REPORT ON THE SANITARY CONDITION AND VITAL STATISTICS OF THE Metropolitan Borough of Bethnal Green, DURING THE YEAR 1902. BY GEORGE PADDOCK BATE, M.D., Fellow of the Royal College of Surgeons and Licentiate of the Royal College of Physicians of Edinburgh; Fellow of the Royal Microscopical Society; Fellow of the Royal Institute of Public Health; Vice-President (past President) of the Incorporated Society of Medical Officers of Health; Examiner in Sanitary Science, &c., to His Majesty's Civil Service Commissioners; Honorary Consulting Physician to Queen Adelaide's Dispensary; J.P. for the County of London; and Medical Officer of Health for the Borough of Bethnal Green. LONDON: J. S. Forsaith & Son, Printers, 329, Bethnal Green Road 1903. SUMMARY. 1901. 1902. Estimated Population of Bethnal Green—Adults 129,700 129,889 Young Children, under 5 years 17,690 17,720 Made up as follows : Old People, over 60 years 4,782 4,790 *Area— 755 Acres. Number of Inhabited Houses 14,005 14,940 Number of Families or Separate Occupiers (Census) 28,209 — Average number of Persons to each Acre 170 .8 - Total number of Deaths in the year 2,628 2,747 Total number of Births in the year 4,608 4,589 Total number of Marriages 1,084 1,066 Marriage Rate—Bethnal Green 16.1 16.4 Marriage Rate—England and Wales 17.6 17.7 Death Rate —Bethnal Green 20.2 21.1 Death Rate —London 17.6 17 .2 Birth Rate—Bethnal Green 35˙5 35˙3 Birth Rate —London 29˙0 28˙5 Infantile Death Rate (on Births) —Bethnal Green 153 155 Infantile Death Rate (on Births) —London 149 139 Young Children's Death Rate (on estimated number of Young Children) 63.2 64.8 Old People's Death Rate (on estimated number of Old People) 98.7 104.8 Zymotic Death Rate—Bethnal Green 2.8 2.6 Zymotic Death Rate—London 2.2 2.2 Inquest Cases 283 309 Uncertified Deaths (no Inquests held) 2 3 *Note.—For the purpose of this return, a “House” includes all the space within the external and party walls of a building, although parts of the building may be separately entered in the rate book by reason of their being separately occupied. Houses which are not in any way used as dwellings are not included in column 2 of the return, and, consequently, such buildings as warehouses, factories, and workshops are excluded from that column unless they comprise a place of residence for a caretaker or other person. See Eorough Treasurer's Return in Appendix, page 70. Snnopsis OF MEDICAL OFFICER'S ANNUAL REPORT, 1902. Vital Statistics— page Estimate of Population 5 Births 6 Deaths 7 Death Rate 8 Mortality Rates in Sub-Districts 8 Birth Rate 9 Marriages 10 Deaths of Infants 11 Deaths of Young Children 11 Elderly Persons Death Rate 11 Weekly Mortality 11 Special Causes of Death 11 The Seven Principal Zymotic Diseases 13 Notification of Infectious Diseases 14 Small Pox 17 Chicken Pox 32 Scarlet Fever 32 Diphtheria (including Membranous Croup) 33 Enteric Fever 34 Diseases of Parturition 34 Whooping Cough 35 Measles 35 Diarrhœal Diseases 35 Tubercular Disease 35 Phthisis 36 Respiratory Diseases 39 Malignant Disease 39 Uncommon Causes of Death 39 Suicides 39 Murder 40 Uncertified Deaths 40 SYNOPSlS—continued. PAGE Workshops 40 Sanitary Accommodation 4 1 Ventilation in Workshops 43 Bakehouses 44 Cow-Houses 5 1 Milk-Shops and Dairies 5 1 Slaughter Houses 5 2 Ice Creams 5 2 Customs' and Inland Revenue Acts, 1890 and 1891 53 Housing of the Working Classes Act, 1890 54 Sewers and Drains 58 Tables— I.—Vital Statistics of Whole District during 1902 and Previous Years 62 II.—Vital Statistics of Separate Localities in 1902 and Previous Years 64 III.—Cases of Infectious Disease notified during the Year 1902 65 IV.—Causes of, and Ages at, Deaths during Year 1902 ... 66 V.—Shewing the Number of Deaths from the seven principal Zymotic Diseases, inclusive of Hospital Deaths, in the ten years, 1892 to 1901, and in the year 1902 ... 68 Street List 71 Metropolitan Borough of Bethnal Green REPORT. TO THE MAYOR, ALDERMEN, AND COUNCILLORS OF THE METROPOLITAN BOROUGH OF BETHNAL GREEN. Sir and Gentlemen, I have the honour to submit for your consideration my twenty-seventh Annual Report on the Vital Statistics and Sanitary condition of the Metropolitan Borough of Bethnal Green. The period covered by this report includes the 52 weeks of the registration year 1902, which terminated on Saturday, January the 3rd, 1903. ESTIMATE OF POPULATION. The Registrar General estimates the population of Bethnal Green in the middle of the year under consideration at 129,889 ; this estimate, however, does not take into consideration the Alien influx which has been steadily going on for some years past. As I have no means of ascertaining the actual numbers of these immigrants, it will be convenient to accept the official figures, which are calculated upon the rate of increase obtaining during the decade 1890-1900 BIRTHS. The total number of births registered in the Borough during the year is 4,589, against 4,608 in 1901, a decrease of 19. The excess of the births over the deaths is 1,842, this should represent the natural increase of our population, but immigration is constantly going on, and, notwithstanding the foreign influx, our numbers are not increasing at anything like this rate. Table " B " compares the births, deaths, and estimates of population of the two years 1901 and 1902. TABLE B. I 1901. 1902. 129,700 129,889 Estimated population in the middle of the year ... ... 4,589 Total Births 4,608 Total Deaths 2,628 2,747 Excess of Births over Deaths, shewing the natural increase of the population 1,980 1,842 The number of births registered in the three sub-districts into which Bethnal Green is divided are shewn in the following table: — District. Estimated Population. Registered Births. North 51,600 1,938 South 34,000 1,237 East 44,289 1,414 Total 129,889 4,589 Bethnal Green is divided for registration purposes into three subdistricts ; and the table overleaf shews the births registered in each during the year 1902. The populations shewn in the same table are estimates formed upon the numbers of births registered in each subdistrict during 1902, as compared with those in the census year, when the actual inhabitants in each sub-district were counted. The population of the South sub-district has increased, that of the North is nearly stationary, whilst the East appears to have decreased in numbers. DEATHS. The District Registrars forwarded to me particulars of 2,522 deaths in Bethnal Green, indicative of a crude death rate of 18.5, but amongst the deaths so registered, are included those of 245 nonresidents who died in Bethnal Green Hospitals ; in arriving at a correct death rate, these must be excluded. On the other hand, the Somerset House authorities have forwarded to me particulars of the deaths of 470 persons ordinarily resident in Bethnal Green, but registered as having died in public institutions outside our boundaries. After adding these deaths, and subtracting those of the non residents, there remains a net total of 2,747. The deaths in each sub-district, corrected by the distribution of institution deaths, both within and without our boundaries, were as under:— Sub-District. Deaths. North 1,056 South 730 East 961 Total 2,747 DEATH RATE. On the estimated population, I calculate a mortality for the year 1902 of 21-15, this is nearly one per thousand above that of the previous year. The increase is to some extent accounted for by the small pox epidemic from which we suffered in company with other East End Boroughs. The death rate for the whole of London was, however, unaffected by the epidemic, as it shews a small decrease, and stands at 17.2, as against 17.6 for the previous year. MORTALITY RATES IN SUB-DISTRICTS. Amongst the 961 deaths credited to the East sub-district, are included those of 42 homeless persons, who died in the workhouse infirmary. The Registrar General apportions such deaths to the poor law district of the institution in which they occur, and as all districts having workhouse infirmaries are treated in a similar manner, the Borough as a whole, has no reason to complain. It would, however, be manifestly unfair to saddle the East sub-district with the whole of these deaths ; they are therefore excluded in calculating the mortality rates for the sub-districts. In the following table the mortality rates in the three registration sub-districts are shewn, and compared with those of the previous year. It will be noted that the rate in the East sub-district has considerably advanced; here again small pox is responsible, as the visitation fell heaviest on this portion of the Borough. District. 1901. 1902. North 21˙60 20˙46 South 21˙51 21 ˙ 47 East 19˙82 20˙79 1902. Deaths from all causes. In the following table, the mortality rates for London and for Bethnal Green are compared by months; the rainfall and the mean temperature are also shewn for each period. Rainfall (Inches). Month. London Death Rate. Bethnal Green Death Rate. Mean Temperature. January 18˙8 22˙4 40˙5 0˙76 February 26˙5 31˙7 35˙8 1˙13 March 1˙87 20˙9 23˙6 45˙0 April 48˙6 0˙49 17˙3 22˙1 May 16˙4 2˙60 20˙3 50˙7 June 17˙4 59˙8 3˙13 14˙4 63˙3 1˙40 July 14˙3 16˙4 August 14˙9 3˙69 62˙1 15˙9 57˙9 1˙00 September 17˙0 19˙0 19˙4 51˙0 1˙46 October 16˙5 November 1˙80 22˙4 17˙9 45˙0 December 18˙2 1 ˙ 51 20˙1 4 1 ˙ 3 17˙2 21˙1 50˙1 Total R.F.— 20.84 Average BIRTH RATE. The total number of births registered during the year was 4,589 ; this equals a rate of 35-3 per thousand population at all ages, and is slightly lower than that of the preceding year, which was 35.5. The general Metropolitan birth rate is the lowest on record, and stands at 28-5 per thousand. This figure is, as usual, six and-a-half below our own. In the registration sub-districts of Bethnal Green, the birth rates were as under; the death rates in each sub-district are also shewn for purposes of comparison :— Sub-District. Death Rate. Birth Rate. North 37˙57 20˙46 South 21˙47 36˙40 East 20˙97 31˙93 The following table compares the birth rates for Bethnal Green and for London by Quarters: — Quarter ending. London. Bethnal Green. March 29th 29˙8 36˙5 June 28th 33˙7 27˙7 September 27th 28˙9 33˙7 January 3rd 27˙8 37˙4 28˙5 Yearly Average 35˙32 MARRIAGES. First Quarter 211 Second Quarter 231 Third Quarter 273 35 1 Fourth Quarter Total 1,066 This total indicates a marriage rate of 16.4 to every 1,000 persons, as against 17.7 in the whole of England and Wales. DEATHS OF INFANTS. Nearly 26 per cent, of the deaths from all causes were those of infants aged less than 12 months ; for out of 4,589 infants born alive, 710 died before reaching the age of one year ; thus giving a death rate, calculated upon the births, of 155. The corresponding rate for the whole of London is 139. DEATHS OF YOUNG CHILDREN. Nearly 42 per cent, of the deaths from all causes, that is to say 1,149, were those of children aged less than five years. This gives a proportion equivalent to a rate of 64.8, calculated upon the estimated population of young children. ELDERLY PERSONS DEATH RATE. The deaths of elderly persons, that is to say people over 65 years of age, numbered 502. This gives a death rate of 104.8, calculated upon the estimated population of persons over that age. WEEKLY MORTALITY. The line on the Chart " deaths from all causes " indicates the number of deaths week by week, corrected by the inclusion of hospital deaths and the exclusion of non-residents. SPECIAL CAUSES OF DEATH. The table on the next page shews mortality rates for all causes of death, for infantile deaths, and for some of the principal diseases included in Table IV. in the Appendix. The general and special mortality rates are shewn as yearly averages, calculated on the deaths in each quarter on the estimated population in the middle of 1902. The infantile death rate for each quarter is calculated upon the actual number of births registered in that quarter, and the yearly rate upon the total registered births. Quarter ending 1902. Per 1.000 Persons Living. Deaths from All Causes. Principal Zymotic Diseases. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhoea. Phthisis. Deaths under one Year to 1,000 Registered Births. 12 March 29th 25.6 3.62 1.02 0.52 0.19 0.31 1.33 0.19 0.06 2.47 142 June 28th 20 .2 2.96 0.83 0.65 0.09 0.28 0.93 0.03 0.15 1.88 154 September 27th 17.2 2.49 0.12 0.19 0.15 0.15 0.43 0.12 1.33 1.82 161 December 28th 2.15 1.30 — 0.43 0.14 0.26 0.06 0.09 0.32 1.72 164 Rate for the year 1902. 21.1 2.6 0.49 0.45 0.14 0.25 0.68 0.11 0.46 1.99 155 THE SEVEN PRINCIPAL ZYMOTIC DISEASES. The total number of Zymotic deaths is 339; of these 267 were amongst young children aged less than five years. In table "D " the number of deaths from each disease in this class is shewn and compared with those of the preceding year. TABLE D. 1901. 1902. Small Pox 64 2 Measles 84 59 Scarlet Fever 44 19 Diphtheria 63 33 Whooping Cough 89 38 - - Typhus Fever 14 19 Enteric Fever Simple Fever 1 1 119 Diarrhœa 60 Total 370 339 Twelve and-a-quarter per cent, of the deaths, from all causes,, arereferred to the diseases included in table " D," against 14 per cent, in 1901. The actual decrease in numbers is 31. Notwithstanding the small pox epidemic, which is responsible for 64 deaths, the 339 Zymotic deaths were 112 below the decennial average for the ten years 1892 to 1901. Table V. in the Appendix shews this average to be 451. From an examination of Table "D" it will be seen that, with the exception of small pox and whooping cough, the mortality from all the Zymotic diseases has decreased, and that this decrease is most marked under the heads of scarlet fever, diphtheria, and diarrhoea. The deaths from the last named disease have fallen from 119 in 1901, to 60 in 1902 ; the cool summer and plenteous rainfall undoubtedly conduced to the washing away of effete matter before it had time to decompose. This probably accounts for the diminution in the number of diarrhœa deaths. The death rate from the seven principal Zymotic diseases is 2.6, against 2 8 in 1901, whilst the corresponding Metropolitan rates are 2.2 for each year. Table " F" shews the percentage of deaths from each disease, as compared with the total number of Zymotic deaths. TABLE F. Small Pox caused 64 deaths. 18˙8 per cent., or 1 in 5˙2 deaths. Measles „ 59 „ 17˙4 „ „ 5.7 „ Scarlatina „ 19 „ 5˙6 „ „ 17.8 „ Diphtheria „ 33 „ 9˙7 „ „ 10 ˙ 3 „ Whooping Cough „ 89 „ 26˙2 „ „ 3˙ 8 „ Enteric Fever „ 15 „ 4˙4 „ „ 22˙6 „ Diarrhœa „ 60 „ 17˙7 „ „ 5.6 „ NOTIFICATION OF INFECTIOUS DISEASES. The total number of notification certificates received during the year was 2,873 ; of these 226 were duplicates, a proportion of eight per cent, on the whole number. Forty-five certificates were forwarded to the medical officers of other boroughs, as the residences of the patients to which they referred were outside Bethnal Green. Six certificates were withdrawn by the senders as the result of revised diagnoses. The certificates relate to a total of 2,596 persons; Table 111. in the appendix indicates the disease from which each of them suffered. It also shows the sub-districts in which they resided, and the number, 1,369, of those removed to hospital. The cases of mistaken diagnoses, that is to say instances where the notification certificate under the hand of the medical attendant was found, upon further investigation at the hospital, to be incorrect, were as follows :— Small Pox 35 Diphtheria 25 Scarlatina 27 Enteric Fever 12 Total 99 This figure indicates a proportion of error equal to 7.2 per cent, on the total admissions to hospital during the year. It compares favourably with that of other districts, as will be observed by an inspection of the return on the next page. Metropolitan Asylums Board. London, E C., Dear Sir, 5th February, 1903. Hospitals Department—Cases of Mistaken Diagnosis In connection with the subject of hospital provision for infectious diseases, I am directed by the Hospitals Committee of this Board to advert to the statistical reports issued annually (a copy of which is sent to each Medical Officer of Health of the Metropolis), and in particular to the figures set out in the tables concerning cases of miscellaneous disease admitted into the Board's hospitals. The Committee have caused this information to be collated for three years, and X have been requested by them to transmit to you the accompanying summary of these cases, with a view to the assistance of the Medical Officers of Health being secured to prevent, so far as circumstances may make it practicable, the introduction into this Board's hospitals of cases of " other diseases " than those which such hospitals are designed to treat. Yours truly, T. DUNCOMBE MANN, The Medical Officer of Health, Clerk to the Board Bethnal Green. Summary of Cases of Mistaken Diagnosis treated in the Board's Hospitals during 1899, 1900 and 1901. Parish or Union. No. of Cases Admitted. Percentage of Mistakes to Total Cases. 1899. 1900. 1901. 1899. 1900. 