Bet 1 THE Metropolitan Borough of Bethnal Green. REPORT ON THE SANITARY CONDITION AND VITAL STATISTICS DURING THE YEAR 1904. TOGETHER WITH THE REPORT OF THE CHIEF SANITARY INSPECTOR. 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 0f 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: Printed by Prince & Baugh, Ltd., 14, Collik;;: Hill, London, E.C. 1905 Synopsis OF MEDICAL OFFICER'S ANNUAL REPORT, 1904. PAGE Summary 4 Estimate of Population 5 Births 5 Table " A," Excess of Births over Deaths 5 Table " B," Births in Sub-districts 6 Deaths 6 Death Rate 7 Table " C," Mortality Rates in Sub-districts 8 Table " D," Monthly Death Rates and Meteorology 8 Tables " E " and " F," Birth Rates 9 Marriages and Marriage Rate 10 Deaths of Infants 10 Deaths of Young Persons 10 Deaths of Elderly Persons 10 Weekly Mortality Chart 11 Special Causes of Death 11 Table " G," Mortality Rates of certain Diseases, London 12-13 Table " H," Mortality Rates of certain Diseases, Bethnal Green 12 13 Table " I," Deaths at Home and in Hospital 14 The Seven Principal Zymotic Diseases 14 Table " K," Deaths from Zymotic Diseases 15 Table " L," Percentages of Deaths from Zymotic Diseases 16 Notification of Infectious Diseases 16 Scarlet Fever in Tram-cars 18 Table " M," Hospital Doctors' and Private Practitioners' Notifications 20 Small Pox 22 Small Pox and Vaccination 22-27 Small Pox at the London Hospital 27 Chicken-pox 30 Scarlet Fever 30 Diphtheria 31 Enteric Fever 32 SYNOPSIS.— Continued. PAGE Other Forms of Fever 33 Diseases of Parturition 33 Whooping Cough 33 Diarrhoeal Diseases 33 Measles 34 Closure of Schools 35 Tubercular Disease 35 Phthisis 36 Respiratory Disease 37 Malignant Disease 37 Suicides 38 Murder 38 Uncertified Deaths 38 Cow-houses and Slaughter-houses 38 Bakehouses 40 Customs and Inland Revenue Acts 43 Housing of the Working Classes Acts, 1890 to 1903:— Brady Street Area 47 Digby Street Area 53 By-Laws for Houses let in Lodgings 54 Public Health Department 58 Tables — I.—Vital Statistics of Whole District during 1904 and Previous Years 59 ll.—Vital Statistics of Sub-districts in 1904 and Previous Years 60 lll.—Cases of Infectious Diseases notified during the Year 1904 61 IV. —Causes of, and Ages at, Death during the Year 1904 62, 63 V. —Shewing the Number of Deaths from the Seven principal Zymotic Diseases, inclusive of Hospital Deaths, in the Ten Years 1894 to 1903, and in the Year 1904 64 Public Institutions into which Inhabitants of Bethnal Green have been received, and where they have subsequently died 65 Total Public Institution Deaths in Bethnal Green (Residents and Non-Residents) 66 Factories and Workshops 67 Proceedings during 1904 72 Street List 73 SUMMARY. 1903 1904 Estimated Population of Bethnal Green Averages: 130,028 130,207 Young Children, under 5 years 17,765 17,790 Old People, over 60 years 4,795 4,801 Area—755 Acres. Number of Inhabited Houses 14,831 14,934 Trade Premises not used as Dwellings 1,321 1,359 Average number of Persons to each House 8.70 8.78 1901 Census, 9.2. Average number of Persons to each Acre 172 172 1901 Census, 170-8. Total number of Deaths in the Year 2,363 2,489 Total number of Births in the Year ... 4,627 4,526 Total number of Marriages 957 945 Marriage Rate—Bethnal Green 14.5 14.7 Marriage Rate—London 17.4 17.0 Death Rate —Bethnal Green 18.17 19.1 Death Rate—London 15.2 16.1 Birth Rate —Bethnal Green 35.6 34.7 Birth Rate—London 28.4 27.9 Infantile Death Rate (on Births) —Bethnal Green 141 157 Infantile Death Rate (on Births) -London 130 144 Yonng Children's Death 'Rate (on estimated number of Young Children) 57.8 60.0 Old People's Death Rate (on estimated number of Old People) 91.0 84.0 2.24 2.70 Zymotic Death Rate—Bethnal Green Zymotic Death Rate—London 1.76 2.1 Inquest Cases 284 276 Uncertified Deaths (no Inquests held) 5 5 Metropolitan Borough of Bethnal Green. REPORT. TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE METROPOLITAN BOROUGH OF BETHNAL GREEN. Gentlemen, I beg to submit for your consideration my twenty-ninth Annual Report on the Vital Statistics and Sanitary condition of the Borough of BethnaJ Green for the registration year 1904, which terminated on the 31st of December last. ESTIMATE OF POUPLATION. The Registrar Genera] estimates the population of the Borough at 130,207 in the middle of the year 1904. MIRTHS. The total nun:her of births registered in Bethnal Green during the year is 4,526, against 4,627 in 1903, a decrease of 101. The excess of the births over the deaths is -2,037. Table "A " shews this and compares the two years. TABLE A. 1903. 1904. 130,028 Estimated population in the middle of the year 130,207 Total Births 4,627 4,526 Total Deaths 2,363 2,489 Excess of Births over Deaths, shewing the natural increase of the population 2,037 2,264 The number of births registered in the three subdistricts, into which Bethnal Green is sub-divided, is shewn in the following table, while for purposes of comparison the population of each sub-district, estimated to the middle of the year 1904, is also shewn : — TABLE B. BIRTHS IN SUB-DISTRICTS. District. Births. 1904. Estimated Population in 1904. Births. 1903. North 1,945 1,892 51,600 South 1,194 33,179 1,171 1,511 East 45,428 1,440 DEATHS. The weekly returns of the Local Registrars forwarded to me shew particulars of 2,393 deaths in Bethnal Green, indicating a crude death rate of 18.4 Amongst the deaths so registered are included those of three hundred non-residents who died whilst under treatment in Bethnal Green Public Institutions ; four other persons, also non-residents, died violent or sudden deaths whilst temporarily within the boundaries of the Borough; one of these was an unknown man, aged about 15, who was killed on the railway near Bethnal Green Junction ; another, a Brixton man, was injured in a lift accident in Bacon Street, and was found to have broken his neck; a third was found drowned in the Canal ; and the fourth man, aged 45, ruptured an aneurism of the aorta whilst passing through Brick 190.4 Deaths from al causes Lane. The deaths of these 304 non-residents must, for purposes of correction, be struck off the number actually returned by the Registrars. On the other hand I have received information from Somerset House of the deaths of 400 persons, ordinarily resident in Bethna] Green, but who died in Public Institutions outside our boundaries. After adding these 400 deaths and subtracting the 304 non-residents, there remains a net total of 2,489. The deaths in the sub-districts were as under: — North 1,001 South 665 East 802 Previous residence unknown 21 Total 2,489 DEATH RATE. We shew a mortality for the year 1904 of 19'1. This is one per thousand in excess of the rate of the previous year (which was an exceptionally healthy one) ; but our relation to the general Metropolitan rate is maintained as this also has increased in the same ratio and is one per thousand above that of the previous year; for the death rate for the whole of London was 16' 1 as against 15-2 for 1903. MORTALITY RATES IN SUB-DISTRICTS In the following table is shewn the corrected mortality rate in each of the three registration subdistricts. 192 BIRTH KATE. The births registered during the year numbered 4,526 and were equal to a rate of 34 - 75 per thousand population. This rate is one per thousand lower than that of the preceding year, viz., 35.62. The general Metropolitan rate has also decreased and stands at 27.9, the lowest on record, as usual about seven below our own. In the registration sub-districts of the Borough the birth rates were as under ; the death rate in each district is also shewn for purposes of comparison:— TABLE E. Sub-Districts. Birth Rate. Death Rate. North 37.77 19.4 South 19.7 35.30 East 33.26 17.6 The following table compares the death rates for Bethnal Green and for London by quarters: — TABLE F. Quarter ending. London. Bethnal Green. April 2nd 17.8 20.1 July 2nd 17.5 14.3 October 1st 15.8 18.9 December 31st 16.4 20.5 Yearly Average 19.1 16.1 MARRIAGES. First Quarter 138 Second Quarter 275 Third Quarter 264 Fourth Quarter ... 268 Total 945 These figures indicate a marriage rate of 14 - 5 to every thousand persons, as against 17.0 in the County of London. DEATHS OF INFANTS. Twenty-eight and a half per cent, of the total deaths from all causes were those of infants aged less than twelve months ; for out of 4,526 infants born alive, 711 died within one year of their birth ; thus giving a rate, calculated upon the total births, of 157. The corresponding rate for the whole of London is 144. DEATHS OF YOUNG CHILDREN. Forty per cent, of the deaths from all causes, that is to say 1,069, were those of children aged less than five years. This is equivalent to a rate of 60'0 per thousand calculated upon the estimated population of young children. ELDERLY PERSONS DEATH RATE. The number of deaths among persons aged over 65 years of age was 437 ; this gives a death rate of 91.0, calculated upon the estimated population of elderly persons. WEEKLY MORTALITY. The line on the chart of deaths from all causes indicates the number of deaths, week' by week, corrected for institution deaths. SPECIAL CAUSES OF DEATH. (Quarterly and Annual Deaths). On the next two pages will be found tabulated the quarterly and annual rates of mortality for some of the principal diseases included in Table I\". in the appendix. The table also shews mortality rates for all causes of death and for infantile deaths, this latter rate is calculated upon the actual number of births registered in each quarter and the annual rate upon the total registered births. The other rates indicate mortalities from the diseases specified, calculated upon the estimated population of the borough in the middle of the year 1904. TABLES G. & H. 1904 Estimated Populationin the middle of 1904 Births All Causes Small Pox Measles Scarlet Fever Diphtheria Whooping Cough Typhus Enteric Fever Pyrexia Diarrhœa Phthisis Deaths of Infants under 1 year of age All Causes Principal Epidemic Diseases Small Pox Measles Scarlet Fever Diphtheria Whooping Cough Typhus Enteric Fever Pyrexia Diarrhœa Phthisis Deaths under 1 year to 1000 Births Registered County of London:— 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 4 1 2 3 5 6 7 8 4,648,950 20,604 670 204 595 - 54 1 239 2.0 55 4,438 17.8 16.61 0.01 0.58 0.07 0.18 0.51 - 0.05 0.00 0.21 1.77 133 April 2nd 8 81 33,294 July 2nd 4,648,950 32,536 16,546 12 930 81 163 505 - 42 2 246 1,815 3,475 1.71 0.01 0.80 0.07 0.14 0.44 - 0.04 0.00 0.21 1.57 14.3 107 October 1st 4,648,950 18,352 5 369 150 240 - 85 2 3,931 1,577 6,667 15.8 4.20 0.00 0.32 0.08 0.21 - 0.07 0.00 3.39 1.36 208 32,034 87 0.13 December 31st 4,648,950 31,471 19,054 - 116 206 155 - 105 1 335 2,079 4,020 16.4 1.04 - 0.25 0.10 0.18 0.13 - 0.09 0.00 0.29 128 287 1.79 4,648,950 74,556 25 2,256 365 723 1,495 - 286 6 4,75 1 7,526 18,600 16.1 2.14 0.005 0.49 0.08 0.16 0.32 - 0.06 0.00 1.62 144 1.02 129,335 Bethnal Green:— 130,207 1,169 650 10 3 13 15 — - 7 82 162 19.9 1.65 0.15 .31 0.09 0.40 0.46 - 0.03 - 0.2l 2.53 139 April 2nd 5 1 130,207 1,127 565 2 5 8 - - 1 3 79 145 17.3 2.27 0.06 1.27 0.15 0.25 0.43 - - 0.03 2 .43 129 July 2nd 41 14 0.09 October 1st 1,110 612 21 4 15 7 - - 126 50 243 18.8 5.40 0.03 0.65 0.46 O.21 - 0.06 - 3.87 1.54 O.12 219 130,207 1 2 December 31St 130,207 1,120 - 17 6 12 8 - 3 - 11 69 161 20.3 1.75 - 0.52 0.18 0.37 0.24 - 0.09 - 0.34 2.13 144 662 4,5 2 6 2,489 8 89 18 48 44 - 6 1 147 19.1 0.6 0.13 0.37 0.33 - - 1.12 2.16 280 7 11 158 130,207 2 .77 0.7 0.04 In the following table is shewn the relative proportion of deaths in hospital and in their own homes of the sufferers from Zymotic diseases : — TABLE I. Disease Deaths at Home. Deaths in Hospital. 1 Small Pox 7 Scarlet Fever 17 1 Diphtheria 8 40 3 Enteric Fever 3 4 Erysipelas 6 2 Puerperal Fever 7 Measles 82 7 Diarrhœa 127 20 THE SEVEN PRINCIPAL ZYMOTIC DISEASES. The total number of deaths from the seven principal Zymotic diseases, including those of 65 persons who died in the hospitals of the Asylums Board, was 361 against 289 in 1903, an increase of 72. Notwithstanding" this increase, the total deaths of this class for the year were fifty below the decennial average for the ten years 1894 to 1903. Table Vin the appendix shows this average to be 411. TABLE K. 1904. 1 903. 8 Small Pox Measles 85 Scarlet Fever 13 Diphtheria 48 Whooping Cough 44 41 - Typhus Fever Enteric Fever 12 Simple Fever 1 Diarrhœa 147 112 - - Cholera 289 361 From an inspection of this table it will be noticed that the increased mortality is general, and that the only one of the seven diseases which shews a diminished mortality is enteric fever. The total deaths included in table D, form exactly fourteen and a half per cent, of the total mortality from all causes. The death rate from these seven Zymotic diseases is 2-7 against 2-2 in 1903, whilst the corresponding Metropolitan rates are 2 - 2 and 2*l. Table F shews the percentage of deaths from each disease as compared with the total number of Zymotic deaths. - 6 - 26 18 8 9 - TABLE L. Small Pox caused 8 deaths, 2.21 per cent., or 1.in 45.12 deaths. Measles 89 24.65 4.05 Scarlatina 18 4.98 20.05 Diphtheria 48 13.30 7.52 Whooping Cough 44 12.19 8.20 Typhus Fever ” ” ” ” ” Enteric Fever 6 1.66 60 02 Simple Fever 1 0.27 361.00 Diarrhœa 147 40.72 2.45 NOTIFICATION OF INFECTIOUS DISEASE. The total number of notification certificate's received during the year was 2,119; of these 116 were duplicates, a proportion of five and a half per cent, on the whole number. Nine certificates were forwarded to the Medical Officers of other Boroughs, as they referred to persons ordinarily resident outside Bethnal Green. One certificate was withdrawn by the sender; three chicken pox certificates were disallowed, as they were received after the expiration of the order ; four others were cancelled, as they referred to persons whose addresses could not lie traced. The certificates relate to a total of 1,994 persons. Table III. in the appendix indicates the number of persons suffering from each disease. It also shews the sub-districts in which they had resided and the number (655) of those removed to hospital. The most virulent of the notifiable diseases are Small pox, Scarlet Fever, Diphtheria and Chicken pox, yet we find that numbers of children suffering from some one of these and consequently in a highly infectious condition, are taken through the public streets for treatment as hospital out-patients. It is impossible to estimate how many people thus become infected in cars, omnibuses and waiting rooms; but I feel sure that many mysterious outbreaks of disease are attributable to some such source. Possibly some parents err in ignorance, but I am afraid that many are so selfish as to be utterly careless of the danger to which they expose,their- temporary neighbours. It occasionally happens that parents who call in a private medical practitioner to a child sick with some infectious complaint, are dissatisfied with the doctor's opinion, which, if correct, would necessitate the patient's removal. In these circumstances it is not an uncommon thing for the child to he taken to one of the general hospitals for confirmation of diagnosis or otherwise. The following communication from a medical practitioner in the district refers to an equally reprehensible practice : — 22nd September, 1904 DEAR DR. BATE, In forwarding a notification for E. H., of i i8, Royston Street, I would like to draw your attention to a procedure on the part of parents of which I have had one or two other instances. A child is brought to the surgery and diphtheria is diagnosed, the parents will not at once agree to removal and the notification is withheld for a day, or overnight, till they should make up their minds. Meanwhile, in order to prevent the ambulance being brought to their door, they take the child to the London Hospital. The authorities there telephone for the ambulance and the case is removed without the " neighbours " seeing it. This course involves the exposure of a child (in E. H's case for three hours) in a public place, to her own great risk and the danger of infecting others. Yours truly, B I, of course, drew the writer's attention to the illegality of his action in withholding certificates, and carefully investigated the circumstances of the case referred to. The mother denied that she was warned by the doctor as to the infectious nature of the complaint from which her child was suffering, and I was unable to obtain sufficient confirmatory evidence to take the case into court. Undoubtedly the exposure of persons suffering from infectious disease is a punishable offence under sec: 68 of the Public Health (London) Act 1891, but it is extremely difficult to prove to the satisfaction of a Magistrate, that the person in charge of the sick child is aware of the infectious nature of the disease from which it is suffering. That it is possible to obtain a conviction in cases of this kind the following extract from a local paper will shew:— CASES OF SCARLET FEVER EXPOSED IN A TRAMCAR. A mother, named Emma Cohen, was convicted at the Thames Police Court on October 29th, and fined 40/-, with 