BER 31 metropolitan Borough of Bermondsey. REPORT ON THE Sanitary Condition OF THE BOROUGH OF BERMONDSEY For the Year 1911. BY R. KING 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. 1912. TABLE OF CONTENTS. PAGE VITAL STATISTICS— Population 4 Births 5 Marriages 5 Deaths 5 Infantile Mortality 8 Zymotic Diseases 8 Senile Mortality 9 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 9 Phthisis 10 Alcoholism and Cirrhosis of Liver 10 Cancer and Malignant Disease 10 Heart Diseases 10 Suicides 10 Accidents 10 Other Violent Deaths 10 NOTIFICATION OF INFECTIOUS DISEASE— Small-pox 11 Typhus Fever 11 Diphtheria 11 Scarlet Fever 12 Measles 12 Enteric Fever 12 Puerperal Fever 12 Membranous Croup 12 Phthisis 13 Cerebro-spinal Meningitis 16 Anthrax 17 Consultations 17 Plague 17 Children excluded from School 18 SANITARY ADMINISTRATION— Offensive Matter 20 Offensive Trades 20 PAGE SANITARY ADMINISTRATION—continued. Unsound Food 20 Food Places 21 Unsound Food Seizures 21 Milk Premises 21 Cowsheds 21 Food Examined 21 Unsound Food and Foreign Meat Regulations 22 Food Inspectors' Work 25 Food and Drugs 25 Slaughterhouses 26 Ice Cream Premises 26 Hairdressers and Barbers 26 Inspections 26 Housing of the Working Classes Acts 26 Housing, Town Planning, &c., Act, 1909 27 Bacteriological Laboratory 27 Houses Let in Lodgings 27 Sec. 48 Public Health (London) Act, 1891 28 Disinfection 29 Cleansing of Persons Act, 1897 29 Smoke Nuisances 29 House Refuse 29 Overcrowding 29 Health Visitor's Work 33 FACTORIES AND WORKSHOPS— Outworkers 33 APPENDIX—TABLES— Local Government Board Tables 36-40 Population, &c., of Wards 41 Meteorology 41 Marriages 41 Proceedings during Year 42 Factories and Workshops 43-45 Sanitary Work 46 Food and Drugs 47 - 49 List of Bakehouses 50 Phthisis Sanatorium and Hos- pital Accommodation 51 Extended Table of Deaths 52 PUBLIC HEALTH DEPARTMENT. COMMITTEE, 1911: Chairman —Councillor CLARK. Councillor Markwick, Alderman Lawrence, „ Speer, „ Oake, Councillor Bevington, „ O'Connor, „ Pridmore, „ Brenner, „ Renwick, „ Davies, „ Delderfield, „ Richmond, m.d. „ Dhonau, „ Salter, „ Saunders, „ Gardiner, „ Vezey. „ Hooton, Ex-offcio: HENRY F. MORRISS, ESQ., J.P. Mayor of Bermondsey. STAFF: Medical Officer of Health—R. KING BROWN, B.A., M.D., D.P.H. Sanitary Inspectors. No. 1 District Mr. M. Grice. No. 5 District Mr. E. C. Freeman. No. 6 „ „ J. Bartlett. No. 2 „ „ J. W. Wood. No. 7 „ „ J. Pitts. No. 3 „ „ A. H. Merryman. 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 B. Nuttall. Clerical Staff. Mr. H. A. W. Bush, Sanitary Clerk, Mr. J. C. Watts, Fourth Clerk, „ E. J. Pitts, Second Clerk, „ F. C. Shaw, Office Lad. „ J. G. Francksen, Third Clerk, PUBLIC HEALTH DEPARTMENT, TOWN HALL, SPA ROAD, S.E. Metropolitan Borough of Bermondsey. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Bermondsey. Gentlemen, I have the honour to submit my Eleventh Annual Report on the sanitary condition of the Borough of Bermondsey during the year 1911. The report deals with the 52 weeks beginning January 1st. and ending December 30th, 1911. The death-rate was 18.4, compared with 17.6 in 1910, and 18.8 in 1909. 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 large increase in diarrhœal diseases due to the hot dry summer, an increase 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. R. KING BROWN. I.—VITAL STATISTICS. Population. The populations of the Borough of Bermondsey and its registration sub-districts, as enumerated in the Census of 1901 and 1911, and the estimate for the year under report, are as follows:— 1901. 1911. Estimated to June 30th, 1911. Bermondsey 82,483 82,119 82,110 Rotherhithe 38,460 35,142 35,059 St. Olave 9,817 8,699 8,671 Borough 130,760 125,960 125,840 As the Census is taken in April, it is usual to calculate the various rates on the mean population, which is assumed to be that existing at the end of June or the middle of the year under report. To arrive at this it is therefore necessary to estimate for further three months, which in Bermondsey is assumed to be a decrease. The decrease 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. This is an object to be desired, since it is beneficial alike to those going and those remaining, for only in this way can sufficient space be provided round houses and overcrowding on large areas be avoided. If the demand for slum property ceased it would soon lead to its abolition. The same method of estimating has been adopted as that employed in former years. Births. The total number of births registered in the Borough for the 52 weeks ended December 30th, 1911, was 3,842, consisting of 1,948 males and 1,894 females. This is 329 below the average for the last 10 years, and 115 below the figure for 1910. This total includes 2,528 for Bermondsey, being 133 below that for 1910, and 248 below the average for the last 10 years; 1,067 for Rotherhithe, being 37 above the number for 1910, and 49 below the average for the last 10 years; and 247 for St. Olave, being 9 below the number for 1910, and 33 below the average for the last 10 years. In Table II. of the appendix will be seen the figures for the last 10 years in the three registration sub-districts, and in Table I. figures for the whole Borough. The birth-rate for 1911 was 30.5 per thousand persons living, which is 1.9 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 1911 number 74, and if they are added to the above total the rate would be 31.1. Table A — Birth-rates. Year. Bermondsey. Rotherhithe. St. Olave. Whole Borough. London 1901 35.42 31.73 34.1 29.0 32.73 33.4 34.70 30.47 33.92 28.5 1902 31.12 30.83 32.4 1903 29.10 28.4 40.69 27.8 1904 33.52 28.27 32.4 29.53 30.64 33.3 27.1 1905 35.35 31.08 31.4 1906 32.83 28.48 26.5 1907 32.76 29.06 31.4 25.6 28.45 32.58 32.1 1908 33.53 29.02 25.2 1909 33.65 28.02 32.99 31.9 24.2 32.73 27.27 35.53 31.3 23.6 1910 33.56 26.6 32.4 Average for years 1901-1910 29.10 32.94 1911 30.79 30.43 28.48 30.5 24.8 From this table it will be seen that there is a reduction of the birth-rate for the Borough, which is shared by Bermondsey and St. Olave. Marriages. The total number of marriages in the Borough in 1911 was 1,130, being 19 below the number for 1910, and 20 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 Sub-districts. The numbers have been supplied by the Superintendent Registrar. Deaths. In Table IY. of Appendix will be 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 total number of deaths registered in the Borough for the 52 weeks ended December 30th, 1911, was 1,782, which is 65 more than in 1910, and 230 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 number is raised to 2,320. This is 65 more than in 1910, and 158 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 1910. The largest number of deaths occurred in the first quarter of the year. Table B. — Deaths. Bermondsey. Rotherhithe. St. Olave. Whole Borough. Quarter. 1910. 1911. 1910. 1911. 1910. 1911. 1910. 1911. First 322 415 155 51 36 637 186 528 139 35 40 528 354 321 139 500 Second 499 620 383 119 190 43 47 Third 337 56 61 674 563 Fourth 428 351 190 151 1,441 1,470 603 666 185 184 2,229 2,320 Total Deaths The death-rate for the Borough in 1911 was 18.4 per thousand living inhabitants, being 0.8 above that recorded in 1910, and 0.8 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 17.7, which is 0.7 above that for 1910. Table C.—Death-rates. Year. Bermondsey. Rotherhithe. St. Olave. Whole Borough. London. 1901 21.44 19.43 20.93 20.8 17.1 21.66 19.30 24.62 21.2 17.2 1902 22.23 1903 18.54 17.08 18.4 15.1 27.65 19.91 18.59 20.1 16.0 1904 15.1 15.78 22.98 1905 19.51 18.6 18.36 15.1 19.80 25.08 19.7 1906 18.45 17.51 20.25 18.3 14.6 1907 13.8 1908 19.42 15.70 27.78 18.8 1909 19.20 17.14 22.70 18.8 14.0 25.67 17.6 12.7 1910 17.72 15.81 Average for years 1901-1910 19.57 17.47 23.99 19.2 15.1 1911— On estimated population 19.0 21.22 15.8 18.4 17.90 21.15 On Census population, 1911 18.95 17.7 17.90 Table D. Increase or Decrease of Deaths from various Diseases in 1911 COMPARED WITH 1910. Increase. Decrease. Whooping Cough 4 Measles 92 Enteric Fever 2 Scarlet Fever 8 Influenza 6 Diarrhœa 60 Diphtheria 3 Enteritis 79 Erysipelas 1 Puerperal Fever 1 Cancer 30 Other Tubercular Diseases 19 Alcoholism and Cirrhosis of Liver 6 Phthisis 8 Heart Diseases 13 Other Respiratory Diseases 12 Bronchitis 19 Premature Birth 15 Diseases and Accidents of Parturition 1 Pneumonia 30 Venereal Diseases 1 Accidents 11 Other causes 25 Suicides 7 Total 194 Total 259 It will be seen from the above that the increases amount to 259 and the decreases to 1!)4. Diarrhoea, enteritis, and pneumonia are chiefly accountable for the increase, whereas the principal cause of the decrease is the diminished number of deaths from measles and cancer. If it were not for the great increase of deaths under the headings of diarrhoea and enteritis alone due to the long, dry and hot summer, the death-rate would have been the lowest on record. In column 1, foot of Table I. of the Appendix, will be found a list oh places where deaths of non-parishioners occurred in the district. There were 22 such deaths in all, against 30 in 1910, and 26 in 1909. 4 such deaths occurred in the infirmary; 1 in the workhouse, Parish Street; 12 in River Thames and Docks; 1 on the railway; lin a private house; 2in the street; and 1 in a factory. 560 persons belonging to this .Borough died in outlying institutions, against 542 in 1910, and 466 in 1909. The names of the various places where the deaths occurred will be found in columns 2 and 3 at foot of Table I. of Appendix. Table E. Death-rates corrected for Age and Sex Constitution of the various Populations, 1911. Area. England and Wales London, County of Factor for Correction for age and sex distribution 1.0000 1.0511 Crude Deathrate per 1,000 persons living. 1911. 14.60 Corrected Death-rate per 1,000 persons living. 1911. 14.60 15.81 Comparative Mortality Figures. 1911. 1,000 1,083 15.04 1.0677 13.35 14.25 976 Paddington 1.0778 13.68 14.74 1,010 Kensington 1.0414 15.57 16.21 1,110 Hammersmith 15.03 1.0462 14.37 1,029 Fulham 1.0361 15.45 16.01 1,097 Chelsea 1.1217 13.97 Westminster, City of 12.45 957 15.09 St. Marylebone 1.0652 16.07 1,101 1.1280 10.87 754 9.64 Hampstead 1,111 1.0456 15.51 16.22 St. Pancras 1,058 1.0391 14.87 15.45 Islington 13.60 Stoke Newington 1.0438 13.03 932 1.0420 14.35 14.95 1,024 Hackney 1.0766 15.69 16.89 1,157 Holborn 1,403 1.0355 19.79 20.49 Finsbury 1.0993 15.09 16.59 1,136 City of London 1.0493 21.06 1,442 Shoreditch 20.07 1,256 1.0102 18.15 18.34 Bethnal Green 1.0450 17.35 18.13 1,241 Stepney 1,332 Poplar 1.0314 18.87 19.46 19.20 1,315 1.0450 18.37 Southwark 14.91 15.39 1,054 Lambeth 1.0320 1.0728 14.30 15.34 1,051 Battersea 11.97 12.62 864 Wandsworth 1.0547 1.0373 14.29 14.82 1,015 Camberwell 1.0511 15.63 1,125 16.43 Deptford 14.72 15.03 1,029 Greenwich 1.0210 11.76 805 Lewisham 1.0420 11.29 13.72 940 1.0690 12.83 Woolwich 1.0244 18.42 18.87 1,292 BERMONDSEY 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 1833 the Registrar-General commenced a method of correcting the death-rates of the great towns of England and Wales. Taking account of the differences of age and sex distribution between these and the latter, he has calculated a factor for each great town by which the recorded death-rate must be multiplied so as to allow for the differences of age and sex, and thus places them as regards these matters on an equal footing. You thus get death-rates the difference in which we can put down to general sanitary conditions alone. In illustration of this I have taken the above figures from the Registrar-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 recorded death-rate down, notwithstanding the great number of children under 5." Table F. —Infantile Mortality. London. Year. Bermondsey. Rotherhithe. St. Olave. Whole Borough. No. of Deaths. Rate per 1,000 Births. Rate per 1,000 Births. No. of Deaths. Rate per 1,000 Births. No. of Deaths. Rate per 1,000 Births. Rate per 1,000 Births. No. of Deaths. No. of Deaths. 170 215 176 42 132 754 169 19,412 497 148 1901 159 174 153 678 156 139 455 149 49 18,478 1902 176 657 156 130 428 153 179 160 50 16,978 1903 723 477 173 187 173 59 163 172 18,600 143 1904 146 170 164 145 45 631 147 16,324 129 1905 422 155 130 408 115 170 156 46 178 624 16,307 1906 116 335 125 144 130 22 96 501 125 14,114 1907 411 151 134 48 186 610 146 13,943 113 1908 147 141 396 144 143 134 137 573 12,582 108 1909 34 26 127 103 341 128 135 130 101 502 11,809 1910 Average for years 1901 to 1910 42 625 417 149 146 167 149 149 15,855 126 1911 403 159 167 157 41 166 611 159 14,440 129 As there were 158 deaths from summer diarrhoea during 1911, against 63 in 1910, it is scarcely necessary to enquire further into the causes of the increase of the death-rate among children under one year old. If the deaths due to this one cause could be reduced to a figure equal to that for 1910, we would have a comparatively low infantile death-rate for Bermondsey to record ; but unfortunately elements over which we have no control, in the shape of a hot, dry summer, frustrated our efforts to keep down the death-rate due to this particular cause. The obvious connection between heat and infantile mortality is difficult to explain, and has not hitherto been satisfactorily accounted for by any one theory. At present the two main views are (1) that excessive heat causes death by direct influence—the so-called "heat-stroke," and (2) that it is due to diarrhœal diseases caused by contamination of the infant's food by fermentation, flies, &c., favoured by the heat. The former view has most adherents on the Continent, the latter most in England. Possibly both are correct for the particular country, since on the Continent they are more liable to extremes of heat and cold than in England, and if, as I believe, both causes are operative, this will account for the higher infant mortality on the Continent as a whole than in England, where the first factor is not so important. The further one proceeds north from the equatorial zone the less the infantile mortality, and this at present reaches its minimum in Sweden. In England, where intestinal troubles are paramount, the most important contributory factor is want of breast feeding, others being insufficient light and ventilation in and around the dwelling houses. Table G. Whooping Cough. Typhus Fever. Enteric Fever. Pyrexia. (Origin uncertain). Diarrhœa. All Causes. Principal Zymotic Diseases. Small-pox. Measles. Scarlet Fever. Diphtheria. Year. No. Rate. No. No. Rate. No. No. Rate. No. Rate. No. Rate. No. Rate. No. Rate. Rate. No. Rate. Rate. Rate. No. .27 .42 22 .16 - - 133 1.0 2719 20.8 14 .10 76 45 .34 - - 382 56 1901 2.92 .58 36 .24 18 .14 29 .09 - 88 .68 1902 2756 21.2 396 3.06 31 154 1.19 .22 64 .49 - - 12 - 103 18.4 .19 18 4 - .80 1903 1.96 - 50 .39 25 .14 41 .32 .03 11 .09 2382 251 - - 1.05 .13 68 16 189 1.46 1904 2593 20.1 3.44 - - 136 18 .14 17 .53 - - .13 - - 444 38 - .07 145 1.13 1905 18.6 287 2.23 1 .01 59 .45 17 .13 18 .14 .29 - 9 - - 2399 .73 .23 34 .27 4 .03 188 1.46 1906 2529 19.7 400 3.12 - - 94 30 50 .39 - - - - .28 - 7 55 .43 1907 18.3 223 1.74 - - 51 .40 36 22 .17 52 .41 - .05 - 2338 - .81 26 18 - 12 - 113 .87 1908 18.8 300 2.31 - 105 .20 26 .20 .14 - .09 - 2444 - 17 .13 12 .09 1 .00 - 86 .68 1909 2387 18.8 368 2.89 - 196 1.54 54 .42 2 .01 - - 14 .11 18 - - 4 .03 87 .68 1910 2229 17.6 310 143 1.12 .14 44 .34 - - 2.44 - - 10 .92 25 23 .18 .38 - 199 .00 Average for years 1901 to 1910 .19 49 0 .08 - 5 .04 106 .83 2478 19.3 2.61 336 .12 .05 - 226 1.80 352 2.79 15 48 .38 6 - 1911 2320 18.4 - 51 .41 6 .05 - - - - 1.18 2570 172 .04 612 - 5313 London 1911 .00 - .03 - 15.8 9858 .57 .014 1038 144 67826 2.18 9 There has been an increase in the deaths from these diseases, the figures being 352, against 310 in the previous year, and 336 the average for the last ten years. This gives a zymotic death-rate of 2.79. The total number of deaths from notifiable diseases, viz., scarlet fever, diphtheria, typhus fever, and enteric fever, was 27, compared with 36 in 1910, and for the non-notifiable, viz., measles, whooping cough, and diarrhoea, 325, compared with 274 in the previous year. Senile Mortality. The number of deaths over 65 years of age in 1911 was 467, compared with 443 in 1910. Death Certification. There were no uncertified deaths in 1911. Small-pox. There were no deaths from this cause in 1911. Measles. There were 51 deaths due to this disease, which is 55 below the average for the last ten years, and 92 below the number for 1910. The deaths occurred in quarters as follows, viz.:—27, 15, 2, 7. Diarrhœa. 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 diarrhœa 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 ground 3 ft. below surface. Temperature of the Air. Rainfall. Deaths from Diarrhœa. Weeks. 1910. 1911. 1911. 1910. 1911. 1910. 1910. 1911. July ° ° ° ins. ins. ° 1.22 59.2 69.5 58.82 63.31 0.00 1 2 58.8 71.0 59.06 65.17 0.35 0.26 1 7 August 60.2 68.0 60.12 66.11 0.85 0.06 7 - 66.43 60.7 72.5 60.48 0.18 0.00 15 - 62.7 69.4 60.13 67.06 0.19 0.58 6 18 59.9 63.9 61.26 66.39 0.80 0.29 2 31 65.36 September 58.3 65.3 60.59 0.41 0.41 20 8 54.7 66.9 59.68 64.63 0.02 0.01 3 23 64.19 56.1 60.3 58.71 0.66 0.41 10 20 54.3 53.8 58.01 61.74 0.00 0.48 7 22 58.6 55.0 57.35 59.94 0.10 0.44 6 17 October 57.4 48.2 57.61 57.03 0.08 0.27 2 9 53.1 51.9 57.23 55.99 0.61 0.29 6 9 51.4 54.5 55.69 55.92 9 0.63 0.37 4 Weekly average 57.5 62.2 58.90 62.80 0.28 4 14 0.43 Whooping Cough. 48 deaths were due to this cause, against 44 in 1910. The deaths occurred in quarters as follows:— 15, 24, 6, 3. Typhus Fever. No deaths occurred from this disease. Enteric Fever. 6 deaths were due to this cause, 4 in Bermondsey, 1 in Rotherhithe, and 1 in St. Olave. The corresponding figures for 1910 were 4 for the Borough, viz., 1 in Bermondsey, 2 in Rotherhithe, and 1 in St. Olave. Other Allied Diseases. 