 445 Third 151 190 34 56 563 674 Fourth 378 428 2,387 2,229 1,563 1,441 654 603 170 185 Total Deaths The death-rate for the Borough in 1910 was 17.6 per thousand living inhabitants, being 1.2 below that recorded in 1909, and 2.2 below the average for the last 10 years If the Census population be taken as the basis of calculation of the rate, it works out at 17.0, which is 1.2 below that for 1909. This is the lowest death rate yet recorded in the Borough. Table C. —Death-rates. St. Olave. Whole Borough. London. Year. Bermondsey. Botherhithe. 22·79 22·91 23·2 18·3 1900 23·49 20·93 20·8 17·1 1901 21·44 19·43 21·66 19·30 24·62 21·2 17·2 1902 17·08 22·23 18·4 15·1 1903 18·54 27·65 20·1 16·0 1904 19·91 18·59 22·98 19·51 15·78 18·6 15·1 1905 25·08 20·25 19·7 15·1 1906 19·80 18·36 18·3 14·6 1907 18·45 17·51 19·42 15·70 27·78 18·8 13·8 1908 22·70 18·8 14·0 1909 19·20 17·14 Average for years 1900-1909 20·14 18·17 23·71 19·8 15·6 1910— On estimated population 15·81 25·67 17·6 12·7 17·72 On Census population, 1901 15·67 18·84 17·0 17·47 Table D.—Increase or Decrease of Deaths from various Diseases in 1910 compared with 1909. Decrease. Increase. Diphtheria 6 Measles 53 Scarlet Fever 3 Enteric Fever 2 Whooping Cough 10 Diarrhœa 1 Typus Fever 1 Enteritis 2 Influenza 7 Cancer 11 Gastritis 6 Other Respiratory Diseases 10 Erysipelas 5 Premature Birth 1 Puerperal Fever 1 Diseases and Accidents of Parturition 2 Phthisis 1 Accidents 32 Other Tubercular Diseases 42 Suicides 8 Bronchitis 29 Pneumonia 12 Alcoholism and Cirrhosis of Liver 4 Venereal Diseases 7 Heart Diseases 1 Other causes 51 Total 233 Total 75 7 It will be seen from the above that the increases amount to 75 and the decreases to 233. Accidental deaths are chiefly accountable for the increase, whereas, the principal cause of the decrease is the diminished number of deaths from measles, tubercular diseases, bronchitis and pneumonia. 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 30 such deaths in all, against "20 in 1909, and 37 in 1908. 12 such deaths occurred in the infirmary; 12 in River Thames and Docks; 1 on the railway, 2 in private houses, and 3 in the street. 542 persons belonging to this Borough died in outlying institutions, against 466 in 1909, and 530 in 1908. The names of the various places where the deaths occurred will he found in columns 2 and 3 at foot of Table I. of Appendix. Table B.—Death-bates corrected for Age and Sex Constitution of the various Populations, 1910. Factor for Correction for age and sex distribution Crude Deathrate per 1,000 persons living. 1910. Corrected Death-rate per 1,000 persons living. 1910. Comparative Mortality Figures. 1910. Area. England and Wales 1.0000 13.36 13.36 1,000 London, County of 12.71 13.36 1,000 1.0511 1.0677 11.77 12.57 941 Paddington Kensington 1.0778 11.89 12.82 960 950 Hammersmith 1.0414 12.19 12.69 Fulham 1.0462 10.55 11.04 826 Chelsea 1.0361 12.62 13.08 979 Westminster, City of 1.1217 11.85 12.73 953 St. Marylebone 1.0652 12.82 13.66 1,022 Hampstead 1.1280 8.6 9.71 727 St. Pancras 1.0456 13.75 14.38 1,076 Islington 1.0391 12.85 13.35 999 Stoke Newington 1.0438 10.97 11.45 857 Hackney 1.0420 11.69 912 12.18 Holborn 1.0766 14.94 16.08 1,204 Finsbury 1.0355 17.66 18.18 1,361 City of London 1.0993 15.45 16.98 1,271 Shoreditch 16.70 17.52 1,311 1.0493 Bethnal Green 1.0102 15.32 15.48 1,159 Stepney 1.0450 13.72 14.34 1,073 Poplar 15.17 15.65 1,171 1.0314 Southwark 1.0450 15.91 16.63 1,245 Lambeth 1.0320 12.54 12.94 969 Battersea 1.0728 11.29 12.11 906 Wandsworth 1.0547 10.17 10.73 803 Camberwell 1.0373 12.06 12.51 936 Deptford 1.0511 13.97 14.68 1,099 Greenwich 1.0210 11.60 11.84 886 Lewisham 1.0420 9.64 10.04 751 Woolwich 1.0690 10.46 11.18 837 BERMONDSEY 1.0244 17.65 18.08 1,353 Note.—The following extract from a previous report explains Table E :— " 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 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 1893 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 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 difference in which we can put down to general sanitary conditions alone. In illustration of this I have taken the above figures from trar-General's Annual Summary for 1910 to form Table E. "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 reorded death-rate down, notwithstanding the grout number of children under 5." Table F.—Infantile Mortality. Whole Borough. Year. St. Olave. Bermondsey. Rotherhithe. London. Rate per 1,000 Births. Rate per 1,000 Births. Rate per 1,000 Births. Rate per 1,000 No. of Deaths. No. of Deaths. No. of Deaths. Rate per 1,000 Births. No. of Deaths. No. of Deaths. 1900 48 526 186 120 185 243 817 20,730 158 205 1901 170 497 215 176 42 132 754 169 19,412 148 1902 455 159 174 149 49 153 678 156 18,478 139 1903 428 153 179 160 50 176 657 156 16,978 130 1904 477 173 187 173 59 163 723 172 18,600 143 1905 422 146 164 145 45 170 631 147 16,324 129 1906 408 115 170 156 46 178 624 155 16,307 130 1907 335 125 114 130 22 96 501 125 14,114 116 1908 411 147 151 134 48 186 610 146 13,943 113 1909 141 12,582 396 144 143 134 34 137 573 108 435 Average for years 1900 to 1909 152 156 131 177 44 151 657 155 16,747 341 1910 128 135 130 26 101 502 127 11,809 103 It is satisfactory to note in the above table that there is a large reduction in the infantile mortality. Judging from the figure'for London this reduction seems to have been general, and it will probably be found to apply to the Provinces as well. Part of this reduction is no doubt due to the cold wet summer, for it will be remembered that any fine weather we had did not come until September. Part is also due to the work of the Health Visitor, which was in full swing during the year under report, but how much will be difficult to say. As the work of the Health Visitor deals substantially with this subject, the reader is referred to the section of this report dealing with her work. Table G. All Causes. Principal Zymotic Diseases. Scarlet Fever. Whooping Cough. Typhus Fever. Pyrexia. (Origin uncertain). Diphtheria. Enteric Fever. Diarrhœa. Small-pox. Measles. Year. Rate. No. Rate. Rate. No. Rate. No. Rate. No. Rate. No. No. No. Rate. No. Rate. No. Rate. Rate. No. No. Rate 437 .89 1900 3062 23.2 3.32 - - 87 .66 14 .11 88 .67 .71 37 .28 117 94 - - - - 1901 2719 20.8 382 2.92 14 .10 76 .58 45 .34 36 .27 56 .42 22 .16 1.0 - - - - 133 1902 2756 21.2 396 3.06 31 .24 154 1.19 18 .14 29 .22 64 .49 12 .09 - 88 .68 - - - 1903 2382 18.4 251 1.96 50 .39 25 .19 18 .14 41 .32 4 .03 11 .09 103 - - - - .80 1904 20.1 2593 444 3.44 - 136 1.05 18 .14 17 .13 68 .53 16 .13 189 1.46 - - - - - 1905 2399 18.6 287 2.23 1 .01 59 .45 17 .13 18 .14 38 .29 9 .07 145 1.13 - - - - 3.12 1906 2529 19.7 400 94 .73 30 .23 34 .27 50 .39 4 .03 188 - - - - - 1.46 - 1907 2338 18.3 223 1.74 36 7 51 .40 22 .17 52 .41 - - .28 - - .05 - 55 .43 - 1908 2444 18.8 300 2.31 - 105 .81 26 .20 26 .20 18 .14 12 .09 .87 - - - - 113 - 1909 2387 18.8 368 2.89 196 .13 12 1.54 17 .09 54 .42 1 .00 2 .01 86 86 - - - - Average for years 1900 to 1909 2561 30 19.8 349 4.6 .00 2.70 0.3 101 .78 25 .19 .23 .41 13 .10 53 5 122 .94 - - 1910 2229 17.6 310 2.44 143 1.12 14 .34 .11 18 .14 44 4 .03 87 .68 - - - - - - London 1910 12.7 5559 1.14 .28 61756 1980 .41 214 .04 .09 1363 .28 196 .04 .00 1368 - 434 - 4 - - There has been a decrease in the deaths from these diseases, the figures being 310, against 368 in the previous year, and 349 the average for the last ten years. This gives a zymotic death-rate of 2.44. The total number of deaths from notifiable diseases, viz., scarlet fever, diphtheria, typhus fever, and enteric fever, was 36, compared with 32 in 1909, and for the non-notifiable, viz., measles, whooping cough, and diarrhcea, 274, compared with 336 in the previous year. Measles, the deaths from which fell from 196 in 1909 to 143 in the year under report, entirely accounts for the decrease. It will be noticed that the mortality from enteric fever for London as a whole is - 04 and for Berniondsey 0.3 This we may regard as very satisfactory, since enteric fever is one of those diseases which is generally acted upon as affording some indication of the general efficiency in Public Health administration. Senile Mortality. The number of deaths over 65 years of age in 1910 was 443, compared with 470 in 1909. .Death Certification. There were no uncertified deaths in 1910. Small-pox. There were no deaths from this cause in 1910. Measles. There were 1-W deaths due to this disease, which is 42 above the average for the last ten years, and 53 below the number for 190!). The deaths occurred in quarters as follows, viz.:—3, 2C. 42, (J't. Diarrhcea. Table H shows the connection between the meteorological conditions and deaths from this disease. The second table still emphasises that the most important factor in the prevention of diarrhoea is undoubtedly breast-feeding. If young children are breast-fed and given reasonable care, their chances of life are four or five times, and according to some authorities ten times, as great as children artificially fed, even when this is done under favourable conditions. Table H. Temperature of the Air. Temperature of ground 3ft. below surface. Rainfall. Deaths from Diarrhœa. Weeks. 1910. 1909. 1910. 1909. 1909. 1909. 1910. 1910. ins. ins. I ° ° ° ° July{ 61.9 59.2 59.39 58.82 0.15 1.22 1 - 599 58.8 59.49 59.06 1.31 0.35 2 1 August{ 60.8 60.2 59.68 0.26 60.12 0.85 2 - 66.9 60.7 61.25 0.00 60.48 0.18 3 - 63.3 62.7 62.79 60.13 0.82 0.19 4 6 58.1 59.9 61.26 61.48 0.70 0.80 10 2 September{ 60.19 60.59 54.5 58.3 0.30 0.41 7 8 54.5 54.7 58.70 59.68 0.32 0.02 4 3 58.71 55.3 56.1 57.87 0.58 0.66 8 10 56.3 53.8 58.01 57.60 0.57 0.00 5 7 53.1 58.6 57.11 57.35 0.72 0.10 4 6 October{ 55.8 57.4 57.04 57.61 0.08 2 1.01 2 56.28 56.4 53.1 57.23 0.59 0.61 2 6 55.69 55.7 51.4 56.38 0.46 0.63 4 9 59.12 58.90 Weekly average 58.03 0.55 4 4 57.5 0.43 Table I.—Deaths from Diarrhcea. State of Premises. Family. Cases Inquired into. Method of Feeding. Year. Overcrowding. Dirty and Improvident. Artificially. Partially by both Methods. Clean and Careful. Good. Breast. Fair. Defective 1901 74 23 49 2 70 4 13 59 2 - 1902 40 21 18 1 37 3 6 33 1 1 1903 15 22 3 38 8 3 - 40 2 29 1904 115 55 54 6 101 14 16 82 17 - 1905 65 33 29 3 56 9 4 1 5 56 1906 81 40 34 7 66 15 4 15 50 16 1907 21 10 9 2 16 5 4 17 1 - 1908 46 28 16 2 45 1 8 35 3 - 1909 51 30 19 2 47 41 5 4 5 - 1910 38 36 1 1 33 5 6 20 12 - Total 571 317 225 29 509 62 86 7 422 63 Whooping Cough. 44 deaths were due to this cause, against 54 in 1909. The deaths occurred in quarters as Typhus Fever. No deaths occurred from this disease. Enteric Fever. 4 deaths were due to this cause, 1 in Bermondsey 2 in Rotherhithe, and 1 in St. Olave The corresponding figures for 1909 were 2 for the Borough, viz., 1 in Bermondsey and 1 in Rotherhithe. Other Allied Diseases. • ) deaths were registered under this heading, viz.. 1 death from chicken-pox and 2 from cerebrospinal meningitis. An account of the latter will he found in the section of my report dealing with the notification of that disease. 10 Tubercular Diseases. The number of deaths from all forms of tubercular disease in 1910 was 289, against 333 in 1909. This figure comprises 197 for Bermondsey, 65 for Rotherhithe, and 27 for St. Olave. Of these, 219 were due to phthisis and 70 to the other tubercular diseases. Phthisis. In Table J. will be found particulars of deaths from phthisis since the year 1900. There were 219 deaths due to this cause, which is one less than the number recorded in the previous year. Table J.—Phthisis. ROTHERHITHE. ST. OLAVE. WHOLE BOROUGH. BERMONDSEY. SUB-DISTRICT. LONDON. No. No. Year. No. Rate. No. Rate. Rate. Rate. No. Rate. 169 235 1900 47 1.21 29 1.78 7809 2.04 2.88 1.71 1901 150 1.82 57 1.48 19 1.95 226 1.73 7514 1.66 2.22 1.83 1902 163 1.98 55 1.43 21 239 7424 1.62 1.79 1.96 1.70 1903 147 56 1.46 18 221 7124 1.54 1904 165 2.02 60 3.48 1.62 1.57 31 257 1.99 7526 1905 148 1.81 55 1.44 20 2.32 223 1.73 6622 1.42 1906 155 1.90 77 2.01 18 2.16 250 1.95 6775 1'44 1907 150 1.84 68 1.78 19 2.36 237 1.85 6654 1.40 1908 157 1.89 60 1.54 24 303 241 1.85 6419 1.32 1909 147 1.80 56 1.46 17 220 1.73 6337 2.27 1.31 Averages for years 1900-1909 155 1.56 18.1 7020 1.50 1.89 59 22 2.46 235 50 1.31 21 219 1910 148 1.82 5555 2.91 1.73 1.14 Alcoholism and Cirrhosis of the Liver. 15 deaths were attributed to this cause in 1910, against 19 in 1909. This number gives 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. 146 deaths were attributed to this cause, 137 being due to carcinoma, or cancer, as ordinarily understood, and 9 to sarcoma. This increase, as mentioned in last year's report, is not surprising, considering that the average life is longer, and more people now reach old age than formerly, in which period of life they are more prone to suffer from this disease. The Cancer Research Commission have not yet issued their final report on the subject. Table K.—Cancer. Deaths during 1903—1910 (inclusive). 55 to 65. 15 to 20. 25 to 35. 35 to 45. 45 to 55. 65 to 75. 75 to 85. All ages Under 15. 20 to 25. 85 & upwards. Sex. M M F M F F F M M F F M F M F F M M F M Cancer of rectum 5 1 10 10 1 74 - - 1 1 2 10 14 8 9 2 - - - - - Cancer of stomach 127 1 4 2 6 6 15 24 11 20 19 5 6 - - - 7 1 - - - Cancer of bowel 5 1 25 2 1 1 5 3 5 1 1 - - - — — — - - — — 117 1 2 4 13 16 17 19 6 22 7 9 Cancer of liver - 1 - - - - - — - Cancer of breast 69 1 13 - 24 15 1 10 4 - - - 1 - — - - — - - Cancer of female pelvis, uterus, &c. 7 4 129 - - 24 39 38 16 - 1 - - - - - - - - - - 2 15 3 21 - 18 1 2 1 Cancer of oesophagus 63 - - - - - - - - — — - Cancer of mouth, tongue, pharynx and lower jaw ... 6 17 2 2 76 1 1 23 3 15 6 - - - - - - - - - - Cancer of peritoneum - 1 1 3 1 1 12 1 3 1 - - - - — - - - - — - Cancer of other parts 184 1 1 1 1 13 8 27 12 39 20 27 21 10 1 2 — - - — - Malignant disease, kind not stated 1 - 1 7 - 1 1 2 1 - - — - - - - - - - - - 66 8 5 2 3 3 3 4 8 3 5 3 2 Sarcoma 4 7 5 - 1 - - - 8 5 3 65 106 122 153 124 106 35 2 Totals 949 4 5 1 12 15 36 107 34 6 DIPHTHERIA. Average 10 year, 1901-1910, marked Green. Notifications,1910,marked Red. Heart Diseases. 151 deaths were due to this cause, which number is 1 below that for the previous year, This refers to organic or valvular disease of the heart. Suicides. 11 persons committed suicide in 1910, viz., 3 by poison, 5 by hanging, 2 by cut or stab, and 1 by precipitation from an elevated place. Accidents. 90 deaths were due to accidents, against 58 in the previous year. Particulars will be round in the extended table of the Causes of Death in the Appendix. Other Violent Causes. There were no deaths by homicide during the year under report. II.—NOTIFICATION OF INFECTIOUS DISEASE, In Table III. of Appendix will be found particulars of infectious diseases notified during the year under report. The number of cases notified was 746, compared with 810 in 1909, and 1,121 in 1908. The diseases which show a decrease on the numbers for the previous year are scarlet fever (78), typhus fever (3), and erysipelas (9), while those showing an increase are smallpox (1), diphtheria (16), enteric fever (8), and cere b r o-spinal meningitis (1). The number of cases notified in the registration sub-districts was 501 in Bermondsey against 517 in 1909, 192 in Rotherhithe against 249, and 53 in St. Olave against 44 in 1909. The attack-rate per thousand inhabitants was 5.9, the rate for the sub-districts being 6.1 for Bermondsey, 5.0 for Rotherhithe, and 7.3 for St. Olave. The corresponding rates in the previous year were 6.4 for the Borough, 6.3 for Bermondsey, 6 .5 Rotherhite, and 5.9 for St. Olave. 71 cases were returned from hospital as not suffering from the disease for which they were notified, but if allowance is made for mild unreported cases, the recorded notifications would, if anything, understate the actual number of cases. This number is somewhat larger than in the year 1909. The increase is difficult to account for, but in a working class population like Bermondsey one would expect this figure to remain higher than in a residential borough. Small-pox. One case was notified as suffering from small-pox, but was returned as not suffering from that disease. Typhus Fever. No cases of typhus fever were notified during the year under report. Diphtheria. There were 207 cases of diphtheria notified in 1910, of which 131 occurred in Bermondsey 61 in Rotherhithe, and 15 in St. Olave. This is a slight decrease on 1909, for which the figures were:- Borough, 191; Bermondsey, 131; Rotherhithe, 59, and St. Olave, 12. From the following table it will be seen that a general decrease has taken place throughout London. Cases of Diphtheria Notified. Year. London. Bermondsey. 1892 8,368 161 1893 13,712 367 1894 11,204 446 1895 11,231 281 1896 13,825 425 1897 13,217 393 1898 11,883 326 1899 13,711 734 1900 12,023 471 1901 12,156 329 1902 10,731 277 1903 7,738 172 1904 7,219 191 1905 6,482 165 1906 8,041 327 1907 8,779 311 1908 8,001 251 1909 6,679 191 1910 5,494 207 Average 10,026 317 The attack rate per thousand inhabitants was 1.6, against 1.5 in 1909. The case mortality was 8.7 per cent., against 6.3 per cent, in 1909 and 10.3 per cent, in 1908. 15 cases were returned as not suffering from this disease. 122 specimens were sent in by medical practitioners for bacteriological examination, against 134 in 1909 and 199 in 1908. Of these 27 were found to contain diphtheria bacilli, all of which were notified. In 10 cases of diphtheria the source of infection was attributed to previous cases in the house or family. Diphtheria is a disease caused by a characteristic bacillus known as the Klebs-Loeffler Bacillus, which occurs in the throats of persons attacked by the disease. It seems to be conveyed from person to person by direct contact, and there is no virulent disease which will spread more rapidly under certain circumstances than this will among school children. It is more or less directly conveyed from throat to throat by children passing sweets, slate pencils, and other articles which they are liable to put in their mouths, from one child to another. Kissing an affected person on the mouth will also frequently give rise to the disease, and an infected child coughing in the neighbourhood of non-infected ones will also often transmit the disease to them. Sometimes the bacilli will exist in the throat for a long time without producing any symptoms, but such children, while not suffering themselves, will be liable to convey the infection to others. For this reason they have been called " carrier " cases, and, as expressed in previous reports, my belief is that a large part of the spread of the disease is due to such cases. Since 1902 an endeavour has been made in this Borough to prevent any of these "carrier" cases returning to school, and each Annual Report has contained some account of the working of the plan. This consists in getting the parents of a child which is notified as suffering from diphtheria to bring up the other members of the family within a week or so after the removal or recovery of the case to the municipal laboratory at the Town Hall for examination. If diphtheria bacilli are found in the throats they are excluded from school for a fortnight, and if then found to be free, are allowed to return to school. The number of children thus examined in 1910 was 260, belonging to 119 families. Out of this number 7 had diphtheria bacilli in their throats or noses, and one developed the clinical symptoms of diphtheria, and was therefore notified. Provision of Diphtheria Anti-toxin. In October, 1903, the Council decided to keep a small stock of diphtheria anti-toxin which was to be sold to practitioners in this Borough at cost price. The demand has not been very great, for only twenty bottles have been sold in the seven years. During the year 1909 six were sold, and so far none have been required this year. Each of these bottles contains a dose of 2,000 units, which is generally regarded as the minimum dose for curative purposes, and the cost is 2s. 3d. per bottle. The reason of this small demand is obviously due to the fact that the large majority of cases are removed to hospital within a few hours of notification, and very often before they are notified. In 1909, for instance, of 191 cases notified, 174 were removed at once to hospital and only li treated at home. No doubt the six bottles of anti-toxin were used for the latter patients. I believe it would be a very useful thing to have a free supply of anti-toxin at the Town Hall, and it would be specially useful for those doubtful cases which are sometimes held over twenty-four hours pending bacteriological diagnosis and for such cases as are kept at home. There is also another class in which it would be useful, viz., those cases which, while not suffering from diphtheria, have the infection in their throats or noses. They are very few in number, but when they exist are a great source of danger, as the infection may remain for a month or two. The most effective treatment for these would be small prophylactic doses of anti-toxin. Taking these three classes into consideration, it is impossible to say how much will be required, but Ido not think it will cost more than a few pounds. The case mortality of diphtheria for the Borough in 1909 was 6*3 per cent. This is very low and not more than a quarter to a sixth of that which obtained in the pre-anti-toxin times. I do not think, therefore, that diphtheria patients in this Borough have suffered much from delay in treatment. Diphtheria is a disease which is, of course, liable to break out suddenly at any time, especially in connection with a school, and for this as well as other reasons stated above I would recommend the Council to keep a small stock, say of one dozen tubes, the initial cost at the present rate being 27s., and this stock could be renewed from time to time as required. A letter should also be sent to the practitioners in the Borough advising them that tubes can be obtained free by application at the Town Hall. I do not think that any distinction should be made as to the social status of the patients, but that anti-toxin should be given free to any practitioner who asks for it. The above report was made to the Public Health Committee on October 11th and from that time to the end of the year three tubes were applied for. Scarlet Fever. There were 361 cases of scarlet fever notified—260 for Bermondsey, 78 for Rotherhithe, and 23 for St. Olave. This is a decrease of 78 for the Borough on the total for 1909. The distribution of the disease iin the various Wards, as shown in Table 111. of Appendix, was fairly uniform. 