BET 13 The Public Health Committee. Councillor T. A, Dean, Chairman. Councillor J. T. Hobney, Vice-Chairman. Aldermen J. J. Fleming and J. Merison. Councillors G. Bayley, J. C. Davey, T. A. Dean, J. Durell, J. T. Hobney, J. W. How, R. Larkins, J. Phipps, E. A. Slade, J. W. Ward, His Worship the Mayor, G. Edmonds, Esq., J.P. EX-OFFICIO MEMBERS. The Chairmen of Standing Committees of the Council: Councillor W. Rawles (Finance) Councillor T. F. Salmon (Works and Stores). Councillor T. Brooks, (Law and General Purposes). Councillor W. Sweetman (Baths). Meetings— Alternate Wednesdays at 6 p.m. at the PUBLIC HEALTH OFFICES. 2, Paradise Row, Cambridge Road, N.E. THE Metropolitan Borough of Bethnal Green. REPORT ON THE SANITARY CONDITION AND VITAL STATISTICS DURING THE YEAR 1907. 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 RoyaI College of Physicians of Edinburgh; Fellow of the Royal Society of Medicine; Fellow of the Royal Microscopical Society; Fellow of the Royal Institute of Public Health; Vice-President (past President) of the Incoporated Society of Medical Officers of Health; Examiner in Sanitary Science, &c., to His Majesty's Civil Service Commissioners; Honorary Consulting Physician to Queen Adelaide's Dispensary; J.P. for the County of London; and Medical Officer of Health for the Borough of Bethnal Green. LONDON: Printed by Furby & Co., Alpha Works, Hampton Road, Forest Gate, E. 1908. Synopsis OF MEDICAL OFFICER'S ANNUAL REPORT, 1907. General Summary 6 Birth and Death Rates in Metropolitan Boroughs 5 Population 7 Table "A" Births. 7 Deaths. Table "B" Public Institutions outside Bethnal Green into which residents have been received and where they have died 10 Residents found drowned outside the Borough 11 Table "C" Public Institutions in Bethnal Green 13 Table "D" Deaths in Sub-districts 14 Table "E" Monthly mortality rates.— London and Bethnal Green 15 Table "F" Quarterly rates, London and Bethnal Green 16 Birth Rates 16 Table "G" Birth rates and death rates in sub-districts 16 Table "H" Marriages 17 Table "1.,' Infantile deaths, Bethnal Green and England and Wales 17 egitimate Births, Bethnal Green and England and Wales 18 Remarks on death of infants— Percentages of causes of death 19 Averages, Home and Foreign Countries 21 Special causes of death 21 Unfavourable influences on pregnant women 23 Suggested remedies 29 Report of Woman Inspector 31 Deaths of young children 39 Elderly persons death rate 40 Weekly mortality chart 40 BET 13 SYNOPSIS.— Continued. page Table "K." Quarterly Mortalities, London 42 Table "L." do. do. Bethnal Green 43 The seven principal Zymotic diseases 44 Table "M." Deaths at home and in hospital 44 Table "N." Comparison between 1906 and 1907 45 Table "O." Percentages of Zymotic diseases 45 Notification of infectious diseases 46 Do. Cerebro-Spinal Fever 49 Do. Certificates 49 Table "P." Details of notifications 50 Scarlet Fever 51 Diphtheria 52 Enteric Fever 53 Typhus do. 54 Whooping Cough 54 Diarrhœal diseases 55 Measles 55 Do. Schools closed 56 Tuberculosis 56 Diseases of Parturition 57 Midwives 57 Cancer 58 Inquests 59 Suicides 59 Uncertified deaths 59 Public Health Legislation, 1907— London County Council General Powers Act 60 Vaccination Act 62 Notification of Births Act 63 Orders— Glanders or Farcy Order 64 Building regulations 65 Outworkers 66 Customs and Inland Revenue Acts, 1890 to 1903 67 Cleansing of Persons Act, 1897 67 Bakehouses 67 Housing of Working Classes Acts, 1890 to 1903 67 SYNOPSIS.— Continued. PAGE Tables— I.—Vital Statistics of Whole District 70 II.—Vital Statistics of Separate Localities in previous years 71 III.—Cases of Infectious Disease notified during the year 1907 72 IV.—Causes of, and Ages at, Death 73 V.—Infantile Mortality 74 VI.—Number of deaths from the seven principal Zymotic diseases in the ten years 1897 to 1906 and in the year 1907 77 Home work order and circular 84 Memorandum on Cerebro-Spinal Fever 81 Glanders or Farcy Order, 1907 90 Street List 99 London and the Metropolitan Boroughs. Birth-rate, based upon births registered in each Borough, and Death-rates after distribution of Deaths in Public Instituions, of Persons belonging to London and the Metropolitan Boroughs during the 52 Weeks of 1907.* Boroughs. Per 1000 Persons Living. Deaths under 1 year to 1000 Births. Deaths from Births All Causes. Principal Epidemic Diseases, Measles. Scarlet Fever. Diphtheria. Whooping-cough. Enteric Fever. Pyrexia † (Origin uncertain). Diarrhœa. Phthisis. COUNTY OF LONDON 25.6 14.6 1.42 0.38 0.14 0.16 0.38 0.0i 0.00 0.32 1.40 116 West. Paddington 21.8 13.5 1.13 0.25 0.09 0.13 0.35 0.03 ... 0.28 1.09 109 Kexsingtox 19.0 13.7 1.04 0.17 0.05 0.13 0.45 0.03 ... 0.21 1.03 128 Hammersmith 25.3 14.3 1.16 0.44 0.08 0.15 0.27 0.05 ... 0.17 1.20 117 Fulham 27.8 13.2 1.73 0.42 0.08 0.23 0.45 0.05 ... 0.50 1.19 122 Chelsea 20.3 15.0 1.44 0.56 0.03 0.09 0.33 0.04 ... 0.39 1.50 122 City of Westminster 17.2 13.0 0.72 0.11 0.07 0.10 0.15 0.05 ... 0.24 1.37 102 North. St. Marylebone 20.9 15.0 0.97 0.14 0.15 0.12 0.35 0.02 ... 0.19 1.48 101 Hampstead 15.1 9.0 0.51 0.13 0.06 0.08 0.13 0.02 ... 0.09 0.70 69 St. Pancras 24.7 15.0 1.17 0.37 0.11 0.13 0.33 0.02 ... 0.21 l.66 108 Islington 25 0 14.7 1.25 0.38 0.06 0.12 0.36 0.04 0.00 0.29 1.32 116 Stoke Newington 20-0 11.5 1.02 0.13 0.19 0.13 0.30 0.06 ... 0.15 0.94 100 Hackney 24*3 13.6 1.37 0.26 0.19 0.20 0.29 0.09 ... 0.34 1.17 112 Central. Holborn 19.4 17.4 1.28 0.22 0.04 0.18 0.51 0.04 ... 0.29 2.58 131 Finsbury 29.8 18.7 1.83 0.51 0.18 0.17 0.54 0.02 ... 0.41 2.33 130 City of London 18.7 16.8 0.85 0.05 0.05 0.25 0.35 0.10 ... 0.05 2.02 94 East. Shoreditch 33.0 20.5 3.01 1.03 0.24 0.17 0.88 0.05 0.04 2.10 150 BETHNAL GREEN 31.8 17.5 1.06 0.54 0.33 0.14 0.46 0.05 ... 0.44 1.90 I38 Stepney 33.6 15.9 1.97 0.50 0.27 0.30 0.33 0.07 0.00 0.50 1.56 117 Poplar 31.0 16.9 2.11 0.56 0.26 0.29 0.48 0.06 ... 0.46 1.33 124 South. southwark 29.8 18.0 1.90 0.54 0.17 0.17 0.49 0.05 ... 0.48 2.03 138 Bermondsey 31.7 18.3 1.71 0.41 0.28 0.16 0.43 0.05 ... 0.38 1.88 123 Lambeth 24.6 14.6 1.28 0.34 0.13 0.15 0.35 0.02 ... 0.29 1.53 120 Battersea 25.5 13.3 1.34 0.38 0.10 0.21 0.38 0.02 ... 0.25 1.25 114 Wandsworth 25.6 12.3 1.16 0.23 0.00 0.14 0.40 0.04 ... 0.26 0.95 99 Camberwell 24.4 13.9 1.43 0.44 0.13 0.14 0.43 0.03 ... 0.26 1.31 115 Deptford 28.3 14.1 1.47 0.46 0.12 0.22 0.32 0.05 0.01 0.29 1.34 108 Greenwich 24.3 12.7 1.44 0.54 0.09 0.17 0.24 0.05 ... 0.35 1.08 100 Lewisham 23.9 11.5 0.85 0.11 0.08 0.12 0.34 0.01 ... 0.19 0.93 90 Woolwich 25.8 12.5 1.38 0.56 0.11 0.12 0.29 0.03 0.01 0.26 1.25 112 In this Table 0.00 indicates that the deaths were too few to give a rate of 0.005; where no death occurred,.. is inserted. † Called Simple Continued Fever previous to 1901. No deaths from Small Pox and Typhus SUMMARY. 1906 1907 Estimated Population of Bethnal Green— 130,609 130,831 Young Children, under 5 years 17,817 17,850 Old People, over 65 years 4,816 57,100 Area—755 Acres. Number of Inhabited Houses 14,906 14,882 Rateable Value £550,052 £550,500 Average number of Persons to each House ... 8.76 8.79 (1901 London Census 9.2). Average number of Persons to each Acre 174.3 173.3 (1901 London Census 170.8). Total number of Deaths in the year 2,458 2,281 Total number of Births in the year 4,430 4,152 Total number of Marriages 961 992 Marriage Rate—Bethnal Green 14.7 15.16 Marriage Rate—London 17.1 17.0 Death Rate—Bethnal Green 18.8 17.43 Death Rate—London 15.1 14.60 Birth Rate—Bethnal Green 33.9 31.74 Birth Rate—London 26.7 25.80 Infantile Death Rate (on Births)—Bethnal Green 157 138.23 Infantile Death Rate (on Births)—London 130 116.00 Young Children's Death Rate (on estimated number of Young Children) 59.1 49.90 Old People's Death Rate (on estimated number of Old People) 87.8 94.70 Zymotic Death Rate—Bethnal Green 2.5 1.92 Zymotic Death Rate—London 2.1 1.42 Inquest Cases 276 258 Uncertified Deaths (no Inquests held) 9 4 Metropolitan Borough of Bethnal Green. REPORT. TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE METROPOLITAN BOROUGH OF BETHNAL GREEN. Sir and Gentlemen, I have the honor to submit to you my thirty-second Annual Report on the Vital Statistics and Sanitary condition of the Borough of Bethnal Green. The report covers fifty-two weeks forming the Registration year 1907, which terminated on Saturday, December 28th, last. POPULATION. The Registrar General estimates the population of the Borough in the middle of the year 1907, at 130,831, an increase of 222 over the previous year. TABLE A. 1906. 1907. Estimated population in the middle of the year 130,609 130,831 Total Births 4,430 4,152 Total Deaths 2,485 2,281 Excess of Births over Deaths, shewing the natural increase of the population 1,972 1,871 8 *BIRTHS. The number of births registered during the year was 4,152 against 4,430 in the preceding year, a decrease of 333. The births exceeded the deaths by 1,871. Table "A" shews this and compares the two years. DEATHS. The weekly returns of the local registrars give particulars of 2,200 deaths in Bethnal Green during the year. This number indicates a crude death rate of 16.82. Amongst the deaths registered as occurring in the Borough are included those of 298 non-residents who were temporarily in-patients of Public Institutions situated in Bethnal Green. Twelve other persons, also non-residents, died sudden deaths or were found dead in the streets, water-ways or public places of Bethnal Green, they were:— A man aged 72 of Wanstead, died suddenly of heart disease at Globe Road Railway Station. A fish-hawker aged 53 of Kingsland Road, died in Bethnal Green Road from heart disease and chronic alcoholism. A boy aged 7 years, the son of a Hoxton Porter, was found drowned in the Regent's Canal. A Coffee-house keeper from Islington died from Hœmorrhage, caused by gastric ulcer, whilst on a visit to some friends at Evesham Houses. A newly born child was found drowned in Duckett's Canal. *On December 14th, the wife of a printer, residing in Kerbela Street, gave birth to triplets, a male and two females, they lived 2, 3 and 8 days, and died from inanition. 9 The seven weeks old daughter of a clerk residing in Mile End died from convulsions at 21, Theydon Road. A bricklayer aged 52 residing at Lower Edmonton died in Victoria Park Lavatory from Heart Disease. A labourer of Forest Gate, aged 35 was knocked down and decapitated by a light engine on the Great Eastern Railway near St. John Street Arch. The four months old son of a Clapton Clerk died in Goldsmith's Row from Bronchitis; and the two year old daughter of a porter residing in Islington died from Marasmus in the Hackney Road; both these children were on their way to the Queen's Hospital for children. A Painter aged 57 of Leatherdale Street, committed suicide by throwing himself under a train at Globe Road Station. A Hackney Cabinet Maker who was suffering from Phthisis died in Globe Road from Hœmorrhage. As none of these 310 persons resided in Bethnal Green during life, their deaths must be struck out from the number returned by Registrars. Rut in addition to the deaths actually registered in Bethnal Green I receive monthly, from Somerset House, lists of Bethnal Green residents who have died in various parts of London; these include particulars of 379 deaths in various Metropolitan Hospitals, and also of of twelve Bethnal Green people who died sudden or violent deaths in various parts of London and upon whom Coroner's Inquests were held:— 10 TABLE B. Public Institutions situated outside the Borough into which Bethnal Green residents have been received and where they subsequently died. Banstead Asylum 8 Belmont Asylum 2 Brompton Hospital 1 Cancer Hospital, Chelsea 1 Caterham Asylum 2 Children's Hospital, Paddington Green 1 City of London Lying in Hospital 2 Claybury Asylum 8 Colney Hatch Asylum 3 Dartford Heath Asylum 3 Eastern Hospital, Homerton 32 East London Hospital, Shadwell 12 Epileptic Colony, Epsom 1 French Hospital, Victoria Park 2 Friedenheim Hospital 4 German Hospital 6 Guy's Hospital 1 Hackney Infirmary 4 Hanwell Asylum 2 Horton Asylum 2 Hospital for Sick Children, Gt .Ormond Street 8 Infants' Hospital, Hampstead 1 King's College Hospital 2 Leavesden Asylum 7 London Hospital 186 London Temperance Hospital 1 Long Grove Asylum 1 Manor Asylum, Epsom 1 Metropolitan Hospital 8 Mile End Infirmary 3 11 National Hospital, Queen's Square 1 North Eastern Hospital, Tottenham 24 Poplar Hospital 1 Royal Chest Hospital, City Road 1 St. Ann's House, Stoke Newington 2 St. Bartholomew's Hospital 17 St. John's Hospital, Lee 1 St. Joseph's Hospice 2 St. Luke's House, Kensington 1 Shoredicch Infirmary 1 South Eastern Hospital, Deptford 8 Tooting Bee Asylum 2 University College Hospital 1 Wandsworth Infirmary 1 Whitechapel Infirmary 1 Twelve other deaths occurred as under:— At Huntingdon Street, Hoxton, the wife of a Fish Porter aged 58, fell into an area and fractured her skull. At Buxton Street, Mile End, a hoy aged 5, slipped off the pavement under the wheel of a passing trolley and was killed. A boot clicker aged 32, died at the Epileptic Colony from brain disease. As the result of a collision on Shooter's Hill, a carman aged 16 was thrown from his van and sustained fatal injuries. A rope spinner aged 50, hanged himself at 54, Bow Road. Three infants died at the Mother's Home in Commercial Road. The following persons from Bethnal Green were found drowned:— In the River Lea, near Lea Bridge, a labourer aged 25; verdict, drowning, temporary insanity. 12 In the River Lea, near Kingsford Bridge, a dock labourer aged 50; verdict, drowning, bat no evidence to shew how. In the River Thames, at Adelphi steps, a chairmaker, aged 32—verdict, suicide. In the River Thames at Ratcliff Cross Stairs, a Naval Pensioner who had fallen from a boat whilst painting H.M.S. Buzzard; verdict, accidentally drowned. These twelve deaths of persons ordinarily resident in Bethnal Green, together with the 379 Hospital deaths form a total of 391, and after adding these and subtracting the 310 non-residents, there remains a net total of 2,281. 13 TABLE C. Public Institutions in Bethnal Green. INSTITUTIONS. Beds Available. In-patients Treated. DEATHS. Out-patients Treated. Residents. Non-Residents. City of London Hospital for Diseases of the Chest 140 956 5 51 9,493 North-Eastern Hospital for Children, Hackney Road 130 1,482 67 164 26,073 Mildmay Mission Hospital 50 640 17 14 13,581 Bethnal House Asylum 300 — 5 34 — Bethnal Green Infirmary and Workhouse 669 3,823 590 27 — Children's Home, Bonner Road 288 (20 in Hospital) in addition. — 2 1 — 14 TABLE D. Deaths in Sub-districts. DISTRICT. Deaths. Estimated Population. North East 1,069 65,716 South West 1,178 65,115 Previous Residence unknown 34 — Total 2,281 130,831 In the North East District, out of an estimated population of 65,716, there were 1,069 deaths; in the South West District, out of 65,115, there were 1,178; in addition to these, thirty-four homeless persons died in the Workhouse or Infirmary; these persons either could not or would not give any information to the authorities as to the Parish to which they were chargeable. As probably a similar condition of things obtains in every Poor-law district throughout London, these Workhouse deaths are properly included in calculating the general mortality of the Borough; but I do not take them into consideration when dealing with the Sub-districts. DEATH RATE. On the corrected number of deaths we show a mortality for the year 1907 of 17.43, this is 1.4 per thousand below the rate for the previous year, but is nearly three (2.83) per thousand above the general Metropolitan rate. The death rate for the whole of London was 14.6, and was 0.5 below that of the previous year. 15 MORTALITY RATES IN SUB-DISTRICTS. On the basis of the estimated population in the North-East sub-district I calculate a mortality of 16.3 per thousand, and for the South-West sub-district one of 18.1 per thousand. These rates are exclusive of the deaths of homeless persons. The next table shews the mortality rates for London and for Bethnal Green compared by months; the rainfall and the mean temperature are also shewn for each period. TABLE E. Month. London Death Rate. Bethnal Green Death Rate. Mean Temperature. Rainfall (inches). January 20.6 23.1 38.6 0.91 February 19.0 22.8 37.9 1.17 March 17.6 19.7 44.9 0.97 April 16.5 20.7 48.1 3.22 May 14.6 16.3 54.6 1.74 June 12.8 13.8 58.7 2.03 July 11.9 13.4 60.7 I .96 August 11.8 13.3 61.5 1.94 September 12.6 14.7 59..9 0.62 October ... 14.1 16.5 52.0 2.52 November 15.1 18.3 45.7 2.16 December 15.7 17.5 41.8 3.79 Average 14.6 17.4 50.4 Total Rainfall, 23.03 16 The following table compares the death rates for Bethnal Green and for London by quarters:- TABLE F. Quarter ending. London. Bethnal Green. March 30th 18.3 21.9 June 29th 14.0 16.8 September 28th 11.5 13.7 December 28th 14.3 17.5 Yearly Average 14.6 17.4 BIRTH RATE. The births registered during the year numbered 4152, and are equal to a rate of 31.74 per thousand population. This rate is over two (2.18) per thousand below that of the preceding year, which was 33.92. The general Metropolitan rate has decreased and stands at 25.8. This is the lowest on record and is about six per thousand below our own. In the registration sub-districts of the Borough the birth rates were as under; for purposes of comparison the death rate in each sub-district is also shewn:— TABLE G. Sub-Districts. Birth Rate. Death Rate. North-East 29.35 16.3 South-West 33.28 18.1 17 TABLE H. MARRIAGES. First Quarter 220 Second Quarter 191 Third Quarter 265 Fourth Quarter 316 Total 992 These figures indicate a marriage rate of 15.6 to every thousand persons, as against 17.0 in the County of London. TABLE I. Infantile Deaths. Proportion of Deaths to 1,000 Births. Diseases. England and Wales. Average 1901-1905. Hethnal Green. 1907. Diarrheal Diseases. Diarrhoea, Gastro-Knteritis, etc 25.44 18.54 Ante-Natal Causes. Premature Birth, Injury at Birth, Congenital Defects 26.86 33.71 Respiratory Diseases. Bronchitis, Pneumonia 23.14 27'.70 Wasting Diseases. Atrophy, Marasmus, Want of Breast Milk 18.55 13.97 Convulsive Diseases. Including non-tuberculous meningitis 16.60 8.43 Common Infectious Diseases. 