44/- costs, for an offence which richly deserved the penalty inflicted. A medical man had been called in by her to attend her little boy, aged four years, and had found him to be suffering from Scarlet Fever. He had informed her of this and had forbidden her to take the child out, notwithstanding which she had conveyed him to the London Hospital in a tramcar and had there remained with him for some time in the reception room where other patients were awaiting their turn for attention. The recklessness and selfishness of persons who can claim not to be "aware" of the presence of a notifiable infectious disease are not punishable, but in this instance the fact that a medical man had informed the defendant of the nature of her child's illness and had warned her as to her conduct disposed of any difficulty on this score. Another woman was fined at the same time for a similar offence. Hospitals were originally instituted for: — (a) The medical and surgical relief of the necessitous poor who are not paupers. (b) The treatment of those particular forms of disease or injury which require special skill or appliances for their cure, in persons who are unable to meet extraordinary expenses. Most certainly it was never contemplated that children sickening with infectious disease, or grown persons suffering from trivial illnesses, and able to pay ordinary medical fees, should take up the valuable time of Hospital Physicians and Surgeons to the detriment of the more deserving. In by-gone days the treatment of such ailments was the peculiar province of the private doctor, who was rightly considered a specialist in these particular complaints, and the hospital was only applied to in serious or prolonged illnesses; but since many of the hospitals have ceased to require a governor's letter, and have converted their out-patient departments into cheap dispensaries, this condition of things no longer obtains; moreover as applicants pay for their physic, they do not consider that they are in receipt of charitable relief. The result ol this is that amongst a certain class of people, no sooner is a child, or even a grown person taken ill, than he or she is rushed off to the hospital, where, for the sum of three pence, medical advice and a week's supply of medicine can be obtained, without any inconvenient enquiries as to the applicant's ability to pay proper fees. The hospital 'authorities are always most anxious to shew numbers of out-patients cured or " relieved," as these figures appeal to the charitable public, and the hospitals, notwithstanding the profit they derive from their out-patients, are always impecunious. The following table gives the relative proportions of notifications of certain infectious diseases received by me from hospital out-patient doctors and private practitioners. TABLE M.—INFECTIOUS DISEASE NOTIFICATIONS, 1904. Disease. Hospital. Private. Totals. Hospital Percentages. Chicken Pox 104 393 497 21.0 Diphtheria 410 171 239 41.7 502 655 Scarlet Fever 153 23.3 Small Pox 11 115 126 8.7 An inspection of this table will give some idea of the extent to which the hospital out-patient department is encroaching upon the field of the general practitioner. The table shews that the total number of persons suffering from these four diseases in Bethnal Green during the year was 1,688, and that one fourth of this number of infectious sick persons must have passed through the public streets on their way to and sometimes from the hospitals. These figures reveal a most unsatisfactory condition of things, and I have no hesitation in asserting, with reference to certain hospitals, that the overgrown out-patient departments, as at present managed, art , not only grossly unfair to the general practitioner, but they constitute a grave public danger. I am told that the crowded condition of the waiting rooms precludes the possibility of any enquiry as to the suitability of the applicants for treatment, either on medical or financial grounds. Surely some system of selection could he devised whereby such applicants as are not urgently ill could he required to produce either a medical certificate, or a letter from a householder, to the effect that their condition or circumstances are such as to require hospital treatment. Some check of this kind is required for another reason: the numbers at present attending are so enormous that it is physically impossible for the Physicians to deal personally with the whole of the applicants, and they are compelled to delegate a large portion of their duties to the Clinical Assistants—these gentlemen, though legally qualified, have so recently passed their examinations that they cannot have had much experience, and are merely advanced students. I will conclude my remarks on this subject by relating the following case: —On July sth, I received a communication from H.M. Chief Inspector of Factories desiring me, in my capacity as Certifying Factory Surgeon, to investigate a case of lead poisoning at 46, Meadow's Dwellings, reported from the London Hospital. Upon visiting at the address given, I found J. J., a stereotyper at Waterlow's (the person named in the Report), with no symptom of lead poisoning beyond the blue line at the edge of the gums, which is not uncommon amongst workers in lead ; he was, however, suffering from well marked small pox with the eruption (6th day) out over face, arms and legs. The man informed me that he had applied for treatment at the London Hospital a week previously as he had a severe headache and felt ill ;he had paid three pence and had received a week's supply of medicine. 'The Clinical Assistant who prescribed probably noticed the blue line at the edge of the man's gums, and considering the headache to lie caused by the nature of his employment, accordingly he notified the case to the Home Office as one of lead poisoning, and hence my visit. Had the patient's temperature been taken, it would have been obvious that he was suffering from an acute disease, and not from chronic lead poisoning. J. J. imformed me that he had visited the hospital again that morning, where he saw another young doctor who told him to keep at home as he had chicken pox (I received a notification certificate to this effect next day). Of course, I promptly got the man removed, but, unfortunately, he, had already infected his father and his two brothers, one of whom subsequently died of confluent small pox. To how many other persons J. J. communicated this disease on his two journeys to and from the hospital I have no means of ascertaining. This man was in regular employment at Waterlow's, earning good wages and living at home with his parents, yet he went to a hospital as an outpatient for what he considered to be a mere head ache. Comment is superfluous. SMALL-POX. Deaths 8. (Desennial average 7.) One hundred and twenty-six persons were reported to be suffering from small-pox, all of these except one were removed to hospital, ten patients were sent home again after vaccination, as not suffering from small-pox ; in no instance did the patient so returned contract small-pox. Seven deaths were actually registered, but a man died (from variola hemorrhagica) and was buried before the true nature of his disease was recognised. The cause of his death was incorrectly certified to be purpura hemorrhagica. 'The ease death rate on the notifications was 6.3. The black line on the chart overleaf indicates that the disease prevailed in Bethnal Green from March to the last week in July, after which no fresh ease was reported during the year. The following table shews the condition of the sufferers as to vaccination :— TABLE N. SMALL-POX. No. of Small Pox Cases Notified. Under 13 Years 13 to 25 Years. 25 Years and upwards. Vaccinated. Unvaccinated. No Inf. Vaccinated. Unvaccinated No Inf. Unvaccinated. Vaccinated. 127 No Inf. 12 28 2 3 1 51 2 5 3 1 Deaths - 2 - - - - - 6 - Small-pox first broke out in some blocks of model dwellings in Corfield Street. On Friday, March 4th, I received a note from Dr. A** (a medical practitioner in the Bethnal Green Road) requesting me to see a Mrs. Hart, at 395, Corfield Street, who had a suspicious rash. I found her suffering from modified small pox ; in bed with her was a six week's old baby with confluent small-pox ; two other sons, Albert (22) and Sydney (19) were also shewing symptoms of Variola with the eruption just appearing ; I got all four cases removed as soon as possible. Upon making enquiry, I ascertained that J. Hart, the husband of the first patient, a bricklayer, aged 48, had died on February 23rd, and that his death had been certified by Dr. A** to have been due to Purpura, I communicated with this gentleman and ascertained that the deceased had been suffering from piles and had been attending as a surgery patient for about a fortnight. On the last attendance, February 18th, Hart complained of sickness and shivering. As the man had a foul tongue and had been eating some bloaters on the previous evening, the symptons were attributed to fish poisoning; on February 19th he was seen at home, he then had three purpura-like spots on his chest. On the 21st he was again seen, the face and chest were now covered with purpura spots, but I am informed that there was no constitutional disturbance and no rise of temperature. The same evening he bled from penis, mouth and anus, and died suddenly the following morning. Hart was buried on Wednesday March 2nd, and the funeral was attended by a large number of friends and relatives (some of them from Braintree in Essex).- I understand that the coffin was opened in order that the mother of the deceased might see the last of her son. I have no doubt the case was one of hemorrhagic smallpox, as Mrs. Hart, senior, and several other members of the family residing at Braintree, who attended the 1904 small pox. funeral, subsequently developed small-pox. After the removal of Mrs. Hart and her family from Corfield Street, the premises were carefully disinfected; all contacts were kept under observation, and on March 7th, Ellen Lee, one of them, developed small-pox and was removed from 140 Corfield Street ; on the same day Ellen Quilter (22) and Lilly Quilter (16) sickened and were removed from 386; these were the two daughters of the Mrs Quilter who had assisted in nursing the late J. Hart. Hearing that there had been some cases of chickenpox in this block, I made an investigation and found that three families had suffered from so-called chickenpox, I was told that the children had a scattered pustular rash over arms, chest and face, but they had not been bodily ill. At the time of my visit all were convalescent and all scabs fallen, but from the appearance of the scars I feel certain the children had suffered from mild small-pox. No medical attendant had been called to one family, but I had an opportunity of interviewing the doctor who attended the first lot; he acknowledged that "he was suspicious as to the nature of the eruption, but as the children were unvaccinated and had no constitutional symptons he felt sure they were not suffering from small-pox, which he should expect to be severe in unvaccinated persons." Upon further search I found in this same block, at No. 242, Annie Knight (33) who was at the moment under the care of a doctor in Mile End. This gentleman had been in attendance for a fortnight, and had assured the patient that she was suffering from chickenpox ; as a matter of fact she was convalescent from small-pox, and was still in an infectious condition; so I got her away to hospital in the afternoon. On March 10th, I saw with a neighbouring doctor, Amelia Sherwin, aged 47, who was suffering from small-pox and was removed the same morning. She resided at 69 Finnis Street ; the back windows of this flat look into those of the Corfield Street block, and the infection may have been conveyed through the air. Other cases now commenced to crop up at a distance. Francis Mudie, an unvaccinated child aged fourteen months, was removed from 105 Bethnal Green Road, another unvaccinated child from Holmes Avenue, and on the 14th Matilda Stevens, from 398 Corfield Street, and Hannah Quilter from 360; both these women resided in the infected block, and Hannah Quilter had attended the funeral party at Hart's. Mr. Quilter subsequently sickened and was removed. On March 16th, Charles Smith, an employe of the undertaker who had conducted Hart's funeral, was found to be suffering from smallpox and was removed. On March 16th, John Turvey of 79 Somerford Street (who had been a patient in the London Hospital for three weeks) was somewhat tardily discovered to be suffering" from small-pox, and was removed to Dartford. Some friends who visited him in the hospital report seeing a rash on Turvey's face on March 9th, a week before his removal, but beyond this statement I have no information. On the same day (16th) Samuel Bouvier of 6 Thurlow Place, was found to be suffering from small-pox, he was removed but died the same day ; a fortnight previously he had visited his brother Edward, who was an in-patient at the London Hospital and supposed to be suffering from rheumatism and chicken-pox. Upon enquiry it was ascertained that Edward Bouvier, after being in the hospital for about a month, had been discharged on March 12th. Inspector Richards managed to get hold of this man, Edward Bouvier, as he was pushing a barrow along Globe Road, he noticed a suspicious scarring about his face and got a doctor to look at him. This gentleman, however, was unable to say positively that Bouvier was still infectious, so he was allowed to go to his home at 140 Sydney Street, Stepney. As soon as he got to the office, Mr. Richards telephoned to the Stepney authorities, but Dr. Thomas had already visited and found two of Bouvier's children suffering from small-pox. Bouvier and his two children were removed to hospital forthwith. As a result of the mistaken diagnosis in Bouvier's and Turvey's cases there was an outbreak of small-pox at the London Hospital. This is referred to in the following article from the British Medical Journal of March 26th, 1904:— SMALL-POX AT THE LONDON HOSPITAL The circumstances of the outbreak of small-pox at the London Hospital, out of which some newspapers have made a good deal of capital, are as follows :—On February Bth a boy named Bouvier visited the receiving room with symptoms deemed to be those of chicken-pox. According to instructions he came again two days later and the diagnosis was reaffirmed. A fortnight later, or on February 23rd, Bouvier's father was admitted to George Ward as suffering from acute rheumatism. Four days later lie developed a rash which was diagnosed as that of chicken-pox. He was therefore sent to Davis Ward and kept there in one of the small rooms annexed until March 12th, when he was discharged free from the symptoms both of the rheumatism for which he was admitted and of those which supervened. On March 15th, three days after the discharge of Bouvier senior, a man named Turvey in George Ward developed distinct signs of small-pox, and was handed over to the sanitary authorities. On the same day two patients in the adjoining Baker Ward developed suspicious rashes, and were put into the isolation ward for observation. One of these cases turned out to be small-pox, and was sent away ; but the other still remains in the observation ward, and the rash is deemed to be an iodide rash. On March 16th another patient in Baker Ward definitely developed small-pox, and was also sent away, and in the afternoon of the same day a case was found in Davis Ward, and was treated in the same fashion. Since then no other cases have occurred, but the following precautions are still in force : — Baker, George, and Davis Wards are all kept in strict quarantine, and cases are neither admitted nor discharged. The house physician in charge of the wards keeps himself isolated, as also do the nurses; whi e the visiting physician visits no other wards. The nurses, porters, and patients belonging to the wards have been vaccinated, and the only patient who refused vaccination was discharged, and his name given to the medical officer of health. If no other cases occur in the infected wards it is considered that quarantine may be raised about the end of this month. Special instructions have been given to the receiving-room officers to keep a sharp look out for any other cases which may present themselves among the casualty patients, and a hut has been prepared for the instant isolation of any case which may be recognised, while Dr. Thomas, the medical officer of health for Stepney, has promised to attend at once and inspect any case which may seem to be merely suspicious. As a result of the investigation which he made upon being apprized of the first case identified in the wards, Dr. Thomas visited the Bouvier family and found reason to send to the smallpox hospital Bouvier senior, his son and daughter, and the landlady of the house in which they all lived. Fresh centres of infection continued to be discovered, notwithstanding our efforts to localize the disease. William Cooper, a barber, aged 61, was removed on March 