54 cases were returned from hospital as not suffering from scarlet fever. The accompanying chart shows the prevalence of the disease in each of the 52 weeks under report. The average notifications for the past nine years are shown in green. There were 14 deaths, which gives a case mortality of 3.8 per cent. This is the same rate as that for the previous year. The disease, as in recent years, was of a mild type. The attack rate per thousand inhabitants was 2.8, against 3.4 in 1909. In 47 cases the source of infection was attributed as follow :— Previous cases in house or family or neighbouring houses 35 School infection 6 "Return" cases 6 SCARLET FEVER. Notifications, 1910,marked Red. Average 10 years,1901-1910,marked green, ENTERIC FEVER. Average 10 years, 1901-1910, marked green. Notifications, 1910, marked red. In the 6 cases classified as "return" cases the source of infection was some other member of the family or occupant of the same house who had returned from hospital after an attack of scarlet fever within a fortnight previous to the second case occurring. In this case the source of infection in the second case is presumed to he the child recently returned from hospital. The following statement on the subject is reprinted from my Annual Report for 1907:—"A good deal of attention has been given to these so-called 'return' cases on the part of the laity, and also by medical authorities, the former generally being inclined to attribute it to premature discharge from the infectious disease hospital. As stated, however, in previous reports, facts do not support this view, because in the first place the cases are very few compared with the number discharged, and in the second case it is sometimes those children who are detained months over the usual time and that cannot be considered to have been prematurely discharged who produce the disease. "The micro-organism which produces scarlet fever has yet to be discovered, and the probability is that when this is made it will be found it behaves in a somewhat similar manner to diphtheria, and will be found to exist in the noses and throats of the patients who either have not got the disease at all, or who have recovered from an attack some considerable time previously. Those patients who have suffered from complications leading to pathological discharges from nose, throat and ears are more liable to spread the disease than simple, uncomplicated cases." Measles. The number of deaths for 1910 was 143, against 196 in 1909 and 105 in 1908. The annexed table gives the number of notifications received from schools, the number of "contacts" excluded. In the first quarter there were only 3 deaths, in the second 29, in the third 42, and in the fourth 69. As remarked in my previous report, there is no doubt that the infants' departments of the schools are very largely responsible for the spread of this disease, but the London County Council's regulations, of which the following is a copy, are strictly carried out:— (1) Senior Departments— (a) If a child has had measles it need not be excluded from attendance at school. (b) If a child has not had measles it should be excluded from attendance at school for a period of 14 days from the date of the occurrence of the first case. (2) Infants' Departments- All children should be excluded from attendance at school for a period of 14 days from the date of the occurrence of the last case. Enteric Fever. 37 eases of enteric fever were notified, being 21 for Bermondsey, 13 for Rotherhithe, and 3 for St. Olave. 1 case was returned as not suffering, making an actual total of 36. The total number of cases notified in the previous year was 29. They may all be classified as sporadic, i.e., isolated cases, so that there was nothing at all in the nature of an outbreak. In 8 cases the source of infection was attributed as follows:— From previous cases 5 From eating mussels 2 From eating oysters 1 Puerperal Fever. 6 cases of puerperal fever were notified. There were 3 deaths. Membranous Croup. No patients were notified as suffering from membranous croup. Phthisis. During the year 1910, 289 fresh cases of phthisis were notified. Of these 106 were notified voluntarily, compared with 102 in 1909, and 183 under the Poor Law Order, compared with 346 in the previous year. In the appended table will be seen particulars of cases notified in the various wards:— W * G C £ W ° M Bermondsey 'Wards. R °^™s THE St - Olave Wards. 1 2 j 3 I 4 ° 6 1 2 3 John Olive Thomas Voluntary Notifications 106 12 . 17 19 21 6 4 8 7 3 j 6 1 2 Poor Law Notifications 183 33 I 27 17 5 10 20 27 13 6 J 9 15 1 ! 289 j 45 44 I 36 26" 16 24 | 35 20 9 15 i 16 . 3 Re-notifications ...1 (Changes of Address, 210 46 45 16 8 7 12 34 6 9 12 10 5 &e.) J Rooms disinfected ... 618 [128 85 83 76 ' 43 56 56 39 32 ' 11 4 5 The following is the special report on pulmonary tuberculosis, and measures to be taken in dealing with it, made to the Public Health Committee on June 14th, 1910 :— Gentlemen,—As a result of your instructions, I beg to submit the following report on the precautions now taken in this Borough to prevent the spread of pulmonary tuberculosis, together with suggestions as to their improvement. Before entering into what we are already doing and what additional preventive measures we might undertake, it is advisable to give a short account of the cause and nature of disease and state briefly the position of scientific opinion on the subject. The causes of tuberculosis have been fully entered into in previous reports, but for completeness it will be no harm to re-state them. In describing the causes of any disease it is usual to refer to them as predisposing and " exciting " —the soil and the seed. Neither of these factors can be neglected in dealing with disease, though the importance of each varies with the particular disease, and also with the advance of scientific knowledge. At present more stress is being laid on the exciting causes, though the others are not being neglected, and this is probably due to the fact that the general improvement in health due to sanitary legislation and education is steadily proceeding and will proceed more or less automatically. On the other hand, the special causes of infectious disease, including tubeiculosis, have only comparatively recently been discovered, and generally require special treatment, which must vary from time to time as our knowledge increases. The widespread nature of tuberculosis is not generally appreciated by the laity, and it is only the pulmonary form, known as phthisis, which, on account of its obvious symptoms and ravages, is usually considered when formulating preventive measures. A sharp line, however, cannot be drawn between the various forms of tuberculosis, for one form is always liable to give rise to another, and every tubercular focus in our bodies is a potential source of danger. A recent investigation goes to show that about 50 per cent of the general population are infected with tuberculosis, though only a small number of these develop definite symptoms of disease. Some investigators go so far as to state, as the result of post-mortem examinations, that only about 2 per cent, of the population are quite free from tuberculous infection during some period of their lives. The presence of these latent foci of infection explains the occurrence of some cases of phthisis in which an obvious source of infection cannot be traced. "While we are robust and in good health they do not develop and we are not aware of their existence, but as soon as privation or excesses, or other causes, lower our health and resisting power, the bacilli, imprisoned in these places, break loose and produce the well-known symptoms of consumption. Infection thus acquired in childhood may not appear till middle life. Now among predisposing causes you will find poverty, bad and insufficient food, overcrowding and want of fresh air, over-work, ignorance, alcoholism and heredity generally mentioned. As some of these causes, such as poverty, insufficient food, &c., are beyond our control as a municipality, and others involving overcrowding and want of fresh air are appreciated and being gradually dealt with, I do not purpose to discuss them further, but will deal with the exciting cause, for it is here that we are in a position to do a great deal more than we are doing. The immediate cause of the disease is a micro-organism known as the tubercle bacillus. It is extremely small, and can only be detected by the most powerful microscopes. As far as we know, it does not exist in nature outside the animal body, and can only be made to grow on artificial media with difficulty. It may gain entrance into the body by swallowing or inhalation, and, if by the former, it passes through the wall of the intestinal canal, sometimes causing ulceration in its passage, but generally becoming arrested in the lymph glands, which act as our first line of defence. Here the bacillus may be killed at once or proceed to multiply, and in doing so may simply form a small nodule, which eventually becomes encapsuled and innocuous, or else may spread to other parts of the body. The disease in this region is known as tabes mesenterica or abdominal tuberculosis. If the bacillus proceeds to the brain coverings, you get tubercular meningitis, or to the joints, you may get hip disease, with "white swelling" of the knee, &c., or spinal disease. When the bacillus is inhaled, it generally, but not invariably, goes to the lungs and settles there, producing pulmonary tuberculosis or phthisis. Now the prevailing opinion is that inhalation is by far the commonest method, since much larger quantities can get into the system at one time, and with this opinion I am in accord, though there is no doubt that in some cases the bacillus may reach the lungs by the roundabout way of the alimentary canal. Since therefore inhalation is the main method of the reception of the bacillus in the body, we may inquire whence these large numbers of bacilli arrive. They undoubtedly come from the coughing, spitting, and sneezing of consumptive patients. It has been proved over and over again that there are enormous numbers of bacilli in the sputum of phthisical patients, and I wish to note here that there are two distinct phases in which they may be inhaled. This may occur while the bacilli are fresh or dried. It is now known that for a couple of yards or more round every consumptive patient during and immediately following the act of coughing and sneezing the air is tilled with little droplets of spray containing bacilli, and it is these droplets which may be inhaled before they have had time to settle. It seems that they are more virulent or active while wet, and this shows the importance of consumptives sleeping as much as possible quite alone. In the second phase the bacilli may at once sink to the floor and get dried, in which condition they may live for months, and though capable of giving rise to the disease, are not considered so dangerous as when damp. At present there is no accurate method of calculating the actual number of cases of phthisis in Bermondsey, as we have not compulsory notification, but adopting the proportion of cases to deaths which is generally accepted by authorities, viz., 5 to 1, we get the number of cases in Bermondsey as 220 X 5 = 1,100, and from personal experience and observation I believe this is considerably understating the probable number. Table I. Whole Borough. Bermondsey Wards. Rotherhithe Wards. St. Olave Wards. St. Olave. St. Thomas. 1 2 3 4 5 6 1 3 St. John. 2 13 14 17 14 5 9 7 - 2 - 3 104 20 Voluntary Notifications 12 4 22 10 235 45 23 27 12 9 25 44 2 Poor Law Notifications 339 58 37 44 32 23 53 24 10 5 30 19 4 Total 242 39 42 16 23 7 26 40 11 6 16 12 4 Re - Notifications (changes of address, &c.) 38 22 31 12 17 6 5 196 29 2 2 18 Rooms Disinfected 14 In Table I. will be found the voluntary and poor law notification for the 52 weeks ended April 2nd, 1910. This period was chosen as it gives a year's working of the poor law notification after the scheme was well started, and from this it is evident that we only hear of a small number of probable cases. This much may, however, be said, that we hear of the majority of the advanced cases, for the poor law notifications consist of little else. In the case of the voluntary notifications we often get cases in the early stages, and before they are incapable of working. The procedure as regards prevention is somewhat different according to whether the notification is voluntary or poor law. If the former, the case is visited directly by myself and the necessary inquiries made and precautions recommended. Disinfection is advised but not always accepted. We have, however, been more successful recently in getting this carried out, since the people are beginning to understand its value. Secondary visits are, as a rule, not paid, since time and other duties do not permit of it. In the case of poor law notifications it has been found that as patients do not come under the guardians as a rule till the last stage of the illness, when they are no longer capable of supporting themselves or families, and see the parish doctor only as a preliminary to removal into the infirmary, it saves time to get the sanitary inspector to visit the house and see if the patient has gone or intends going into the infirmary. If the patient decides on the latter the names and ages of the contacts are obtained and disinfection is arranged for. Of the 235 poor law cases notified during the period to which the above table refers, 103 went into the infirmary either immediately or very shortly after notification, and those who elected to be treated at home were visited and advised by me. It is these visits which have impressed me greatly with the necessity of doing something more to assist consumptives in their illness. For various reasons they do not care to go into the infirmary, and those who enter it generally do so from sheer necessity. It is a great pity that this should be so, since an infirmary to which advanced cases readily resorted would be a powerful weapon in preventing the spread of the disease. You visit a house and find the father of the family in advanced phthisis, possibly bed-ridden, with one or two rooms at his disposal. He is sleeping in a room with other members of the family, not earning any money, and therefore has insufficient food and clothes, and there is added to this insufficient fresh air. With such a state of affairs, the advice of the Medical Officer of Health frequently seems somewhat farcical both to himself and to the patient. All I can offer him is a little disinfectant and a spit-pot. Now in considering what further measures might be undertaken by the Council, it will assist if one considers the different classes of cases to be dealt with. "Consumptives" may be roughlydivided into three classes, according to the stage of the disease. First you have a very small class of eases (as far as notification is concerned) in the very early stage which, with suitable treatment and after-care, may be considered curable. Such cases come under my notice through voluntary notification. The second class is larger and may be considered to include those which are still in the early stage or have just begun the second stage, and while not completely curable, still under suitable treatment can have the disease arrested sufficiently to enable them to follow their employment many years; and finally you have the third class, including cases in the late second and final stages. These are incurable and generally past work, and are probably the greatest danger to their families and neighbours. Prevention. (a) General. In considering this matter there are some measures which would apply to all cases, and other measures which are only suitable for a particular class. Among the first is systematic visiting. Each case notified, whether poor law or voluntary, should be visited by a medical man, who would make careful inquiries as to the origin of the disease and the health of the other members of the patient's family and advise as to general measures to prevent spread and for the benefit of the patient. Such would include disposal of sputum, disinfection, sleeping accommodation, ventilation, sunlight, and also inquiry into the general sanitary condition of the home, abatement of any nuisance, such as overcrowding, dirt, verminous conditions, &c.: he could arrange for systematic disinfection, and, in conjunction with the medical attendant, classify the patient in view of any further measures which might be thought desirable. The case should be followed up by systematic visits of the Health Visitor at such intervals as occasion requires. She would see that all precautions and recommendations were being carried out faithfully, and in cases which were being assisted in any way by the Council that the conditions were complied with. This should be part of the work of a properly instructed Health Visitor, and is not suitable work for a male sanitary inspector. Where possible, all rooms should be sprayed weekly (as at present done), sputum-pots provided, and a precautionary leaflet distributed. This health visiting may be very advantageously done, as sketched above, but the Council have powers to extend this work and do a certain amount of treatment. This extension could take the form of the tuberculosis dispensary. A dispensary was first started in Edinburgh over 25 years ago by Dr. Phillips, and has been extensively copied all over the world. One of the latest municipalities to take it up is that of the Borough of Paddington; here a house was taken and fitted up as a dispensary by voluntary subscriptions, and in it patients who are suffering from, or suspected to be suffering from, phthisis are systematically examined, advised, given medicine, weighed, &c. The staff consists of a doctor, nurse, Health Visitor and porter. Cases are visited at their own homes where necessary by the doctor, followed up by the Health Visitor. The dispensary is under a committee, who work in conjunction with the Borough Council and the various philanthropic agencies in the Borough. The cost is about £700 per annum. This work could also very suitably be undertaken by the Borough Council, but it would require additional staff and accommodation. (b) Special. There are certain special measures which are recommended in the Memorandum of the Medical Officer of the Local Government Board, copies of which have been supplied to the Committee, and I shall consider them in connection with the three classes of patients mentioned previously. Classes I. & II.