8.67 10.84 Tubercular Diseases 5.91 7.78 Other Causes 12.65 17.34 Total 137.82 138.23 B, 18 Proportion of Illegitimate Births to Legitimate, 1906. births. Bethnal Green. Illegitimate Births, 58 in 4,453 = 1.3 p.c. London. „ „ 4,868 „ 126,392 = 3.9 p.c. England & Wales. „ „ 37,390 ,, 935,081 = 4.0 P.c. DEATHS OF INFANTS. One fourth (25.17 per cent.) of the total deaths from all causes were those of infants aged less than twelve months; 4,152 children were born alive during the year but only 3,578 survived twelve months, the rest (574,) having succumbed to various diseases. A mortality calculated upon these figures gives a rate of 138 deaths per thousand births. We shew some improvement in this direction over 1906 as in that year the rate was 158, twenty in excess of the year under consideration. The general Metropolitan rate has also fallen and stands at 116, against 130 for the previous year. In the first quarter of the year the infantile deaths were 131 per thousand births; in the June quarter they were 137; in the September quarter 122; and in the last quarter they rose to 173. In the appendix is a set of tables prepared in accordance with instructions from the Local Government Board referring exclusively to infantile deaths. Of the total 574 deaths of infants, 108, a proportion of 188 per cent. occurred in the first week of existence and 188 or 32.7 per cent. in the first four weeks after birth. 19 In the second month 9.2, and in the third 7.6 per cent. of the total infantile deaths from all causes occurred. Referring to table five and classifying the chief causes of infantile deaths in the order of fatality we find them as under:— Premature birth and congenital defects 140 equals 24.4 per cent. Respiratory diseases 115 ,, 20.0 „ Diarrhœal diseases 77 „ 13.4 „ Wasting diseases 58 „ 10.1 „ Common infectious diseases 45 „ 7.8 „ Convulsive diseases 35 ,, 6.1 „ Tubercular diseases 32 ,, 5.5 ,, Suffocation 32 „ 5.5 „ In my annual Report for 1895 I drew attention to the increasing uneasiness evinced not only by Sanitary Authorities, but also by the general public at the frightful waste of infant life throughout the country, as revealed by the reports of the Registrar General. In Sir William Dunbar's recently published report, that for the year 1906, the following remarks will be found on page xxxvii:— Infantile mortality.— The deaths of infants under one year of age registered in England and Wales in the year 1906, numbered 123,895, and were in the proportion of 132 per thousand births. Although this rate was four per thousand above that registered in 1905, it was fifteen per thousand below the mean proportion in the ten years 1896-1905. In the year 1899, the rate had risen to 163 per thousand births; since that date, however, it has with fluctuations, shewn an appreciable decline. 20 In the course of the forty years ended in 1900, the corrected death rate at all ages had fallen by about fifteen per cent., but no such corresponding reduction could be recorded in the proportion of deaths of children under one year of age; since the close of the century, however, the subject of the waste of infant life, formerly treated with apathy, has received close and increasing attention from all classes of the community, and to this awakening may fairly be ascribed some portion of the decline in the rate of infantile mortality that has taken place during the past few years. In Sir Shirley Murphy's last published report for the same year (1906), issued in February last, a table is given which shews the average infantile mortality in each of the Metropolitan Boroughs calculated upon the births for the five years 1901-1905; this table states the infantile death rate in Bethnal Green to be an average of 150 deaths in proportion to each thousand children born alive. This mortality is exceeded in five of the other Metropolitan Boroughs Shoreditch 173, Finsbury 160, Bermondsey 159, Southwark 158, and Poplar 154. In the other Metropolitan Boroughs the deaths were fewer in proportion to the births than in Bethnal Green, the lowest being in Hampstead with 95. The proportion for the whole of London is 139. The average birth rate in Bethnal Green during the five years was 35.2; the highest in London with the exception of Stepney which was 36.7; the London birth rate for the same period was 28.0. Usually a high birth rate entails a high infantile death rate but exceptionally (as in the case with France) a comparatively high infantile mortality is coincident with a low birth rate. 21 In this connection the following list of average vital statistics extracted from the last annual report of the Registrar General will be read with interest. AVERAGES (TEN YEARS 1896 to 1905.) Country. Birth Rate. Infantile Death Rate per 1,000 births. General Death Rate per 1,000 living. European Russia 48.7 268 33.6 Austria ... 36.4 223 24.9 German Empire 35.2 199 20.6 Spain 34.8 178 27.5 Italy 33.3 168 22.4 Belgium 28.3 153 17.5 Japan 31.4 153 20.8 France 21.6 149 20.1 England and Wales 28.7 147 16.8 Switzerland 28.3 139 17.9 Denmark 29.5 126 15.6 Scotland 29.5 125 17.4 Ireland 23.2 102 17.9 Queensland 27.7 99 11.7 Norway 29.4 88 15.1 (Compared with these figures those in Bethnal Green read 35.8, 161 and 19. 0 respectively.) The infantile death rate in Russia has recently risen to the enormous figure of 322. SPECIAL CAUSES OF DEATH. Diarrhoea caused 77 deaths of infants against 150 in 1906; a rate of 18 per thousand births, as against an average of 25 per thousand for the whole of England and Wales. 22 Usually diarrhœal diseases are responsible for one fourth of our infantile mortality, but if the records for a series of years be examined, it will be found that the actual number of deaths varies from year to year, and that these fluctuations are influenced by variations of summer temperature and rainfall. A hot, dry summer is much more fatal than a cool, rainy one; diarrhoea is a filth disease, and flies and floating dust are mainly responsible for the distribution of that filth. Nearly all the diarrhœal deaths occur in the Autumn; and during the third quarter of last year the earth temperature was low and the rainfall excessive. This accounts for the fact that the number of deaths from infantile diarrhœal diseases fell from 150 in 1906 to 77 in 1907. The greatest risk of an infant dying from diarrhœa appears to be in the third and fourth months of its life. The mortality amongst artificially fed infants from this disease is much greater than amongst those who are naturally suckled. Farinaceous and most patent foods are very hurtful to young infants, though quite suitable for older children; their sale should be restricted by law. In France the sale of these indigestible farinaceous foods for infants is prohibited by the "Roussell" law which also forbids the use of feeding bottles with tubes and of "dummy comforters" Dr. Newsholme the recently appointed Medical Officer to the Local Government Board and formerly M.O.H. for Brighton has made a careful investigation into the effect of the various methods of infant feeding and has arrived at the following conclusions:— 23 "It is twice as dangerous to feed babies on condensed milk as on fresh cow's milk, that it is fifty-four times as dangerous to feed a baby on cow's milk and 156 times as dangerous to feed a baby on condensed milk as on mother's milk." Next in importance are the various ante-natal influences to which are attributable nearly a fourth of the infantile deaths throughout the Kingdom, Amongst these causes premature birth comes first; very few immature infants survive the first month of of life and a large proportion die during the first week. As still births, which are due to identical causes, are not registered it is impossible to estimate the total wastage due to immaturity. Last year 140, a proportion of 24.4 per cent of the whole infantile deaths in Bethnal Green were due to these ante-natal causes, a rate of 33.7 per thousand births as against 26.8 for England and Wales. As Bethnal Green has almost entirely a working class population this is scarcely to be wondered at. The causation of these deaths is, and always will be, to a great extent outside the control of Borough Councils, for it depends upon circumstances in which they are almost helpless. Any measures having for their object the reduction of this mortality must be directed to improve the condition and environment of the mothers during the last months of pregnancy. The chief unfavourable influences are:— (а) The employment of pregnant women in certain trades. (b) Ignorance and want of care (c) Illegitimacy. 24 (d) Poverty, with its consequent overcrowding, foul air and partial starvation. (e) And last, but not least, the feeling of misery and hopelessness which drives women to drown their sorrows in drink. (a) The first of these unfavourable influences, the employment of pregnant women, was the chief subject of discussion at a largely attended conference on infantile mortality at the Home Office in January last. The law at present forbids the employment of women in factories and workshops for a period of four weeks after childbirth, but it is silent as to the employment of pregnant women. It is well known that severe or prolonged exertion and especially the use of pedal sewing machines is injurions to pregnant women, also that working at certain dangerous trades which involves the handling of poisonous materials, (e.g., lead), is very apt to cause them to abort; but beyond these broad facts there is no definite statistical information available as to the effect upon motherhood and childbearing, of employment in factories during pregnancy. The Home Office Authorities propose that each Medical Officer of Health throughout the kingdom shall, during the year 1908, investigate the births taking place in his district with a view to ascertain the nature and duration of the employment of the mothers both before and after confinement; subsequent enquiries are to be made as to the method adopted for feeding and rearing the infant, and by a second and third visit the condition and health of the child at the ages of six and twelve 25 months, if alive, and if not the cause of death. When the results of these investigations are reduced to figures the Government will be in a position to decide whether or no it will be advisable to initiate legislation with a view to prohibit the employment of pregnant women in certain trades, and to still further restrict employment after childbirth. Should Parliament enact such restriction it will be impossible to enforce the law unless provision be made at the same time to compensate expectant and recent mothers for loss of employment; a system which provides for this already obtains in Denmark and some other countries. At the Home Office conference, Dr. Reid, the Medical Officer of Health for Staffordshire stated as his opinion that :— The restriction now imposed by law of one month's abstention from work after her confinement is advantageous to the mother, but it does not materially benefit the child. If however, the restriction extended to three months, the probability is that the mother would suckle her child during that time, and thus the most precarious period of the infant's life would be tided over, and the chances of subsequent survival would be considerably enhanced. (b) Ignorance and want of care. This is a fruitful source of fatality ; a good-looking factory girl usually marries young, most probably she has received no household training, has never been out to service, but has started work on leaving school, what can such a girl know of the cares and responsibilities of motherhood? 26 (c) Illegitimacy. The waste of life amongst illegitimate children is enormous ; suc h unfortunates experience a death rate which is higher by 106 per cent, than that of legitimate infants. We are fairly moral in Bethnal Green as the illegitimate births in the Borough form only 1.3 per cent, of the total registered births against 3.6 per cent, for the whole of London. (d) Poverty. The effects of poverty, largely caused by want of employment, are chiefly experienced in the winter months, when the expense of firing has to be added to current outgoings ; at this time of year clothing and bedding are usually insufficient and heat must be economised at the expense of ventilation. The difficulty experienced in dealing with overcrowding, one of the worst results of poverty, is well shewn in the report of my colleague Mr. Foot, to whom is entrusted the enforcement of the law against overcrowding and I cannot do better than to quote his words:— "Families have been turned out time after time, and hunted from one tenement to another, and from there on again. One poor wretched family was turned out five times in about as many months. We are of course, carrying out the law, just as we have been doing for some years past, but in the result we do not appear to help these people very much, and the question still remains how to house the lower class worker's family, requiring an average rental of 7/9 per week on their present income. "Preaching and passing resolutions does not, unfortunately, provide any effective remedy and until our Government recognizes that overcrowding, with its attendant evils is an economic question right through, we shall remain just about where we are in the matter." 27 (e) Drink. This is too big a subject for me to more than glance at here but its evil effects are incalculable. Alcoholic parents cannot breed healthy children. The third great cause of infantile mortality is the class of respiratory diseases, which was last year responsible for 115 deaths; a rate of 28 per thousand births as against an average of 23 per thousand for England and Wales. Nearly three-fourths of the total mortality from bronchitis amongst children under the age of five years occurs within a year of birth. The statistics prepared by the Registrar General appear to shew that it is in the second month after birth rather than the first that Bronchitis levies its heaviest death toll. Again igorance, bad nursing and overcrowding with its consequent foul atmosphere, pave the way for the chill which results in fatal bronchitis or pneumonia. Dr. George Newman, the recently appointed medical officer to the Board of Education reported that in Finsbury in 1905,— "The infant mortality in one room tenements (532 births in all) was 219 per thousand, in two roomed tenements (1,216 births) it it was 157 per thousand; in three roomed 141 per thousand; in four roomed 99; and in institutions and houses of more than four rooms only 37 per thousand. Wasting diseases (Atrophy, Marasmus and want of breast milk) caused 58 deaths, a rate of fourteen per thousand as against 18½ per thousand for England and Wales. Most of the deaths in this group are the result of improper feeding. The subject of infant 28 feeding was considered in my report for 1905, and the crass ignorance of first principles shewn by many nursing mothers was my chief reason for urging upon the Borough Council the appointment of a woman inspector and Health Visitor. Mr. Phipps the Chairman of the Public Health Committee took great interest in the subject and at his suggestion a card of simple instructions was prepared and distributed by Miss Harris the newly appointed officer. It is much too early to say what the result of this action may be, but it can do no harm and may save many lives. Convulsive diseases, which include non-tuberculous meningitis caused 35 deaths, a rate of eight and half per thousand as against sixteen per thousand for England and Wales; this calls for no special remark. Common infectious diseases caused 45 deaths, three fourths of which were due to whooping-cough, there were eleven deaths from measles and five from scarlet fever. Next I take Tubercular diseases which caused 32 deaths ; a mortality of about eight per thousand as against six per thousand for England and Wales. I believe most of these deaths were from inherited forms of the disease, for only nine infants died from tubercular disease of the bowels, the local infection usually considered to be due to the ingestion of milk from tuberculous cows, a danger which is much exaggerated. East of all 32 deaths were returned by the Coroner as due to suffocation. Twenty-eight of the infants who died 29 from this cause were found dead in bed, and the death was undoubtedly due to the ignorant and almost criminal practice of putting an infant to sleep in the same bed as its parents. The little creature easily slips down beneath the bedclothes and soon passes from sleep to death. Possibly on such an occasion the parents may have slept heavily and without being drunk may have had an extra glass of liquor. The only excuse for this custom is that the infant requires the warmth of its mother's body but this is not so. It is quite easy to make up a little bed for the baby on two chairs; no elaborate cradle is necessary as an empty orange box is all that is required. To sum up; there are three main causes of infantile mortality:—Poverty, Ignorance and Drink, and the greatest of these is Poverty. Now what are the remedies for these evils? How shall we deal with them ? For ignorance there is no excuse, children at school can and should be taught household management and the simple rules of health; properly trained Health Visitors can instruct and guide mothers who have not had the advantage of efficient teaching. But what shall we do with poverty and its resulting misery and drunkenness ? Healthy infants cannot be reared in unhealthy surroundings, overcrowded rooms,foul smelling and insanitary, make the worst possible nurseries ; but if parents are too poor to provide additional accommodation as their families increase who is to do it for them ? It is common knowledge that although the nation as a 30 whole is becoming more sober, drunkenness is increasing amongst women. I do not believe that women take to liquor because they like it, anyway at first, but because they are driven by the wretchedness of their surroundings and the hopelessness of their outlook to drown their miseries in alcohol. Men are led to drink by example and association, but women are usually secret drinkers and take alcohol for its numbing effects, and by the way they have scriptural warrant for this, in the seventh verse of the last Chapter of the Book of Proverbs where King Solomon says "Let him drink and forget his poverty and remember his misery no more." Probably the wise man did not intend to include women when he wrote these words, but the effect of poverty is the same now as it was two thousand years ago, and women drink to forget. Again and again I repeat—alleviate misery and you destroy the main temptation to alcoholic intoxication. More sanitary surroundings would go a long way towards this end. Sufficient fairly paid employment would enable husbands to provide their wives with better food and better housing and thereby do much to achieve our object, the diminution of the wastage of infant life. 31 REPORT OF THE WORK done by the Woman Sanitary Inspector, DURING YEAR 1907. To the Medical Officer of Health— SIR, I beg to submit to you a report of the work done by me in this Borough during the year 1907. The inspections made (which numbered in all 3,473) may be classified as follows :— Workshops 347 After Confinement 831 Re-inspections 1069 Infants' Deaths 262 Illnesses 942 Special 15 Early in the year some slight change was made in my duties—the inspection of outworkers' premises was exchanged for that of houses where cases of Measles and Chicken Pox occur. The fact may perhaps here be mentioned that in every case, whatever may have been the reason for calling, I have been well received, and the information required willingly supplied, 32 WORKSHOPS. At the beginning of the year there were 178 workshops and workplaces where women are employed on my list: and to these 347 visits have been paid; 42 have been removed, in some cases owing to the fact that the business has been discontinued, or in others that the premises have become a factory. There has been such a scarcity of work during the period under consideration that it is no unusual thing to find that where outsiders had been previously employed the little work now obtainable can be done by members of the family—or even by only one of them. • The condition of the workrooms in this Borough is on the whole fair, and the employers are generally very ready to meet the wishes of the Sanitary Authority. The great difficulty appears to be with regard to ventilation, and this is often the fault of the employees. Fresh air is, more often than not, called "a draught"— so the purity of the atmosphere is sacrificed for its warmth, and where ample means of ventilation exist there is no attempt (and even great objection) to using them. And they will light the gas to warm the room whenever the temperature is below a comfortable degree, regardless, and often in ignorance, of the fact that the impurity of the air is thereby seriously increased. The number of unventilated gas stoves used for heating irons is decreasing, as wherever found, it is required that flues be provided. One thousand three hundred and two women and young female persons are employed in the women's workshops in this Borough ; and they are engaged in the following trades:— 88 Trades. North. South. Wards. Totals. East. West. Tailoring 3 1 15 7 26 Laundries 3 4 11 5 23 Boots 6 3 7 1 17 Dress Making — 1 9 6 16 Cabinet Polishing 2 1 — 2 5 Millinery — 1 2 1 4 Upholsterer's Trimmings i 1 2 — 4 Tie Making — 1 2 — 3 Furriers — — — 3 3 Nursery Shoes i — 2 — 3 Tuft Cutting i 1 1 — 3 Card-board Boxes — 2 — — 2 Baby Linen — 1 1 — 2 Silk Belts i — 1 — 2 Button Holing i — 1 — 2 Cloth Caps — — 1 1 2 Silk Weaving — — 2 — 2 Purse and Bag Making — — 1 1 2 Blouse Making i — — — 1 Corsets — — — 1 1 Bonnet and Hat Shapes — — — 1 1 Fancy Aprons & Underclothing — — 1 — 1 Ostrich Feather Manufacturing — — 1 — 1 Embroidery — — 1 — 1 Hair Manufacturing — 1 — — 1 Waterproofing — — 1 — 1 Clay Pipe Making — — 1 — 1 Pickle Making — 1 — — 1 Oil Packing — 1 — — 1 Show Card Mounting — i — — 1 Wooden Toys — — — 1 1 Tin Toys and Boxes — — 1 — 1 Marine Store i — — — 1 Totals 21 21 64 30 136 During the latter half of the year I have made enquiries among the employers as well as the mothers themselves, with a view to obtaining some definite idea as to the extent to which the mothers of young children are employed. I was informed by many employers that the mothers of young children are not considered very 34 satisfactory workers, as they so often arrive at their work place unpunctually, or absent themselves altogether, owing to the demands made upon their time and attention by their children. The employers therefore give the preference to unmarried women or those mothers whose children are older and more able to look after themselves. It follows therefore that the employment of the mothers of young children does not obtain to any very great extent: and that this is so the following figures show:— Of 1,302 Women Employed in Workshops in this Borough only 91 (less than 7%) are the mothers of children under 5 years, while among 1,859 mothers interviewed for different reasons during this year, only 136 go out to work in workshops, (4.9%). A further 4% are employed as charwomen, school cleaners, hawkers and the like; about 8% are outworkers, and the remainder (83.1%) are not employed. In the great majority of cases, expectant mothers give up their work some time (from 1-2 months is usual) before their confinement. In some work places there is a rule that they shall do so; where they are allowed to do as they please, and work is continued later, poverty is the reason given. It is a usual practice also to allow 2 or 3 months to elapse after confinement before returning to work. There are exceptions to this rule too, and again poverty is the alleged cause. The worst cases that have come under my notice during the year, are these :— (a) Mrs. R., (widow; the mother of an illegitimate child) returned to work when the child was 14 days old. (b) Mrs. W., married. Husband out of work. Returned to work when her infant was 3 weeks old (c) Mrs. B., school cleaner for L.C.C. Husband out of work, returned 28 days after confinement. (d) Mrs. S. Husband deserted her before the child was born. Worked till a few hours before confinement, and returned 3 weeks after. 35 (e) Amelia F., unmarried, worked till the day her child was born. (f) Miss S., (unmarried), in service till two days before birth of child, returned at end of month. (g) Mrs. T. Husband deserted her 8 months before confinement. Worked as machinist in factory till a few days before birth of child. (h) Mrs. H., office cleaner, worked till day of confinement. These are the worst cases I have found among women going out to work, but outworkers frequently carry on their work practically all the time. The women do not inform their employer of the occurrence of their confinement, but get some one to fetch and return their work at the usual times. BIRTHS. Five hundred and thirty eight births were notified, involving 838 visits, and eventually 35 cases were not found as the addresses were incorrect. 416 of these infants were found to be entirely breast fed. 93.5% 6 partly breast fed. 1.3% 18 hand fed. 3.7% while 7 had died within a few hours, and had therefore no food at all. 1.5%. Four of the hand fed babies were so fed by the order of the doctor attending. Fourteen of them were fed with cow's milk, three with Nestle's milk and one on Allenbury's Food. Of the six partly breast fed infants, three were given Nursery biscuits in addition, two oatmeal, and one boiled bread with cow's or Nestle's milk. Irregularity marks the methods of many of the mothers. They feed the bady "when it cries." They say it is "entirely breast fed," but often careful enquiry brings out the fact that it also sometimes 36 has a crust to suck, or a "a bit of what we're having ourselves" (this though on re-inspection at a later period). They obtain their milk sometimes from one dairyman, or sometimes from another, When it happens to be convenient, the child is fairly regularly bathed, but at other times this practice is dropped, and is very generally discontinued after a few weeks. But in nearly every case a baby's "comforter" is used, and when advised against its use, the mothers say, "They must have something to keep it quiet," and "It is always kept clean." This latter statement is often obviously untrue, and the mothers do not take into account "dirt" that is not visible. Apart from the fact that the houses are often badly planned, badly built, and badly arranged, the homes are, on the whole "fair." Where nuisances exist, they are dealt with as they are discovered. And it must of course be remembered that the majority of my visits are paid to houses where there is, or has very recently been, a doctor or nurse in attendance; and as efforts are made to have their homes presentable at such times, my visits are perhaps often paid in exceptionally favourable circumstances. DEATHS. The deaths of 192 infants under one year were referred to me for investigation. Of that number 12 were not found, so that information concerning the child and its treatment was obtained in 180 cases only. 61 were said to have been entirely breast fed. 17 partly breast fed. 88 hand fed. Six were born and died in a Hospital or Institution, so that no information beyond this fact was obtained; and 8 who died in hospital were said to have been entirely breast fed till they went there. Forty-two had cow's milk alone; five cow's milk and bread; two cow's milk and Ridge's Food; two cow's milk and Allenbury's Food; one cow's milk and Mellin's Food; one cow's milk and 37 Virol; seven cow's milk and Nestle's milk; twenty-three Nestle's milk only; one Nestle's milk and Nursery biscuit; one Nestle's milk and Mellin's Food; one Nestle's milk and Ridge's Food; one Nestle's milk and Semolina. Of the partly breast fed infants, seven had cow's milk and seven Nestle's milk in addition, while two were given boiled bread, and one Nursery biscuit, with just a little sugar or butter and no milk. Bottles with rubber tubes were used in twenty-seven cases, and nineteen mothers preferred to use no bottle at all, but fed the child from a feeding cup, or with a spoon. In fifty-nine cases boat shaped feeding bottles of various makes were used. DIARRHCEAL DEATHS. Enquiries were made as to the method of feeding in the case of sixty-two infants who died during the year from diarrhoeal diseases. In almost every case I was informed that the child had been very delicate from birth, and often, that it was only with the greatest care that it had been kept so long alive. It was found that seventeen (27.4%) were entirely breast fed, and seven (11.3) were partially so fed. Four of these last were given cow's milk only, in addition to the natural food ; and of the other three, one had Nursery biscuit, one cornflour, and one bread, prepared in each case with Nestle's milk. Many mothers who can only partly breast feed their children, think that cow's milk would disagree, and they must therefore supplement in some other way. Twenty-two hand fed infants had cow's milk only; nine Nestle's milk only; three had both; two cow's milk or bread; and two cow's milk and Ridge's Food. That the mothers are beginning to realize the danger of the bottle with the rubber tube would seem to be proved by the fact that twenty-two boat shaped bottles were used as against twelve with the tube; and that five mothers used no bottle of any kind, but fed from a feeding cup or with a spoon. 38 RE-INSPECTION. When the period arrived for the re-inspection of those infants who had been visited shortly after their birth, much time and labour were fruitlessly spent. It was usually necessary to make several calls before the mother was found at home. Eventually 375 infants were re-inspected at between four and six months of age, and 219 at about 12 months. Among the year old babies, 27 per cent, were found to be still entirely breast fed, quite a number of mothers remarking that they begin to wean a baby on its first birthday. Many mothers too, keep a baby at the breast as long as they can possibly do so, it thus being quite a common thing to find two year old children still partly breast fed. To enumerate all the things that are given to a year old child for food would be a lengthy proceeding; but the articles most favoured are perhaps bread and milk, eggs, fish, oatmeal, cornflour, nursery biscuits, rice, and the various patent foods, and in addition very often, a little of what the rest of the family may be having. It was found that between four or six months 43 per cent, of the infants were entirely breast fed ; 27 per cent, partly breast and partly hand fed ; and 30 per cent, entirely hand fed, the food given being Cow's Milk in 47 cases Nestle's „ ,, 28 Nursery biscuit „ 8 Bread and Milk „ 9 Ridge's food „ 7 Boiled bread ,, 7 Oatmeal „ 5 There is little subject for remark in the cases of measles and Chicken pox notified from the Schools. Incorrect addresses are often given, and cause much waste of time. Disinfection is offered, and though frequently declined is occasionally accepted; and where nuisances exist these are dealt with. In many cases where there is no doctor in attendance, it is to be feared that children do not receive the attention they need, and frequently become sources of danger to others. For this is 39 what happens: The child is obviously unwell, and has a slight rash. The mother thinks it has measles, gives it saffron and brandy and keeps it warm. In a few days the child feels better, and on regaining its normal spirits is noisy und troublesome in the house. Whereupon the mother thinks perhaps it was not measles after all, but only a cold, and the child is allowed then to return to school. It is alleged too by the mothers that the Attendance Officers tell them that measles is not a serious complaint; that the children are better in warm, light, airy school rooms than in their own stuffy homes; and that they must send the children to school as soon as possible. Thus encouraged they do send them back—much too soon. One other matter calls for remark. The cards of "Advice to Mothers" have been widely distributed, They are usually received with some remark as to their usefulness, and of appreciation that such things are. But I have not yet in many cases found the cards in evidence at a subsequent visit. They are sometimes handed on to a relative or friend; sometimes put away so carefully that when wanted they cannot be found; and on two occasions I know that they fell into the hands of the children of the family. But as at the time that they are given, attention is directed to the most important points, they no doubt help to impress these on the mother's mind. I am, Sir, Yours faithfully A. K. HARRIS. DEATHS OF YOUNG CHILDREN. The deaths of young children aged less than five years numbered 829, and form 39.1 per cent, of the deaths from all causes; this is equivalent to a rate of 49.9 Per thousand calculated upon the estimated population of young children. 40 ELDERLY PERSONS DEATH RATE. Of the 2,281 deaths of all ages, 457, were those of persons aged over 65 years, a proportion of twenty per cent. This gives a death rate, calculated upon the estimated population of elderly persons of 947. WEEKLY MORTALITY. The line on the chart of deaths from all causes indicates the number of deaths in the Borough week by week corrected for institution deaths. QUARTERLY AND ANNUAL DEATHS AND MORTALITY RATES. Tables K and L overleaf, shew in addition to actual numbers of deaths, quarterly and annual rates of mortality for the principal Zymotic diseases and for Phthisis in Bethnal Green and in the whole of London. Particulars of birth and death rates and of infantile death rates are also given. 1907. Deaths from all causes 42 43 TABLES K & L. 1907 Estimated Population in the middle of 1907. Births. Deaths. All causes. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus. Enteric Fever. Pyrexia. Diarrhoea. 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. Diarrhoea. Phthisis. Deaths under 1 year to 1000 Births Registered. Borough of Bethnal Green:- l 2 3 4 5 6 7 8 9 10 l1 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 March 30th 130,831 1,123 715 — 31 6 7 19 — — — 4 90 147 21.9 2.05 — 0.95 0.18 0.22 0.58 — — — 0.12 2.76 131 June 29th 130,831 1,015 548 — 22 10 5 20 — — — 8 52 139 16.8 1.99 — 0.67 0.31 0.15 0.61 — — 0.25 1.59 137 September 28th 130,831 1,006 448 — 11 14 1 15 — 1 — 24 41 123 13.7 2.03 — 0.34 0.43 0.03 0.46 — 0.03 — 0.74 1.26 122 December 28th 130,831 953 570 — 7 13 5 6 — 6 — 21 65 165 17.5 1.76 — 0.21 0.40 0.15 0.18 — 0.18 — 0.64 1.99 173 130,831 4,097* 2281 — 71 43 18 60 — 7 — 57 248 574 17.5 1.96 0.54 0.33 0.14 0.46 — 0.05 — 0.44 1.90 138 County of London:— March 30th 4,758,218 31,708 21,969 — 461 104 222 534 — 56 1 194 2,056 4,195 18.5 1.33 0.39 0.09 0.19 0.45 — 0.05 0.00 0.16 1.73 132 June 29th 4,758,218 31,645 16,626 — 657 141 157 675 — 33 1 193 1.676 3,182 14.0 1.56 — 0.55 0.12 0.13 0.57 — 0.03 0.00 0.16 1.41 101 September 28th 4,758,218 29,914 13,677 — 404 168 162 364 — 39 1 540 1,330 2,936 11.5 1.42 — 0.34 0.14 0.14 0.31 — 0.03 0.00 0.46 1.12 98 December 28th 4,758,218 28,938 16,996 — 279 231 240 213 — 66 1 583 1,592 3,801 14.3 1.36 — 0.24 0.19 0.20 0.18 — 0.06 o.oo 0.49 1.34 131 4 758,218 122 205 69,268 — 1,801 644 781 1.786 — 194 4 1,510 6,654 14,114 14.6 1.42 — 0.38 0.13 0.16 0.38 — 0.04 0.00 0.32 1.40 115 * This figure does not include births in Lying-in Institutions outside Bethnal Green, 44 THE SEVEN PRINCIPAL ZYMOTIC DISEASES. Included in the Zymotic mortality are the deaths from the seven diseases usually placed in this class and upon which the Zymotic mortality rate is calculated. The total number of deaths from these seven diseases, including seventy six in hospital, was 251 against 331 in 1906, a decrease of eighty. Table "M" shews the relative proportion of deaths in hospital and at their own homes of the sufferers from Zymotic diseases. TABLE M. Disease. Deaths at Home. Deaths in Hospital. Total. Scarlet Fever 4 39 43 Diphtheria — 18 18 Enteric Fever 7 — 7 Erysipelas 5 2 7 Measles 70 1 71 Diarrhoea 47 12 50 The total Zymotic deaths for the year were 116 below the decennial average (for the ten years, 1897 to 1906.) Table VI in the appendix shews this average to be 367. Table "N" compares the deaths from each of the Zymotic diseases in the two years 1906 to 1907, a glance at it shews that the increase in the mortality is confined to Scarlet Fever, the deaths from which doubled those of the previous year, all the other diseases shewed a considerable decrease. 