1901. Kensington 33 51 5˙6 8˙3 43 6˙8 Hammersmith 24 26 7˙3 5˙5 5˙3 24 Fulham 53 70 4˙2 6˙5 6˙6 73 Paddington 18 28 38 3˙8 7˙3 5˙5 Chelsea 25 22 19 6˙0 8˙2 5˙9 St. George's 16 30 8˙7 7˙8 3 1 3˙4 Westminster 15 24 7˙9 13 ˙ 2 13 9˙4 St. Pancras 46 39 5˙7 7˙3 30 8˙0 St. Marylebone 66 70 115 5˙5 6˙2 7˙0 Hampstead 12 15 10 6˙3 4˙3 4˙8 Islington 131 88 112 8˙0 6˙8 6˙7 Hackney 111 93 157 8˙9 9˙6 8˙1 Bloomsbury 6 9 5˙5 5˙3 5˙9 4 Strand 7 4˙4 10˙6 12 ˙ 7 3 9 Holborn 75 37 72 8 ˙ 5 6˙9 7˙3 City of London 5 13 13˙4 4˙5 9˙3 14 Shoreditch 81 74 119 12˙0 11˙9 14˙4 Bethnal Green 44 55 8˙2 10˙4 8˙4 82 Whitechapel 49 75 82 13˙6 12˙4 16˙1 St. George in the East 17 36 10˙4 13˙2 14 ˙ 0 29 Stepney 17 39 66 11˙7 14˙7 6˙2 Mile End Old Town 58 8˙6 12˙6 27 36 6˙4 Poplar 60 131 8˙4 7˙3 13 ˙ 1 49 Southwark 115 173 7˙7 9˙8 126 6˙5 St. Olave's 130 76 11 ˙ 0 88 5˙9 10˙4 Lambeth 106 132 4˙4 10 ˙ 1 70 7˙9 7˙5 4˙9 Wandsworth and Clapham 122 108 122 7˙6 Camberwell 124 9˙8 9˙0 94 156 5˙7 Greenwich 66 4˙8 10 .5 58 125 6˙4 Woolwich 3˙7 11 ˙ 0 63 42 37 4˙0 Lewisham 52 48 6˙5 9˙3 55 6˙0 Tottenham 33 27 48 10˙6 7˙4 9˙4 Extra Metropolitan - 6˙0 18˙2 - 4 3 Totals 1,583 1,706 2,365 7˙9 9˙2 6 ˙ 3 1901 small box. 1902 small pox. Notifications. - Deaths. SMALL POX. ( Deaths, 64. Decennial average, 2.) The number of cases notified daring the year was 520, but thirtyfive of the patients were sent back from hospital within a few hours of removal as they were not suffering from small pox ; sixty-four deaths were registered. The epidemic commenced at the end of August, 1891, and continued until the last case reported on September 16th, 1902. The disease first broke out in Bethnal Green at the Salvation Army shelter in Green Street, here a music hawker sickened and was removed to hospital. On August 23rd, twelve days afterwards, another inmate, also a music hawker, who had slept in the bed next to the previous case of small pox, developed the disease and was removed. We had no more cases until October, when one occurred in Viaduct Street. This patient, a female, was promptly removed and the disease did not spread. The next centre of infection was an undiagnosed case in Virginia Road where a girl (who was supposed by her medical attendant to be suffering from chicken pox) was allowed to remain at home until convalescent, and subsequently (whilst in the scabbing stage of the disease) resumed her usual employment until I traced her and got her away to hospital. It would be impossible to say how many persons she infected. The next outbreak was at Father Jay's shelter in Old Nichol Street, whence the infection was carried by another inmate to a common lodging house in Whitechapel; with the exception of this one no further case came to our knowledge from this source. I am sure that Mr. Foot's vigilance and prompt action prevented a serious outbreak here. 2 REPORT BY MEDICAL OFFICER OF HEALTH ON OUTBREAK OF SMALL POX AT 35, ROMAN ROAD, BOROUGH OF BETHNAL GREEN. On January 2nd, 1902, I received a communication from the Medical Officer of Health for Poplar, to the effect that a Miss 8., aged 22, had been removed to the Small Pox Hospital on December 31st, 1901, from 12, Lacey Street, Bow. The patient had been a female assistant at E.'s (Drapers), Roman Road. She fell ill on December 27th, came home to Lacey Street on the 28th, showed small pox eruption on the 30th, and was removed to hospital on the 31st. Miss B. informed Dr. Alexander that she had been in attendance on a fellow assistant named Sarah Jane M., who had slept in the same bedroom with her until she was sent to her home in Wales, with an eruption well out on her face and wrists. Dr. Alexander could not tell me Miss M.'s destination, but he was informed that she had been attended by a doctor named Lewis, whose address he did not know. On receipt of this letter Inspector Richards was directed to visit 35, Roman Road, in order to obtain further particulars. I received Mr. Richard's report at Worship Street at 2 p.m., and as soon as I was able to get away from the Court I drove with Mr. Richards to 35, Roman Road. We found the shop closed for the Thursday half holiday, but obtained admission. I saw Mr. E. and obtained the following particulars :— "Miss M. was last in business for half-an-hour on Monday, December 16th, she was ill and went upstairs to bed. On Tuesday, December 17th, Mr. Lewis, who is a friend of Mr. E.'s, came into the shop. Mrs. E. informed him that one of the female assistants was not well, and asked him to see her, he examined Miss M., prescribed for her, and informed Mrs. E. that the girl was in a very weak state and that he was afraid she was in a consumption. On this report Mrs. E. communicated with Miss M.'s friends, Messrs. T. (Drapers), of Long Lane, Southwark, and asked them to write to Miss M.'s eldest brother in London. ' Dr.' Lewis continued his attendance, and Mr. William M., on receipt of a letter from Long Lane, visited his sister at 35, Roman Road, on Thursday, December 19th. Here he saw " Dr." Lewis, who advised removal to the country, he also said that Miss M. was fit to travel, and it was arranged that Monday, December 23rd, should be the day of departure." The only persons who saw Miss M. after December 16th, and previously to her leaving for Wales on December 23rd, were the residents at 35, Roman Road, the nurse girl, a clergyman (the Rev. C. Jones, of 8, Hilda Road, Brixton), " Dr." Lewis, and Miss M.'s two brothers. I was also informed that, since Inspector Richards's visit earlier in the day, Dr. Morgan Davis, the usual medical attendant of the family, had been called in to see Mrs. E. (who was near her confinement), and a little child who was suffering from bronchitis. I inquired as to any other illness in the house and was informed that Lily M., aged 17, another shop assistant, and a room-mate of Miss M. also, was ailing, I found her with a high temperature (103°) and the usual premonitory symptoms of variola; I advised her immediate removal to hospital and she was removed the same afternoon. I ascertained that Miss M., who went to Wales on December 23rd, had proceeded to Langton House, Ystalyfera, in Glamorganshire. Reference to Churchill's Medical Directory showed that Dr. Thomas is the Medical Officer of Health for that district. A telegram was sent to him at once with the necessary particulars, and a letter confirming this followed by post. I ascertained that " Dr." John Lloyd Lewis resided at 96, Antill Road, that he had been an irregular practitioner in Wales, and was now a medical student at the London Hospital. Mr. E. knew that this man was not a qualified medical practitioner. Late in the same day Dr. Morgan Davies again visited his patients at 35, Roman Road, and afterwards telephoned to me that he was of opinion that Mrs. E., aged 32, was sickening for small pox, also the day nurse girl Caroline 8., who slept at 47, Palm Street. I advised him to forward the necessary certificates by hand to the ambulance station at Homerton, as it was then too late (n p.m.) to communicate with the authorities at the Metropolitan Asylums' Board office. I understood that this was done, and Mrs. E. and the nurse girl were removed on January 3rd. Immediately the patients were removed, the living rooms at 35, Roman Road (except one in which the child suffering from pneumonia lay) were cleared out and disinfected under the personal supervision of Mr. Richards, as were also the rooms at 47, Palm Street. The premises were kept under observation, and on January 4th I found E. W., aged 20, a shop assistant, and M. D., aged 29, a servant, both with premonitory symptoms of small pox, and although neither showed eruption, I had no hesitation under the circumstances in directing the removal of these two girls to the hospital, and the premises were again disinfected. On January 5th I received a letter from Dr. Thomas of Ystalyfera, acknowledging receipt of telegram and letter of January 2nd ; these he said were too late to be of value to him, as he had on that day been called to see two brothers and a sister of Miss M. at Langton House, evidently sickening for small pox; he had also received information of other cases contracted from the same source. I wrote Dr. Thomas forwarding further particulars, and heard from him again on January 7th, to the effect that there were already eleven cases of small pox in four families residing in his district, all arising from direct contact with Miss M. On January 6th I was requested by a medical man in Old Ford to see a case of suspicious illness with him at 71, Ellesmere Road; here I found Mary Ann F. suffering from small pox with eruption well out. I ascertained that her mother did the washing at 35, Roman Road, and that Mary Ann F. collected and sorted the soiled linen. This patient was forthwith removed to hospital and the premises disinfected. I may mention here that the circumstance of the washing from 35, Roman Road, being done at 71, Ellesmere Road, was not communicated to me by Mr. E.; he stated that he did not know where his wife had her washing done. In the evening of January 7th I received another visit from Dr. Morgan Davies, who called to report a case of small pox at 96, Antill Road. The patient was the identical Irregular Medical Practitioner to whose ignorance and presumption the whole outbreak is due. I advised Dr. Davies how to get his patient removed, but discovered the following morning that 96, Antill Road, is in Poplar, just outside Bethnal Green. I have since heard that Lewis died in hospital. I note from the L.C.C. daily return that F. M., a draper's assistant, aged 18 years, employed by Mr. Herbert Thomas, of 134, Long Lane, Southwark, sickened on January 2nd, and was removed to the Small Pox Hospital on January 6th; he visited his sister at 35, Roman Road, on December 22nd, and dined with the family. Dr. Thomas, in his letter of January 7th, gave me the address of Miss M.'s elder brother, who is employed in the goods department at St. Pancras Station, and who had an interview with Mr. E., the employer of Miss M., and also with the unqualified " Doctor " who advised her removal to Wales. I wrote to Mr. M., and also directed Inspector Richards to call upon him for the purpose of obtaining such information as was possible. I append Mr. Richards's report: — By direction of Dr. Bate, I went to see William M., of 49, Fairbridge Road, Upper Holloway, on 10th January, 1902, in respect of his sister. M. said he heard first that his sister was ill on Wednesday or Thursday, December 18th or 19th, by letter from Long Lane, Borough. He went to see his sister on Thursday, December 19th, at 35, Roman Road. Whilst he was there "Dr." Lewis was sent for; he informed Mr. M. that his sister was very ill, her lungs being diseased, and advised that she should be sent to the country. The people at 35, Roman Road thought that Miss M. could travel to Wales on Saturday night, December 21st, as there was an excursion, but William M. demurred, he thought that as his sister was ill, it would be better that she should travel by day, and suggested Monday, which was agreed to. He quite thought that Lewis was a doctor, and that in removing his sister to Wales he was acting on the advice of a properly qualified medical man. William M, called on December 23rd at about 9 o'clock a.m. for his sister; they took an omnibus to Bishopsgate and train to Paddington and travelled by G.W.R. to Wales. After William M. had given me the above information, I noticed a rash on his face, and asked him to shew me his arms, and I saw a rash there. He told me he had been feeling unwell and had been sent home from work that day. I asked him if he had seen a doctor, he replied " No," but intended going to see one that night. Being satisfied in my own mind that the man was suffering from small pox, I told him it would be better for me to go for a doctor, and advised him not to leave the room in which this conversation occurred (front parlor). I went to get a medical man, and brought Dr. Martin of Fairbridge Road, and was with him when he examined M. He certified the case as one of small pox. I went to the Town Hall, Upper Street, and I saw Inspector Lawrence, to whom I gave the certificate. William M. said he first heard that the family at Ystalyfera were down with Small Pox on Monday, January 6th. Signed, EVAN RICHARDS, January 11th, 1902. Sanitary Inspector for the Borough of Betlinal Green. It is suggested that E., the head of the family of which Miss M. was a member, must have been aware of the infectious nature of his assistant's illness, and that the object of his calling in an irregular practitioner and passing him off to Miss M. as "a very clever doctor from the London Hospital," was a dodge to avoid the statutory duty of reporting the case to me; any way, if E. really was as ignorant as he professes to be of the true nature of Miss M.'s illness, he shewed gross carelessness, bordering on actual inhumanity, inasmuch as he neglected to call in proper medical aid for a girl to whom he stood in loco parentis. I recommend that E. be prosecuted for failing to report to me that an inmate of his house was suffering from small pox, as required by Sec. 55 of the Public Health (Lond.) Act, 1891. Also for unlawfully exposing Miss M., whilst she was suffering from an infectious disease, in a public place, contrary to Sec. 68 of the same Act. Had Lewis recovered from his attack of small pox, I should have felt it my duty to draw the attention of the Secretary of the Apothecaries' Company to this man's conduct, as he appears to have rendered himself liable to a penalty of £10 for illegally acting as an apothecary. I also suggest that the attention of the Asylums Board be drawn to the difficulty at present experienced in obtaining the removal of a patient suffering from an infectious disease late at night and oil Sundays. The least the Board can do is to place the Ambulance Stations in Telephonic communication with the Local Authorities, as with a virulently infectious disease such as small pox is, every moment's unnecessary delay in removing the patient is fraught with danger to the public. I am also of opinion that the residences of your Chief Inspector and Medical Officer of Health should be connected by telephone with the Town Hall. Signed, GEORGE PADDOCK BATE, M.D., Medical Officer of Health for Belhnal Green. The matter was carefully considered by the Public Health Committee. Mr. E. was called upon for an explanation, but he absolutely denied all knowledge of the nature of his shop girl's illness, and as it was impossible to prove that he was aware she was suffering from small pox, it was decided not to institute Police Court proceedings. With reference to this case, I extract the following paragraph from the 1902 report of Dr. Thomas, the Medical Officer of Health for the Eastern District of Pontardawe in Wales: — Early in January we had the misfortune of having small pox imported from London into Ystalyfera, and before becoming aware of the fact we had, in nine different families, eighteen cases of small pox. Fourteen of these were traced to direct contact with the imported case, and occurred almost simultaneously; the remaining four arose probably from secondary infection from some of the infected centres. There being at the time no small pox hospital in the district we had to place our reliance entirely upon isolating the cases as well as we could in the infected houses, and in preaching and practising vaccination and revaccination throughout the whole district. And it was really gratifying to find the readiness with which the people, especially those residing in the infected area, availed themselves of the protection of vaccination. During the early excitement of the first outbreak the applications to be vaccinated were so numerous that it was with great difficulty sufficient calf lymph could be procured to meet the demand. There were in all revaccinated over eleven hundred persons, who were nearly all residents of Ystalyfera or the immediate neighbourhood. Particulars of a number of noteworthy centres of small pox infection, and methods by which the disease gets distributed, will be found fully set forth in my monthly reports for 1902, but it is only necessary to recapitulate two of these :— On June 17th my attention was called by an anonymous letter to a house in Baxendale Street; here I found a lad aged 15, and a man aged 27, both suffering from well marked small pox. No doctor had been called in. The father said he did not know the nature of his son's illness, but I felt certain this ignorance was assumed. Both patients were removed to hospital. Three unvaccinated persons in another family residing in this house were vaccinated next day, but too late to prevent small pox, which developed a week afterwards. All three were removed to hospital, as was another person from an adjacent house. The particulars were reported to the Public Health Committee, a prosecution was ordered, and the father of the two first patients was summoned to Worship Street for failing to notify as required by Sec. 55 of the Public Health (London) Act, 1891. Unfortunately we failed to prove that the father was aware of the nature of the illness from which his sons were suffering, and the summons was dismissed by Mr. Cluer (the magistrate) who inclined to the idea that had the father been aware that his sons were suffering from such a serious affection as small pox he would certainly have called in a doctor. This case illustrates the difficulty there is in getting non-medical persons to grasp the fact that a patient may be suffering from a modified though very infectious form of small pox and yet feel well enough to walk about and even follow his usual avocations. At the end of the first week in July the epidemic appeared to be subsiding. Three persons, aged respectively 5, 26, and 32, were removed from 23, Hersee Place, on July 1st, 4th, and 6th respectively, but no further case was reported until July 25th (an interval of 19 days), when E. R., a female aged 22, was removed from 21, Hersee Place, next door to the house whence the three persons mentioned above were removed nearly three weeks previously. At first sight this appeared to be a fresh outbreak, but upon further enquiry it transpired that the little child of A. R., who was removed from 23, Hersee Place on July 6th, had been taken charge of by relations at 21. It was then supposed that this little child might in some way have conveyed the infection. On August Ist three other cases were removed from 21, and, on revisiting the premises, I elicited with some difficulty the fact that S. V., an adopted child of the occupier of 21, had been ill about four weeks previously with what was stated to be chicken pox. This child was reluctantly produced for my inspection, and I found her covered with small pox marks and with many crusts still unfallen. Shortly after my visit Inspector Richards called, and to him S. V.'s presence was denied. He searched the premises, and found the girl concealed in a henhouse in the yard. She was removed to hospital on my certificate. I have since ascertained that on each occasion these premises were visited either by Mr. Richards or myself, S. V. was similarly concealed, as she had a great dread of being taken away to hospital. The case had not been notified (either as small pox or chicken pox) by the person who had charge of S. V., and no doctor had been called in. Altogether eight cases of small pox were directly traceable to this one unreported case. By direction of the Public Health Committee the person who had charge of the child was prosecuted at Worship Street for failing to notify the case as required by Sec. 55 of the Public Health (London) Act, 1891. He was fined twenty shillings and twenty-three shillings costs. In this instance we were before Mr. Haden Corser and had the good fortune to obtain a conviction, but here the same difficulty arose as in the Baxendale Street case, we could not prove, except indirectly, that the person in charge was aware of the disease from which the child was suffering, and that he knowingly concealed the fact. I am strongly of opinion that the Public Health Act should be amended in the direction of requiring that the head of a family who has reasonable cause to suspect that a person in his charge is suffering from a dangerous infectious disease, should either report his suspicions to Medical Officer of Health or call in a doctor, who would confirm or disprove them. Since the commencement of the epidemic in August last 510 cases of true small pox have been reported to me from 327 houses ; in addition to these, forty-one persons were incorrectly certified to be suffering from small pox, and though removed to hospital were returned to their homes after revaccination. Of these 41 persons only one is known to have subsequently developed small pox, and this case was a doubtful one. The numbers notified week by week since August, 1901, are shown on the chart herewith. All were removed to hospital, with the exception of one man who died from haemorrhagic small pox before the disease was recognised. Cases of Small Pox Reported—August, 1901, to November, 1902. Under 13 years. 