2 deaths were registered under this heading, viz., 1 death from post-basic-meningitis and 1 from rothelm. Tubercular Diseases. The number of deaths from all forms of tubercular disease in 1911 was 305, against 289 in 1910. This figure comprises 199 for Bermondsey, 80 for Rotherhithe, and 26 for St. Olave. Of these, 211 were due to phthisis and 94 to the other tubercular diseases. Phthisis. In Table J. will be found particulars of deaths from phthisis since the year 1901. There were 211 deaths due to this cause, which is 8 less than the number recorded in the previous year. TABLE J.- PHTHISIS. SUB-DISTRICT. BERMONDSEY. ROTHERHITHE. ST. OLAVE. WHOLE BOROUGH. LONDON. No. Rate. No. Rate. No. Rate. No. Rate. No. Rate. Year. 150 57 19 226 1.48 1.95 1.73 7514 1.66 1901 1.82 1.43 21 2.22 239 1.83 7424 1.62 1902 163 1.98 55 7124 147 1.46 18 1.96 221 1.70 1.54 1903 1.79 56 7526 165 60 1.57 31 3 .48 257 1.99 1.62 1904 2.02 20 223 6622 1905 148 1.81 55 1.44 2.32 1.73 1.42 18 155 1.90 77 2.01 2.16 250 1.95 6775 1.44 1906 150 1.78 19 2.36 237 1.85 6654 1.40 1907 1.84 68 1.85 6419 1908 157 1.89 60 1.54 24 3.03 241 1.32 1.46 220 147 56 17 2.27 1.73 6337 1.31 1909 1.80 50 1.31 21 1.73 5555 1910 148 1.82 2.91 219 1.14 Averages for years 1901-1910 153 1.87 59 1.55 21 233 1.81 6795 2.47 1.45 141 1.72 52 1.48 18 2.08 211 1.68 6084 1.35 1911 These figures on the whole are encouraging, for though they record many fluctuations from 1901, still there is an apparent tendency to a permanent lowering of the death-rate. The figures for London show a slow but steady fall. It is probable that a specially wet and cold winter, by killing off a number of chronic cases, may account for the fluctuations. Further account of the work done in connection with tuberculosis will be found under notification of the disease. Alcoholism and Cirrhosis of the Liver. 21 deaths were attributed to this cause in 1911, against 15 in 1910. 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. 116 deaths were attributed to this cause, 110 being due to carcinoma, or cancer, as ordinarily understood, and 6 to sarcoma. The Cancer Research Commission have not yet issued their final report on the subject. Heart Diseases. 166 deaths were due to this cause, which number is 15 above that for the previous year. This refers to organic or valvular disease of the heart. Suicides. 6 persons committed suicide in 1911, viz., 1 by poison, 1 by hanging, 1 by drowning, 1 by cut or stab, and 2 by crushing. Accidents. 89 deaths were due to accidents, against 90 in the previous year. Particulars will be found in the extended table of the Causes of Death in the Appendix. Other Violent Causes. There were 4 deaths by homicide during the year under report. DIPHTHERIA. Average 10 yews, 1901-1910, marked Green. Notifications, 1911, marked Red. 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 943, compared with 746 in 1910, and 810 in 1909. The diseases which show a decrease on the numbers for the previous year are scarlet fever (56), small-pox (1), enteric fever (6), cerebro-spinal meningitis (4), while those showing an increase are diphtheria (53), puerperal fever (7), post-basic meningitis (1), ophthalmia neonatorum (36), chickenpox (142), acute polio-myelitis or acute polio-encephalitis (3). The number of cases notified in the registration sub-districts was 655 in Bermondsey against 501 in 1910, 242 in Rotherhithe against 192, and 46 in St. Olave against 53 in 1910. The attack-rate per thousand inhabitants was 7.5, the rate for the sub-districts being 8.0 for Bermondsey, 6.9 for Rotherhithe, and 5.3 for St. Olave. The corresponding rates in the previous year were 5.9 for the Borough, 6.l for Bermondsey, 5.0 for Rotherhithe, and 7.3 for St. Olave. 47 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. Small-pox. No cases were notified during the year under report. Typhus Fever. No cases of typhus fever were notified during the year under report. Diphtheria. There were 260 cases of diphtheria notified in 1911, of which 184 occurred in Bermondsey, 60 in Rotherhithe, and 16 in St. Olave. This is an increase on 1910, for which the figures were:— Borough, 207; Bermondsey, 131; Rotherhithe, 61, and St. Olave, 15. From the following table it will be seen that a general increase has taken place throughout London. Cases of Diphtheria Notified. Year. London. Bermondsey. 1892 161 1893 367 8,368 13,712 1894 11,204 446 11,231 281 1895 425 1896 13,825 1897 13,217 393 326 1898 11,883 1899 13,711 734 1900 471 12,023 1901 12,156 329 1902 277 10,731 172 1903 7,738 1904 7,219 191 1905 165 6,482 1906 8,041 327 1907 8,779 311 251 1908 8,001 191 1909 6,679 1910 5,494 207 1911 260 7,385 9,894 315 Average The attack-rate per thousand inhabitants was 2.1, against 1.6 in 1910. The case mortality was 5.0 per cent., against 8.7 per cent, in 1910 and 6.3 per cent, in 1909. 12 cases were returned as not suffering from this disease. 176 specimens were sent in by medical practitioners for bacteriological examination, against 122 in 1910 and 134 in 1909. Of these 33 were found to contain diphtheria bacilli, all of which were notified. In 13 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 B 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 1911 was 332, belonging to 148 families. Out of this number 15 had diphtheria bacilli in their throats or noses, and 11 developed the clinical symptoms of diphtheria, and were therefore notified. Scarlet Fever. There were 305 cases of scarlet fever notified —206 for Bermondsey, 89 for Rotherhithe, and 10 for St. Olave. This is a decrease of 56 for the Borough on the total for 1910. The distribution of the disease in the various Wards, as shown in Table III. of Appendix, was fairly uniform. 34 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 ten years are shown in green. There were 6 deaths, which gives a case mortality of 2.0 per cent., against 3.8 per cent, in 1910. The disease, as in recent years, was of a mild type. The attack rate per thousand inhabitants was 2.4, against 2.8 in 1910. In 36 cases the source of infection was attributed as follow: — Previous cases in house or family or neighbouring houses 25 School infection 5 "Return" cases 6 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 be 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 1911 was 51, against 143 in 1910 and 196 in 1909, The annexed table gives the number of notifications received from schools, the number of "contacts" excluded. In the first quarter there were 27 deaths, in the second 15, in the third 2, and in the fourth 7. 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. 29 cases of enteric fever were notified, being 18 for Bermondsey, 7 for Rotherhithe, and 4 for St. Olave. 1 case was returned as not suffering, making an actual total of 28. The total number of cases notified in the previous year was 37. The majority of the cases may be classified as sporadic, i.e., isolated cases. There was one small chain of cases which occurred towards the end of the year, but as they extended into the spring of 1912 they will be dealt with in the report for that year. In 6 cases the source of infection was attributed as follows:— From previous cases 5 From eating cockles 1 Puerperal Fever. 13 cases of puerperal fever were notified. There were 4 deaths. Membranous Croup. 2 patients were notified as suffering from membranous croup. SCARLET FEVER. Average. 10 years, 1901-1910, marked Green. Notifications, 1911, marked Red. ENTERIC FEVER. Notifications, 1911, marked Red. Average 10 years, 1901-1910, marked Green. Phthisis. During the year, 652 fresh cases of phthisis were notified. Of these 110 were notified voluntarily, compared with 106 in 1910, 210 under the Poor Law Order, compared with 183 in the previous year, and 332 under the Hospital and Dispensary Order. In the appended table will be seen particulars of cases notified in the various wards:— Whole Borough. Bermondsey Wards. Rotherhithe Wards St. Olav e Wards. 1 2 3 4 5 6 1 2 3 St. John St. Olive St. Thomas Voluntary Notifications 110 9 21 18 20 12 11 6 9 1 1 2 - Poor Law Notifications 210 32 34 29 13 15 15 29 18 3 15 6 1 Hospital and Dispensary Notifications 332 39 64 48 41 21 35 20 32 16 9 3 4 652 80 119 95 74 48 61 55 59 20 25 11 5 Re-notifications (Changes of Address, &c.) 218 31 23 24 20 12 19 36 13 13 11 15 1 573 71 78 74 40 59 57 97 63 9 7 14 4 Rooms disinfected During 1911 a good deal of attention was given to various measures for the prevention and treatment of consumption, and following the decision of the Council to contract for three beds in Maitland Sanatorium, Peppard Common, Oxon, announced in my last annual report, a beginning was made in the end of 1910. The following report was made to the Public Health Committee in January, and no further deaths among these patients have been recorded at time of writing (June 6th, 1912) :— Report on Sanatorium Patients. Age. Remarks. No. Initials. Sex. Occupation. Date of leaving Sanatorium. Condition on leaving. Present condition. Present occupation. 1 A. T. H. M. 21 Chemist's Assistant 1911 Feb. 9th Very good. In good health; full work In full work as farm labourer Same work; lives in Paris Still at Sanatorium Undergoing tuberculin treatment in Paris. 19 - S. G. M. M. - - 2 Clerk Jan. 24th Died August 28th, 1911, of heart failure following on acute attack. N. M. H. Much improved F. 22 3 Leatherstitcher - - C. H. R. M. 28 Fairly good progress; improved Disease progressing; not fit for work Fair health; full work No work April 13th A.B. Royal Navy Could not get employment after leaving Sanatorium; is under dispensary. 4 W. S. M. 41 May 16th Same work Under dispensary. Progress good; improved Brewer's Labourer 5 A. A. 22 F. Getting tuberculin at dispensary. Do. May 16th Bookfolder Good Very good health; full work 6 J. S. C. - 24 Still at Sanatorium Odd jobs Clerk Was part of time at St. Mary's Hospital. M. - 7 - Aug. 16th Much improved Market Porter Fair health W. F. S. M. 27 Could do full work, but cannot get regular employment. 8 M. Same work W.R.S.G. 24 Baker Good health; full work Fair health; full work Do. 9 Aug. 30th Very good; progress excellent - - T. H. 34 Lamplighter Do. 10 M. Sept. 6th. Progress fair; condition improved Unsuitable work; dusty and long hours; under dispensary. Do. 20 M. Warehouseman Oct. 16th Progress excellent; much improved 11 H. B. 23 W. S. M. Nov. 15th Slight improvement Temporary Sorter, G.P.O. Under dispensary; getting tuberculin treatment. Same 12 Clerk Plumber's Mate 45 M. Good Full work Under dispensary. R. S. H. T. Dec. 5th Progress good; much improved 13 Out of the 12 patients who have completed three months' treatment, 7 are at present in full work and 1 is able to do it if he could get it. None of those in full work have changed their occupation. One death has occurred, that of patient No. 3. In July she went for a long walk of 12 to 14 miles in the county, which fatigued her very much and apparently caused a recrudescence of the mischief in her lungs. She was treated at the tuberculosis dispensary and recovered fairly well, but took a sudden attack of heart failure, which resulted in death. The great difficulty with all the patients is their not being able to get suitable work, and in many cases work of any kind after they leave the sanatorium. If it were possible to get all the patients work in the open air, or at least under healthier conditions than they were working under previously, there is no doubt the results would be very much better. Case No. 11 is a very good example of this. He is working in a dusty room for 12 hours per day, and during the busy season at Christmas he frequently worked 17 hours per day. Under such circumstances it is remarkable that he has been able to maintain his health at all. Could some systematic plan of " after care "be adopted, whereby suitable employment could be assured, the value of sanatorium treatment would be more than doubled. At present their situations are often filled up, and the two or three months immediately following the sanatorium treatment are often spent in semi-starvation looking for work. This period is undoubtedly a most important one, since in these two or three months special care and good food are needed to confirm the healing process which was completed, or nearly completed, by the open-air treatment. Tuberculosis Dispensary. I was asked to report on the advisability of starting one in Bermondsey, and the following came before the Public Health Committee in January, 1911. It was then adjourned till the following meeting, and on the Committee being informed that the Central Fund were thinking of starting a voluntary dispensary on the Edinburgh plan, they dropped the matter after a final adjournment for six months. In a previous report to the Committee it was pointed out that there are three classes of consumptive patients—1st, those which are in a very early and curable stage; 2nd, those in which the symptoms, though marked, are not sufficient to preclude them following their occupations; and 3rd, the advanced cases in which there is no hope of either cure or amelioration. To these a fourth class might be added, viz., those suffering from tuberculous disease of other parts of the body besides the lungs, which class contains a large proportion of the child population. These four classes may therefore all be included under the one term, " Tubercular Diseases. Up to a recent period efforts have been mainly directed to the first and third classes, on account of the curability of the former and the infectivity of the latter; but the efforts to deal with the second and fourth classes, which comprise the bulk of tuberculous subjects, have been unequal and spasmodic, and an organised attempt has only been made to fill this gap during the last two or three years by the establishment of tuberculosis dispensaries. The originator of the tuberculosis dispensary is Dr. R. W. Phillip, who started one in Edinburgh as far back as 1887, and it is the remarkable success he achieved by it that has induced sanitary authorities not only in Great Britain but in most other civilised countries to imitate his method. The general aims and objects of a tuberculosis dispensary are to provide a place where treatment and advice in all matters pertaining to tuberculosis can be obtained free of charge by the poorer inhabitants. It is intended for those who are too poor to pay for medical advice. Owing to dealing with one disease only, the very highest expert advice is brought to bear on the subject, and the medical officers in it can act as referees in any case in which their advice is desired by other practitioners. It is now recognised that tuberculosis is essentially a home disease, and any treatment which does not take the dwelling of the tuberculosis subject into its purview is necessarily incomplete. It is useless treating a consumptive patient if the surroundings in his home are not properly attended to, and the object of the dispensary is to supply advice to the individual both as to personal hygiene and the hygiene of the home. The dispensary is also intended to act as a co-ordinating centre between the municipal authority and the various voluntary agencies which are working for the stamping out of tuberculosis. One most important part of their duty is, therefore, besides examining and treating the patients, to divide them into the various classes with a view to deciding what kind of supervision or treatment is best. Suitable cases are selected for sanatorium treatment; those not suitable for this purpose, but still able to follow their employment, are advised as to the best kind of work they should engage in, and assisted in getting it, as to how to take advantage of fresh air, &c., in the home, and in case food or money is needed sending them to the proper quarter for it. Another important duty of the medical officer is in visiting the homes to persuade the " contacts," i.e., the other members of the family of the phthisical patient, to be examined with a view to discovering fresh cases in the early stage. The majority of the poor people will not consult a doctor for occasional coughs and colds, which they look upon as of trilling importance, but which may really be the beginning of consumption, until it is too late. As regards class three, steps are taken to get them sent to an infirmary or other suitable institution, and the fourth class receive advice or recommendation according to the nature of their case-for instance, tuberculous children of school age may be sent to open-air schools or suitable hospitals for treatment. Those found to be suffering from any other disease than tuberculosis are referred to a hospital or private practitioner, as the case may be, for treatment. Another very important duty of the tuberculosis dispensary is the following up cases which have undergone sanatorium treatment and finding them suitable employment. From the above sketch it is evident that the activities of the dispensary are very many, and the experience of Paddington, which established a dispensary in January, 1909, amply proves that there is room for an institution of this description. During the first year of its working 857 new patients attended, paying 4,453 subsequent visits, making a total of 5,310 attendances during the year. The work, lam informed, has increased so much during the year 1910 that it has been found necessary to appoint a second medical officer and increase the nursing staff. The following are roughly particulars of the expenses which would be incurred during the first year of a dispensary :—Medical Officer, £300 ; Nurse, £105 (including uniform) ; Clerk and Dispenser, for records, &c., £110; rent, &c., £60; drugs, nourishment, disinfectants, £100; cleansing and wages, £25; heating, lighting, repairs and