20th from 399, Bethnal Green Road; a number of his customers resided in the infected area, and probably conveyed the disease to him. Mary Attfield, of 38, Middleton Street, was reported to have chicken-pox. On visiting I found she had well marked confluent small-pox ; she was removed to hospital, but died the following day. I could trace, no source of infection. The Sanitary Inspectors worked in a most praiseworthy manner, the staff of disinfectors was largely increased, and they were kept at work' early and late. As fast as the patients were removed the rooms were disinfected and the walls stripped of paper. All contacts were kept under observation and visited by me on the least sign of illness ; employers were notified, and the Public Vaccinators got notice of each case as it was dealt with. The whole matter received careful consideration at the hands of the Public Health Committee, who on my recommendation advised the Borough Council to make chicken-pox a notifiable disease. This was done, and the Order came into operation on March 26th. The London County Council followed our example and made chicken-pox a notifiable disease throughout London for a period of four months. This Order came into operation on April 8th, 1904. The L.C.C. also appointed Mr. S. Bingham, formerly Medical Superintendent of one of the small-pox hospitals, and Mr. W . Wanklyn, lately Medical Superintendent of the River Ambulance Service, as referees, to facilitate the diagnosis of doubtful cases of small-pox. I was glad to avail myself of these gentlemen's services on several occasions. The chicken-pox Order of the London County Council was once renewed, and finally expired on November 7th. As I learned that it was not the intention of that Council to again extend the Order, I made a report to the Public Health Committee, who advised the Borough Council to make a new Order. This was accordingly done, and chicken-pox is still notifiable in Bethnal Green. Whilst we were in the middle of the epidemic a new trouble cropped up. In our anxiety to destroy all germs of small-pox, the disinfectors were instructed to subject articles of infected clothing to the fumes of burning sulphur for the period during which the room, lately occupied by the patient, was in process of disinfection. The following day such articles as could be removed were taken away, still saturated with sulphur dioxide, and probably containing some free sublimed sulphur as well, and subjected to steam heat in the Washington Lyon apparatus. The result of this combined operation was disastrous, for the moist steam under pressure , rapidly converted the non-corrosive sulphur dioxide (SO2) into vitriol (H2 SO 4 ) minute in quantity, but still sufficient to change the colour and rot the fibre of woollen articles. At first the apparatus got the blame, but when it was noted that damage in the Washington Lyon only followed sulphur fumigation, the cause became apparent. CHICKEN-POX. No Deaths During the period the chicken-pox Orders were in force 497 cases of this disease were reported. A large proportion of these were personally visited, and eleven of them were found to be cases of small-pox, two others were pustular forms of syphilis. SCARLET FEVER Deaths 18. (Decennial average 23). The number of scarlet fever cases reported during the year was 655, of which IS terminated fatally, indicating a case rate on the notifications of 2.7 per cent. 1904 Scar latina. The scarlet fever death rate is equal to 0.13 per thousand population, whilst that for the whole of London is 0.08. From the North Sub-district 211 cases were reported, from the South 129, and from the East 315; of these 584 were removed to hospital, but with respect to 27, a report was received to the effect that the patient was not suffering from any form of notifiable disease. The Inspectors' reports on the sanitary condition of the premises where the sick persons had resided give the following particulars: —In 279 instances the houses ware in a fairly satisfactor) condition, in 78 the closets were defective, in seven the drains inside the house were leaky, and in 65 the external drains were defective. In four instances the premises were overcrowded, and minor insanitary defects were noted in '212. Thirtyfive cases occurred amongst families inhabiting single room tenements. DIPHTHERIA (INCLUDING MEMBRANOUS CROUP). Total Death 48 (Decennial average 71). The total number of the cases reported under these two heads was 421, eleven of which were designated membranous croup. The total deaths were 48, indicating a mortality of 11.4 per cent, on the notifications. The death rate on the estimated population was 0.37. In the County of London the death rate was O.16 per thousand population. Of the notifications, the North Sub-district contributed lO6, the South 59 and the East 172. 335 persons suffering from diphtheria were removed to hospital, and five children suffering from membranous croup requiring immediate surgical assistance were treated either in the London Hospital or in the North Eastern Hospital for Children. Amongst the 335 cases removed as diphtheria, 29 were found by the Asylums' Board Medical Officers not to be suffering from that disease and were sent home again The Inspectors report that in 242 instances the residence of the patient was in a satisfactory condition, but in 27 the W.C.'s were defective, in 4 the internal drainage was out of order, and in 45 the external drains required amendment; minor insanitary defects were found in 99 instances. Thirty-two cases were removed from single room tenements. ENTERIC FEVER. Deaths 7. (Decennial average 7). The total number of cases reported was 57 with seven deaths. The case mortality on the number notified is 12.2 per cent. The death rate on the estimated population is 0.04, the corresponding rate for the County of London is 0.06. Five of the patients removed to the Asylums' Board Hospital were reported not to be suffering from enteric fever. Upon enquiry it was ascertained that eight of the patients had been in the habit of eating shell-fish, seven were fond of fried fish, three eat watercress and three icecream. One patient had eaten both mussels and fried fish, and another watercress and fried fish. The Inspectors report that in twenty-six instances the premises were in a satisfactory condition, in eight 1904 Diphtheria 1904 Enterica the W.C. was defective and four faulty drains were found, other minor sanitary defects obtained in fifteen instances. OTHER FORMS OF FEVER. No typhus was reported, but on ( )ctober 31st a case of relapsing fever was notified from 278, Hackney Road ; the patient, a butcher's assistant, aged 21, had resided in the house of his master for about two months. Application was made to the Asylums' Board but they declined to take the case, subsequently he was removed to the Infirmary where lie ultimately recovered. Dr. Potts reported to me, that in his opinion, the man did not suffer from relapsing fever. Three other cases of ill-defined fever were reported, and the death of one of them was registered as " pyrexia." DISEASES OF PARTURITION. Twelve women were certified to be suffering from puerperal fever and there were nine deaths. Ten women died from diseases and accidents incidental to childbirth. WHOOPING COUGH. Deaths 44, (Decennial average 72). The mortality from this disease was about the same as that of the previous year. All the deaths except one were amongst young children. DIARRHOEAL DISEASES Deaths 147. (Decennial average 115). Epidemic enteritis and certain forms of diarrhoea were the registered cause of 147 deaths; possibly some other diarrhoea deaths should have been included in c this class, but where the medical certificate shewed another cause of death in addition to diarrhoea I have preferred to classify under that head, instead of the indefinite " diarrhoea " which may be only a symptom of some other disease. MEASLES. Deaths 89. (Decennial average 103). The 89 deaths from measles, though exceeding the number registered in 1903, were fourteen below the decennial average. All except two of the deaths were amongst young children aged less than five years. The child mortality from measles and its sequelae is in the proportion of 4.9 on the estimated population of young children. During the year 728 cases of measles have been reported to us by the school authorities. Each house so reported is visited by an Inspector, instructions are given, insanitary conditions are noted and remedied, information as to schools attended by other children inhabiting the house is obtained, and the head teachers of these are subsequently notified. Disinfection is invariably proffered but was accepted in 39 instances only. Of the school reports, 98 were found to be incorrect ; in 330 of the cases acknowledged to be measles no doctor was in attendance, and such information as was obtainable had to be accepted. Many parents look upon measles as something which no child can escape, so the sooner he gets it over the better for all parties. The disease is treated almost with contempt and in a large number of instances (50 per cent, of the reported cases) medical assistance is not sought. Simple, uncomplicated measles may not be a fatal disease, yet by means of its concomitant pulmonary affections it destroys five times as many children as the more dreaded scarlet fever. The younger a child, the more likely it is to succumb to pneumonia or bronchitis, so that if it were possible to postpone the incidence of measles from four or five to seven or eight years, many young lives would be saved. Measles is a malady usually contracted in the infant departments of the elementary schools ; the crowded class rooms of these are simply breeding grounds for the cultivation of the disease, and in my opinion should be abolished. As a child of five is not very teachable, infant schools serve no useful educational purpose and simply keep the youngsters off the streets. Small epidemics of measles have been frequent during the year, and it was found necessary to close and disinfect the infant departments of the following schools :— St. Barnabas........... 18th January. Wood Close.......... 16th May. Mowlem Street........... 4th June. Daniel Street.........6th ,, Virginia Road........... 22nd ,, St. Peter's......... 9th July. Wilmot Street................ 25th November. TUBERCULAR DISEASE. 280 deaths were recorded as due to phthisis, and 112 to other forms of tubercular disease. The deaths from diseases of this class form fifteen-and-a-half per cent. of the mortality from all causes, and are equal to a death rate of 3.01 per thousand on the estimated population. The tubercular diseases of children caused 98 deaths, a mortality upon the estimated population of young children of 5.5 per thousand. PHTHISIS. Deaths (280). The death rate from phthisis alone is equal to 2.1 per thousand in Bethnal Green, whilst that for the whole of London is 1.6. The public mind is much exercised at the moment over the care of phthisical patients ; in the early stages of the disease this may well be left in the hands of the officers of public institutions supported by private charity, as the risk of infection is small ; indeed, the thought sometimes passes through my mind to question the wisdom of prolonging the lives of these phthisical weaklings so as to enable them to beget more weaklings. The isolation of advanced cases of consumption is quite another matter; each sufferer is a centre for the spread of the disease, and should his circumstances not permit of the occupation of a separate sleeping room he should, for the protection of his family and neighbours, be placed in some institution where he can do the least harm. I have frequently referred in previous reports to the want of proper sanatoria for cases of this kind. As such institutions are not so much for the benefit of the patient as for the protection of others I think their provision and maintenance might justly be made a charge upon the rates. In these circumstances the Metropolitan Asylums' Board is certainly the proper authority to undertake the building and management of the sanatoria. As palliative treatment only would be attempted, elaborate buildings and expensive medical and nursing staffs would be unnecessary, so that the initial cost and future upkeep need not be very great. RESPIRATORY DISEASES. The deaths from diseases of the respiratory organs, exclusive of phthisis, numbered 513, and formed 20.6 per cent, of the total mortality from all causes. This is equal to a rate of 3.9 per thousand population at all Nearly half the respiratory deaths (216) were amongst young children, a mortality of 12.1 per thousand on the estimated population under five. MALIGNANT DISEASE. Cancerous diseases caused 112 deaths, all except three amongst persons aged over twenty-five years. The estimated number of inhabitants of Bethnal Green aged over twenty-five years is 56,820; on this number we shew a cancer mortality of 1.9 per thousand living. The parts of the body chiefly affected by malignant disease were: —Intestines (26), Uterus (14), Stomach (20), Liver and Pancreas (10), Tongue (5), Larynx (6), Breast, Neck and Skin (10). SUICIDES. These numbered 14:—Seven took poison:—Oxalic Acid (3), Laudanum, Hydrochloric Acid, Bichromate of Potash, Rat Poison, one each; two died from drowning; three hanged themselves; one shot himself, and two cut their throats. MURDER. A French polisher in Gibraltar Walk murdered his two children aged four and six by cutting their throats. A baker in Columbia Road shot his mate and then shot himself, both were aliens. UNCERTIFIED DEATHS. Five deaths were registered without medical certificates. The cause of death was in each instance entered as premature birth. COWHOUSES AND SLAUGHTERHOUSES. LIST OF APPLICATIONS FOR RENEWALS OF LICENCES, 1904. SLAUGHTERHOUSES Read, James, 294, Bethnal Green Road. Meadway, George, 354, Bethnal Green Road. Salmon, Alfred, 212, Brick Lane. Challis, William Stanley, 278, Hackney Road. Hudson, George, 397, Hackney Road. Kimber, George Frederick, 21, Roman Road. COWHOUSES. Skinner, Edward, 63, Bishop's Road. (No. of cows—Shed No.1 —8, No. 2—6.) Museum Dairy Co., 379, Cambridge Road. (12 cows.) Phillips, William, 42, Cheshire Street. (6 cows.) Jones Bros., 216. Columbia Road. (No. of cows —Shed No. 1—8, No. 2—12.) Morris, Emma, 23, Ezra Street. (6 cows.) Cresswell, Henry. 38, Fellbrigg Street. (No. of cows —Shed No.1-8, No. 2-8.) Jenkins, Meredith, 104, Gibraltar Walk. (18 cows.) Lloyd, Evan, 34b, Green Street. (45 cows.) Jones, Thomas, 1, Hamilton Road. (13 cows.) Evans, Rees. 55, Kerbela Street. (No. of cows -Shed No. 1—18, No. 2—2.) Hughes, John, 2, Lisbon Street. (19 rows.) Sykes, William James, 34, Minerva Street. (8 cows.) Sweetman, Walter, 64, Squirries Street. (14 cow Motts, Ephraim & Arthur, 38, Three Colts Lane. (23 cows.) Griffiths, Mary Ann, 6, Warley Street. (10 cows.) SLAUGHTERHOUSES. There are six slaughterhouses in the Borough, to which forty-seven visits have been paid by the Inspector. On October the sth all were visited by the Public Health Committee, in view of the annual renewal of the licences by the London County Council on October 3 1st The premises calling for special consideration were the following: — JAMES READ, 294, BETHNAL GREEN ROAD. This slaughterhouse is clean and well kept, and there is no objection to the slaughtering of sheep therein; but Mr. Read frequently kills pigs. In view of the very limited lair space and the close proximity of the neighbouring houses, it is doubtful if this should be permitted therein. On Mr. Read undertaking to limit the number of pigs killed, and promising not to keep the animals upon the premises longer than was absolutely necessary, it was decided to offer no opposition to the renewal of the licence. W. CHALLIS, 278, HACKNEY ROAD. The paving of the slaughterhouse was defective and the ventilation insufficient. These conditions were remedied, and the licence was granted. COWHOUSES. There are nineteen cowsheds in the occupation of fifteen persons. One licence was abandoned, as John Elliott, of 65, Roman Road, did not apply for a renewal of his ; 189 visits were made by the Inspector. The whole of the cowsheds are in a fairly satisfactory condition, and no licence was opposed. BAKEHOUSES. In 1904 there wore eighty-nine bakehouses actually in use in the Borough. The occupation of a large underground factory bakehouse in Bethnal Green Road has discontinued, and the premises are still unoccupied. It is not probable that they will be again used as a bakery. There are thirty-eight underground bakehouses, but in ten instances, including the factory, the premises are no longer used for baking bread. In compliance with Sec. 101 (4) Factory and Workshops Act, 1901, nine certificates were granted in 1903, and eighteen in 1904. One wholesale bakehouse is still uncertified ; the premises have been satisfactorily reconstructed, but as the surroundings are bad, the certificate has been held over. G. Davis, of 78, Old Bethnal Green Road, was summoned before Mr. Cluer at Worship Street on September Bth for using his