45 The total deaths included in table "N" form eleven per cent, of the total mortality from all causes. TABLE N. 1907. 1900. Measles 71 60 Scarlet Fever 43 22 Diphtheria 18 20 Whooping Cough 53 63 Typhus Fever — — Enteric Fever 7 14 Diarrhoea 59 152 Totals 251 331 The death rate from these seven Zymotic diseases is 1.92 against 2.5 in 1906, whilst the corresponding Metropolitan rates are 2.1 and 1.42. Table "O" shews the percentage of deaths from each disease on the total number of Zymotic deaths. TABLE O. Measles caused 71 deaths, 28.3 per cent., or 1 in 8-5 deaths. Scarlatina 48 17.1 5.8 „ Diphtheria 18 7.2 13.9 „ Whooping Cough 53 21.1 4.7 „ Typhus Fever „ „ „ Enteric Fever 7 2.8 35.8 „ Diarrhoea 59 23.5 4.2 „ 46 NOTIFICATION OF INFECTIOUS DISEASE. The total number of notification certificates received during the year, including eight relating to Cerebrospinal Meningitis, was 1,999; of these 105 were duplicates, a proportion of five per cent, on the whole number. On the 20th of February 1907 the Local Government Board issued a circular relative to Cerebro-spinal or spotted fever. The circular, a print of which will be found in the appendix pointed out that the disease had recently been somewhat prevalent in parts of Ireland and Scotland but that there was no ground for apprehension in the matter. It however appeared to the Board that Sanitary Authorities should be on the alert to detect the presence of the disease in their districts or to satisfy themselves as to its absence. Enclosed with the circular was a memorandum by Dr. Power, the Medical Officer to the Board which described the various forms which the disease might take and gave instructions as to its correct diagnosis by bacteriological examination of cerebro-spinal fluid. The Board's circular called attention to the powers possessed by local authorities to make an Order with respect to the compulsory notification of the disease; following on this the London County Council made an Order which was approved by the Board making Cerebro-spinal Fever a notifiable disease for a period of six months. On the 28th of August the London County Council made a further Order extending the notification period for an additional period of 47 eighteen months from and including the 13th of September 1907. As will be seen from the terms of the Order, a copy of which is printed below, posterior basal meningitis, a disease which is very similar in its symptoms to Cerebro-spinal fever has also to be notified. LONDON COUNTY COUNCIL. County Hall, Spring Gardens, S.W., 28th August, 1907. Sir, Notification of Cerebro-spinal Fever (Epidemic Cerebrospinal Meningitis). In accordance with the provisions of section 56 of the Public Health (London) Act, 1891, I send herewith (on the third page) a copy of an order made by the Council requiring, for a further period of eighteen months as from and including 13th September, 1907, the notification of cases of cerebro-spinal fever (epidemic cerebro-spinal meningitis) in the Administrative County of London. The order, which has been duly approved by the Local Government Board, will be advertised on 3rd September, 1907, and will come into operation as from and including 13th September, 1907, the date of expiration of the order at present in force. The Council has considered whether the term "cerebro-spinal fever" includes, for the purposes of notification, cases posterior basal meningitis, and, on 48 the advice of a committee appointed by the President of the Royal College of Physicians, has decided that for notification purposes, the disease at present known as posterior basal meningitis is included in the term "cerebro-spinal fever." That term, however, is not to be interpreted to include cases of meningitis due to tuberculosis, syphilis, middle-ear disease, or injury. I am to add that the services of Dr. Wanklyn, the Assistant Medical Officer of Health, Public Health Department, 8, St. Martin's Place, W.C., will be available with a view to the investigation of cases in association with medical practitioners, should they so desire. I am, Sir, Your obedient Servant, G, L. GOMME, Clerk of the Council. COPY OF ORDER. The London County County Council doth hereby Resolve and Order that section 55 of the Public Health (London) Act, 1891, with respect to the notification of infectious disease, shall apply, in the Administrative County of London, for a further period of eighteen calendar months as from and including 13th September, 1907, to the disease known as cerebrospinal fever (epidemic cerebro-spinal meningitis). On the 12th of April a girl was notified as suffering from cerebro-spinal meningitis. She was taken ill whilst attending as a pupil at Hague Street School; at the request of the authorities Class room D was closed and disinfected, 49 In all eight cases of this disease were reported in Bethnal Green between the 26th of March and the 12th of August, after which date no furthur case was notified. NOTIFICATION CERTIFICATES. The notification certificates received refer to a total of 1,894 persons. Table III in the appendix indicates the number of persons suffering from each disease ; it also shews the sub-district in which persons had resided and the number (1,572) of these removed to hospital. In 139 instances information was received from one of the Medical Superintendents of the Metropolitan Asylums Board Hospitals that the diagnosis as stated on the notification certificate was incorrect, a proportion of seven per cent, on the whole number. One certificate was cancelled owing to the Doctor having notified the same case a second time. Table "P" gives full details of all the notifications. TABLE P. Nature of Disease. No. of certificates received. Duplicate certificates received. Actual number of cases reported. Treated at Home. Removed to the M.A.B. Hospitals. Treated at other Hospitals and Infirmary. Diagnosis incorrect. Small Pox — — — — — — — Diphtheria 280 8 281 14 262 5 51 Membranous Croup 9 — 9 — 9 — — Scarlet Fever 1,338 50 1,288 48 1,227 13 82 Typhus 1 — 1 — 1 — — Enteric 58 3 55 6 32 17 6 Continued — — — — — — — Relapsing — — — — — — — Puerperal 5 — 5 2 — 3 — Cholera — — — — — — — Erysipelas 291 44 247 — — — — Cerebro Spinal Meningitis 8 — 8 2 — 6 — Totals 1,999 105 1,894 72 1,531 44 139 50 51 SCARLET FEVER. Deaths 43. (Decennial average 29.) Scarlet Fever has been prevalent during the whole of the year, and 1,288 cases were reported with 43 deaths, twice as many as last year. One thousand two hundred and forty persons suffering with this disease were removed to hospital where 39 of them died; 48 were treated at home with four deaths. The case mortality on the whole number was 3.6 against 2.8 on the whole number of cases treated at the Asylums' Board Hospitals during the year. Eighty two of the patients sent to hospital were found not to be suffering from Scarlet Fever and are therefore not taken into consideration in these figures. All the fatal cases except six were of young children aged less than five years; the scarlet fever death rate is equal to 0.32 per thousand population at all ages, whilst that of London is 0.14. Five hundred and thirty two of the cases were reported from the North-East sub-district and 756 from the South-West. The homes of 795 of the patients were in a fairly satisfactory condition, but in 103 the W.C.'s were defective; in nine the drain inside the house was faulty; in 27 the external drains were defective; six cases of overcrowding were reported, and other sanitary defects of a less serious character were noted m 261 instances ; 101 cases were removed from single room tenements. On the whole the epidemic was of a mild character, the symptoms were in many cases so trivial as to permit the patient to be about during convalescence; 52 in many instances to my own knowledge, 110 suspicion as to the true nature of the disease arose until the patient was found to be desquamating, I feel sure that a number of other slight cases, where no medical man was called in, never got reported at all. They were not excluded from school altogether in an infectious condition and undoubtedly communicated the disease to their schoolmates. In like manner some of the children sent away to cottage homes by the Country Holiday Fund returned to London after slight attacks and brought the disease with them; a number of cases were traced to this source. These facts account for the prevalence of the disease during the year. DIPHTHERIA. Total Deaths 18. (Decennial average 50). The number of cases reported was 290 including nine cases of membranous croup. Two hundred and seventy one patients were removed to Metropolitan Asylums Board Hospitals, five more were treated in other hospitals and fourteen remained at home. In fifty one instances a notification was received from the M.A.B. Medical Superintendents to the effect that the diagnosis as stated on the certificate was incorrect. Fourteen persons stated to be suffering from Diphtheria were retained at home. I visited all these and the illness in each case was of such slight nature as to raise a considerable doubt in my mind as to the accuracy of the diagnosis; all these patients recovered, but eighteen of the hospital cases died, a case mortality of 7.5 per cent. On the whole number exclusive of those stated to be incorrectly diagnosed, the corres- 1907. Scarlet Feber. 1907. Diphtheria. 53 ponding case mortality for the whole of London was 9.58. Thirteen patients who died were young children aged less than five years. The Diphtheria mortality in Bethnal Green was 0.14 against 0.16 for the whole of London. One hundred and thirty seven of the cases were reported from the North-East sub-district and 153 from the South-West. The Inspectors report that in 126 instances the sanitary condition of the parent's home was satisfactory; in twenty nine the W.C.'s were out of order; in four the drains inside the house were leaky and in twelve the external drains were defective. There were three cases of overcrowding and twenty nine patients were removed from single room tenements. ENTERIC FEVER. Deaths 7. (Decennial average 17) Fifty five cases of Enteric Fever were reported; forty nine of which were removed to hospital; thirtytwo of these were treated in the Metropolitan Board Hospitals and seventeen in general Hospitals, all these patients recovered. Seven other persons suffering from Enteric Fever were treated in their homes and all of them died. In nearly every one of these fatal cases the patient was too ill to be removed when the notification was received. Six of the patients removed to the M.A.B. Hospitals were stated to have been incorrectly diagnosed. The mortality in Bethnal Green was 0.05 against 0.04 for the whole of London. Twenty-five cases were reported from the NorthEast sub-district, and thirty from the South-West. 54 Ten of the patients had been in the habit of eating fried fish, nine had eaten shell-fish, four ice cream, and four watercress. One patient, a girl aged two years, had eaten a quantity of beef sausages and pork a few days before she was taken ill; she died at home. The Inspectors report that in twenty-four instances the homes of the patients were in a satisfactory condition; in four, the W.C.'s were out of order ; in two, the drains were defective; and minor insanitary conditions calling for notice were found in fifteen instances. Seven patients were removed from single room tenements. TYPHUS FEVER. On April 5th, P.R., aged nineteen years, of 25, Hare Street, was notified as suffering from Enteric Fever. The patient, a Russian immigrant, had arrived in England twelve days previously; he complained of severe headache and sickness on arrival; he was removed to the Eastern Hospital the day lie was notified. On the 8th of April, Dr. Goodall reported that the man was suffering from Typhus and not Typhoid Fever. On receipt of this information the room in which the patient had slept was stripped and repapered, and the bedding was burned. All contacts were kept under observation, but no further case was reported. WHOOPING COUGH. Deaths 53. (Decennial average 63.) All these deaths except two were amongst young children aged less than five years; a rate on the 1907. Enterica. 55 estimated population of young children of 2.8 per thousand living at that age. The mortality on the estimated population at all ages was 0.40, whilst that of London was 0.38. DIARRHŒAL DISEASES. Deaths 59. (Decennial average 152). Various forms of Diarrhœa caused fifty-nine deaths, all except four amongst young children. This indicates a mortality rate of 3.1 per thousand upon the estimated population of young children. The death rate on the whole population is 0.45 per thousand in Bethnal Green, whilst that for the County of London is 0.32. See remarks on infantile diarrhoea page 21. MEASLES. Deaths 71. (Decennial average 84). Simple uncomplicated Measles rarely kills, but the pulmonary affections by which it is accompanied or followed are very fatal. Nearly all the seventy-one deaths in which Measles was certified as the primary cause were due to either bronchitis or pneumonia. All the deaths except four were amongst young children aged less than five years, a mortality of 37 The total mortality on the estimated population at all ages was 0.54 against 0.38 for the County of London. The school Authorities reported to us a total of 713 children excluded from school on account of measles. All these were visited by Miss Harris, but in eightyeight instances the address in the report was incorrect. As an exemplification of the popular belief that 56 measles is a trivial disorder, 261 of the children apparently suffering from measles were found to be without medical attendance. Owing to the prevalence of measles, class rooms at the following schools were closed and disinfected:— March 14th Class-room G. Wilmot Street School Sept. 28th ,, F. Globe Terrace ,, Oct. 12th ,, C. ,, ,, ,, Oct. 12th „ D. „ „ „ Oct. 19th „ G. Portman Place „ CHICKEN POX. Two hundred cases were reported from schools, twenty-four of the addresses were incorrect. The children were all visited by Miss Harris and their cases call for no special remark. TUBERCULOSIS. The deaths from Phthisis numbered 246 and those from other forms of tubercular disease 103. Tuberculosis in its various forms is responsible for over fifteen per cent. (15.3) of our total mortality; the deaths from this group of diseases are equal to a rate of 27 per thousand population at all ages. The deaths from Phthisis alone are equal to 1.9 per thousand in Bethnal Green as against 1.4 in the whole of London. Various forms of tuberculosis affecting children caused seventy-one deaths, a mortality on the estimated population of young children of 4.0 per thousand living. 57 By permission of the Public Health Committee specimens of suspected tubercular sputum may, at the instance of qualified medical practitioners, be submitted for bacteriological examination at the public expense. Under this regulation 15 samples were forwarded during the year but upon examination by the Clinical Research Association a positive result was obtained in only two instances. All these examinations were made at the request of the medical officers of the Jewish Board of Guardians. DISEASES OF PARTURITION. Five women were notified as suffering from Puerperal Fever; two were treated at home and three in the Infirmary. There were four deaths; and in addition sixteen women died from diseases and accidents incidental to or immediately following childbirth. These were:— Caesarian Section necessitated by a contracted pelvis and followed by peritonitis, one; Rupture of tubal pregnancy, one; Rupture of uterus, two; Tear of neck of womb, one; Rupture of perineum, one; Gangrene of vulva, one; Placenta prsevia, one; Haemorrhage, three; Heart disease, one; Pneumonia, two; Nephritis, one; Embolism, one. MID WIVES. During the year the Central Midwives Board issued a new set of rules superseding those already in force. The alterations made provide for a more complete qualifying examination, fuller instructions as to methods; stringent enquiry in to alleged cases of mala- 58 praxis, negligence See. by local supervising authority (the London County Council) and subsequent adjudication thereon by the Board. Shortly after the issue of the new regulations a circular letter was sent stating that under certain conditions the Board would be prepared to sanction fully qualified midwives taking entire charge of lyingin cases among women in poor-law institutions, the objections which had previously held against this practice having ceased to be generally applicable. CANCER. By order of the Local Government Board the following diseases are included under this head:— Cancer, Carcinoma, Malignant disease, Schirrus, Epithelioma, Sarcoma, Villous tumour, Papilloma of bladder, and Rodent ulcer. The various forms of cancerous disease caused 112 deaths, all of which except four were amongst persons aged over 25 years. I estimate the number of persons over this age living in Bethnal Green at 57,100; on this number the cancer mortality was 1.9 per thousand. The organs and parts of the body chiefly affected by the various forms of malignant disease were as under:— Stomach 21 Intestines 21 Liver and Pancreas 15 Uterus and female organs of generation 13 Lung and mediastium 6 Jaw, Face and Orbit 5 Tongue 5 Larynx 4 Female Breast 4 Bladder 3 (Esophagus 2 59 INQUESTS. The Coroner held 258 Inquests at the Court in Church Row upon the bodies Of 148 males and 110 females; 87 of them were infants aged less than twelve months. Ninety-six of the Inquests were upon persons who had died violent deaths. Thirty-two of the infants died from suffocation; twenty eight of these were found dead in bed, one of them was suffocated by another child. Three infants were suffocated at birth and one was suffocated in a fit. Twelve persons died from burns and scalds, four were run over in the street and one on the Great Eastern Railway. There were two deaths under chloroform, administered for the performance of a necessary operation. SUICIDES. These numbered sixteen, three were females and the remainder were men. Seven of them took poison (four oxalic acid, two spirits of salt and one bichromate of potash, all these are drugs used for trade purposes and easily obtainable). Four persons hanged themselves, three perished by drowning, one man shot himself with a revolver and another jumped out of a window. A verdict of felo-de-se was returned in three cases. UNCERTIFIED DEATHS. Four deaths were registered without medical certificates ; all were cases of premature birth. 