sundries, £100; making a total of £800. This, in my opinion, is the minimum expense which could be expected in the first year of working; but this would doubtless be increased as the institution became better known. As to the value of the dispensary in the war against tuberculosis there can be no two opinions; of this I am absolutely convinced. The only question in my mind is whether it should be municipal or voluntary. Opinions differ very much on this point, and the matter is one which the local authority, after full consideration of the circumstances of their district, must decide for themselves. Tuberculosis causes tremendous ravages, and its extermination would mean an enormous reduction in poor relief, so that any money spent in this direction is undoubtedly a first-class investment. If the dispensary is run by voluntary subscription it must be in close touch with the sanitary authority if it is to be a success. This is made one of the primary conditions of a grant from the Central Fund for providing voluntary tuberculosis dispensaries in London; for if the dispensary and the sanitary authority do not work together it means a great deal of overlapping and waste of energy. If the sanitary authority do not see their way to be responsible for the dispensary themselves, a middle course would be to grant the voluntary one a subsidy, as has been recently done in Edinburgh. In some respects a voluntary dispensary could work more cheaply than a municipal one; for instance, they could save the wages of a clerk or clerks by getting voluntary helpers to keep the records and do the secretarial work. There is a lot of such work, for which I have made an allowance of £110, but lam not quite sure this is sufficient. There is a great deal of recording to be done, and if this is to be done properly there must be sufficient clerical staff. The dispensary medical officer would advise disinfection and request the sanitary authority to carry it out. In Bermondsey, too, the sanitary authority would carry out the examination of suspected sputum for tubercle bacilli, as they have done for many years. Against the saving effected by voluntary workers mentioned above, it is quite possible that a municipal authority could effect a saving of half the salaries of the medical officer and nurse by appointing them as assisting medical officer of health and health visitor respectively. The cost of the first fifteen months' working of the Paddington Dispensary was £1,033 18s. 5d., but this includes an item of £228 16s. 4d. for altering and fitting up premises. In the case of Bermondsey this would be saved, since there is an excellent dispensary ready fitted up in 62, Riley Street, which can be had for a rent of £60 per annum, including rates and taxes. It is part of a building belonging to the Oxford Medical Mission, and is for hire, as they are giving up the medical branch of the work. In June the Central Fund for the Promotion of the Formation of Tuberculosis Dispensaries assisted in starting one in Bermondsey, on the lines laid down by Dr. R. W. Phillip in Edinburgh, which since has done excellent work. The full report made to the Committee on October 10th gives a very good idea of the work. Among the many agents employed in the campaign against tuberculosis an important place must be given to the " Tuberculosis Dispensary." As pointed out in previous reports to the Council, some provision has been made for the treatment of early cases in sanatoria and advanced cases in infirmaries, &c., but for the large bulk of consumptives of the poorer classes between these extremes no provision has yet been made on a large scale. To remedy this omission is the aim of the tuberculosis dispensary. The first dispensary was founded in Edinburgh in 1887 by Dr. R. W. Phillip, and the system there elaborated is known as the " Edinburgh system." It has has been very successful, for during the ten years 1897 to 1906 the death rate in that city fell from 1.9 per 1,000 to 1.1 per 1,000, a fall of "42.1 per cent., as compared with a fall of only 17.65 per cent., or from 1.7 per 1,000 to 1.4 per 1,000 during the same years in London. In Edinburgh the dispensary is supported by voluntary contributions, is under voluntary management, and while at first it received no municipal support, quite recently the Corporation decided to grant an annual contribution to it. It forms, as it were, a pivot round which the other activities are ranged, and the whole organisation in that city therefore consists of the following: — 1. Compulsory notification of phthisis. 2. Tuberculosis dispensary. 3. Isolation hospital for advanced cases. 4. Sanatorium for early cases with 100 free beds, supported by voluntary contributions. 5. A working farm colony for after care of sanatorium cases. From this it will be seen that the organisation of the anti-tuberculosis campaign in Edinburgh is very complete. Within the last two or three years a campaign on similar lines to those which have proved so successful in Edinburgh has been inaugurated in London. A central fund has been started, supported by voluntary contributions, the object of which is to provide a portion of the funds required to found and support tuberculosis dispensaries in the poorer London Boroughs. Kensington and Paddington have got a joint dispensary which has been working now about two years, and recently St. Marylebone, Stepney, and Bermondsey have followed suit, while Woolwich, Battersea, and Fulham are about to start. In Bermondsey a provisional committee of representative persons interested in the fight against consumption was formed in the spring of the present year, and with the help of a contribution of £350 from the Central Fund, and a further £150 from a local appeal, suitable premises were acquired at No. 62, Riley Street and a dispensary was started on June 15th. The following short description of the methods, &c., was circulated along with the first appeal for funds:— " The dispensary will be maintained by voluntary support, will be absolutely non-sectarian and free from all bias. It will co-operate with the Sanitary Authority, philanthropic agencies, and Guy's Hospital, who would welcome its establishment, as they are only able to afford temporary relief to the chronic cases who come to their out-patients' department. It will co-operate with all local medical practitioners, and will refuse to attend any case already in the care of a doctor. At present the majority of cases of consumption have not consulted a doctor, and therefore have not been discovered in time for treatment. The following is the programme of such a dispensary : — (1) The reception and examination of patients at the dispensary, the keeping a record of every case, with an account of the patient's illness, history, surroundings, and present condition, the record being added to on each subsequent visit. (2) The bacteriological examination of expectoration and other discharges. (3) The instruction of patients how to treat themselves and how to prevent or minimise the risk of infection to others. (4) The dispensing of necessary medicines. (Combined with specific treatment in suitable cases.) (5) The visitation of patients at their own homes by (1) a qualified medical man, and (2) a specially trained nurse, for the double purpose of treatment and of investigation into the state of the dwelling, and the general conditions of life and risk of infection to others and examination of other members of the family. In addition to the provision of treatment and instruction, the dispensary acts as a centre round which the whole voluntary organisation for the prevention and cure of consumption is grouped. Owing to their intimate knowledge of the patient's home conditions, family history and powers of resistance, added to the clinical knowledge obtained at the dispensary, the physicians are able to select the most suitable cases for treatment in institutions—the early cases for sanatoria and the late cases for homes for incurables. They can also watch carefully over patients after their discharge. By the dispensary system it is also possible, in many cases, to provide adequate home treatment for patients who would otherwise have to be sent away if they are to be treated at all." The premises at present are on a modest scale, and consist of a waiting room, dressing room, a dispensing room, and a room for the examination of patients. The staff consists of a medical officer, a nurse and porter. The patients attend at the dispensary on certain days, those for women and children being different from the men's. Patients' homes are visited by the doctor and nurse, who endeavour to persuade the other members of the infected family to allow themselves to be medically examined. The report submitted to the executive committee at their last meeting by the medical officer shows that between June 15th and September 30th there were 226 new patients, 413 re-visits of patients to the dispensary, and 8 cases confined to bed and visited regularly. The nurse paid 592 visits to homes and the doctor 308. Of the 226 new patients 91 had consumption, 52 were doubtful, and 83 other diseases. There were 106 contacts examined, and of these 10 (which were mostly children) showed definite signs of phthisis, 23 were doubtful, and 73 seemed in good health. I consider this a very good record of work done for a beginning, and the last item specially shows the importance of the examination of contacts, for here are 10 cases discovered early which would otherwise have entirely escaped till the disease had progressed. A notable feature among the patients is the number of advanced cases with cavities in the lungs. This is also Paddington's experience, but as with them it is expected as the work progresses these will be replaced entirely by early cases. I trust that some more public-spirited, men with means, when they know of the good work being done by the dispensary will come forward with substantial help, for it cannot be carried on without money. About £560 has already been subscribed, including the £350 from the Central Fund, but we must get at least another £140 before the end of the year. Portable Shelters. During the year the Council provided three portable shelters to enable patients to carry out the open-air treatment in their back yards. They are constructed of light wood, varnished, and consist of a bottom, roof, two ends, and a back. The front is completely open. They are 8 feet long, 4 feet wide, and the height varies from 9 feet in front to 6 feet at the back, the roof sloping towards the latter. They have been used by patients who have returned from the sanatorium, for it is only these who have the courage and knowledge to undertake the task of sleeping in the open-air in all weathers. As these are much appreciated the Council have decided to have three more made. Cerebro-spinal Meningitis. Two cases of the above disease were notified. They were sporadic in nature, and I have very great doubts as to whether they are the same disease which was so prevalent in Belfast a year or two back, and has occurred in frequent epidemics in America. The organism found is certainly similar, but I have got some evidence that it is not identical, and that the disease here notified comes under what was formerly diagnosed as post-basic meningitis. Anthrax. The following is a list of the cases of anthrax in connection with the Borough notified during 1911:— Date Notified 1911. Name and Address of Patient. Occupation. Part affected. Source of Infection. Result of Illness. H. L., Beaconsfield Road, Edmonton Flock sorter Foreign hides Sept. 8th Left arm Recovered Neck Sept. 9th D. P., Longley Street Leather dresser Doubtful Recovered Oct. 22nd A. A., Barnham Street Buildings General labourer Breast Foreign hides Recovered Foreign hides Face Nov. 14th J. B., Liverpool Road, N. General labourer Recovered Consultations. I was called in by medical practitioners to assist in the diagnosis of doubtful cases of infectious disease in 7 cases. 8 patients were also examined at the request of school teachers, parents, &c. I examined at the Town Hall 40 phthisis patients, and 1 person who met with an accident. I also examined 8 members of the Council's staff. Plague. On Monday, June 19th, a telegram was received from a medical inspector of the Local Government Board, requesting the Mayor, the Chairman of the Public Health Committee, the Town Clerk, Borough Surveyor and Medical Officer of Health to meet him at the Town Hall that afternoon. As the Mayor and Chairman of the Public Health Committee was otherwise engaged, the inspector was met by the officials mentioned. On arrival, he informed us that plague-infected rats had been discovered at a wharf in Wapping, and that as this is the furthest point up the river these infected rats had yet been found, the Board considered it necessary that active measures should at once be taken by London riparian authorities to ascertain whether plague-infected rats existed in their districts and undertake their destruction. The importance of this investigation cannot be overestimated by a sanitary authority, since it has been shown in districts invaded by plague that the human cases have almost invariably been preceded by cases of plague among rats. The commonest form of plague is the bubonic, and this is always spread by means of rats which have become infected by the disease. Rats, however, do not give plague directly, but only by means of the bites of fleas, by which they are always infested. The rat flea differs from the human flea, and will not attack men unless they are compelled to do so owing to the death of their natural host. It is therefore very dangerous to handle the bodies of rats which have recently died of plague. The preventive measures recommended by the Inspector were as follow:— An immediate systematic visitation and enquiry at all the riverside premises in the Borough by the Sanitary Inspectors; such enquiry to embrace observations as to the increase or decrease in the number of rats infesting the premises, whether there has been any unusual mortality, methods (if any) employed to destroy rats, methods of disposal of refuse likely to encourage rats, such as food, &c., and at the same time requesting the occupiers to inform us if any dead rats are found so that one can have an opportunity of having the cause of death investigated. Similar recommendations were made to the Borough Surveyor, as a consequence of which an enquiry letter was given to the scavengers, sewermen, dust carriers, and others employed in his department to take particular notice of business premises, private houses, sewers. &c., that may come under their observation, and report to their foremen as to the presence of rats. Enquiry as to the riverside premises was made on June 20th and 21st; the number of premises visited being 163. Of these 99 imported food (including grain) and 64 did not import either food or grain. Of the total, some method of keeping down rats was employed on 117 wharves, 28 using poison, 55 dogs and cats, 40 traps, and 4 used other methods. In only 1 wharf had dead rats been found which could not be accounted for, and we are in special communication with the occupiers. Two specimens of young rats were recently killed at wharves in Shad Thames and Rotherhithe Street, which were sent to the Medical Officer of the Local Government Board, who reported them free from plague. Special precautions were recommended in collecting and sending rats for examination so as to prevent fleas escaping from the dead bodies, for which purpose it has been necessary to order suitable tongs for lifting them and special boxes for transport. Special attention is also being paid to complaints of rats in private and other premises in the Borough. In the event of any plague-infected rats being found it will be necessary for the Council to take into consideration the various methods available for the extermination of all rats on a large scale. Between the above date and the end of August traps were set by the Surveyors' Department in all the principal sewers, several were set by the Public Health Department and private owners along the wharves, and wherever we heard that rats were prevalent. In this way a very complete general examination of the Borough was made, and 128 rats were obtained, of which 123 were sent to the Local Government Board laboratory for bacteriological examination, all of which proved negative as regards The remaining five were cremated as they were mostly in too advanced, a state of decomposition for examination. CHILDREN EXCLUDED FROM SCHOOL ON ACCOUNT OF INFECTIOUS DISEASES. School. Total Exclusions. Scarlet Fever. Diphtheria. Enteric Fever. Erysipelas. Measles. German Measles. Whooping Cough. Chickenpox. Mumps. Smallpox. Ophthalmia Eczema. Scabies. Ringworm. Patients. "Contacts." Patients. "Contacts." Patients. "Contacts." Patients. "Contacts." Patients. "Contacts." Patients. "Contacts." Patients. 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Bacon ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 62 3 5 8 11 1 1 5 1 ... ... 5 5 1 13 ... ... ... 3 Boutcher ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 1 Brents Court 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 30 4 3 2 1 1 Chaucer 8 1 4 ... ... 2 ... 3 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... Christ Church 59 9 8 8 5 ... 3 8 2 1 2 1 ... ... 1 ... 10 ... ... 1 ... ... ... ... ... ... ... ... ... 9 2 2 3 ... Clarence Street 21 ... ... 1 1 1 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 1 ... Charles Street ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Coburg Road ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 4 6 Credon Road 61 7 1 1 27 11 ... ... ... 