underground bakehouse without having obtained a certificate as required by Section 101 (2) of the Factory and Workshops Act, 1901. He was lined £2 and twenty-three shillings costs. On February 9th S. Liscovitch, 269, Brick Lane, was summoned for failing to wash the painted woodwork of his bakehouse with h ot water and soap once at least in every six months, as required by Section 99 (a) of the Factory and Workshops Act, 1901. In addition the floor, walls and utensils were in a filthy state; but we have no power under the Factory Act to deal with these conditions. The owner was fined £2, and forty shillings costs for the technical offence. For a similar failure to obey the law J. Davis, the owner of another dirty bakehouse in Brick Lane, was fined on November 24th £1 and twenty-three shillings costs by Mr. Corser. An underground bakehouse at 106, Columbia Road, gave us much trouble before the certificate could be granted. We had great difficulty in getting the ventilation and lighting satisfactorily arranged; repeated visits were paid by myself and the inspector, but progress was very slow. The premises were twice visited by the Public Health Committee. Upon the last occasion of the Committee's visit the bakehouse was found to be in a very dirty condition, the utensils and floor were filthy, and there was an accumulation of refuse flour and sweepings beneath the troughs. I always object to this, as the refuse becomes sour, harbours vermin, and is apt to taint the bread I had found similar conditions on previous occasions, but as the mess was always cleared up after service of notice, no proceedings could be taken. This time the Committee ordered a summons to be taken out under Section 98 of the Factory and Workshops Act, 1901 : — Where a court of summary jurisdiction is satisfied on the prosecution of an inspector or a district council that any room or place used as a bakehouse is in such a state as to be on sanitary grounds unfit for use or occupation as a bakehouse, the occupier of the bakehouse shall be liable to a fine not exceeding for the first offence forty shillings, and for any subsequent offence, five pounds. The case was heard at Worship Street before Mr. Cluer. The Magistrate showed by his remarks that he considered the section under which the proceedings were taken was intended to deal with something much more serious than a dirty bakehouse. He drew my attention to the fact that some foreign nations habitually eat sour bread and thrive upon it, also that many kitchens are allowed to remain in a dirty condition without rendering the food cooked therein unwholesome. Mr. Cluer did not consider the nuisance I complained of injurious to health, and on the principle de minimis non curat lex, he declined to convict. I agree that proceedings against a dirty baker under Section 98 somewhat resemble cracking nuts with a steam-hammer; hut the Factory Act of 1895 has taken away from London Sanitary Authorities the power to recover a penalty for permitting a (workshop or) bakehouse to be in a dirty condition. I am, of course aware that proceedings can be taken under the Public Health (London) Act, 1891, after service of notice, and that on proof of nuisance injurious to health a recurring order can he granted; but magistrates as a rule decline to grant these orders, and prefer to treat each case on its merits as it arises. CUSTOMS AND INLAND REVENUE ACTS, 1890 to 1903. Application for certificates qualifying for exemption from taxation under the terms of these Acts were made in respect of the following premises, with results as stated: — Hollybush Mansions, Hollybush Gardens, twelve tenements. Only two W.Cs. are provided for each three tenements. There are two sinks and one copper on each landing (three lettings). Certificate refused. 30 Church Street, three tenements. A fish shop on the ground floor of this building excludes the premises from the operation of the Act. Certificate not granted. 46, 48 and 50, Mount Street, nine tenements. 46 and 48 are in a satisfactory condition except that the rent limit is exceeded, they are therefore entitled to exemption from part only of the tax. No. 50 is satisfactory. Certificates granted. Numbers 7, 9, 11, 13, 15, 17, 21, 23, 25, 27, 29, 31, Derbyshire Street. 39 tenements. Extensive drainage amendments were necessary in these cases before the certificate could he granted. These were not quite completed at the date of last inspection. A written promise was given by Messrs. H. J. Bliss & Sons, the agents, that my requirements should be satisfactorily carried out and upon this assurance the certificate was granted. HOUSING OF THE WORKING CLASSES ACT, 1890 TO 1903. The recent amending Act (3 Edward VII. C.39) effects a considerable modification of the law. It permits closing orders to be made in certain circumstances without the necessity of serving a notice render the premises fit for habitation, one ground upon which this course can be taken being that the premises in question are not reasonably capable of being made habitable. In my opinion this does not apply to mere structural conditions, as I know that no house, other than a mere ruin, is in so bad a condition that it cannot somehow be made passably fit, though the question whether the necessary expenditure would or would not be economical is for the owner to decide. The conditions referred to are, in my opinion, such bad position or close surroundings as would render the house unhealthy by reason of defective lighting or ventilation, and over which the owner could exercise no control. Amongst other things, certain schemes may now be carried through without the necessity for obtaining Parliamentary sanction; the period for which money can he borrowed by a local authority for purposes of the Act is extended from 60 to 8O years; additional powers arc given to include the provision, upon a cleared site, of shops and public buildings, &c., which in the opinion of the Local Government Board would benefit the community. The amending Act is, of course, another instance of legislation by reference, and he would be a hold man who should say exactly from the wording of the text how the law will work without carefully considering the controlling effect of previous enactments. No proceedings were taken under Part 11. of the principal Act during the year, but a representation was made to the London County Council under Part I. of which the following is a copy : — METROPOLITAN BOROUGH OF BETHNAL GREEN. PUBLIC HEALTH DEPARTMENT, TOWN HALL, CHURCH ROW, N.E. TO THE LONDON COUNTY COUNCIL, SPRING GARDENS, S.W. HOUSES OF THE WORKING CLASSES ACT, 1890. I have the honour to report that I have investigated the sanitary condition of a small area in the South Registration District of the Borough of Bethnal Green, in the CountY of London. The area referred to is delineated and coloured red on the plan herewith annexed, and signed by me, and I hereby 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) Many of the houses within the said area are unfit for human habitation. (2) The narrowness, closeness and bad arrangement of some 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 re-arrangement and re-construction of the streets and houses within the area. Dated this Twenty-fourth day of February, 1904. (Signed) GEORGE PADDOCK BATE, Medical Officer of Health for Bethnal Green. Name of Sireet. Population. -I Year. Deaths from. Death Rate per 1 .(>OO Population Total Deaths from all j Causes. ! Tubercular Disea-e*. Inspiratory Diseases. General Diseases. Zymotic I Diseases. Little Collingwood St. 7i igoo I ... ... ... I i ... l»l 1 I I 3 - rfe ••• ! I \ - m ••• 3 years Total i i 2 5 9 »I York Place ... 21 1900 ... ... i ... i I i ? o. ... | ... I I , ... I ■ I i 3 years Total I | 3 2 5 79 3 Pereira Street 313 igoo I I 4 i 5 II ... IQOJ ... I 22 ! 3 7 ; ... fe- ' 1 .! —^ 3 years Total 2 6 1 3 10 21 22 3 I Neath Place 201 igoo 22 1 6 ii "I igoi 1 22 5 10 igo* i I ... 2 3 I ... I 3 years Total 4 4 I 3 '3 *4 I 39'8 I I T nnn I I t t O I Somerfortl Street (West of Tapp St ... '8 7 --1 : i t igoi ... I ... I ... 22 ! ■■■ __! 1 — 3 years Total I i 3 4 15 3 Reuben Street 101 igoo 21 ... I 4 j ... 1901 I ... ... 2 3 1902 ... I I I I 3 ... I 3 years Total I 3 2 ' 1 4 10 jjo I Dagnall Place 11l 'y OO l - - I I - I9 °l ••• 1 f ? 1 igoa ... ... I i 2 3 ... I 3 years Total | ... 112 4 7 210 I Holmes A venue 139 I 1900 ... i|i i I 3 igDi ... ... i | 3 4 -LW 1 1 i • j years Total ... I i 3 7 11 263 I 11 inn t 9 t t 11 I Brady Street (part of) 183 '9°° I | 3 1 I 1 I 6 I i9°i 1 ... 1 i I I 3 | 5 ! 1902 I I I 2 I 4 ... I 3 years Total 15 4 5 ~ '5 t r\r»r\ r i ▼ o Merceron Street 4 6 j 1900 I I ... ... 2 ig°i ... i ... i 2 ... 19 02 I ... — 1 — ••• ••• ••• I 3 years Total | i 2 1... i 1 4 28 <j I Tapp Street ... (South of Somerford Street) 13 1 I '-' OO l - I - - i - ■901 ... ... ... : ... 1902 ... • ... ... ... ... ... I 3 years Total ... ... | ... ... oo I Cieorfje Court o i goo 1901 1902 ... ... ... ... ... 3 years Total ... ... | ... ... ... oo I I Totals for 3 years tori I Whole Area ...j 3858 | ... 12 22 22 54 no Average Rate per > ,. A ( r , ea . 3"' 5 7 57 - 28 5 1,000 Population.. { 2 8 s'' 10 8 ... 215 | — Plan of — BRADY STREET, Housing Scheme. of the property is held under short leases, any repairs carried out are mere surface work. It would obviously not pay to rebuild. The houses were originally constructed in the cheapest manner, and of inferior materials; many are mere two-roomed huts with a small yard in rear, and almost without exception the buildings are worn out and insanitary. Twenty houses in Gloucester Gardens were certified in 1883 under the Artisans' and Labourers' Dwellings Act of 1868, but the then Vestry declined to take action. The houses were afterwards closed under the Nuisances Removal Act of 1866. The structures were, too old and decayed to be worth repairing, and remained closed for some years. Ultimately they were demolished, but no attempt has been made to rebuild, as the approach is so bad. Part of Neath Place was similarly dealt with in 1888; the houses wire closed and partly rebuilt, after which they were reopened. The width of the alley in this portion is only 8 feet 10½ inches from house to house. The dwellings are from position and condition quite unfit for habitation. A number of houses in Pereira Street and Tapp Street were similarly dealt with, and were reopened after being patched up. In 1893 the greater number of the houses in Little Collingwood Street were closed under the Housing of the Working Classes Act, 1890. These houses underwent a process of so-called repair, after which they were reopened, and they are still occupied. The average width of Little Collingwood Street from house to house is 9 feet 10 inches. In 1897 nearly all the houses shown on the plan in Collingwood Street were closed under the Housing of the Working Classes Act, 1890. A piteous appeal was made to the Sanitary Committee on behalf of the tenants, and the owner was permitted to close a few houses at a time, patch them up, and shift the tenants backwards and forwards until the whole of the houses were dealt with. The so-called repairs were of the roughest description, but were allowed to pass muster, with the result that the houses are at the present time very little better than they were before they were closed, with the exception of the drainage, which has been almost entirely remodelled. In my opinion nothing short of clearing the anea and rebuilding the houses would be effectual. 1 have the honour to be, Sir, Your obedient Servant GEORGE PADDOCK BATE, Medical Officer of Health for Bethnal Green. G. L. GOMME, Esq., Clerk to the London County Council, Spring Gardens, S.W. The following correspondence, though not coming within the year under consideration, must be read in connection with the original representation of February 24th, 1904, and is therefore printed below :— D LONDON COUNTY COUNCIL. County Hall, Spring Gardens, S.W. 18th March, 1905. Sir, Brady Street Area. The Housing of the Working Classes Committee of the Council have had under consideration your letter of 24th February, 1904, forwarding an official representation under Part I. of the Housing of the Working Classes Act, 1890, in respect of an area known as the Brady Street area in the Metropolitan Borough of Bethnal Green. In dealing with the matter the Committee have been given to understand that it is proposed to erect new buildings on a portion of the area, and, in view of the alterations which are being effected in the character of the surrounding property, it would appear probable that at no distant date the area will be re-developed through private enterprise. Under the circumstances the Committee cannot but feel that the re-arrangement of the area at the public expense may not be altogether justifiable, and they trust, therefore, that pending the re-development the Borough Council will exercise, as far as possible, its powers under the Public Health and other Acts for remedying the evils connected with the area. I am, Sir, Your obedient servant, (Signed) G. L. GOMME, Clerk of the Council. The Medical Officer of Health, Metropolitan Borough of Bethnal Green. METROPOLITAN BOROUGH OF BETHNAL GREEN. 30th March, 1905. To the Clerk of the London County Council, Spring Gardens, S.W Sir, Brady Street Housing Scheme. Adverting to your letter of the 18th March, 1905, I am directed by the Public Health Committee of this Council to express their extreme disappointment at the decision of the London County Council not to deal with this area under Part I. of the Housing of the Working Classes Act, 1890 ; more especially as this decision appears to have been arrived at under a misapprehension. It is not now a fact that private enterprise is likely to develop this area in the near future ; undoubtedly something of the kind was contemplated in 1904, but all the proposed arrangements have fallen through with the exception of the re-building of a small portion of Collingwood Street and Somerford Street. This affects a few houses only and does not materially touch or modify the more insanitary portions of the area. It will not lead to the widening of a single street or passage, or to any re-arrangement or improvement in the insanitary area. I beg again to draw the Council's serious attention to the statements contained in my letter to you of the 24th February, 1904, copy of which is enclosed herewith. Since the receipt of yours the whole area has been re-surveyed and I adhere most strongly to my original statement that the large proportion of the premises are worn out and quite beyond the possibility of any permanent or satisfactory repair. I am sure the result of closing individual houses under Part 11. of the Act will only lead to further surface patching and a perpetuation of existing evils. The details of past action in this direction by the Borough Council are fully set forth in my letter and are not encouraging, as nothing beyond temporary improvement has resulted from our efforts. I am, Sir, Your obedient servant, GEORGE PADDOCK BATE, Medical Officer of Health for Bethnal Green LONDON COUNTY COUNCIL. County Hall, Spring Gardens, S.W. 20th April, 1905. Sir, I have laid before the Housing of the working Classes Committee of the Council your letter of the 30th March last, on the subject of the official representation made by you in relation to the area known as the Brady Street area, within the Metro, politan Borough of Bethnal Green. In reply, I am directed to inform you that the Committee have very carefully reconsidered the matter, and, having regard to the shortness of the period within which the existing leases of the property will expire, and to the prospect of the area being re-developed by private enterprise, regret that they are still unable to see their way to recommend the Council to prepare a scheme for the improvement of the area under Part I. of the Housing of the Working Classes Act, 1890. I am, Sir, Your obedient Servant, (Signed) G. L. GOMME, Clerk of the council. Dr.Bate, The Medical Officer, Metropolitan Borough of Bethnal Green. DIGBY STREET AREA. On 15th June a communication was received from the Clerk to the London County Council to the effect that my representation of the Digby Street unhealthy area was under consideration by the Housing of the Working Classes Committee of the Council. A deputation from the Bethnal Green Borough Council was invited to confer with the Committee to consider the best method of dealing with the matter. The invitation was accepted and an appointment was made to meet at Spring Gardens ; the deputation included the Chairman and Vice-Chairman of the Public Health Committee, Alderman Belsham and Councillor Spurling, and the Medical Officer of Health, and was introduced to the Committee by Mr. Branch, J. P., L.C.C. From the opening remarks of the Chairman of the Housing Committee it was obvious that it was not the intention of the Council to deal with the representation under Part I. of the Act, as the area was said to be so limited that a forty foot street, driven through the middle of it, would leave no space