60 PUBLIC HEALTH LEGISLATION, SESSION 1907. London County Council General Powers Act 1907. Part IV Milk Supply. Section 24, Under powers conferred bv this section the County Council Medical Officer, or other authorized person may take samples of milk for examination within the County, including Railway Stations of milk intended for sale within the County. The Council may if they think fit confer similar powers upon the Medical Officer of any Sanitary Authority. Section 25, Authorizes the County Council Medical Officer, or other person properly authorized (either to be accompanied by a veterinary surgeon) to enter any dairy and inspect the cows kept therein, and if he has reason to suspect that any particular cow is suffering from tuberculosis of the udder, he may require that cow to be milked in his presence for the purpose of having a bacteriological examination made of the milk. If, as the result of such examination he is of opinion that tuberculosis is likely to be caused from the consumption of such milk, an order may be made by the Council forbidding the Dairy-man to supply milk within the County from any specified cow or cows until the order has been withdrawn. These powers may be exercised outside the County area upon an order of a Justice, having jurisdiction in the particular district concerned without reference to the District Authority, but notice has to be given to the Medical Officer of the County within which the district is situated. Other sections make illegal:— 61 (а) Selling milk for human consumption from any cow suffering from tuberculosis of the udder. (b) Failing to isolate cows suffering from tuberculosis of the udder. (c) Failing to notify cases of tuberculosis of the udder among cows in any dairy. Part V—Cleansing of verminous persons. Power is given to the County Council Medical Officer or his deputy to examine the person or clothing of any child in any provided school within the Countv, and if the person or clothing of such child is found to be infested with vermin, or is in a foul and filthy condition, to require, by notice in writing, the parent or guardian of the child to properly cleanse its person or clothing within twenty-four hours. In default the Medical Officer may remove the child from the school to suitable premises and may cause its person and clothing to be properly cleaned. Similar powers apply with respect to inmates of common lodging houses. By Section 38, Power is given to the Council and to Sanitary Authorities to make and carry into effect agreements and arrangements for the purposes of this part of the Act. Further details of the action taken by the Officers of the London County Council and the Public Health Department of this Borough will be found on page 43 of Mr. Foot's report. Part XII—Miscellaneous. Supply of water to tenement houses. Section 48 of the Public Health Act, 1891, enacts that an occupied house without a proper and sufficient supply of water shall be a nuisance liable to be dealt with summarily under the Act, 62 Section 78 of the new Act, extends this provision to certain conditions in tenement houses:—"A tenement house shall be deemed to be a house without a proper and sufficient supply of water unless there shall be provided on the storey or one of the storeys in which the rooms or lodgings in the separate occupation of each family occupying such house are situate, a sufficient provision for the supply of water for domestic purposes." I agree that this is a very necessary requirement but I foresee all sorts of difficulties in the execution of the Act. Many tenement houses are so constructed that it would be impossible to fix water-supply taps and sink wastes on the staircase or landings; and to fix these in a room on any floor would only benefit the tenant of that particular room to the exclusion of other inhabitants. VACCINATION ACT 1907. During the year a new vaccination Act was passed for the relief of the "conscientious objector." Owing to differences of opinion amongst Police Court Magistrates as to what exactly constitutes a conscientious objection an anomalous situation had arisen. By the new Act the conscientious objector is entitled to exemption upon merely making a declaration of his belief that vaccination will be prejudicial to the health of his child before a Commissioner for Oaths, Justice of the Peace or other Officer authorized to take a Statutory declaration. 63 By the Expiring Laws Continuance Act the Vaccination Act of 1898, which created the right of objectors to exemption, as amended by the Act above referred to, is Continued in force until 31st of December 1908. NOTIFICATION OF BIRTHS ACT 1907. This Act is only in operation where it has been adopted by the Local Authority with the consent of the Local Government Board, or has been declared to be in force by the Board. The object of the Act is to provide a speedy means whereby information of the birth of a child may be given to the Medical Officer of Health of the Local Authority so that if necessary, advice may be given to the mother as to the nature and rearing of her child. Where the Act is adopted it will become the duty of the father of the child, if he be actually residing in the house where the birth takes place at the time of its ocurrence, also of any person in attendance upon the mother at the time of or within six hours after the birth to notify the Medical Officer of Health of the Local Authority, within thirty-six hours. Notice may be given by post or by delivering a written notice of the birth at the office or residence of the Medical Officer of Health. The Local Authority is required to supply without charge addressed and stamped post-cards containing the form of noticeto any medical practitioner or midwife practising in the district who applies for them. The notification is compulsory under a penalty of twenty 64 shillings in default, but no fee is payable for the same. The notification is in addition to and not in substitution for the requirements of the Act relating to the Registration of births. By the terms of the Act the Medical Man or Midwife in attendance upon the mother is equally responsible with the parents for the statutory notification under penalty in default. This obligation thrown upon the medical profession without fee or reward has been deeply resented. I agree that the intentions of the Act are good, and that useful information will be afforded where it is in operation, but in company with my brother practitioners, I strongly object to the machinery provided. To compel a medical man to reveal a professional secret under pain of monetary loss is monstrous, and I very much doubt if the Act can be worked without the goodwill of the doctors. As previously pointed out, the Act is an adoptive one and at present only seventeen out of the twentynine Metropolitan Borough Councils have signified their intention to put it in force. So far as Bethnal Green is concerned no decision has been arrived at, the matter is still under consideration. THE GLANDERS or FARCY ORDER. On the 23rd day of August, the Board of Agriculture and Fisheries issued an order which requires that every case of Glanders or Farcy occurring in London shall be notified by the Veterinary Inspector of the Local Authority to the Medical Officer of Health of the district in which the case occurs. The Local Authority upon whom devolves the execution of this 65 order is the London County Council. The order referred to came into operation on the Ist January, 1908. The reason for this notification is doubtless the fact that Glanders is communicable to man by the discharges from a diseased horse coming in contact with abrasions or sores on the limbs or bodies of grooms or stable-men. A similar risk is entailed by riding behind a diseased horse in a Hansom Cab. Human Glanders is almost invariably fatal. BOARD OF EDUCATION. On the 18th of June 1907 the Board of Education issued a set of building regulations with reference to the construction of Public Elementary Schools. Part II relates to the construction of the fabric, to the sanitary and other hygienic conditions and to the provisions for ensuring the safety of the scholars in the event of fire or panic. Stress is laid upon securing a sunny site and an open airy playground. It is also laid down that an open space of ground unbuilt upon should be reserved in the proportion of thirty square feet to each child. Infant schools should have a playground on the same level as the school, a sunny aspect being regarded as of special importance. Other clauses provide for a minimum height of rooms and cubic capacity per head. The imperviousness of roofs to cold and heat, the proper concreting and ventilation beneath the floors of the building, and the lighting, warming and ventilation of the class- 66 rooms are specially dealt with. Sanitary arrangements are duly provided for. The number of closets and urinals in proportion to the number of children is set out in detail. OUTWORKERS. On May 23rd the Home Secretary issued a further Order relating to outworkers. By this order the provisions of the "outworkers" sections of the Factory and Workshop Act 1901 are extended to the following additional classes of home-work:— Artificial Flowers; Nets other than wire nets; tents and sacks, covering of racquet or tennis balls; boxes of cardboard, chip, or similar material; pea picking; feather sorting; carding, boxing, or packeting of buttons, hooks and eyes, pins and hair pins; and the making of baskets. An additional requirement is that occupiers of workshops and factories, also contractors are required to state the particular class of work on which the outworker is engaged. Immediate steps were taken to ascertain the names and addresses of employers of any additional classes of labour named in the order and to secure a return of the outworkers employed by them. In no case was it necessary to take legal proceedings against employers for failure to furnish lists, as these are received promptly. Particulars requesting outworkers will be found in the table in the appendix. Outworkers are further dealt with in the report of the Chief Inspector pages 48, 75, and 76. 67 CUSTOMS AND INLAND REVENUE ACTS, 1890 TO I903. Applications for certificates to secure relief of taxation under these Acts were made in respect of thirty houses, comprising eighty-six tenements, fifty-eight were granted and twenty-eight refused. CLEANSING OF PERSONS ACTS, 1897. Only six applications were made and all were attended to at the Disinfecting Station, Digby Street Depot. BAKEHOUSES. The number of Bakehouses on the register at the end of the year was ninety-four, sixty-three of these were above ground and thirty-one below pavement level; 275 inspections were made and twenty-one notices were served; all these were obeyed so that no prosecution was necessary, but a Bakehouse at 56, Collingwood Street, which has been in an unsatisfactory condition for some years became so dilapidated as to be unfit for use. I reported the matter to the Public Health Committee and was authorized to take proceedings against the occupier on the ground that the premises were in such a state as to be unfit for use as a Bakehouse. When the occupier became aware of our intentions he closed the premises and there is no immediate prospect that they will be reoccupied. HOUSING OF THE WORKING CLASSES ACT 1890 TO 1903. The Brady Street insanitary area remains in statu quo; no steps have been taken by the London County Council to deal with it. On June 7th a conference 68 was held between the members of your Public Health Committee and Messrs. Harris, Headlani and Smith, the L.C.C. representatives for this Borough. At the conference I described the present condition of the area and detailed the steps I have taken to bring the matter before the London County Council, with the result that this authority finally declined to act on my representations. The Town Clerk shewed that no foundation existed for the belief expressed by the Housing Committee of L.C.C. that the area would shortly be developed by private enterprise, he also pointed out that rehousing was not absolutely necessary and that with the consent of the Home Secretary the cleared site could be utilized for other purposes. Any amount of sympathy Was shewn by the Gentlemen from the Council but they were unable to promise much help. They referred to the fact that housing schemes in the past had been unremunerative and had absorbed enormous sums of money, and they expressed an unanimous opinion that as economy was now the order of the day, no avoidable expense was likely to be incurred by new Council. Nothing resulted from this conference and no further official communication has been received from Spring Gardens. I have quite lost hope that any serious attempt will be made to deal with this area under Part I of the Housing Act. The project has been on foot for over five years and all my endeavours to induce the Council to accept my representations have ended in failures. Our own local efforts in the way of continued inspection and re-inspection and the enforcement of such repairs as are possible have had this 69 result:—There is now no single house in the whole area in such condition that a Magistrate's order could be obtained to close it on its merits. Still all this only touches the fringe of the evil, the narrow streets, blind courts and ill-constructed, badly lighted houses remain. No real improvement is possible without a comprehensive scheme for the clearing and reconstruction of the whole area. I have the honor to be, Sir and Gentlemen, Your most obedient servant, GEORGE PADDOCK BATE. 70 TABLE I. Vital Statistics of Whole District during 1907 and Previous Years. Metropolitan Borough of Bethnal Green. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Total Deaths in Public Institutions in the District. Deaths of Nonresidents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all. ages belonging to the District. Number. Rate..* Under 1 Year of Age. At all Ages. Number. Rate per 1,000 Births registered. Number. Rate.* Number. Rate* 1 2 3 4 5 6 7 8 9 10 11 12 13 1897 129,200 4,818 37.3 791 169 2,551 17.4 663 148 358 2,761 21.4 1898 129,200 4,779 37.0 839 185 2,633 20.4 620 119 358 2,872 22.2 1899 129,200 4,753 36.8 827 174 2,669 20.7 727 164 431 2,936 22.7 1900 129,600 4,588 35.4 771 168 2,535 19.5 873 150 431 2,816 21.7 1901 129,700 4,608 35.5 678 147 2,423 18.7 834 220 425 2,628 20.3 1902 129,889 4,589 35 .3 710 155 2,522 18.5 864 245 470 2,744 21.1 1903 130,028 4,627 35.6 630 136 2,253 17.3 915 272 380 2,361 18.1 1904 130,207 4,526 34.7 711 157 2,393 18.4 918 300 399 2,489 19.1 1905 130,401 4,321 33.2 652 151 2,351 18.0 975 295 356 2,412 18.5 1906 130.609 4,430 33.9 696 157 2,398 18.4 934 326 391 2,463 18.9 Averages for Years 1897.1906 129,803 4,604 35.5 731 160 2,473 18.7 832 224 400 2,649 20.4 1907 130,831 4,152 31. 81 574 138 2,200 16.82 985 298 379 2,281 17.43 * 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. 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 persona who have been taken out of the district on account of sickness or infirmity, and have died in public institutions elsewhere. The "Public institutions" to be taken into account for the purpose of this Table are those into which persons are habitually received on account of sickness or infirmity, such as hospitals, workhouses and lunatic asylums. A list of the Institutions in respect of deaths in which corrections have been made is given on page. Area of District in acres (exclusive of area covered by water,) 755 Total population at all ages 128,929 Number of inhabited houses 14,005 Average number of persons per house 9.2 At Census of 1901 TABLE II. Vital Statistics of separate Localities in 1907 and previous years. Names of Localities 1..North. 2..South. 3..East. 4..Totals 5..North-East. 6..South-West. Year, Population estimated, to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Births at all Ages. | Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. a. b. c. d. a. b. c. d. a. b. c. a. a. b. d. d. a. b. c. d. a. b. c. d. 1897 49,339 1,961 1,028 321 34,194 1,333 803 243 45,667 1,524 933 250 129,200 4,818 2,761 814 1898 49,339 1,971 1,122 372 34,194 1,291 853 265 45,667 1,517 897 243 129,200 4,779 2,872 880 1899 49,339 1,930 1,168 355 34,194 1,361 814 227 45,667 1,462 954 245 129,200 4 753 2,936 827 1900 51,500 1,935 1,142 314 33,450 1,218 776 211 44,650 1,435 898 246 129,600 4,588 2,816 771 1901 51,514 1,864 1,112 308 33,472 1,239 721 177 44,714 1,505 795 223 129,700 4,608 2,628 708 1902 51,600 1,938 1056 307 34,000 1,237 730 186 44,289 1,414 961 217 129,890 4,589 2,747 710 1903 51,600 1,945 ,947 269 33,000 1,171 616 181 45,428 1,511 800 202 130,028 4,627 2,363 652 1904 51,600 1,892 1,001 351 33,179 1,194 665 154 45,428 1,440 802 206 130,207 4,526 2,468 711 1905 51,617 1,808 979 263 33,266 1,088 629 191 45,518 1,425 810 197 130,207 4,321 2,418 651 *1906 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 65,600 ... †1,178 ... 65,009 ... †l,224 ... Averages of Years 1897 to 1905. 50,828 1,916 1,062 318 33,661 1,237 734 204 45,225 1,470 872 225 129,692 4,623 2,668 747 ... ... ... ... ... ... ... ... 1907. ... ... ... ... ... ... ... ... ... ... ... ... 130,831 4,152 2,281 574 65,716 1,929 †l,068 357 65,115 2,168 †1,178 217 Notes.—(a) The separate localities adopted for this table are areas of which the populations are obtainable from the census returns. (b) Deaths of residents occurring in public institutions beyond the district are included in sub-columns c of this ta,ble, and those of non-residents registered in public institutions in the district excluded (c) Deaths of residents occurring in public institutions, whether within or without the district, are to be allotted to the respective localities according to the addresses of the deceased. In 1906 the Borough was re-divided into two sub-districts instead of three as heretofore. † Exclusive of Homeless persons who died in the Workhouse. —1 to TABLE III. Cases of Infectious Disease notified during the year 1907. Notifiable Diseases. Cases Notified in Whole District. Total cases notified in each Locality. No of cases removed to Hospital from each Locality. At all Ages. All Ages..Years, 1 2 1 t 3 Under 1. 