1 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 3 ... ... ... ... ... ... ... ... Deaf and Dumb School, Old Kent Road ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 4 ... Dockhead 197 6 16 3 12 1 ... 7 4 ... 7 11 13 4 ... ... 73 8 ... 14 ... 14 ... ... ... ... ... ... 5 2 1 1 East Lane 96 4 27 2 1 ... ... 18 3 ... ... 23 3 6 ... ... ... ... ... ... ... ... ... ... ... Edward Street 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... English Martyrs ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9 Fair Street 118 5 10 2 ... 7 6 2 34 11 16 5 1 5 ... ... ... 5 ... ... ... ... ... ... ... ... ... 1 ... 30 2 6 2 7 1 ... 1 4 ... 2 4 Farncombe Street ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Galley wall Road 75 2 6 9 8 ... 9 9 ... 2 7 7 2 ... ... ... 14 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... Galley wall Road (Special) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 13 3 2 6 ... Grange Walk 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 2 2 ... ... ... ... Green School ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 13 7 ... ... ... 3 ... Gomm 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... Hatcham ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... ... 3 ... Holy Trinity ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Ilderton 61 8 3 9 14 4 2 7 265 7 21 4 10 47 40 16 9 3 ... ... ... Keetons Road ... ... ... ... ... ... ... ... ... 61 10 35 5 11 ... ... ... ... ... ... ... ... ... ... ... ... Kirby Street ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 6 1 16 1 2 2 ... 2 ... 4 3 4 ... ... ... ... Laxon Street 52 8 ... ... ... ... ... ... 2 ... ... 3 1 1 16 ... 41 3 5 ... 2 3 2 ... ... ... ... Magdalen Street 1 2 ... ... ... ... ... ... ... ... ... ... 3 2 3 3 ... ... ... ... ... Mawbey Road 11 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 1 1 14 5 1 23 6 7 2 3 ... ... ... 1 ... Melior Street 96 4 15 7 ... ... ... ... ... ... ... ... ... 15 3 1 192 23 4 9 ... 7 4 5 27 7 19 28 6 17 ... 6 ... Midway Place 11 ... ... ... ... ... ... ... ... 2 2 Mina Road ... 1 1 ... ... ... ... ... ... ... 7 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 83 6 4 42 14 1 1 1 1 3 1 ... ... Monnow Road 3 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 12 122 1 9 13 3 27 10 5 2 10 ... ... ... ... Neckinger 2 16 12 ... ... ... ... ... ... ... ... ... ... ... 30 ... 2 2 10 10 1 8 6 13 1 17 6 2 11 Pages Walk 159 6 23 11 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... Pitman's 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 23 5 ... 2 ... Redriff 95 6 6 5 ... ... 42 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 3 12 22 1 3 2 2 6 ... ... Riley Street 63 10 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 12 9 4 1 1 1 ... 2 Rolls Road 45 3 3 ... 1 ... ... 2 5 ... ... ... ... ... ... ... ... ... ... ... 4 6 2 1 3 2 3 1 ... Rotherhithe New Road 65 3 6 ... ... 12 4 ... ... ... ... ... 6 12 ... ... ... ... ... ... ... ... ... ... ... Ruskin 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 1 31 1 1 ... 1 3 ... 17 1 ... ... ... ... 61 St. Barnabas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... St. James' 29 2 5 1 8 7 ... 1 ... ... ... ... ... 5 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 St. Joseph's 38 3 17 1 5 3 ... 1 2 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 St. Mary's 11 1 4 1 1 ... ... ... ... ... ... ... ... ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... St. Olave's (Boys) 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... ... ... ... ... ... ... ... St. Olave's (Girls) 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 2 1 63 1 4 6 3 2 25 1 2 9 St. Paul's ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... St. Winifred's 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Silwood Street 5 ... ... ... 2 ... 1 3 ... ... ... ... ... ... ... ... ... 14 ... ... ... ... ... ... ... ... ... ... 1 70 ... 14 7 6 1 22 9 6 1 ... 3 Snowsfields ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... South London Jewish School 9 ... 2 7 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 16 45 5 6 3 1 1 4 9 Southwark Park 151 2 14 2 1 ... ... 33 7 1 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... Southwark Secondary, Yalding Road 2 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... Surrey Square 4 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Townsend Street 7 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... Victory Place 88 ... ... ... ... ... ... ... ... ... ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... 21 2 6 7 2 3... 2 1 Webb Street 88 3 8 2 ... 6 11 ... 1 2 ... ... ... 11 ... ... ... ... ... ... ... 1 ... 1 ... 2 Weston Street 5 2 2 5 1 2 1 ... 1 ... 28 ... ... ... ... ... 4 ... ... ... ... ... ... ... 177 ... 285 1 1 ... 174 Totals 3,211 131 360 325 2 441 52 17 63 103 13 ... 249 61 7 ... 278 25 1 3 317 125 20 SANITARY ADMINISTRATION. Offensive Matter. One summons was taken out under the London County Council's by-laws for carriage of offensive matter through streets in unsuitable receptacles and during prohibited hours, particulars of which are given below:— Date of Offence. Name and Address. Offence. Result of Prosecution. 1911. July 12th. William Beckhouse, Carriage of offensive Fine, 5s.; Costs, 12s. 42, Westlake Eoad. matter during prohibited hours. Offensive Trades. The offensive trades on the Register are as follow:— Tripe boiler 1 4 Glue and size makers Fellmongers 3 Fat melters 4 1 Manure manufacturer 122 inspections were made, against 115 in 1910. 1 notice was 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 10 1 7 - Apple Waste 1 4 3 8 Apricot Pulp 2 6 2 - Bananas 2 28 - 1 Beef 1 3 2½ - „ Pressed 7½ - - - „ Potted 6 3 - 3 Blackberries 3 3 8 - Black Currants 1 7 - - Bread 1 - 2 24 Broccoli 2 24 - - 1 Butter - - - Cauliflower 2 - - - 2 3 7 Celery - Cheese 7 - - - Crabs 24 - - - 1 7 Eels - - 4 Eggs - - - Fruit 19 - - - Gooseberries, Bottled 3 - - - Grapes 14 - - 1 Greengages 4 1 - 14 Haddock 1 14 - 3 Herrings 3 7 - - Kippers 2 - - - Lard 2 - - - Lemons 3 24 1 - Lemon Waste 1 - 1 7 Mackerel 2 7 - - Meat 1 2 8 - Melons 1 8 - - Mushrooms, Bottled - 2 - 3 Mussels 3 1 21 - Onions 2 2 22 - Oranges 8 2 19 - Orange Waste 3 16 4 - Peas 2 21 - - Pears 14 - - - 29½ Pigs - - - Pigs' Heads, Salted 1 19 - - Pigs' Kidneys 1 4 - - Plaice 1 - - - 5 1 4 Plums - 8 3 Plum Waste - - Pomegranates 24 - 3 - Potatoes 1 5 3 14 Raspberry Pulp 1 2 - - Rhubarb 20 - - - Salmon and Shrimp Paste 2 - - - 1 15 Shrimps - - 21 Tons. cwts. lbs. qrs. Shrimp Paste 4 - - - Skate 2 - - - Strawberries 1 10 1 20 Tangerines 4 - - - Tinned Apricots 8 11½ - - „ Beef 4 - - - „ Fish 13 - - - „ Fruit 1 1 20 - „ Herrings 4 - - - „ Lobster 27 - - - 3 „ Meat - - - „ Meat Trimmings 2 16 - - „ Peas - 2 - - „ Salmon 5 2 9 - „ Sliced Pines 2 1 18 - „ Soup 3 - - - „ Tomato 7½ - - - „ Quince 10 - - - Tomatoes 3 3 16 - Tomato Pulp 13 1 12 - Turkeys - 16 - - Various Tinned Goods 3 10 3 20¾ Vegetables 1 20 - - 27 14 0 13½ Register of Placcs 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 76 Ice cream 139 Butchers 75 Milk-sellers 294 Fishmongers, friers and curers Restaurants and eating houses 141 81 15 Food stores 363 Coffee stalls 99 Food wharves and depots 1,428 Food factories 40 Fruiterers and greengrocers 105 Unsound Food Seizures. The following prosecutions took place during the year under report:— February 8th Exposing for sale unsound turkeys Fine £5, costs 10s. „ 15th „ „ „ Fine £10. May 17th „ „ „ oranges Bound over in the sum of £5 to come up for judgment if called upon within 12 months. November 1st „ „ „ lemons, Fine £1, or 14 days' imprisonment, onions, tomatoes and melons. Food Examined during the year 1911. Inspectors. Meat. Fish. Fruit. Vegetables. Tinned Goods. Dairy Produce. Cereals. Various. No. of Inspections. Tons. No. of Inspections. Tons. No. of Inspections. No. of Inspections. Tons. Tons. No. of Inspections. Tons. No. of Inspections. Tons. No. of Inspections. Tons. No. of Inspections. Tons. Mr. Ashdown l7 127 9128 925 7746½ 378 9¾ 616 ¼ 6970½ 313 25137¼ 101 135 4626 27 19 468 „ Scott 839 513½ 518 248½ 591 1928¼ 523¼ 88 37¾ 14 5 - 3 1½ - 934½ 575 149 676 2244 694 886 655 45½ 23 11 51 2769½ 14 „ Hoskins 1038 151½ „ Wood 1 3 ½ - 2 ¼ - ¼ - - - - - - - - „ Merryman - - 1 ¼ - - - - - - - - - - - - - 17 - „ Toogood - 5 - - - - - - - - - - - „ Freeman 1 ¼ 1 ¼ - - - - - - - - - - - - - ¼ - - - - „ Pitts - - - - - - - - - - 841 1133 418½ 1291 78 Totals 2257 1580 29309½ 10537½ 172 3694½ 844 699½ 36 7899½ 4642 Note. —The inspections refer to the number of separate lots, and the weights are only approximate. Milk Premises. There were 286 milk premises on the Register at the end of 1910. Thirty-five were added and 27 removed during 1911, making a total of 294 on the Register at the end of the year under report. 1,118 inspections were made and 10 notices served. Cowsheds. There are 3 cowsheds in the Borough. These received regular visits, the total number of inspections for 1911 being 20. One notice was served. Unsound Food and Foreign Meat Regulations. The following articles of food were dealt with under the above regulations during the period under report: — Article. Quantity Unsound. Disposed of for other Purposes than Human Food. Destroyed. Removed for Sorting under S.A. Quantity. Weight. Quantity. Weight. Quantity. Weight. I Tons. I __ Tons. cwts. qrs. lbs. cwts. Tons. qrs. cwts. lbs. qrs. lbs. Turkeys - 13 - 1 2 - - - - - - - - - - 6 4 cases - - - Poultry - - - - - - - - - - - - - - - 23 - - - Beef (Frozen) - - - - - - 1 Boneless Meat „ ½ cask - 4 - - - - - - - - - - - 36 tongues 1 23 - - - - Tongues „ - - - - - - - - - 6 tongues - - 18 - - Ox Tongues „ - - - - - - - - 21 cases - 1 1 - Kidneys „ - - - - - - - - - - 30 15 Pigs' Carcases „ 9 3 9 - 15 3 12 - - 550 - - - - - 2 cases 3 11 - Bowels „ - - - - - - - - - - - 14 Lampreys „ 1 tub - - - - - - - - - - - - 4 10 2 - - 181 cases Poultry (Frozen) - - - - - - - - - - 36 cases 3 12 Game „ - - - - - - - - - - - 53 - - Pork (Salted) 1 side - - - - - - - - - - - - - Pigs' Tongues „ - - - - - - - - - - - - - 4 3 7 - 2 18 1 Sausage Skins „ - - - - - - - 1 1 - Tongues „ - ½ cask and 9 tongues - 17 - - - - - - - - - - - Ox Tongues „ - 5 tongues - - 10½ - - - - - - - 2 - Pigs' Heads „ - - - 14 - - - - - - - - - 1 - Bacon „ 3 sides and 1 hind quarter - 3 26 - - - - - - - - - 5 6 Bacon 1 6 1 55 bales and 12 sides 1 48 sides 7 3 4 24 sides and 1 hind quarter 4½ 2 - - - Ham - - - - - 5 bales 1 ham and 1 piece - - - - - - - - 4 - Salmon (Pickled) - - - 1 barrel - - - - - - - - 7 30 cases and 97 tins 2 1 25 - Meat (Tinned) - - - - - - - - - 26 17 cases and 228 tins 1 4 Beef „ - - - - - - - - - - - 13 - - Mutton „ - 5 tins - - - - - - - - - - 1 - - Beef Loaf „ - 2 tins - - - - - - - - - - 5 tins 11 - Beef, Boast „ - - - - - - - - - - - - 1 10 12 8 Beef, Boiled „ - 46 cases and 10 tins 12 cases and 6 tins - 4 - - - - - - Minced Steak „ 8 tins - 16 - - - - - - - - - - - - - 2 Sheep's Tongues „ 2 tins - - - - - - - - - - - - - Ox Tongues „ - 6 1 26 - - - - - - - - - - Tongue „ 81 tins - 5 7¼ - - - - - - - - - - - Tripe „ 12 tins - 18 - - - - - - - - - - - - Sausage and Ham „ 1 box - 2 - - - - - - - - - - - - - - 11 tins - 22 - Stewed Kidney (Tinned) I - - - - - - - - - Ham and Chicken „ - - 2 tins 1 - - - - - - - - - - - - - 2 tins - Ham Paste „ 2 - - - - - - - - - - - 10 tins - - 16½ Soup „ - - - - - - - - - Ox Tail Soup „ - 28 tins - 28 - - - - - - - - - - - Fish „ - 30 cases, 12 tins 3 8 12 - - - - - - - - - - Salmon „ - 21 cases, 186 tins 3 2 25 - - - - - - - - - - Sardines „ - - - 34 tins - - 2 4 - - - - - - - - Crab „ - 34 tins - 1 5½ - - - - - - - - - Fruit „ - 84 cases, 1,215 tins 9 10 2 12 - - - - - - - - - Fruit Pulp „ - - 4 cases, 839 tins 5 3 3 - - - - - - - - - Apples „ - - - 1 1 - - - - - - - - - - Apricots „ - - 47 cases 2 6 1 27 - - - - - - - - Peaches „ - 9 cases, 216 tins 1 4 3 15 - - - - - - - - - Pears „ - 117 cases, 350 tins 7 10 1 26 - - - - - - - - - Pineapple „ - 29 cases 2 14 27 - 3 - - - - - - - - Tomatoes „ - 310 cases, 734 tins 27 16 2 24 - - - - - - - - - Tomato Pulp „ - 588 tins 2 13 1 19 - - - - - - - - - Vegetables „ - - - 7 2 - - - - - - - - - - Peas „ - 264 tins 1 3 17 - - - - - - - - - - Green Peas „ - - 264 tins - 2 1 12 - - - - - - - - Baked Beans „ - - 4 tins - 4 - - - - - - - - - - Asparagus „ - 8 tins - 16 - - - - - - - - - - - Pickles (Bottled) - 2 bottles - 1 - - - - - - - - - - - Catsup „ - 1 bottle - - ½ - - - - - - - - - - Tomato Catsup „ - 2 bottles - 1 - - - - - - - - - - - Apples - - 40 barrels, 17 boxes, and 55 packages 4 7 14 - - - - - - - - - Bananas - 302 crates 11 24 - - 16 1 - - - - - - - Pears - 23 cases, 10 boxes, and 33 trays 12 8 30 - - - - - - - - - - Apples and Pears - 10 boxes - - - - 5 - - - - - - - - Plums - - 157 packages 1 13 2 16 - - - - - - - - Melons - 157 cases 7 8 1 10 - - - - - - - - - Oranges - - 6 13 24 31 cases 1 18 3 - - - - - - - 764 crates, 59 boxes, and 76 eases 19 18 2 11 208 crates 5 3 16 Tomatoes 6 - - - - Endives - 104 baskets 1 6 - - - - - - - - - - - Onions - 155 cases 7 15 - - - - - - - - - - - Potatoes 383 bags 19 3 126 bags, 9 cases 8 15 476 bags 27 2 - - - - - - Cauliflower in Brine - 3 casks - 13 2 - - - - - - - - - - Cucumbers in Briue - - 1 cask - - - - 5 2 - - - - - - Flour 7 11 2 18 - - - 70 5 2 - - - - Maize 102 - - - 560 - - - - - - - - - - Oats 66 11 - - - - - - - - - - - - - Wheat 116 4 3 16 - - 8 1 22 18 16 - - - - Eice 127 19 2 27 - - - - - - - - - - - Cheese - 20 cases - 10 1 12 - - - - - - - - - Eggs - 237 cases, and 500 eggs 21 13 2 1 322½ cases 32 5 - - - - - - Sugar - - - 186 - 1,319 bags 18 - - - - - - - The two Wharves Inspectors have been very busy under the Unsound Food Regulations during the year. In Mr. Hoskins' district, which is the eastern one, practically the only food product dealt with to any extent is grain, and this is very little trouble unless it happens to bo damaged. During the year very large quantities of damaged grain came which had to be stopped pending drying and sorting. After these processes it is not uncommon to find that the whole bulk or the major portion is unfit for human food. This then is sold in very small quantities for the feeding of cattle and fowl, and entails a tremendous lot of clerical w r ork. These small consignments, which range in bulk from one quarter to several tons, have to be followed to their destination in all parts of England and given in charge to other Sanitary Authorities so as to make sure they are not used for human food. The destruction of a large number of pigs' carcases found unfit for human food has also given cause for considerable anxiety. The only thing they are fit for is boiling down for tallow, but, unfortunately, some merchants who deal in this kind of article have a doubtful reputation and we make a rule of not permitting any to go for this purpose until full inquiries are instituted and they are stamped and numbered. They are traced to their destination and given in charge of the Medical Officer of Health of the district in which the consignee has his works. This naturally entails a good deal of labour. The regulations on the whole have been a great benefit to the public, and since they have come into force we have come to realise that large quantities of unsound food must formerly have found their way into the markets and been disposed of in some way or other not beneficial to the consumers. Powers are still wanted to compel owners of tinned goods, not only in wharves but inland, to deliver up to the Sanitary Authority for their districts tinned articles which are unsound. Some of the better class traders at present do this, but I am aware that very large quantities of unsound tins are still dealt with for human food. The following remarks by the Wharves Inspector of the west end of the Borough, Mr. Ashdown, made in a report to me on his year's work, will give a very good idea of the work required to be done in his district. "There seems on the whole to have been an increase in food imports compared with the two previous years, with the exception of meats, pigs' carcases, quarters of beef, &c. There has been a considerable increase in the importation of Hussian bacon, but the smaller number of examinations does not necessarily mean a shortage of imports, especially in meat products, which are often temporarily stored prior to exportation, in which case they are not examined. A large percentage of the pigs' carcases arriving with the heads on were found to show tuberculosis in the glands of the neck, and were consequently seized. It may be pointed out, however, that had such carcases been divided and sent here as bacon, wholly or partly cured, they would have been passed without question, since they -would only come under the regulations if actually diseased. The amount of possible danger to health is better realised if one considers that about 86,000 bales, averaging 4¼ sides per bale, were received here during 1911. When these consignments of bacon first arrived it was necessary to stop a considerable number of one particular brand, but owing to the stringent application of the regulations, interviews with the agents, &c., some of whom attended and saw the nature of the examination and communicated with the exporters on the other side, the result was that the quality greatly improved. Pigs' heads, officially stamped, and other offal from the same ports were frequently found diseased, and condemned, but this trade has now almost stopped. Ox tongues caused some trouble, since some were sent with glands, and others ' short cut,' so as to exclude the glands, the result being that many of the former were condemned, whereas the latter escaped. Unfortunately ox tongues cannot be brought under any 'class' of the Foreign Meat Regulations. I think some alteration should be made so as to include them. Queensland beef has been arriving in better condition since the examination on the other side for the parasite which is found in the flanks, briskets, and hindquarters sent over here has been evidently a more rigid one. A large quantity of this beef was cold stored in the district and exported, only that for home consumption being examined. Butter imported has been above the average in quantity, but it is only occasionally dealt with under the regulations A few consignments were found to be unfit for food, as they had gone rancid. Eggs.