upon which to erect dwellings for the displaced inhabitants. The dilapidation and unhealthy condition of the area were not denied, but it was the expressed opinion of the Committee that the representation could be satisfactorily dealt with by a reconstruction scheme under Part 11. of the Act by the Borough Council ; and a promise was given that if this was undertaken the London County Council would contribute towards the cost of clearing the site. The result of the conference was reported to the Borough Council, and by their instructions the Surveyor has prepared three alternative schemes for dealing with the area together with plans and estimates for rehousing, and these are still under consideration. HOUSES LET IN LODGINGS, PUBLIC HEALTH (LONDON) ACT, 1891, s: 94. The number of premises on the register of houses let in lodgings was 333 at the end of the year 1903. During the year which has just terminated, 112 fresh premises were added and 124 removed, leaving a net total of 321 at the end of the year 1904. To avoid overlapping no special officer is appointed to deal with these, but each inspector looks after the tenements situated in that portion of the Borough under his control. A total of 1,589 inspections were made and reported, but only nine summonses were taken out for failure to obey bylaws, four were for overcrowding and five for other conditions, these were all successful, but in each instance we were sure of our ground and a penalty was inflicted. In view of the disputed legality of several of the bylaws, the Chief Inspector, in consultation with the Solicitor to the Council, has preferred to proceed under the Principal Act, after service of statutory notice. The definition in the Public Health (London) Act, 1891, as to what actually constitutes a house let in lodgings is misleading, and gives rise to frequent disputes. Cases recently decided in the Courts (VVeatheritt v. Cantley, etc.) leave very little doubt that many of the Bethnal Green tenements are illegally registered, The London County Council looks upon the rigorous enforcement of tenement house regulations as a panacea for all sorts ot evils including overcrowding and insufficient housing accommodation. Personally, I never had a high opinion ot the bylaws, but was always anxious to give them atrial as I believe good would result it we were able, by means of night visits, to detect overcrowding; the power (supposed to be) given by the bylaws to require periodical cleansing, etc., is also most valuable. Unfortunately recent decisions in the Law Courts have shewn that night inspections are ultra vires and that periodical cleansing, etc., cannot be enforced without notice (Stiles v. Galinski and Nokes v. the Islington Borough Council). Since the publication of these decisions I sent a circular letter toall the Medical Officers of Health in London asking for their opinions as to future methods of procedure. From the answers I received I gather that thirteen do not attempt to make night visits, and only one * Sec. 10 (a) Public Health (London) Act, 1891. Medical Officer of Health is of opinion that the bylaws would give him power to enter premises at night. On the second point the general opinion seems to be, that with the exception of those cases where a breach of a bylaw is knowingly committed by a resident " landlord," a notice would have to be served, so that the benefit of summary procedure supposed to be given by the bylaws is almost non-existent. In 1901, the London County Council became extremely angry with the Bethnal Green Sanitary Authority by reason of their alleged failure to enforce these bylaws ; indeed the Council went so far as to make a complaint to the Local Government Board, under Section 101 of the Public Health (London) Act of 1891. Fortunately for poor Bethnal Green the Board did not agree with t he, contention of the Council that that the Vestry had been in default, for the Bethnal Green bylaws (No. 2) give the Sanitary Authority discretion as to what houses should be required to be registered. The Council after consulting Counsel determined to raise the question of the validity of this particular bylaw, and again wrote to the Local Government Board upon the subject, but failed to get any help. Counsel's opinion, taken at the instance of the London County Council, is printed below, and the following question was put to Mr. Cripps, K.C. :— “ Whether there is any power under Section 94 of the Public Health (London) Act, 1891, to exempt any houses from the operation of bylaws for the registration of houses let in lodgings or occupied by members of more than one family, or whether every local authority is bound to make bylaws for the registration of every such house in its district ?” Mr. Cripps' opinion was as follows : — “In my opinion Section 94 of the Act of 1891 is imperative, and there is no power to exempt from the operation of bylaws for the registration of lodging-houses any houses so occupied as to come within the lodging-house definition. A bylaw in the Bethnal Green form which enables the local authority to exempt any or all lodging-houses within their district, is not a compliance with the requirements of the Act, and I am unable to agree with the view put forward by the Local Government Board." Observe now the absurdity of the contention of the London County Council. The Lord Chief Justice, in the Galinski case, declared such bylaws as required the registration of all houses let in lodgings, and which contain no clause giving the Sanitary Authority discretion as to what particular tenement houses should he registered, to be unreasonable. All this points to what is really required, that is, such an amendment of the Public Health (London,) Act, 1895, as would definitely give to sanitary authorities those powers erroneously supposed to be conferred by the bylaws. No sensible man disputes the necessity for such powers, but they must be definite and not open to dispute. The London County Council poses as the central Health Authority of London ; as a matter of fact their powers in this direction are very limited (except in default of the Borough Councils) ; that body, however, enjoys the privilege of initiating legislation; theoretically the Borough Councils have similar powers, with the difference that Parliament is most unlikely to agree to any partial legislation at the instance of the Borough Councils, whereas the London County Council, acting on behalf of the whole of the Metro- polis, is sure of sympathetic attention at the hands of the Government. Unfortunately many of the Bills of the London County Council have, in the past, included some encroachment upon the particular duties of the local authorities with the result that their proposals have in every instance been vehemently and successfully opposed by the Borough Councils. To my mind it is extraordinary that the London County Council has never grasped the fact that the Borough Councils have not followed the bad example of their predecessors (the vestries) but are, in every instance, honestly endeavouring to carry out their duties. PUBLIC HEALTH DEPARTMENT. In the report of the Chief Inspector will be found full details of the routine work of my department, and I take this opportunity of congratulating Mr. Foot upon the excellent results obtained by the staff under his supervision. These results are in a large measure due to the sympathetic and helpful attitude of the Public Health Committee, and I beg to tender to the Chairman and Members of that Committe my grateful thanks for their continued confidence and support, which have much assisted me in carrying out the duties of my office. 1 have tin honour to be, Sir and Gentlemen, Your obedient servant, GEORGE PADDOCK BATE, M.D. Medical Officer of Health for the Borough of Bethnal Greem. 1897 129,200 4,818 37.3 791 169 2,551 17.4 663 148 358 2,761 21.4 1898 839 185 2,633 620 358 2,872 129,200 4,779 37.0 20.4 119 22.2 164 1899 129,200 4,753 36.8 827 174 2,669 20.7 727 431 2,936 22.7 129,600 4,588 35.4 873 2,816 21.7 1900 77 1 168 2535 19.5 150 431 2,628 1901 129,700 4,608 35.5 678 147 2,423 18.7 834 220 425 20.3 129,889 4,589 35.3 18.5 864 245 470 2,747 21.1 1902 710 1 55 2,522 380 2,361 18.1 1903 130,028 4,627 35 .6 630 136 2,253 17.3 915 272 Averages for Years 1894-1803 128,702 4,704 756 162 2,526 19.3 733 180 397 2,747 21.3 36.0 1904 130,207 34.7 7 11 157 2,393 18.4 918 300 399 19.1 4,526 2,489 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. Area of District in Acres (exclusive of area covered by water), 755 Total Population at all Ages 129,700 Number of Inhabited Houses 14,005 Average number of Persons per House 9.2 At Census of 1901. 1894 47,585 1,862 1,018 282 32,975 1,240 741 213 883 4,636 2,642 42,440 1,534 214 258 123,000 709 1895 49,000 1,905 1,024 292 34,300 1,343 789 222 45,000 1,523 956 128,300 4,771 2,769 772 1896 1,892 3 26 814 240 45,667 1,644 263 129,200 4,869 829 49,339 1,14 2 34,194 1,333 953 2,909 4,818 1897 49,339 1,961 1,028 321 34,194 1,333 803 2 43 45,667 1,524 933 2 5 0 129,200 2,761 814 1898 1,97 1 1,122 372 34,194 1,291 853 265 45,667 1,517 897 243 129,200 4,779 2,872 880 49,339 1899 49,339 1,930 1,168 355 34,194 1 ,361 81 4 227 45,667 1,462 954 245 129,200 4,753 2,936 827 1900 5 1 ,500 1,935 1,142 314 33,450 1,218 776 211 44,650 1,435 898 246 129,600 4,588 2,816 77 1 1901 1,864 308 177 4,608 2,628 708 51,514 1,112 33,472 1,239 721 44,714 1,505 795 223 129,700 2,747 1902 51,600 1,938 1,056 307 34,000 1,237 730 186 44,289 1, 4 1 4 961 217 129,890 4,589 710 1,945 269 616 181 45,428 1,5 11 800 130,028 4,627 2,363 652 1 903 51,600 947 33,000 1,17 1 202 Averages for Years 1894-1903 50,015 1,920 314 33,797 1,276 766 216 44,919 236 128,732 4,704 2,744 1.0 75 1,507 903 767 130,207 7 11 1,194 1,440 206 4,526 1904 51,600 1,892 1,001 351 33,179 665 154 45,428 802 2,468 Notes.— (a) 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. (b) 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. Membranous croup 11 1 6 4 - - 3 1 7 2 - 3 5 Erysipelas 22 3 13 16 24 36 118 16 98 64 6 1 - - - - Scarlet Fever 655 10 258 359 20 8 - 211 129 315 188 121 584 275 Typhus Fever - - - - - - - - - - - - - - Enteric Fever 57 - 4 17 18 18 - 19 22 16 18 19 13 50 Relapsing Fever 1 - - 1 - - - 1 - - 1 - - 1 Continued Fever 1 - - 1 - - - - 1 - - - - - Puerperal Fever 12 - - - 5 7 - 9 3 - 2 1 - 3 Plague - - - - - - - - - - - - - - Chicken-pox 497 65 237 182 7 6 - 148 182 167 - - - - Totals 1994 102 713 825 118 219 17 655 537 802 47 8 1102 354 2 70 TABLE IV. Causes of, and Ages at, Death during Year, 1903. Name of District—Bethnal Green. (See Notes.) CAUSES OF DEATH. 1 Deaths in or belonging to whole District at subjoined ages. Deaths in or belonging to Localities, at all ages. Deaths in Public Institutions in the District. All ages. 2 Under 1 1 and under 5 and under 15 5 15 and under 25 6 25 and under 65 7 65 and upwards 8 N. 9 S. 10 E. 11 No Home. 12 Small-pox 8 1 ... 1 ... ... 6 ... ... ... 3 3 2 ... 1 Measles 89 18 6 9 2 ... ... ... 45 32 12 ... 2 Scarlet Fever 18 1 15 2 5 5 8 ... Whooping Cough 44 ... ... 22 7 ... 8 22 21 1 ... 15 ... ... ... ... ... ... ... ... Diphtheria and Membranous Croup 48 4 30 ... ... 1 ... ... 15 1 22 ... 1 3 11 5 ... ... Croup ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Enteric 6 1 ... ... 1 ... ... ... 4 2 2 ... ... ... ... ... ... Other continued 1 1 1 ... ... ... Epidemic Influenza 6 ... ... 1 ... ... ... 4 1 4 2 ... ... ... ... 1 ... ... 27 Cholera ... 1 ... ... ... Plague ... ... ... ... ... ... ... ... Diarrhœa (See notes) 147 116 26 1 3 6 7 36 1 44 Enteritis (See notes) 53 40 6 1 ... 3 3 27 13 13 ... 7 ... Puerperal Fever (see notes) ... 2 ... ... 4 9 ... ... 7 ... 5 2 Erysipelas 10 3 ... ... 3 4 2 2 5 ... 1 ... 5 Other Septic Diseases 19 2 3 11 5 8 3 ... 6 9 61 Phthisis (See notes) 280 6 6 7 37 210 14 110 106 3 193 Other Tubercular Diseases 43 11 56 30 112 43 ... 11 3 1 25 I 41 Cancer, Malignant Disease (See notes) 112 2 35 48 1 72 1 28 ... 1 45 Bronchitis 2 5 8 67 24 ... 52 5 2 77 88 113 61 78 6 91 Pneumonia 222 70 6 5 86 72 61 49 40 3 92 Pleurisy 23 ... ... 1 11 6 7 5 11 10 Other Diseases of Respiratory Organs 10 1 6 5 2 ... 2 3 ... 1 1 Alcoholism Cirrhosis of Liver 1 ... 25 16 29 1 ... 2 ... 8 5 6 4 1 4 ... ... ... ... 2 1 Venereal Diseases ... ... 1 Premature Birth 36 92 92 ... ... ... ... ... 35 21 ... ... Diseases and Accidents of Parturition 10 ... ... 3 7 2 5 ... ... ... 3 Heart Diseases 201 8 6 8 11 46 58 63 3 86 122 77 98 38 Accidents 22 4 ... ... 3 16 15 31 2 9 37 1 ... ... ... 26 Suicides 12 1 2 3 ... 4 ... 14 ... 7 1 Murder 3 ... 1 1 ... 1 3 ... 4 88 25 1 Old Age 92 ... 1 ... 23 43 43 86 All other causes 47 1 173 25 15 13 161 194 134 142 1 215 2489 711 358 823 437 66 5 802 21 918 77 83 1001 All causes ... ... ... ... Notes. —(a) In this Table all deaths of "Residents" occurring in public institutions, whether within or without the district, are included with the other deaths in the columns for the several age groups (columns 2-8). They are also, in columns 9-12, included among the deaths in their respective " Localities" according to the previous addresses of the deceased as given by the Registrars. Deaths of "Non-residents" occurring in public institutions in the district are in like manner excluded from columns 9-12 of this Table. (b) All deaths occurring in public institutions situated within the district, whether of " Residents " or of " Non-residents," are, in addition to being dealt with as in note (a), entered in the last column of this Table. The total number in this column equals the figures for the year in column 9, Table I. (c) The total deaths in the several " Localities " in columns 9-12 of this Table equal those for the year in the same localities in Table 11., sub-columns c. The total deaths at all ages in column 2 of this Table equal the gross total of columns of 9-12, and the figures for the year in column 12 of Table I. (d) Under the heading of "Diarrhoea" are included deaths certified as from diarrhoea, alone or in combination with some other cause of ill-defined nature ; and also deaths certified as from Epidemic enteritis; Zymotic enteritis ; Epidemic diarrhoea. Summer diarrhoea ; Dysentery and dysenteric diarrhoea; Choleraic diarrhoea, cholera, cholera nostras (in the absence of Asiatic cholera), Under the heading of "Enteritis" are included those certified as from Gastro-enteritis, Muco-enteritis, and Gastric catarrh. Under the headings of "Cancer," "Phthisis" and "Puerperal fever " are included all registered deaths from causes comprised within these general terms. Deaths from diarrhoea secondary to some other well-defined disease are included under the latter. TABLE V. Shewing the number of Deaths from the seven principal Zymotic Diseases, inclusive of Hospital Deaths in the 10 years 1894 to 1903, and in the year 1904. DISEASE. 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 Annual Average of 10 years, 1894 - 1903. Proportion of Deaths to 1000 Deaths in 10 years. 1894-1903. 1904 Proportion of Deaths to 1000 Deaths in 1904. Public Institutions into which Bethnal Green Residents have been Received and where THEY HAVE SUBSEQUENTLY Died. Aged Pilgrims Asylum, Islington. Banstead Asylum, Surrey. Brompton Hospital. Bethnal Green Infirmary. Bethnal Green Workhouse. Bethnal House Lunatic Asylum. Cane Hill Asylum. Caterham Asylum. Charing Cross Hospital. City of London Lying-in Hospital, City Road. City of London Hospital for Diseases of the Chest. Children's Hospital, Great Ormonde Street. City Workhouse, Robin's Hood Court, City. Claybury Asylum. Colney Hatch Asylum. East London Hospital, Shadwell. Eastern Hospital. Hackney. Friederheim Hospital. Friern Barnet Lunatic Asylum. French Hospital, Victoria Park. German Hospital, Hackney. Guy's Hospital. Horton Asylum, Epsom. Hospital of St. John and St. Elizabeth, Grove End Road. Hackney Union Infirmary. H. M. Hospital, 19, Stepney Causeway Homerton Fever Hospital. Hoxton House Asylum. Homeopathic Hospital, Great Ormonde Street. Infants' Hospital, Hampstead. Italian Hospital, Queen Square, Holborn. Joyce Green Hospital, Dartford London County Lunatic Asylum, llford E FACTORIES, WORKSHOPS, LAUNDRIES, WORK PLACES AND HOMEWORK. 1—INSPECTION. Including Inspections made by Sanitary Inspectors. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries) 31 6 - Workshops (Including Workshop Laundries) 3037 374 5 61 - Workplaces 539 Homeworkers' Premises 1125 305 - Total 4732 746 5 2.—DEFECTS FOUND. Particulars. Nuisances under the Public Health Acts: — Want of cleanliness Want of Ventilation Overcrowding Want of Drainage of Floors Other Nuisances insufficient Sanitary Accommodation unsuitable or defective not separate for sexes Offences under the Factory and Workshop Act — Illegal occupation of underground bakehouse (s. 101) Breach of special sanitary requirements for bakehouses (ss. 97 to 100) Failure as regards list of outworkers (s. 107) Giving out work to be done in premises which are unwholesome (s. 108) infected (s. 110) - - - - Allowing wearing apparel to be made in premises infected by scarlet fever or small pox (s. 109) Other offences - Total Number of Defects. Found. Remedied. Referred to H M. Inspector. 