—Now of these Class I. is the most suitable for the out-door sanatorium treatment, and this the Borough Council are entitled to expend money on by virtue of the Public Health (Tuberculosis) Regulations of 1908. These give power under Section 75 of the Public Health (London) Act, 1891, to provide hospital accommodation for certain infectious diseases. Endeavour has been made in London during the past eight years to get some central body, such as the Metropolitan Asylums Board, to take the matter up and provide sanatoria for cases of comsumption, but nothing whatever has been done towards this; and while public bodies are arguing who is to take the matter up, I think it is the best that the Borough Council follow the example of Woolwich and contract for the use of beds in one of the private sanatoria. The above Borough contracts for seven beds at a cost of 28s. per bed when they are occupied and 20s. when unoccupied, but the charge is now raised to 30s. The institution is the Peppard Sanatorium, and the results so far have been very satisfactory. In 1908 38 patients were admitted and 38 discharged. Of the discharged 14 stayed one month, 8 two months, 6 three months, 5 four months, 3 five months, and 1 six months. None died in the sanatorium, and all but 3 returned home improved in general health and showing increase of weight. There are generally more applicants than can be admitted, but the cases have to be carefully sorted out before sending, since many are too advanced to receive any benefit. When patients come out of the sanatorium they should be systematically visited and helped, where necessary, to get occupations which will be suitable for their condition, otherwise much of the benefit of their stay there is thrown away. Another measure which could with great advantage be adopted for this class as well as a portion of the second class is the provision of wooden shelters, where they would have an opportunity of carrying on the open-air treatment in their own homes. The Paddington Dispensary have four such shelters in use, which cost £4 10s each. They consist of movable wooden sheds, closed in on three sides and completely open on the remaining side. They are large enough to contain a single bed, and the patients soon get used to sleeping out in the open air. I visited two which are in use in Paddington, and both the patients, who belonged to the working class and had been sleeping out for a year in these shelters, which were placed in their backyards, expressed themselves as highly satisfied with the result, and feeling much the better for it. The provision of such shelters, however, is closely bound up with the question of health visiting, which must be systematically done, to see that proper use is being made of them. Another measure which would apply to these classes as well as the more advanced cases is the provision of separate beds and bedroom accommodation for those cases in which the homes are overcrowded and in which the patients are obliged to sleep in a room with other members of their family. This is extremely common in Bermondsey and could be remedied to some extent by the letting out on loan of single beds, so that the patients would not be so likely to infect their relatives. In a certain number of cases also an extra room could be hired in the house, so as to give the patient In opportunity of sleeping alone. The disease, as is well known, is specially liable to spread from husband to wife, and the same remark applies to children which sleep in the room with phthisical parents. Class III.—As regards precautionary measures which are to be taken for advanced and incurable cases, we are greatly handicapped. The proper method undoubtedly is for them to be segregated in suitable homes or hospitals, and the provision of these should form part of a general scheme by some central body. In the meantime, however, the only available institution we have is the poor law infirmary, and there is, as previously mentioned, a great aversion to this. I think it is a great pity that the Bermondsey Guardians, when altering the infirmary recently, did not bring the building a little more in line with the requirements of the modern treatment of consumption, as suggested by me, so as to induce consumptives, especially advanced cases, to enter and remain there. In view of the above considerations, I beg to put my recommendations in definite form as follows. lam not mentioning the question of the tuberculosis dispensary, since while I think such an institution very desirable, I prefer to leave it for a future occasion. (a) That cases of phthisis remaining at home should he visited as hitherto by the Medical Officer of Health, these visits to be followed up by systematic periodical visits of the Health Visitor. (6) That these beds be contracted for in one of the sanatoria, at a cost of about 30s. per week when occupied and 20s. when not occupied, where suitable cases could receive treatment. (c) The purchase by the Council of three or four shelters which could be given on loan to suitable cases for home treatment. (d) The provision of a few single beds, which could be also given on loan in suitable cases. (e) That arrangements be made for the hire of an extra room in suitable cases, and after report to the Public Health Committee by the Medical Officer as to the suitability of the cases for such assistance. Health Visitor. As the duties outlined in this special report add considerably to the work of the Health Visitor, it will be necessary to consider her duties with a view of appointing some one to assist in carrying out the work. The following table shows the work done by the Health Visitor during- the year ended April 2nd, 1910:- Table II. Whole Borough. Bermondsey Wards. Rotherhithe Wards. St. Olave Wards. 1 2 3 6 1 2 3 St. John St. Olave. St. Thomas. 5 4 Births Notified:- I I I I I I I I I I By Guy's Hospital 3 6 226 5 - 95 1,478 483 345 260 2 36 17 110 78 185 44 26 17 „ Mid wives 893 71 65 111 98 83 5 42 27 1 „ Doctors 886 28 32 96 161 115 179 156 48 1 „ Parents 937 40 69 114 153 118 115 192 69 23 3 1 40 4,194 622 511 581 427 337 386 171 57 24 484 161 Total 433 2,743 643 377 413 208 204 260 53 Births Visited:— I — '! — — "H r~ I rn 1 — Primary Visits 288 74 64 138 21 20 37 15 18 4 – Secondary Visits 344 113 68 58 11 – – 11 6 Other Calls and Visits 98 19 16 13 11 6 10 6 – – – 3,185 775 461 484 239 285 80 57 64 162 21 Total Visits Paid 226 331 33 13 4 – – 2 – Insanitary Conditions reported to Medical Officer of Health 4 6 – 2 1 1 Table 11. is compiled from the various reports given to the Committee from time to time, and relates to the 52 weeks ended April 2nd, 1910. From this it will be seen that 4,194 births have been notified in the Borough, and of these only 2,743 have received visits, the secondary visits being 344. As pointed out in all my annual reports, 95 per cent, of the population of this Borough consist of the working class, and there are very few houses where births occur which, in my opinion, should be exempted from visits by the Health Visitor. The number of secondary visits is small, and these for several reasons are quite as important as the primary ones. In addition to the work shown in the table, the Health Visitor has her class for mothers every Tuesday afternoon. She also has various calls and visits to make as the result of complaints of the Care Committees of Schools. There is also a very large number of complaints received about the verminous condition of children attending schools (from November, 1909, to March, 1910, 435), necessitating visits to the homes. Hitherto these have been attended to by the District Inspectors, but Ido not consider it at all suitable work for male inspectors. In such cases it means not only visiting the home, but examining the bedding and the clothing of the inmates, and this can only be done satisfactorily by women inspectors. Taking all these duties and the size of the Borough into consideration, it is absolutely impossible for one Health Visitor to undertake all the work, and the very least I can recommend is the appointment of another. For administrative purposes I therefore recommend : — (a) That the Borough be divided into two parts coterminous with the present districts of the Food Inspectors. (b) That a Health Visitor be appointed for each district. (c) That their duties should be to pay a visit to every house where a birth occurs; to pay secondary visits where necessary; to visit consumptives at such intervals as the Medical Officer may, from his knowledge of the cases, consider necessary, and also follow them up on changes of address; to visit homes where complaints are received as to the verminous condition of inmates, in order to arrange for suitable measures to get rid of the vermin; to visit homes where complaints are made by the School Care Committees, and do such other work as may from time to time be required by the Council. Your obedient servant, R. K. BROWN, M.D., Medical Officer of Health. Recommendations adopted by the Council: — (a) That cases of phthsis remaining at home should be visited, as hitherto, by the Medical Officer of Health, these visits to be followed up by systematic periodical visits of the Health Visitor. (b) That three beds be contracted for in one of the sanatoria, at a cost of about 30s. per week when occupied and 20s. when not occupied, where suitable cases could receive treatment. (c) The purchase by the Council of three or four shelters which could be given on loan to suitable cases for treatment. Sanatorium. On July 26th the Council decided to contract for three beds in one of the sanatoria. A full report of this will be given next year. The following is a special report on the question of a sanatorium and the conditions under which patients will be received:— Prevention of Consumption. I beg to report that in company with Councillor Richmond I visited Benenden Sanatorium on Thursday, September 15th, and in company with the Chairman and Councillor Richmond the Maitland Sanatorium, Peppard Common, on Saturday, September 17th. The following is a brief description of each sanatorium:— Benenden Sanatorium is situated in Kent, about six to seven miles from Headcorn, which is on the main line between London Bridge and Dover. It takes a little over two hours to reach Headcorn, and the distance between this and Benenden can be covered by a vehicle in a little under an hour, or by a light railway which runs part of the distance. The sanatorium, which is built on two large farms comprising together about 250 acres, is situated in an undulating country mainly given over to agriculture, the geological formation being marl loam resting on greensand. The building is a large one of crescentic form with a southern aspect, and consists mainly of cubicles arranged in two stories, the majority containing two beds each. The cubicles are ventilated towards the north by windows, and towards the south they are fully open to passages which run the whole length of the building. These passages are ventilated direct to the open air by casement windows. There is no verandah, but the south windows open on to a terrace. The height above the sea level is 250 feet. The building is constructed of hollow tiles fitted into a suitable framework, and is put up in a very inexpensive style. There are administrative blocks attached to it for the Assistant Medical Officer, the nursing staff, &c., and the Medical Superintendent lives in a farmhouse some distance off. The drainage and general sanitary arrangements are very good. There are 101 beds for men only, 90 of which are at present occupied. The principal occupants of these are members of various trade unions, and might be described as of the artisan class. Recently a wing has been added for post office employees. The system of treatment here is known as the open-air treatment, combined with graduated work. The graduated work consists of doing a certain amount of domestic work and walks of various distances according to the strength of the patient, until he gets up to the average work done by an agricultural labourer, and the results are said to be very good. The fare from London Bridge to Headcorn is 3s. 10d., and by special arrangement with the Kent and East Sussex Railway, patients can be conveyed from there at Is. 9d. per return journey. By ordinary cab the cost from Headcorn to the sanatorium is 4s. The cost per bed per annum is £78, i.e., 30s. per week, but there is no rebate made on account of any period during which beds maintained at the annual charge may be unoccupied, whatever may be the cause. The regulations also state that, as far as possible, the patients nominated should be members of trade unions or friendly societies. Maitland Sanatorium is situated on a farm of about 50 acres of arable and pasture land in an open district of the Chiltern Hills six miles from Reading, and adjoins an extensive gorse common. The buildings are quite of a different type from those at Benenden, and this is mainly explained by the development of the sanatorium itself. This began some ten years ago in a very small way as a single building, and additions have been made as required. These did not follow any special plan, but are scattered about the grounds in various directions. They are single storied, with large verandahs situated in front on to which the separate bedrooms open. The windows are specially made to open up and down like those in railway carriages, so that when the weather permits the patients get the full benefit of the "open window." Scattered over the grounds are several shelters each containing a single bed. They are the size of a small room, with windows on three sides and completely open in the front. They are made to turn on a pivot, so that their backs can always be turned to the side from which the wind is blowing. To obtain permission to sleep in one of these is one of the rewards of progress in health in the sanatorium, and patients are very anxious to get sufficiently well to avail themselves of this privilege. The site of the sanatorium consists of gravel situated on chalk, and is very dry, and the height above sea level is 375 feet. There are 55 beds, which include 8 for children and 12 for women. Reading can be reached from Paddington in a little under an hour at a cost of 3s., and from the former, patients are conveyed by an open trap or cab, at a cost of 4s. and 6s. 6d. respectively each way. The patients are admitted to the sanatorium for a month on trial, and then if not found suitable for any reason are returned home, but if suitable, are retained for a period of two months or more as arranged for. The system of treatment is the same as at Benenden, viz., open air and graduated work, the latter being divided into three classes. For women the work consists of needlework,. housework, gardening, Swedish drill, &c., in varying lengths. The patients seem very happy and comfortable. They are well fed, and have 2½ pints of milk per diem. The country in the neighbourhood seemed very healthy and picturesque. The charge here is £78 per annum per bed, and the authorities are willing to make an allowance of 10s. per week when beds are unoccupied. The question now arises as to which sanatorium one should choose, for the terms of admission are very similar, and as regards treatment they both seem very efficient. In visiting Maitland Sanatorium we had the advantage of meeting the Medical Officer of Woolwich, who stated his Authority had had beds there for six years. He spoke very highly of the treatment and personal supervision, and the interest taken in the patients by the Medical Superintendent. We are very much impressed by the administration of this sanatorium, which has the advantage of having beds for women and children and is somewhat less restrictive in the cases taken. I therefore recommend the Committee to take the three beds in the Maitland Sanatorium. I also recommend that the Committee adopt the following recommendations as a guidance in the choice of patients:— (1) Patients should be in quite an early stage, with reasonable prospect of cure. (2) They should be residents of Bermondsey of at least one year's standing. (3) People with a wage of over £2 10s. per week shall not be eligible. (4) Patients should pay their own travelling expenses, hut power should be given to the Medical Officer of Health to pay these expenses in those cases that cannot afford them. Cerebrospinal Meningitis. 5 cases of the above disease were notified, viz.:— S. T., 4 years, male, of 1, Woolf Street, was notified on April 21st as suffering from epidemic cerebro-spinal meningitis. The disease was diagnosed in Guy's Hospital, where the child was taken by the parents, and presented all the typical signs of this complaint, more so than any other case which has been notified in this Borough. A bacteriological examination was made, and the characteristic organism causing the disease was found in the spinal fluid. As the organism which causes this disease has frequently been found on the Continent in the nasal pharynx, i.e., the part of the throat situated above the soft palate and at the back of the nose, I sent the members of the family who were in immediate contact with the patient to Guy's Hospital Laboratory, where they were specially examined by Dr. Eyre. He found an organism in the throat which has the appearance of the organism causing the disease, known as meningococcus, but he was unable to state absolutely whether it was this organism, since it would take an extremely long and exhaustive inquiry to ascertain this. As the disease has shown little tendency to spread, I did not consider the results of such an inquiry would pay for the trouble and cost entailed. All the "contacts" were kept under observation, the usual disinfection carried out, and the children excluded from school. D. J., 7 months, female, of 142, Tanner Street, was certified on April 17th as having died from posterior basic meningitis. This disease is looked upon as a sporadic form of cerebrospinal meningitis, but the symptoms differ somewhat. The usual precautions were carried out in this case. On May 25th, H. D., 6 months, male, of 41, Reverdy Road, was notified as suffering from cerebro-spinal meningitis. The patient died on May 23rd in Guy's Hospital. On June 11th 2 cases of posterior basic meningitis were notified, viz.:— E. B., 17 months, female, 3, Staple Street, and C. M., 4 months, female, 60, Alice Street. Both patients died in Guy's Hospital. The usual precautions as to disinfection, &c., were taken. The death in the latter case was certified to be due to tubercular meningitis. Anthrax. The following is a list of the cases of anthrax in connection with the Borough notified during 1910:— Date Notified 1910. Name and Address of Patient. Part affected. Source of Infection. Result of Illness. Occupation. July 9th A. C., Marcia Road. Wharf labourer Forehead Foreign hides Recovered Recovered Dec. 30th C. L., Faircross Avenue, Barking Wharf labourer Neck Cape sheep skins Consultations. I was called in by medical practitioners to assist in the diagnosis of doubtful cases of infectious disease in 8 cases. 