1 to 5. 5 to 15. 15 to 25 25 to 65 65 and upwards. North East. South West. North East. South West. Total cases removed to Hospital. Small Pox ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous croup) 290 11 141 108 21 9 ... 137 153 130 146 276 Erysipelas 247 12 22 19 32 136 26 104 143 ... ... ... Scarlet fever 1288 15 451 719 84 19 ... 532 756 519 720 1239 Typhus fever 1 ... ... ... 1 ... ... ... 1 ... 1 1 Enteric fever 55 ... 5 18 20 12 ... 25 30 23 27 50 Relapsing fever ... ... ... ... ... ... ... ... ... ... ... ... Continued fever ... ... ... ... ... ... ... ... ... ... ... Puerperal fever 5 ... ... ... 1 4 ... 3 2 2 1 3 Plague ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Cerebrospinal Meningitis 8 3 ... 3 2 ... ... 1 7 ... 6 6 Totals 1894 41 619 867 161 180 26 802 1902 674 901 1575 Notes. . .The localities adopted for this table are the same as those in Tables II. and IV. Isolation Hospitals .. Metropolitan Asylums Board Hospitals. 73 TABLE IV. Causes of, and Ages at, Death during Year, 1907. Name of District—Borough of Bethnal Green. Causes of Death. Deaths at the subjoined ages of "Residents" whether occuring in or beyond the District. Deaths at all ages of "Residents" belonging to Localities, whether occurring in or beyond the District. Total Deaths whether of Residents or Nonresident in Public lnslitut ion s in the District. All Ages Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. T. N.E. S.W. No Home. 1 2 3 4 5 6 7 8 9 10 11 12 13 Small-pox ... ... ... ... ... ... ... ... ... ... ... ... Measles 71 11 56 2 2 ... ... 71 28 43 ... 21 Scarlet fever 43 5 32 4 1 1 ... 43 19 24 ... 1 Whooping-cough 53 26 25 1 ... 1 ... 53 19 34 ... 12 Diphtheria (including Membranous croup) 18 2 11 5 ... ... ... 18 12 6 ... 4 Croup ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... Enteric 7 1 ... 2 3 1 ... 7 1 6 ... 4 Other continued ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza 19 ... 1 ... 2 11 5 l9 7 12 ... 2 Cholera ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa 59 43 12 1 1 2 ... 59 28 31 ... 29 Enteritis 41 31 5 1 ... 1 3 41 21 20 ... 8 Puerperal fever 4 ... ... ... ... 4 ... 4 2 2 ... 1 Erysipelas 7 5 1 ... ... 1 ... 7 1 6 ... 4 Other septic diseases 32 2 6 1 2 11 10 32 13 18 1 17 Phthisis, Pulmonary Tuberculosis 246 ... 1 5 27 197 16 246 129 116 1 144 Other tubercular diseases 103 32 38 11 9 10 3 103 42 60 1 76 Cancer, malignant disease 112 ... 1 2 1 68 40 112 51 56 5 65 Bronchitis 226 54 20 4 ... 58 90 226 118 102 6 90 Pneumonia 270 69 71 7 13 77 33 270 20 147 3 112 Pleurisy 13 ... 3 1 1 6 2 13 8 5 ... 17 Other diseases of Respiratory organs 4 ... ... ... ... 3 1 4 ... 4 ... 6 Alcoholism 37 ... ... ... 1 33 3 37 18 19 ... 18 Cirrhosis of liver Venereal diseases 8 8 ... ... ... ... ... 8 5 3 ... 3 Premature birth 95 95 ... ... ... ... ... 95 48 47 ... 7 Diseases and accidents of parturition 16 ... ... ... 3 13 ... 16 4 12 ... ... Heart disease 194 10 4 6 11 99 64 194 97 92 5 103 Accidents 99 36 12 12 3 23 13 99 46 52 1 30 Suicides 16 ... ... ... ... 15 1 16 7 9 ... 2 Kidney disease 98 ... 2 2 1 60 33 98 39 55 4 51 Pickets 7 5 2 ... ... ... ... 7 7 ... ... 3 Cerebrospinal and Basilas Meningitis 11 7 1 2 1 ... ... 11 5 6 ... ... Old age 71 ... ... ... ... 3 68 71 31 36 4 30 All other causes 301 132 14 8 11 62 74 301 143 155 3 125 All causes 2281 574 318 77 93 760 457 2281 1069 1178 34 985 74 TABLE V. Borough—Bethnal Green. Infantile Mortality during the Year, 1907. Deaths from stated Causes in Weeks and Months under One Year of Age. cause of death. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months, 8-9 Months, 9-10 Months. 10-11 Months, 11-11 Months. Total Deaths under One Year. All Causes. Certified 108 32 31 16 187 53 44 38 35 36 29 37 30 24 25 35 573 Uncertified ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 i. Common Infectious Diseases Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... 2 2 5 2 11 Scarlet Fever ... ... ... ... ... ... ... ... ... ... 2 1 2 ... ... ... 5 Diphtheria (including Membranous Croup) ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... 2 Whooping Cough ... ... ... 1 1 2 2 1 ... 2 3 3 4 1 4 4 27 ii. Diarrhoeal Diseases Diarrhoea, all forms ... ... 1 ... 1 4 3 5 6 3 3 6 1 2 ... 3 37 Enteritis, Mucoenteritis, Gastroenteritis ... 1 1 ... 2 2 1 3 4 4 3 ... 4 1 ... 2 26 Gastritis, Gastrointestinal Catarrh ... ... ... ... ... 2 3 1 2 1 2 2 ... ... ... 1 14 iii. Wasting Diseases Premature Birth 61 13 9 1 84 7 2 1 1 ... ... ... ... ... ... 95 Congenital Defects 20 5 6 ... 31 2 2 ... 3 ... ... 1 ... ... 1 ... 40 Injury at Birth 5 ... ... ... 5 ... ... ... ... ... ... ... ... ... ... ... 5 Want of Breast-milk, Starvation ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Atrophy, Debility, Marasmus 9 4 3 3 19 9 5 6 ... 8 2 3 2 1 1 2 58 iv. Tuberculous Diseases Tuberculous Meningitis ... ... ... ... ... ... ... 1 1 3 3 1 ... 2 ... 1 12 Tuberculous Peritonitis, Tabes Mesenterica ... ... ... ... ... ... 2 1 2 ... 1 1 ... 2 ... ... 9 Other Tuberculous Diseases ... ... ... ... ... ... 2 1 ... ... 1 3 ... 3 1 ... 11 v. Other Causes Erysipelas ... ... 1 ... 1 2 ... ... 1 ... 1 ... ... ... 5 Syphilis ... ... 1 2 3 5 ... ... ... ... ... ... ... ... ... ... 8 Rickets ... ... ... ... ... ... 1 ... ... ... 2 ... ... ... ... 2 5 Meningitis (not Tuberculous) ... ... ... ... ... ... 1 ... 3 1 1 3 1 1 1 1 13 Convulsions 4 3 2 3 12 1 1 4 ... 1 1 1 1 ... ... ... 22 Bronchitis 1 1 3 3 8 6 10 3 4 3 1 3 2 3 6 3 52 Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia ... ... ... 1 i 5 5 7 4 8 2 3 9 3 5 11 63 Suffocation, overlying 6 5 1 2 14 4 5 2 2 ... 1 1 2 1 ... 32 Other Causes 2 1 3 ... 6 2 1 1 2 ... 1 3 ... 2 1 3 22 108 33 31 16 188 53 44 38 35 36 29 37 30 24 25 35 574 Population, (estimated to middle of 1907), 130,831. Births in the year, 4,152. Deaths in the year, 574 Infants, Deaths from all Causes at all Ages. 2,281. 75 TABLE V(a). District—North East Bethnal Green. Infantile Mortality during the Year, 1907. Deaths from stated Causes in Weeks and Months under One Year of Age. cause of death. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Totai under 1 Month. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under 1 Year. All Causes. Certified 40 19 17 7 89 26 24 20 17 18 11 18 10 7 12 10 262 Uncertified 1 ... ... 1 2 ... ... ... ... ... ... ... ... ... ... ... 2 i. Common Infectious Diseases Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... .. ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Scarlet Fever ... ... ... ... ... ... ... ... ... ... 2 1 1 ... ... ... 4 Diptheria (including Membranous Croup) ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 Whooping Cough ... ... ... 1 1 ... 1 ... ... 2 2 ... ... ... 2 ... 8 ii. Diarrlioeal Diseases Diarrhoea, all forms ... ... ... ... ... 2 2 2 5 ... 1 3 ... ... ... 2 17 Enteritis, Mucoenteritis, Gastroenteritis ... 1 1 ... 2 1 1 1 1 4 ... ... 1 1 ... ... 12 Gastritis, Gastrointestinal Catarrh ... ... ... ... ... ... 2 ... 1 1 1 2 ... ... ... ... 7 iii. Wasting Diseases Premature Birth 31 5 7 l 44 5 ... 2 ... 1 ... ... ... ... ... ... 52 Congenital Defects 8 4 3 ... 15 1 ... ... 1 ... ... ... ... ... ... ... 17 Injury at Birth 2 .. ... ... 2 . ... ... ... ... ... ... ... ... ... ... 2 Want of Breast-milk, Starvation ... ... ... ... ... . ... ... ... ... ... ... .. ... ... ... ... Atrophy, Debility, Marasmus 1 1 1 l 4 5 2 4 ... 4 2 2 2 ... 1 1 27 iv. Tuberculous Diseases Tuberculous Meningitis ... ... ... ... ... ... ... . l 1 1 1 ... 2 ... ... 6 Tuberculous Peritonitis: Tabes Mesenterica ... ... ... ... ... ... 2 1 l ... ... ... ... ... ... ... 4 Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... ... 2 ... 1 ... ... 3 v. Other Causes Erysipelas ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 Syphilis ... ... ... 2 2 3 ... ... ... ... ... ... ... ... ... 5 Rickets ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 Meningitis (not Tuberculous) ... ... ... ... ... ... 1 ... l 1 1 1 1 ... 1 ... 7 Convulsions 2 3 1 2 8 1 ... 2 ... 1 .. 1 1 ... ... ... 14 Bronchitis 1 ... 2 ... 3 2 6 3 2 2 1 1 1 1 5 1 28 Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia ... ... ... ... ... 2 4 2 ... 1 ... 1 2 1 1 4 18 Suffocation, overlying 1 4 1 1 7 2 2 2 2 ... ... 1 1 1 ... ... 18 Other Causes 1 1 1 ... 3 1 ... 1 2 ... ... 1 ... ... 1 2 11 47 19 17 7 91 26 24 20 17 18 11 18 10 7 12 10 264 Population, (estimated to middle of 1907), 05,716. Deaths from all Causes at all Ages, 1,069. 76 TABLE V. (b) District—South West Bethnal Green. Infantile Mortality During the Year 1907. Deaths from stated Causes in Weeks and Months under One Year of Age. CAUSE OF DEATH. Under 1 week. 1-2 Weeks 2-3 Weeks. 3-4 Weeks. Total under one month. 1-2 Months. 2-3 Months 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under one Year. All causes Certified 59 14 14 8 95 29 20 18 18 18 16 19 20 17 13 25 308 Uncertified 2 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 2 i. Common Infectious Diseases Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... 2 2 4 2 10 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 Diphtheria (including Membranous Croup) ... ... ... ... ... .. ... ... ... 1 ... ... ... ... ... ... 1 Whooping Cough ... ... ... ... .. 2 1 1 ... ... 1 3 4 1 2 4 19 ii Diarrhœal Diseases Diarrhcea, all forms ... ... 1 ... 1 2 1 3 1 3 2 3 1 2 ... 1 20 Enteritis, Mueoenteritis, Gastroenteritis ... ... ... ... ... 1 ... 2 3 ... 3 ... 3 ... ... 2 14 Gastritis, Gastrointestinal Catarrh ... ... ... ... ... 2 1 1 1 ... 1 ... ... ... ... 1 7 iii. Wasting Diseases Premature Birth 30 8 2 ... 40 2 ... ... 1 ... ... ... ... ... ... ... 43 Congenital Defects 12 1 3 ... 16 1 ... ... 2 ... ... 1 ... ... 1 ... 23 Injury at Birth 3 ... ... ... 3 .. ... ... ... ... ... ... ... ... ... ... 3 Want of Breaat-milk, Starvation ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Atrophy, Debility, Marasmus 8 3 2 2 15 4 3 2 ... 4 ... l ... 1 ... 1 31 iv. Tuberculous Diseases Tuberculous Meningitis ... ... ... ... ... ... ... 1 .. 2 2 ... ... ... ... 1 6 Tuberculous Peritonitis, Tabes Mesenterica ... ... ... ... ... ... ... ... 1 ... 1 1 ... 2 ... ... 5 Other Tuberculous Diseases . ... ... ... ... ... 2 1 ... ... 1 1 ... 2 1 ... 8 v. Other Causes Erysipelas ... ... 1 ... 1 1 ... ... 1 ... ... 1 ... ... ... ... 4 Syphilis ... ... 1 ... 1 2 ... ... ... ... ... ... ... ... ... ... 3 Rickets ... ... ... ... ... 2 ... .. ... ... ... ... ... ... ... 2 4 Meningitis (not Tuberculous) .. ... ... ... ... .. ... ... 2 ... ... 2 ... 1 ... 1 6 Convulsions 2 ... 1 1 4 .. 1 2 ... ... 1 ... ... ... ... ... 8 Bronchitis ... 1 1 3 5 4 4 ... 2 1 ... 2 1 2 1 2 24 Laryngitis .. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia ... ... ... 1 1 3 1 5 4 7 2 2 7 2 4 7 45 Suffocation, overlying 5 1 ... 1 7 2 3 ... ... ... 1 ... 1 ... ... ... 14 Other Causes 1 ... 2 ... 3 1 1 ... ... ... 1 2 ... 2 ... 1 11 61 14 10 8 97 29 20 18 18 18 16 19 20 17 13 25 310 Population (estimated to middle of 1907,) G5,115. Deaths from all causes at all ages 1,178. 77 TABLE VI. Shewing the number of Deaths from the seven principal Zymotic Diseases, inclusive of Hospita Deaths in the 10 years, 1897 to 1906, and in the year 1907. DISEASE. 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 Annual Average of 10 years 1897-1906. Proportion of Deaths to 1,000 Deaths in 10 years 1897-1906. 1907 Proportion of Deaths to 1,000 Deaths in 1907. Small Pox ... ... ... ... 2 64 ... 8 ... ... 7 2.6 ... ... Measles 109 151 90 63 84 59 85 89 48 60 84 31'7 71 31.1 Scarlet Fever 24 11 9 12 44 19 13 18 27 22 20 7.5 43 18.8 Diphtheria 87 64 64 60 63 33 26 48 31 20 50 18-9 18 7'9 Whooping Cough 53 110 44 93 38 89 41 44 50 63 63 23.8 53 232 Fever 20 17 38 18 20 15 12 7 9 14 17 6-4 7 31 Diarrhoea 151 143 157 103 119 60 112 147 119 152 126 47.6 59 25.8 444 496 402 349 370 339 289 361 284 331 367 1385 251 110.0 78 FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. 1.—INSPECTION. Including Inspections made by Sanitary Inspectors. APremises Number of Inspections. Written Notices Prosecutions, Factories (Including Factory Laundries) 88 4 ... Workshops 3681 680 ... (Including workshop Laundries) Workplaces 922 178 ... Total 4691 862 ... 2.—DEFECTS FOUND. Particulars, Number of Defects, Number of Prosecutions. Found Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Act:— Want of cleanliness 317 317 ... ... Want of Ventilation 15 15 ... ... Overcrowding 8 8 ... .. Want of Drainage of Floors .. ... ... ... Other Nuisances 253 253 ... ... Sanitary Accommodation insufficient 5 5 ... ... unsuitable ordefective 165 165 ... ... not separate for sexe: 5 5 ... ... 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 768 768 ... ... 79 3.—HOME WORK. NATURE OF WORK outworkes' lists, section 107 Number of Inspections of Outworkers' Premises outwork in unwholesome premises section 108 outwork in infected premises sections 109, 110 Lists received from Employers Numbers and Addresses of Outworkers received from other Councils Numbers of Addresses of Outworkers forwardeel to other Councils Prosecutions Instances Notices served Prosecutions Instances Orders made (s. 110) Proseccutions Sections 109, 113 Twice in the year Once in the year Failing to keep or permit inspection of lists Failing to send lists Lists Outworkers Lists Outworkers Wearing apparel—(1) making, &c., (2) cleaning and washing } 144 1,919 8 90 2,010 1,011 ... ... 3,723 ... ... ... ... ... ... Lace, lace curtains and nets ... ... ... ... 5 ... ... ... 5 ... ... ... ... ... ... Artificial flowers ... ... ... ... 20 ... ... ... 20 ... ... ... ... ... ... Furniture and upholstery 4 31 1 50 1 03 ... ... 33 ... ... ... ... ... ... Fur pulling ... ... ... ... 11 1 ... ... 10 ... ... ... ... ... ... Umbrellas, &c ... ... ... ... 04 2 ... ... 77 ... ... ... ... ... ... Paper bags and boxes 20 415 1 12 340 75 ... ... 1,079 ... ... ... ... ... ... Brush making 10 915 1 11 05 555 ... ... 530 ... ... ... ... ... ... Total 178 13,280 11 175 2,013 1,707 ... ... 5,474 ... ... ... ... ... ... 4.—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. Number Workshops, including Laundries 1,778 Workplaces 232 Bakehouse 93 Total numbers of workshops on Register 2,103 5.—OTHER MATTERS. Class. Number. Matters notified to H.M. Inspector of Factories— Failure to affix Abstract of the Factory and Workshops Act (s 133) 44 Action taken in matters referred by H.M. Inspectors as remediable under the Public Health Acts, but not under the Factory Act, (s. 5) Notified by H.M. Inspector 44 Reports (of action taken) sent to H.M. Inspectors 44 Underground Bakehouses (s. 101) - Certificates granted during the year — In use at the end of year 30 80 CEREBRO-SPINAL FEVER. Local Government Board, Whitehall, S.W. 20th February, 1907. Sir, I am directed by the Local Government Board to state that cerebro-spinal Fever has recently been somewhat prevalent in parts of Ireland and Scotland, and that a few cases have occurred in this country. The Board do not think that at present there is any ground for apprehension on this subject, but at the same time it appears to them that Sanitary Authorities should be on the alert to detect the presence of the disease in their districts, or to satisfy themselves as to its absence. The Board therefore direct me to enclose copies of a Memorandum prepared by their Medical Officer in 1905 and recently reprinted, which deals generally with the characteristic symptoms of the disease, and especially with its minor and anomalous manifestations. I am to request that one of the copies, together with a copy of this Circular, may be given to the Medical Officer of Health for his information. In the event of the discovery in any district of groups of cases of illness which might possibly be of the nature of cerebro-spinal fever, it would of course be important that the facts should be made the subject of a special report to the Sanitary Authority by the Medical Officer of Health for the district. A copy of such report should at the same time be forwarded to the Board. Should such a report be received, the Board would be prepared to render the Sanitary Authority such advice or assistance as, in the circumstances, might appear to be necessary. As the Sanitary Authority are aware, they can make an Order to the effect that cases of cerebro-spinal fever shall be compulsorily notifiable in their district. In the case of an emergency, such an Order can be made at any meeting held after three clear days' notice; it is to be advertised forthwith, and comes into force at the 81 expiration of a week from the date of the advertisement. The resolution for the Order should declare the cause of the emergency. An Order made under the provisions relating to emergencies would not remain in force for more than a month, except with the approval of the Board, but I am directed to state that in the event of the Sanitary Authority desiring, interview of any special circumstances, that cases of the disease should be made compulsorily notifiable in their district, the Board would be prepared to consider an application for their approval to a resolution of the Authority extending the provisions of the Infectious Disease (Notification) Act, 1889, or in London of Section 55 of the Public Health (London) Act, 1891, to that disease for a limited period. I am also directed to state that a Report has recently been made to the Board by Dr. H. M. Gordon on the Micrococcus of Epidemic Cerebro-Spinal Meningitis with special reference to its identification in the Upper Respiratory Passages. This Report is now passing through the press, and will be published in the course of a few days. It can then be purchased either directly, or through any bookseller, of Wyman & Sons, Limited, Fetter Lane, London, E.C. The Memorandum can also be purchased in the same way, so that Sanitary Authorities desirous of obtaining further copies of it, of distributing copies amongst the medical practitioners in their districts, can readily procure the same. I am, Sir, Your obedient Servant, S. B. PROVIS, Secretary. Memorandum on Cerebro-spinai. Fever. Cerebro-spinal fever, known also as epidemic cerebro-spinal meningitis, spotted fever, and by many other less frequently used names, has recently attracted renewed attention in this country by reason of the serious mortality occasioned by disease of this class in New York and in certain localities on the Continent of Europe. Interest in this malady has been further stimulated by the public F. 82 notice which has been taken of the recent indentification of a case in the neighbourhood of London, and of several cases, four of which terminated fatally, at Irthlingborough in Northamptonshire. Cerebro-spinal fever is not a rare occurrence in the United Kingdom. In the course of the last forty years this malady is known to have been prevalent in a considerable number of different localities in England and Wales, several of these loci.1 outbreaks having taken place in recent years. In some instances they have formed the subject of investigation by a medical Inspector of the Local Government Board, whose report has usually been made public. Occurrences of cerebro-spinal fever have also been observed in Scotland and in Ireland. There is indeed, as will appear later reason for belief that this disease is even less uncommon in this country than the foregoing particulars would seem to indicate. The late Mr. Netten Radcliffe defined cerebro-spinal fever as "an acute, epidemic disease, characterised by profound disturbance of the central nervous system, indicated at the onset chiefly by shivering, intense headache or vertigo or both, and persistent vomiting: subquently by delirium, often violent, alternating with somnolence or a state of apathy or stuper: an acutely painful condition with "spasm—sometimes tetanoid—of certain groups of muscles, especially the posterior muscles of the neck, occasioning retraction of the head; and an increased sensitiveness of the surface of the body. Throughout the disease there is marked depression of the vital powers; not unfrequently collapse : and in its course an eruption of vesicles, petechial, or purpuric spots, or mottling of the skin, is apt to occur. If the disease tend to recovery, the symptoms gradually subside without any critical phenomena, and convalescence is protracted: if to a fatal termination, death is almost invariably preceded by coma. After death the enveloping membranes of the brain and spinal cord are found in a morbid state, of which the most notable signs are engorgement of the blood vessels, usually excessive, and an effusion of sero-purulent matter into the meshes of the pia mater and beneath the arachnoid." 