—Special attention has been paid to these, and an endeavour is being made to get egg merchants to deliver up the class known as 'spots.' A small spot occurring in an egg is generally the first sign of putrefaction, but some people do not consider it unfit for food in the early stage. Few merchants will acknowledge that these are sold for human food, but there is, no doubt, a considerable trade done with these eggs among the Jews of the East End. An endeavour has been made, with more or less success, to have them delivered up to the sanitary authority for destruction. A little more control oyer these imports would seem desirable, since no egg can be considered good for food once putrefaction has set in. Soft Fruit and Vegetables.—These arrived in much better condition during the year than formerly, and the regulations have led to more careful packing, with the result that the fruit arrives here in much better condition. Exportation of Foods.—Considerable quantities of frozen beef were re-exported to France, Switzerland, and Italy after being stored here a longer or shorter time. Large quantities of butter were re-exported to France. Trade Competition.—There is a good deal of competition between the importers, wharfingers, and others in London and the provinces, and a very small advantage, such as apparently a less stringent examination at the port of entry, will often result in the diversion of considerable quantities of food from a port where the examination is more strict. It is therefore very desirable that there should be uniformity of examination at all the ports in the United Kingdom. The Local Government Board have endeavoured to obtain this object, with the result that there has been a great improvement, but judging from the reports which one hears further improvement is needed." Food Inspectors. Particulars of Work, 1911. 1 2 4 11 13 14 15 16 17 4 Visits. 3 5 6 7 8 9 10 12 Food Wharves and Depots. Destruction of Food. Nuisances Reported. Butchers. Cowsheds. Fishmongers, Friers and Curers. Food Stores. Fruiterers and Greengrocers. Ice Cream. Milk Sellers. Restaurants and Eating Houses. Slaughterhouses. Food Factories. Bakehouses. Markets. Number of Samples Taken. Various. Jam. Butter and Margarine. Other. - 345 - Re-visits 2 - - 8 - 5 2364 12 - 16 - 128 17 6 - Mr. Ashdown 94 - New occupiers or Premises - - - - - - - - - - - - - - - - - - 11 482 Re-visits 248 43 104 315 134 22 74 45 325 46 19 42 602 7 454 142 23 Mr. Scott 5 - New occupiers or Premises - 2 - 3 17 - 2 - 13 2 - - - - - 1 - 9 105 623 141 126 Re-visits 100 25 80 95 124 192 386 599 138 - 140 54 218 Mr. Hoskins 613 8 New occupiers or Premises - 10 12 22 - - - 6 1 - 24 11 - - - 44 - - 32 Re-visits 350 123 199 244 2578 227 1081 254 276 1221 447 20 1422 171 727 280 23 228 Totals - New occupiers or i Premises - 13 1 - 7 - 17 24 37 - 61 - 13 - - - - 10 Food and Drugs. In Tables XIII. and XIV of Appendix will be found a list of the samples taken in 1911, and the action taken; 1,214 samples were taken, compared with 1,172 in 1910 and 1,219 in 1909. Of these 11.4 per cent, were found adulterated, compared with 9.6 per cent, in the previous year and 7.9 per cent, in 1909. The most notable feature of the analysis of samples of this and recent years is the number of adulterations of milk which show the addition of small percentages of water, ranging from 1.5 to 4.0 per cent. This is due to the present standard which requires 3 per cent, of fat and 8.5 per cent, of non-fatty solids. Magistrates and others are liable to forget that this so-called " standard " represents the lowest limit below which milk must not go. The vast majority of natural milks show considerably higher figures, and the result is that the samples are watered down so as to be as near as possible this "standard" and the small percentages show that they occasionally overstep the mark. Sixteen per cent, is the amount of water allowed in butter, and it is astonishing how closely manufacturers keep to this amount, but occasionally they also overstep the mark, but even this small percentage beyond the legal limit is very beneficial to the trader if undetected, since he can make a very large profit out of 1 per cent. In the accompanying table will be seen the percentages of milk fat in the various samples of genuine milk. Year. Total Genuine Samples. Milk Fat. Under 3 per cent. 3 per cent, and under 3-5 per cent. 3.5 per cent, and under 4 per cent. 4 per cent, and over. No. of Samples. Percentage of total. Percentage of total. No. of Samples. No. of Samples. Percentage of total. No. of Samples. Percentage of total. 1903 371 32 8.6 135 70 18.9 134 36.1 36.4 1904 419 5 1.2 35.1 164 39.1 103 147 24.6 1905 505 9 1.7 216 42.8 168 33.3 112 22.2 1906 211 507 3 0.6 41.6 178 35.1 115 22.7 1907 24 3.9 232 37.6 249 617 40.3 112 18.1 575 12 1908 2.1 258 44.9 226 39.3 79 13.7 1909 10 722 1.4 332 46.0 271 37.5 109 15.1 676 0.7 294 1910 5 43.5 281 41.6 96 14.2 22 395 282 36.2 1911 778 2.8 50.8 79 10.2 Average 9 years. 13 246 42.0 217 97 17.7 2.5 574 37.6 Slaughterhouses. There is 1 slaughterhouse in the Borough. Twenty-three inspections were made. No notices were served. Ice Cream Premises. There were 144 premises where ice cream is manufactured on the Register at the end of 1910, 5 were removed during the year under report, making a total of 139. 195 inspections were made and 12 notices served. Hairdressers and Barbers. At the end of 1911 ten 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 1911, and in Table IX. the number of premises on the Registers to which special attention has been paid. The house-to-house inspections number 2,075. This is 3,612 below the total for the previous year, and is an average of 259 per Inspector, against 711 in 1910. 3,403 intimation notices were served, compared with 4,144, and 909 statutories, against 1,197 in the previous year. The following table shows the work done by the District Inspectors during the year:- 10 11 12 I I 1 2 3 4 5 6 7 8 9 Drains Tested. Re-inspections. Other Calls and Visits. Chimneys Watched. Underground Conveniences. Special Inspections. Complaints. Outworkers. - Bi-Annual Inspection. Factories and Workshops specially Inspected. Infectious Diseases. Offensive Trades. House to House. No. No. No. No. No. No. Ints. No. No. Ints. No. Ints. Ints. No. Ints. No. Ints. Ints. Ints. No. 94 233 2,873 11 2 Mr. Grice 53 287 142 137 18 7 1 - 5 335 379 204 286 294 1 1 217 326 56 58 12 73 8 16 108 2,545 577 265 43 2 7 „ Wood 325 231 120 311 54 12 116 255 193 90 159 165 32 6 2 - 13 213 260 12 160 2,872 24 27 „ Merryman „ Toogood 148 331 - - 36 61 82 3,239 7 343 138 258 76 489 264 396 61 - 29 32 687 117 33 284 11 36 297 2,977 385 8 5 „ Freeman 258 208 48 316 190 340 52 12 - 127 79 - 111 191 20 14 2 - - 31 - 449 2 249 1,615 342 „ Bartlett „ Townsend 268 41 - 108 289 42 68 134 1,080 146 2 94 49 82 27 17 64 10 1 - - 56 1 9 181 64 3 49 70 1,096 17 10 „ Pitts 58 42 55 21 101 50 72 20 - - - 2 234 16 137 104 252 247 41 1 30 239 23 140 2,628 2 1 „ Cockburn 180 23 163 - - 220 2,978 36 1,417 122 1,114 1,401 20,925 Totals 2,075 409 1,219 2,187 308 117 1 1,732 101 1,299 2,053 The most noticeable difference between the figures of this table and those for 1910 is the small number of house-to-house inspections for 1911 compared with the former. This is due to an alteration in the methods of house-to-house inspection occasioned by the requirements of the Housing and Town Planning Act of 1909 and the regulations made under it. By this Act the Medical Officer of Health is required to submit from time to time lists of houses requiring early inspection with a view of finding out whether they should be dealt with under Section 15 or 17, and this was thought to be a good opportunity of keeping a very complete record of the condition of each house. Inspectors were therefore instructed, among other matters, to note the cubic capacity of the living and sleeping rooms, and this plan was adhered to during the year. It has, however, since been decided to omit the measurements in the future except where it is proposed to take action, since it adds greatly to the work and the result does not seem commensurate with the trouble involved. The figures of 1912, therefore, should revert more nearly to those of 1910, but will probably not quite come up to them, since, apart from the measurement of the rooms, the inspections now made are more thorough and the records kept more complete than formerly. Housing of the Working Classes Acts, 1890-1909. The Improvement Scheme under Part I. of the Act of 1890 for the acquisition, pulling down, and rebuilding, &c., of the areas known as Tabard Street, Grotto Place, and Crosby Row was carried a stage further during 1911. It will be remembered that "official representations" were made during 1910 on the above areas by Dr. Millson, Medical Officer of Health, Southwark, as regards the first two, and by myself on Crosby Row, the result of which was that the London County Council, who have the administration of this part in London, made inquiries, and having satisfied themselves that an improvement scheme was required, proceeded to make one. This is officially known as " The London (Tabard Street, Grotto Place, and Crosby Row) Improvement Scheme, 1910," and was approved formally by the Local Government Board in March, 1912, as a result of a public inquiry held in the Southwark Town Hall in April, 1912. Part of Tabard Street is already being pulled down, but the London County Council at the time of writing (June, 1912) have not actually acquired any of the property of Crosby Row. Housing and Town Planning, &c., Act, 1909. Considerable advantage was taken of the provisions of this Act for dealing with insanitary property. Closing orders under Section 17 were served during the year on the owners of fortythree houses, viz , 1.20, Bell Court; 1.9, Medley Place; 137, Bermondsey Street; and 59, 60, 61, 62, 63, 64, 65, 70, 71, 73, 74, 75 and 78, Snowsfields, and orders under Section 15 requiring certain work to be done to render the houses reasonably fit for human habitation were served on the owners of six houses, viz., 2, 3 and 4, Vine Street, and 1, 2 and 3, Fort Passage. Appeals to the Local Government Board against the closing orders were made in the cases of Medley Place, Bell Court, and Snowsfields, but in only one of these, viz., Bell Court, was a Local Government Board inquiry held. In the cases of Medley Place, and 75 and 78, Snowsfields, the appeals were for various reasons withdrawn, while as regards Bell Court the Board upheld the Council's action. The remaining houses in Snowsfields are at present under consideration. Nos. 75 and 78, Snowsfields, and 187, Bermondsey Street, were rendered fit human habitation, and the closing orders were subsequently removed. The 24 houses in St. Mary's Place and St. Mary church Street, which had been closed in 1910, were in hand during 1911, but the orders were not determined till 1912. In the case of the six houses dealt with under Section 15, the requirements of the Council were promptly complied with. Demolition orders were served on the owners of 16 and 18, Fulford Street, and they were pulled down in the course of the year. Demolition orders were also served on the owners of Bell Court and Medley Place, but they are still standing, as the owners asked for an extension of time before pulling them down. It is difficult yet to express an opinion on the advantages and disadvantages of these sections of the Act, as they are still on their trial, but so for in Bermondsey they have proved useful. The procedure is very complicated and admits of great delays before the final result can be recorded. Bacteriological Laboratory. The total number of specimens examined in 1911 was 843, compared with 708 in 1910, and 596 in 1909. Results of Examination. Nature of Specimen. Total Examinations. Positive. Negative. 1910. 1911. 1911. 1910. 1910. 1911. 7 14 350 260 Diphtheria (specimens taken by Medical Officer of Health) 336 143 253 122 176 27 33 95 Ditto (taken by general practitioners) Diphtheria (total specimens taken) 34 526 382 47 57 2 2 348 479 Phthisis 239 291 46 193 234 Enteric 24 14 4 20 12 63 12 63 10 Various ... 843 108 735 Total specimens taken 708 84 624 Houses Let in Lodgings. In 1910 there were 227 "houses let in lodgings or occupied by members of more than one family" on the Register. Four were added during 1911, making a total of 231. These were visited quarterly in accordance with the instructions of the Public Health Committee. One hundred and seventy-nine notices were served, 10 of these being for overcrowding. The following is a list of registered houses let in lodgings:— 5, Aberdour Street 56, Arnolds Place 100 Abbey Street 11 „ 82, Abbey Street 10, Alice Street 36, Barnham Street 13 „ 86 „ 14 „ 95 „ 6, Bermondsey Square 7 „ 17 „ 98 „ D 27 26, Bermondsey Square 84, Bermondsey Street 115 „ 117 „ 131 „ 136 „ 50, Bermondsey Wall 52 „ 6, Bell Court 8 „ 9 „ 12 „ 15 „ 18 „ 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, Flim Street 7 „ 9 „ 18 „ 19 „ 21 „ 40 „ 41 „ 45 „ 24, Freda Street la, Flock ton 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 16 „ 18 „ 12, Gedling Street 14 „ 60, Gainsford Street 151, Grange Road 9, Grange Walk 76 „ 81 „ 87 „ 91 „ 5a, Green Walk 6, Hatteraick Street 1, Jane way Street 4 „ 10 „ 14 „ 16 „ 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 „ 20 „ 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 „ 9 „ 10 „ 13 „ 15 „ 20 „ 23 „ 28 „ 25, Princes Street 37 „ 11, Reed Street Lawrence House, Rephidim St. Edward House, „ 9, Riley Street 350, Rotherhithe Street 302 „ 556 „ 1, Suffolk Street 42 „ 8, Salisbury Street 24 „ 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 24, Tower Bridge Road 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 „ 190, 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 „ Section 48, Public Health (London) Act, 1891. No applications were received for certificates for water supply during the year under report. Disinfection. The following table shows the number of articles passed through the steam disinfector during the year under report:— Beds ... ... ... 671 Quilts ... ... ... 694 Blankets ... ... ... 679 Sheets ... ... ... 904 Bolsters ... ... ... 483 Books ... ... ... 133 Carpets ... ... ... 24 Miscellaneous ... ... 4,144 Cushions. .. ... ... 299 Verminous Clothing ... 4,370 Mattresses ... ... 464 Total ... ... 14,360 Overlays ... ... ... 253 Pillows ... ... ... 1,242 8,364 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 68 male adults, 5 female adults, 182 male and 209 female children used the Verminous Baths and had their clothing disinfected. The total number of articles disinfected for this purpose was 4,370. Smoke Nuisances. 220 chimneys were kept under observation and 36 notices served. House Refuse. The following table shows the amount of house and trade refuse disposed of during the year ended December, 1911:— HOUSE REFUSE. TRADE REFUSE. Tons cwt. qrs. Bermondsey Destructor 10,861½ loads. 18,936 1 1 Barged away 1,025½ „ 1,794 12 2 Total 11,887 „ 20,757 13 3 Tons cwt. qrs. 193 loads. 105 7 2 1,369 „ 2,395 15 0 1,562 „ 2,501 2 2 Overcrowding. The following cases of overcrowding were visited by the Medical Officer of Health during the year under report: — Man, wife, boys 5 and 2 years. Maze Pond Living and sleeping, 1,200 cubic feet. Back room, ground floor, 937 cubic feet. 263 The husband is a waterside labourer in the winter, and in the summer attends race meetings, with an average weekly wage of 20s. The wife also earns a little in the summer fruit picking. The light and ventilation were fair. Man, wife, boys 7 and 5 years, and girl 2 years. 375 English Grounds Sleeping, 1,050 cubic feet. Room, second floor. The husband is a waterside labourer, earning 30s. per week. The light and ventilation were bad, and the room fairly clean at time of visit. 404 Man, wife, boys 9, 6 and 5 years. Truscott Court Sleeping, 1,050 cubic feet. Room, first floor. The husband is a casual dock labourer, earning from 18s. to 20s. per week, and the wife earns 10s. per week as an office cleaner. The room is small and the light and ventilation bad. 625 Vauban Street Man, wife, boy 4 years, girls 8, 6 and 1 year. Living and sleeping, 1,600 cubic feet. Front room, first floor, 975 cubic feet. The husband is a cooper, but has been out of work for the past fortnight; they have no other money coming in, and have had to pledge their belongings to get food. The light and ventilation were fair. The rent is 3s. 6d. per week. White Lion Court Boys 15 and 13 years. Living and sleeping, 800 cubic feet. Room, ground floor, 614 cubic feet. 186 The husband is in regular work, earning 3s. to 4s. per day. The boy, 15, earns 8s. per week. The rent is 4s. 6d. per week. The light and ventilation were bad and the rooms dirty and untidy at the time of visit. 362 Do. Man, wife, boy 8, and girl 1 year. Sleeping, 900 cubic feet. Room, first floor, 538 cubic feet. cubic feet, 255 Tilbury Place 2 men, 2 women, and 2 children. Living and sleeping, 2,000 cubic feet. Two rooms, ground and first floors. The husband is a sawyer in regular work. Girl, 22 years, earns 2s. per day, and girl, 20 years, earns 8s. per week. The light and ventilation were bad and rooms very dirty and untidy at the time of visit. 