11 patients were also examined at the request of school teachers, parents, &c. I examined at the Town Hall 23 phthisis patients, and 1 person who met with an accident at an underground convenience. I also examined 7 members of the Council's staff. Children excluded from School on account of Infectious Diseases. Chickenpox. Total Exclusions. Diphtheria. Enteric Fever. Scarlet Fever. Whooping Cough. Erysipelas. German Measles. Measles. Mumps. School. "contacts." "Contacts." Patients. Patients. " Contacts." " Contacts." "Contacts." "Contacts." "Contacts." "Contacts." Patients. "Contacts." Patients. Patients. Patients. Patients. Patients. Patients. 2 Albion Street 260 10 9 8 68 2 56 13 30 ... ... 1 ... 38 ... 23 ... ... Alexis Street 319 12 34 8 21 102 91 3 2 8 5 17 10 ... ... ... ... ... ... 88 Alma 7 22 2 5 ... 20 8 2 13 5 ... ... ... ... ... ... ... ... Amicable 8 1 5 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... All Saints 10 1 2 2 ... 5 ... ... ... ... ... ... ... ... ... ... ... ... ... Brent's Court 7 1 ... 1 2 2 1 ... ... ... ... ... ... ... ... ... ... ... ... Bacon 8 6 1 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... Boutcher 48 5 5 4 7 1 ... 23 1 ... 1 ... 1 ... ... ... ... ... ... Chaucer 30 2 11 ... 1 ... 6 1 2 1 2 1 ... ... ... ... ... ... ... Clarence Street 29 1 7 ... 1 6 1 ... ... 2 1 10 ... ... ... ... ... ... ... Cow Lane 1 8 3 10 47 6 2 1 1 104 1 12 12 ... ... ... ... ... ... Christ Church 6 16 1 6 5 8 1 20 5 ... 6 86 ... ... ... 12 ... ... ... Credon Road 19 1 6 2 5 2 2 ... ... 1 ... ... ... ... ... ... ... ... ... Cripple School, Old Kent Road 3 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Dockhead R.C. 105 12 5 20 2 9 ... 15 20 ... 1 1 ... ... ... ... ... ... ... Deptford Park 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 89 7 15 ... 12 East Lane 30 2 ... 20 1 ... 2 ... ... ... ... ... ... ... Fair Street 221 23 2 34 10 15 4 8 26 4 25 1 1 2 39 23 ... ... ... Farncombe Street 99 8 26 4 17 1 ... 18 11 6 ... 2 1 4 ... ... ... ... ... 116 Galleywall Road 17 24 3 1 ... ... 21 7 23 4 10 3 2 ... ... ... ... ... Galleywall Road (Special) 9 ... 2 1 2 ... ... 2 1 ... ... 1 ... ... ... ... ... ... ... Grange Walk 25 10 1 5 ... ... 9 ... ... ... ... ... ... ... ... ... ... ... ... Gomm 17 2 4 ... 4 6 1 ... ... ... ... ... ... ... ... ... ... ... ... Holy Trinity 21 7 2 7 ... ... ... 3 ... 2 ... ... ! ... ... ... ... ... ... ... 115 Keetons Road 16 ... 140 565 34 4 12 49 12 53 32 60 35 3 ... ... ... ... ... ... ... ... Laxon Street 1 112 2 12 2 3 3 50 16 3 2 16 2 ... ... ... ... ... ... ... ... ... ... 6 Magdalen Street 42 4 5 6 6 5 7 1 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... Mawbey Road 12 2 4 ... 6 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 74 1 3 10 1 2 2 8 3 1 43 Melior Street ... ... ... ... ... ... ... ... ... ... ... ... 6 2 4 ... Mina Road ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Monnow Road 189 3 22 1 3 19 25 22 2 22 9 50 11 ... ... ... ... ... ... ... ... 3 ... ... Midway Place 155 4 7 9 3 54 24 9 3 8 3 12 5 7 4 ... ... ... ... ... 17 ... ... Neckinger 140 5 25 4 40 25 4 3 16 1 ... ... ... ... ... ... ... ... ... ... ... ... Pages Walk 196 13 29 2 14 46 38 7 13 3 19 11 1 ... ... ... ... ... ... ... ... ... ... Private, Southwark Park Road 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rolls Road 2 3 1 1 5 2 2 26 4 ... 4 2 ... ... ... ... ... ... ... ... ... ... ... Riley Street 2 22 1 5 1 93 5 32 18 3 1 1 2 ... ... ... ... ... ... ... ... ... ... ... Riley Street Special 2 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rotherhithe New Road 1 41 107 6 10 2 2 15 ... 9 8 2 11 ... ... ... ... ... ... ... ... ... ... 34 St. James' 159 2 17 2 1 49 ... 9 15 19 7 4 ... ... ... ... ... ... ... ... ... ... 5 St. Joseph's 91 5 22 1 9 1 1 22 12 ... 7 2 4 ... 21 ... ... ... ... ... ... ... ... St. Paul's Lane 8 16 63 1 1 2 ... 3 3 5 9 11 4 ... ... ... ... ... ... ... ... ... ... St. Mary's 19 2 12 1 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Silwood Street 19 1 1 1 3 1 ... 9 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... Southwark Secondary, Yalding Road 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... St. Barnabas 28 20 8 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... St. Olave's (Girls) 3 2 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... St. Olave's (Boys) 2 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... St. Winifred's 2 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 158 8 2 30 50 Snowsfield 13 7 7 3 29 2 7 ... ... ... ... ... ... ... ... ... ... ... 2 22 61 32 36 Southwark Park 237 3 17 2 1 14 29 18 ... ... ... ... ... ... ... ... ... ... Townsend Street 5 2 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Webb Street 22 1 1 27 186 6 21 26 15 3 9 26 2 27 ... ... ... ... ... ... ... ... ... Weston Street 19 1 4 1 4 3 2 3 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 2 1 Westcott Street ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4,437 208 589 76 336 15 ... Totals 6 950 735 1 ... 300 | 60 284 104 152 92 1 25 2 501 ... 22 SANITARY ADMINISTRATION. Offensice Matter. No summonses were taken out under the Loudon County Council's by-laws for carriage of offensive matter through streets in unsuitable receptacles or during prohibited hours during the year under report. Offensive Trades. The offensive trades on the Register are as follow:— Tripe boiler 1 Glue and size makers 4 Fellmongers Fat melters 4 3 Manure manufacturer 1 115 inspections were made, against 105 in 1909. 2 notices were served. 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: — Tons. cwts. qrs. lbs. Apples 14 2 18 - 14 Apricots 3 - - Apricot Pulp 3 3 - - Bacon 25 - - - Black Currants 2 24 - - Bullock's Liver 14½ - - - Catfish 7 1 3 - Celery 5 1 - - Chestnuts 9 - - - Crabs 1 21 - - Cucumbers 14 - - - ½ Eggs - - - Fish 1 21 - - Fruit 1 - - - Greengages 3 2 9 - Haddocks 2 4 - - 7 Herrings - - - Kippers 3 6 - - Lemons 2 15 2 1 7 Mackerel 2 - - Melons 2 - - - Mussels 1 - - - 2 Mutton 27 - - Oranges 18 2 24½ - Oranges and Lemons 5 16 1 24 Peach Pulp 10 - - - Pig - 3 9 - Pig's Liver 3½ - - - Pig's Mesentery and Spleen 3 - - - Plums 11 - - - Potatoes 1 3 2 16 Rabbit 7 - - - Rabbit Livers ½ - - - Raspberries 2 26 1 - 26 Sheep's Liver - - - Shrimps 2 - - - Skate 3 - - - Sprats 3 14 - - Strawberries 1 16 2 - Strawberry Pulp 1 12 - - 4 Tinned Apricots 2 16 - Apricot Pulp 2 15 24 - „ Beef 12 - - - Black Currants 2 - - - „ Bloater Paste 1 - - - „ Cod Roe 3 6 - - „ Condensed Milk 1 10½ - - „ Fruit... 5 - - - „ „ Pulp 3 1 2 24 „ Giblet Soup - 4 - - „ Lobster 3 10 - - „ Paste - ¼ - - „ Peaches 2 4 - - „ Pears 2½ - - - „ Prawns 15 - - - „ Salmon 2 2 12 - „ Sardines 1¾ - - - „ Shrimps 2 6 - - Tomatoes 7 9 - - Turkeys 9 1 14 - Various Tinned Goods 3 18 1 12½ Veal 1 14 - - Walnuts 10 2 - - Winkles - 3 - - 14 - 20½ 26 23 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 or stored:- Bakehouses 81 Ice cream 144 Butchers 74 Milk-sellers 286 Fishmongers, friers and curers 76 Restaurants and eating houses 142 Food stores 374 Coffee stalls 15 Food wharves and depôts 99 1,425 Food factories 36 Fruiterers and greengrocers 98 Unsound Food Seizure. The following prosecution took place during the year under report:— March 2nd Exposing for sale unsound tomatoes. Bound over in the sum of £5 to come up for judgment if called upon within 12 months. Bacteriological Laboratory. The total num ber of specimens examined in 1910 was 708, compared with 596 in 1909, and 752 in 1908. Results of Examination. Total Examinations. Nature of Specimen. Positive. Negative. 1909. 1910. 1909. 1910. 1909. 1910. Diphtheria (specimens taken by Medical Officer of Health) 215 260 4 7 211 Ditto (taken by general practitioners) 134 122 13 27 121 253 95 349 382 17 34 348 Diphtheria (total specimens taken) 332 Phthisis 229 239 61 46 168 193 Enteric 13 4 24 4 9 20 Various 5 63 ... 5 63 ... 82 84 624 514 Total specimens taken 596 708 Unsound Food and Foreign Meat Regulations. The following articles of food were dealt with under the above regulations during the period under report:— Quantity Unsound, Disposed of for other Purposes than Human Food. Article. Destroyed. Removed for Sorting under S.A. Exported. Quantity. Weight. Weight. Weight. Quantity. Quantity. Quantity. Weight. I Tons. qrs. Tons. Tons. cwts. lbs. cwts. lbs. lbs. Tons. Pigs' Carcases (Fresh) qrs. cwts. qrs. cwts. qrs. lbs. - - 26 carcases - 19 - 26 - - - Pigs' Offal - - - - - - 11 - - - - 3 plucks and 2 livers - - - - - - - - Turkeys „ - - - - - - - - - 27 cases and 123 loose birds 2 17 12 - - - - - - 29 cases 2 13 2 - - - - - - - Beef (Frozen) 724 briskets and flanks - 12 6 2 11 2 2 16 - - - - - - - - - - - Pigs' Carcases „ 46 carcases - 2 4 2 - - - - - 170 carcases Fowls „ - - - - 8 9 2 1 - - 96 birds 2 - - - - 6¼ Bacon - - - - - - - - - 4 sides 3 - - - - - - - - 3 4 96 bales and 1 side 13 15 2 Hams - 9 - - - - - - - - - 24½ 15 cases Tongues (Salted) - - - - - 1 8 3 20 - - - - - - - - - - 24 - - - - - - 34 cases, 5 casks, and 1 barrel 17 - - - - 1 27 - Pigs' Heads „ - - - - - 18 heads 2 - 18 14 - - 14 casks 2 Salmon (Pickled) - - - - 18 - 1 cask - - - 4 Beef (Tinned) - - - - - - - - - - - 618 tins - - - - - - 1 2 11¼ - - - - Boiled Beef „ - - - - 59 eases and 12 tins - - - - - - 1 18 2 8 - - - - - - Roast Beef „ - - - 6 tins - - - - - - 11 - - - Mutton „ - - - - - - - - - - - - - - - 49 tins - - - - - 3 25 Veal „ - - - - - - - - - - 1 tin - - - - - - - 1 - Meat „ - - - - - - - - - - - - 9 2 5½ - - - - Meat Loaf „ - - - - - - - - - - - 2 tins 3 - - - - - - - Ham Loaf „ - - - - - - - - - - 8 tins 8¾ - - - - - - - - Minced Steak „ - - - - - - - - - - - 10 tins - - - - - - - 24½ Steak and Onions „ - - - - - - - - - - 5 tins - - - - - - - - 9 Brawn „ - - - - - - - - - - - - 15 tins - - - - - - 1 2 Kidneys „ - - - - - - - - 21 tins 23½ - - - - - - - - 1 - Sausage „ - - - - - - - - 8 tins - - - - - - - - - 8 Tongue „ - - - - - - - - 538 tins - 24¼ - - - - - - - - - 9 2 - Ox Tail „ 132 cases - - - - - 1 8 1 4 2 tins Ox Tail Soup „ - - - - - 4 - - - - - - - - - - - - - - - 2 tins 2 - - Tripe „ - - - - - - - - - - - - - - - 58 tins 1 7½ - - - Tripe and Onions „ - - - - - - - - - - - - - - - - 6 tins - 12 - Meat Extract „ - - - - - - - - - - - - 1 case - - - - - - - 3 16 - - - - - - - - - - - 2 tins Potted Meat (Tinned) 0½ - - - - - - - - - - - - - - - - - - 3 tins 1 - - - - - - - - - - - Meat Paste „ - - - - - - - 2 - - 2 tins - - - - - - - - - Veal Paste „ - - - - - - - 0½ - - 2 tins - - - - - - - - Mince „ - - - - - - - - 15 - - - 7 tins - - - - - - Chicken and Ham „ - - - - - - - - - 13 tins 18½ - - - - - - - - Chicken and Veal „ - - - - - - - - - - - 1 2 8 - - 110 tins - - - - Soup - - - - - - - - - 1 1 tin - - - - - - Gravy „ - - - - - - - - - - - - 1 23 50 tins - - - - - Jellied Hock (Bottled) - - - - - - - - - - - - 10 - 1 - - - - - - Fish (Tinned) - - - - - - - - - - - 19 - 47 tins 1 - - - - - - - - - - - Salmon „ - - - - - 0¼ 1 tin - - - - - - - - - - - - - Bloater Paste „ - - - - - 1 tin 1 - - - - - - - - - - - - - Milk „ - - - - - 18 - - 379 tins 1 21 - - - - - - - - - Fruit „ - - - - - 103 cases, 630 tins 8 3 1 7 - - Fruit Pulp „ - - - - - - - - - - - - - 26 265 tins 1 2 - - - - - - - - - Apricots „ - - - - - - - - 114 cases 3 1 8 - - - - - - - - Currant Pulp „ - - - - - - - 9 tins 22½ - - - - - - - - Peaches „ - - - - - - - - - - 1 8 1 21 53 cases, 2 tins - - - - - - - - - Pears „ - - - - - - 4 tins 4 - - - - - - - - Pine Chunks „ - - - - - - - - - - 7 2 14 cases - - - - - - - - Raspberry Pulp „ - - - - - - - - - 13 20½ - 2 loads, 513 tins 3 - - - - - Tomatoes „ - - - - - - - - - - - 1 bottle 1 - - - - - Tomatoes (Bottled) - - - - - - - - - - - - 25 ½ 99 tins 4 - - - - - Tomato Pulp (Tinned) - - - - - - - - - - - - 3 20 - - 199 tins 4 - - - - Vegetables „ - - - - - - - - - - 6 tins 10½ - - - - - Asparagus „ - - - - - - - - - - - - - - 7 tins - 21 - - - Beans „ - - - — - - - - - - - - - 132 tins 3 2 4 - - - - - Peas „ - - - - - - - - - - - - 3 jars 3 - - - Chutney (Bottled) - - - - - - - - - - - - - - - 3 19 - - - 29 cases - - - - - - Salad Dressing „ - - - - - - - 44 10 2 274 - Various Tinned Goods - - - - - - - - - - - - - - - 122 barrels and 5 cases 8 3 16 - Apples - - - - - - - - - - - - - - - Bananas 11 20 217 crates, 10 double crates, and 6 cases 9 1 - - - - - - - - - - - - - - - Black Currants 2 3 4 - - 13 baskets - - - - - - - - - - - - - - 10 9 4 10 - 159 bags - - - - - - Chestnuts 136 bags 21 16 - - - - - 299 bags 25 6 - - - - - Dates - - - - - - - - - - - - 13 2 - - 3 cases - - - - - Figs - - - - - - - - - - - 2 casks 9 - - - - - Fruit Pulp - - - - - - - - - - - - - Grapes 8 barrels 4 - - - - - - - - - - - - - - - - - 17 12 half sieves - 2 2 8 - 548 sieves 4 3 12 - - - - Greengages - - - - - - - 17 12 1 10 - - - - - Lemons - - - - - - - - - - 34 cases, 24 boxes 2 6 - - - - - - - - - - - Melons - - - - - 3 6 - 116 cases and some odd lots 34 10 16 cases - 18 - Oranges - - - - - - - - - - 9 - - - Peaches - - - 1 package - - - - - - - - - - - - Article. Quantity Unsound. Destroyed. Removed for Sorting under S.A. Disposed of for other Purposes than Human Food. Quantity. Weight. Quantity. Weight. Quantity. Weight. Quantity. Tons. cwts. lbs. Tons. qrs. cwts. qrs. lbs. Tons. cwts. bs. qrs. 5 crates, 1 box, 68 trays, 81 packages, 27 cases Pears - 4 7 2 6 - - - - - - - - - - Peel (in brine) - - - - - 1 cask 8 2 - - - - - - - Plums 29 packages, 5 half sieves, & 100 pecks - - - 2 2 11 1 - - - - 6 - - - - Pomegranates - - 69 cases 4 6 1 - - - - - - - - Tomatoes - - - 60 boxes, 54 eases, 24 crates, 1 bundle, 1 package 1 17 1 20 - - - - - - - - - 0 - Cauliflower (in brine) - 25 casks, 6 barrels - 6 13 - - - 2 - - - - - - Onions - 60 bags 2 7 3 12 - - - - - - - - - Potatoes - 60 bags and odd lots - - 8 - 350 bags 17 10 - - - - - - - - Haricots 19 - - - 200 bags 11 2 - - - - - - - - Lentils and Peas - 11 2 2 - - - - - - - Maize - - - - - - 220 12 3 12 - - - - - - Oats - - - - - - 580 15 3 12 - - - - - - 7½ bags - - - - - Rice 9 1 14 - - - - - - - - - - - - Rolled Oats 1 4 3 8 - - - - - - - Wheat - - - - 337 7 1 6 - - - - - - - - - - - - Cocoa - - - 15 bags 1 1 1 25 - - - - - - - - Coffee - 12 bags 15 214 bags 19 15 20 - - - - - - - - - Eggs 3½ cases, 2 part half cases, and 1,450 loose eggs 9 2 14 3 cases 6 2 - - - - - - - - - Lard 214 buckets 2 13 2 2½ 10 buckets 2 2 - - - - - - - - Sugar 3 bags 6 51 bags & 100 boxes 10 2 - - - - - - - - - - - Stoppage notices under the above regulations were served on May 9th. 91 bags oats. June 14th. 60 tons grain. „ 17th. 60 tons barley and oats. „ 18th. 60 tons grain. „ 19th. 60 tons grain. Un the Inspector subsequently making enquiries it was found that the grain had been removed without our permission, contrary to Part II., Article IV., of the above regulations. The Public Health Committee interviewed the owner of the grain, but decided, as the offence appeared to have been committed through ignorance of the regulations, to warn, and not prosecute him. Hairdressers and Barlers. At the end of 1910 nine barbers were in possession of certificates. Inspections. In Table XII. of Appendix will be found particulars of the general sanitary work by the District Inspectors during 1910, and in Table IX. the number of premises on the Registers to which special attention has been paid. The house-to-house inspections number 5,687. This is 610 above the total for the previous year, and is an average of 711 per Inspector, against 634 in 1909. 4,144 intimation notices were served, compared with 4,000, and 1,197 statutories, against 854 in the previous year. The following table shows the work done by the District Inspectors during the year:— 1 2 3 7 8 9 10 11 4 5 6 12 Offensive Trades. House to House. Complaints. Factories and Workshops specially Inspected. Drains Tested. Other Calls and Visits. Infectious Diseases. Outworkers. Bi-Annual Inspection. Re-inspections. Chimneys Watched. Special Inspections. Underground Conveniences. No. Notices. No. Notices. No. Notices. No. Notices. No. Notices. No. Notices. No. Notices. No. No. No. No. No. Notices. 351 85 369 — 133 289 109 2,260 485 41 4 16 Mr. Grice 141 234 159 208 68 38 11 4 304 47 8 8 „ Cartledge 205 214 120 127 20 3 11 – 12 2 29 24 1,604 233 „ Wood 193 103 47 3 - - 1 96 39 18 79 18 5 4 - 38 - 15 340 151 - - - „ Merryman 812 424 186 134 63 44 9 20 12 163 2,776 345 24 - 236 133 346 15 2 73 „ Toogood 988 345 190 306 165 398 77 - - - 137 16 7 60 3,394 647 - 37 4 718 284 111 64 „ Freeman 149 101 324 88 42 18 38 2 315 45 9 233 2,679 269 8 1 „ Bartlett 1,187 192 1 1 95 100 42 358 2,377 109 174 222 17 21 1 4 253 67 323 6 128 76 - „ Townsend 546 306 128 271 32 13 3 70 6 219 375 3,458 570 4 - 12 50 18 127 - „ Cockburn 588 308 178 304 30 9 7 193 193 2,815 2 1 - - 4 264 1 Totals 5,687 2,308 441 929 2,278 115 1,162 1,280 21,703 3,026 223 22 994 1,691 374 180 56 2 1,492 108 The following is the report made to the Public Health Committee on November 29th, and the recommendations in it were adopted by the Council:— (a) Housing and Town Planning, &c., Act, 1909. Under this Act the duty of making a systematic or house-to-house inspection of their district is laid on the Sanitary Authority. In the circular of the Local Government Board, pointing out this, it is stated that it is not intended that such inspection should supersede that already carried out by many authorities, and that where certain records which the Board require are kept such house-to-house examination will suffice. Systematic house-to-house inspection has been for many years the policy of the late Vestry of Bermondsey, as well as the Borough Council, and to have this systematised so that the worst property will be kept under constant surveillance, and none which requires inspection shall be neglected, it will not be necessary to organise a completely new system, but only to make such alterations in the present one as shall satisfy the requirements of the Local Government Board and at the same time enable this Council to satisfy themselves that such records of inspection and action are kept as will enable them to judge of the thoroughness of the supervision which is being exercised over insanitary property and conditions and take what further action they may deem advisable. The main sections of the Act which deal with this subject are Nos. 14, 15 and 17. Under Section 14 in the case of a house or part of a house, situated in London, let for habitation at a rent not exceeding £40, there shall be implied a condition that the house at the commencement of the holding is reasonably fit for human habitation; but if leased for a term of three years and upwards, where such lease is not terminable at the option of either party before that term is expired, such condition is not implied. Section 15 (1) provides that the condition of fitness mentioned in Section 14 shall be maintained during the holding, and the remaining sub-sections give power of entry to the Sanitary Authority to see that the landlord is complying with these conditions, and of serving notice, &c., in cases of default. Section 17 deals with all dwelling houses in the district irrespective of rent, and is evidently intended to deal drastically with the more serious insanitary conditions found in them. Sub-section (1) states it shall be the duty of every Local Authority to cause to be made from time to time inspection of their district with a view to ascertain whether any dwelling-house is in a state so dangerous or injurious to health as to be unfit for human habitation. For this purpose the Local Authority and their officers are to comply with such regulations and keep such records as may be prescribed by the Sub-sections (2) to (6) explain the method of dealing with insanitary houses, and Sub-section (7) forbids the use of underground rooms for sleeping places except under certain Conditions. In their Order of September 2nd, 1910 (a copy of which is enclosed), the Local Government Board prescribe (1) the inquiries to be made when examining a dwelling-house, and (2) the records of such inquiries which are to be kept. The requirements here detailed are to be looked upon as a minimum, and a certain amount of latitude is obviously intended so that Sanitary Authorities will be enabled to adapt their methods to the requirements of their districts. For instance, no inquiry would be complete which did not deal