39 6 14 7 - - - - 311 4 143 5 1 3 11 1 - 895 892 Number of Prosecutions. 3 - 396 14 - - 7 - - 311 - 2 4 - - 143 - - 5 - - 1 - 1 3 - 2 8 - - - 1 - - - - - - - 8 - 3.—OTHER MATTERS. Class. Number. Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshops Act (s. 133) Action taken in matters referred by H.M. Inspectors as remediable under the Public Health Acts, butnot under the Factory Act (s.5) Notified by H.M. Inspector Reports (of action taken) sent to H.M. Inspectors Underground Bakehouses (s. 101): — In use during 1903 in 1903 Certificates granted in 1904 In use at the end of 1904 (this number includes one wholesale bakehouse) Homework ;— Lists of Outworkers (s. 107): — Lists received Addresses of Outworkers forwarded to other authorities received from other authorities Homework in unwholesome or infected premises:— Notices prohibiting homework in unwholesome premises (s.108) Workshops on the Register (s. 131) at the end of 1904 Workshop bakehouses Important classes of workshops Workshop laundries Total number of Workshops on Register 60 18 18 33 9 18 28 Number of Outworkers. Lists. 35 645 298 1073 Other. Wearing Apparel 1 1217 8 4 33 1334 *Workshops Workshop Bakehouses 88 - 8 4 108 5 15 4 1 4 4 - B.—MATTERS DEALT WITH. Number of Defects. Notices Issued. Notified b y Home Office. Notified to Home Office. Found. Prosecutions. PARTICULARS. Remedied. Matters under the Public Health (London) Act, 1891. Want of Cleanliness 386 10 396 - 396 3 Want of Ventilation 11 3 14 - 14 - Want of Air Space : Overcrowding 6 1 7 - 7 - 1 2 2 1 6 66 129 167 10 ... ... ... 2 233 Tie-making Tailoring METROPOLITAN BOROUGH OF BETHNAL GREEN. STREET LIST. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Name of Street. Abingdon buildings 2 ... 2 Bonner road ... 4 9 3 ... ... 2 Bonner street ... ... Abbey street ... ... ... 8 8 2 4 6 Abingdon street ... ... 1 1 2 Bonwell street 2 1 2 3 8 Boreham street 1 1 Ada place 5 ... 1 6 1 1 4 ... Ainsley street 2 ... ... ... 2 Boundary street ... ... 1 2 3 Albert buildings ... ... ... ... ... Brady street bldgs. ... 1 ... ... 1 Albert grove ... ... ... ... ... Bradys buildings ... ... ... ... ... Albion place ... ... ... ... Brady street 1 2 7 ... 4 14 Braemar street 5 Alfred place ... ... ... 5 5 2 ... 1 2 Allas road 8 Bratley street 1 ... 2 3 ... ... 4 4 ... Brick lane 2 6 Alma road ... ... 4 5 9 5 9 22 Ames street ... 1 ... 1 2 Brierley street 3 1 1 1 6 Angela gardens Bucks court ... ... ... ... ... ... ... ... ... ... Anglesea street 1 ... ... 1 2 Buckhurst street 1 1 4 8 14 Anns place Bullards place 1 ... ... ... 1 ... ... 3 1 4 Bunsen street ... ... ... ... ... Approach road ... 1 ... 6 7 Arbery road (Except Nos. 74 and 76). 1 4 9 Burgoyne road 1 ... ... ... 1 2 2 Burnham square ... ... ... 2 2 Burnside street 1 1 2 ... 4 Busby street Archer street ... ... ... ... ... 1 1 1 4 7 Arline street 6 Busby square 1 1 1 ... 3 2 ... ... ... Artillery street Butler's buildings. ... 1 ... 1 1 ... ... 1 ... ... Arundel street 1 2 2 6 Butler street ... ... ... 2 2 1 Buxton street (Odd Nos. 1 to 33. Even Nos. 2 to 10) Ashwell road 1 2 1 4 8 ... 1 1 ... 2 Auckland road 1 2 1 10 14 Austin street 2 1 1 ... 4 ... Cadell street 1 3 1 5 Calvert avenue Bacon street 1 3 2 10 16 ... ... ... ... ... Baker's court ... ... ... 2 2 Cambridge circus 1 2 ... 4 7 Cambridge road (All Odd Nos. and Even Nos. from 160). 17 Baker's rents ... ... ... ... ... 3 3 4 7 Baker street ... ... ... ... ... Bandon road 2 ... 2 7 11 Barnet grove 2 5 8 15 ... ... ... ... Barnsley street Cambridge bldgs. 2 2 3 7 14 1 1 Cambridge street Baroness road 1 ... 2 1 4 ... ... ... 2 2 2 Bath grove Camden street 2 ... 1 2 1 4 1 2 7 Canrobert street 5 6 Bath street 3 14 28 ... ... ... ... ... Baxendale street ... 1 1 2 4 Carlisle street ... ... ... ... ... Bedford row Carlton place ... ... ... ... ... ... ... ... ... ... Bellhaven street ... 5 1 2 8 Carter street ... ... ... ... ... Benson buildings Catherine street ... ... ... ... ... 2 2 1 1 2 Bethnal Green road 4 ... 11 14 29 Centre street 1 ... 2 3 6 Birkbeck street ... ... ... Chambord street 2 2 2 3 ... 2 7 Chance street ... ... ... ... ... Bishops road ... ... 3 8 11 Blythe street 2 2 10 Chapel place 3 ... ... 6 2 4 3 STREET LIST—continued. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Foster street 1 Hackney Road (All Even Nos. and Odd Nos.from 323) 4 2 7 1 3 3 8 32 19 Fountain street ... ... ... ... ... Fox street 1 2 ... ... 1 Fox's buildings ... ... ... ... ... Hague buildings ... ... ... ... ... Fuller street ... 2 Hague place ... ... ... ... ... 3 9 14 Hague street ... ... 3 5 8 Hammond gardens ... ... ... 1 1 Hamilton road 2 1 2 4 9 Gales gardens ... 2 2 3 7 1 2 Hare court ... ... 1 Garden place (Violet street). ... ... ... ... ... Hare marsh ... ... ... 1 1 Hare row ... ... ... ... ... Garden place (James street). ... ... ... Hare street 5 ... ... 3 3 13 24 Harold street ... 2 ... 2 4 Gardners road ... 1 2 4 7 Hartley street ... 1 2 9 12 Garner street 2 1 4 7 Hassard place 1 ... ... 2 3 ... Gascoigne place ... 2 ... 1 3 Hassard street 1 2 1 5 9 Gawber street 1 Havelock place ... 2 3 ... ... 1 1 2 ... George gardens Helens place ... ... ... ... ... ... ... ... ... ... George place ... ... ... Hedsor buildings ... ... ... ... ... 2 2 George walk ... ... ... ... ... Henley buildings 1 3 ... 2 6 Georgina gardens ... ... Henrietta street 4 2 3 5 ... ... ... 4 Gernon road ... ... ... 1 1 Hereford buildings ... ... ... ... ... Gibraltar buildings Hereford street 1 ... 5 4 2 ... ... ... 2 10 Gibraltar gardens ... ... Hersee place 2 ... ... 2 2 4 2 4 Gibraltar place ... ... ... ... Hill street ... ... 1 1 2 ... Gibraltar walk Hollybush gardens. 1 ... 3 5 9 2 ... 2 2 6 Gilman street 1 1 2 ... Hollybush place ... ... ... ... ... 4 Glass street Holmes avenue 1 ... ... 1 2 ... ... ... 2 2 Globe road... (Even Nos. from 156, odd,from 131) Horatio street 3 7 ... 13 23 ... ... 2 1 3 Horts place ... ... ... ... ... Hunslet street 1 1 ... 3 5 Gloucester gardens ... ... ... ... ... Huntingdon bldgs. 2 ... 1 2 5 Goldsmith's row (Children's Hospital, and Nos. 8 to 62 even). 1 3 1 1 6 Hurley buildings ... ... ... ... ... Iffley buildings ... ... ... 2 2 Gossett street 1 Ion Square 3 5 7 16 1 ... ... 1 2 Granby place Ivimey street 1 1 ... 1 1 1 3 ... ... ... Granby street 8 1 2 2 3 Gt. Eastern b'ld'gs ... ... ... 1 1 Green street James court ... ... ... 3 7 5 12 27 ... ... Gretton houses James place ... ... 2 ... 2 8 12 ... ... ... Grove place 1 ... 1 James street (Odd Nos.from 39, Even from No. 4). ... ... 4 2 2 4 12 Grove road (Odd Nos.from 59 Even Nos. from 110). 1 1 2 12 16 ... Jersey street 2 4 4 10 Grove row ... ... ... ... ... Kay street (Nos. 3 to 53 Odd). Grove street ... 1 1 2 1 3 ... 2 6 ... Guinness' buildings 8 2 4 9 23 1 Kelsey street ... ... ... 1 STREET LIST—continued. Name of Street. Zymotic Diseases. Tubercular Diseases. General Diseases. Total. Respiratory Diseases. Kenilworth road 1 1 ... 3 Middle walk ... ... ... ... ... 5 Kerbela street 2 4 1 10 17 Minerva street ... 1 2 8 11 Kings place ... ... ... ... ... Minto place ... ... ... ... ... Knottisford street 1 ... 4 2 7 Molesey buildings ... ... ... ... ... Montford houses ... ... ... 1 1 Morpeth street 3 ... 2 9 14 Laleham buildings ... ... Merceron street 2 2 4 ... 1 1 ... 2 Lansdell place ... 1 1 1 3 Moss street 2 2 3 4 11 Lark row ... 1 1 3 5 Mount street ... 1 ... 1 2 Lawfranc road ... ... Mowlem street ... ... ... 1 1 2 1 1 Leopold buildings ... 1 1 4 6 Museum buildings 1 ... ... 1 2 Letchford place ... ... ... ... ... Lessada street 3 5 3 3 14 Nant street ... ... ... ... ... Linden buildings ... ... 4 1 3 Lisbon buildings ... ... Neath place 1 3 4 3 ... 2 8 13 Lisbon street ... ... ... ... ... Nelson place ... ... 1 ... 1 Little Collingw'dst. ... ... 1 ... 1 Nelson street ... 2 ... 5 7 Little York street ... 1 ... 1 New Church street 1 ... ... 1 2 ... London street ... 1 1 4 6 Newling street 1 2 ... 3 6 Lucas street ... ... 1 1 New Tyssen street ... 2 4 6 ... ... Lyal road ... (Nos. 57A, and 58 to 88 Consecutive Nos.) Lyte street ... ... 1 1 1 3 Norah street 1 ... 2 6 9 North passage ... ... ... ... ... North place ... ... 6 2 4 North street (Nos. 1, 2, 3 and 4 on North side). ... ... ... 1 1 1 ... 1 Northampton street 2 2 1 2 7 1 2 1 8 Mace street 4 Norton street 1 1 2 1 5 Manchester bldgs. ... ... ... 2 2 Mansford buildings ... 4 1 8 3 Mansford street 1 Octagon street ... ... ... 3 ... 8 12 1 1 Mape street 1 2 1 8 12 Old Bthnl. Grn. rd. 2 1 5 7 15 Margaret place ... Old Ford road (Odd Nos. to 205, Even Nos. to 368). 8 16 2 ... 2 4 7 4 35 Marion place ... ... ... ... ... Marion street ... 2 ... ... 2 Marion square 1 1 ... 2 4 Old Nichol street ... ... 1 2 3 Marlow buildings ... 1 ... ... 1 Olga street... ... ... ... 1 1 Martha court ... ... 1 Orange street 1 ... 1 2 4 Marys place ... 1 ... Oval 1 1 ... 3 5 ... ... ... ... Matilda street 2 Oxford street ... ... ... ... ... 1 ... 2 5 Meadows dwellings 1 3 1 4 9 Medhurst road ... 2 1 7 10 Medway buildings ... ... Palm street 6 ... ... ... 1 1 1 9 Medway road 2 ... 2 6 10 Palmers road ... ... ... ... ... Paradise row 1 ... ... 3 4 Park place ... ... ... ... ... (Odd Nos. 3 to 49, Even Nos. 2 to 62). Memorl. Hall bdgs. ... ... ... ... ... Parliament place ... ... ... 1 1 Mendip houses 1 ... 1 ... 2 Parliament street ... ... ... 1 1 Menotti street 1 Parmiter houses ... ... ... 1 1 2 1 5 9 Merceron houses ... ... 1 3 4 Parmiter street ... 2 1 4 7 Middleton street 1 2 10 Patriot square 1 1 ... 2 4 3 4 STREET LIST —continued. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Rooks place ... ... ... ... ... Peacock place ... ... ... ... ... Peacock street 2 1 ... 2 5 Ropley street 1 ... 2 ... 3 Pearl yard Ross buildings (Moss street). ... ... ... ... ... ... ... ... ... ... Pedley street 1 ... 1 1 3 Peel grove ... 6 Royal Victor place ... ... ... ... ... 2 ... 4 Peel grove mews ... ... ... ... ... Royston street 1 3 4 4 12 Pereira street 2 2 2 7 Russia lane ... 1 3 5 9 1 Peter street 1 3 1 1 ... Pitt street 1 3 2 2 8 Pollard place ... ... ... Sabbage yard ... ... ... ... ... ... ... 6 Pollard row ... 2 3 4 9 Sale street 5 1 ... 12 Pollard street 2 Sandford buildings ... ... ... ... ... 2 ... 1 5 Portman place 1 1 ... 2 4 Satchwell rents ... 1 ... 1 2 Pott street ... 1 Satchwell street 1 2 1 4 8 ... 9 10 Poyser street 6 School place ... ... ... ... ... 1 ... 1 4 Preston street 2 ... ... 1 3 Sclater street 1 1 4 6 ... Primrose street ... Scott street 4 3 3 3 13 ... ... ... ... Princes court ... ... 4 2 6 Seabright street 3 3 5 3 14 Pritchards road (Except Nos. 57 to 117). Selby street (Even Nos.) ... ... ... 2 2 2 2 2 7 13 Sewardstone road 2 12 1 4 5 Prospect terrace 1 ... 5 6 Shacklewell street ... ... ... 1 1 ... Providence place Sheldon place ... 1 2 ... 3 1 1 ... 5 7 Providence yard ... ... ... ... ... 6 Shiplake buildings 1 ... 3 2 Punderson gardens. 1 6 Shipton houses ... ... ... 1 1 1 3 11 Shipton street 1 3 3 4 11 Skinners court ... ... ... ... ... Queen's buildings (Princes place). ... ... ... ... ... Sidney street 1 1 1 7 10 Smart street ... 1 1 1 3 Queen's buildings (Gossett street). Smiths place ... 1 ... ... 1 2 2 ... 4 ... Somerford street 8 16 2 1 5 Queen's buildings (Chambord st.) ... Sonning buildings 5 1 ... ... 6 ... ... ... ... S'thampt'n cottages ... ... ... ... ... Qu'n Caroline plce. 2 ... ... 1 3 Southampton place ... ... ... ... ... Quilter street S'thampton street 3 5 3 4 15 ... ... ... ... ... S'thampton terrace ... ... ... ... ... Quinns square 3 3 5 11 22 Spencer passage ... ... ... ... ... Spicer buildings ... ... ... ... ... Railway arches Spital street (Nos. 11 to 27). ... ... ... ... ... ... ... ... ... ... Ramsey street 1 ... 1 5 7 Rapley place ... ... Squirries street 4 2 1 5 12 ... ... ... St. Andrew's street ... ... Ravenscroft bldgs 4 3 ... 3 10 1 2 3 Ravenscroft street ... 2 1 3 6 St. James road ... ... ... 4 4 Reuben street St. John street ... ... 1 3 1 ... ... 1 2 4 Riders buildings ... ... ... ... ... St. Jude street 2 ... ... 2 4 Roan Horse yard ... ... St. Mark's buildings (Tagg street). ... 1 ... ... 1 ... ... ... Robert street 1 ... ... 2 3 Robinson road ... 1 1 2 St. Marys place ... ... ... ... ... 4 3 St. Matthias place ... ... ... Roman road (Odd Nos. to 127, Even Nos. to 142). 1 2 4 10 ... ... St. Peter square ... ... ... ... ... St. Peter street 6 1 18 2 9 METROPOLITAN BOROOGH OF BETHNAL GREEN. THE CHIEF INSPECTOR'S NINTH ANNUAL REPORT ON THE WORK OF THE Public Health Department, FOR THE YEAR ENDING DECEMBER, 1904. THE PUBLIC HEALTH COMMITTEE. Councillor J. Spurling, Chairman. Councillor C. W. Hovell, Vice-Chairman. Aldermen Merison and Norris. Councillors Felton, Fleming, How, Larkins, Pearl, Phipps, Ward, and His Worship the Mayor, C. Wood, Esq., J.P. EX-OFFICIO MEMBERS. The Chairmen of Standing Committees of the Council: Alderman Fox (Finance). Councillor Barnard (Works). Alderman Clark (Law and General Purposes). Councillor Hobney (Baths). Councillor Hall (Electricity). Councillor Hardy (Stores). Meetings—Alternate Wednesdays at 6. p.m. THE Chief Inspector's Ninth Annual Report ON THE WORK OF THE PUBLIC HEALTH DEPARTMENT, FOR The Year ending December 31st. 1904. To the Chairman and Gentlemen of the Public Health Committee of the Metropolitan Borough of Bethnal Green. Mr. Chairman and Gentlemen, I respectfully beg leave to present my Ninth Annual Report on the work of your department. The work done by your staff for the year 1904, is I believe fully equal in all respects to that of any year preceding it ; and it is with the greatest confidence that I submit for your consideration the following particulars of the measures that have been taken under your directions in the interest of the public health of your district. Full details are set out in the several appendices attached hereto, and referred to in the following :— NUISANCES AND INSANITARY CONDITIONS. Appendix A shows month by month throughout the year the measures that were taken for the improvement of the sanitary condition of the Borough, and the various works found necessary for the abatement of nuisances and the provision of sanitary conveniences, &c. RETURN OF INSPECTIONS OF ALL CLASSES AND SAMPLES TAKEN, &c. In Appendix B will be found a detailed statement of the different inspections made by each of your Inspectors. This calls for no special remark except to mention that the high level of primary inspections has been fully maintained, whilst the inspections of the various trade premises and workplaces have never previously been carried out with such regularity or frequency. INSPECTIONS, &c., IN CONNECTION WITH INFECTIOUS DISEASE. Appendix C give details of the inspections made in connection with cases of infectious diseases reported, the number of patients removed to hospital, and particulars of disinfection of rooms and premises. It will be noted that 94 persons required accommodation at the shelter during the disinfection of their dwellings, &C. HOUSES LET IN LODGINGS. In Appendix D will be found particulars of inspections made in connection with houses let in lodgings, and proceedings in respect of the same. Each of these houses are visited about once per month. Special cases more frequently. UNSOUND FOOD. Appendix E gives full details of unsound food seized or surrendered together with the resultant proceedings and penalties. The markets have been efficiently and regularly inspected. FOOD AND DRUGS. From Appendix Fit will be seen that 609 samples of food of various kinds have been taken and submitted for analysis by the Public Analyst. This is the largest number of samples hitherto taken in one year. The results of the legal proceedings will, I think, be found satisfactory, except in the Milk cases. As regards the sale of Milk the legal technical difficulties now made possible by what is known as the warranty defence are rendering the Act a dead letter. In September I presented a short report on this matter, a copy of which I have attached hereto. There seems to be nothing I can add to that except to reiterate the folly of passing an Act of Parliament professedly to prevent the sale of adulterated food, and then to permit anyone who feels so disposed to contract themselves out of it, and to sell watered Milk with the greatest impunity. POLICE COURT PROCEEDINGS. In Appendix G is set out the proceedings taken at the Police Court. It will be noted that practically all the nuisance summonses were dealt with prior to the date of hearing. COMBINED AND MISCELLANEOUS DRAINAGE WORKS. Appendix H gives particulars of the premises drained by the department in pursuance of what is known as combined drainage works. Appendix I gives premises at which miscellaneous works were carried out by the Council's workmen, as opening up drains for examination, &c. SLAUGHTER-HOUSES. From Appendix J it will been seen that the slaughter-houses are now reduced to six. CLERICAL WORK. Appendix K gives, so far as mere figures can convey, an idea of the amount of clerical labour involved in the indoor work of the department. FINANCE. Appendix L. Under three heads, viz. : —Sanitary labour account, combined drainage account, and sanitary disbursements account, will be found an account of the moneys dealt with respecting wages and petty disbursements in this department. SPECIAL REPORTS. Several short reports dealing , with special matters were presented during the year, and I attach three of what appear to be the most important. These deal with the following subjects. 