25 and upwards. 13 to 25. Vaccinated. Unvaccinated. No information. Vaccinated. Unvaccinated. No information. Vaccinated. Unvaccinated. No information. 22 115 2 151 8 149 8 26 9 Deaths from Small Pox. Under 13 years. 13 to 25. 25 and upwards. Vaccinated. Un vaccinated. No information. Un vaccinated. No information. Vaccinated. No information. Vaccinated. Un vaccinated. 0 30 0 3 2 18 3 2 6 The particulars given in the first of the two tables as to vaccination are such as the Inspectors were able to obtain upon enquiry, but as a large proportion of the patients were removed prior to my visit, I was unable to check the statements by actual observation. The particulars as to the fatal cases in the second of the two tables are extracted from the death certificates, and I have no doubt are correct. The total deaths amongst the 510 cases were 65; this gives a gross mortality of 12.7 per cent. Three hundred and twenty-two persons were stated to have been vaccinated at some period of their lives, and amongst these there were 24 deaths, a mortality of per cent. One hundred and fifty were avowedly unvaccinated, and of these 36 died, a mortality of 24.0 per cent. In 18 cases we were unable to obtain any information as to vaccination or otherwise, so I have not taken them into consideration. On this point the death certificates in four cases state that no information as to vaccination could be obtained. Possibly complete statistics as to each Metropolitan Borough will shortly be available, but the Medical Officers of the Metropolitan Asylums Board are the only persons who can make accurate statements as to vaccination. In February we received a visit by appointment from Dr. Fletcher, one of the Medical Inspectors of the Local Government Board, and a conference was held at the Town Hall, at which were present the Chairman of the Public Heath Committee (Mr. Belsham), the Town Clerk, the Chief Inspector and myself. The object of Dr. Fletcher's visit was to ascertain what Bethnal Green was doing towards checking the epidemic. The Inspector first enquired as to the action of the Poor Law Guardians. He was informed that they had issued a broadsheet, setting forth the protective power of vaccination, and pointing out the risks of neglect, these statements being supported by statistics of the Metropolitan Asylums' Board; this broadsheet had been extensively posted on the walls throughout the Borough, together with the names and addresses of the public vaccinators. Dr. Fletcher was of course aware that chicken pox had been made a notifiable disease in Bethnal Green since October, 1901, and he was supplied with statistics of the cases reported. He next enquired as to the provision of a shelter, and was informed that after many refusals, premises had been secured and furnished, and the chief disinfector and his wife placed in charge. The action of Mr. Foot, in enlarging and strengthening the staff of disinfectors, &c., was described, and their methods of working were detailed. The type of disinfecting apparatus in use was next brought under review. Here Dr. Fletcher recommended certain improvements, and advised that the machine should be modernized by the addition of a vacuum apparatus for rapidly drying articles after disinfection; he further advised that a self-recording steam gauge should be fixed in order to ensure the maintenance of a proper temperature during the operation of disinfection. Dr. Fletcher also advised the installation of a laundry in connection with the disinfecting station. His next suggestion was that an arrangement should be made with the medical practitioners in the district whereby, on payment of an additional fee, an extra copy of the notification certificate should be given, one of these to be left with the patient, as required by the regulations of the Metropolitan Asylums' Board, and the other to be immediately forwarded to the Town Hall by special messenger. Dr. Fletcher was of opinion that much valuable time would be saved by the adoption of this plan. The Doctor is evidently a man of wide experience, he is a staunch advocate of the protective power of vaccination, as every sensible man must be ; he enquired how many members of the sanitary staff had undergone re-vaccination, and expressed a strong opinion to the effect that those who had not done so, should be given the option of either being re-vaccinated or of taking their discharge. On the whole, he expressed himself as thoroughly satisfied with the action of the Council and its Officers. A report of the interview was laid before the Public Health Committee, and it was decided to pay an additional fee of 2s. 6d. over and above the legal notification fee, for copy certificates; also a fee of is. to the messenger who brings the document to the Town Hall. The effect of the adoption of this plan was that instead of the notification of cases of small pox reaching us in the course of post, the Sanitary staff were made acquainted with the nature of the case within half-an-hour of the doctor's visit, with the result that frequently the patient was removed, and disinfection well in hand, hours before information could have reached us through the post. Enquiries were made of Messrs. Manlove, Alliot and Fryer, as to the addition of the vacuum apparatus and recording steam gauge to the present disinfector, but as it was found that these could not be fitted without suspending the use of the machine for at least a week, action in this direction was postponed. As a matter of fact, the capacity of the disinfecting apparatus has been strained to the utmost on several occasions, and for some weeks steam was kept up almost continuously day and and night, fortunately without any serious mishap, though a burst tube or a leaky valve would have had most disastrous results. I may here mention that the Council has recently sanctioned the provision of a new disinfecting station, with a second set of apparatus, at an estimated cost of With reference to Dr. Fletcher's suggestion that the employes of the Council who were likely to come in contact with small pox cases in the course of their duties, should be ordered to be revaccinated, the Public Health Committee resolved accordingly, and an attempt was made in this direction ; it was, however, soon evident that if persisted in, we should be left without a disinfecting staff, and. the resolution was modified. The following is a List of the Cases of Small Pox amongst the Council's Employes in the Public Health Department. Name and Address of Employe. Date of removal to Hospital. Particulars as to Vaccination. Occupation Remarks. In Infancy. The Wife of this man removed to 1, Baxendale street, 14 days afterwards, S. I., aged 15, was removed to Small Pox Hospital. William Thomas, 45, St. Peter street. November 6th, 1901. Permanent Disinfector. Edwin Ainley, 4, Robinson road. November 12th, 1901. Sanitary Inspector. Re-vaccinated 6 days before removal. February 16th, 1902. Temporary Disinfector. In Infancy. William Suter, 59, Moss street Fatal Case. Wife contracted Small Pox and was removed March 17th, Re-vaccinated March 9th. Recovered. William Harper, 23, Egglington road, Poplar, E. March 9th, 1902. Temporary Disinfector. In Infancy. In Infancy. John Jeapes, 20, Wennington road May 19th, 1902. Temporary Stripper. Previous cases in house. Charles Hussy, 28, Arundel street. May 20th, 1902. Temporary Disinfector. In Infancy. Mother, E. H., removed May 28th Vaccinated in infancy. Robert Turner, Jr., 10 Devas street, Stepney, E. May 20th, 1902. Temporary Disinfector. Unvaccinated. John Ward, 37, Medhurst road. May 24th, 1902. General Assistant. In Infancy. Alfred Dunster, 10, Vyner street. May 29th, 1902. Temporary Stripper. In Infancy. Several of the cases were severe, but all recovered, except Harper, who died shortly after admission to hospital. All of them had been urged to submit to re-vaccination on first employment, and the danger they incurred was clearly pointed out to them, but with the exception of Inspector Ainley, they declined. The Sanitary Inspectors who had not been re-vaccinated underwent the operation, and though I had had small pox myself, I considered it wise to do the same. Inspector Ainley was re-vaccinated during the stage of incubation, and had a very slight attack. Throughout the epidemic the sanitary staff have been prompt and energetic in dealing with the cases as they were reported. How we should have managed without a telephone I scarcely know, though delays, even with the present system, are unavoidable. An exchange station, confined to the Borough Councils and the Hospitals, would save time. The office has been kept open daily, Sundays included, until nine every evening, and a sanitary Inspector and a disinfector have been constantly on duty ready to receive and deal with notifications as they arrive. This arrangement was in operation from February 3rd, 1902, to August 31st, 1903. Persons who have been exposed to infection, have been kept under observation for the period of incubation and medically examined by me on the least symptom of illness. The employers of such contacts have been sought out where possible and advised, but latterly many false answers have been given to the enquiries of the inspectors. I am of opinion that the giving false answers respecting cases of infectious disease should be made a punishable offence. The schools attended have been always promptly notified; in one or two instances it was found necessary to close and fumigate infected class rooms. Full particulars, with lists of contacts, have been supplied daily to the Public Vaccinators by special messenger, and an enormous amount of vaccination and re-vaccination has been accomplished by these officers. Just as this report is going to press, a difficulty has arisen with reference to the payment for copy certificates and messenger fees on the plan recommended by the Local Government Board Inspector; the Government Auditor, who is an official of the same Board, is of opinion that these payments are illegal, as they are not provided for in the Public Health (London) Act 1891, and he declines to sanction them. The matter is still under consideration. CHICKEN POX. (No Deaths.) This disease was made notifiable in Bethnal Green under Section 56 of the Public Health (London) Act, 1891, for a period of six months from October 16th, 1901. Subsequently the London County Council exercised their powers under the same section, and the disease was made notifiable throughout London for the six months up to and including November 6th, 1902. The order was afterwards extended for an additional period of two months. The total number of cases reported during 1902 was 860, none of the cases were removed, except thirty incorrectly diagnosed. All these, together with five others who were suffering from measles (though all were reported as small pox), were sent home again after revaccination at the wharf, only one of the chicken pox cases developed small pox. Sixteen of the persons reported as chicken pox were found upon examination to have small pox and were sent to hospital. Undoubtedly these persons would have remained at home distributing infection had chicken pox not been reportable. SCARLET FEVER. (Deaths, 19. Decennial average, 32.) The number of cases notified during the year was 511, and the deaths numbered 19, a rate on the notifications of 37 per cent. The death rate in the Asylums Board hospitals was 3.81 per cent, on the total admissions from the whole of London. The scarlet fever death-rate is equal to 0.14 per thousand population whilst that of London is 0.12. From the North subdistrict 212 cases were reported, from the South 130, and from the East 169. Four hundred and thirty-five persons were removed to hospital, but with respect to 27 of these 1902 Srarlation 1902 Diphthrrin. a report was received from one of the hospital medical superintendents to the effect that the certificate under which the patient was removed to hospital was incorrect, inasmuch as the patient was not suffering from any form of notifiable disease. In addition to these a number of the cases notified as scarlet fever turned out to be suffering from diphtheria and vice versa. The Inspector's reports on the sanitary condition of the residences of the sick persons give the following particulars : In 203 instances the premises were in a fairly good condition, in 40 the closets were out of order, in 11 the drains inside the house were leaky, and in 34. the external drains were defective. In four instances the premises were overcrowded, and minor insanitary conditions were noted in 179. Thirty-seven of the cases occurred amongst families inhabiting one room only. DIPHTHERIA (including MEMBRANOUS CROUP). (Total deaths, 33. Decennial average, 90.) The total number of cases reported under the two heads was 310, 11 of these were designated membranous croup. The deaths numbered 33; this indicates a mortality rate of io - 6 per cent, on the notifications. The Asylums Board death rate on the admissions for the whole of London is 11*15 per cent. On the estimated population at all ages the mortality is 0-25, whilst the general Metropolitan rate is 0.24. Of the notifications, 136 of the diphtheria and five of the membranous croup cases were reported from the North sub-district, 71 and 3 from the South, and 92 and 3 from the East. 235 patients were removed to hospital, 25 of these were subsequently reported as incorrectly diagnosed. Amongst the 235 persons removed to hospital, are included five children suffering from croup, admitted to either the London Hospital or the North Eastern Hospital for operation. In 138 instances, the residence of the patient was found to be in a satisfactory sanitary condition, but in 35 the closets were faulty, in three the external drainage was out of order, and in four the internal drainage was defective, and minor insanitary conditions were found in 151 instances. 