with the cubic capacity of rooms in relation to the number of inhabitants, especially as the Board may require details on this point under Section 37. In the scheme which I here recommend all the above requirements of the Local Government Board are met, and certain other useful and, I might say, indispensable information is included. The Board suggest the use of the card system or loose-leaved books for keeping records, and I am recommending the former as being very compact and convenient, where quick and ready reference to any house is required. In a previous report the number of dwelling houses in Bermondsey is estimated at nearly 20,000, counting each tenement in the block dwellings as one house. Since, therefore, a house-tohouse inspection on the lines laid down by the Board would take a long time with the present staff of Inspectors and clerks, I have, with the assistance of the district Inspectors, made out a list of the streets containing the worst properties in the Borough, and propose to subject them first to a systematic house-to-house inspection. The majority of the houses should be examined every six months, but as the first examination will be the most difficult, inasmuch as it involves measuring up the various rooms, it is impossible to say how far this can be carried out till the primary inspection is made. The list here given is far from perfect, for a few good houses may be included among the insanitary ones, and there are no doubt isolated houses omitted which should have been included. There are also many houses and streets which, while not requiring so frequent inspection as here suggested, still require inspection at intervals of from one to two years, and these houses might well be included in a second list, when the inspection of this first batch is completed. The primary inspection will naturally take place in some districts sooner than others, since there is a considerable difference in the amount of insanitary property in the various districts. Aberdour Street Adams Gardens Ainsty Street Alice Street Ambrose Street Anchor Street Arica Place Aylton Street Baffins Place Bantry Place Banville Grove Barnham Street Beatson Street Bell Court Bermondsey Buildings Bermondsey Square Bethel Place Bisley Cottages Black Swan Yard Blackman's Court Brunel Road. Bryants Alley Carmarthen Place Caroline Court Castles Buildings, Derrick Street Charlotte Place Clarehall Place Clarks Orchard Cluny Place Corbetts Lane Coxon Place Crosby Row Cusack Place Davis Buildings Decima Street Dix's Place Dunlop Place List of Streets Requiring Special Inspection. Kintore Street Edward House Lagos Place Earls Cottages Lamb Alley Eckett Street Landrail Place Edmund Place Leroy Street Elephant Lane Little Maze Court Elim Street Llama Place Elizabeth Place Lawrence House Emba Street Lynton Mews English Ground Enid Street (46-60) Farthing Alley Faustin Place Finnimore Place Flockton Street Fort Passage Foxlow Street Fulford Street (No. 14) Gareth Place George Court Gibbons Rents Gilhams Court Goulston Buildings Great Maze Court Guttridge Court Great Russell Street Halfpenny Alley Hargrave Place Hargrave Square Hatteraick Street Hickmans Court Hickmans Folly Iphigenia Cottages Irwell Place Jacob Street James Place Jane way Street King's Arms Place Kinross Street Mariners Buildings Marshalls Place Maze Pond Medley Place Mellicks Place Musk Court Napoleon Court Neckinger Place Nolan Place Oran Place Osborne Buildings Pepin Place Paragon Alley Parfitt Road (35 to 59) Parkers Buildings Paulin Place Paulin Street Pleasant Row Porlock Place Princes Place Prospect Street Purnell Place Queen's Place Regia Place Risdon Street Rotherhithe Street (348 to 352 and 370 to 374) Rowleys Buildings Rudyard Place St. Marychurch Street St. Mary's Place Salisbury Street Sards Rents Sarnells Court Sedgers Buildings Sernes Alley Snowsfields Star Place Sun Street Surrey Buildings Shakespeare House Tay Buildings Thetford Place Tilbury Place Trinity Road Truscott Court Turners Retreat Tyers Gateway Vauban Street Victoria Place Vine Street Virginia Row Warford Place West Lane (34 to 62) Whites Court Whites Grounds White Lion Court Wilderness Street Wilds Rents Winter Square Wolseley Buildings Wolseley Street Woodlands Place Woods Place Wormald Place Number of Houses in each Inspector's District Requiring Special Inspection. District No. 1. Mr. Grice 263 houses. District No. 5. Mr. Freeman 160 houses. „ 2. Mr. Wood 514 „ „ 6. Mr. Bartlett 77 „ „ 7. Mr. Townsend 527 „ „ 3. Mr. Merryman 314 „ „ 4. Mr. Toogood 544 „ „ 8. Mr. Cockburn 107 „ Total 2,506 „ The card which I have drawn up, and a copy of which is enclosed, is intended to contain what seems to me only necessary information, and the tabulated form for "particular rooms" is designed to save clerical labour. This card (10 by 8 inches) may appear somewhat large, but where wilting is to be done a cramped space is false economy. My recommendation is to have two cabinets, each containing four drawers capable of holding 2,000 of these cards each. One drawer would be assigned to each Inspector's district, and would contain at the same time the latest inspection of a certain house together with the card of the last previous inspection in close juxtaposition. As soon as a third inspection of a certain house is made, the two most recent would only be kept, the others being filed away in the strong room, where they would always be available. I tried to make one card sufficient for several inspections, so as to keep a sort of continuous record on one card, but found it impracticable, since the conditions are likely to be greatly altered at each inspection, with the exception of the cubic capacity and the number of rooms. These cabinets would be kept in my office and written up by one of the clerks from information received from the Inspectors, and the notifications and other books. The plan I propose is to have leaflets printed containing the necessary questions, and a certain number would be handed out fortnightly to each Inspector, who would return them as they are filled. A copy of the proposed leaflet is enclosed. At first it seemed as if this plan would do away with the necessity of a house-to-house book, but this is not so, since an Inspector is required by the Local Government Board order of duties to keep a diary of his inspections, and it will be also necessary for him to have a record in front of him so as to be able to follow up those houses in which "further action" is required. For this purpose I have designed an Inspector's house-to-house book with headings for the recording of the information necessary for his purpose. It is not necessary for these to be nearly as numerous as those on the card. This book would be used for house-to-house inspections under the Housing, Town Planning Act alone, and his ordinary report book would be still used for complaints, infectious diseases, &c. Cost:—l have made inquiries from several firms dealing in the apparatus required for card indexing, and have found one firm much cheaper than the remainder, and on visiting them ascertained that they had two cabinets the exact size which were made for Marylebone Borough Council, but were rejected because the drawers were 10 by 8 in. instead of 8 by 10 in. These are made throughout of oak and offered at the much reduced price of £3 5s. each. Estimates for a cabinet of this description cannot well be asked for, since each firm has its own speciality and do not manufacture out of stock sizes at a cheap rate. Tenders, which will be laid before the Committee, were asked for from several firms for the cards, books and leaflets separately, and the lowest prices quoted make a total for all requirements, including the cabinet, of a cost of £2O 5s. 6d. Nos. 14 and 16, Fulford Street were reported under the above Act, and have since been demolished. Nos. 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 12, 14, 17, 18, 19, St. Mary's Place, and Nos. 74, 76, 78 and 80, St. Marychurch Street were also reported, but the matter is in abeyance, as they are houses that can be put into satisfactory condition if an owner can be found. Milk Premises. There were 273 milk premises on the Register at the end of 1909. Forty were added and 27 removed during 1910, making a total of 286 on the Register at the end of the year under report. 559 inspections were made and 20 notices served. Cowsheds. There are 4 cowsheds in the Borough. These received regular visits, the total number of inspections for 1910 being 51. No notices were served. Slaughterhouses. There is 1 slaughterhouse in the Borough. Twenty-one inspections were made. No notices were served. Ice Cream Premises. There were 133 premises where ice cream is manufactured on the Register at the end of 1909, and 11 were added during the year under report, making a total of 144. 165 inspections were made and 10 notices served. Houses Let in Lodgings. In 1909 there were 219" houses let in lodgings or occupied by members of more than one family "on the Register. Eight were added during 1910, making a total of 227. These were visited quarterly in accordance with the instructions of the Public Health Committee. Eighty-eight notices were served, 14 of these being for overcrowding. The following is a list of registered houses let in lodgings:— 5, Aberdour Street 16, Fulford Street 9, Parkers Buildings 11 „ 18 „ 10 „ 13 „ 12, Gedling Street 13 „ 14 „ 14 „ 60, Grainsford Street 15 „ 17 „ 20 „ 56, Arnolds Place 151, Grange Road 23 „ 82, Abbey Street 9, Grange Walk 28 „ 86 „ 76 „ 25, Princes Street 95 „ 81 „ 11, Reed Street 98 „ 87 „ 9, Riley Street 100 „ 91 „ 350, Rotherhithe Street 10, Alice Street 5a, Green Walk 352 „ 36, Barnham Street 6, Hatteraick Street 556 „ 6, Bermondsey Square 1, Janeway Street 1, Suffolk Street 7 „ 4 „ 42 „ 26 „ 10 „ 8, Salisbury Street 29 84, Bermondsey Street 14, Janeway Street 24, Salisbury Street 117 „ 131 „ 136 „ 50, Bermondsey Wall 52 „ 6, Bell Court 8 „ 9 „ 12 „ 15 „ 18 „ 24, Tower Bridge Road 7, Cloyne Row 1, Curlew Street 2 „ 5 „ 10, Crosby Row 19, Debnams 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 86 „ 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 „ 14, Fulford Street 20 „ 9, Kenning Street 10 „ 11 „ 19, Kipling Street 31 „ 6, Lamb Alley 7 „ 8 „ 46, Larnaca Street 47 „ 44, Leroy Street 54 „ 58 „ 62 „ 72 „ 74 „ 76 „ 78 „ 82 „ 86 „ 22, Litlington Street 230, Long Lane 201, Lower Road 4, Maze Pond 6 „ 8 „ 10 „ 12 „ 14 „ 16 „ 18 „ 19, Manor Lane 6, Marigold Street 10 „ 12 „ 1, Marshalls Place 21 „ 9, Maynard Road 9, Marcia Road 13 „ 35, Mellicks Place 39 „ 41 „ 43 „ 63 „ 2, Oldfield Road 3 „ 1A, Osborne Buildings 10, Pages Walk 9, Porlock Place 19 „ 21 „ 21, Paulin Street 2, Parkers Buildings 4 „ 6 „ 8 „ 115 „ 16 „ 27 „ 29 „ 55 „ 57 „ 58 „ 59 „ 66 „ 12, Snowsfields 14 „ 43 „ 62 „ 63 „ 75 „ 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 „ 29, West Lane 40 „ 42 „ 43 „ 45 „ 48 „ 50 „ 20, Westlake Road 22 „ 199, Weston Street 247 „ 253 „ 14, Wilds Rents 1, William Square 11, Wolseley Street 12 „ 13 „ 14 „ 15 „ 16 „ 17 „ 18 „ 19 „ 20 „ 4, Woods Place 11 „ 14 „ 15 „ 16 „ 1, Woolf Street 2 „ Food Examined during the Year 1910. Meat. Fish. Vegetables. Tinned Goods. Dairy Produce. Cereals. Various. Fruit. No. of Inspections. Tons. No. of Inspections. Tons. No. of Inspections. Tons. No. of Inspections. Inspectors. Tons. No. of Inspections. Tons. No. of Inspections. Tons. No. of Inspections. No. of Inspections. Tons. Tons. 358 4056 20 108 171181¼ 147 4004 Mr. Ashdown 384 187 862¼ 57 2013 33 6243 19 106¾ 612 403 223½ 536 „ Scott 466 1622½ 435 562 58 53¼ 4 1¾ 3 190 615 - - „ Hoskins 840 559¼ 457 84¾ 3½ 1566 675 48 29 6½ 76 2110 680 661 14 24¼ „ Toogood - - 17 - - - - - - - - - - - - - - - - - „ Cockburn 2 ½ - - - - - - - - - Totals 1810 5018¼ 962 420¼ 1535 20369¾ 1262 5241 906 963½ 90 112 33 131 2021¼ 8543 Note.—The inspections refer to the number of separate lots, and the weights are only approximate. Food Inspectors. Particulars of Work, 1910. Visits. 1 2 3 4 6 7 8 9 10 11 12 13 14 15 5 Food Factories. Bakehouses. Butchers. Cowsheds. Fishmongers, Friers and Curers. Food Stores. Food Wharves and Depots. Fruiterers and Greengrocers. Ice Cream. Markets. Milk Sellers. Restaurants and Eating Houses. Slaughterhouses. Nuisances Reported. Number of Samples Taken. Jam. Butter and Margarine. Other. Mr. Ashdown Re-visits 37 - - 14 40 10 292 - 13 2688 33 - 25 - - 14 - 13 - - - - - - New occupiers or Premises - - - - - - - - - - 222 Re-visits 309 7 38 107 18 64 471 122 21 566 132 288 26 - Mr. Scott 484 52 - New occupiers or Premises - 1 2 2 5 - - 11 - - 3 5 - 9 4 8 Re-visits 118 97 115 765 22 91 108 142 258 - 260 631 20 187 92 Mr. Hoskins 66 145 New occupiers or Premises - - - 20 6 8 13 - 16 17 - - - - 8 14 - Re-visits 464 377 48 239 144 571 267 300 Totals 29 212 253 2875 21 537 135 1541 1210 - New occupiers or Premises 8 10 3 18 - 21 - 19 - - 1 21 22 29 - - Housing of the Working Classes Acts. There was no action taken under the above Acts during the year under report. Food and Drugs. In Tables XIII. and XIV. of Appendix will be found a list of the samples taken in 1910, and the action taken. 1,172 samples were taken, compared with 1,219 in 1909 and 1,281 in 1908. Of these 9-6 per cent, were found adulterated, compared with 7-9 per cent, in the previous year, and 8-6 per cent, in 1908. In the accompanying table will be seen the percentages of milk fat in the various samples of genuine milk. Total Genuine Samples. Milk Fat. Under 3 per cent. 3 per cent. and under 3.5 per cent. 35 per cent. and under 4 per cent. 4 per cent. and over. Year. Percentage of total. No. of Samples. Percentage of total. No. of Samples. Percentage of total. No. of Samples. Percentage of total. No. of Samples. 1903 371 32 8.6 134 36.1 135 36.4 70 18.9 1904 419 5 1.2 147 35.1 164 39.1 103 24.6 1.7 1905 505 9 216 42.8 168 33.3 112 22.2 1906 507 3 0.6 211 41.6 178 35.1 22.7 115 1907 617 24 3.9 232 37.6 249 40.3 112 18.1 1908 575 12 2.1 258 44.9 226 39.3 79 13.7 1909 722 10 1.4 332 46.0 271 37.5 109 15.1 676 1910 5 0.7 294 43.5 281 41.6 96 14.2 Average 8 years. 549 13 2.5 228 40.9 209 37.8 99 18.7 Section 48, Public Health (London) Act, 1891. Certificates were granted to the owners of the following premises for a proper and sufficient water supply:— No. 9A, Tranton Road. Nos. 88A and 88b, Albion Street. Disinfection. The following table shows the number of articles passed through the steam disinfector Sector during the year under report:— Beds 757 Quilts 640 Blankets 708 Sheets 945 Bolsters 466 Miscellaneous 4,251 Carpets 60 Verminous Clothing 3,417 Cushions 269 Mattresses 494 Total 13,445 Overlays 223 Pillows 1,215 10,840 new tabs were used to replace those taken off mattresses, palliasses, and cushions before disinfection. Cleansing of Persons Act, 1897. During the year under report 87 male adults, 24 female adults, 169 male and 149 female children used the Verminous Baths and had their clothing disinfected. The total number of articles disinfected for this purpose was 3,417. Smoke Nuisances. 223 chimneys were kept under observation and 22 notices served. House Refuse. The following table shows the amount of house and trade refuse disposed of during the year ended December, 1910 : — HOUSE REFUSE. TRADE REFUSE. iiVVkJiJ -IV-UJ. I Tons cwt. Tons cwt. qrs. qrs. Bermondsey Destructor 10,929 loads. 19,039 15 2 271 loads. 188 7 0 Barged away 707 „ 1,237 5 0 1,191 „ 2,084 5 0 Total . 11,636 „ 20,277 0 2 1,462 „ 2,272 12 0 Overcrowding. The following cases of overcrowding were visited by the Medical Officer of Health during the year under report:— Medley Place Man, wife, boys 2 years and 3 months respectively. Living and sleeping, 1,200 cubic feet. Second floor room, 688 cubic feet. 512 The husband is a waterside labourer, with casual work. His wife is not at work. The light and ventilation were bad and the room was very dirty and dilapidated. Man, wife, boy 6, and girls 5 and 2 years. Man, wife, boys 5 and 3, and girl 8 years. Living and sleeping, 1,400 cubic feet. Sleeping, 1,050 cubic feet. Ground floor back room, 1,306 cubic feet. First floor room, 637 cubic feet. 94 The husband is a pill-box maker, earning about 10s. per week. The room was dirty and the light and ventilation fair at the time of visit. Osborne Buildings 413 The husband is a railway porter, earning 22s. per week. The rent is 6s. 6d. The room was very dirty and verminous and the light and ventilation bad at the time of visit. Kintore Street Man, wife, and boy 2 years. Living and sleeping, 1,000 cubic feet. First floor room, 929 cubic feet. 71 The husband is a waterside labourer, with very uncertain earnings. The room was in good condition and the light and ventilation good at the time of visit. Medley Place Ante-room, 482 cubic feet The house is owned by this family. The husband is a dock labourer whose work is rather slack at present. The light and ventilation were fair and the place clean at the time of visit. Temeraire Street Boys 8 and 4, girls 11, 9 and 6 years. Sleeping, 900 cubic feet. 418 The husband is a gasworks labourer, earning 25s. per week. The light and ventilation were fair at the time of visit. These people have now obtained another place to go to, and are only waiting for the rooms to be done up; the first-mentioned family will then take over the whole house. Do. Man, wife, and boys 4 and 3 and 10 months. Sleeping, 1,050 cubic feet. First floor back room, 591 cubic feet. 459 The mother, a widow, works at a fur factory, and the two eldest sisters each earn 10s. per week. The bedding was scanty and dirty, but the light and ventilation were fair at the time of visit. The rent is 7s. 6d. per week. Great Maze Court Woman, girls 20,18 and 13 years. Sleeping, 1,200 cubic feet. First floor room. 427 Man, wife, girl 5, boys 2½ years and 4 months. Sleeping, 1,050 cubic feet. Bedroom first floor, 852 cubic feet 198 An alteration has been made in the distribution, so that the overcrowding is partially abated. The husband is steady, but somewhat delicate. He does a little painting in the summer, and sells firewood in the winter, earning 8½d. per hour at the former while at work, and in the winter he can earn from 20s. to 255. per week, providing he is able to procure wood. The difficulty in obtaining the latter is due to the competition by a large charitable organisation which deals with firewood. It seems that, having more capital at its disposal, it is able to buy up the wood of old buildings, bidding against small men when an auction takes place. The wife sometimes works at a jam factory in the summer months. The rent is 6s. 6d. per week. The house was clean, the mother and children tidy and clean, and the light and ventilation fairly good. Man, wife, boy 7 and girl 3 years. Sleeping, 900 cubic feet. First floor room, 778 cubic feet. 122 The husband is a labourer at a jam factory, earning 21s. per week, and his wife also at times works at the factory. The rent is 5s. 6d. per week. There has been a re-distribution here, but although the overcrowding is somewhat less than before, I think some action should be taken. The mother and children were tidy and clean, but the latter seemed somewhat delicate. The walls and ceilings of the house are very dirty, and the light and ventilation of the room used for sleeping is very defective. The people seem respectable but struggling, and the wife has promised that as soon as she can earn a few shillings at the jam factory she will move to Guinness' Buildings. Edward House Man, wife, boys 14,12, 8, 6 years, 4 months, and girls 10 and 4 years .. Living and Sleeping, 2,800 cubic feet. Two rooms, 2,192 cubic feet. cubic feet. 608 The husband is a French polisher in delicate health, and at present out of employment. The wife receives 6s. per week from each of the three eldest children in return for some meals supplied by her, and she earns a few shillings extra by doing machine work and mangling. The sewing machine and the mangle she has on the hire-purchase system. She occasionly gets work at a jam factory. The rooms were fairly clean for the neighbourhood, but the people seemed very poor, and must have great difficulty in making ends meet. There is no question but that