1. The warranty defence in Milk cases, under the sale of Food and Drugs Acts 1875 to 1899. 2. A memo re the new Disinfecting Station. 3. A return of Workshops, Trade Premises, Outworkers, &c. STAFF. Changes in staff and duties. It will perhaps be advisable to refer shortly to the recent changes in the staff and variation of duties. Certain of these changes became necessary, consequent upon some of the Clerk's having obtained appointments under other Councils. Apart from this it had. however, become apparent to me that as compared with Inspectors the clerical staff was undermanned, and incapable of satisfactorily coping with the ever increasing work of the department. If I were to avoid increasing unduly the number of new appointments I could not see any other course open than to recommend a re-arrangement of the Inspectors duties and districts, and to put Mr. Bilham in charge of the indoor and clerical work. This re-arrangement has been effected, and is most satisfactory, and I can see no reason to doubt that it will result in permanently smooth and efficient working. As regards inspection the Borough will be very well provided for. For the future working there will be six districts each, with an Inspector to carry out all the duties prescribed by the order of the Local Government Board, whilst Mr. Rowsell and Mr. Jones will each continue their special work as heretofore. The staff will therefore consist of (in addition to myself) six district Inspectors, one special Inspector for food and markets, and one for drainage works, &c. The latter is paid wholly by the Council. The staff of indoor Clerks with Mr. Bilham will number six. Practically we are now working with one Inspector less than we recently had, but having regard to the fact that the whole Borough has been visited twice over, and probably considerably more than one-half of the drainage and sanitary conveniences either renewed, modernised or amended, I am quite convinced that with a reasonable amount of energy and a loyal wish to carry out the work of the department in a creditable manner your staff of Inspectors is ample to continue the work satisfactorily. I am, Mr. Chairman and Gentlemen, Your obedient Servant, JOHN FOOT. Special Reports Presented During 1904. Metropolitan Borough of Bethnal Green. To the Public Health Committee. Mr. Chairman and Gentlemen,— Re .—Warranty Defence, Milk Cases. Sale of Food and Drugs Acts, 1875 to 1899. Agreeably with your instructions that in consequence of the numerous cases in which recent prosecutions taken in connection with the sale of milk have either resulted in the summonses being dismissed or withdrawn, the whole question should be considered, I respectfully beg to report for your assistance as follows : — What is now known as the "Warranty Defence" is a matter of quite recent growth, undoubtedly arising out of the unsatisfactory and defective condition of the law relating to the Sale of Food and Drugs generally, and of Milk especially. Under Section 20 of the Sale of Food and Drugs Act, 1875, in any prosecution, if the defendant proves that he had purchased the article in question as the same in nature, substance and quality as that demanded of him by the prosecutor, and with a written warranty to that effect, and that he had no reason to believe at the time when he sold it that the article was otherwise, and that he had sold it in the same state as when he purchased it, the prosecution fails. Section 20 of the Act, 1899, does not materially vary the above, except to require that the person who intends to rely on this defence shall give seven days' notice in writing, and shall send a copy of the warranty or invoice he intends to rely upon to the prosecutor. But Sub-Section 6 of Section 20 provides that every person who, in respect of an article of food or drug sold by him as principal or agent, gives to the purchaser a false warranty in writing, shall be liable to a fine not exceeding £20, etc., unless he proves to the satisfaction of the Court that when he gave the warranty he had reason to believe that the statements or descriptions therein contained were true. Probably all the trouble has arisen from the last few lines of this Section, which I have italicised. No official experience is needed to be able to see at a glance that properly managed the manufacture of warranty defences is a very easy matter. A far easier matter than the payment of even a small fine would be. The method of procedure is that, on any retailer of milk, who "knows the ropes." being summoned, he at once gives notice of this warranty defence. The warranty is of course produced in Court, and the summons is dismissed. Proceedings can then be taken against the person giving the warranty, and all he has to do to defeat the prosecution is to go into the witness box and say that when the warranty was given he had reason to believe that the statements or descriptions therein contained were true. No one is in a position to contradict it. Under these circumstances it is easily understood that since this so-called amending Act of 1899 came into force the proper administration of the Acts has been rendered more difficult by the possibilities afforded to offenders by these warranty sections for evading the law. The extent to which this defence is being taken advantage of may be gathered from the fact that, whilst in any previous year only about 2 per cent. of our milk summonses have been dismissed on this ground, the percentage of such dismissed cases in the present year has increased to over 13 per cent. of the prosecutions taken in respect of the sale of milk. The whole question has been so admirably dealt with by Dr. Louis C. Parkes, the Medical Officer of Health to the Borough of Chelsea, that I have ventured to quote from Dr. Parkes' report. Inter alia he says : — In this connection the following considerations are of importance :- (1.) A considerable majority of the retail milk dealers are now protected by warranties either from the wholesale dairy companies, who act as middlemen, or from the farmers direct. Warranties are now being given with the greatest readiness, as tho warrantors are aware that for all practical purposes their warranties are unassailable. (2.) The wholesale dairy companies, who act as middlemen, rely upon warranties from the farmers who supply them, such warranties being for all practical purposes sufficient evidence that when they— the middlemen- gave the warranty to the retailer, they had reason to believe that the statements or descriptions contained therein were true. Sale of Food and Drug Act, 1899, Section 20 (6.)) (3.) The small general traders, who sell milk in small quantities as part of a general grocery business, are, as a rule, unprotected by warranties, and are at present the only persons whom the Acts can touch. (4.) Where warranties are set up in defence, either by the retail dealer in the origi nal prosecution or by the middleman in proceedings for giving a false warranty, it is almost impossible to obtain a convicton. The retail dealers have no difficulty in showing that they had no reason to disbelieve the warranties on which they rely, and that they sold the milk in the same state as when they purchased it. The magistrates are bound to accept this evidence, which is incapable of contradiction, and consequently dismiss the summonses. In the case of proceedings for giving false warranties, the defendants have no difficulty in proving that when they gave the warranties they had reason to believe that the statements or descriptions contained therein were true, and this evidence also is incapable of contradiction. The magistrates are then bound to discharge the defendants. (5.) In proceedings for giving a false warranty, the original defendant —the retail dealer—has to be called as a witness for the establishment of the complainant's case. The retail dealer is practically a hostile witness, for it is against his trade interests to help proceedings against a person or persons with whom he does business. Moreover he is no longer concerned in the result, as he has already been discharged for his share in the transaction, and cannot be prosecuted twice for the same offence. (6.) No proceedings can be taken against a warrantor for giving a false warranty, if the warranty was given more than six months before the institution of proceedings. (7.) The case of successive warranties has not been provided for in the Acts. In Mr. Cunningham Glen's opinion, proceedings can only be taken against the farmer, who has given a false warranty to the middleman, If the churn or churns forming the consignment of milk had labels attached, and if these labels are held to amount to warranties in writing. It follows from this opinion that whilst the middleman can rely upon a general warranty of anterior date from the farmer as evidence of his bona fides, no proceedings are possible against the farmer if he sends his churns to the middleman without labels attached that could in any way be construed as warranties. The retail dealer who deals direct with the Farmer would be protected in the same way, whilst there would be no case against the farmer if he sent his churns to the retailer without laliels. (8.) Proceedings against a farmer for giving a false warranty may have to be taken in the country at a distance from London, involving possibly several hours railway travelling and very considerable expense. (9.) In all proceedings for giving false warranties in writing it is necessary to call the Public Analyst as a witness, a process involving expense, when the Analyst's salary does not Include fees for personal attendance in court. In conclusion, the system of defence under warranties is very seriously weakening the powers of local authorities in safeguarding the public from adulterated milk; and it is becoming more and more evident that nothing less than the total abolition of the warranty clauses from the Acts will be effectual in restoring those powers to check adulteration which the Acts were intended to convey. The public protection can only be secured by rendering the actual seller to the public liable for what he sells. If the retailer is protected by a warranty, he should be able to recover by some simple civil process from the warrant or the amount of any fines, penalties, and costs he has incurred by reason of a false warranty ; but it is contrary to public policy that the public should be concerned in the obligations entered into between individual traders for the protection of their own interests. Nothing more effectual to increase the efficiency of the Acts and to prevent fraudulent adulteration could be designed than the simple repeal of the warranty clauses, with the insertion of such powers to consignees to recover costs after conviction from the warrantors as justice dictates. Other Public Health Authorities are experiencing the same difficulty, and there is a general impression that unless the law is amended it is almost useless taking samples of milk. Apparently the proper thing for your Committee to do is to support the Chelsea Borough Council, as desired in their letter of August 4th, 1904, and to send a communication to both the President of the Local Government Board and the Board of Agriculture, pressing for an amendment of the Act on the lines suggested, and which is as follows : — "That the Local Government Board and the Agricultural Department be requested to introduce a Bill in Parliament next Session, having for its object the repeal of the Warranty Sections in the Sale of Food and Drugs Acts of 1875, 1879, and 1899, and the insertion of such clauses as would enable the vendor, who has a warranty, to recover the penalties and costs of a conviction by simple civil process from the warrantor." Legislature on the lines suggested would, of course, meet the immediate difficulty of these milk warranty-defences without touching the much larger question of the practical administration of the Sale of Food and Drugs Acts as a whole. Until the Legislature shall prohibit the sale of adulterated or mixed articles of food, except as such, and shall once for all put an end to "Contracting out" by means of warranties, Notices, and other means (all of which are taken advantage of by dishonest traders to foist off upon the public an article inferior to the one paid for), there is not much prospect of these Acts giving the public the full protection desired or expected. To return to the question immediately under consideration, it appears highly desirable, having regard to the importance of milk as an article of food, that all Health Authorities should lie given ample powers for establishing throughout their districts depots for the production and sale of milk. This, the staple food of children, invalids, and aged person s has too long been left to the mercy of the dishonest, to the handling of the uncleanly, and to the care of the "middleman," with his "chemicals." "colouring," and "preservatives," all of which are inconsistent with a low death rate and healthy life. Whilst an amendment of the Act may be a step in the right direction, I venture to suggest thai the real remedy is in place the production and supply of milk under the control of the Municipal Authorities, and that full power should be given them to do all things necessary to this end. Once you get this power the reducton of the infantile death rate would be a comparatively easy matter. I have the honour to remain, Mr. Chairman and Gentlemen, Your obedient servant, JOHN FOOT, Chief Inspector. New Disinfecting Station. November 23rd, 1904. Memo by the Chief Inspector. In view of the Fact that the new station is now approaching completion, and as the bulk of the work in connection with the initiation of the scheme was carried out by the Committee now retiring, it was thought advisable that before proceeding to ordinary routine business the new Committee should inspect their new building, and take possession of it at the commencement of their career. Moreover, the Committee's instructions are necessary for the settlement of one or two small matters necessary for the full completion of the machinery and appliances, which it is hoped will be in full working order in the course of a few days. The following particulars of the work of removing the old station and providing for the new may be of interest : — OLD STATION. The old station was in itself totally inadequate, and quite unsuitable for the purpose intended. It was a mere corner of the old Vestry Yard, enclosed with a sort of boundary wall into which had been fixed one of the very earliest of the Washington Lyon type of disinfector. There were no modern or indeed any other appliances about the station, or machinery, and no means for keeping the infected side free or distinct from the clean or disinfected side, neither were there any baths or lavatories for the men to clean themselves. Things went on in this casual sort of way down to the middle of 1902, when the outbreak of Small Pox commenced, and probably in consequence of the additional pressure put upon it, the machinery, then about 19 years old and practically worn out, began to give way. Many articles of clothing were spoiled, and compensation had to be paid in several instances. In other cases the work was no doubt ineffectually done, and on a full report being presented, it was at once seen that a larger station, with up-to-date machinery and appliances, was necessary, if the work was to be carried out efficiently. Moreover, the disinfecting work was rapidly increasing. Hospitals, school, and other institutions commenced to call upon the authority to disinfect, whilst in private cases we had Measles, Erysipelas, Phthisis, and similar cases that were entirely ignored in the brave old days, and that were now calling for disinfection by the authority, just as in the case of more recognised infectious disease. Something had to be done, and that with very little delay, to prevent the scandal that was within measurable distance of a London Sanitary Authority being caught with no proper disinfecting station and appliances. First the Committee proposed to obtain a site outside of and quite apart from the Depot. From one cause or another, which need not be recapitulated here, one proposition after the other had to be abandoned, and the Committee finally decided to appeal to both the Stores and Works Committees for a little more space, to enable them to erect a larger and more suitable building within the Depot. Both the Stores and Works Committees favourably responded, and after weary months, during which the Committee visited several of the more recently erected stations in London, they were at last able to instruct Mr, Ayling to proceed with plans and particulars of cost, &c. Our