588 Vauban Street 2 adults, boys 8 and 4 years, and girls 5 and 3 years. Living and sleeping, 1,600 cubic feet. Front room, first floor, 1,012 cubic feet. The husband is at present oat of work, but expects to get work soon. The wife earns 5s. to 6s. per week at ironing. They are looking for another place. 515 Do. Man, wife, girl 11 years, and boy 9 months. Sleeping, 1,050 cubic feet. Back room, first floor, 535 cubic feet. From this report it is evident that all the bedrooms are overcrowded to a considerable extent, and as they are very small and the ventilation somewhat defective the conditions cannot be considered as sanitary. It is also an unsatisfactory arrangement to have members of the family sleeping in these small living rooms. If they are children it means that they are kept out of bed for several hours after they ought to be there, and, whether children or adults, it cannot be considered healthy to occupy during the night a small room which has been used for living in during the daytime, for the atmosphere by bedtime is hot and polluted by the breath of the occupants, artificial lights, cooking, &c. Further, we have no guarantee that the re-arrangement here described is carried out. If an inspector visits at night he is shown a bed in the living room, but I have very little doubt that as soon as the disturbance caused by his visits and notices has ceased that the occupants return to their original rooms. The houses in Edmund Place have only one small bedroom and a small living room and are really not fit for couples with large families, for the bedroom should not be occupied for sleeping by more than two adults or four small children under 10 years of age. It is very difficult to know what to do with such cases as these, but it seems to me that as a Sanitary Authority we must take steps to get the overcrowding abated. Man, wife, boy 5 years, and girl 2 years. 213 Edmund Place Sleeping, 900 cubic feet. Room, first floor, 687 cubic feet. 382 Do. Widow, girls 17 and 12 years, and boy 7 ½ years. Sleeping, 1,050 cubic feet. Room, first floor, 668 cubic feet. Room, first floor, 657 cubic feet. 243 Man, wife, girls 7 years and 10 months. Do. Sleeping, 900 cubic feet. Man, wife, boy 2¾ years, and girl 1 year. 221 Do. Sleeping, 900 cubic feet. Room, first floor, 679 cubic feet. Man, wife, boys 10½ and 7 years. 351 Crosby Row Living and sleeping, 1,400 cubic feet. Back room, first floor, 1,049 cubic feet. The husband is a waterside labourer in fairly regular work, and the wife has obtained a situation since the notice was served as an office cleaner at 10s. 6d. per week. The room was fairly clean and the light and ventilation fair. The rent is 3s. 6d. per week. They purpose getting an extra room. Occupants of overcrowded portion of house. Cubic feet space required. Rooms occupied and cubic space. Deficiency. State of Premises and Family. cubic feet. 1,196 The husband is a waterside labourer, but his work does not seem very regular. The rent is 3s. per week. The light and ventilation were bad and the room was not very clean at the time of visit. The overcrowding in this case is very bad. Man, wife, boys 12, 7 and 3 years, and girls 9 years and 8 weeks. Living and sleeping, 2,000 cubic feet. Front room, top floor, 804 cubic, feet The husband is a builder's labourer. The light and ventilation were fair and the house was clean at the time of visit. The wife has promised to get a proper bed for girl 12, and boy 8 years, to sleep in ground floor room, and this will abate the overcrowding. The premises will be kept under observation. Man, wife, girls 12 and 2½ years, boy 8 years, and baby 1 month. Sleeping, 1,350 cubic feet. Room, first floor, 834 cubic feet. 516 The husband is a waterside labourer, with irregular work. The light and ventilation were fair and the room was clean at the time of visit. The rent is 4s. per week. Man, wife, girl 8 years, and boy 3 years. Living and sleeping, 1,200 cubic feet. Front room, first floor, 799 cubic feet. 401 Man, wife, boy years, and girl 7 months. Living and sleeping, 1,200 cubic feet. Room, second floor, 969 cubic feet. The husband is a waterside labourer, whose work is generally regular, but he is now on strike. The light was fair, the ventilation bad, and the room clean at the time of visit. 231 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. 5 6 1 2 4 2 3 at. Olave. St. Thomas. St. John. 3 1 I Births Notified— 3 2 292 5 231 103 470 3 4 45 18 By Guy's Hospital 1,569 393 104 119 34 2 By Midwives 737 23 29 63 131 42 176 6 8 167 115 39 137 168 78 27 3 2 By Doctors 855 13 36 701 61 75 101 5 2 - By Parents 447 17 19 281 48 20 71 390 187 141 58 3,608 523 477 453 351 283 391 332 22 Total I — I — Births Visited— 306 106 16 363 252 224 275 242 88 45 Primary Visits 2,756 440 399 1 1 Secondary Visits 9 3 1 1 1 1 - - - - - 335 68 63 59 25 20 37 22 20 4 14 1 3 Other Calls and Visits 91 423 278 245 313 264 121 19 326 47 Total Visits paid 3,100 511 462 1 1 2 - 20 1 Insanitary Conditions reported to Medical Officer of Health - - - 12 1 2 - Number of babies breast fed 2,756 „ bottle fed 123* (53 part breast and bottle) „ fed otherwise {e.g., spoon) 8 2,625 *Type of feeding bottle used:—Boat shape, 104; long tube, 19. Children put out to nurse—nil. The total number of births which took place in Bermondsey last year was 3,842, and of these 3,608 were notified under the Notification of Births Act, 1907. There is some difficulty in getting the whole of the cases notified, mainly because the father, on whom the obligation primarily rests, is able to plead ignorance of the existenca of the Act, and a great many think they have done their duty when they have registered the birth. In my opinion, it would have been better had the time allowed for registration been shortened from six weeks to one, instead of having a special Act. An endeavour is now being made to hunt up delinquents, and a letter is being sent to the medical practitioners pointing out to them that it is their duty to inform the father of his duty under the Act, and that the medical man in attendance is not exempt unless he has reason to believe that someone else has notified. Of the 3,608 births notified, 2,756 received primary visits from the Health Visitors. There were very few secondary visits, as one Health Visitor is very little use in a borough of this kind. Of this number 2,633 were breast fed, so that, with very few exceptions, breast feeding among the working classes in Bermondsey is the rule. This, however, only continues for a period of a month, or six weeks at furthest, after which period working mother here find it necessary to supplement the meagre income by work of some description. Their infants are then left in charge of a stranger or some inexperienced member of the family, the result being they are artificially fed, and the wonder is that the infantile mortality is not much greater. It speaks well for the vitality of the infantile population that they survive the extraordinary methods of feeding to which some of them are subjected. Any enquiries into the subject of breast feeding and the best methods for ensuring its continuance will be incomplete if the economic conditions of the mothers is not taken into account. At the beginning of this year a second Health Visitor was appointed, so that the next report no doubt will show a very much larger number of secondary visits. 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 1911. Including bakehouses, of which there were 76 in use, the total is 769. OUTWORKERS. There were 561 outworkers on the Register at the end of 1911. 96 lists were sent in by firms in this Borough employing outworkers. Table X. of the Appendix shows the various trades followed by outworkers in this district. APPENDIX. 36 APPENDIX. Table I.—Vital Statistics of Whole District during 1911 and Previous Years. Year. Net Deaths at all Ages belonging to the District. Births. Total Deaths registered in the District. Population estimated to Middle of each Year. Deaths of Residents registered in Public Institutions beyond the District. Deaths | of Xon- | Residents registered in Public Institutions in the District. Total Deaths in Public Institutions in the District. Rate.* No. Under 1 Year of Age. At all Ages. Rate per 1,000 Births registered. Rate. * No. Rate. * No. No. 10 4 5 6 8 2 11 12 13 3 7 9 1 20.8 711 159 130,633 4,459 34.1 2,320 451 17.8 423 52 2,719 1901 21.2 636 146 2,323 17.8 460 63 496 2,756 1902 130,137 4,346 33.4 18.4 129,654 32.4 596 142 1,973 15.2 414 40 449 2,382 1903 4,200 654 2,142 20.1 32.4 156 16.6 440 44 495 2,593 1904 129,187 4,193 18.6 33.3 547 127 439 33 521 2,399 1905 128,730 4,288 1,911 14.8 20 2,529 19.7 31.4 533 132 1,979 15.4 456 570 1906 128,288 4,031 25 507 2,338 18.3 31.4 441 110 1,856 460 1907 127,856 4,013 14.5 591 37 2,444 534 128 15.0 530 18.8 1908 127,438 4,172 32.1 1,951 562 2,387 480 118 15.3 26 466 18.8 1909 127,030 4,055 31.9 1,947 2,229 403 102 1,717 13.5 550 30 542 17.6 1910 126,634 3,9571 31.2 2,478 19.2 37 503 Averages for years 1901-1910 128,559 32.4 4,171 554 132 180 2,012 15.6 30.5 515 22 560 2,320 1911 125,840 3,842 18.4 498 1,782 14.2 130 *Rates in columns 4, 8. and 13 calculated per 1,000 of estimated population. Area of District in acres (exclusive of area covered by water), 1336 1. At Census of 1911—Total population of all ages, 125,960. Do. Number of inhabited houses, 15,817. Do. Average number of persons per house, 7.96. I. Institutions within the District receiving sick and infirm persons from outside the District. 111. Other Institutions, the deaths in which have been distributed among the several localities in the District. 11. Institutions outside the District receiving sick and in linn persons from the District. No. of Deaths. No. of Deaths. Bermondsey Workhouse, Ladywell—68 deaths Bermondsey Workhouse, Ladywell 68 Bermondsey Infirmary, Lower Road Guy's Hospital 218 4 Brook Hospital 4 Charing Cross Hospital 3 Workhouse, Parish Street 1 Children's Hospital, Great Ormond Street 2 Evelina Hospital 27 Deathsin River Thames, Surrey Commercial Docks, &c. East London Hospital 9 Friedenheim Hospital 1 12 King's College Hospital 1 London Hospital 6 1 Railway London Temperance Hospital 1 Lying-in Hospital, Endell Street 1 Private House 1 Maternity Hospital, Hackney 1 1 2 Metropolitan Hospital Street Middlesex Hospital 1 North Eastern Hospital 2 1 Factory Park Hospital 11 Queen Mary's Hospital, Carshalton 3 1 Royal Free Hospital Royal Hospital, Waterloo Road 3 Total 22 St. Bartholomew's Hospital 4 St Joseph's Hospital 1 St. Mary's Hospital 1 St. Peter's Hospital 1 St. Thomas' Hospital 12 Seamen's Hospital 1 South Eastern Hospital 28 South Western Hospital 3 Westminster Hospital 2 Hostel of God, Clapham 2 11. 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. I, Institutions within the District receiving sick and infirm persons from outside the District. No. of Deaths. Banstead Asylum 51 Cane Hill Asylum 10 Caterham Asylum 11 Claybury Asylum 2 Colney Hatch Asylum 1 Darenth Asylum 3 Dartford Heath Asylum 9 Horton Asylum 8 Hanwell Asylum 1 Leavesden Asylum 4 Long Grove Asylum 13 Manor Asylum 1 Tooting Bee Asylum 17 Belmont Workhouse 1 Newington Workhouse 2 St. George's Workhouse 1 Camberwell Infirmary 1 City Infirmary 1 Chelsea Infirmary 1 Greenwich Infirmary 1 Southwark Infirmary 3 Children's Infirmary, Carshalton 2 St. Peter's House, Lambeth 1 Mildmay Mission 1 Peckham House 1 Chase Farm Schools, Enfield 2 Home for Sick Children 1 Rescue Society Servants' Home 1 River Thames and Canal 6 In Private Premises or Street 19 On Railway 2 Parkwood Convalescent Home 1 West Norfolk and Lynn Hospital 1 Lady Margaret Hospital 1 Metropolitan Convalescent Institution 1 Mailing Union Infirmary 1 Mount Vernon Hospital 1 Throston Port Sanitary Hospital 1 St. Lawrence Convalescent Home 1 Capel Isolation Hospital 1 Total 560 Table II.—Vital Statistics of Separate Localities in 1911 and Previous Years. Year. Bermondsey. Rotheehithe. St. Olavb. Deaths under 1 year. Population estimated to middle of each year. I Births registered. Deaths at all Ages. Population estimated to middle of each year. Deaths under 1 year. Population estimated to middle of each year. Deaths at all Ages. Births 1 legistered. Deaths at all Ages. Deaths under 1 year. Births registered. 1901 82,441 1,768 497 38,446 1,220 747 9.74G 204 42 215 2,920 319 1902 741 82,281 2,855 1,782 455 38,394 1,170 174 9,462 321 233 49 655 168 1903 82,129 2,801 1,523 453 38,347 1,116 9,178 283 204 36 187 1904 81,986 2,748 1,634 477 38,304 1,083 713 8,897 362 246 59 604 1905 81,852 2,894 1,597 422 38,264 1,130 164 8,614 264 198 45 1906 81,727 2,683 1,618 408 38,229 1,089 702 170 8,332 259 209 46 144 1907 81,610 2,674 1,506 335 38,197 1,110 669 8,049 229 163 22 1908 81,500 2,785 1,613 411 38,169 1,129 611 151 7,769 258 220 48 1909 81,398 2,739 1,563 396 38,145 1,069 654 143 7,487 247 170 34 1910 81,304 2,661 1,441 341 38,125 1,040 603 134 7,205 256 185 27 165 Averages of years 1901-1910 2,776 1,605 38,262 1,116 670 8,474 41 81,823 420 280 203 2,528 1,470 1,067 167 8,671 247 184 41 403 35,059 666 82,110 1911 Table III.—Cases of Infectious Disease Notified during the Year 1911. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified ill each Locality. At Ages—Years. At all Ages. Borraondsey. 15 to 25 25 to 45 45 to 65 65 and upwards 1 3 4 6 Total. 5 to 15 2 5 Under 1 1 1 to 5 ... ... ... ... ... ... ... ... Small-pox ... ... Cholera ... ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup) ... ... ... ... ... ... ... ... ... ... ... ... 34 36 29 28 28 260 14 119 111 16 184 9 6 1 41 Erysipelas ... 153 3 8 12 18 63 31 18 18 19 24 11 7 109 14 30 Scarlet Fever 109 305 8 162 21 5 30 26 22 206 34 55 39 34 Typhus Fever ... ... ... ... ... ... ... ... ... Enteric Fever ... ... ... ... ... ... ... ... ... 29 8 12 9 3 ... 7 2 3 18 3 ... ... ... ... ... Relapsing Fever ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... 13 ... 4 9 2 1 3 1 1 8 2 ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... Post Basic Meningitis 1 ... ... 1 ... 1 1 Cerebro-spinal Meningitis ... ... ... ... ... ... ...... ... 1 ... ... ... 1 1 ... 1 ... ... ... ... ... ... ... ... Ophthalmia Neonatorum 36 ... ... ... 36 1 11 9 8 2 31 1 26 ... ... ... ... ... ... Chicken-pox 142 ... 64 52 23 20 17 16 4 14 94 4 ... ... Acute Polio-myelitis or Acute Polio-eucephalitis ... ... ... 3 3 3 ... 1 ... ... 2 ... ... ... ... ... ... ... 124 86 655 110 62 162 122 943 88 75 345 64 39 Table IV,-Causes of and Ages at Death during the Year 1911. Causes of Death. Deaths at the subjoined ages of "Residents" 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. Rother liithe. Under 1. 1 and under 5. 5 and under 15. 125 and under 45. 45 and under I 65. All Ages. 15 and under 25. 65 and 1 wards. Berniondsey. St. Olave. Enteric Fever 6 ... ... ... ... 4 1 4 2 1 1 ... ... ... ... Smallpox ... ... ... ... ... ... ... ... ... 16 51 16 34 1 34 1 2 Measles ... ... ... ... ... ... 6 1 5 ... ... ... Scarlet Fever ... ... - ... 36 9 Whooping Cough 18 24 22 1 1 ... 3 2 ... ... Diphtheria & Croup 6 3 11 3 1 15 6 ... ... ... ... ... ... ... 7 2 1 Influenza ... ... 4 4 1 ... ... 1 1 3 1 Erysipelas 3 1 ... ... ... ... ... ... 7 Phthisis (Pulmonary Tuberculosis) 2 141 106 7 59 18 100 211 3 27 52 Tuberculous Meningitis 7 7 8 ... 1 198 28 1 7 11 1 1 22 Other Tuberculous Diseases 66 39 15 4 20 ... 7 19 15 5 5 3 Rheumatic Fever ... 8 1 1 ... 2 ... ... ... ... ... 77 Cancer, Malignant Disease 116 ... 54 34 ... 48 1 1 23 37 5 228 130 18 Bronchitis 43 9 1 1 8 66 100 80 82 16 9 Broncho-Pneumonia 149 69 61 2 2 10 5 94 39 ... Pneumonia (all other forms) 37 116 10 8 74 11 10 25 14 29 13 31 Other Diseases of Respiratory Organs ... 5 1 1 1 4 16 2 4 8 7 ... 2 Diarrhoea & Enteritis 226 158 2 1 1 3 148 62 59 16 34 Appendicitis and Typhlitis 2 2 1 8 ... 3 4 1 1 3 ... ... 5 1 Alcoholism 3 2 3 2 ... ... ... ... ... ... ... Cirrhosis of Liver 16 10 6 3 5 1 10 ... ... ... ... 48 11 Nephritis & Bright's Disease 26 8 21 2 14 1 22 5 ... ... ... 3 Puerperal Fever 1 1 ... 3 1 2 ... ... ... ... Other Accidents and Diseases of Pregnancy and Parturition ... ... ... 3 1 2 2 1 ... ... ... ... Congenital Debility and Malformation, including Premature Birth 2 ... ... 89 76 11 59 26 4 11 ... ... Violent Deaths, excluding Suicide 10 25 93 18 13 7 22 11 12 58 10 ... 6 3 3 buicides Other Defined ... ... ... 0 1 ... - ... ... 217 748 1,59 18 23 25 76 173 274 472 59 Diseases 146 All Causes 2,320 611 280 88 470 467 1,470 666 184 515 92 312 Table V. Infantile Mortality during the Year 1911. Deaths from Stated Causes in Weeks and Months under One Year of Age. Cause of Death. 1-2 weeks. Total under 1 month. Total Deaths under 1 year. 1911. Under 1 week. 2-3 weeks. 3-4 weeks. 1-3 months. 9-12 mouths. Total Deaths under 1 year. 1910. 3-6 months. 6-9 months. {Certified 22 26 11 All Causes 104 104 113 110 143 611 84 502 {Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... Chicken-pox ... ... 1 1 ... ... ... ... ... ... Measles ... ... ... 1 3 12 16 ... ... ... 22 Rothelm ... ... ... 1 1 ... ... ... ... ... ... ... Scarlet Fever ... 1 ... 1 ... ... ... Diphtheria and Croup ... ... ... ... ... 2 ... 4 6 ... ... 2 ... ... ... Whooping Cough ... ... 4 4 3 13 24 ... ... 12 Diarrhœa (all forms, including Zymotic Enteritis) ... ... 1 1 2 24 64 36 32 158 ... 63 Enteritis (non-Zymotic) ... 1 ... 1 3 1 1 7 ... 2 ... Tuberculous Meningitis ... ... 1 2 1 7 ... 3 5 ... ... Abdominal Tuberculosis 2 ... ... 6 1 10 ... ... 12 ... ... Other Tuberculous Diseases ... 1 1 6 6 14 ... ... 14 Congenital Malformations ... ... 9 3 4 1 17 ... 17 ... ... ... ... Premature Birth 42 9 6 1 58 5 3 ... ... 66 83 Atrophy, Debility, and Marasmus 8 6 4 26 23 5 7 83 8 8 88 Atelectasis 3 ... 3 2 ... ... ... ... ... 5 Injury at Birth 11 ... 11 1 ... ... ... 12 7 ... ... ... Erysipelas ... ... 1 ... ... ... ... ... 1 3 Syphilis ... 1 ... 1 1 ... 2 1 ... 5 1 Rickets ... ... ... ... 3 3 3 ... ... ... ... ... Meningitis (not Tuberculous) 1 4 ... ... ... ... 