3 ENTERIC FEVER. (Deaths, 14. Decennial average, 22.) The total number of cases reported during the year was 132, with fourteen deaths certified as enteric fever and one as simple fever. The case mortality on the number notified was 11.3 per cent. The general death rate in the Metropolitan Board Hospitals was 14.2 per cent, on the total admissions. The mortality rate on the population was 0.11, which is identical with the rate for the whole of London. The Inspectors report that in 60 instances the premises were in a fairly satisfactory condition ; in 14 the w.c.'s were defective; in four the internal drains were faulty, and in two the external drainage arrangements were unsatisfactory. In one instance the premises were overcrowded, and other minor insanitary conditions were found in 62 houses. Ten cases occurred in families inhabiting one room only. Forty-four of the patients were removed to hospital, where 12 of them were found upon further examination not to be suffering from enteric fever at all. Enquiry was made in each case as to the habits of the sick person with reference to the eating of shell fish, but no definite statistics could be obtained. Some of the patients had been in the habit of eating mussels and winkles, but hitherto oysters have been too expensive for Bethnal Green, and other shell fish is usually cooked before it is eaten. I think that the scare which is the result of recent revelations as to sewage-fed oysters will have produced such a fall in price as to bring this delicious bivalve within the reach of many who could not otherwise afford them. It may be that this fall in price will shift the incidence of typhoid fever from the rich to the poor. DISEASES OF PARTURITION Ten women were reported to be suffering from puerperal fever, of whom six died. Eight women died from diseases, other than puerperal fever, incidental to childbirth: the causes of death stated on the medical certificates were as under :— 1902. a mortality upon the estimated population of young children of 5.3 per 1,000. PHTHISIS. (Deaths, 259). The death rate from phthisis alone is equal to 2.0 per 1,000 in Bethnal Green, whilst that for the whole of London is 1.6. It is only within the past ten years that the infectious nature of tuberculosis has been generally recognised, and even now very few sanitary authorities take any steps to check the spread of a scourge which is more fatal to youth and middle age than all the seven principal Zymotic diseases put together. The Local Government Board will not sanction the inclusion of phthisis amongst the (compulsory) notifiable diseases, but voluntary notification has been attempted in some districts and has met with a modified amount of success. Its chief use is for the purpose of enabling Public Health Authorities to issue instructions to phthisical persons pointing out how they may best avoid communicating the disease with which they are affected to others. It would be impossible to isolate every case of phthisis, for the early stages of this disease do not preclude the sufferer from being a useful member of society and earning his own living with safety to others, provided he adopts certain precautions. It is the later stages of the disease that are so dangerous to others. A man whose lungs are riddled with cavities sprays everything around him with germs each time he coughs. The mucous he expectorates is deadly, and unless received in proper vessels and subsequently destroyed, dries and forms infectious dust. Those who have command of money can and do take proper precautions under medical advice, but my experience is that in the humbler walks of life a sufferer from the later stages of consumption will haunt the out-patients' rooms of hospitals until he is too feeble to walk. He can rarely be admitted, as hospitals are not asylums for hopeless cases, so the poor fellow (perhaps until recently the support of a family) remains at home to die. Soon his circumstances become more straitened, the three rooms occupied in happier days can no longer be afforded and are exchanged for one, with the result that limited air-space enormously increases the danger of the wife and family becoming infected. A man in this condition is a burden to his friends and a danger to his neighbours, but if he were housed in a proper sanatorium he would be more comfortable and would cease to be a centre of infection. Moreover his wife, relieved of her duties as nurse, would be free to earn something towards the support of the children. The provision of sanatoria and the prevention of indiscriminate spitting are the two measures urgently required for the purpose of checking the spread of tuberculosis. On this last point I cannot do better than quote the opinion of Professor Brouardel, the representative of the French Government to the British Conference on Tuberculosis, he says " The danger is in the sputum, which contains thousands of consumptive germs : to expectorate on the street is a dangerous and disgusting habit. When this habit has quite disappeared tuberculosis will disappear rapidly." Overleaf will be found a print of the resolutions passed by the British Conference on Tuberculosis in 1901. RESOLUTIONS Passed, by the British Conference on Tuberculosis, 1901. Resolution No. 1. —Tuberculous sputum is the main agent for the conveyance of the virus of Tuberculosis from man to man; indiscriminate spitting should therefore be suppressed. Resolution No. 2. —It is the opinion of this Congress that all public hospitals and dispensaries should present every out-patient suffering from Phthisis with a leaflet containing instructions with regard to the prevention of Consumption, and should supply and insist on the proper use of a pocket spittoon. Resolution No. 3.—That the Voluntary Notification of cases of Phthisis attended with tuberculous expectoration, and the increased preventive action which it has rendered practicable, have been attended by a promising measure of success, and that the extension of notification should be encouraged in all districts in which efficient sanitary administration renders it practicable to adopt the consequential measures. Resolution No. 4. —That the provision of Sanatoria is an indispensable part of the measures necessary for the diminution of Tuberculosis. Resolution No. 5.-That in the opinion of this Congress, in the light of the work that has been presented at its sittings, Medical Officers of Health should continue to use all the powers at their disposal, and relax no effort to prevent the spread of Tuberculosis by milk and meat. Bearing upon the subject of spitting in public, I reproduce a leading article from the Daily Telegraph of May 12th, 1903 :— On the agenda paper of the London County Council for to-day's meeting appear some most interesting suggestions for new bye-laws " for the good rule and government of London," embodied in a special report of the Local Government and Taxation Committee. They recommend that it be made a punishable offence to sweep refuse into the street—whether that refuse consist of the litter of shops and houses, waste paper and shavings, or all the heterogeneous miscellany of domestic rubbish, which ought to be placed in the dustbin, or, better still, burnt. The edict is to apply to newsvendors who carelessly fling their discarded "bills" and wrappers into the gutters; to bill-posters; to costers, whose leavings are not only unsightly, but positively offensive and dangerous; and to the thoughtless people who cast broken bottles and glass upon the roads, callous as to the injury they may inflict on man or beast. We wish the London County Council and the Borough Councils much more power to their elbows in this respect, though bye-laws of this sort are, as a rule, more honoured in the breach than in the observance. Anything to keep the streets of London tolerable, and to cure the heedless of their gross selfishness in throwing their litter casually out into the streets ! If the penalties could be extended to the throwers of orange peel and banana skins it would be better still. Every blessing seems fated to be attended by its own special curse, and the cheap fruit for the million which we at present enjoy has added another terror to the streets, which is responsible for many broken bones and countless rude shocks and narrow escapes. Perhaps the population that eats in public will learn a little more consideration in time, but there is no trace of it at present, and both sexes are equally guilty in the matter, not even taking the trouble to see in what direction they fling their slippery refuse. More important to the general health is the proposed bye-law with respect to spitting, which runs thus: " No person shall spit upon the floor, side, or wall of any public carriage, hall, waiting-room, or place of public entertainment, whether admission be obtained by payment or not." By this time everyone in the Kingdom is surely aware that spitting is the chief agent in the spread of consumption, and that if spitting in public places could be prevented, the most practical and efficacious step would have been taken towards checking that national scourge. The person who is guilty of this most objectionable and dangerous practice ought to feel the weight of public condemnation. The Committee were in favour of extending the prohibition to pavements and footways, but apparently the Home Secretary takes the view that there are not quite such valid grounds for interference in the open air as in closed rooms, and is " not prepared to allow such an extension." We do not think that he need have feared to adopt a measure which is already in force in other countries—where, it is true, the habit is far more common than in England—but it is the English way to proceed cautiously. Even more efficacious, however, than a municipal bye-law would be the sharp punishment of the habit in the elementary schools, and a periodical reminder to the children of the peril with which it is accompanied. RESPIRATORY DISEASES. The deaths from diseases of the respiratory organs, exclusive of phthisis, numbered 695, and formed 25 per cent, of the total mortality from all causes. This is equal to a rate of 5.3 per 1,000 population at all ages. A large proportion (323) of the respiratory deaths was amongst young children, a mortality of 18.2 on the estimated population of under five. MALIGNANT DISEASE. Cancers of various organs and parts of the body caused 108 deaths. Malignant disease rarely affects young people, and 104 of the deaths recorded from it last year were amongst adults aged at least 25 years and upwards. The estimated number of persons over 25 in Bethnal Green is 56,700; on this number we shew a cancer mortality of 1.8 per 1,000. UNCOMMON CAUSES OF DEATH. The registered cause of death of an infant aged 21 months, the male child of a tailor, was entered as colic, varicella and convulsions. A child aged six months died from acute tuberculosis following small pox. The infant son of a cabinet maker died six days after birth from tetanus. A horsehair dresser, aged 22, also died from tetanus, said in this instance to be due to the irritation caused by decayed teeth. An old lady died in the infirmary on December 29th last, from senile decay and heart failure, her age was stated to be 100 years; previously to her removal she resided in Duke Street. Amongst the accidental deaths are registered those of the victims of the Hackney Road Fire, from burns and suffocation ; two were males aged 24 and 5, and five females aged 26, 8, 3, 3 months and 26 years. SUICIDES. These numbered 20 —seven of them took poison; oxalic acid, three; spirit of salt, sulphuric acid, bichromate of potash and carbolic acid, one each; six found a watery grave; three shot themselves; three jumped out of window; and two hanged themselves. MURDER. Three verdicts of wilful murder and one of manslaughter were returned by Coroner's juries: these were (1) a new-born child strangled at birth ; (2) another found in Duckett's canal, also strangled; (3) a child aged 21 months, who died in the Mildmay Hospital from collapse following injuries to perineum and contusions about head and body; this child did not belong to Bethnal Green, but had been removed at the instance of the police from Spitalfields. A verdict of manslaughter was returned against the mother of a child, which died from pneumonia accelerated by neglect, but the jury at the Central Criminal Court declined to endorse the verdict of the Coroner's jury, and acquitted the prisoner. UNCERTIFIED DEATHS. Three deaths were registered without medical certificates, all were referred to the Coroner, but he did not consider inquests necessary; the causes of death were entered as gastro-intestinal catarrh (hand fed) male, three months; convulsions, male, six hours; atelectasis and premature birth, male, newly born. WORKSHOPS. Section 132 of the Factory and Workshops Act, 1901, requires that " The Medical Officer of Health of every District Council shall, in his annual report to them, report specifically on the administration of this Act in workshops and work places, and shall send a copy of his annual report, or so much of it as deals with this subject, to the Secretary of State." During the past year considerable attention has been devoted to the workshops in the Borough. The district inspectors have visited and reported upon such of the domestic workshops as have been brought under their notice in the ordinary course of their duties, but Inspector Bare has had special charge of the workshops where women and young persons are employed. During the past year, 178 of these workshops were inspected, measured up and placed upon the register, and 161 notices were served to cleanse and repair premises. In one or two instances summonses were taken out, but the necessary cleansing, &c., was in each case effected without police court proceedings, though several reinspections were necessary before the final completion of the work. Very little statutory overcrowding was found to exist, the requirements of the Factory Act (250 cubic feet of air space per worker) are so modest that the floor space necessarily occupied by a workman with his tools and materials almost invariably entails his taking up more cubic space than the law requires. A number of w.c.'s were repaired and cleansed under notice; 10 that were badly situated were abolished, and 31 new closets and six urinals were provided. In three instances closets were parted off from workrooms by ventilated lobbies, under our instructions. In 42 of the workshops visited, no abstract of the Factory Act was posted. These illegal omissions were duly reported to H. M. Factory Inspectors, as required by Sec. 133 of the Factory and Workshops' Act, 1901. Twenty lists of outworkers, containing the names of 569 persons, were received from manufacturers in Bethnal Green. These were dissected, and the names and addresses of non-residents (if any) were forwarded to the Medical Officers of the districts concerned. Similar particulars of 404 addresses were furnished to me in return by these gentlemen, extracted from the lists received by them. (Factory and Workshops' Act, 1901, Sec. 107 (2). The homes of 603 outworkers were visited and reported upon by Mr. Bare. In 36 instances insanitary conditions were found, all of which were remedied on notice. SANITARY ACCOMMODATION. A Sanitary Accommodation Order has been drafted by the Home Secretary, who, in pursuance of Section 9 of the " Factory and Workshops Act," 1901, has determined that the accommodation in the way of sanitary conveniences provided in a factory or workshop shall be deemed to be sufficient and suitable within the meaning of the said section if the following conditions are complied with, and not otherwise:— 1. In factories or workshops where females are employed or in attendance, there shall be one sanitary convenience for every 25 females. 2. In factories or workshops where males are employed or in attendance, there shall be one sanitary convenience for every 25 males, provided that (a) In factories and workshops where the number of males employed or in attendance exceeds 100, and sufficient urinal accommodation is also provided, it shall be sufficient if there is one sanitary convenience for every 25 males up to the first 100, and one for every 40 after. (b) In factories and workshops where the number of males employed or in attendance exceeds 500, and the District Inspector of Factories certifies in writing that by means of a check system, or otherwise, proper supervision and control in regard to the use of the conveniences are exercised by officers specially appointed for that purpose, it shall be sufficient if one sanitary convenience is provided for every 60 males, in addition to sufficient urinal accommodation. Any certificate given by an inspector shall be kept attached to general register, and shall be liable at any time to be revoked by notice in writing from the inspector. 3. Every sanitary convenience shall be kept in a cleanly state, shall be sufficiently ventilated and lighted, and shall not communicate with any workroom, except through the open air or through an intervening ventilated space. 4. Every sanitary convenience shall have a proper door and fastenings, and be so enclosed as to secure privacy. 5. The sanitary, conveniences in a factory or workshop shall be so arranged and maintained as to be conveniently accessible to all persons employed therein at all times during their employment. 6. Where persons of both sexes are employed, the conveniences provided for each sex shall be completely separate, with separate screened approaches. This order does not run in the Metropolis, as the administrative County of London is specifically excluded from the operation of clause 9. The powers of London Sanitary Authorities are those laid down in Section 38 of the Public Health (London) Act, 1891. This clause permits a much wider discretion to the sanitary authorities than does the order of the Home Secretary, and our requirements have hitherto exceeded those of this order. How we shall fare in the next case we take before a police court magistrate remains to be seen, for if the Home Secretary's order be quoted against us as a standard it certainly will not assist us. VENTILATION IN WORKSHOPS. A Departmental Committee appointed to enquire into ventilation of factories and workshops has presented a first report. It is a most interesting document, and contains much useful information. The conclusion of the Committee is shortly : —That the amount of carbonic acid present in the atmosphere of a given workshop should be taken as the measure of the impurity of that atmosphere, and consequently of the efficiency or otherwise of the ventilation. The Committee recommends that in the exercise of the powers conferred on the Secretary of State by section 7 of the Factory and Workshops' Act, 1901, such a standard of ventilation should be prescribed for workrooms, that the proportion of carbonic acid in the air therein shall not rise during daylight beyond 12 volumes per 10,000 of air, and that when gas or oil is used for lighting purposes, the proportion shall not exceed 20 volumes. Pure country air contains three volumes of carbonic acid in every ten thousand, and even in towns this proportion is only very slightly exceeded. In summer, whilst vegetation is active, the proportion rises slightly at night and falls by day. In dense fogs such as the " London particular " the proportion is enormously increased and rises to as much as fourteen parts per ten thousand, it therefore follows that it would be unfair to test the air of workshops in foggy weather. In workrooms there are two sources of an excess of carbonic acid (a) Respiration, and (b) Combustion. During active employment a man gives off about a cubic foot of carbonic acid an hour, and a woman rather less. In addition to the carbonic acid, certain organic compounds are exhaled (occasionally also the germs of disease.) These impurities cause the stuffy sensation experienced in badly ventilated rooms, but it is impossible to measure them, except from the fact that they always bear a certain known proportion to the carbonic acid exhaled. These organic impurities are much more prejudicial to health than the carbonic acid, and unless freely diluted or removed by ventilation they cause ill health. The mere increase of the carbonic acid by itself (within reasonable limits) does very little harm, but the proportion found in a given sample of air is, under ordinary circumstances, the measure of the respiratory impurity therein, hence the importance of its estimation. In addition to the ordinary products of respiration the air may be contaminated with disease germs should any consumptive person be included amongst the employes in a workshop. ( b) Combustion.