the present overcrowding is injurious to the health of the family, and the mother has promised to get out as soon as possible. Sleeping, 750 cubic feet. Gibbons Rents Top floor room, 490 cubic feet. 260 Man, wife and girl 5 years The overcrowding, as far as cubic space is concerned, is partially abated by removing the boy, who was in the top room, down to the ground floor. Had the light and ventilation of the top room been good, this might have been looked upon as an abatement, but the room in question is an attic room, and in my opinion is not suitable for any more than one person to occupy. The husband is a painter, and has been out of work for six weeks. The wife has promised, as soon as he gets some work, she will look for a more suitable place. Sleeping, 1,800 cubic feet. Man, wife, girls 7, 4 years and 11 months, and boys 14, 11 and 5 years. Snowsfields 1,041 First floor back room, 759 cubic feet. The husband is a chronic invalid, as the result of an accident about eighteen months ago. They make a precarious living by a small shop on the ground floor, and let off the other rooms. An endeavour is being made to re-arrange the occupants so as to abate the overcrowding, and if satisfactory will be reported later. Gibbons Rents Top room, 490 cubic feet. Sleeping, 600 cubic feet. Man and wife 110 The husband is a labourer in fairly constant work. The house is fairly clean. The top bedroom is an attic room very badly ventilated, and there is insufficient cubic capacity for two. There "are three rooms in the house, the rent of which is 7s. per week. The middle room is let off at 2s. 6d. per week. Occupants of overcrowded portion of house. Cubic feet space required. Rooms occupied and cubic space. Deficiency. State of Premises and Family. Man, wife, boys 14 years and 6 months, girls 6 and 3 years. Living and Sleeping, 1,800 cubic feet. First floor front room, 1,375 cubic feet. cubic feet, 425 The husband is a packer earning £1 per week, and the boy, aged 14, earns 7s. per week. The light and ventilation were good, and the people were very clean, but poor. Man, wife, boys 8 and 2, and girls 12, 6 and 4 years. Living and Sleeping, 2,000 cubic feet. First floor back room, 1,561 cubic feet. 439 The father is a lighterman. The room was fairly clean, but the light and ventilation were bad. Two children, included .in the previous report, have been removed to the Infirmary suffering from scabies, and this has temporarily reduced the overcrowding from 1,039 to 439 cubic feet. Man, wife, girls 2 years and 7 weeks. Living and Sleeping, 1,200 cubic feet. Ground floor back room, 830 cubic feet. 370 The husband is a barge builder's labourer, with uncertain work. The light and ventilation were fair, and the room was clean and tidy, but very small. Man, wife and 2 children, aged 2 years and 2 months respectively. Living and Sleeping, 1,200 cubic feet. First floor back room, 874 cubic feet. 326 The husband is a waterman, with very little work at present, earning about, 15s. per week. The room was fairly clean, but very small. The light and ventilation were indifferent at the time of visit. Health Visitor. The following table shows the work done by the Health Visitor during the year under report:— Whole Borough. Bermondsey Wards. Rotherhithe Wards. St. Olave Wards. 1 2 3 4 5 6 St. John. St. Olave. St. Thomas. 1 2 3 Births Notified— 1,724 I 1 183 179 92 455 —\ 177 I - 31 50 71 152 28 107 19 19 17 162 - 98 17 39 10 2 1 52 64 8 16 3 - 2 21 16 - - 568 403 13 31 35 482 223 338 86 88 61 573 372 4 119 138 77 338 155 5 106 103 73 287 213 243 35 37 17 332 -\ 198 - 107 167 145 419 — 42 By Guy's Hospital By Midwives 730 18 By Doctors 841 27 By Parents 617 26 3,912 639 Total Births Visited— 569 2,155 Primary Visits 97 28 Secondary Visits 444 76 102 35 27 45 7 2 Other Calls and Visits 99 9 20 15 12 10 9 13 6 3 2 - 205 255 33 Total Visits paid 309 249 218 117 72 16 2,698 675 494 55 16 - Insanitary Conditions reported to Medical Officer of Health 1 4 — - - 1 - 1 5 3 1 Number of babies breast fed ... ... ... 2,128 „ bottle fed ... ... ... 20* „ fed otherwise (e.g., spoon) ... ... 7 2,155 *Type of feeding bottle used:—Boat shape, 14; long tube, 6. Children put out to nurse, 20. From this table it will be seen that out of a total of 3,912 births notified 2,155 were visited at least once. Since it was impossible for one Health Visitor to visit every case in the Borough, it was decided that at least the poorer patients and those least likely to have a private medical man in attendance, who could advise them at any time, should be visited by the Health Visitor. It was thought, therefore, that all cases notified by Guy's Hospital and by midwives should be systematically visited, and that, after these, notifications by parents and special notifications by doctors should receive attention. lam of opinion, however, that a Health Visitor should call at every house in the Borough where a birth occurs, because only in this way can she judge if there is any necessity for further advice. I look upon the secondary visits as quite as important as the first, and my reasons for saying this will be found in the figures immediately below the table. Out of the 2,155 cases visited it was found that 2,128 were breast fed and only 27 artificially fed. Such a statement as this without fin-ther explanation would seem to indicate that a Health Visitor is quite superfluous, as breast feeding is apparently universal in the Borough, but such an opinion would not be correct. The babies are breast fed for the first month or six weeks at the most, i.e., until the mothers return to work. There is a tremendous amount of casual labour in Bermondsey, and as a consequence the incomes of the poorer families must be supplemented by the mother's work. When they go out they leave the_ babies in charge of neighbours and cease breast feeding. It is a wonder so many children are alive at the end of the first year as there are. This only emphasises the necessity of the Health Visitor following up suitable cases, and also the advisability of extending the creche sj'stem for taking care of babies whose mothers are out at work. This paragraph, which was in last year's report, has been reproduced without alteration except for figures, since the opinion expressed then still holds good, and it emphasizes the advisability of having at least one more Health Visitor if the work is to be effectually done. The number of primary visits are not so many as last year, but this is owing to the fact that we were without a Health A isitor for the last two months of the year, and the number of secondary visits was larger. IV.—FACTORIES AND WORKSHOPS. In Table X. of the Appendix will be found particulars of the inspections of factories and workshops, and in the following table particulars regarding the trades and persons employed in connection with workshops. There were 693 workshops on the Register in 1910, against 692 in 1909. Including bakehouses, of which there were 81 in use, the total is 774. OUTWORKERS. T here were 709 outworkers on the Register at the end of 1910. 95 lists were sent in by firms in this Borough employing outworkers. Table X. of the Appendix shows the various trades followed by outworkers m this district. 38 APPENDIX. Table I.—Vital Statistics of Whole District during 1910 and Previous Years. Year. 1 Population estimated to Middle of each Year. 2 Births. Total Deaths registered in the District. Total Deaths in Public Institutions in the District. 9 Deaths of Non- Residents registered in Public Institutions in the District. 10 Deaths of Residents registered in Public Institutions beyond the District. 11 Net Deaths at all Ages belonging to the District. No. 3 Rate.* 4 Under 1 Year of Age. At all Ages. No. 12 Rate. * 13 No. 5 Rate per 1,000 Births registered. 6 No. 7 Rate. * 8 1900 131,748 4,410 33.5 837 190 20.4 3,062 2,684 99 477 23.3 540 17.8 1901 130,633 4,459 34.1 711 159 52 451 2,320 423 2,719 20.8 1902 130,137 4,346 636 146 2,323 63 496 2,756 33.4 17.8 460 21.2 1903 129,654 596 1,973 15.2 40 4,200 32.4 142 414 449 184 2,382 1904 129,187 156 2,142 4,193 32.4 654 16.6 440 44 495 2,593 20.1 33.3 547 127 439 1905 128,730 4,288 1,911 14.8 33 521 2,399 18.6 128,288 533 570 2529 1906 4,031 31.4 132 1,979 15.4 456 20 19.7 1907 441 110 1,856 2338 127,856 4,013 31.4 460 25 507 18.3 14.5 1908 127,438 534 1,951 4,172 32.1 128 15.0 37 2,444 18.8 591 530 1909 127,030 4,055 118 562 31.9 480 1,947 15.3 26 466 2,387 18.8 129,070 4,217 32.6 597 141 2,109 16.3 478 44 496 19.8 Averages for years 1900-1909 2,561 1910 126,634 3,957 31.2 403 102 1,717 13.5 550 30 542 2,229 17.6 * Kates 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. Do. Number of inhabited houses, 15,817. Do. 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. Bermondsey Infirmary, Lower Road Bermondsey Workhouse, Ladywell—59 deaths Bermondsey Workhouse, Lady well 59 12 Guy's Hospital 247 Brompton Hospital 1 Deaths in River Thames, Surrey Commercial Docks, &c. Belgrave Hospital 2 Charing Cross Hospital 2 12 Children's Hospital, Great Ormond Street 1 Evelina Hospital 30 Railway 1 East London Hospital 19 Great Northern Hospital 1 Private Houses 2 Gore Farm Hospital 1 General Hospital, Tunbridge Wells 1 Street 3 London Hospital 3 Middlesex Hospital 1 - National Hospital, Queen Square 1 Royal Eye Hospital 1 Total 30 Royal Free Hospital 1 Royal Hospital, Waterloo Road 5 St. Bartholomew's Hospital 10 St. Thomas' Hospital 11 Seamen's Hospital 1 St. Mary's Hospital 1 South Eastern Hospital 26 South Western Hospital 1 University College Hospital 2 Sick Asylum, Cleveland Street 1 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. Banstead Asylum 8 Cane Hill Asylum 3 Caterham Asylum 10 Claybury Asylum 2 Colney Hatch Asylum 1 Darenth Asylum 1 Dartford Heath Asylum 4 Horton Asylum 10 Hanwell Asylum 1 Leavesden Asylum 4 Long Grove Asylum 15 Tooting Bee Asylum 9 Camberwell Workhouse 1 City Infirmary 2 Greenwich Infirmary 1 Lambeth Infirmary 1 Holborn Infirmary 1 Southwark Infirmary 3 Whitechapel Infirmary 1 Children's Infirmary, Carshalton 8 Mothers' Home, 396, Commercial Rd., E. 1 Catholic Nursing Institute, Lambeth Road 1 St. Peter's House, Lambeth 3 River Thames and Canal 4 In Private Premises or Street 18 Total 542 Table II. —Vital Statistics of Separate Localities in 1910 and Previous Years. Year. Bermondsey. Rotherhithe. ST. Olave. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. 1900 82,925 2,826 526 1,184 1,220 1,170 1,116 1,083 1,130 1,089 1,110 1,129 1,069 243 10,081 400 231 48 38,742 1,948 883 319 204 1901 82,441 2,920 1,768 497 38,446 747 215 9,746 42 1902 82,281 2,855 1,782 455 38,394 741 174 9,462 321 233 49 1903 82,129 2,801 1,523 168 204 453 38,347 655 9,178 283 36 1904 187 81,986 2,748 1,634 477 38,304 713 8,897 362 246 59 1905 81,852 2,894 1,597 422 38,264 604 164 8,614 264 198 45 1906 81,727 170 2,683 1,618 408 38,229 702 8,332 259 209 46 1907 81,610 2,674 1,506 335 38,197 669 144 8,049 229 163 22 1908 81,500 2,785 1,613 411 611 151 38,169 7,769 258 220 48 34 81,398 143 1909 2,739 1,563 396 38,145 654 7,487 247 170 81,985 43 Averages of years 1900-1909 698 176 8,761 294 208 2,792 1,655 438 38,324 1,130 1910 81,304 2,661 1,441 341 603 134 256 38,125 1,040 7,205 185 27 Table III. —Cases of Infectious Disease Notified during the Year 1910. No. of Cases Removed to Hospital from each Locality. Total Cases Removed to Hospital. Total Cases Notified in each Locality. Notifiable Disease. Cases Notified in Whole District. Bormondsey. Rotherhithe. At all Ages. At Ages—Years. St. Olave. 1 Total. St. John. St. Thomas. St. i. Olave. Total. 1 2 3 4 5 Total. 2 3 Under 1 1 to 5 5 to 15 25 to 65 65 and upwards 6 Bermondsey. Rotherhithe. St. Olave. 15 to 25 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... 1 1 Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup) 23 20 27 14 125 57 14 207 17 15 61 G 2 15 196 6 104 74 12 11 ... 21 131 29 7 26 2 2 12 Erysipelas 16 11 11 13 10 79 20 14 4 38 ... ... ... ... 129 4 3 10 10 89 13 8 18 34 28 16 78 1 4 23 249 72 23 344 361 4 127 199 ... 39 54 52 41 28 260 18 Scarlet Fever 23 8 46 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Typhus Fever ... ... ... 20 8 3 ... ... 16 8 12 1 5 1 6 5 ... 21 7 1 5 13 1 ... 3 31 37 2 Enteric Fever 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Relapsing Fever ... ... ... ... .. ... ... ... ... ... ... ... ... ... ... ... ... ... 3 9 ... ... ... ... ... Continued Fever ... ... ... ... 1 3 ... ... ... 4 ... ... ... ... ... ... 1 ... 1 2 6 ... Puerperal Fever ... ... ... 3 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... 2 ... 1 ... ... 5 Cerebro-spinal Meningitis ... ... ... ... ... ... .. ... ... ... ... .. 3 2 ... ... ... ... 5 2 746 17 236 299 56 124 14 41 192 35 10 8 53 394 137 40 571 Totals 91 90 97 73 59 501 60 89 93 41 Table IV,—Births and Corrected Deaths for the Year 1910. Cause of Death. Deaths at the subjoined ages of "Resident s" whether occurring in or beyond the District. Deaths at all ages of "Residents," belonging to Localities, whether occurring in or beyond the District. Total Deaths whether of "Residents" or "Nonresidents" in Public Institutions in the District. Bermondsey. Rotlierliithe. St. Olave. All Ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards Small-pox ... ... ... ... ... ... ... ... ... ... ... 143 22 118 3 ... ... ... 109 27 7 25 Measles 14 ... 10 4 ... ... ... Scarlet Fever 12 2 ... ... Whooping Cough 44 12 31 1 ... ... ... 2 29 13 6 Diphbheria including Membranous Croup) 18 2 13 3 ... ... ... ... 9 9 ... ... ... ... Croup ... ... ... ... ... ... ... ... (Typhus ... ... ... ... ... Fever ... ... ... ... ... ... Enteric 1 ... 2 1 1 2 1 1 4 ... ... Other Continued 3 1 2 ... ... ... ... 1 3 ... ... Epidemic Influenza 16 ... 1 1 1 7 6 10 6 ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... Plague ... ... ... ... ... ... ... ... ... ... ... 87 63 24 ... ... ... ... 58 23 6 10 Diarrhoea 4 1 1 Enteritis 6 2 ... ... ... 4 ... ... 1 2 ... Gastritis 3 1 ... ... ... 2 ... ... 3 ... ... ... 2 1 ... 2 1 .... 1 Puerperal Fever 4 3 1 ... 1 Erysipelas 1 3 ... ... ... ... Phthisis (Pulmonary Tuberculosis) 219 3 7 2 29 169 9 148 21 104 50 Other Tuberculous Diseases 49 15 7 28 11 3 2 ... 27 16 71 Cancer, Malignant Disease 146 ... 2 2 1 49 82 53 11 92 55 119 67 23 Bronchitis 209 28 8 1 1 66 | 105 87 Pneumonia 235 74 75 7 4 55 20 161 53 21 34 5 ... 4 ... ... 1 ... 3 1 1 Pleurisy ... Other Diseases of Respiratory Organs 23 1 2 ... 1 14 5 15 7 1 3 Alcoholism Cirrhosis of Liver 15 ... ... ... 1 10 4 10 5 ... 4 6 1 1 ... 1 3 ... 2 2 2 1 Venereal Diseases Premature Birth 56 26 1 83 83 ... ... ... ... ... ... Diseases and Accidents of Parturition 2 1 1 4 ... ... 2 2 ... ... ... 151 ... ... 7 16 93 35 102 42 7 Heart Diseases 47 90 23 6 15 8 29 9 Accidents 60 21 9 3 11 ... ... ... 10 1 11 ... ... Suicides ... ... 616 156 37 17 18 189 199 All other Causes 382 171 63 151 All Causes 502 369 75 88 752 443 1,441 603 185 2,229 550 Births. Bermondsey. Rotherhithe. St. Olave. Whole Borough. F. M.& F. M. F. M. & F. M. F. M. & F. F. M. & F. M. M. 1,342 1,940 3,957 1,319 2,661 540 500 1,040 135 121 256 2,017 Table V.—lnfantile Mortality during the Year 1910. 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. All Causes - Certified 86 17 18 18 139 56 51 39 38 25 24 34 19 28 22 27 Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Common Infectious Diseases— ' ! ... ... ... ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 5 2 4 8 2 Measles ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup) ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... 1 1 2 Whooping Cough ... ... ... ... ... 1 3 2 ... 1 ... 1 ... Diarrhoea! Diseases —- - - Diarrhoea, all forms 5 9 4 6 3 6 2 4 1 1 2 6 11 5 ... ... ... ... 1 1 ... ... ... ... Enteritis, Muco-enteritis, Gastro-enteritis ... ... ... ... ... ... ... ... 1 Gastritis, Gastro-intestinal Catarrh ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Wasting Diseases— - 72 Premature Birth 53 7 6 6 10 1 ... ... ... ... ... ... ... - ... 4 1 3 1 9 1 ... 2 ... ... ... ... ... ... 1 Congenital Defects ... 7 ... ... Injury at Birth 7 ... ... ... ... ... ... ... ... ... ... ... ... Want of Breast-milk, Starvation ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Atrophy, Debility, Marasmus 15 19 10 2 3 3 ... 1 9 3 1 6 19 12 4 ... Tuberculous Diseases — I ! 1 Tuberculous Meningitis 1 2 ... ... ... 1 ... ... ... ... ... ... ... ... ... 4 1 4 1 ... 2 ... ... ... ... ... Tuberculous Peritonitis : Tabes Mesenterica ... ... ... ... ... 1 ... 2 2 3 3 ... 1 2 ... Other Tuberculous Diseases ... ... ... ... ... ... Other Causes — Erysipelas 1 1 1 1 ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... Rickets ... ... ... ... 1 1 ... ... 1 ... ... ... ... ... ... ... Meningitis (not Tuberculous) 1 ... ... ... ... 1 ...... 1 ... ... ... ... ... ... ... ... 3 3 1 ... 7 2 1 1 2 1 1 ... ... 1 ... Convulsions ... Bronchitis ... 1 1 ... 2 5 2 2 1 2 1 2 3 4 2 2 ... ... ... ... 1 ... ... ... Laryngitis ... ... ... ... ... ... ... ... 3 6 5 10 8 5 5 6 6 4 8 3 8 Pneumonia 1 ... 2 3 2 3 2 5 ... 2 ... ... ... ... ... Suffocation, overlving 1 ... 2 ... 5 1 1 ... ... 1 2 3 3 1 4 Other Causes 8 2 1 11 ... 86 17 18 56 51 39 38 25 24 34 19 28 22 1 27 18 139 Table VI.—Population, Births and Deaths in Wards. Estimated population, 1910. Population at Census, 1901. Deaths under 1 year of age. Infantile Mortality per 1,000 Births. Births, 1910. Wards. Birthrate. Deaths, 1910.* Deathrate. Bermondsey— ..... ... Ward 1 14,323 14,119 551 39.0 351 24.8 104 189 „ 2 14,405 14,199 511 35.9 211 14.8 57 111 „ 3 15,633 15,409 564 36.6 262 17.0 53 94 „ 4 16,336 16,103 375 23.3 210 13.0 36 96 „ 5 11,804 11,635 329 28.3 192 16.5 42 128 „ 6 9,982 9,839 331 33.6 184 18.7 49 148 Rotherhithe— ! Ward 1 15,508 15,046 15,375 471 30.6 282 18.3 68 144 „ 2 14,917 429 28.7 233 15.6 45 105 „ 3 St. Olave— 140 17.8 88 11.2 150 7,906 7,833 140 17.8 88 11.2 21 150 St. John 5,986 4,393 166 37.8 110 25.0 18 108 St. Olave 2,250 1,651 64 38.7 58 35.1 7 109 St. Thomas 1,581 1,161 26 22.4 17 14.6 2 77 Whole Borough—Totals 130,760 126,634 3,957 31.2 2,229 17.6 502 127 Note.-3Deaths in outlaying Institutions could not be allocated to any particular Ward, but an included in the total for the whole Borough. Table VII.—Meteorology of the Year 1910 (Greenwich Record). 1910. Month. Mean reading of the Barometer. Temperature of the Air. Rain. A Maximum. B Minimum. Mean of A and B. Amount Collected. I January ins. 29-681 ° 44-1 ° 35.4 ° 39.7 ins. 1.72 29.500 February 47.9 35.7 41.8 2.69 March 29 991 51.3 34.7 43.0 1.10 April 29.672 55.4 38.8 47.1 2.62 May 29.713 63.3 45.2 54.3 2.24 June 2.-720 71.0 51.6 61.3 2.08 July 67.0 29.709 51.9 59.4 3.52 August 70.8 29.741 52.7 61.8 2.43 September 30.046 64.6 48.5 56.6 0.74 October 29.841 59.8 47.6 53.7 1.81 November 29.476 45.4 32.4 38.9 3.57 December 48.3 29.545 40.0 44.2 3.54 Means 29.719 42.9 57.4 501 2.34 Table VIII.—Marriages. Year. Rotherhithe. St. Olave. Whole Borough. Bermondsey. Rate. No. Rate. No. Rate. No. Rate. No. 18.8 334 17.24 69 13.68 1,186 1900 18.00 783 1901 800 19.44 296 1542 58 11.92 1,154 17.70 1902 270 799 19.55 14.22 54 11.50 1,123 17.39 1903 794 19.56 238 12.65 69 15.23 1,101 17.22 1904 767 18.71 280 14.62 58 13.04 1,105 17.11 1905 801 256 19.57 13.38 51 11.81 1,108 17.21 719 1906 17.59 310 16.22 70 16.80 1,099 17.13 1907 736 315 18.69 16.49 69 17.14 1,147 17.94 1908 750 18.05 250 12.85 84 21.21 1,084 16.69 1909 723 17.76 256 59 13.42 15.76 1,038 16.34 Average for years 1900-1909 767 18.78 280 64 14.81 17.27 1114 14.65 1910 754 16.52 18.55 315 80 22.21 1149 18.14 Table IX.—Proceedings during 1910. Number of Places. Number of Inspections, 1910. Number of Notices, 1910. Number of Prosecutions, 1910. Premises. On Register at end of 1909. Added in 1910. Removed in 1910. On Register at end of 1910. Milk premises 40 273 27 286 559 20 - Cowsheds 5 1 4 51 - - - Slaughter-houses 1 - - 1 21 - 2 - Other offensive trade premises 13 - 13 115 - - 10 Ice-cream premises 133 11 - 144 165 - Registered houses let in lodgings 219 8 - 227 908 { *(a) 14 *(b) 74} - * (a) For overcrowding. * (b) For other conditions. Total number of Intimation Notices served for all purposes ... ... ... ... 