83 To the clinical manifestations of the disease, indicated in this definition, may be added the presence of Kernig's sign* and of tache cerebrate.† Local prevalence of a malady distinguished by the foregoing features would, no doubt, attract attention and would, it may be presumed, lead to early recognition of its true nature. But, while these features are characteristic of cerebro-spinal fever of typical and severe sort, experience has taught us that this fever may and does appear in milder or in anomalous forms which render identification difficult, and which lead to its being mistaken for other ailments of more common occurrence in this country. Illustration of this is afforded by certain localised outbreaks of cerebro-spinal fever in the eastern counties in 1890, where this disease was generally mistaken for sunstroke or for enteric fever, or was looked upon as a new form of illness; by the prevalence of what would seem to have been cerebro-spinal fever in Northamptonshire in 1890-91, where the malady was for the most part diagnosed as pneumonia or as sorethroat ; and by the occurrence of cerebro-spinal fever in Irthlingborough in the present year, where many of the persons attacked were regarded as suffering from influenza. In these anomalous forms of cerebro-spinal fever, many or even most of the symptoms associated with the recognised type of the disease may be absentj while, in mild cases, they may be so slight or of such brief duration as to escape notice. It is, however, for such cases that it is necessary to be on the outlook, whether in relation with a definite occurrence of cerebro-spinal fever in a locality; or by reason of the prevalence in a particular neighbourhood of illness not clearly referable to definable cause. In these circumstances, there would be advantage in the local medical officer of health endeavouring to secure, by arrangement with the medical men practising in his district, information as to the existence of cases of the kind in question. * To obtain this sign, the patient is placed so that hip-joint is semi-flexed, and while the hip-joint is retained in this position, the knee-joint is extended passively. A contraction of the hamstrings then sets in which causes resistance to the extension, † A congested streak produced by drawing the finger-nail gently over the patient's thigh, abdomen, or face. In cases of meningitis this appears earlier (within 30 seconds), lasts longer (8, io, or 15 minutes), and is broader and of deeper colour than in healthy persons. 84 Failure to recognise cerebro-spinal fever is also apt to happen when the malady is of the "fulminant" variety, in which death ensues rapidly. In these instances the disease has been mistaken for typhus fever, idiopathic tetanus, or malignant measles. An important aid to diagnosis may be found in examination of cerebro-spinal fluid, withdrawn from the lower part of the spinal canal by lumbar puncture, for the presence of the "diplococcus meningitidis intracellularis" of Weichselbaum; a micro-organism which is now generally regarded as the specific cause of cerebrospinal fever. Whether cerebro spinal fever is spread by direct infection from person to person is matter of uncertainty, indeed, there is as yet no definite knowledge as to the way or ways in which its transmission may take place. Since, however, the possibility of direct personal infection cannot, on the evidence available, be excluded, it will be wise to endeavour to secure, as far as practicable, the isolation of the sick from the healthy. It will also be advisable to apply suitable measures of disinfection to piemises that have been occupied by the sick, and to articles that may have been in relation with them. In view of the fact that the presence of Weichselbaum's diplococcus has been observed in the mucus of the nose and mouth, not only of the sick, but also of those attending on the sick, there may be advantage in resorting to periodical ablutions of the nasal and buccal passages of the sick and their attendants. W. H. POWER, Medical Officer. Local Government Board, July 1905. Home Office, Whitehall, 26th July, 1907. Sir, I am directed by the Secretary of State to enclose, for the Information of the Council, a copy of a new Home Work Order 85 made by him on the 23rd May last, which is now in force and relapses the earlier Order of 15th August, 1905. It will be observed that the Order extends (a) the obligation of occupiers and contractors to keep and send to the Council lists of the outworkers employed by them, and (b) the power of the Council to prohibit occupiers and contractors from giving out work to be done in unwholesome or infected dwellings, to the following additional classes of home work, viz.:—Artificial flowers ; nets other than wire nets; tents; sacks; covering of racket or tennis balls; boxes of cardboard, chip, or similar material; pea picking; feather sorting; carding, boxing or packeting of buttons, hooks and eyes, pins and hairpins; and baskets. The form of Outworkers List to be kept by occupiers and contractors, prescribed by the Schedule to the Order, has been modified by the addition of a new column (col. 3), requiring the occupier or contractor to specify the particular class of work on which the outworker is engaged. I am, Sir, Your obedient Servant, M. D. CHALMERS. FACTORY AND WORKSHOPS. Home Work. The Home Work Order of 23rd May, 1907. In pursuance of Sections 107, 108, and 110 of the Factory and Workshop Act, 1901, 1 hereby make the following order :— I. Section 107 (relating to lists of out-workers) and Section 108 (relating to employment in unwholesome premises) shall apply to the following classes of Work:— The making, cleaning, washing, altering, ornamenting, finishing, and repairing of wearing apparel; The making, ornamenting, mending, and finishing of lace and of lace curtains and nets ; 86 Cabinet and furniture making and upholstery work; The making of electro-plate ; The making of files; Fur-pulling; The making of iron and steel cables and chains; The making of iron and steel anchors and grapnels; The making of cart gear, including swivels, rings, loops, gear buckles, mullin bits, hooks, and attachments of all kinds The making of locks, latches, and keys ; The making or lepairing of umberellas, sunshades, parasols, or parts thereof; The making of artificial flowers; The making of nets other than wire nets; The making of tents; The making or repairing of sacks; The covering of racquet or tennis balls; The making of paper bags; The making of boxes or other receptacles or parts thereof made wholly or partially of paper, cardboard, chip, or similar material; The making of brushes; Pea picking; Feather sorting; The carding, boxing, or packeting of buttons, hooks and eyes, pins, and hair pins; The making of stuffed toys; The making of baskets; And any processes incidental to the above. II. Section 110 (relating to the prohibition of home work in places where there is infectious disease) shall apply to the following classes of work:— 87 The making, cleaning, washing, altering, ornamenting, finishing, and repairing of wearing apparel and any work incidental thereto (as in the said section specified); The making, ornamenting, mending, and finishing of lace and of lace curtains and nets; Upholstery work; Fur-pulling; The making or repairing of umbrellas, sunshades, parasols, or parts thereof; The making of artificial flowers; The making of nets other than wire nets; The making of tents; The making or repairing of sacks; The covering of racquet or tennis balls; The making of paper bags; The making of boxes or other receptacles or parts thereof made wholly or partially of paper, cardboard, chip, or similar material; The making of brushes; Pea picking; Feather sorting; The carding, boxing, or packeting of buttons, hooks and eyes, pins, and hair pins; The making of stuffed toys; The making of baskets; And any processes incidental to the above. 2. The lists of out-workers required to be kept by Section 107 and the copies thereof shall be kept and made in the form and manner and with the particulars shown in the Schedule hereto. 3. This Order may be referred to as the Home Work Order of the 23rd May, 1907. 88 4. The Home Work Order of the 15th August, 1905, is hereby revoked. H. J. Gladstone, One of His Majesty's Principal Secretaries of State. Home Office, Whitehall, 23rd May, 1907. Schedule. List of Out-workers. A correct list of out-workers employed in the following classes of work— (a) the making, cleaning, washing, altering, ornamenting, finishing, and repairing of wearing apparel; (b) the making, ornamenting, mending, and finishing, of lace and of lace curtains and nets; (c) cabinet and furniture making and upholstery work; (d) the making of electro plate, (f) the making of files (/) fur pulling; (g) the making of iron and steel cables and chains; (h) the making of iron and steel anchors and grapnels; (i) the making of cart gear, including swivels, rings, loops, gear buckles, mullin bits hooks, and attachments of all kinds; (j) the making of lock Watches, and keys; (k) the making or repairing of umbrellas, sunshades, parasols, or parts thereof; (l) the making of artificial flowers; (m) the making of nets other than wire nets; (n) the making of tents; (o) the making or repairing of sacks; 89 (p) the covering of racquet or tennis balls; (q) the making of paper bags; (r) the making of boxes or other receptacles or parts thereof made wholly or partially of paper, card board, chip, or similar material; (s) the making of brushes; (u) pea picking; (v) feather sorting; (w) the carding, boxing, or packeting of buttons, hooks and eyes, pins, and hair pins; (x) the making of stuffed toys; (y) the making of baskets; (z) and any processes incidental to the above; must be kept in the form and with the particulars specified below in the factory or workshop or place from which the work is given out, and must be open to inspection by H.M. Inspectors and the officers of the local authority; and a copy of the list signed and dated and corrected up to that date must be forwarded to the local authority of the district on or before the first day of February and on the first day of August in each year. In order that the list may be correct, the name of any person newly taken into employment should be immediately entered, and the name of any person ceasing to be employed should be immediately struck out. Factory, Workshop, or place from which the work is given out. Full postal address Business Name of Occupier List of Persons directly employed by in the business of, but outside, the above Factory, Workshop, or Place, in the classes of work specified above. 90 Name in full. (1.) Whether employed as Workman (W) or Contractor (C). (2.) Class of work. (Specify by means of index letters as above.) (3.) Place of Employment. i.e. place where the work is actually done. (4.) Address (No entry need be made in this column if the entry in column is a sufficient address.) (5.) COUNTY OF LONDON. DISEASE OF ANIMALS ACTS. AND THE GLANDERS OR FARCY ORDER OF 1907. REGULATIONS AS TO GLANDERS OR FARCY. In pursuance of Articles 11, 12 and 17 of the Glanders or Farcy Order of 1907, the London County Council, being the Local Authority for the County of London (exclusive of the City of London), on 29th November, 1907, made the following Regulations, which Regulations supersede those made by the Council on 17th March, 1893— As to the marking of diseased and suspected animals. 1. A diseased animal shall be conspicuously marked by or under the direction of a Veterinary Inspector 91 of the Council with the word "glandered," and with a number, and no person shall remove, deface, or in any way obliterate such mark. 2. A suspected animal shall be conspicuously marked by or under the direction of a Veterinary Inspector of the Council with the words "suspected of glanders," and with a number, and no person shall remove, deface, or in any way obliterate such mark. As to cleansing and disinfection. 3. All places used by a diseased animal, and all utensils, mangers, feeding troughs, pens, hurdles, or other things used for or about any diseased animal, shall forthwith, after such use, be sprinkled with one of the disinfectants prescribed in Regulation 5, and afterwards washed with water and scrubbed or scoured, and then roughly disinfected. 4. Every van, cart, or other vehicle which has been used for carrying any diseased animal on land otherwise than on a railway shall immediately after each occasion of such use be cleansed and disinfected in the following manner (a) The interior of such vehicle shall be effectually cleansed by the application of steam to all parts thereof. (b) The interior of such vehicle shall then be throughly washed with water containing one of the disinfectants prescribed in Regulation 5. (5) Every place or thing or vehicle required by these Regulations to be disinfected shall be thoroughly coated or washed with:— 92 (a) A i per cent. (minimum) solution of chloride of lime containing not less than 30 per cent, of available chlorine; or (b) A five per cent. (minimum) solution of carbolic acid (containing not less than 95 per cent. of actual carbolic acid) followed by a thorough sprinkling with limewash; or (c) A disinfectant equal in disinfective efficiency to the above-mentioned solution of carbolic acid, followed by a thorough sprinkling with limewash. 6. All places, utensils, mangers, feeding troughs, pens, hurdles, or other things, vans, carts, or other vehicles required to be cleansed and disinfected in pursuance of these Regulations shall be so cleansed and disinfected at the expense of the owner, lessee, or occupier thereof. 7. Litter used for or about any diseased animal shall forthwith, after such use, be sprinkled with one of the disinfectants prescribed in Regulation 5 and at once removed by the owner from contact with any other animal. 8. Fodder, litter, or any other thing that has been in contact with or used for or about any diseased animal shall not be taken out of any stable, building, field, or other place until a Veterinary Inspector of the Council has certified that such fodder, litter, or any other thing has been disinfected, and until a licence has, when necessary, been granted by the Council, pursuant to Article 15 of the Glanders or Farcy Order of 1907. 93 As to disposal of carcases. g. The carcase of a diseased animal, and of every animal slaughtered under the Glanders or Farcy Order of 1907, shall not be moved except under a licence granted by a Veterinary Inspector of the Council. 10. These Regulations shall take effect and be in force on and after the first day of January, 1908. Throughout these Regulations "animal" means a horse, ass, or mule; "glanders" includes farcy; "Council" means the London County Council; and all other words have the same meaning as in the Glanders or Farcy Order of 1907. G. L. GOMME, Clerk of the London County Council. County Hall, Spring Gardens, S.W. 29th November, 1907. N.B.—Any person guilty of an offence against the foregoing Regulations is liable to a penalty of twenty pounds. 94 Names, Addresses and districts of the Council's Veterinary Inspectors. Telephone Numbers. Name. District. Kensington 2728 Mr. W. Hunting, Chief Inspector, 16, Trafalgar-square, Chelsea, S.W. The City of Westminster, the Royal Borough of Kensington, and the Metropolitan Borough of Paddington, Chelsea, Hammersmith, Fulham, Wandsworth, and Battersea. Brixton 797 Mr. C. J. Humphrey, Inspector, 30, Stockwell-road, Clapham, S.W. The Metropoliton Boroughs of Lambeth, Southwark, Camberwell, Bermondsey, Deptford, Lewisham, Greenwich and Woolwich. Northern 2489 Mr. W. F. Shaw, Inspector, 443, Liverpool-road, Highbury, N. The Metropolitan Boroughs of Hampstead, St. Marylebone, St. Pancras, Holborn, Finsbury, Islington, Stoke Newington, Shoreditch, Stepney, Bethnal Green, Hackney and Poplar, Symptoms of, and Precautions as to Glanders. Notification of disease. Every person having, or having had, in his possession or under his charge, any animal affected with Glanders or Farcy, must at once give notice thereof to a Veterinary Inspector of the London County Council. 