—It is a common and very bad custom to light the gas in workrooms on cold days for the purpose of raising the temperature. The burners in use are usually common fishtails, and they are not only wasteful, but they assist in fouling the air with sulphur compounds as well as carbonic acid. Roughly speaking an ordinary gas jet produces as much carbonic acid as three men, and as much heat as five men. The only instance in this country where a standard of purity is actually fixed by law, is the case of the artificially humidified air of cotton-cloth weaving sheds, and here the maximum of carbonic acid permitted in any part of the factory is nine volumes per 10,000. So far as I know, this standard has been found satisfactory, and the requirement has not proved oppressive. It is to be regretted that the Committee did not see its way to recommend the general adoption of the cotton-cloth weaving shed standard for all factories and workshops, instead of the new and much inferior standard of 12 per 10,000. BAKEHOUSES. (See List in Appendix.) There are in the Borough 99 bakehouses, of which no fewer than 37 are underground. All these premises have been carefully inspected, and the underground ones have been measured up and plans taken of their present condition. Bread of some sort forms a portion of the diet of nearly every human being throughout the world; it follows that an article of such universal consumption ought, if possible, to be pure and free from contamination. These requirements can only be secured by insisting that sound flour shall be made into bread under such conditions as will preclude the admixture of filth of all kinds. About the worst place to select for a bakehouse is the cellar beneath a retail shop, yet more than a third of the bakehouses in the Borough are so situated. These places are usually lighted and ventilated by means of openings beneath the stall-board of the shop above. The oven is commonly built beneath the footway of the public road in front. To this there are two objections: first the necessity of the baking room being in the most dusty portion of the premises, and second the oven, which runs out beyond the footway, is brought into dangerous proximity with the public sewer (which may or may not be in a watertight condition); thus a very serious; danger of contamination is incurred. Very often the floorboards of the shop above form the ceiling of the bakehouse, with the result that the dirt brought in by the footwear of the customers finds its way between the boards and falls right on to the dough in the troughs below. Moreover the stall-board openings not only admit light and air, but also a plentiful supply of street dust, ordinarily composed of road detritus, dried horse-dung, dogs' excrement, human sputa, and other filthy abominations. Much of this dust gets mixed up with the dough, and were it not for the fact that the temperature at which bread is baked is destructive to most disease germs, epidemies would certainly be spread by the agency of bread. Too much faith, however, must not be placed on this sterilization by heat, for bacteriologists have shewn that a variety of germs other than those known to be associated with disease, may be cultivated from the crumb of ordinary loaves. Apart from the bread eater's point of view, we must take into consideration the conditions under which those who are fated to work long hours, in the hot foul atmosphere of such a cellar bakehouse as I have described, carry on their employment. No one can question the desirability of abolishing all such places, but unfortunately the expense and inconvenience of this precludes the possibility of its accomplishment suddenly. The legislature, in 1895, contented itself with forbidding the future use of any underground premises for the purpose of baking bread, unless so used before the 1st of January, 1896; but the amending Factory Act of 1901, goes a step further, and requires in section ioi, sub-sections 2 and 4, that an underground bakehouse shall not be used after the ist day of January, 1904, unless certified by the District Council to be suitable for that purpose, and unless it satisfies the requirements of the District Council as regards construction, light, ventilation, and all other respects. Parliament has thus placed in the hands of the District Councils an enormous power of prohibition (subject to an appeal to a Court of Summary Jurisdiction), but the certificate once granted, cannot be recalled. It therefore behoves the Councils to be extremely cautious how these certificates are granted. The matter was carefully considered by the Public Health Committee on my report, and a circular was sent early in the year to every proprietor of an underground bakehouse, drawing his attention to the terms of section 101 of the Factory and Workshop Act, 1901. In October a second circular, together with the schedule of the minimum requirements insisted upon by the Committee prior to the granting of the certificate, was sent round, and so far as we are concerned the matter rests. A print of the circular and the schedule of requirements will be found overleaf. Up to the end of 1902, not one single application was made to the Committee to sanction any plans of proposed alterations. Metropolitan Borough of Bethnal Green. UNDERGROUND BAKEHOUSES-AMENDED REQUIREMENTS Factory and 101 (3) —An Underground Bakehouse means a bakehouse, Workshop any baking room of which is so situated that the Act, 1901. surface of the floor is more than three feet below the surface of the footway of the adjoining street, or of the ground adjoining or nearest to the room. The expression, " baking room," means any room used for baking, or for any process incidental thereto. 101 (4)— An Underground Bakehouse shall not be certified as suitable unless the Sanitary Authority is satisfied that it is suitable as regards construction, light, ventilation, and in all other respects. 101 (8) —Where the certificate required cannot be obtained unless structural alterations are made, and the occupier alleges that the whole or part of the expenses of the alterations ought to be borne by the owner, he may, by complaint, apply to a Court of Summary Jurisdiction, and that Court may make such order concerning the expenses, or their apportionment, as appears to the Court to be just and equitable, under the circumstances of the case, regard being had to the terms of any contract between the parties, or, in the alternative, the Court may, at the request of the occupier, determine the lease. Minimum Requirements for Underground Bakehouses, 1904 An underground bakehouse shall not be used as such after January Ist, 1904, unless such underground bakehouse be, in the opinion of the Medical Officer of Health, suitable and fit on sanitary grounds for use or occupation as a bakehouse, as shewn by possessing the following minimum sanitary requirements:— A. — Construction . (1) The underground bakehouse to be of a minimum capacity of 1,000 cubic feet, and to be in every part thereof at least 7-ft. 6-in. high. (2) The walls to be made, and kept at all times, smooth and impervious throughout, so that the underground bakehouse is free from damp. (3) The ceilings to be properly ceiled, and to be kept impervious to dust, or, if made of brick, rendered smooth. (4) The floors to be made with at least 6in. concrete, rendered smooth in cement, in cement, or with other jointless or impervious paving throughout, so that the underground bakehouse is free from damp. (5) All fixed woodwork, e.g., window frames, doors and door frames, and staircasings within the bakehouse, to be made sound and painted with three coats of good oil colour. (6) There is to be appurtenant to, but outside and totally distinct from, and not communicating directly with, the underground bakehouse (preferably in an open yard adjoining and connected by a covered way) water-closet accommodation, which shall be sufficient, suitable and separate for the use of the two sexes (if required), together with a proper and sufficient receptacle or receptacles for the deposit of ashes or refuse matters. 7 Any drain passing under an underground bakehouse to be properly constructed of a gas and water-tight pipe, and no gulley to be provided within the underground bakehouse for the purpose of removing waste waters therefrom, unless the drain from such gully be made to discharge over, or on to, a properly trapped inlet situated outside such underground bakehouse. (8) Provision to be made (a) for the proper storage of flour and coals elsewhere than in the underground bakehouse itself. (b) for suitable means of access (other than by ladders) to the underground bakehouse in the form of convenient stairs, with an external entrance if practicable. B.—Light. (9) The bakehouse must be efficiently lighted, the standard required being such, that the official abstract of the Factory Act may be read without artificial light in any part of the bakehouse at noon, on a clear day. Pavement lights, stall board lights, and area windows abutting upon the footway, are to be constructed in such manner as to exclude dust, so far as is possible. Pavement lights may be either glazed with thick clear glass, or with Hayward's or other approved forms of prisms. Stall board and area windows should be of similar construction, for so much as is less than 24-in. above the pavement level; the remaining portion (if any) may be left as an open grating for ventilating purposes. The interior splays of area windows and stall board lights must be lined with glazed bricks. C.—Ventilation— (10) The underground bakehouse to be properly and effectually ventilated by permanent inlets and outlets (other than the window or windows), communicating directly with the open air, but in such a way, and at such a height above the street level, as to prevent, as far as possible, the entrance into the underground bakehouse of street dust and dirt; the inlets and outlets to be of such nature and dimensions as shall be sufficient to ventilate the bakehouse to the satisfaction of the Medical Officer of Health ; and, further, such openings to be not under the control of the persons employed, and one to be situated in the ceiling and the other at such a height as to deliver the air upwards without draughts, so as to ensure a constant and equable temperature (60 degrees—65 degrees Fahr.) D.—All Other Respects (11) Provision to be made (a) for dough troughs and other furniture or fittings (if any) to be mounted on strong casters or wheels, so as to be readily movable for cleansing purposes and not to be fixed. (b) for a proper and adequate water supply for drinking purposes (preferably by means of a tap from the rising main), either within the underground bakehouse itself or convenient thereto. (12) Any damp, ill-ventilated or badly-lighted cellar, or underground room, to be completely separated from the underground bakehouse. By order of the Public Health Committee, GEORGE P. BATE, M.D., Medical Officer of Health for Bethnal Green It is to be regretted that the Factory Act did not authorize the issue of any bye-laws as to the maintenance of the required standard of ventilation, lighting and cleanliness. Rules, founded upon the sections of the Factory Acts regulating bakehouses, were formulated and issued some years ago. They were recently, by order of the Committee, brought up to date and reissued. These rules refer to the conduct of all bakehouses both above and below ground, but except where they follow the wording Factory Act, they cannot be enforced. Metropolitan Borough or Bethnal Green. GENERAL REQUIREMENTS FOR ALL BAKEHOUSES This does not vary the Special Requirements as to Underground Bakehouses. A.—STRUCTURAL 1. Every room or place used as a bakehouse to be in such a state as to be, on sanitary grounds, fit for use in occupation as a bakehouse. 2. No water-closet, earth-closet, privy or ashpit to be within, or communicate directly with, the bakehouse. 3. Every cistern for supplying water to the bakehouse to be separate and distinct from any cistern for supplying water to a water-closet. 4. No drain or pipe for carrying off fœcal or sewage matter to have an opening within the bakehouse. 5. All the inside walls of the rooms of a bakehouse, and all the ceilings or tops of the rooms (whether those walls, ceilings or tops are plastered or not), and all the passages and staircases of a bakehouse, to be either painted with Paragraphs in Italics are Revised Regulations, as the original ones were found to be too onerous. 4 oil or varnished, or be limewashed, or be partly painted or varnished and partly limewashed; and (a) Where the bakehouse is painted with oil or varnished, there must be three coats of paint or varnish, and the paint or varnish must be renewed once at least in every seven years, and must be washed with hot water and soap at least in six months; and (6) Where the bakehouse is limewashed, the limewashing must be renewed once at least in every six months. 6. No place on the same level with a bakehouse, and forming part of the same building, to be used as a sleeping place, unless it is constructed as follows, that is to say :— (a) is effectually separated from the bakehouse by a partition extending from the floor to the ceiling; and (b) has an external glazed window of at least nine superficial feet in area, of which, at the least, four and a half superficial feet are made to open for ventilation. B.—Administrative. 1. The bakehouse to be kept at all times periodically cleansed, and in a cleanly state, and free from offensive effluvia arising from drains, w.c's, urinals, or other nuisance. 2. Nothing to be stored within the underground bakehouse itself, and no sweepings, ashes, or other refuse matters to be allowed to remain and accumulate, but to be removed from such underground bakehouse immediately after the day's work be concluded, or shift changed. 3. All utensils, troughs, etc., to be kept at all times scrupulously clean 4. No animal to be kept in a bakehouse on any pretence whatever 5. No overcrowding to be allowed at any time within a bakehouse—a minimum 250 cubic feet of space being allowed for each person employed therein during ordinary work, and 400 cubic feet of space during overtime. A number of notices were served upon the occupiers of bakehouses with respect to want of cleanliness and defective ventilation. Most of these were obeyed, but H. H. of Green Street was, after repeated warnings, summoned to Worship Street and fined 40s. and 235. costs for failing to keep his bakehouse in a cleanly condition. I understand that the Secretary of State purposes issuing a new regulation (as he has power to do under section 3 (2) of the Factory and Workshops' Act, 1901), substituting the proportion of 500 cubic feet of air space to each workman in bakehouses instead of the 250 at present required. This new regulation will probably come into operation on the 1st day of January, 1904. COW-HOUSES. (See List in Appendix) The number of licensed cow-sheds in the Borough is 19; all these have been frequently inspected, and are in a fairly satisfactory condition. The annnal licensing day was Monday, October 27th. Two of the licenses were opposed by the Officers of the London County Council. The particulars were as under: — 55, Kerbela Street, occupied by Rees Evans, who had failed to cover the woodwork of his shed with sheet zinc. 2, Lisbon Street, occupied by John Hughes. He also had failed to cover portions of the woodwork of his shed with sheet zinc, and had also neglected, at the appointed time, to whitewash the walls. In both instances the licenses were granted, but were held over, pending the completion of the necessary works. Thomas Edward Jones, of 44, Squirries Street, did not apply for a renewal of his license, which accordingly lapses. MILK-SHOPS AND DAIRIES. The retail milk-shops in the Borough number 344. These businesses (many of them carried on in connection with small general shops), are constantly changing hands, and as the license to sell milk is personal, each change necessitates a reinspection of the premises, and a fresh entry in the register. During the year Mr. Bare made 1,248 inspections of retail milkshops; eight unregistered persons were found selling milk. Nine notices were served in respect of dirty utensils, and two milk sellers were prosecuted at Worship Street for failing to keep their premises and utensils clean after repeated warnings and notices. These were : — J. L., of Brick Lane. Fined 5s. and 10s. 6d. costs. L. T., of Bacon Street. Fined 20s. and 2s. costs. SLAUGHTER-HOUSES. (See List in Appendix). There are in the Borough seven slaughter-houses; 24 visits havebeen paid to these premises by Mr. Jones, the Inspector under whose charge they are. He reports that they are whitewashed twice a year and are in a satisfactory condition ; no notices were served and no licence was opposed at the sessions. Owing to the small amount of slaughtering now done in the Borough these premises are seldom found in an unclean