4,144 Overcrowding, 1910— Number of dwelling rooms overcrowded ... ... ... ... ... ... ... 129 Number remedied ... ... ... ... ... ... ... ... ... ... 127 Number of prosecutions ... ... ... ... ... ... ... ... ... ... - Underground rooms— Illegal occupation dealt with during year ... ... ... ... ... ... ... 4 Number of rooms closed... ... ... ... ... ... ... ... ... ... 4 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 - Number closed under the Housing, Town Planning, &c., Act, 1909 ... ... ... 21 Shelters provided under sec. 60 (4) of the Public Health (London) Act, 1891- Number of persons accommodated during the year ... ... ... ... {Families ... 5 {Adults ... 4 {Children ... 14 Bevenue Acts— Number of houses for which applications were received during year ... ... ... 146 Number of tenements for which certificates were granted ... ... ... ... ... 146 Number of tenements for which certificates were deferred ... ... ... ... ... - Housing, Town Planning &c., Act, 1909, Sec. 35— Number of houses for which applications were received during the year ... ... ... 6 Number of houses tor which certificates were granted 6 Number of prosecutions under By-laws under Public Health Act, 1891- (a) For prevention of nuisance arising from snow, ice, salt, filth, &c. ... ... ... - ( b) For prevention of nuisance arising from offensive matter running out of any manufactory, &c. - (c) For the prevention of keeping of animals in such a manner as to be injurious to health 1 (d) As to paving of yards, &c., of dwelling houses - (e) In connection with the removal of offensive matter, &c. - (f) As to cesspools and privies, removal and disposal of refuse &c. (g) For securing the cleanliness of tanks, cisterns, &c. (h) With respect to water closets, earth closets, &c. - (i) With respect to sufficiency of water supply to water closets - (j) With respect to drainage, &c. (Metropolis Management Act, section 202) - (k) With respect to deposit of plans as to drainage, &c. (Metropolis Management Acts Amendment (By-laws) Act, 1899) - Mortuaries— Total number of bodies removed 216 Total number of infectious bodies removed 6 Table X. —Factories, Workshops, Laundries, Workplaces and Homework. Inspection. Number of Premises. Inspections. Written Notices. Prosecutions. Factories (including Factory Laundries) 107 27 ... Workshops (including Workshop Laundries) 131 86 ... Workplaces (other than Outworkers' Premises) 93 40 ... 331 153 ... Total Defects Found. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts— 51 51 ... Want of Cleanliness ... Want of Ventilation 1 1 ... ... Overcrowding 3 3 ... ... Want of Drainage of Floors 2 2 ... ... Other Nuisances 78 78 ... ... 11 Sanitary Accommodation Insufficient Unsuitable or Defective Not separate for Sexes 9 ... ... 9 8 ... ... 6 6 ... ... ... 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) 2 ... 2 ... Other Offences ... ... ... ... 161 158 ... ... Total Other matters. Class. Number. Matters notified to H.M. Inspectors of Factories— Failure to affix Abstract of the Factory and Workshop Act (s. 133) ... Action taken in matters referred by H.M. Inspectors as remediable under the Public Health Acts, but not under the Factory Act (s. 7) Notified by H.M. Inspectors Reports (of action taken) sent to H.M. Inspectors 21 21 Other ... Underground Bakehouses (s. 101)— Certificates granted during 1909 ... In use at end of 1909 33 Workshops on the Register (s. 131) at the end of 1909 693 Workshop Bakehouses 81 774 Total number of Workshops on Register Table X.—Factories:, Workshops, Laundries, Workplaces, and Homework (continued). Home Work. OUTWORKERS' LISTS, SECTION 107. Outwork in Unwholesome Premises, Section 108. Outwork in Infected Premises, Sections 109, 110. Nature or Work. (1) Inspections of Outworkers' premises. (13) Lists received from Employers. Addresses of Outworkers. Notices served on Occupiers as to keepingor sending lists. (10) Prosecutions. Instances. (17) Notices served. (15) Prosecutions. (16) Older made (S. 110). (18) Prosecutions (Sections 109, 110). (19) Instances. (14) Received from other Councils. (8) Forwarded to other Councils. (9) Failing to keep or permit inspection of lists. (11) Failing to send lists. (12) Sending twice in the year. Sending once in the year. Lists. (2) Outworkers. Outworkers. Lists. (5) Contractors. (3) Workmen. (4) Contractors. (6) Workmen. (7) Wearing Apparel:— I I 753 261 ... ... 64 12 13 ... ... 1,088 ... (1) Making, &c. 481 4 ... 108 108 ... ... ... (2) Cleaning and Washing ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lace, Lace Curtains and Nets ... ... ... ... ... ... ... 5 ... ... ... ... ... ... ... ... ... ... Artificial Mowers 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Nets, other than Wire Nets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tents ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 258 Sacks 12 318 60 ... ... ... ... ... ... ... ... ... ... ... ... ... ... Furniture and Upholstery ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9 Fur Pulling 2 ... 2 ... ... ... 7 ... ... ... ... ... ... ... ... ... ... Feather Sorting ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Umbrellas, &c. 8 2 ... 3 ... ... ... 6 1 ... ... ... ... ... ... ... ... ... Carding, &c., of Buttons, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 63 Paper Bags and Boxes 6 ... 51 1 ... 3 19 10 ... ... ... ... ... ... ... ... ... Basket Making 16 2 ... 16 ... ... ... ... ... ... ... ... ... ... ... ... ... ... Brush Making 45 2 ... 7 ... ... ... 40 2 ... ... ... ... ... ... ... ... ... ... Racquet and Tennis Balls ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Stuffed Toys ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... File Making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Electro-plate ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cables and Chains ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Anchors and Grapnels ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cart Gear ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Locks, Latches and Keys ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pea Picking ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total 90 830 Table XI.—Workshops. Number of Workshops on Register. Number of Workrooms. Persons Employed. Trade. Males. Females. Young Persons. 56 56 112 ... Boot Makers and Repairers ... Boat and Barge Builders 22 4 ... ... Bottle Washers ... 3 4 14 7 ... Builders 13 ... 54 ... Buttonhole Makers 4 ... ... 2 12 3 ... Basket Makers 3 13 ... ... Brushmakers 21 28 17 10 ... Blacksmiths 6 17 ... 2 ... ... Cabinet Makers 2 7 1 Carmen, Stables 152 ... 40 ... ... ... Carpenters 4 4 9 ... ... Collar Workers 2 4 ... 23 4 ... Chair Makers 3 5 6 ... Coopers 17 81 ... ... ... Cork Cutters 6 3 3 ... ... Curriers 6 8 17 ... ... Cycle Makers 7 5 7 2 ... Dressmakers, &c. 61 70 44 178 5 Engineers and Smiths 6 6 12 2 ... 7 22 2 Farriers ... 1 ... Fish Curers 1 20 ... ... Hairdressers 94 94 164 1 4 Harness and Strap Makers, &c. 23 9 9 2 ... Hop Warehouses 19 101 ... Laundries 40 69 5 ... ... 209 37 ... Leather Work 27 275 34 1 Paper Bag Makers 1 ... ... 4 ... Picture Frame Makers 4 10 33 50 ... Rag Sorters 3 3 7 5 ... Sack Makers 8 10 17 22 2 Slate and Stone Merchants 3 20 ... ... ... Tobacco Pipe Makers 3 5 13 4 Wheelwrights 8 ... 33 ... ... 22 ... Wood Choppers 33 ... 57 18 Various 181 177 968 141 65 Totals 693 2,334 602 760 106 15 11 Houses supplied with water 2 42 2 5 77 ... ... ... 78 49 11 106 121 179 42 108 60 754 Defective roofs repaired Defective rainshoots and gutters repaired, unstopped, or disconnected from drain 82 61 107 20 8 138 124 35 32 607 1 13 10 2 8 66 Offensive accumulations removed 20 5 7 ... Defective water apparatus in w.c s repaired 19 40 13 51 97 7 19 246 ... ... 5 24 Animals kept so as to be a nuisance removed 2 5 1 5 4 1 1 ... Urinals cleansed, supplied with water and doors 1 5 7 47 7 1 ... 17 9 ... 4 5 30 Stables and other premises drained and paved 4 4 2 1 1 9 ... Waste-water pipes disconnected from drains and made to discharge in the open air, and new waste pipes provided 5 22 147 1 3 8 76 11 7 14 33 Providing means of ventilation beneath ground floor 5 ... 2 ... ... 14 12 ... ... 3 1 1 3 9 Dung receptacles provided or repaired 1 ... ... ... ... 1 7 22 Accumulations of manure removed 1 2 2 2 7 ... ... ... Separating w.c. and domestic water supplies ... ... ... ... ... ... ... ... ... 8 5 14 71 9 95 224 Effective means taken to prevent dampness 3 4 15 50 8 Yards cleansed 42 13 12 1 2 8 136 ... 7 Means of ventilation provided, or improvement in ventilation made 7 10 9 4 37 ... ... ... ... 1 6 4 25 Cisterns cleansed or covers provided 10 1 2 1 ... ... Cowsheds cleansed ... ... 1 ... ... 2 3 ... ... ... 49 Table XIII.—Food and Drugs. Articles submitted for Analysis. Total Samples taken. Number Genuine. Number Adulterated. Percentage of Articles Adulterated. 677 9·8 74 751 Milk 238 214 24 Butter 10·0 Cocoa 32 23 9 28·1 18 Pepper 18 ... ... 17 Mustard 17 ... ... 14 Separated Milk 12 2 14·3 9 Rice 9 ... ... 7 7 White Pepper ... ... 7 Coffee 7 ... ... 6 Skim Milk 6 ... ... 5 Olive 0i1 5 ... ... 5 5 Lard ... ... Raspberry Jam 4 4 ... ... 4 4 ... Cod Liver Oil ... 4 4 Glycerine ... ... 3 2 Margarine 1 33·3 3 Arrowroot 3 ... ... Camphorated Oil 3 ... ... 3 Tapioca 2 2 ... ... 2 Ice Cream 2 ... ... Ground Rice 2 2 ... ... Malt Vinegar 2 1 1 50·0 Eucalyptus Oil 2 2 ... ... 2 Cheese 2 ... ... Lime Juice Cordial 2 2 ... ... Beef Dripping 2 2 ... ... 1 1 Pasteurized Skim Milk ... ... 1 Olives 1 ... ... Gorgonzola Cheese 1 ... 1 ... Ginger Boot 1 1 ... ... Crushed Linseed 1 1 ... ... Kola 1 1 ... ... 1 ... Beef Sausages 1 100·0 Honey 1 1 ... ... Green Ginger Wine 1 1 ... ... Hop Ale ... 1 1 ... Ground Ginger 1 1 ... ... Sarsaparilla Wine 1 1 ... ... 1 Lemon Squash 1 ... 1 ... Orange Quinine Wine 1 ... ... Cream 1 1 ... ... 1 Castor Oil 1 ... ... 1 1 Oil of Camphor ... ... 1 Fine Oatmeal ... 1 100·0 Tincture of Iodine 1 1 ... Sterilized Milk 1 1 ... ... ... Pure Cocoa Essence 1 1 ... ... Mincemeat 1 1 ... ... Dark Cheese 1 1 ... ... Sausage Meat 1 1 ... ... 1 Raisin Wine 1 ... ... Orange Wine 1 1 ... ... Totals 9·6 1,059 113 1,172 50 Table XIV.—Prosecutions in connection with Samples taken during 1910. No. Sample. Adulteration or Infringement. Result. 391s Dismissed. Warranty proved Milk First Quarter. Added water 4·5 per cent. 395S Milk Added water 4·9 per cent. Fine 20/-; costs 15/- 483H Milk Fine 40/-; costs 15/- Added water 8 per cent. 486H Milk Added water 4 per cent. Fined the costs 17/- Warranty unsuccessful. Wrapper not marked 510H Fine 5/-; costs 15/- Margarine 542H Milk Added water 3·5 per cent. Fine 40/-; costs 27/6 566H Added water 3·3 per cent. Milk Fined the costs 15/- 575H Dismissed. Warranty proved Milk Added water 3·6 per cent. 581H Milk Added water 14 per cent. Dismissed. Warranty proved 581H Deficient in milk fat 5·3 per cent. Dismissed. Warranty proved Milk 593H Butter Contained 47·6 per cent. of fats other than butter fat Fine £5; costs 21/- 594H Margarine Fine 20/-; costs 17/- Contained more than 10 per cent. of butter fat Milk Fined the costs 17/- Warranty unsuccessful Added water 2·8 per cent. 605H Added water 2·7 per cent. Milk Fine 20/-; costs 17/- 607H 425S Dismissed. Warranty proved Milk Added water 2·92 per cent. 426S Milk Added water 7·00 per cent. Fine 10/-; costs 17/- Warranty unsuccessful Milk Added water 6·61 per cent. Fine £3; costs 17/- Warranty unsuccessful 432S Milk Added water 3·9 per cent. and deficient in milk fat 5·3 per cent. Dismissed. Warranty proved 438S Milk Fined the costs 17/- Warranty unsuccessful 439S Added water 2·06 per cent. Added water 2·25 per cent. Milk 451S Fine 10/- ; costs 17/- 455S Milk Added water 3·2 per cent. Dismissed. Warranty proved Milk 460S Fine 20/-; costs 17/- Warranty unsuccessful Added water 4·35 per cent. Added water 3·50 per cent. Milk Dismissed. Warranty proved 462S 485S Milk Added water 2·06 per cent. Dismissed. Warranty proved 489S Milk Deficient in fat 7 per cent. Fined the costs 15/- Second Quarter. Dismissed. Warranty proved Milk 4S Added water 2·86 per cent. 6H Milk Deficient in milk fat 42 per cent. Fine £5 ; costs 23/- Warranty unsuccessful Added water 7·74 per cent. Dismissed. Warranty proved 14H Milk 14S Milk Deficient in milk fat 27 per cent. Dismissed. Warranty proved 17S Milk Added water 2·31 per cent. Dismissed. Warranty proved 20S Milk Deficient in milk fat 11 per cent. Dismissed. Warranty proved 31S Butter Margarine 100 per cent. Fine 40/-; costs 27/- Bulk not marked Withdrawn Wrapper not marked Withdrawn 29H Milk Dismissed. Warranty proved Added water 3·81 per cent. 38H Butter Margarine 100 per cent. Fine 10/-; costs 17/- Wrapper not marked Withdrawn Milk 43H Dismissed. Warranty proved Added water 6·27 per cent. 49S Milk Added water 3·77 per cent. Dismissed. Warranty proved 50H Milk Deficient in milk fat 17 per cent. Dismissed. Warranty proved 60H Malt Vinegar Artificial vinegar 93 per cent. Fine 10/-; costs 17/- 63H Margarine Wrapper not marked Fine 10/- ; costs 15/- 92H Milk Deficient in milk fat 9 per cent Fine 40/-; costs 15/- 96H Added water 4·03 per cent. Milk Dismissed. Defendant proved the milk was sold in same state as received from the cow Milk Deficient in milk fat 19 per cent. Fine 20/-; costs 17/- 97H Fine 20/-; costs 17/- 124S Separated Milk Added water 15·5 per cent. 131H Milk Deficient in milk fat 16 per cent. Dismissed. Warranty proved Added water 3·96 per cent. 145H Milk Dismissed. Warranty proved 149H Milk Fined the costs 12/- Deficient in milk fat 12 per cent. Butter Margarine 100 per cent. Fine 40/-; costs 17/- 156H Wrapper not marked Withdrawn Milk Third Quarter. Dismissed. Warranty proved 152S Deficient in milk fat 7.7 per cent. Cocoa Contained 48 per cent, of added shell Fine 5/-; costs 17/- 182H Butter Fine 40/-; costs 17/- 283H Margarine 100 per cent. Withdrawn Wrapper not marked Milk Fine 20/-; costs 15/- 272H Deficient in milk fat 7·7 per cent. 275H Cocoa Contained 18 per cent, of added shell Fined the costs 15/- Table XIV.—Prosecutions in connection with Samples taken during 1910—continued. No. Sample. Adulteration or Infringement. Result. 245S Milk Added water 4·86 per cent. Dismissed. Warranty proved 251S Butter Margarine 100 per cent. Fine 20/-; costs 17/- Withdrawn Wrapper not marked 283S Milk Added water 7 per cent. Fine 20/-; costs 17/- Fourth Quarter. 349H Cocoa Contained 15 per cent. of added shell Fine 20/-; costs 15/- Milk 355H Deficient in milk fat 7.3 per cent. Fine £5; costs 24/- Warranty unsuccessful 359H Cocoa Contained 16 per cent, of added shell Dismissed. Warranty proved 382H Milk Added water 7.1 per cent. Added water 2.8 per cent. and deficient in milk fat 4.7 per cent. Fine £12; costs £2 2/- 389H Milk Dismissed. Warranty proved 373S Butter Margarine 100 per cent. Fine £3; costs 17/- Withdrawn Wrapper not marked 413H Butter, Fresh Margarine 100 per cent. Fine 40/-; costs 17/- Withdrawn Wrapper not marked Fine £5; costs 17/- Withdrawn 414S Butter Margarine 100 per cent Wrapper not marked SUMMARY. £ s. d. Fines ... ... ... ... 70 8 0 Costs ... ... ... ... 28 15 6 Total ... £99 3 6 The following report was made to the Public Health Committee on March 8th, 1910, and a circular letter addressed to the traders in the Borough as recommended:— "Faced" Rice. I received two samples of rice known in the trade as Patna and Bassein respectively, imported from abroad, with the request that I should express an opinion as to whether the fact of the rice being polished by means of talc was "according to the rules of the Food and Drugs Act." I had them analysed as informal samples and found that the Patna rice contained 1·22 per cent, and the Bassein 1·4 per cent, of foreign extraneous mineral matter in the form of talc. It seems there is a demand on the part of the public for a highly polished rice, the consequence being that the appearance of the more expensive class of rice is being improved by subjecting them to the polishing process by means of talc. This has been going on to such an extent that the Local Government Board made a special investigation into the matter, and the report of their inspector, Dr. Hamill, was issued two or three months ago. In this the writer comes to the conclusion that "an outside limit of not more than 0·5 per cent. of mineral matter would seem amply to meet the requirements of the traders who represent this practice as necessary," and incidentally suggests that prosecutions be instituted where this amount is exceeded. To my mind it seems an objectionable and unnecessary practice, especially as it only affects the article in the raw state, for when cooked the rice, whether polished or not, appears the same. The following reply was sent to the sender of the samples:— February 11th,1910. Gentlemen, — Polished Pices— In reply to your letter of the 4th instant, accompanying two samples of rice cleaned and dressed abroad (viz., Patna and Bassein), I beg to say that there is no definition of rice under the Sale of Pood and Drugs Acts, and that any action that might be taken would be ordinarily under Section 6 of the Sale of Food and Drugs Act, 1875, where it would be proved that the rice is not of the nature and substance of the article demanded by the purchaser. Since this is so one cannot speak of any quantity of talc being allowed, and the seller must therefore take the risk of being prosecuted in case the rice is found mixed with this mineral. Personally on general principles I do not approve of the adulteration with talc, but I am given to understand that the polishing of the rice in this manner facilitates its sale, and provided there is only a trace left in the article at the outside, 0·5 per cent., I would not be prepared on my present knowledge to recommend prosecution. I have had both these samples analysed, and I find that the Bassein contains 1·04 per cent. and the Patna 1·22 per cent. talc, both of which you see are much above the suggested limit of 0·5 per cent. I should therefore recommend you make sure that no imported rice contains above this limit, as proceedings will probably be taken for samples showing an excess.