3 3 ... ... ... Convulsions 2 ... 2 5 1 ... 12 ... 4 16 Gastritis ... ... ... 1 ... ... ... ... 1 ... ... Laryngitis ... ... ... ... ... ... 1 ... ... ... ... Bronchitis ... 2 1 3 8 28 6 11 13 5 43 Pneumonia (all forms) ... 1 2 1 20 74 2 6 18 13 21 78 Suffocation, overlying 3 1 5 1 1 5 11 17 ... ... Other Causes 3 ... ... 2 3 9 6 4 5 26 32 ... 84 22 502 26 11 143 110 141 611 104 113 Nett Births in the year: Legitimate, 3,784; Illegitimate, 58. Nett Deaths in the year of Legitimate Infants, 611. 41 Table VI.—Population, Births and Deaths in Wards. Population at Census. 1911.+ Estimated population. 1911. Birthrate. Deaths under 1 year of age. + Infantile Mortality per 1.000 Births. Births, 1911. Deaths, 1911.* Deathrate. Wards. Bermondsey— 82,119 82,110 487 14,258 270 Ward 1 14,260 34-2 19.0 92 189 497 „ 2 14,341 14,340 34-7 261 18.2 86 173 „ 3 15,564 15,562 507 32.6 261 16.8 60 118 23.4 236 14.5 129 „ 4 16,264 16,262 380 49 28.5 199 51 11,752 11,751 335 16.9 152 „ 5 322 9,938 9,937 202 20.3 62 192 „ 6 32.4 Rotherhithe— 35,142 35,059 305 14,170 14,137 463 85 Ward 1 32-8 21.6 184 412 30.0 47 „ 2 13,748 13,715 242 17.6 114 192 26.6 119 35 7,224 7,207 16.5 182 „ 3 8,699 St. Olave— 8,671 St. John 5,304 5,287 151 28-6 ! 101 19.1 24 159 56 St. Olave 1,994 1,988 34.2 28.2 13 68 191 St. Thomas 1,396 28 20.0 27 4 143 1,401 19.3 611 159 125,840 30.5 125,960 3,842 2,320 Whole Borough—Totals 18.4 *Note.—41 Deaths in outlying Institutions could not be allocated to any particular Ward, but ore included in t/ie total for the whole, Borough. † The Ward populations in this column arc estimated, as the census figures have not been supplied. ┼ 3 deaths in this column could not be allocated to any particular Ward. Table VII.—Meteorology of the Year 1911 (Greenwich Record). Temperature of the Air. Rain. 1911. Month. Moan l eading of the Barometer. B Minimum. Mean of A and B. A Maximum. Amount Collected. " I ° ins. ° ° ins. 30.147 34.2 1.23 January 42.0 38.1 February 30.009 46.0 35.3 40.7 1.38 March 35.8 29.738 48.4 42.1 1.66 April 29.846 55.3 38.6 46.9 1.73 May 29.815 68.1 46.3 57.2 1.88 June 2.10 29.827 70.9 50.3 60.6 July 29.990 81.1 55.0 68.0 0.27 69.0 57.0 1.34 August 29.845 81.1 60.0 September 29.892 72.1 47.9 1.34 October 29.742 57.4 43.9 50.7 3.30 November 29.569 49.2 38.4 43.8 3.42 48.6 39.7 44.1 4.02 December 29.577 60.0 43.5 51.8 29.833 1.97 Means Table VIII.—Marriages. Bermondsey Rotherhithe ST. Olave. Whole Borough. Year. Rate. No. Rate. No. Rate. No. Rate. No. 1901 800 15.42 58 11.92 1,154 2 96 19.44 17.70 799 1902 19.55 270 14.22 11.50 1,123 17.39 54 1903 15.23 794 19.56 238 12.65 1,101 69 17.22 1904 18.71 280 14.62 58 13.04 1,105 17.11 767 1905 801 19.57 2 5 6 51 11.81 13.38 1,108 17.21 1906 719 17.59 16.22 70 16.80 1,099 310 17.13 1907 736 1869 315 16.49 69 17.14 1,147 17.91 1908 750 250 12.85 84 21.21 1,084 18.05 16.69 1909 256 59 723 17.76 13.42 15.76 1,038 16.34 754 80 1,149 1910 18.55 315 16.52 22.21 18.14 Average for years 1901-1910 18.75 278 17.29 65 15.66 764 1,110 14.58 1911 757 18.44 284 16.20 89 17.96 20.53 1,130 Table IX. —Proceedings during 1911. Premises. Number of Places Number of Inspections, 1911. Number of Notices, 1911. Number of Prosecutions. 1911. On Register at end of 1910. Added in 1911. Removed in 1911. On Register at end of 1911. 27 1,118 Milk premises 35 294 - 286 10 20 1 3 1 - Cowsheds 4 - Slaughter-houses 1 - - 1 23 2 - 2 - Other offensive trade premises 13 - 13 - 195 - - 144 - 5 139 12 Ice-cream premises 924 4 231 - Registered houses let in lodgings 227 *(a) 10 *(b) 169 - * (a) For overcrowding. * (b) For other conditions. Total number of Intimation Notices served for all purposes 3,403 Overcrowding, 1911— Number of dwelling rooms overcrowded 169 Number remedied 169 Number of prosecutions - Underground rooms— Illegal occupation dealt with during year - Number of rooms closed - Insanitary houses— Number closed under the Public Health (London) Act, 1891 - Number closed under the Housing of the Working Classes Act - Number of premises cleansed under Section 20 of the L.C.C. (General Powers) Act, 1904 - Number closed under the Housing, Town Planning, Ac., Act, 1909 43 Shelters provided under Sec. 60 (4) of the Public Health (London) Act, 1891— Families 4 Number of persons accommodated during the year Adults 8 Children 11 Revenue Acts — Number of houses for which applications were received during year - Number of tenements for which certificates were granted - 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 1 Number of houses for which certificates were granted 1 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, Ac. - (c) For the prevention of keeping of animals in such a manner as to be injurious to health — (d) As to paving of yards, Ac., of dwelling houses (e) In connection with the removal of offensive matter, &c., 1 (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, Sec. 202) 2 (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 186 Total number of infectious bodies removed 5 Table X.—Factories, Workshops, Laundries, Workplaces and Homework. Inspection. Number of Premises. Written Notices. Inspections. Prosecutions. Factories (including Factory Laundries) 45 ... 218 68 Workshops (including Workshop Laundries) 132 ... 76 164 Workplaces (other than Outworkers' Premises) ... 189 514 Total ... Defects Found. Particulars. Number of Defects. Number of Prosecutions. Found. Referred to H.M. Inspector. Remedied. Nuisances under the Public Health Acts— ... 38 38 ... Want of Cleanliness 1 ... Want of Ventilation 1 ... 1 Overcrowding 1 ... ... ... ... 4 4 Want of Drainage of Floors 127 Other Nuisances 128 ... ... 4 4 ... ... 5 5 ... ... { Insufficient Sanitary Accommodation Unsuitable or Defective Not separate for Sexes ... ... ... ... 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) ... 3 3 Other Offences ... ... ... ... Total 184 183 ... ... 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 Notified by H.M. Inspectors H.M. Inspectors as remediable under the Public Health Acts, but Reports (of action taken) sent to not under the Factory Act (s. 7) H.M. Inspectors Other ... ... ... Underground Bakehouses (s. 101) — Certificates granted during 1909 ... In use at end of 1909 ... Workshops on the Register (s. 131) at the end of 1909 693 Workshop Bakehouses 76 Total number of Workshops on Register 769 Table X. —Factohibs, Workshops, Laundries, Workplaces, and Homework (continued) Home Work. Nature of Work. (1) Outworkers' Lists, Section 107. Outwork in Unwholesome Premises, Section 108. Outwork in Infected Premises, Sections 109,110. Instances. (14) Prosecutions (Sections 109, 110). (16) Prosecutions. Notices served. (12) Order made (S. 110). (15) Lists received from Employers. Prosecutions. (13) Notices served oil Occupiers as to keeping or sending lists. (8) Instances. (ii) Failing to send lists. (10) Sending once in the year. Failing to keep or permit inspection of lists. (9) Sending twice in the year. Lists. (2) Outworkers. Lists. (5) Outworkers. Workmen. (4) Contractors. (6) Workmen. (7) Contractors. (3) Wearing Apparel:- 49 480 101 ... ... ... ... 101 6 ... 64 12 ... ... (1) Making, &c. ... ... ... ... 44 (2) Cleaning and Washing ... ... ... ... ... ... ... ... ... ... ... ... Household Linen ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lace, Lace Curtains and Nets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Curtains and Furniture Hangings ... ... ... ... ... ... ... ... ... ... ... ... ... Furniture and Upholstery ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Electro-plate ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... File Making ... ... ... ... ... ... ... ... ... ... ... ... ... ... Brass and Brass Articles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 Fur Pulling ... ... ... ... ... ... ... ... ... ... ... ... ... Cables and Chains ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Anchors and Grapnels ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cart Gear ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Locks, Latches and Keys ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... Umbrellas, &c. 2 ... ... ... ... ... ... ... ... ... ... ... ... ... Artificial Flowers ... ... ... ... ... ... ... ... ... ... ... ... ... ... Nets, other than Wire Nets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tents ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 230 ... Sacks 10 1 4 ... ... ... ... ... ... ... ... ... ... ... ... ... Racquet and Tennis Balls ... ... ... ... ... ... ... ... ... ... ... ... 33 ... Paper Bags and Boxes 4 30 3 ... ... ... ... ... ... ... ... ... ... Brush Making 6 2 ... ... ... ... ... ... ... ... ... ... ... ... ... Pea Picking ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Feather Sorting ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Carding, &c., of Buttons, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Stuffed Toys ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Basket Making ... ... 20 ... ... ... ... ... ... ... ... ... ... ... ... 86 12 770 ... ... ... 10 86 ... 101 101 ... ... ... ... ... Table XI.—Workshops. Trade. Number of Workshops on Register. Number of Workrooms. Persons Employed. Males. Females. Young Persona. Boot Makers and Repairers 56 ... 112 56 ... Boat and Barge Builders ... 22 ... 4 7 ... Bottle Washers 3 4 14 ... 13 54 Builders ... ... 12 ... Buttonhole Makers 2 4 ... ... Basket Makers 3 3 13 ... ... 10 Brushmakers 17 21 28 ... Blacksmiths 6 ... 17 ... ... Cabinet Makers 2 2 7 1 Carmen, Stables ... 40 ... 152 ... ... Carpenters 4 4 9 ... Collar Workers ... 2 4 23 ... ... 3 Chair Makers 4 5 6 ... Coopers 17 81 ... Cork Cutters 3 ... 3 6 3 ... ... 6 Curriers 8 17 ... 2 5 7 Cycle Makers 7 2 ... Dressmakers, &c. 61 70 44 178 5 Engineers and Smiths 6 6 12 ... 2 7 Farriers ... 22 2 ... 1 Fish Curers 1 20 164 ... 94 94 ... Hairdressers 1 4 Harness and Strap Makers, &c. 9 9 23 2 ... Hop Warehouses 19 ... 101 ... ... Laundries 40 5 209 69 ... Leather Work 37 27 34 275 ... Paper Bag Makers 1 1 ... 4 ... Picture Frame Makers 4 10 33 50 ... 3 3 5 Rag Sorters 7 ... 10 17 Sack Makers 8 22 2 Slate and Stone Merchants 3 20 ... ... .... Tobacco Pipe Makers 3 5 13 4 ... Wheelwrights 8 33 ... ... ... 22 33 Wood Choppers ... 57 18 Various 181 177 968 141 65 Totals 693 602 106 2,334 760 Totals. 1,401 81 9 6 20 42 211 291 131 27 3 868 1,902 27 448 189 161 509 260 452 31 748 496 64 182 17 38 9 Mr. Cockburn. 234 ... Post-mortem examinations 115 Bodies removed to mortuary 186 256 2 55 73 15 69 16 69 4 55 39 5 12 1 14 2 15 7 7 30 23 5 ... ... 1 29 Mr. Pitts. ... 70 74 ... 18 ... 1 44 8 24 9 58 32 6 15 1 1 3 ... ... ... ... ... 5 4 7 1 ... 39 ... Mr. Townsend. ... 134 ... ... ... 64 ... 21 ... 9 41 7 16 5 26 19 3 1 3 ... 1 33 12 11 2 32 Mr. Bartlett. 127 6 2 127 2 13 6 8 49 27 42 2 63 16 2 16 1 2 ... 10 ... 2 ... 1 1 ... 5 1 Mr. Freeman. 52 33 2 297 284 6 35 7 8 121 39 53 5 170 76 8 56 2 8 2 18 2 3 3 1 53 1 237 Note.—Mr. Townsend left the Council's service on May 8th Mr. Toogood. ... ... 82 ... 6 12 20 4 78 78 339 31 53 72 27 65 51 5 101 57 ... 3 4 1 10 ... 21 Mr. Pitts commenced duties as Sanitary Inspector on September 4th. ... Mr. Merryman. ... 116 10 2 ... 9 3 14 3 29 1 ... 193 188 2 64 17 6 67 20 65 1 95 60 27 2 ... ... Table XII.— Sanitary Work, 1911. Mr. Wood. ... 108 ... 18 10 52 3 36 4 3 6 ... 1 10 85 146 225 15 113 19 62 44 ... 64 1 37 1 1 Mr. Grice. ... ... ... ... ... 122 116 145 27 19 3 6 7 29 107 30 11 ... 112 233 345 98 15 23 29 34 ... 1 Houses or parts of houses cleansed or repaired Closets panned and trapped, or old pans cleansed or new ones fixed Drains tested Rooms disinfected 1,130 Articles disinfected 14,360 Inquests 138 Defective rainshoots and gutters repaired, unstopped, or disconnected from drain Defective water apparatus in w.c.s repaired W.C. accommodation provided or reconstructed Offensive accumulations removed Animals kept so as to be a nuisance removed Urinals cleansed, supplied with water and doors Waste-water pipes disconnected from drains and made to discharge in the open air, and new waste pipes provided Separating w.c. and domestic water supplies Cisterns cleansed or covers provided Cowsheds cleansed Miscellaneous Closets supplied with water, or defective water supplies remedied Stopped drains and w.c.s cleared Houses supplied with water Defective roofs repaired Stables and other premises drained and paved Providing means of ventilation beneath ground floor Accumulations of manure removed Effective means taken to prevent dampness Yards cleansed Means of ventilation provided, or improvement in ventilation made W.C.s repaired, ventilated, and whitewashed Yards and forecourts paved or paving repaired Dung receptacles provided or repaired Defective drains reconstructed, repaired, ventilated, and trapped Table XII.—Food and Drugs. Articles submitted for Analysis. Total Samples taken. Number Genuine. Number Adulterated. Percentage of Articles Adulterated. 809 90 Milk 719 11.1 223 248 Butter 25 10.0 Margarine 22 20 2 9.0 18 11 7 38.8 Separated Milk Cocoa 13 13 ... 13 13 ... Coffee ... 10 ... 12 16.6 White Pepper 2 4 500 Black Currant Jam 8 4 Mustard 6 6 ... ... 6 4 2 33.3 Skim Milk 4 ... ... Pepper 4 4 2 2 50.0 Raspberry Jam 4 3 Malt Vinegar 1 25.0 2 1 25.0 Lime Juice Cordial 3 3 Arrowroot 3 ... ... Milk-blended Butter 3 3 ... ... 3 3 Cocoa Essence ... ... Lard 2 2 ... ... Cod Liver Oil 2 2 ... ... Camphorated Oil 2 2 ... ... Ginger Wine 2 1 1 50.0 Ground Rice 2 2 ... ... Semolina 2 2 ... ... 2 Castor Oil 2 ... ... Ammoniated Tincture of Quinine 2 2 ... ... 2 Scalded Milk 2 1 ... ... Sterilized Milk ... 1 1 ... ... Olive Oil 1 ... ... 1 Tapioca 1 ... 1 ... Ice Cream 1 ... ... Brompton Lozenges 1 1 ... ... Self-raising Flour 1 1 ... ... Mercury Pills 1 1 ... 1 ... Peppermint Cordial 1 100.0 ... Raspberry Cordial 1 1 100.0 ... 1 Lemon Squash 1 ... ... Lime Juice 1 1 100.0 ... 1 1 ... Tartaric Acid ... Tomato Sauce 1 1 1 ... ... Cream 1 ... ... Ground Ginger 1 1 ... ... 1 Acetic Acid 1 ... 1 ... Jamaica Rum 1 ... ... 1,214 1,075 139 11.4 Totals Table XIV.—Prosecutions in connection with Samples taken during 1911. No. Sample. Adulteration or Infringement. Result. Milk Dismissed. Warranty proved 437s First Quarter. Added water 5 - 3 per cent. 473H Milk Added water 8.7 per cent. Dismissed. Warranty proved 448s Milk Added water 3.3 per cent. Dismissed. Warranty proved 477s Milk Added water 2.8 per cent. Dismissed. Warranty proved 483s Milk Dismissed. Warranty proved Added water 4-6 per cent. 498s Milk Added water 4.3 per cent. Dismissed. Warranty proved 512s Milk Fined the costs 15/- Added water 3 per cent. 525s Milk Added water 3.7 per cent. Dismissed. Amount of adulteration found at Somerset House too small Added water 2.7 per cent. Separated Milk 551s Fine 20/-; costs 15/-; also fined £5 for obstruction Milk Deficient in milk fat 93 per cent. 559s Fine 20/-; costs 18/- Malt Vinegar Contained 95 per cent, of artificial vinegar Fine 5/- ; costs £1 16/- 591H 595s Black Currant Jam Contained 20 per cent, of apple and raspberry Fine 10/-; costs 15/- Dismissed, £5 5/- costs against Council. Magistrate stated that the sample was a very low grade of white pepper, in fact on the border line 596s White Pepper Contained 10 per cent, of pepper husk Milk Second Quarter. Dismissed. Warranty proved 7s Deficient in milk fat 24.3 per cent. Added water 3.6 per cent. Milk Withdrawn on suggestion of Magistrate, one of the witnesses for defence being in a home for consumptives. There was also a warranty, which was apparently good 10s Butter Fine 20/-; costs 15/6 17H Consisted of Margarine 100 percent. 30s Milk Added water 11.8 per cent. Fine £5; costs £3 7/- 31s Milk Withdrawn, costs included in No. 30s Added water 19 per cent. 47H Milk Deficient in milk fat 15 per cent. Fine 5/-; costs 15/- 57H Milk Fine 5/-; costs 15/- Added water 4.1 per cent. Milk 58s Deficient in milk fat 11.3 per cent. Dismissed. Warranty proved 70s Milk Deficient in milk fat 10 per cent. Fined the costs 12/6 Milk 79s Deficient in milk fat 22 per cent. Dismissed. Warranty proved Milk 95s Deficient in milk fat 8.7 per cent. Dismissed. Warranty proved 116H Milk Added water 10 per cent. Dismissed. Warranty proved Margarine Fine 10/-; costs 17/- 131H Wrapper not marked 129s Milk Deficient in milk fat 10 per cent. Fine 10/-; costs 15/- 132s Deficient in milk fat 24 per cent. Milk Fine 40/-; costs 17/- Third Quarter. Dismissed. Warranty proved Milk Added water 8.1 per cent. 182H 202H Margarine Wrapper not marked Fine 7/-; costs 14/- 207s Margarine Wrapper and bulk not marked Fine 10/-; costs 17/- 218s Milk Added water 4.2 per cent. Dismissed. Warranty proved Milk 225s Added water 3.2 per cent. Dismissed. Warranty proved 231s Milk Added water 5 per cent. Dismissed. Warranty proved 240s Milk Added water 3.3 per cent. Dismissed. Warranty proved Milk 241s Added water 4 9 per cent. Dismissed. Warranty proved 243s Milk Added water 4.1 per cent. Fined the costs 15/- Milk Added water 3.3 per cent. 244s Dismissed. Warranty proved 259H Milk Added water 10.8 per cent. Dismissed. Warranty proved 271H Margarine Wrapper not marked Fine 40/-; costs 15/6 Butter Water beyond legal limit 2.9 per cent. 265s Fine 10/-; costs 15/- Butter 269s Water beyond legal limit 1.8 per cent. Fine 10/-; costs 15/- 275H Milk Added water 4.6 per cent. Fined the costs 15/6 284H Milk Added water 10 per cent. Dismissed. Warranty proved 283s Milk Added water 3.3 per cent, and deficient in milk fat 4.3 per cent. Dismissed. Warranty proved Fourth Quarter. Contained 60 per cent. of margarine Fine £3; costs 19/- 310H Butter Butter Water beyond legal limit 1.9 per cent. 311H Fine 10/-; costs 15/- Separated Milk 341H Added water 61.8 per cent. Fine £5 or 1 month imprisonment Table XIV.—Prosecutions in connection with Samples taken during 1911—continued. No. Sample. Adulteration or Infringement. Result. 