condition; in the few instances where the business is above the average the limewashing and cleansing are done more frequently. Sheep are the only animals killed, except at Christmas, when a few of thebutchers signalise the occasion by killing a prize bullock or so apiece. It is satisfactory to note that, so far as we are aware, no cows are slaughtered. These animals frequently develop tuberculosis through being kept in dark sheds, and the meat is always of adoubtful character; a private slaughter-house offers opportunities for killing and dressing animals such as would not be passed in a public abattoir. The butchers evidently find it more profitable to deal in foreign meat, and the nearness of Smithfield Market enables them to pay daily visits for the purpose of purchasing that which is most reasonable in price. All the slaughter-houses have back entrances, with the exceptionof o ne in Brick Lane ; this one has a passage adjoining the shop, and the licence is granted on the express condition that only sheep are to be slaughtered. ICE CREAMS. The London County Council General Powers Act, 1902, cameinto operation on November 1st last : it provides as follows:— Any person being a manufacturer of or merchant or dealer in ice creams or other similar commodity who within the County— (a) Causes or permits ice creams or any similar commodity to bemanufactured, sold or stored in any cellar, shed or room in which there is any inlet or opening to a drain, or which is used as a living room or sleeping room; (b) In the manufacture, sale or storage of any such commodity does any act or thing likely to expose such commodity to infection or contamination, or omits to take any proper precaution for the due protection of such commodity from infection or contamination; or (c) Omits, on the outbreak of any infectious disease amongst the persons employed in his business, or living or working in or about the premises in or on any part of which any such commodity as aforesaid is manufactured, sold or stored, to give notice thereof forthwith to the Medical Officer of the Sanitary District in which such business is carried on or such premises are situate; shall be liable for every such offence on conviction in a Court of Summary Jurisdiction to a penalty not exceeding Forty Shillings. Every itinerant vendor of any such commodity as aforesaid shall, if not himself the manufacturer thereof, exhibit in a legible manner on a conspicuous part of his barrow a notice stating the name and address of the person from whom he obtains such commodity, and if such vendor is himself the manufacturer of such commodity he shall in the same manner exhibit his own name and address. Every such itinerant vendor who shall fail to comply with the provisions of this Section shall be liable for each offence on conviction as aforesaid to a penalty not exceeding Forty Shillings. Proceedings for the recovery of the penalties shall be instituted by the Sanitary Authority for the District in which the offence was committed, or of the District to the Medical Officer of which such notification as aforesaid ought to have been made, or in which such itinerant vendor as aforesaid shall offer any such commodity as aforesaid for sale, as the case may be. There are in the Borough 53 places where ice cream is manufactured, and each proprietor has been served with a copy of the requirements of the Act in Italian and in English. Twenty-two premises were found in an insanitary condition, and by direction of the Public Health Committee notice was served on each ; so far it has not been found necessary to take legal proceedings to enforce the terms of these notices. CUSTOMS' AND INLAND REVENUE ACTS, 1890 & 1891. During the year applications were made to me for certificates under these Acts, in respect of the following blocks of dwellings. 7, Cambridge Circus, Hackney Road. Three tenements. The certificate was refused, as there is only one W.C. for three lettings, and the premises were not clean. Delamere Dwellings, 1 to 21, Collingwood Street. 21 tenements. At the time of my visit these dwellings were dirty and untidy, the windows broken, the closets foul, and the yards filthy. I was much surprised at an application to certify premises in such a condition of disrepair. A report was made to the Public Health Committee, by whose directions notices to abate the nuisances were served; the premises were repaired and cleansed under notice, but I regret to say the improvement has not been maintained, and I have declined to grant a certificate. HOUSING OF THE WORKING CLASSES ACT, 1890. No houses have been certified under Part 11. of the Act, and such closing orders as were necessary have been obtained under the provisions of the Public Health (London) Act, 1895. The unhealthy area in rear of Green Street and Globe Road, referred to in my report for 1891, was reinspected, and a fresh set of statistics prepared and brought up to date. A report, of which the following is a copy, was forwarded to the London County Council on September 20th. Town Hall, Church Row, Bethnal Green September 20th, 1902 Sir, HOUSING OF THE WORKING CLASSES ACT, 1890 I have examined the whole of the houses in the following streets, namely, Digby Street, Digby Walk, and Lansdell Place, and Nos. 45 and 47, Bonwell Street, all in the Borough of Bethnal Green, and shewn on the map herewith. I am of opinion that the houses included in this area are unfit for human habitation by reason of the narrowness and bad arrangements of the streets and faulty construction of many of the houses situated therein. The continued habitation of these houses is dangerous to the health of the inhabitants of the said area, and also of the neighbouring buildings. Lansdell Place and Digby Walk are so narrow and crooked that nothing short of entire reconstruction and rearrangement will remedy their present insanitary condition. The number of inhabited houses in the area is 89, the population is as nearly as can be ascertained 532 persons, the average mortality amongst whom for the three years, 1899, 1900 and 1901, is 38.2 as against 21.5 for the whole of Bethnal Green for the same period. A statistical table is enclosed herewith, also a map of the district, indicating in colour the condition of every house in the area The houses coloured green are modern buildings, those coloured red are for the most part old and more or less dilapidated (but capable of repair), those coloured blue are for various reasons unfit for habitation. The area has been viewed by the members of the Public Health Committee of this Council. They support this representation, with an additional expression of opinion that the houses in Globe Road, North from the corner of Lansdell Place to the corner of Green Street, and those from the corner of Green Street (Eastwards) up to and including the houses on the West side of Baker Street, should be included in any scheme for reconstruction, so as to obtain a proper frontage to Globe Road and Green Street. I have the honour to be, Sir, Your obedient Servant, GEORGE PADDOCK BATE Mr dual Officer of Health for the Borough of Bethnal Green Condition of Houses, Digby Street Area. A C Total B 33 Digby Street 21 4 8 Digby Walk 27 24 - 3 Lansdell Place 27 15 3 9 Bonwell Street 2 - - 2 Total 16 89 62 11 A Premises, for various reasons, unfit for habitation; coloured blue on map. B. Houses, old and dilapidated, but capable of repair; coloured red on map. C. Modern buildings; coloured green. Metropolitan Borough or Bethnal Green. DIGBY STREET AREA. Year. Deaths from. Total Deaths from all causes. Death Rate per 1000 Population. Population. Respiratory Diseases. General Diseases. Zymotic Diseases. Tubercular Diseases. 194 1899 1 3 1 4 9 39˙5 1900 1 1 1 4 7 1901 0 2 2 3 7 3 years Total 2 6 11 23 4 156 1899 1 0 4 8 44˙8 3 1900 0 0 3 2 5 1901 4 0 0 4 8 7 9 21 3 years Total 5 0 182 1899 1 0 2 5 31.1 2 2 4 6 1900 0 0 0 6 1901 1 2 3 3 years Total 1 6 17 1 9 3 years Totals 7 29 61 38˙2 8 17 ... ... 5˙0 4˙4 10˙6 18˙2 38˙2 I 5˙1 532 Green whole district 2˙8 2˙8 10˙8 21˙5 Forsairh Si Son, Bethna/ Green Rood. My report was acknowledged, and shortly afterwards a communition was received by the Town Clerk from Mr. Gomme to the effect that as some time must elapse before the London County Council would be in a position to deal with the report it would be advisable to close as many as possible of the worst of the houses under Part 11. of the Housing of the Working Classes Act, 1892. The letter also asked for an expression of opinion by the Medical Officer of Health on this point. I reported to Mr. Voss and a copy of this, together with a resolution of the Public Health Committee in support, was forwarded to the London County Council. Metropolitan Borough of Bethnal Green Public Health Department, Town Hall, Church Row, N.E., November 11th, 1902. Re DIGBY STREET AREA. HOUSING OF THE WORKING CLASSES, 1890 Adverting to Mr. Gomme's letter advising that proceedings should be taken under Part 2 of the above Act with reference to some of the worst houses included in the above scheme, I may mention that I carefully considered this point before making any representation under Part 1 of the Act. I am strongly of opinion that no useful purpose would be served by closing a few of the houses. The insanitary condition of the large portion of the dwellings coloured blue on the map is due either to faulty original construction or to the narrowness of the streets in which the houses stand, though in some instances these conditions are accentuated by the state of disrepair into which the houses have fallen. A great deal of sanitary work has already been accomplished in this area under the orders of the Public Health Committee. New drains have been laid, new w.c.'s have been fitted, floors have been dug out, roofs repaired, and yards repaved. In view of these works I doubt if a police-court magistrate could be induced to make closing orders. Moreover, in the present congested state 01 the Borough it would be cruel to close a number of houses until there is a reasonable prospect of a rehousing scheme. (Signed), GEORGE PADDOCK BATE, Medical Officer of Health This was acknowledged, and followed by a demand for a formal certificate in the terms of the Housing Act, together with a map indicating in a single color the exact boundaries of the area certified; the following certificate, together with a fresh map, was forwarded as requested. HOUSING OF THE WORKING CLASSES ACT, 1890 To the London County Council, I, George Paddock Bate, of 365, Bethnal Green Road, N.E., in the County of London, Medical Officer of Health to the Borough of Bethnal Green in the said County, do hereby with reference to a certain area within the said Borough, which is delineated and coloured red on the plan hereunto annexed and signed by me, make an official representation within the meaning of the Housing of the Working Classes Act, 1890, to the effect following, that is to say— 1. That many of the houses within the said area are unfit for human habitation ; 2. That the narrowness, closeness, and bad arrangement of the streets and houses within such area, and the want of light, air, and ventilation, are dangerous and injurious to the health of the inhabitants of the buildings in the said area and of the neighbouring buildings; 3. That the evils connected with such houses, and the sanitary defects in such area, cannot be effectually remedied otherwise than by an improvement scheme for the rearrangement and reconstruction of the streets and houses within such area. Dated this 20th day of September, one thousand nine hundred and two (Signed), GEORGE PADDOCK BATE, Medical Officer of Health for Bethnal Green. SEWERS AND DRAINS. A glance at the map herewith will give some idea of the enormous amount of good work accomplished either by or at the instance of the Public Health Department. New houses and buildings are shown coloured green, house drains newly laid by the owners are shown in blue, and those by the men in the employment of the Council, red ; all drains serving premises coloured green, red and blue have been subjected to a rigorous hydraulic test under the supervision of the Inspectors, and have not been passed until found to be absolutely watertight. The drains in the premises coloured. yellow have been, after amendment in part, subjected to the smoke test without discovering any leakage. It is not contended that this method is absolutely satisfactory, but it is the best available. The drains coloured red have been reconstructed by the men in the employment of the Public Health Department at the expense of the ratepayers. These drains were originally found upon examination to be so defective as to require relaying, and as each of them was legally a " sewer " (that is to say a combined drain for which no plan or official sanction was discoverable) the responsibility for the repairs and maintenance of the pipes was thrown by the owners upon the Council. The details of the actual expenditure of public money upon these works, subsequently to April, 1898* (apart from the money laid out by private owners upon combined drains), will be found clearly set forth in Mr. Foot's reports, and the whole of the work has been carried out under his direction. The yearly amounts are as follows :— £ d. s. 1899 6½ 1,150 9 1900 1,399 17 7 1901 1,125 1 9 5 1902 2,609 12 2 For this expenditure of public money (upon what are after all private drains), we naturally expect some return in the direction of a decrease in the general death rate, but unfortunately our anticipations have not been realised ; perhaps this may be accounted for by the fact that the public sewers of the Borough are not in a satisfactory condition. No fault can be found with the main (County Council) sewers, as these are well constructed and sufficiently large to permit of inspection and cleansing, but the condition of many of the smaller (pipe) sewers is bad. The matter was recently brought before the Borough Council by a prominent member, who has a reputation for making himself thoroughly acquainted with any subject in which he takes an interest. This gentleman stated in open Council that he had ascertained, by actual inspection, that a * Note.—Previously to April. 1898, the accounts were kept in the Surveyor's office and are included in the general sewer account. large number of the smaller sewers under the control of the Works Department are defective, being badly laid, and as much as 10-12ths choked ; he instanced cases in which these defective sewers had caused the basements of the houses served by them to be flooded out; he gave chapter and verse for his statements, and these were in the main uncontradicted. The gentleman who is responsible for these statements, also expressed his surprise at the failure of the Medical Officer and Chief Inspector to call the attention of the Council to the condition of these sewers. This indictment is a very serious one, for sound well laid private drains, communicating with elongated cesspools (for such these sewers of deposit really are), are merely contrivances for laying on sewer air to the houses they serve. I grant that many of these private drains are trapped and ventilated, but the gas generated by such a mass of festering filth as that contained in a sewer of deposit will force any trap, and the health of persons breathing air contaminated with such emanations must suffer. Moreover these leaky sewers permit percolation of their semi-liquid contents at every joint, thereby saturating the adjacent earth with filth ; the constant alteration in the level of the ground water pumps the contaminated air contained in the dry upper strata through anything less solid than a concrete floor. Now very few of the houses in the Borough are so provided, whilst the backyards, forecourts and public streets are impermeable owing to concrete pavements, so that the ground air, having no other vent, must find its way into the basements of the dwellings, to the manifest deterioration of the health of the occupants. The remedy for the condition of things detailed above is obvious, but it does not lie within the purview of the Public Health Department. I have the honour to be, Sir and Gentlemen, Your most obedient servant, . Via/Iq . Medical Officer of Health for Bethnal Green APPENDIX. BETHNAL GREEN. —TABLE I.— Vital Statistics of Whole District during 1902 and Previous Years. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Total Deaths in Public Institutions in the District Deaths of Non-residents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all ages belonging to the District. Year. Under 1 Year. At all Ages. Number. Rate.* Number. Number. Rate.* Rate per 1,000 Births registrd. Rate.* Number. 1 2 3 4 5 6 7 8 9 10 11 12 13 1892. 4,911 158 2,800 588 127,040 38˙7 779 22˙0 179 363 2,984 23˙5 1893. 123,000 4,756 38˙6 849 177 3,031 24˙6 722 175 399 3,257 26˙5 1894. 123,000 4,636 37˙7 709 152 2,398 19˙5 570 152 395 2,642 21˙4 1895. 128,000 4,771 37˙3 772 162 2,564 20˙0 625 150 355 2,796 21˙6 1896. 129,200 2,909 22˙5 4,869 37˙7 829 170 2,717 21˙0 638 177 369 1897. 129,200 4,818 37˙3 791 169 2,551 17˙4 663 148 358 2,761 21˙4 1898. 129,200 4,779 37˙0 839 185 2,633 20˙4 620 119 358 2,872 22˙2 1899. 129,200 4,753 36˙8 827 174 2,669 727 164 431 2,936 22˙7 20˙7 1900. 129,600 4,588 35˙4 771 168 2,535 19˙5 873 150 431 2,816 21˙7 1901. 4,608 35˙5 425 2,628 129,700 678 147 2,423 18˙7 834 220 20˙3 Averages for years 1892-1901. 127,714 4,748 37˙2 166 2,632 20˙3 784 686 163 388 2,860 22˙3 1902. 