— Yours faithfully, R. K. Brown. I recommend that a circular letter be addressed to the traders in the Borough, stating that prosecutions will be instituted if rice is found on analysis to contain extraneous mineral matter to the extent of more than 0·5 per cent. The cost of the analysis has been refunded by the firm in question. The following is a copy of the report made to the Public Health Committee on October 11th: Storage of Bread. In accordance with the instructions of the Committee, all the shops which sell bread, exclusive of bakers, have been specially visited and examined. There are 308 of these in the Borough, 304 of which are reported to be in a clean or fairly clean condition, and 4 dirty. The shops which sell bread are mostly small general shops which deal in groceries, general provisions, milk, ice creams, &c. Of these 308, 101 sell oil, 262 candles, 265 soap, and 194 brawn, &c. Although oil is not always kept in a separate room, there is always an endeavour on the part of the shopkeeper to keep it away from bread and in juxtaposition to the candles and soap. In no case did the bread seem to be exposed to any sort of contamination which would be injurious or dangerous to health. The only articles sold in the shops which would be likely to give a taste to the bread are the oil, soap and candles, and this is only likely to happen if the shopkeeper handles the bread with dirty hands. I do not consider contamination of this description would be dangerous to health, and the purchasers have the remedy in such cases in their own hands; besides, every shopkeeper had a separate knife for cutting bread. The following is the report I made to the Committee on this subject in 1903:— "I beg to say that I have visited 30 small shops in the poorest parts of the Borough where bread is sold, and beyond such general regulations as to cleanliness of making and storing which should apply to all articles of food, do not see any necessity for special regulations as to the sale of bread analogous to those for milk, as suggested by the writer of the letter. "Bread, from its mode of manufacture and nature, cannot be compared with milk as regards its tendency to absorb noxious matters from its surroundings. It is thoroughly sterilized during the manufacture, and when baked becomes comparatively dry. The longer it is kept the drier it becomes, and at no time is the dampness sufficient to permit it absorbing noxious micro-organisms. The worst keeping can do is to render it hard and unpalatable. It is kept in dairies and small general shops, where oil is often sold, but I have not in any case seen it kept in greengrocers or in juxtaposition to old clothes or marine stores, or pure and simple oil shops. "Of all foods, bread, after thorough baking, is probably the least liable to absorb noxious effluvia, and I did not see it stored in any shop in a position likely to specially expose it to such absorption. The only way it might convey disease is by being handled by a person suffering from some infectious complaint, and this applies to all articles, whether food or not. lam not aware of a single instance of infectious disease being conveyed by the food in question, and considering the amount of bread consumed, some case would surely have been discovered had such taken place." I see no reason to alter my opinion in the matter, and can only state that there are other articles of food sold in these shops which, in my opinion, are much more liable to become contaminated than bread. As regards the changing of bread, this is never done in general shops, since they only buy bread in very small quantities as required. In many cases the bread is bought from meal to meal. There is no doubt there is a danger to public health in the changing of stale bread, and such a custom should be make illegal. Coming to the allegations referred to in the letter of the Local Government Board dated July 5th, my replies which are embodied in the above report are briefly:— I have no evidence of infection being carried through the selling of bread in chandlers' shops or in insanitary or diseaseinfected premises. My own opinion is that disease is seldom or never conveyed in this way, and one is hardly justified on a priori grounds in accusing bread of being a common medium for the conveyance of disease when there are so many more obvious channels of infection known to us. The custom of exchanging bread, I am informed, has been largely, if not altogether, done away with, and if it is done anywhere at present, it is by a few bakers, and not by keepers of small general shops. Under these circumstances I cannot recommend any action being taken in the matter beyond regular inspection and attention to such cleanliness as is required where any food is sold, and taking steps to prevent the exchanging of stale loaves. 53 Table XV.—List of Bakehouses in the Borough. Situation of Bakehouse. Situation of Bakehouse. Address. Address. 333, Old Kent Road 49, Abbey Street Underground Above ground 91, ,, 157, ,, ,, ,, 2, Alscot Eoad 7, Paradise Street Underground ,, 246, Rotherhithe New Road 186, Abbey Street Above ground ,, 66, Abbeyfield Road 365, „ „ ,, 218, Bermondsey Street Underground 173, „ ,, 88, Bermondsey Wall 25, Parkers Row Above ground ,, 49, „ 92, Bermondsey Street Above ground ,, 111, „ 25, Paradise Street ,, ,, 3, Plough Road 31, Charlotte Street (not in use) ,, ,, 48, Cherry Garden Street 1, Roseberry Street ,, ,, 62, Chilton Street (not in use) 79, Rouel Road ,, ,, 31, Crimscott Street (not in use) 270, Rotherhithe Street ,, ,, 145, Drummond Road 34, Rotherhithe New Road Underground ,, 51, Dockhead Above ground 574, Rotherhithe Street (not in use) ,, 27, Derrick Street 39, St. James' Road Underground ,, 30-36, Denman Street 239, Southwark Park Road ,, ,, 351, ,, 51, Esmeralda Road ,, ,, 49, Frean Street 479, ,, ,, 49, Southwark Park Road ,, 77, Grange Road Underground Above ground 31, George Row ... 119, ,, ,, 158, ,, ,, 68, Galleywall Road ,, ,, 198, ,, 33, Grange Road (not in use) Above ground ,, 125, ,, 319, ,, ,, ,, lA, Ilderton Road 355, ,, Underground ,, 16, ,, 92, Snowsfields ,, ,, 92, Spa Road ,, 170, Jamaica Road ,, 53, „ 104, ,, (not in use) ,, ,, 140, „ 61, Salisbury Street ,, ,, 75, „ 5, St. Marychurch Street Above ground ,, 96, Tooley Street 203, „ Underground ,, 157, „ 227, „ ,, ,, 29, Kipling Street 167, „ ,, ,, 82, Keetons Road Underground 95, Tower Bridge Road ,, 43, Tanner Street Above ground 142, Long Lane ,, 2, Lucey Road 144, „ ,, ,, 97, Lynton Road 245, Tooley Street ,, 53, Tower Bridge Road ,, 132, Lower Road ,, ,, 93B, 26, „ ,, ,, 184, Long Lane 65, „ Above ground 49, Lucey Road ,, 22, The Grange ,, ,, 160, Lower Road 106, Union Road (not in use) ,, ,, 182, „ 22, ,, ,, ,, 204, ,, 94, „ (not in use) ,, ,, 47, Maltby Street Underground 62, Weston Street ,, Above ground 17, Neckinger Street (not in use) * Factory Bakehouse. Table XVI.—Causes of Death, 1910. Corrected for Deaths of Non-residents within the Borough and Deaths of Residents without the Borough. Disease. Whole Borough. All Ages. Under 1 1 and under 5 5 and under 10 10 and under 15 15 and under 20 20 and under 25 25 and under 35 35 and under 45 45 and under 55 55 and under 65 65 and under 75 75 and under 85 85 and upwards Sub-Districts. Bermondsey. Rotherhithe. St. Olave. M F Total M F Total M F Total M F Total M F M F M F M F M M F M F M F M F M F F M F M F F M 12 10 63 55 ... ... ... ... ... ... ... ... ... ... ... ... ... 53 56 109 18 9 27 5 2 2 ... Measles 76 67 143 1 7 ... ... ... ... ... ... Scarlet Fever 5 9 14 ... 5 5 4 ... ... ... ... ... ... ... ... ... ... ... ... 4 8 12 1 1 2 ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 7 9 16 ... ... 1 ... 1 1 ... 1 ... ... 3 ... 1 2 1 2 1 1 ... 1 4 6 10 3 3 6 ... ... ... ... ... ... ... ... ... 28 44 5 7 11 20 Whooping Cough 16 ... 1 ... ... ... ... ... ... ... ... ... ... 12 17 29 4 9 13 2 2 ... ... ... ... ... ... . ... ... ... ... 1 1 8 5 2 1 ... ... ... ... ... ... ... ... ... ... ... ... 7 2 9 4 5 9 ... ... Diphtheria, Membranous Croup 11 7 18 ... ... ... .. ... ... ... ... ... Enteric Fever 2 2 4 ... ... ... ... 1 ... ... 1 ... ... ... 1 ... ... 1 ... ... ... ... .. 1 1 1 1 2 1 1 ... ... ... ... ... ... ... Diarrhoea, Dysentery 24 34 5 8 ... 18 21 6 13 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 16 23 39 6 7 13 2 4 6 ... ... ... ... ... ... Epidemic or Zymotic Enteritis 12 17 29 9 15 3 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9 10 19 3 7 10 ... ... ... ... ... ... ... ... ... Cerebro-spinal Meningitis 1 2 2 1 1 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 4 ... ... ... ... ... ... ... ... ... ... Chicken Pox 1 ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... 2 ... 2 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 1 ... Tetanus ... ... ... ... ... 1 ... ... ... ... ... ... ... Syphilis 3 1 4 ... 1 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 1 2 1 ... 1 1 Gonorrhoea 2 ... 2 ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... 1 ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... 1 ... 2 2 4 2 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 1 2 1 3 ... ... ... Erysipelas ... ... Puerperal Fever ... 3 3 ... ... ... ... ... ... ... ... ... ... 2 1 ... ... ... ... ... ... ... ... ... ... ... 2 2 1 1 ... ... ... ... ... ... ... ... Pyaemia, Septicaemia 2 5 7 ... ... ... ... ... ... ... 1 1 1 ... ... 1 ... 1 ... 1 ... 1 ... ... ... ... 2 3 5 ... 1 1 ... 1 1 ... ... ... Septic, Ulcerative, or Infective Endocarditis 1 ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Allied Diseases 6 4 10 3 3 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 1 1 ... ... ... 4 1 5 2 3 5 ... ... ... ... ... ... ... Rheumatic Fever 3 6 9 ... ... ... ... ... 1 ... 3 1 ... ... 1 1 1 ... ... 1 ... ... ... ... ... ... ... ... 2 4 6 1 1 2 ... 1 1 ... Rheumatism of the Heart 2 2 ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 2 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculosis of Brain or Meninges, Acute Hydrocephalus 11 25 14 2 3 4 7 3 4 1 ... 1 ... ... ... ... ... ... ... ... ... ... 7 11 18 4 1 5 ... 2 2 ... ... ... ... ... ... ... ... Tuberculosis of Larynx 2 2 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 ... ... ... ... ... ... Tuberculosis of Lungs, Phthisis, Phthisis Pulmonalis ... ... 136 83 219 2 1 4 3 ... ... 6 4 23 11 13 ... 93 55 148 28 22 50 15 1 1 10 9 24 18 51 17 12 4 4 1 6 21 ... ... Tuberculosis of Intestines, Tabes Mesenterica 12 11 23 7 5 4 5 ... ... 1 1 ... ... ... ... 9 7 16 2 2 4 1 2 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... General Tuberculosis, Tubercular Disease of undefined position 8 13 21 4 6 4 4 ... 1 ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... 4 9 13 3 3 6 1 1 ... ... ... 2 ... ... ... Other forms of Tuberculosis, Scrofula 1 3 4 ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... 1 2 3 ... 1 1 ... ... ... ... ... ... Actinomycosis 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... Osteoarthritis, Rheumatoid Arthritis ... 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... 1 1 ... 2 2 ... ... ... ... ... ... ... ... ... ... 1 1 Gout ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... Cancer 77 60 137 ... ... ... ... ... ... ... ... ... ... 1 ... 1 1 3 9 15 19 29 10 20 15 7 4 1 2 43 32 75 26 25 51 8 3 11 Sarcoma 7 2 9 ... ... 2 1 1 ... ... ... 1 ... ... ... 2 1 1 ... 1 ... ... ... ... ... ... 5 2 7 2 ... 2 ... ... ... ... ... ... Diabetes 5 6 11 ... ... ... ... ... .. ... 1 ... ... ... 2 ... 1 1 ... 2 ... 1 1 1 ... 1 ... ... 3 3 6 2 3 5 ... ... ... ... Purpura Hemorrhagica 1 1 2 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... 1 1 2 2 ... ... ... ... ... ... ... ... ... ... Ancemia, Leucocythaemia 4 2 6 ... 1 1 ... .. ... ... ... ... ... ... ... ... ... 1 1 1 ... ... ... 1 ... ... ... ... ... 3 1 4 1 1 2 ... ... ... Premature Birth 38 45 83 38 45 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .. 23 33 56 14 12 26 1 ... 1 ... ... ... ... 4 ... ... ... ... ... ... ... ... ... ... ... ... ... Injury at Birth 3 4 7 3 ... ... ... ... .. ... ... ... ... ... 3 2 5 ... 1 1 ... 1 1 6 ... ... ... ... ... ... ... ... ... ... ... ... Debility at Birth ... 11 6 17 11 ... ... ... ... ... ... ... ... ... ... ... ... ... 8 4 12 3 2 5 ... ... ... 4 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 ... 4 1 ... ... ... ... Atelectasis 5 ... 5 1 ... ... Congenital Defects 8 6 14 7 6 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 5 5 10 2 1 3 1 ... 1 ... ... ... Atrophy, Debility, Marasmus 48 34 82 42 29 6 5 .. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 32 25 57 10 6 16 6 3 9 ... ... ... Dentition 1 2 3 ... 1 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 2 ... 1 1 ... ... ... ... ... ... ... ... Rickets 7 1 8 2 1 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 5 1 6 ... ... 2 ... 2 ... ... ... ... ... Old Age, Senile Decay 30 48 78 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 2 9 20 22 7 16 17 25 42 11 16 27 2 7 9 ... ... ... ... ... 7 Convulsions 9 12 21 10 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 6 8 7 6 13 ... ... ... ... ... ... ... Meningitis 3 4 7 1 1 1 2 ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 4 1 ... 1 2 ... 2 ... ... ... ... ... Encephalitis 3 1 4 ... ... 1 ... ... ... 1 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 3 1 4 ... ... ... ... ... ... ... ... ... Apoplexy 1 5 ... 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 3 ... 1 ... 1 4 5 ... ... ... ... ... ... .. ... ... ... ... ... ... Softening of the Brain 1 ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... Hemiplegia, Brain Paralysis 5 4 9 ... ... ... ... ... ... ... ... ... ... ... 2 ... ... 1 1 ... ... ... 2 3 ... ... 1 4 5 4 ... 4 ... ... ... ... ... General Paralysis of Insane 5 2 7 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 1 2 2 ... ... .. ... ... ... 3 ... 3 1 ... 1 1 2 3 ... ... . Other forms of Insanity ... 3 3 ... ... ... ... ... ... ... . ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 1 ... 1 1 1 2 1 ... ... ... ... ... Cerebral Tumour 2 2 4 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... 1 ... ... ... ... 1 2 1 3 ... 1 ... ... ... ... Epilepsy 4 2 6 ... ... ... 1 ... ... ... ... 1 ... 1 ... ... ... 1 ... ... .. 1 ... ... ... 1 ... ... 3 2 5 ... ... ... 1 ... 1 ... Laryngismus Stridulus ... 1 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... Locomotor Ataxy 4 1 5 .. ... ... ... ... ... 1 ... 1 ... ... 1 1 ... ... ... ... 2 1 3 ... 1 1 ... 1 ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 1 ... ... ... ... ... 4 1 ... 1 ... ... ... Paraplegia 5 ... 5 ... .. ... ... 4 ... ... ... ... ... Other and ill-defined Diseases of Brain or Nervous System . ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 2 2 ... ... 2 1 3 ... ... 1 1 ... ... ... ... ... ... ... ... Otitis, Otorrhoea 1 3 4 ... ... 1 ... 1 ... ... ... ... 2 ... ... ... ... ... ... ... 1 2 3 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... Diseases of Nose, Epistaxis 1 ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... Pericarditis 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... Endocarditis 79 71 150 ... ... ... ... ... 4 2 1 7 6 2 1 3 8 5 5 17 14 24 16 12 11 6 3 1 2 54 47 101 20 22 42 5 2 7 Angina Pectoris 2 1 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 1 ... ... ... ... ... ... ... ... 1 2 1 ... 1 ... ... ... Aneurism 7 7 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 ... 1 ... 2 ... 1 ... ... 5 ... 5 2 ... 2 ... ... ... 1 ... Senile Gangrene 3 2 5 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 1 ... 1 ... 2 ... 1 1 2 ... 1 1 ... ... ... ... Embolism, Thrombosis 2 3 5 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 2 ... ... ... ... 1 ... 2 ... 2 ... 3 3 ... ... ... ... ... ... ... Other and ill-denned Diseases of Heart and; Circulatory System ... 1 ... ... ... 2 ... ... 1 2 2 4 6 8 10 20 17 18 8 16 25 52 77 16 19 35 6 6 47 77 124 ... ... 4 5 12 ... ... Laryngitis ... 1 1 ... ... ... 1 ... ... ... .. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... .. ... ... ... ... ... Acute Bronchitis 39 41 80 1 17 11 2 6 ... ... 1 ... ... 1 4 2 4 8 9 7 3 2 28 24 52 8 16 24 3 1 ... ... 4 ... ... ... 2 ... Chronic Bronchitis 60 69 129 ... 1 ... ... ... ... ... ... ... ... ... 1 4 ... 10 7 13 10 21 20 12 23 8 27 40 67 21 22 43 12 7 ... 19 ... ... Lobar, Croupous, Acute Pleuro-pneumonia 16 13 29 3 11 ... 1 2 5 ... 1 ... 1 . ... 1 ... .. 4 2 4 3 ... 2 9 20 6 2 8 1 ... 1 ... ... ... ... ... ... 70 62 132 Lobular, Catarrhal Broncho-pneumonia 38 29 27 25 2 1 ... ... 1 . .. ... 1 1 2 ... ... 2 3 ... 52 44 96 16 11 27 2 7 1 ... 9 ... ... ... ... .. Pneumonia, form not stated 45 29 74 5 1 8 8 1 1 ... 1 ... ... 1 5 2 5 2 4 2 9 6 5 2 2 2 1 1 24 21 45 13 5 18 8 3 ... 11 Emphysema, Asthma 9 2 11 ... ... ... ... ... ... ... ... ... ... ... 1 1 6 1 2 2 ... ... 5 5 1 6 3 4 1 ... 1 ... ... ... ... ... ... 1 4 ... Pleurisy 5 ... 1 3 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 3 3 1 ... ... ... 1 1 ... ... ... ... ... Other and ill-defined Diseases of Respiratory System 1 ... 1 ... ... ... ... ... 1 ... 1 ... ... 2 ... ... ... ... ... 1 6 8 3 ... 3 ... 9 2 11 2 ... 2 2 ... ... ... ... ... Diseases of Mouth and Adnexa 2 1 3 1 ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 2 ... ... 1 1 ... ... ... .. ... Ulcer of Stomach and Duodenum 9 4 13 ... ... ... ... ... ... ... ... 2 3 1 1 1 3 ... ... 1 ... ... ... .. 5 3 8 3 ... 3 1 1 ... ... ... 1 2 ... Other Diseases of Stomach 3 ... 3 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... 1 ... 1 2 ... 2 ... ... ... ... ... Enteritis 4 2 6 1 1 ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 1 1 ... ... ... ... ... ... 3 1 4 4 1 1 1 ... ... ... ... 5 Appendicitis 4 2 6 ... ... ... 1 ... ... 2 ... 1 ... ... ... ... ... 1 ... ... ... ... ... 3 2 1 ... 1 ... ... ... ... 1 ... ... ... ... Obstruction of Intestines Other Diseases of Intestines 5 8 13 2 ... ... ... ... ... ... ... ... ... ... ... 1 1 2 2 1 ... 3 ... ... ... 1 3 5 8 2 1 3 ... 2 ... ... ... 2 Other Diseases of Intestines 1 ... 1 ... ... ... ... ... ... ... ... ... ... .. ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... 5 8 7 15 ... ... ... ... ... ... ... 1 ... ... ... ... 2 1 4 1 ... 2 1 ... 3 ... ... 5 10 3 2 5 ... ... Cirrhosis of Liver ... ... ... ... 4 3 Other Diseases of Liver 1 3 ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 ... 1 ... ... 1 4 ... ... 3 ... ... ... ... ... ... ... ... ... Peritonitis ... 2 2 4 2 1 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 1 1 2 3 ... ... ... ... ... ... ... ... Other and ill-defined Diseases of the Digestive System 2 2 4 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 1 ... ... ... ... 2 1 3 ... 1 1 ... ... ... ... Diseases of Lymphatic System and Ductless Glands ... 1 1 ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... Acute Nephritis 6 2 8 ... 1 ... ... 1 ... ... . . ... ... 1 ... ... ... 1 ... 1 ... 2 1 ... ... ... ... 2 2 2 3 1 4 1 2 1 ... Bright's Disease 21 21 42 ... ... ... ... ... ... ... 1 ... 1 ... 1 1 2 4 7 2 5 2 5 7 1 1 ... ... 11 17 28 7 3 10 3 11 4 2 Calculus ... 1 1 ... ... ... ... ... .. ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... Diseases of Bladder and Prostate 6 ... 6 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 3 ... 2 ... ... ... ... 2 ... 2 2 ... 2 2 ... ... 2 ... Other and ill-defined Diseases of Urinary System 1 1 2 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... 1 1 1 ... 1 1 ... ... ... ... ... ... Puerperal Convulsions ... 2 2 ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... 1 1 ... ... Placenta Previa, Flooding, Accidental Haemorrhage ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... Other and ill-defined Accidents and Diseases of Pregnancy and Childbirth ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... Acromelagy 1 ... 1 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... Pemphigus 1 ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... Accidents — In Vehicular Traffic ... 1 1 3 ... 4 ... 2 ... 1 1 1 ... ... ... ... ... 1 ... ... ... ... ... 10 2 12 2 ... ... ... 2 1 14 2 16 ... ... 2 On Railways 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... On Ships, Boats & Docks, excluding Drowning ... 2 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... By Machinery ... ... 1 ... ... ... 6 3 1 ... 1 1 1 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 5 ... Barns and Scalds 3 ... 1 1 ... ... Poisons, Poisonous Vapours 3 ... 3 ... ... 1 ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... .... ... ... 2 ... ... 1 1 ... ... ... ... ... ... ... ... ... ... Surgical Narcosis 2 1 3 ... ... ... ... ... ... ... ... ... ... ... 2 1 ... ... ... ... ... ... ... ... ... 2 1 3 ... ... ... ... ... ... ... ... ... ... 9 4 Drowning 13 ... 1 ... 1 ... 2 ... ... 1 1 ... 4 ... ... 1 1 ... ... ... 4 3 7 5 1 6 ... ... ... ... ... 1 ... ... ... ... Suffocation, overlaid in bed 11 6 17 11 6 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8 4 12 2 1 3 1 1 2 ... ... ... Suffocation, otherwise 5 2 7 2 1 ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 3 4 1 ... ... 1 ... 1 2 2 ... ... ... ... ... Falls, not specified 6 8 14 ... ... 1 ... ... ... ... ... ... 1 1 1 1 1 ... 2 ... 2 8 11 2 1 ... ... 2 2 3 2 1 ... ... ... ... ... ... Otherwise and not stated 4 3 7 1 ... ... ... ... 1 1 ... ... ... ... ... ... ... 1 ... 1 ... ... 1 1 1 1 2 2 1 3 1 1 2 ... .. ... ... ... suicide — I I I I I I I I I 1 I I I I I 1 i "I I I I I I By Poison ... 3 3 2 3 ... ... ... ... ... ... ... 1 ... ... .. ... ... ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... By Hanging or Strangulation 3 2 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 1 ... ... ... 1 ... ... ... ... ... 3 2 5 ... ... ... ... ... ... ... By Cut or Stab 1 1 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... 1 1 2 ... ... ... ... ... ... ... ... ... ... By Precipitation from Elevated Places 1 ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... Other ill-defined and not specified methods ... ... 1 1 2 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... 1 1 2 ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 269 30 14 11 28 27 64 90 10 41 738 703 1441 233 183 20 20 13 33 45 108 1054 186 64 131 87 1175 2229 143 111 277 326 115 603 111 74 185 123