349H Butter Consisted of margarine 100 per cent. Fine 2/6; costs 17/6 376H Butter Withdrawn Fined the costs 15/6 Wrapper not marked Water beyond legal limit 1.7 per cent. 407H Butter Water beyond legal limit 1.4 per cent. Dismissed. Warranty proved 367s Butter Contained 55 per cent, of margarine Fine 40/-; costs 19/6 Excess of butter fat Withdrawn Withdrawn 450H Butter Wrapper not marked Fined the coats 15/- Water beyond legal limit 1.2 per cent. 452H Butter Water beyond legal limit 2 per cent. Fined the costs 15/6 SUMMARY. £ s. d. Fines 26 14 6 Costs £24 17 0 Less Costs against Council 5 5 0 19 12 0 Total £46 6 6 Table XV.—List of Bakehouses in the Borough. Address. Situation of Bakehouse. Address. Situation of Bakehouse. 49, Abbey Street Underground 333, Old Kent Road Above ground 157, ,, ,, 91, „ 2, Alscot Road 7, Paradise Street ,, Underground 186, Abbey Street 246, Rotherhithe New Road Above ground ,, 66, Abbey held Road 365, „ ,, ,, 218, Bermondsey Street 173, Underground ,, 88, Bermondsey Wall " 25, Parkers Row Above ground 92, Bermondsey Street 49, „ 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) Underground 270, Rotherhithe Street ,, 34, Rotherhithe New Road 145, Drummond Road Underground ,, 574, Rotherhithe Street (not in use) 51, Dockhead (not in use) Above ground ,, 27, Derrick Street Underground ,, 39, St. James' Road *30-36, Denman Street 239, Southwark Park Road ,, ,, 51, Esmeralda Road ,, 351, ,, 49, Frean Street ,, 479 ,, ,, 49, Southwark Park Road Above ground 77, Grange Road Underground 31, George Row 119, „ ,, 68, Galleywall Road ,, 158, ,, ,, 198, 33, Grange Road (not in use) ,, Above ground 125, „ 319, „ „ 355, ,, (not in use) 1A, llderton Road ,, Underground 16, „ ,, 92, Snowsfields ,, 170, Jamaica Road 92, Spa Road „ ,, 104, ,, (not in use) 53, „ ,, ,, 140, „ 61, Salisbury Street ,, ,, 75, „ 5, St. Marychurch Street Above ground ,, 96, Tooley Street 203, „ Underground ,, 157, 227, „ ,, ,, 29, Kipling Street (not in use) 167, ,, ,, 82, Keetons Road 95, Tower Bridge Road Underground ,, 142, Long Lane 43, Tanner Street Above ground ,, 2, Lucey Road 144, „ ,, ,, 97, Lynton Road „ 245, Tooley Street ,, 53, Tower Bridge Road 132, Lower Road „ ,, 26 „ 93B, ,, ,, ,, 184, Long Lane 65, „ Above ground „ 22, The Grange (not in use) 49, Lucey Road „ ,, 160, Lower Road 106, Union Road (not in use) ,, ,, 182, „ 22, „ ,, ,, 204, 94, „ (not in use) ,, ,, 47, Maltby Street 17, Neckinger Street (not in use) Underground Above ground 62, Weston Street (not in use) ,, * Factory Bakehouse. (a) Early cases Borough Council. Maitland Sanatorium, Peppard Common, Oxon. Three, and occasionally an extra one. By M.O.H., and submitted to Public Health Committee, Yes. 30/- per week and 20/- when empty. - Yes, as in previous columns. Yes. Three wooden shelters. - - - (b) Intermediate cases - - No. - Central Fund and Voluntary Subscriptions. 62, Riley Street, as Tuberculosis Dispensary. BER 31 Table XVII.—Causes of Death, 1911. 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 Sub-Districts. 85 and upwards Bermondsey. Rotherhithe. St. Olave. M F Total F M F M F M F M F M F M M F M F M F M M M F M F Total M F Total M F Total F F F 35 16 51 10 6 25 9 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 22 12 34 12 4 16 1 ... 1 ... Measles ... ... ... ... ... ... ... 1 1 Scarlet Fever 5 1 6 ... 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 ... 4 1 1 2 ... ... ... ... ... ... ... 5 ... 5 10 ... 1 ... ... ... ... ... ... ... ... 1 ... 2 1 1 1 ... 2 1 ... ... ... 2 5 7 2 ... 2 1 ... 1 Epidemic Influenza ... ... ... 22 26 48 8 16 12 10 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 17 19 36 4 5 9 1 2 3 Whooping Cough ... ... ... 3 3 3 3 2 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 5 11 2 1 3 1 Diphtheria, Membranous Croup 8 7 15 1 ... ... ... 6 ... ... 12 ... ... ... ... ... ... 2 ... 2 1 ... ... 1 ... ... ... ... ... ... 2 2 4 1 ... 1 ... 1 Enteric Fever 3 3 ... 1 ... ... ... Diarrhœa, Dysentery 56 62 118 41 46 13 12 ... 2 ... ... ... ... ... ... ... 1 ... 1 1 ... ... ... ... 1 31 40 71 22 16 38 3 6 9 ... ... ... ... Epidemic or Zymotic Enteritis 65 43 108 44 27 19 15 ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... 48 29 77 14 10 24 3 4 7 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 ... ... ... ... ... Other Allied Diseases 2 ... 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cow Pox, Accidents of Vaccination 1 ... 11 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... Syphilis 4 2 6 3 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 3 1 4 1 1 2 ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... Gonorrhœa ... Erysipelas 1 3 ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... 1 2 3 ... ... ... ... 2 ... ... ... ... ... ... ... Puerperal Fever 4 4 ... ... ... ... ... ... ... 1 1 2 ... ... ... ... ... ... ... ... ... 3 3 ... ... ... ... 1 1 ... ... ... ... ... ... Pyæmia, Septicæmia 5 2 7 2 1 1 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... 1 ... ... 5 ... 5 ... 1 1 ... 1 ... ... ... ... 1 ... ... 5 4 9 ... ... 1 ... 1 ... ... ... ... 2 ... 1 1 1 1 ... 1 ... ... ... ... ... ... ... ... ... 3 4 7 ... ... ... Septic, Ulcerative, or Infective Endocarditis 2 2 ... Other Allied Diseases 8 4 12 3 ... 1 1 ... 1 ... ... ... 1 ... ... 1 ... ... ... 1 ... 1 2 ... ... ... ... 7 1 8 1 2 3 ... 1 1 ... ... Rheumatic Fever 3 2 5 ... ... 1 1 ... 1 ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 2 3 2 ... 2 ... ... ... ... ... ... ... ... Tuberculosis of Brain or Meninges, Acute Hydrocephalus 28 4 3 6 5 2 5 ... ...... 1 ... 1 ... ... ... ... ... ... ... 1 ... ... ... 8 11 5 3 8 ... 1 13 15 19 1 ... ... ... ... Tuberculosis of Lungs, Phthisis, Phthisis Pulmonalis 211 2 ... 3 1 1 2 5 10 8 31 20 33 22 29 17 11 2 6 1 ... ... ... 88 53 141 30 22 52 15 3 78 ... 133 3 4 18 ... Tuberculosis of Intestines, Tabes Mesenterica 11 20 8 2 1 5 ... 2 1 ... ... ... ... ... ... ... 1 1 ... ... ... ... ... 5 8 13 2 ... 2 2 3 5 9 ... ... ... ... ... General Tuberculosis, Tubercular Disease of undefined position 4 5 1 3 ... 1 ... 1 1 1 2 1 2 ... ... ... ... ... ... ... 9 12 21 8 9 17 ... 1 6 22 39 6 17 3 2 1 ... ... Other forms of Tuberculosis, Scrofula 4 3 7 ... ... ... ... ... 2 3 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 3 2 5 ... 1 1 1 ... 1 ... ... Chronic Alcoholism 2 3 5 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 1 ... ... 1 ... ... ... ... ■ 1 2 3 ... ... ... 1 1 2 ... ... Osteo-arthritis, Rheumatoid Arthritis 2 3 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 ... ... ... 2 2 ... ... ... ... 1 1 ... 1 Gout 2 2 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 ... ... ... 1 ... 1 ... ... ... ... ... Cancer 57 53 110 ... ... ... ... ... ... ... 1 ... 2 1 4 14 13 4 15 21 19 8 3 5 ... ... 41 31 72 15 18 33 1 4 5 ... ... ... Sarcoma 2 4 6 ... ... ... 1 ... ... ... ... ... ... ... ... ... 2 1 ... ... ... 1 ... 1 ... ... 2 3 5 ... 1 1 ... ... ... ... ... Diabetes Mellitus 8 6 14 ... ... ... ... ... ... ... ... ... ... 2 ... 1 1 1 3 2 1 1 ... 1 ... ... 6 2 8 2 2 4 ... 2 2 ... ... Purpura Hæmorrkagica ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 1 ... ... ... 1 ... ... ... ... ... 1 Hæmophilia ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... Anæmia, Leucocythæmia 3 2 5 ... ... ... ... ... ... ... 1 ... ... ... 1 ... 1 ... 1 1 ... ... ... 1 2 3 2 ... ... ... ... ... ... 2 ... Lymphadenoma, Hodgkin's Disease 1 ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... 1 1 ... ... ... ... ... 68 39 27 ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 26 20 46 13 8 21 1 ... 1 Premature Birth 40 28 ... ... ... ... 5 7 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 5 10 ... 2 2 ... ... Injury at Birth 5 7 12 ... ... ... ... ... ... Debility at Birth 14 10 24 14 10 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8 2 10 6 7 13 ... 1 1 ... ... ... ... Atelectasis 4 1 5 4 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 1 5 ... ... ... ... ... ... ... ... ... Congenital Defects 12 9 21 9 8 1 1 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7 6 13 3 2 5 2 1 3 ... ... ... ... ... Atrophy, Debility, Marasmus 44 24 68 38 21 6 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 32 16 48 10 5 15 2 3 ... ... ... 5 ... ... Dentition 3 3 6 3 2 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 2 5 ... 1 1 ... ... ... ... ... ... ... Rickets 1 6 7 3 ... 3 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 4 ... 4 ... ... ... 2 1 3 ... ... ... ... ... ... ... ... ... Old Age, Senile Decay 42 64 106 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 3 9 12 24 31 8 18 25 40 65 15 19 34 2 5 7 ... ... ... ... ... Convulsions 5 7 5 ... ... ... ... ... ... ... ... ... ... ... ... ... 5 6 ... 1 1 ... ... 12 7 11 ... ... ... ... ... ... ... ... ... ... ... ... Meningitis 3 7 10 1 3 1 2 1 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 5 8 ... 2 2 ... ... ... ... ... ... ... ... Encephalitis 4 2 2 ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Apoplexy 4 3 7 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 1 1 ... 1 1 ... ... 2 2 4 ... 1 1 2 ... 2 ... ... ... Softening of Brain 2 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... 1 ... ... 1 ... ... 1 ... 1 1 1 ... 1 ... 2 ... ... ... ... Hemiplegia, Brain Paralysis 4 2 6 ... ... ... 1 ... ... ... ... ... ... 1 ... 1 1 2 ... ... ... 1 ... ... ... 2 2 4 2 ... 2 ... ... ... ... ... 1 2 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 5 ... 1 ... ... ... ... ... ... ... 4 ... 4 1 1 2 General Paralysis of Insane 7 1 8 2 ... 2 ... ... ... ... ... ... ... ... ... 1 1 ... 1 ... Other forms of Insanity 2 3 ... ... ... 1 ... ... ... ... ... ... ... 1 1 2 ... 1 1 ... ... ... ... ... ... ... Chorea ... 1 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... Cerebral Tumour 1 2 3 ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... 2 2 ... ... ... 1 ... ... 1 ... ... Epilepsy 2 3 5 ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... 1 1 ... ... ... ... ... 2 ... 2 ... 2 2 ... 1 1 ... ... ... ... Locomotor Ataxy 3 3 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... 1 ... ... ... ... 2 ... 2 1 ... 1 ... ... ... ... ... ... Paraplegia, Diseases of Spinal Cord 2 5 7 ... ... ... ... ... ... ... ... 1 1 ... 1 2 ... 1 ... 1 ... ... ... 1 3 4 ... 1 1 1 1 2 ... ... ... ... ... ... Other and ill-defined Diseases of Brain or Nervous System 3 8 11 ... ... ... 1 ... ... ... ... ... ... ... 1 ... 2 ... 3 1 1 1 ... ... 1 4 ... 1 1 ... 3 3 ... ... 3 7 ... ... Otitis, Otorrhœa 3 2 5 1 1 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 3 2 5 ... ... ... ... ... ... ... ... ... ... ... Diseases of Eye, Ophthalmia 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 Pericarditis 4 1 5 ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... 1 ... 2 ... ... ... ... ... ... 1 1 2 2 ... 2 1 ... 1 ... ... ... Endocarditis, Valvular Disease of the Heart 72 89 161 ... ... ... 1 1 3 3 5 5 2 1 4 7 5 9 10 13 8 11 19 16 22 5 9 1 1 43 57 100 25 28 53 4 4 8 Angina Pectoris 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... Aneurism 6 7 ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 1 1 3 ... ... ... 6 1 7 ... ... ... ... ... 1 ... ... ... ... ... ... ... Senile Gangrene ... 6 6 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 3 ... 2 ... ... ... 1 1 ... 4 4 ... 1 1 ... ... ... ... Embolism, Thrombosis 5 2 7 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 1 ... 1 1 1 ... 1 ... ... ... 3 1 4 1 1 2 1 ... 1 Varicose Veins ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... Other and ill-defined Diseases of Heart and Circulatory System 49 61 2 110 1 ... ... ... ... ... ... ... 1 ... 2 10 8 8 13 21 24 10 2 2 31 41 72 12 29 6 3 5 ... ... 1 17 9 Laryngitis 1 1 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... 1 1 2 ... ... ... ... ... ... Acute Bronchitis 47 21 22 42 2 7 ... 1 ... ... ... ... ... 3 ... 1 1 3 5 5 3 7 6 ... 2 ... ... 24 24 48 15 18 33 3 5 8 89 Chronic Bronchitis 68 71 139 ... ... ... ... ... ... ... ... ... ... 1 1 1 1 9 4 9 18 19 26 17 19 2 2 32 50 82 30 17 47 6 4 10 ... ... Lobar, Croupous, Acute Pleuro-pneurnonia 15 16 31 ... ... 1 3 1 3 ... 2 ... 2 2 2 1 2 4 1 2 3 ... ... ... ... 10 10 20 3 5 8 2 1 2 3 ... ... ... Lobular, Catarrhal Broncho-pneumonia 89 60 149 41 28 35 26 1 1 ... ... ... ... ... ... 1 ... 1 ... 2 2 4 2 3 1 1 ... ... 53 41 94 25 14 39 11 5 16 ... Ptaeumonia, form not stated 53 32 85 6 3 3 4 4 1 1 1 1 3 1 4 ... 8 6 7 4 8 8 8 2 1 1 ... ... 33 21 54 13 8 21 7 8 10 ... Emphysema, Asthma 3 2 5 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 1 ... 2 ... ... ... 3 2 5 ... ... ... ... ... ... 1 ... ... ... ... Pleurisy 3 1 4 ... ... ... ... ... 1 ... ... ... ... 1 ... 1 ... ... ... ... ... 1 ... ... ... ... 1 1 2 ... 2 1 ... 1 ... ... ... Other and ill-defined Diseases of Respiratory System 4 1 5 ... ... ... ... ... 1 ... ... ... ... ... 2 ... 2 1 ... ... ... ... 1 3 ... ... ... 1 ... ... ... ... 1 ... 1 2 ... ... Ulcer of Stomach and Duodenum 8 1 9 ... ... ... ... ... ... ... ... ... 2 1 ... ... 4 ... 2 ... ... ... ... 5 ... 1 ... 5 2 1 3 ... 1 ... ... ... ... ... Other Diseases of Stomach ... 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... 2 1 1 ... ... ... ... ... ... Enteritis 7 8 15 3 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 1 2 3 ... ... ... 5 6 11 21 2 4 ... ... ... ... Appendicitis 6 2 8 ... ... ... ... ... 1 ... 1 1 ... 1 ... ... 1 ... ... ... ... ... ... ... ... 3 1 2 1 3 1 1 1 1 1 4 ... ... Obstruction of Intestines ... 8 19 ... ... ... ... ... ... ... ... ... ... ... 1 1 2 2 ... 1 2 2 1 1 ... ... 6 5 11 5 2 7 ... 1 1 1 1 ... Cirrhosis of Liver 7 9 ... ... ... ... ... ... ... ... ... ... ... ... ... 3 2 2 4 2 2 ... 1 ... 3 7 10 4 2 6 ... ... 16 ... ... ... ... Other Diseases of Liver ... 3 3 ... ... ... ... 2 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 1 ... 2 2 ... ... ... ... ... ... ... Peritonitis 3 1 4 ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... 2 ... ... ... ... ... ... 1 1 2 ... 2 1 ... 1 ... ... ... ... ... ... Other and ill-defined Diseases of the Digestive System 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 1 ... ... 1 ... ... ... 1 1 ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... Diseases of Lymphatic System and Ductless Glands ... 5 5 ... ... ... ... ... ... ... ... ... 1 ... ... 1 2 ... 1 ... ... ... ... ... 2 2 ... 3 3 ... ... ... ... ... ... ... ... ... Acute Nephritis 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... 1 ... ... ... ... 25 22 47 ... ... ... ... 1 ... ... 1 ... ... 1 ... 2 3 3 7 7 5 7 5 2 1 ... ... ... 12 10 22 11 9 20 Bright's Disease 2 3 5 Diseases of Bladder and Prostate 6 ... 6 1 1 ... ... ... ... ... ... ... ... 1 ... 3 ... 2 ... ... ... ... 1 1 3 ... 3 2 ... 2 ... ... ... ... ... ... ... Other and ill-deiined Diseases of Urinary System 3 1 3 1 ... ... ... ... ... ... ... ... ... 1 ... ... 2 ... ... ... ... ... ... ... 2 ... 2 1 1 ... ... ... ... ... ... ... ... ... Diseases of Ovaries ... 1 1 1 ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... v ... ... ... ... Diseases of Uterus and Appendages 1 1 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... Placenta Prævia, Flooding, Accidental Hemorrhage ... ... ... ... ... 1 ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... Other and ill-defined Accidents and Diseases of Pregnancy and Childbirth ... ... ... 2 2 ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... Accidents — In Vehicular Traffic 8 2 10 ... 1 3 ... ... 1 1 1 1 1 ... 1 ... ... ... 5 ... ... ... ... ... ... 1 ... ... ... ... 4 1 5 4 ... ... ... ... On Railways 2 ... 2 ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... 1 ... 1 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... On Ships, Boats, Docks, excluding Drowning 2 ... ... ... 2 ... 2 ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... In Building Operations 1 ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... By Weapons and Implements 1 ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... Burns and Scalds 6 4 10 1 ... 3 3 ... 1 ... ... ... 1 ... ... ... ... ... 1 ... ... ... 1 2 3 3 1 4 2 1 3 ... ... ... ... ... ... ... Poisons, Poisonous Vapours ... 2 2 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 2 2 ... ... ... ... ... ... 1 ... ... ... ... ... ... Surgical Narcosis ... 1 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... Drowning 13 13 ... ... 1 ... 3 ... 1 ... ... ... ... ... 2 ... 3 ... 2 ... ... ... 8 ... 8 3 ... 3 2 2 ... ... 1 ... ... ... ... Suffocation, overlaid in bed 6 5 11 6 ... ... ... ... ... ... ... ... ... ... ... 4 4 8 2 1 3 ... ... ... 5 ... ... ... ... ... ... ... ... ... ... ... ... ... Suffocation, otherwise 1 3 4 1 ... ... ... ... ... ... ... ... 1 3 4 ... ... ... ... ... ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Falls, not specified 10 11 21 ... ... 2 1 ... ... ... ... ... ... ... ... ... 1 1 1 5 ... 1 6 6 12 3 5 3 4 2 2 1 4 2 ... 1 ... ... Weather Agencies 2 ... 2 ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... I 4 I • ... ... ... ... ... 1 ... 1 1 1 ... ... ... ... ... ... ... ... Otherwise and not stated 5 4 9 1 1 ... ... ... ... ... ... 1 ... 1 ... ... ... ... 2 ... 1 1 1 ... ... ... ... ... 5 2 7 ... 1 1 ... 1 1 ... Homicide 2 2 4 ... 1 ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... 1 2 3 1 1 ... ... 1 ... ... ... ... ... ... ... Suicide — By Poison ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... By Hanging and Strangulation 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... By Drowning ... 1 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 By Crushing ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... 2 2 2 ... ... ... ... ... By Crushing ... 2 ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 1246 2320 342 269 156 124 31 27 14 20 22 23 25 84 33 100 85 129 87 128 126 140 128 64 96 13 26 689 1470 364 302 101 83 666 781 1074 18 184