129,889 4,589 35˙3 710 155 2,522 18 ˙5 864 245 470 2.747 21˙1 Rates in Columns 4, 8, and 13 calculated per 1,000 of estimated population. Note. —The deaths included in Column 7 of this table are the whole of those registered during the year as having actually occurred within the district or division. The deaths included in Column 12 are the number in column 7, corrected by the subtraction of the number in Column 10 and the addition of the number in Column 11. By the term " Non-residents " is meant persons brought into the district on account of sickness or infirmity, and dying in public institutions there; and by the term " Residents " is meant persons who have been taken out of the district on account of sickness or infirmity, and have died in public institutions elsewhere. The " Public Institutions " taken into account for the purposes of these tables are those into which persons are habitually received on account of sickness or infirmity, such as hospitals, workhouses and lunatic asylums. A list of the Institutions in respect of the deaths in which corrections have been made is given on the next Page. Area of District in acres (exclusive of area covered by water). 733 Statute acres. Total population at all ages 129,680} At Census of 1901. Number of inhabited houses 16,374 Average number of persons per house 7 List of the Institutions in respect of the Deaths in which corrections June been made. I. Institutions within the District receiving Sick and Infirm Persons from outside the District. City of London Hospital for Diseases of the Chest. North-Eastern Hospital for Children Mildmay Mission Hospital. Bethnal Green Workhouse. Bethnal Green Infirmary. Children's Home, Bonner Road. Cripples' Home, Grove Road (Dr. Barnardo). Bethnall House Lunatic Asylum. II. Institutions outside the District receiving Sick and Infirm Persons from the District. The Hospitals of the Metropolitan Asylums Board. The Various London Hospitals. The London County Council Asylums. The French Hospital, Victoria Park (Huguenot Asylum ) Hackney Infirmary. Whitechapel Infirmary. Poplar and Stepney Sick Asylum Mile End Infirmary. Hoxton House Asylum BETHNAL GREEN. —-TABLE II.— Vital Statistics of Separate Localities in 1902 and previous years. Names of Localities. 1 —North 2. —South 3.—East 4. —Total Population estimated to middle of each year. Births registered. Population estimated to middle of each year. Births registered. Population estimated to middle of each year. Births registered. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths under 1 year. Deaths under 1 year. Deaths at all ages. Deaths at all ages. Deaths under 1 year. Deaths at all ages. Deaths at all ages. Year. a c d b c d c b c d b a a b d a 1892 51,520 2,052 1,187 31,175 1,266 798 211 44,615 127,310 4,911 2,984 743 1,593 999 219 31.3 1893 47,585 1,905 1,240 310 32,975 1,339 938 233 42,440 1,512 1,079 269 123,000 4,756 3,257 812 1894 47,585 1,862 1,018 282 32,975 1,240 741 213 42,440 1˙534 883 214 123,000 4,636 2,642 709 1895 49,000 1,905 1,024 292 34,300 1,343 789 1˙523 956 258 128,300 4,771 2,769 772 222 45,000 1896 49,339 1,892 1,142 326 34,194 1,333 814 45,667 1,644 953 263 4,869 2,909 829 240 129,200 1897 49,339 1,961 1,028 321 34,194 803 243 1,524 930 250 129,200 4,818 2,761 814 1,333 45,667 1898 149,339 1,971 1,122 372 34,194 1,291 853 265 897 243 129,200 2,872 880 45,667 1,517 4,779 1899 49,339 1,930 1,168 355 34,194 1,361 814 227 45,667 1,462 954 245 129,200 2,936 827 4,753 1900 51,500 1,935 1,142 314 33,450 1,218 776 211 44,650 1,435 898 246 129,600 4,588 2,816 771 1901 51,514 1,86 4 1,112 308 33,47 2 1 1,239 721 177 44,714 1,505 795 223 129,700 4,608 2,628 708 Averages of yrs. 1892-01. 49,606 1,927 1,118 319 33,512 1,296 224 44,652 934 243 127,771 4,748 786 1,524 804 2,857 1,056 34,000 1902 51,600 1,938 307 1,237 730 186 44,289 961 217 129,89 4,589 710 1,414 2,747 Notes.—(b) Deaths of residents occurring in public institutions beyond the district are included in sub-columns c of this table, and those of non-residents registered in public institutions in the district excluded. (See note on Table I. as to meaning of terms " resident " and " non-resident.") (c) Deaths of residents occurring in public institutions, whether within or without the district, are allotted to the respective localities according to the addresses of the deceased. BETHNAL GREEN. —TABLE lll.—Cases of Infectious Disease notified during the Year 1902. Cases Notified in Whole District. Total Cases notified in each Locality. No. of Cases removed to Hospital from each Locality. Notifiable Diseases. At all Ages. At Ages-Years. 3 East. 1 North. 3 East. Under 1. 5 to 15 15 to 25. 25 to 65. 1 North. 2 South. Total. 65 and upwards. 1 to 5. 2 South. *125 *172 *223 *125 *172 *223 - 168 176 5 Small pox 520 11 41 119 Diphtheria 299 10 147 111 18 13 - 13 6 7 1 9 2 104 59 67 2 30 Membranous croup 11 1 2 - 13 5 3 1 2 2 5 8 - 3 Erysipelas 2 53 18 9 19 22 168 17 106 64 83 25 14 20 - Scarlet fever 5 11 9 2 25 2 31 33 13 - 212 130 169 186 105 144 435 Enteric fever 511 9 5 40 49 37 - 50 39 42 43 36 37 - Continued fever 1 - - 1 - - - 1 - - 1 - - - 6 - 6 1 3 2 - 1 - Puerperal fever 10 - - - 4 Chicken pox 860 104 288 17 6 - 362 239 445 259 - - - - Totals 2596 153 880 811 311 419 22 1003 719 874 487 494 670 388 * Thirty-five of these cases were afterwards returned as not small pox. Notes.—The localities adopted for this table are the same as those in Tables II. and IV BETHNAL GREEN. —TABLE IV. —Causes of, and Ages at, Deaths during Year 1902. Causes of Death. Deaths in or belonging to whole District at subjoined Ages. Deaths in or belonging to Localities (at all Ages). Total Deaths in Public Institutions in the District. 12 All Ages. 2 Under 1 year. 3 1 and under 5. 4 5 and under 15 5 15 and under 25. 6 South. 10 East. 11 65 and up- wards. 8 25 and under 65. 7 North. 9 Small pox Vaccinated 24 - - - 6 18 - 6 3 15 - Unvaccinated 35 7 14 10 2 2 - 6 12 17 - No Statement 3 - - 1 1 3 - 2 - 3 - Measles 59 14 44 1 - - - 15 2 5 19 1 Scarlet fever 19 3 13 3 - - - 10 4 5 1 Whooping-cough 89 38 48 3 - - - 28 22 39 2 Diphtheria and membranous croup 33 5 19 9 - - - 17 8 8 5 Fever Enteric 14 - 2 1 5 6 - 5 1 8 - Other continued - - - - 1 - 1 - - - 1 Epidemic influenza 19 1 1 1 8 8 8 7 8 - 4 Diarrhœa 60 45 15 - - - - 17 21 22 5 Enteritis 36 28 6 1 - 1 - 20 14 2 11 Puerperal fever 6 - - - 3 3 2 1 3 1 - Erysipelas 12 1 - - 1 4 6 6 2 4 9 Other septic diseases 27 8 2 3 3 10 1 15 8 4 21 Phthisis 259 6 5 8 29 191 20 102 75 82 171 Other tubercular diseases 108 41 42 13 1 10 1 52 26 30 50 Cancer, malignant disease 108 - 2 1 1 68 36 46 19 4 8 43 TABLE IV.—continued. Causes of Death, 1 Deaths in or belonging to whole District at subjoined Ages. Deaths in or belonging to Localities (at all Ages). Total Deaths in Public Institutions in the District. 12 All Ages. 2 Under 1 Year. 3 1 and under 5. 4 5 and under 15. 5 15 and under 2 5. 6 25 and under 65. 7 65 and upwards. 8 North. 9 South. 10 East. 11 Bronchitis 37 2 94 61 4 4 92 117 129 103 140 69 Pneumonia 275 7 1 80 15 8 66 35 110 80 85 75 Ple uris y 35 5 5 1 3 14 7 14 9 12 14 Other diseases of Respiratory organs 13 6 1 - - 2 4 4 3 6 4 Alcoholism Cirrhosis of liver 41 - - - - 38 3 16 9 16 18 Venereal diseases 7 3 1 - - 3 - 3 4 - 1 Premature birth 76 76 - - - - - 34 19 2 3 2 - 1 1 3 Diseases and accidents of parturition 8 - - - 1 7 6 Heart diseases 2 5 2 9 9 13 22 12 5 74 89 63 100 9 8 Accidents 141 64 21 11 5 28 12 72 27 24 42 Suicides 5 20 - - - 11 4 7 7 6 7 Murder 4 3 1 - - - - 1 1 2 1 Old age 92 - - - - 1 91 25 16 51 65 All other causes 497 182 48 14 10 160 83 188 128 181 150 All causes 2747 710 439 113 111 872 502 1056 730 961 864 BETHNAL GREEN.—TABLE V. Shewing the number of Deaths from the seven principal Zymotic Diseases, inclusive of Hospital Deaths, in the ten years, 1892 to 1901, and in the year 1902. Disease. 1892. 1893. 1894. 1895. 1896. 1897. 1898. 1899. 1900. 1901. Annual Average of 10 years, 1892 to 1901. Proportion of Deaths to 1000 Deaths in 10 years, 1892 to 1901. 1902. Proportion of Deaths to 1000 Deaths from all causes in 1902. Small Pox 5 7 5 4 - - - - 2 2 0˙7 64 2 3˙3 - Measles 131 82 135 110 149 109 151 90 63 84 110 38˙5 59 21˙4 Scarlet Fever 53 71 27 30 40 24 11 9 12 44 32 11˙2 19 6˙9 Diphtheria 119 137 133 102 77 87 64 64 60 63 90 31˙5 33 12 ˙0 Whooping Cough 122 59 70 33 151 53 110 44 93 38 77 26˙9 89 32 ˙ 4 Fever 22 26 26 17 21 20 38 18 20 22 7˙7 15 5 ˙ 4 17 Diarrhœa 74 128 54 146 109 151 143 157 103 1 19 118 4 1 ˙4 60 21 ˙ 8 Total in Bethnal Green. 526 510 450 370 157˙9 339 123˙4 442 547 444 496 402 349 451 LIST OF LICENSED SLAUGHTERHOUSE AND COWHOUSE PREMISES IN THE METROPOLITAN BOROUGH OF BETHNAL GREEN. SLAUGHTERHOUSES. Read, James, 294, Bethnal Green Road. Meadway, George, 354, Bethnal Green Road. Terry, Elizabeth, 416, Bethnal Green Road. (Condition —This license is granted on the undertaking of the licensee to limit the slaughtering of cattle at these premises to the requirements of the retail trade of her own shop.) Salmon, Alfred, 212, Brick Lane. (Condition —Small cattle only.*) Challis, William Stanley, 278, Hackney Road. Hudson, George, 397, Hackney Road. Kimber, George Frederick, 21, Roman Road. (Condition —This license is granted on the undertaking of the licensee that only sheep or large cattle are allowed to be brought on to the premises at one time.) COWHOUSES. Skinner, Edward, 63, Bishop's Road. (No. of Cows —Shed No. I—8, Shed No. 2—6.) Jelliffe, J. R. (trading as Museum Dairy Co.), 379, Cambridge Road. (12 cows.) †Phillips, William, 42, Cheshire Street. (6 cows.) Jones Brothers, 216, Columbia Road. (No. of Cows—Shed No. I—8,Shed No. 2 —12.) Morris, Emma, 23, Ezra Street. (6 cows.) Cresswell, Mary Sarah A., 38, Fellbrigg Street. (No. of Cows —Shed No. I—6, Shed No. 2 —8.) Jenkins, Meredith, 104, Gibraltar Walk. (18 cows.) Lloyd, Evan, 348, Green Street. (No. of Cows—Shed No. 1—47, Shed No 2—17) Jones, Thomas, 1, Hamilton Road. (13 cows.) Sykes, William James, 34, Minerva Street. (8 cows.) Elliott, John, 65, Roman Road. (13 cows). Sweetman, Walter, 64, Squirries Street. (14 cows.) Webb, Robert, 38, Three Colt Lane. (23 cows.) Griffiths, Mary Ann, 6, Warley Street. (10 cows). †Evans, Rees, 55, Kerbela Street. (No of Cows —Shed No. 1—18,1 —18, Shed No. 2 —2.) Hughes, John, 2, Lisbon Street. (19 cows.) NOTE.—† Signifies change of occupier during the year to 31st October, 1902. *The exact wording of the condition in this case is " This license is granted on the undertaking of the licensee to kill small cattle only at these premises." Copy of the Borough Treasurer's Return re London Equalisation of Rates Act, 1894, sent to the Local Government Board on 16th May, 1903. Borough of Bethnal Green. Statement of the number of Houses (as defined in the note below) on the 6th April, 1903, entered in the Rate Book for the General Rate, made on the 17th October, 1902, being the last rate made before the Ist April, 1903, for the half-year ending 31st March, 1903. Houses not in any way used as Dwellings. 1. Inhabited Houses. 2. Total 3. 16,249 1,309 14,940 Of the number of" Houses " entered in column 2 above, 869 were entered in the Rate Book as comprising two or more rateable hereditaments separately occupied, and these latter comprised in all 3,548 separate occupations. (Signed) W M. H. ASHMOLE, Borough Treasurer. (Date) 13th May, 1903. Note.—For the purpose of this Return, a "House" includes all the space within the external and party walls of a building, although parts of the building may be separately entered in the Rate Book by reason of their being separately occupied. Houses which are not in any way used as dwellings are not included in column 2 of the Return, and consequently such buildings as warehouses, factories and workshops, are excluded from that column, unless they comprise a place of residence for a caretaker or other person. METROPOLITAN BOROUGH OF BETHNAL GREEN. STREET LIST. Name of Street. Zymotic Diseases Tubercular Diseases. Respiratory Diseases. General Diseases. Total. ... 5 11 Bonner road ... 1 3 7 11 0 Abbey street 5 Abingdon buildings 1 ... 1 3 5 Bonner street 2 ... 1 4 7 Abingdon street ... ... ... 1 1 Bonwell street 1 ... 1 6 8 Ada place ... 1 1 1 3 Boreham street 1 ... 3 1 5 Ainsley street ... ... ... 2 2 Boundary street ... ... 1 1 2 Bradys buildings 2 Albert buildings ... ... ... ... ... 1 ... 1 ... Brady street 2 Albert grove ... ... ... ... ... 3 4 4 13 Albion place ... ... ... ... ... Braemar street ... 1 2 2 5 Alfred place 2 ... ... 1 3 Bratley street ... ... ... 1 Brick lane Allas road 4 ... 3 3 10 2 3 7 13 2 5 1 1 3 6 11 Brierley street ... 1 3 3 7 Alma road 1 11 Bucks court 1 Ames street 3 ... 7 ... ... ... 1 ... ... ... 1 Buckhurst street ... 3 4 8 15 Andrew's road 1 Angela gardens ... 2 2 Burgoyne road 1 ... 1 2 4 ... ... Anglesea street ... 1 1 1 3 Burnham square ... ... 1 ... 6 Anns place ... 1 ... ... 1 Burnside street ... 1 2 3 6 Antill road ... ... ... 1 1 Busby street 2 4 2 4 12 Approach road ... 1 2 4 7 Busby square ... ... ... 1 1 Arbery road 1 ... ... 1 2 Butlers buildings ... ... ... ... ... Arline street 2 5 Butler street ... ... ... 1 1 ... 1 2 Artillery street ... ... ... 5 5 Buxton street 1 1 1 1 4 Arundel street 1 ... 3 4 8 Ashwell road 2 ... 1 4 7 Auckland road 1 3 2 4 10 Cadell street 1 ... 2 2 5 Austin street 1 2 2 4 9 Calvert avenue ... ... ... ... ... Cambridge circus ... 1 1 3 5 Bacon street 2 4 7 16 Cambridge road 5 3 11 17 36 3 ... ... ... ... ... Cambridge bldgs 1 Bakers court ... 1 ... ... Bakers rents Cambridge street 1 ... ... 1 2 ... ... ... ... ... Baker street ... ... 1 ... 1 Camden street ... 3 1 3 Bandon road 1 ... 1 4 6 Canrobert street 3 1 3 10 17 Barnet grove ... 2 2 5 9 Carlisle street ... ... 2 ... 2 Barnsley street 2 2 4 1 9 Carlton place 1 2 ... ... 3 Baroness road ... ... ... 2 2 Carter street ... ... ... 1 1 Bath grove ... 1 ... 1 2 Catherine street ... ... ... ... ... Bath street ... ... ... ... ... Centre street ... ... ... 1 1 Baxendale street ... 4 3 2 9 Chambord street 3 2 7 10 22 Bedford row ... ... ... ... ... Chance street ... ... ... 1 1 Bellhaven street ... 4 1 3 8 Chapel place ... ... ... ... ... Benson buildings ... 1 2 1 4 Chapel street ... ... ... 2 2 Bethnal green road 1 5 3 22 31 Chapman gardens ... ... ... ... ... 1 Birkbeck street ... ... ... 2 2 Charles terrace ... ... ... 1 Bishops road 1 3 7 13 Charlotte street ... 1 3 8 2 4 Blythe street 4 1 5 3 13 Chertsey buildings. ... ... ... ... ... STREET LIST—continued. Zymotic Diseases. Total. Tubercular Diseases. Respiratory Diseases. General Diseases. Name of Street. Cheshire street 1 2 3 5 11 ... ... 1 Darling row 1 2 Chester place ... ... ... ... ... Davis place ... ... 1 1 2 Chester street ... 2 1 4 7 Davis buildings ... ... ... 2 2 Chilton street ... ... 3 4 7 Delamere dwellings ... ... ... 2 2 Chisenhale road 2 2 1 4 9 Delta street ... ... ... ... ... Church street 2 1 2 10 15 Derby place ... ... 1 ... 1 Church row 1 6 10 1 2 Derbyshire street 2 3 4 6 15 Clare street 3 ... 1 2 Devonshire place ... ... ... 3 ... ... Claremont street ... 3 4 Digby street 1 ... ... ... ... 3 3 Digby walk ... 1 ... 7 8 Clarence street 4 2 4 ... 10 Clarkson street ... ... 2 4 6 Dinmont street 1 1 1 3 ... Clifton buildings ... 1 ... 1 2 Diss street ... ... 2 2 4 Club row ... 1 ... 1 Dixie street ... 1 4 2 7 ... Code street ... ... 2 6 8 Doveton street ... ... ... 1 1 Collingwood street 2 3 9 8 22 Driffield road ... 3 ... 3 6 Collyer's court ... ... ... 1 1 Ducal street ... ... 2 2 4 Collins place ... ... ... ... ... Durant street ... ... 1 10 11 Columbia market ... ... ... ... ... Columbia road 7 3 9 14 33 1 1 5 8 Eastman street Columbia square ... 1 7 4 12 1 Conyer street 1 1 ... ... 2 Ebor street ... ... 1 ... 1 Eckersley street 1 ... 1 2 Cookham buildings 1 ... 1 2 ... ... Co-operative b'ld'gs ... ... 1 1 1 Edgar place ... ... ... ... ... Coopers gardens ... ... ... 1 1 Edward p lace ... ... 1 1 2 Cordova road Elliott row ... ... ... ... ... 1 ... 3 1 5 Corfield street 3 4 3 12 22 Ellesmere road 1 1 3 2 7 Cornwall road ... ... ... ... ... Elwin street 1 1 2 5 9 Cottage place ... ... ... Emma street ... ... 3 3 6 ... ... Coventry place ... ... ... 3 3 Ernest place ... ... 1 ... 1 Coventry street 3 1 6 7 17 Ezra street 3 ... ... 2 5 Cox's buildings ... ... ... 7 ... Cranbrook street 1 3 4 6 14 Falcon buildings ... ... 1 1 2 Cranbrook road ... 1 2 2 5 Craven buildings 1 1 ... 2 4 Felix street ... 1 3 6 10 Crescent cottages ... ... 1 1 Fellbrigg street 1 3 4 11 19 ... Crescent place 1 1 3 5 10 Finnis street 2 5 1 5 13 Cross street ... ... ... ... ... Fleet street hill ... ... 1 1 ... Flint court ... ... ... ... ... Crossland square ... ... 1 1 ... Cudworth street 2 1 8 Florida street 2 ... 3 5 1 4 ... Culham buildings ... ... 1 1 2 Florida terrace ... ... ... 1 1 Fossett's buildings ... ... ... ... ... Cygnet street 1 ... ... ... 1 Cymon street 3 2 5 Foster street ... 1 ... 2 3 ... ... Cyprus street 4 2 6 9 21 Fountain street ... ... 1 ... 1 Fournier street ... ... ... 1 1 Fox street ... 1 ... 1 2 Dagnall place ... ... 1 2 3 Fox's buildings ... ... ... ... ... Fuller street 2 5 16 11 34 Daniel street 1 1 2 4 ... STREET LlST—continued. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. 1 2 2 6 Harold street ... 1 2 1 4 Gales gardens 1 Garden place, Violet street ... ... ... ... ... Hartley street 4 1 3 5 13 Hassard place ... ... ... ... ... Hassard street ... 2 ... 8 10 Garden place, James street ... ... ... ... ... Havelock place ... 1 ... 1 2 Gardners road ... 1 1 4 6 Helens place ... ... 2 3 1 Garner street 2 1 2 3 6 Hedsor buildings 2 5 1 ... 2 1 ... 1 2 4 Gascoigne place Henley buildings ... ... 1 1 2 Gawber street ... 1 1 2 4 Henrietta street ... ... 1 3 4 George gardens ... ... ... 1 1 Hereford buildings ... ... ... ... ... George place ... ... ... ... ... Hereford street 1 1 4 3 9 Hersee place 1 ... 2 2 5 George walk ... ... 4 ... ... Hill street ... ... ... 2 Georgina gardens ... ... 4 3 7 2 Hollybush gardens 2 10 18 Gernon road ... ... 1 1 2 2 4 Gibraltar buildings 1 ... ... 1 2 Hollybush place ... ... ... ... ... Gibraltar gardens ... 1 2 5 8 Holmes avenue ... ... 1 3 4 Gibraltar place ... ... ... ... ... Horatio street ... 1 4 5 ... Gibraltar walk ... 4 4 3 11 Horts place ... ... ... ... ... Gilman street ... ... ... ... ... Hunslett street 1 1 ... 1 3 Glass street ... ... ... 1 1 Huntingdon bldgs. ... 1 ... 5 6 Hurley buildings ... ... ... ... ... Globe road 5 5 3 15 28 Gloucester gardens ... ... ... 