troubles were, however, not yet ended. On applying to the Local Government Board for a loan, detailed plans and other requirements were called for, and which bid fair to upset all that had been done, and to take us back to chaos. The Finance Committee, however, on the suggestion of Mr. Ashmole, came to our assistance at the most critical moment and the Committee were at last enabled to proceed to invite tenders without any loan at all having to be raised. The Treasurer advised his Committee how ways and means for paying for the building out of the current rate could be provided. We were thus freed from the expense of a loan, and resultant public enquiry, as well as other restrictions of a more or less vexatious nature. THE NEW STATION. After a few other comparatively minor troubles, chiefly in connection with Party Walls, Notices, &c., we were at list enabled, in May, to proceed with our New Buildings, which provide everything requisite for a modern and up-to-date disinfecting station. In place of the old boiler and an obsolete apparatus crammed into a dark and badly arranged corner of the yard, we shall have : — ( a ) Two new boilers of a capacity of six horse power each. (b) One entirely new Washington Lyon Disinfector of full size, and fitted with all modern improvements, including the vacuum hot-air exhaust. (c) The old disinfecting apparatus completely modernised and fitted up with exhaust vacuum and other improvements, rendering it a most useful machine for future work. (d) The two parts of the station completely separated, the clean from the infected side, and each side provided with a bath, a lavatory, and sanitary conveniences. (e) Accommodation for both clean and infected trucks in properly separated yards, external to the station. ( f) A modern well-equipped Incinerator for the destruction of foul bedding and other articles, as well as the destruction of unsound articles of food seized by the Inspectors within the Borough. (g) Ample rooms, shelves, and storage accommodation for the proper keeping of bedding and other article. Generally the New Station is very well lighted from large skylights in the roof. All internal surfaces are of impervious materials, free from cracks or crevices, and capable of being thoroughly washed down from top to bottom, by means of a hose whenever needed. The walls are of white glazed bricks throughout, winch adds to the brightness and cleanliness of the place. The contract price of the building complete amounted to £2,800, of which £615 was for machinery. There will be some small additions. Both the Health Committee and its Department are to be congratulated on having successfully emerged from their troubles, and of being now in possession of a modern, well equipped, and efficient disinfecting station, capable of dealing with the work of the Borough for many years to come. JOHN FOOT. Chief Inspector. In addition to the foregoing there are 230 Trade Premises on the Register, consisting of: — Bakehouses 90 Cowhouses 18 Slaughter-houses 6 Eating-house and places where food is prepared for sale 116 Total 230 OUTWORKERS. N umber of Outworkers homes on Register 642. Consisting of:— Females 544 Males 98 Nature of Trades carried on:- Boot and Shoe Makers 213 Blouse Makers 15 Collar Makers 4 Dress and Mantle Makers 18 Glove Maker 1 Ladies Belt Makers 15 Milliners 8 Shirt Makers 13 Sunshade Maker 1 Tailors 30 Tai 264 Tie Makers 9 Trimming Makers 32 Underclothing Makers 12 Total 642 APPENDIX A. Nuisances and Insanitary Conditions Abated, from 1st January to 31st December, 1904. Cleansing. Drainage Works, and Repairs to Waste and R.W. Pipes. Water Closets Cleansed, Repaired, Built, &c. Works Appertaining to Water Supply. Month Other Matters. Total. January 33 117 219 222 25 616 February 226 31 175 20 230 682 March 708 295 50 140 22 201 Miscellaneous—continued. Overcrowding abated 104 Cellars and Basements, Illegal occupation 6 Urinal accommodation provided 16 Grids provided to Gullies 46 Urinals supplied with proper Water Supply 27 Urinals cleansed 9 Dust Shoots repaired and Receptacles provided 228 Drains relaid 418 Drains amended 40 Vacant lands cleansed 2 Yards cleansed 23 Indecent occupation discontinued 10 Total 7,603 APPENDIX B. PUBLIC HEALTH DEPARTMENT. Annual Return of Inspections and Particulars of Cases in Hand for the Year ended 31st December. 1905. Combined Drainage Inspections. Smoke Nuisa ces— Premises under Observation. Other Inspections or Work of Special Character. Infectious Cases. Complaints. House to House Inspections. Trades' Inspections. Milkshop Inspections. Factory and Workshop Inspections. Outworkers' Homes Inspections. Number of Cases in Hand. Ice Cream Shop Inspections. Police Court Cases. Total Visits for the Year. Nuisances Abated. Samples of Food Taken. Unsound Food Seizures. Visits to New Buildings. Re-inspections. Inspector. District. 269 380 16 3905 - 87 - 656 18 - - 291 - 6 11 5371 Richards. 88 A 399 121 440 428 574 5596 Bridel. 28 3525 - 181 - 88 10 - - - 5 B 24 386 769 110 206 181 13 4828 - - - - - 14 5870 Ainley. 305 251 76 - C 86 - 585 113 333 417 556 35 3274 - 247 - 795 28 - 1 - 1 5586 Henley. 14 681 D 88 209 36 - 1 - 198 140 Weeks. 429 3 25 5762 211 393 22 4698 1 104 E 135 64 - - 15 - 668 - 9 - - - - - 785 30 27 1516 Rowsell. 12 Food and Market Inspector 103 2 - Bare. 3 819 7907 Cowsheds, Factories & Workshops Inspector 13 7 - 1627 1685 2103 382 - - - 640 - - 58 955 217 - 1 - - - - - - 3 - - 102 - 2339 - - - 2510 Jones. 68 Bye-Laws and New Buildings, &c. Inspector 284 302 493 - 3953 - 351 - - - 1 372 5788 E. Q. Bilham. 26 75 Tenement House Inspector 32 - 453 99 1756 2257 2199 782 2510 1695 2800 4074 1009 559 2979 786 115 3281 45906 33 14 - 955 622 Totals APPENDIX C. Infectious Disease. Inspections in connection with cases. Total No. of Rooms and Houses Disinfected. No. of Disinfections by Request. No. of Cases in which Shelter Used. No. of Persons Removed. Month. January 63 55 9 - 72 February 81 72 106 4 1 March 145 114 165 5 13 APPENDIX D. Houses Let in Lodgings. Visits paid during 1904 1,589 Number of Houses on Register 445 Number of Houses added in 1904 112 Cases of overcrowding 8 Cases of Indecent Occupation 7 Summonses Issued *9 Convictions *4 * In one case the Summons was withdrawn, as the persona offending had remedied matters by finding suitable accommodation. In four cases the persons absconded, and the Summonses were adjourned sine die. APPENDIX E. Unsound Food. Date. Owner. Where Inspected. Weight. Seizure or Consent. Nature of Foodstuff. Result. 1904. Mar. 19 W.J.C. Green Street 1 Carcase Pork Consent May 15 - Cabbage Court, Brick Lane 13 Rabbits Seizure Owner absconded upon seizure. 17 Bethnal Green Road Fine £5, costs £5 5s. J.B. Pieces of Meat 70 lbs. ditto 26 M.J.C. Hackney Road 3 Pcs. Beef, 1 pc. Veal ditto Costs £2 4s. 8 „ June 14 B.M. Roman Road ½ Bushel Cherries ditto 28 „ 14 A.B. ditto A.B. New Church Street 4 Bushel Cherries 1 cwt. Fine £2, costs £ 1 3s. July 17 A.W. Bonner Street Pieces of Meat 77 lbs. Fine £25, costs £2 2s. ditto 26 Old Ford Road Salt Meat ditto Fine £5, costs £2 2s. M.B. 20 „ 31 E.S. Globe Road Salt and Fresh Meat 22½” ditto Fine £2, costs £1 5s. Aug. 7 M.G. Buxton Street Boxes Kippers ditto ditto costs £1 3s. 10 H.D. Bacon Street Pears 40 „ ditto ditto costs £1 5s. Oct. 8 F.H. 5 Hands Salt Pork ditto Fine £3, costs £3 3s. Brick Lane 22 W.S. Cambridge Road Conger Eel ditto No action,W.S. in Workhouse. J.B. Bethnal Green Road 298 Bloaters ditto Fine £3, costs £1 3s. 29 Dec. 29 A.I. Green Street 47 Haddocks, Whiting, &c. ditto Vendor cautioned, by Order of Committee. Vendor cautioned, by Order of Committee. APPENDIX F. Food and Drugs Acts. Summonses issued. Adulterated. Convictions. Nature of Articles. Genuine. - - - Arrowroot 3 Borax 8 - - - Butter 96 9 10 5 Cheese 15 — — — Cocoa 7 1 1 1 Coffee 18 6 6 6 Corn flour 2 - - - Ground Ginger 5 - - - „ Rice 4 - - - Hot Drinks 6 - - - Jam 4 - - - Lard 2 - — - Malt Vinegar 2 - - - Margarine 3 - - - Milk 322 56 60 44 Mustard 3 - - - Olive Oil 1 - - - Pepper 8 - - - Sago 6 - - - Sausages - 5 2 - Sugar 5 2 - - Sweets 9 - - - Syrup 1 - - - 79 Totals 530 79 60 Thus it will be seen 609 samples were procured for analysis 79 of which proved to be adulterated, 60 convictions being obtained. In the cases of butter, milk and sausages, a discrepancy will be noticed between the number of summonses issued and convictions obtained. The following are the reasons for such discrepancy. With reference to butter, in 2 cases the persons summoned absconded, and 1 summons was withdrawn on a conviction being obtained on a second summons in respect of the same sample. I summons is pending and I was dismissed. As to milk 1 person summoned absconded, 5 summonses were dismissed on the " warranty " defence, 2 were withdrawn owing to the bottle containing the third portion bursting, five were withdrawn upon, information being received that the "warranty" defence would be raised, and 3 were withdrawn upon convictions being obtained on second summonses in respect of the same samples. In the case of the sausages, the summonses were dismissed, the Magistrate being of the opinion that, though they contained large quantities of borax, the sale was not to the prejudice of the purchaser. The total amounts orderered to be paid were :— £184 15s. 6d., as penalties. £52 10s. 0d., as costs. £1 1s. 0d., costs against Council (Mundlein re Sausages containing borax.) APPENDIX G. POLICE COURT PROCEEDINGS. Initials. Subject of Proceedings. Inspector. Magistrate. Result. LF Overcrowding E. Q. Bilham Mr. Cluer Fine and costs £2 3s. ditto ditto ditto ditto Costs 2s. IH Indecent Occupation ditto ditto Unable to serve Summons. MS ditto ditto ditto ditto Def. went to prison, 1 day c Insanitary Premises E. Ainley Mr. Corser Costs 3s. A ditto ditto A. S. Henley ditto Unable to serve Summons. ditto ditto ditto ditto ditto ditto ditto ditto PC RC HC EB D JS AE c AE SG MJ MJ ditto ditto ditto Cocoa Dirty Milk Vessels Adulterated Milk Insanitary Premises Indecent Occupation Insanitary Premises ditto ditto ditto ditto Adulterated Milk ditto Butter Margarine sold in plain Wrapper E. Q. Bilham A. S. Henley F. T. Bare J. G. Weeks ditto E. Q. Bilham E. Richards E. Q. Bilham E. Richards J. G. Weeks W. Rowsell ditto ditto ditto ditto ditto Mr. Corser Mr. Cluer Mr. Corser ditto ditto ditto Mr. Cluer ditto ditto ditto £2. ditto ditto £3. ditto ditto £3. ditto ditto £12. Costs 3s. Defendant Absconded. Costs 3s. ditto 3s. ditto 3s. Fine and costs £3 13s. Defendant Absconded. ditto ditto JD FJS MJ GC ditto C F YG AD FC FW ditto ditto ditto ditto Adulterated Milk ditto Butter Margarine in plain Wrapper Insanitary Premises 5 Summonses ditto ditto Adulterated Butter ditto Milk ditto ditto ditto ditto A. S. Henley E. Richards ditto E. Ainley ditto E. Richards J. G. Weeks E. Q. Bilham E. Ainley E. Q. Bilham ditto ditto ditto ditto ditto ditto Mr. Baggallay ditto Mr. Cluer ditto ditto ditto ditto 3s. ditto 3s. Defendant Absconded. Withdrawn. Other convictions on same sample. Fine and costs £2 12s. 6d. Costs 15s. ditto 3s. ditto 12s. 6d. Fine and costs £4. ditto ditto £3. ditto ditto £3. O Insanitary Premises J. G. Weeks ditto Order 7 days, & costs £1 1s. ditto ditto ditto ditto ditto AW G D B&S A K K D&S HH MB GD Unsound Meat Insanitary Premises ditto ditto ditto ditto ditto ditto ditto ditto ditto ditto ditto ditto Adulterated Milk Unsound Meat Underground Bakehouse used without Certificate ditto J. G. Weeks H. F. Bridel J.G. Weeks ditto F. T. Bare ditto J. G. Weeks E. Richards W. Rowsell F. T. Bare ditto Mr. Cluer ditto ditto ditto ditto ditto ditto ditto ditto Mr. Corser ditto ditto £ 27 2s. Costs 3s. ditto 3s. Withdrawn. Costs 3s. ditto 3s. ditto 3S. ditto 3s. Dismissed. Warranty Fine and costs £7 2s. ditto ditto £3 3s. DT MD ditto ditto Insanitary Premises E. Richards A. S. Henley ditto ditto Fine and costs £2 3s. Costs 3s. ET ditto ditto ditto ditto ditto ditto £4 2s. APPENDIX H. Combined Drain or Sewers. 2 to 12, Arundel Street 2 to 5, Abingdon Street and 8, Glass Street 36 to 44, Alma Road and 39 to 61, Cranbrook Street 4 to 18, Anglesey Sreet and 83, Vallance Road 1 to 3. Abbey Street and 258 to 260, Bethnal Green Road, and 1 and 3, Voss Street 1 to 3, Brierly Street 15 to 21, Bonwell Street 2 to 24, Baxendale Street 67 to 73, Barnet Grove and 41, Quilter Street 1 and 3, Bacon Street and 1 to 5, Cygnet Street 52 to 72, Bishop's Road and 61 to 67. Russia Lane, and 35 to 41, Parmiter Street 1 to 7, Busby Square and 2, 4, 6 and 8, Busby Street, an 2, 4, 6 and 8, Granby Street 326 to 338, Bethnal Green Road 127 to 129, Columbia Road, and stables at rear 8 and 8a, 10 and 10a, and 12, Chilton Street 7 to 15, Chisenhale Road 90 to 100, Columbia Road 195 and 197, Cambridge Road 483 to 495, Cambridge Road 9 and 10, Chapel Street, and stables at rear 7 and 8, Chapel Street and 13, Chapel Place 3 and 4, Chapel Street 9 to 17, Chapel Street and 22 and 24, Arline Street 212 to 214, Cambridge Road 31 to 37, Cadell Street and 5, Shipton Street 1 to 13, Clarkson Street 1 and 2, Fleet Street Hill and 2, Bratley Street 5 to 7, Fleet Street Hill and 27 to 33, Weaver Street 1 to 7, Gales Gardens 4 to 10, Gales Gardens 9 to 15, ditto 12 to 16, ditto 17 to 23, ditto 43 to 49, ditto 24 to 30, Green Street 233 to 235, ditto 183 to 191, Grove Road 2 and 4, Horatio Street 12 to 20, Hereford Street 1 to 4, Henrietta Street 1 to 19, Hereford Street 395 to 399, Hackney Road 142 to 146, ditto 21 to 39, Hereford Street 21 to 31, Horatio Street and 17 and 19, Shipton Street 13 and 14, Henrietta Street 13, Hunslett Street 49 to 61, James Street 2 to 28, Jersey Street 26 to 28, Lansdell Place 47 and 48, Lessada Street 7a to 15a, Mace Street and 4, 5 and 6, Flint Terrace 5 and 6, New Tyssen Street 48 to 60, Old Ford Road 78 to 82, ditto 90 to 110, ditto 34 to 42, ditto and 306 and 308, Globe Road, and stables at rear. 3 and 5, Pritchards Road 33 to 49, Preston Street 25 to 27, Ravenscroft Street 12 to 18, Russia Lane 57 to 59, ditto 23 to 25, Royston Street 12 to 14, Smart Street 12 to 24, Surat Street 33 to 39, ditto 58 to 60, St. Peter Street 57, Sale Street and 19, Ramsey Street 9 to 19, Sewardstone Road and 47, Bandon Road 5 to 11. Tread way Street 98 to 100, Thoydon Road 2, 3 and 4, Tagg Street and 22, Bonner Street 27 to 29, Usk Street and 1 to 15, Prospect Terrace 170 to 176, Vallance Road 240 to 246 ditto 1 to 6, Victoria Place (The Oval) 1 to 5, Willow Walk 9 and 10, Wood Street 19 to 33, Wimbolt Street 26, 28 and 30, Wadeson Street 13, 15 and 17, Walter Street APPENDIX I. Miscellaneous Works. Opening Up Drains for Examination, &c, 13 and 14, Lessada Street 19, Satchwell Rents 84 to 92, Sewardstone Road 8, Marian Square 24 and 25, Marian Street 67 to 79, James Street 62 to 68, Fuller Street 55, Fuller Street 46 to 48, Camden Street 39 to 45, Barnsley Street 79 to 85, Somerford Street 4, Elwin Street 17, Hague Street 454 and 456, Bethnal Green Road Butlers Buildings 91, Cyprus Street 73 to 81, Coventry Street 20 to 22, Green Street 29, New Tyssen Street 8, Bonwell Street 168 and 170, Brick Lane 11 to 17, Clare Street 125 to 129, Cambridge Road 35, Garner Street 12, Vyner Street 43 & 45, Totty Street APPENDIX J. SLAUGHTERHOUSES. Number in Borough 6 Number of Visits in 1904 43 Number of Orders to Cleanse 4 Licenses Opposed — Licenses Refused — Licenses Lapsed — APPENDIX K. Particulars as to Letters, Notices, &c., During 1904. 4101 Intimation Notices were written 1927 Statutory ditto ditto 5106 Entries in Nuisance Register 466 ditto Tenement House Register 614 ditto Food and Drugs 444 Notices served respecting Combined Drains 34 Smoke Nuisance (intimation) notices served 2 ditto (statutory) ditto 1915 Persons called at the Office, anil particulars entered into Call Book 938 Dnstpail Notices were prepared and served 525 Final Notices ditto ditto ditto 2655 Letters were written 105 Briefs and instructions to Solicitor prepared 179 Summonses were prepared, and two copies made of each APPENDIX L. (A) SANITARY LABOUR ACCOUNT. D isinfectors', Mortuary Keepers', AND Pailmens'Wages, &c. 1904. £ d. s. January 84 5 10 February 2 85 5 March ' 148 0 9* April 128 11 10* May 120 19 5* June 165 19 4* July 63 6 7* August 29 18 3 September 28 18 6 October 36 0 0 November 30 7 5 December 30 7 5 Total £952 0 6 * Months of Small-Pox Outbreak (B) COMBINED DRAINAGE ACCOUNT. 1904. Weeks. Ending. £ d. s. 4 January 30th 123 8 6 4 February 27th 134 8 1 5 April 2nd 170 8 11 April 30th 121 4 10 1 May 28th 4 191 15 3 5 July 2nd 115 17 10 4 July 30th 102 8 5 September 3rd 199 17 5 5 4 October 1st 153 15 9 4 October 29th 113 5 9 5 December 3rd 143 9 3 4 December 31st 70 3 4 Total £1,640 8 7 17 17 5 1 0 2 15 8 - 18 6 - 40 12 7 August September - 5 11 10 1 11 1 - 1 19 3½ 4 16 5 0 6 2 6 4 13 1½ 10 2 3 49 October 12 14 11 3 5 10 8 4 8 November 5 15 11 5 8 0 4 14 4 - 1 19 0 1 8 70 5 4 December 5 8 4 5 1 11 4 2 10½ 10 11 2 0 8½ 6 9½ 35 19 4 139 11 2 Total for year 13 37 16 1 40 12 7½ 4 7 11½ 27 17 9 1½ 667 16 9 8 Total amount received from Committee £139 13 11 Balance in hand from year 1903 10 13 8½ 150 7 7½ Less Expenditure... 136 2 4½ Balance in hand ... £14 5 3