1 1 ... ... ... ... Goldsmith's row ... ... 1 1 2 ... Gosset street 1 1 8 13 23 Iffley buildings Granby place 1 ... ... ... 1 Ion square ... 1 3 6 10 Ivimey street ... ... 1 3 Granby row 1 ... ... 2 3 2 Granby street 5 1 2 3 11 James court ... ... ... G't East'n b'ldings ... 3 1 5 ... ... 1 Green street 7 3 10 19 39 Gretton houses 2 ... 1 1 4 James place ... ... ... ... ... James street 1 2 1 4 8 Grove place ... ... 1 1 2 Grove road ... 4 6 9 19 Jersey street 3 1 3 4 11 Grove row ... ... ... ... 1 1 4 5 Grove street ... 1 ... ... 13 Kay street ... ... Guinness buildings 2 2 ... 9 13 Kelsey street ... ... ... 4 5 Kenilworth road 1 3 4 5 13 Hackney road 2 7 6 16 31 Kerbela street 3 3 6 10 22 Hague buildings 1 ... 1 2 Kings place 1 ... ... 1 2 ... Hague place ... 1 ... ... 1 Knottisford street 1 ... ... 2 3 Hague street ... ... 2 3 5 Hammonds gardens ... ... ... 1 1 Laleham buildings ... ... ... 3 3 Hamilton road 2 ... 1 4 7 Hare court ... ... ... ... Lansdell place 1 1 4 3 9 ... Lark row 2 1 Hare marsh ... ... ... 1 1 ... 1 4 Hare row ... ... ... ... ... Lawfranc road ... ... ... 1 1 Hare street 3 2 3 9 17 Leopold buildings 2 1 ... 3 6 STREET LlST—continued. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. ... ... ... ... ... ... ... ... ... ... Letchford place Nelson place Lessada street 1 1 1 4 7 Nelson street 1 ... 3 2 Linden buildings 2 1 1 5 9 New Church street 1 ... 1 ... 2 Lisbon buildings ... ... 1 1 2 Newling street ... 1 ... 1 2 Lisbon street 1 ... 2 1 4 New Tyssen street ... 1 2 2 5 Ltle. Collingwood st. ... 1 1 1 3 Nichol street 1 ... ... ... 1 Norah street 1 1 2 6 Little York street.. ... ... ... 1 1 North passage ... ... 1 London street 3 2 ... 5 10 North place 2 1 ... 3 6 Lucas street 1 ... ... ... ... 1 2 North street 1 ... ... ... 1 Lyal road ... 4 4 Northampton street 1 ... 1 5 Lyte street ... 1 ... 1 2 Norton street 2 1 4 6 13 1 ... ... 5 7 17 Mace street 4 2 ... ... 4 Manchester bldgs ... ... ... ... Octagon street Manchester place ... ... ... ... Old Bethnal green road ... 2 5 7 Mansford street 3 ... ... ... 5 4 8 20 Mape street 2 4 6 12 Old Ford road 9 4 ... ... ... 5 22 40 Margaret place 1 1 2 4 Old Nichol street 9 2 2 Marian place ... ... ... ... Olga street ... 1 2 3 Marian street 3 3 1 5 12 Orange street 2 ... ... 1 ... 2 5 Marian square 2 ... ... ... ... ... ... ... ... ... ... ... 1 1 5 9 Oval 2 ... 1 2 5 ... Marlow buildings 1 ... 1 2 Oxford street ... ... Martha court ... ... 1 1 Marys place ... ... ... ... Matilda street 1 ... 3 4 1 1 ... ... 7 ... Palm street 1 ... ... 4 Meadows dwellings 2 1 3 Palmers road ... ... ... Medhurst road ... 1 ... ... ... ... ... 5 ... 6 ... Paradise row 1 1 Medway buildings Park place ... ... ... ... 1 ... Medway road 3 3 Parliament place ... ... ... Memorial hall bldgs. ... ... Parliament street ... ... ... ... Mendip houses ... ... ... 1 1 ... Parmiter houses 1 1 Menotti street 1 4 4 9 ... ... ... Parmiter street 3 ... 1 2 Merceron houses ... ... ... 2 2 Patriot square 1 2 4 ... Middleton street ... 3 1 2 6 Peacock place ... ... ... 1 ... Middle walk ... ... ... ... Peacock street ... ... ... ... 2 Minerva street ... 1 4 4 9 Pearl yard ... ... ... Minto place ... ... 1 ... 1 Pedley street 1 ... ... ... 2 ... 3 ... 3 ... 7 Molesley buildings ... ... ... ... ... Peel grove ... Morpeth street 3 1 4 13 21 Peel grove mews ... ... ... Moss street 5 ... 8 8 21 Mount street ... ... ... 1 Pereira street 1 ... ... 2 3 1 Peter street ... ... ... ... 1 5 6 Mowlem street ... 1 1 2 4 Pitt street ... ... ... 2 ... 3 5 Museum buildings ... ... 3 ... 3 Pollard place 6 16 Pollard row 5 ... 5 6 1 ... ... 1 Nant street 2 Pollard street 1 3 4 8 Neath place 1 ... ... 2 3 Portman place 2 2 1 5 ... STREET LIST—continued. Tubercular Diseases. Respiratory Diseases. Zymotic Diseases. General Diseases. Total. Name of Street. 1 ... 2 Scott street 2 ... 5 6 13 Pott street ... 1 Poyser street 1 1 2 1 5 Seabright street ... 1 ... 6 7 Preston street 2 5 10 3 ... Selby street 1 2 2 6 11 Primrose street ... ... ... ... ... Sewardstone road 1 2 1 6 10 Princes court ... ... 2 6 4 Shacklewell street ... ... ... ... ... Pritchards road 1 3 2 6 12 Sheldon place ... ... ... ... ... Prospect terrace 2 ... ... 4 6 Shiplake buildings ... ... ... ... ... Providence place ... 1 1 1 Shipton houses 3 1 ... 2 3 ... Providence yard ... ... ... ... ... Shipton street ... 1 5 2 8 Punderson gardens ... 2 2 6 10 Skinners court ... ... ... ... ... ... ... Sidney street 1 1 ... 3 5 ... Queen's buildings, Princes place 1 Smart street 1 ... ... 1 ... 1 Smiths place ... ... 1 1 2 Queen's buildings, Gossett street ... 1 ... ... 1 Somerford street ... 3 2 7 11 Sonning buildings 2 1 1 ... 4 S'thampton cott'gs. 1 2 ... 1 4 Queen's buildings, Chambord street. ... ... ... ... ... S'thampton place ... ... ... ... ... ... ... ... ... ... Queen Caroline plce. Quilter street ... ... ... ... ... S'thampton street ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... S'thampton terrace 1 ... 1 Quilter street ... 2 4 2 8 Quinns square 3 2 10 16 31 Spencer passage Spicer buildings ... ... ... Railway arches ... ... ... ... ... Spital street ... ... ... ... Ramsey street 1 ... 3 2 6 Squirries street 1 4 6 11 Rapley place ... ... ... ... ... St. Andrew street 2 ... ... ... 1 3 Ravenscroft build'gs ... 1 ... 6 7 St. James road 2 4 6 Ravenscroft street ... 2 2 1 5 St. John street 2 1 3 Reuben street ... 1 1 1 3 St. Jude street ... ... 3 3 Riders buildings St. Mark's build'gs ... 1 ... 1 ... ... ... ... ... Roan Horse yard ... ... ... ... ... St. Mary's place St. Matthias place. Robert street 1 1 2 1 5 ... ... ... ... Robinson road 1 1 1 3 St. Peter square 1 ... ... 1 ... Roman road 3 1 3 9 16 St. Peter street 1 4 3 8 16 Rooks place ... ... ... ... Stainsbury street ... ... 2 2 4 1 Stanfield road ... 4 Ropley street 1 ... ... 1 ... ... ... ... Steels buildings ... ... ... ... ... Ross buildings, Moss street 1 ... 1 Strahan road ... ... 1 2 3 ... ... Royal Victor place ... ... Streatley buildings ... 1 1 2 ... ... ... ... ... ... ... Royston street 5 1 8 9 23 Stroud place ... ... ... ... Russia lane 3 2 4 6 15 Sugarloaf walk ... 1 1 ... Sunbury buildings. ... 2 1 3 Sabbage yard ... ... ... ... ... Surat street 2 ... 1 4 5 12 Sale street 2 1 3 3 9 Sweet Apple square ... 1 1 2 Sandford buildings ... ... ... ... ... Satchwell rents ... 1 1 ... 2 4 5 5 14 Satchwell street 1 2 3 3 9 Tagg street ... ... School place ... ... ... ... Taplow buildings 2 ... 2 4 8 Sclater street 1 2 1 4 8 Tapp street 1 1 ... ... 2 STREET LIST — continued. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. 10 Tavistock street ... ... 1 ... 1 2 Wadeson street 2 2 4 Teale street Walter street 2 ... 1 2 5 ... ... ... c. ... Walton buildings ... 1 11 6 Teesdale street 1 ... 3 6 10 4 Wargrave build'gs. 1 3 Temple dwellings ... 1 1 1 3 ... 2 ... Temple street 1 1 41 6 12 Warley street ... 1 2 8 11 Tent street ... 2 1 2 Warner place 9 13 5 1 1 2 Thomas passage ... ... ... ... ... Waterloo place ... ... ... 1 1 Thomas place ... ... ... ... ... Waterloo road ... ... 2 ... 3 Thorold street 3 ... 4 7 14 Waterloo terrace ... ... ... 2 2 Theydon road 1 ... 1 2 4 Waterlow buildings ... ... ... ... ... Three Colt corner ... ... ... ... ... Weaver street ... 2 1 ... 3 Three Colt lane 1 ... ... 6 7 Weldon street ... ... ... ... ... Thurlow place ... ... 2 ... 2 Wellington place ... 1 1 ... 2 Wellington row 5 8 17 Totty street 5 1 3 5 14 2 2 Wennington road 3 3 8 Toyes dwellings, Old Bethnal Green rd. ... ... ... ... ... 2 ... West street ... ... ... 1 1 Wharf road ... 1 3 2 6 Toyes buildings, Mansford street ... 1 1 1 3 Wharncliffe street ... ... 2 ... 2 Treadway street 3 3 2 11 19 Whites court ... ... ... ... ... Turin street 1 2 2 6 11 Whitechapel road ... ... ... ... ... Whitmore buildings ... ... ... Turville street ... ... 1 ... 1 ... ... Tuscan street ... ... 2 1 3 Willow walk ... ... ... ... ... Wilmot house ... ... 1 Type street 1 ... ... 5 6 ... 1 Tyrrell street ... 1 2 1 4 Wilmot street 2 6 13 22 1 Winbolt street 1 ... 3 6 10 Usk street 4 ... ... 1 5 Winchester b'ld'gs ... ... ... ... ... Winchester crescent ... ... ... 2 2 Winchester place ... ... ... ... ... Vallance road 1 ... 7 16 24 Winchester street ... ... ... 3 3 Wolverley passage. ... ... ... ... ... Valley place ... ... ... ... ... Wolverley street ... 1 1 2 4 Venice street ... 1 1 1 3 Wood close ... ... ... ... ... Viaduct place ... ... 1 1 2 Wood street 1 1 1 1 4 Viaduct street ... 2 3 8 13 Victoria park ... ... ... ... ... ... ... 1 2 3 Victoria place ... ... ... ... ... York place Victoria place, James street ... ... ... ... ... 1 ... ... ... 1 Victoria Park square ... 1 ... ... 1 Barnardo's Homes. Victoria street 1 ... ... ... 1 Bethnall House 8 ... 1 ... 9 Violet row Canal ... ... ... 2 2 ... ... ... 3 3 Violet street Infirmary 4 11 22 51 88 ... ... ... ... ... Virginia road 4 ... 1 9 14 Mildmay Hospital. 1 ... ... 2 3 Vivian road ... 2 3 1 6 N.E. Hospital ... 1 2 1 4 Vyner street ... 1 3 4 8 LIST OF UNDERGROUND BAKEHOUSES in the Metropolitan Borough of Bethnal Green. Means of Height of Bakehouse Construction of Position of Folio. ■ Name and Address. Arthur Conder, 17, Arbery Road Albert Klapper, 5, Approach Road B. Lazarus, 141, Bethnal Green Rd London Cake & Biscuit Co. 44, Bethnal Green Rd. H. E. Croft, 160, Bethnal Green Rd James Syrett, 203, Bethnal Green Rd Mrs. Cooper, 238, Bethnal Green Rd Joseph Kau, 104, Barnet Grove George Sendner, 65, Barnet Grove F. Ringe, 23, Bonner Street Catherine Feuchter, 2, Bonner Road Nicholas Louis, 141, Brick Lane Ludwig Hempel, 47, Brady Street F. Mathias, 9, Cambridge Road Lewis Rosenbloom, 145, Cambridge Road H. Knowles, 395, Cambridge Road William Ross, 507, Cambridge Road Joseph Backes, 106, Columbia Road H. T. Brooks, 1, Georgina Gardens Christiana Batten, 122, Green Street Christopher Bleines, 64, Hackney Road J. H. Hoppe, 124, Hackney Road Robert Stone, 198, Hackney Road Henry Morris, 228, Hackney Road John Frost, 417, Hackney Road Luigi Offredi, 467, Hackney Road J. Miller, 55, Hartley Street William Moore, 49, Medway Road G. Davis, 78, Old Bethnal Green Road J, G. Hauser, 174, Old Ford Road Henry Stone, 3, Roman Road Henry Cooper, 26, Roman Road George Kranz, 17, Turin Street Jacob Louis, 59, Virginia Road John Stein, 184, Vallance Road George Harding, 343, Whitechapel Rd Position. Corner basement Front basement Ditto Whole basement Corner basement Whole basement Ditto Corner basement Rear corner basement Whole basement Front basement Corner front basement Corner basement Back basement Front basement Ditto Back basement Corner back basement Whole basement Front basement Corner basement Whole basement Ditto Back basement In rear of yard Corner basement Ditto Ditto Ditto Ditto Front basement Corner basement Double basement corner Whole basement Corner basement Front basement Ceiling above street level Level 10-in. Level Ditto 6-in. Level 10-in Level Level Level 10-in. below Level Ditto Ditto Ditto Ditto Ditto Ditto Ditto Ditto Ditto Ditto Ditto Ditto 3-ft Level Ditto Ditto Ditto Ditto Ditto Ditto Ditto Ditto 18-in Level Floor to Ceiling. ft. 7 in. 2 7 6 8 6 14 0 8 6 8 0 6 4 7 6 7 4 7 0 8 0 7 9 8 1 7 9 8 7 7 10 7 6 to boards 8 0 8 0 7 0 7 10 8 0 to boards 7 0 7 6 8 6 8 0 8 8 7 6 7 8 8 0 8 0 7 11 8 6 9 0 7 0 7 8 Light. Three areas Windows over oven, etc. Stall-board enclosed yard in rear Stall-board and pavement lights Window in rear Back door and stall-board Stall-board Skylight to yard Three gratings over area From window into small area Stall-board lights Window in front area Window to yard Window in rear Stall-board and back area Door and windows Area and skylight None (except borrowed) Stall-board Stall board and area Stall-boards in front Stall-board end closed Area at rear Window in rear Window into covered area Stall-board, lights and area Three area windows Two areas and stall-board Stall-board and back area Stall-board lights in both fronts Stall-board and window Stall-board and area Stall-board and area at back Pavement lights and skylight Two small windows on pavement Stall-board Ventilation. Three areas Window over oven, etc. Stall-board Fan lights and stall-board Stall-board By door to yard Back door and stall-board Stall-board and opening Opening in skylight Gratings Window and door Louvres and openings in covered yard Window and door Window and door Window in rear and stall-board Stall-board and back area Door, window and stall-board Area and Skylight Air shaft 8ft. square Stall-board and area in rear Stall-boards Stall-boards and staircase Area in rear and stall-board Window in rear and door in front Window into covered area Stall-board, lights & grating Three area windows Two areas and stall-board Stall-board, back area & door Stall-board lights in both fronts Window and door Stall-boards and area Stall-board and area at back Skylight and stall-board light Two small windows and door to area Stall-board, lift and old'chimney flue Walls. Brick plastered Brick Ditto Ditto Ditto Ditto Ditto Ditto Plastered Brick Plastered Plastered Ditto Brick Plaster Brick Ditto Plaster Brick Ditto Ditto Brick and cement dado Brick Ditto Ditto Ditto Brick Ditto Ditto Plaster Brick Ditto Ditto Ditto Ditto Ditto Ceiling. Lath and plaster Ditto Boards and joists Ditto Ditto Roughly ceiled Boards and joists Matchboard Lath and plaster Lath and plaster Lath and plaster partly Lath and plastered Lath and plaster Boards and joists Ditto Lath and plaster Boards and joists Ditto Ditto Ditto Ditto Boards and joists Lath and plaster Boards Joists and boards Boards Lath and plaster Ditto Ditto Ditto Ditto Ditto Boards and joists Lath and plaster Joists and boards Boards Floor. Cement Flagging and Cement Concrete Concrete York Paving York and Cement Rough Concrete Wood Wood & Cement Flagging Concrete Brick & York Concrete York Paving Concrete York and Brick Concrete York Part Wood & Stone Concrete Flagging Concrete Rough Concrete Cement Concrete and Flagging Concrete York Paving Concrete Concrete York Paving Concrete York Paving Concrete Concrete York Paving Brick Staircase. Enclosed step-ladder Staircase Enclosed Ditto Ditto Open ladder Step-ladder and stone steps Enclosed Open step-ladder Open step-ladder Open staircase Enclosed step-ladder Enclosed Enclosed step-ladder Ditto Ditto Open ladder in flour loft Ditto Stone Enclosed Step-ladder and staircase Step-ladder Open step-ladder Step-ladder Stone steps to Area Step-ladder Enclosed step-ladder Ditto Enclosed Ditto Ditto Step-ladder Enclosed Ditto Enclosed stone steps Open step-ladder W.C. In yard Ditto Ditto In rear In passage at rear In rear In yard Ditto Ditto Ditto Ditto In covered yard In yard Ditto Ditto Ditto On first floor Ditto In adjoining cellar In yard Ditto Ditto In yard at rear In yard Ditto On ground floor In yard Ditto Ditto Ditto Ditto Ditto Ditto On first floor In yard Ditto Sink. In bakehouse External Ditto In rear In bakehouse External In yard External In yard Gully in bakehouse In bakehouse In covered yard In yard In bakehouse Ditto In yard External in area Ditto In flour loft In area In bakehouse In yard In bakehouse In yard Ditto In bakehouse In yard In bakehouse External In yard Ditto Ditto External In covered area In area In bakehouse Water Supply. In bakehouse External Ditto In bakehouse Ditto External Ditto Ditto In bakehouse In bakehouse In bakehouse In flour store In bakehouse Ditto Ditto Ditto In area External In flour loft In bakehouse Ditto Ditto Ditto In yard In bakehouse Ditto In bakehouse Ditto Ditto Ditto Ditto In yard Ditto In bakehouse In area In bakehouse Flour Loft. None None None On first floor In rear of bakehouse None None Alongside bakehouse In front basement None Alongside bakehouse In rear of bakehouse Ditto In front basement None None Front Basement In front of bakehouse Adjoining In' rear of bakehouse Ditto None In bakehouse None Overhead None None None None In rear of bakehouse None Ditto Ditto Ditto In front of bakehouse None Coals. In bakehouse Ditto Ditto Ditto Ditto Ditto Ditto Ditto Ditto Ditto In yard Ditto Ditto Ditto In bakehouse Ditto In yard Ditto In flour loft In bakehouse Ditto Ditto Ditto In front basement In yard In bakehouse Ditto Ditto Ditto In rear of bakehouse In bakehouse In yard In rear of bakehouse In bakehouse Ditto Ditto Description of Yard. Open yard Open yard Small open yard on level with bakehouse floor. No yard. Very small open yard on level with bakehouse floor. Very small yard, about 3 feet above bakehouse floor. Fair sized open yard, about 4 feet above bakehouse floor. Very small yard, open, about 7 feet above bakehouse floor. Small yard level with bakehouse ceiling, open. Yard fairly large, open, level with ceiling of bakehouse. Very small yard, open, level with ceiling of bakehouse. Covered yard, very small Small open yard, level with bakehouse ceiling. Small open yard, 5 feet above bakehouse ceiling. Small jard, open, level with bakehouse ceiling. Fa ir ly large y ard . level with bakehouse ceiling. Small open yard, and a small open area, floor of bakehouse level with floor of area. Small yard, open, level with bakehouse ceiling. No yard Large yard, open, about 4 feet above bakehouse floor. Small open yard, level with bakehouse ceiling. Small yard, open, level with bakehouse ceiling. Fairly large yard, open, level with bakehouse ceiling. Fairly large yard, open, about 3 feet above bakehouse floor. Partly-covered yard, about 4ft 6 in. above bakehouse floor. No yard. Small yard, open, level with bakehouse ceiling. Small yard, level with bakehouse ceiling, open. Large open yard, level with bakehouse ceiling. Small yard, open, level with bakehouse ceiling. Large open yard, and an open area, the area level with bakehouse floor. Small yard, partly covered, and level with bakehouse ceiling. Small yard, open, level with bakehouse ceiling. Small open yard, level with bakehouse ceiling. Small yard, open, and a small area, floor of bakehouse level with area. Small yard, open, ceiling of bakehouse level with yard.