95 Any such person failing to give notice is liable to a penalty of £20. On notice being received the animal will be examined by one of the Council's Veterinary Inspectors. Should it prove to be glandered, all necessary steps for its slaughter and for the removal and destruction of the carcase will be taken by and at the expense of the Council. Symptoms of Glanders. Chronic cough. Thin unthrifty appearance with rapid wasting. Excessive staling. Enlargement of the gland (or "jug") under the jaw. Slight discharge from the nose. An ulcerated patch on the membrane which divides the nostrils. Thickened leg. Corded veins. Small lumps (or " buds ")on the hide, which afterwards burst and discharge sticky matter Contagious nature of Glanders. Glanders is a contagious disease, and may be communicated to a healthy animal by contact with a diseased animal; by infected water or food; or by contact with a manger, utensil, or other thing infected by a diseased animal. A horse without showing any outward signs of the disease may be glandered and a source of contagion to other horses. 96 The continuance of glanders is largely due to want of promptitude in detecting disease, to delay in killing diseased horses, and in taking proper precautions against infection. By the vigilance of owners and the adoption of proper precautions against infection, healthy studs may be kept free from glanders. Suppression of Glanders. Horses weeded out from studs should not be sold until it has been ascertained that they are free from disease. The practice of selling weeded-out horses at auction, without such precaution, is a fruitful means of spreading glanders. Horses purchased at auction from other London stables should invariably be malleined before being drafted into the purchaser's stud. Horses that have been turned out to grass with strange horses should be malleined before being replaced in the owner's stud. When glanders is in a stud it can be got rid of only by killing all horses infected, and by thoroughly cleansing and disinfecting the premises. The presence of disease in a stud may be detected by frequent careful inspection. The injection of mallein by a veterinary surgeon skilled in the work should be adopted in doubtful cases. A horse with any discharge from the nostrils, or swelling of the glands under the jaws, or any of the symptoms set out above, should be at once isolated, and reported to the Inspector. 97 Horses that have been in contact with diseased horses, either by standing next them in the stable, working in harness with them, by the common use of stable brushes and other utensils, or otherwise, should be reported to the Inspector and kept under close observation. On the appearance of "wasting" or any indication of suspicious ailment, the Inspector should be immediately notified. Horse-keepers should be instructed to give immediate notice to their employers of any ailment, however slight in the horses under their charge. It is important to remember that far more infection takes place within the stable than in the street. In all cases of disease or suspicion of disease the place in which the diseased or suspected horse has been kept must be thoroughly cleansed and disinfected in accordance with the Council's regulations and the irections of the Inspector, and all clothing, harness, utensils and appliances used in connection with the horse must be thoroughly disinfected or destroyed. Precaution against Glanders. Drivers and horse-keepers should frequently be impressed with the danger of letting their horses come into contact with other horses. Drivers should be warned against leaving their horses more than is absolutely necessary when in the streets, as during their absence their horses may come in contact with glandered horses. Drivers should be warned against allowing their horses to drink at water-troughs at which other horses can drink. 98 Pails should be sent out with vehicles; and watering horses, except by such means of such pails and with water drawn from a stand-pipe or tap, should be prohibited. Horses should be kept under good sanitary conditions, and it is especially important to well ventilate all stables, both near the roof and near the floor, and keep them clean and regularly limewashed. Human Glanders. All persons who have anything to do with glandered or farcied animals should bear in mind the following facts— The disease can be communicated to man by discharge from the nostrils or other parts of a diseased animal or carcase. The disease in man is almost always fatal. It is specially dangerous for any person with scratches or sores on the hands or face to handle diseased horses or carcases. By care and strict attention to cleanliness the danger of inoculation is avoidable. Notification by Veterinary Surgeons. Every Veterinary surgeon employed to examine any animal or the carcase of an animal affected with glanders in the County of London is required to give notice of the fact to an Inspector of the London County Council. 99 METROPOLITAN BOROUGH OF BETHNAL GREEN. STREET LIST. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Abbey street 1 1 2 3 7 Blythe street ... 3 2 3 8 Abingdon street ... ... 2 4 6 Bonner road 2 1 1 4 8 Abingdon buildings ... ... 2 1 3 Bonner street 1 ... 1 5 7 Ada place 2 1 1 1 5 Bonwell street ... 1 4 5 10 Ainsley street 1 1 ... 1 3 Boreham street 2 ... ... 2 4 Albert buildings .. ... ... ... .. Boundary street ... ... ... ... ... Albert grove ... ... ... ... ... Bradys buildings 1 ... 1 ... 2 Albion place ... ... ... ... ... Brady street ... ... 2 7 9 Alfred place ... 1 1 ... 2 Braemar street ... ... 3 3 6 Allas road 1 ... 2 1 4 Bratley street ... ... ... ... ... Alma road ... ... 1 11 12 Brick lane 2 4 6 11 23 Ames street 1 ... 2 6 9 Brierley street .. ... 3 1 4 Angela gardens ... ... 1 ... 1 Bucks court ... ... ... ... ... Anglesea street 1 ... 2 1 4 Buckhurst street 3 ... 5 7 15 Anns place 1 ... 1 ... 2 Bullards place ... 1 ... 1 2 Approach road 1 1 1 4 7 Bunsen street ... ... ... ... ... Arbery road 3 .. 2 2 7 Burgoyne road ... ... 1 ... 1 (Except Nos. 74 & 76) Burnham square ... 1 ... ... 1 Burnside street 3 1 ... 4 8 Archer street ... ... ... ... ... Busby street 2 1 4 8 15 Arline street ... 2 3 3 8 Busby square 1 ... ... ... 1 Artillery street ... ... ... 2 2 Butlers buildings ... ... ... 1 1 Ashwell road 1 ... 2 3 6 Butler street ... ... ... ... ... Auckland road ... 2 4 6 12 Buxton street ... 1 ... 1 2 Austin street 2 2 1 1 6 (Odd Nos. 1 to 33 Even Nos. 2 to 10) Bacon street 2 4 3 7 16 Cadell street 1 2 .. ... 3 Bakers court 1 ... .. 1 2 Calvert avenue ... ... .. ... ... Bakers rents ... ... ... 1 1 Cambridge circus ... 1 2 1 4 Baker street 1 1 ... ... 2 Cambridge road 3 5 6 13 27 Bandon road 1 1 ... 4 6 (All odd nos. and even nos. from 160) Barnet grove ... 2 3 2 7 Barnsley street 2 ... 2 5 9 Cambridge buildings 1 2 ... ... 3 Barnsley houses 1 ... 1 2 4 Cambridge street ... ... 2 2 4 Baroness road ... ... 1 6 7 Camden street 2 ... 1 ... 3 Bath grove ... 1 ... 1 2 Canrobert street ... 5 7 8 20 Bath street ... ... ... ... ... Carlisle street ... ... ... ... ... Baxendale street 1 1 2 2 6 Carlton place ... ... ... ... ... Bedford row ... ... ... ... ... Carmel hse, Hare st. 1 ... ... ... 1 Bellhaven street 1 2 ... 2 5 Carter street ... ... ... ... ... Benson buildings 2 ... ... 1 3 Casket street 1 ... ... 1 2 Bessy street ... ... 1 ... 1 Catherine street ... ... ... 1 1 Bethnal Green road 2 5 3 17 27 Centre street ... ... 1 ... 1 Birbeck street 1 ... 1 1 3 Chambord street ... ... 2 2 4 Bishops road 1 1 1 5 8 Chance street ... .. ... ... ... 100 STREET LIST—continued. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Chapel place ... ... ... ... . Cudworth street ... ... .. 1 2 Chapel street 1 ... 2 2 5 Culham buildings ... ... ... 1 1 Chapmans gardens ... ... ... ... ... Cygnet street ... ... ... ... ... Charles terrace 1 2 ... 1 4 Cymon street 1 2 1 3 7 Charlotte street 1 2 2 3 8 Cyprus street 2 4 4 6 14 Chertsey buildings ... ... ... ... ... Cheshire street ... 2 1 4 7 Chester street 2 2 2 1 7 Dagnall place l ... ... 2 3 Chilton street 2 1 3 3 9 Daniel street ... ... ... ... ... Chisenhale road 1 2 ... 5 8 Darling row 3 ... ... ... 3 Church street 3 ... ... 2 5 Davis place ... ... ... ... ... (Except Even Nos. from 2 to 26.) Davis buildings ... ... ... ... Delamere dwellings ... ... ... 1 1 Church row ... 1 ... 1 2 Delta street ... ... .. ... Clare street 4 ... 3 5 12 Derbyshire street 1 2 5 6 14 Claremont street ... ... ... 1 1 Devonshire place ... ... ... ... ... Clarence street 3 1 2 ... 6 Digby street 1 1 1 1 4 Clarkson street 1 ... 1 2 4 Digby walk ... 1 2 1 4 Clifton buildings ... ... 1 1 2 Dinmont street ... 1 ... ... 1 Club row ... ... ... ... ... Diss street 2 2 ... 1 5 Coate street 1 ... 1 ... 2 Dixie street 2 1 4 3 10 Code street 1 2 2 2 7 Driffield road 1 ... 1 3 5 Colling street l ... ... ... 1 (Odd numbers) Colling place ... ... ... 1 1 Ducal street 2 1 ... 2 5 Collingwood place 2 2 4 6 14 Durant street 2 1 1 3 7 Collingwood street ... ... ... ... ... Collyer's court ... ... ... ... ... Collins place ... ... ... ... ... Eastman street 1 ... 2 6 9 Columbia market ... 1 ... ... 1 Ebor street ... .. ... 1 1 Columbia road 3 1 5 8 17 (Except Nos. 11 to 19 Odd) Columbia square ... ... 3 5 8 Conyer street ... 2 ... ... 2 Eckersley street 2 ... ... 1 3 Cookham buildings ... ... ... ... ... Edgar place 1 ... 1 ... 2 Co-operative b'ld'gs .. ... ... ... ... Edward place ... ... ... ... ... Coopers gardens 2 ... ... ... 2 Elliott row ... ... ... ... ... Cordova road ... 2 ... 4 6 Ellesmere road 1 2 3 8 14 Corfield street 10 4 6 9 29 Elwin street 1 1 1 1 4 Cornwall road ... ... ... ... ... Emma street ... 2 2 2 6 (North side Nos. 163 175) Ernest place ... ... ... 2 2 Evesham houses ... ... ... 1 1 Cottage place ... ... ... ... ... Ezra street ... ... 2 ... 2 Coventry place ... . ... ... ... Coventry street 6 4 9 13 32 Cox's buildings ... ... ... ... ... Falcon buildings ... ... ... ... 8 Cranbrook street 1 2 9 9 21 Felix street 4 ... 4 ... 14 Cranbrook road 1 ... 1 ... 2 Fellbrigg street 3 ... 4 7 10 Craven buildings ... 1 1 1 3 Finnis street ... 1 1 8 2 Crescent cottages ... 1 ... ... 1 Fleet street hill 1 ... ... 1 ... Crescent place ... 2 4 3 9 Flint court ... ... ... ... ... Cross street ... ... ... ... ... Florida street ... 1 1 1 3 Crossland square 3 ... ... ... 3 Florida terrace 2 1 1 1 5 101 STREET LIST—continued. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Fossett's buildings ... 1 ... ... 1 Hackney road 3 3 3 6 15 Foster street 1 ... 1 ... 2 (All even nos and odd nos. from 323) Fountain street ... ... ... 1 1 Fox street 1 ... ... ... 1 Hague buildings ... 1 1 ... 2 Fox's buildings ... ... ... ... ... Hague place ... ... ... ... ... Fuller street 7 2 3 8 20 Hague street ... 1 4 2 7 Hammonds gardens ... ... 1 ... 1 Hamilton road 1 ... 2 3 6 Hare court ... ... ... 1 1 Hare marsh ... ... ... ... ... Gales gardens 4 ... 2 6 12 Hare row ... ... ... ... ... Garden place ... ... ... ... ... Hare street 1 2 3 20 26 Violet street Harold street ... 1 3 3 7 Garden place ... ... ... ... ... Hartley street ... 1 ... 4 5 James street Hassard place ... ... ... ... ... Gardeners road ... ... 1 1 2 Hassard street 1 ... ... 3 4 Garner street 2 1 1 4 8 Havelock place 1 ... ... 1 2 Gascoigne place 1 1 1 1 4 Helens place ... ... .. 1 1 Gawber street ... 2 1 ... 3 Hedsor buildings ... ... 1 1 Georgina gardens ... ... ... 2 2 Hemming street 2 3 1 4 10 Gernon road 1 1 1 4 7 Henley buildings ... ... ... 1 1 Gibraltar buildings 1 ... ... ... 1 Henrietta street 1 ... ... 1 2 Gibraltar gardens ... 1 2 1 4 Hereford buildings ... ... ... ... ... Gibraltar place ... ... ... ... Hereford street ... 1 ... 5 6 Gibraltar walk 2 ... ... 8 10 Hersee place 1 3 1 1 6 Gilman street 1 1 ... 3 5 Holly mansions ... ... ... 1 1 Glass street 1 1 ... ... 2 Hollybush gardens 5 ... 3 3 11 Globe road 1 1 4 6 12 Hollybush place ... ... ... ... ... (even numbers from 156, odd from 131) Holmes Avenue .. ... 1 1 2 Horatio street ... 1 ... ... 1 Gloucester gardens ... ... ... ... .. Horts place ... ... ... ... ... Goldsmith's row .. ... ... ... . Hunslett street ... 1 2 1 4 (Children's Hospital & Nos. 8 to 62 even) Hutingdon buildings 1 4 1 1 7 Hurley buildings ... ... ... ... ... Gossett street 4 1 4 8 17 Granby place ... ... ... ... ... Granby row ... ... ... ... ... Iffley buildings ... ... ... ... ... Granby street ... ... 1 6 7 Ion square 1 1 2 3 7 Great Eastern bldgs ... 1 1 ... 2 Ivimey street 2 1 ... 1 4 Green street 3 5 4 14 26 Gretton houses 3 2 1 2 8 Grove place ... ... 1 ... 1 James court ... ... ... ... ... Grove road 2 1 3 8 14 James place ... ... ... ... ... (Odd nos. from 59 Even nos. from 110) James street ... 2 1 5 8 (Odd nos. from 39, even from no. 4) Grove row ... ... ... ... ... Grove street 1 1 1 1 4 Jersey street ... ... 2 2 4 Guinness' buildings 2 1 11 5 19 Kay street (Nos. 3 to 53 odd) 1 1 1 3 6 102 STREET LIST—continued. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases General Diseases. Total. Name of Street Zymotic Diseases Tubercular Diseases Respiratory Diseases General Diseases Total. Kelsey street 1 ... ... ... 1 Menotti street ... 1 2 3 6 Kenilworth road ... ... 2 8 10 Merceron street ... ... ... 2 2 Kerbela street 4 1 5 8 18 Merceron houses 1 ... ... 2 3 Kings place ... ... ... 1 1 Middleton street 1 1 1 3 6 Kite place ... ... ... 1 1 Minerva street ... 1 1 7 9 Knottisford street ... ... 1 1 2 Minto place ... 1 ... ... 1 Mocatta house ... ... 1 1 2 Molesey buildings ... ... ... 1 1 Laleham buildings 3 ... 1 1 5 Montford houses ... ... ... 1 1 Lansdell place ... 1 1 3 5 Moravian street ... 1 ... 1 Lark row ... ... 2 1 3 Morpeth street 1 ... ... 4 5 Lawfranc road ... ... ... 2 2 Moss street 2 ... 7 8 17 Leopold buildings 2 1 1 2 6 Mount street ... ... ... ... ... Letchford buildings ... ... ... 1 1 Mowlem street ... ... ... 3 3 Lessada street 2 2 1 5 10 Museum buildings 1 ... 1 ... 2 Lily House, Brick Lane ... 1 ... 1 2 Linden buildings ... 2 2 5 9 Nant street 1 ... 1 ... 2 Lisbon buildings ... 1 1 3 5 Neath place 3 2 3 2 10 Lisbon street 2 ... 1 2 5 Nelson place ... ... ... 1 1 Little York street 1 1 1 ... 3 Nelson street 1 1 1 4 7 London street ... 2 ... 2 4 New Church street 1 ... 1 ... 2 Lucas street ... ... ... 1 1 Newling street ... 1 ... 2 3 Lyal road ... ... 1 ... 1 New Tyssen street 1 ... 1 2 4 (Nos. 57a, and 58 to 88 Consecutive Nos) Norah street ... 1 3 4 8 North place 1 1 ... 2 4 Lyte street ... ... 1 3 4 Northampton street 1 2 2 ... 5 Norton street ... 1 .. 3 4 Mace street 3 4 2 2 11 Manchester b'ld'gs ... 1 1 2 4 Octagon street 1 ... ... ... 1 Manchester place ... ... ... ... ... Old Bethnal Green road 2 4 4 3 13 Mansford street 2 3 1 5 11 Mansford buildings ... 1 ... 2 3 Old Ford road 2 7 1 17 27 Mape street 1 ... 1 ... 2 (Odd Nos. to 205 even Nos. to 368) Margaret place ... ... 1 3 4 Marion place ... ... ... ... ... Old Nichol street .. ... 1 2 3 Marion street 1 1 1 ... 3 Olga street ... ... ... 4 4 Marion square ... ... ... 2 2 Orange street 1 1 1 4 7 Marlow buildings ... ... 1 ... 1 Oval 1 1 2 3 7 Martha court ... ... ... ... ... Oxford street ... ... ... ... ... Matilda street 2 ... 1 2 5 Meadows dwellings 3 ... 2 5 10 Medhurst road 2 1 2 5 10 Palm street ... 1 ... 1 2 Medway buildings ... ... ... ... ... Palmers road ... ... ... ... ... Medway road ... 2 1 5 8 Paradise row ... ... 1 3 4 (Odd Nos. 3 to 49 even Nos. 2 to 62.) Park place ... ... .. 2 2 Parliament place ... ... ... ... ... Memorial Hall blds. ... ... ... ... ... Parliament street ... ... 1 ... 1 Mendip houses ... ... ... 2 2 Parmiter houses ... ... 1 1 2 103 STREET LIST—continued. Name of Street. Zymotic Diseases Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Name of Street. Zymotic Diseases Tubercular Diseases Respiratory Diseases General Diseases Total. Parmiter street ... ... 1 3 4 Rooks place ... ... ... ... ... Patriot square ... 1 2 2 5 Ropley street ... ... 1 ... 1 Peacock place ... ... ... ... ... Ross buildings (Moss street) ... 1 ... 1 2 Peacock street ... 1 ... 2 3 Pearl yard ... ... ... ... ... Royal Victor place ... ... ... ... ... Pedley street 3 ... 1 2 6 Royston street 1 4 6 3 14 Peel grove 1 ... ... 1 2 Russia lane 1 1 3 7 12 Peel grove mews ... ... ... ... ... Pelter street ... 1 2 2 5 Sabbage yard ... ... ... ... ... Pereira street ... ... 1 ... 1 Peter street ... 1 ... 2 3 Sale street 1 1 ... 7 9 Pollard place ... ... ... ... ... Sandford buildings ... ... ... ... ... Pollard row 2 4 1 6 13 Satchwell rents ... ... 1 2 3 Pollard street ... 1 2 3 6 Satchwell street 2 1 1 1 5 Portman place 1 ... 2 2 5 School place ... ... ... ... ... Pott street ... 2 2 2 6 Sclater street 2 ... 3 4 9 Poyser street ... ... 2 3 5 Scott street ... 1 1 1 3 Preston street 2 ... ... 3 5 Seabright street 6 2 2 7 17 Primrose street ... ... ... 1 1 Selby street ... ... 1 2 3 Princes court 2 3 1 1 7 (even numbers) Pritchards road 2 3 1 6 12 Sewardstone road 1 1 ... 7 9 (Except Nos. 57 to 117). Shacklewell street ... ... ... ... ... Sheldon place ... ... 1 ... 1 Prospect terrace 1 ... 2 4 7 Shepton houses 1 1 ... ... 2 Providence place 1 ... 1 1 3 Shiplake buildings 2 1 ... 1 4 Providence yard ... ... ... ... ... Shipton street 2 1 2 3 8 Punderson gardens 2 1 2 7 12 Skinners court ... ... ... ... ... Sidney street 1 1 1 3 6 Queen's buildings (Princes place) 1 ... 1 ... 2 Smart street 1 ... ... ... 1 Smiths place 3 ... 3 ... 6 Queen's buildings (Gossett street) 2 2 2 ... 6 Somerford street 3 2 3 6 14 Somerford houses 3 1 5 1 10 Queen's buildings (Chambord street) ... ... ... ... ... Sonning buildings ... ... ... 1 1 Shampton cottages 1 ... ... 2 Qu'n Caroline place ... ... ... 1 1 Southampton place ... ... ... ... ... Quilter street ... 5 2 8 15 Southampton street ... ... ... ... ... Quinns square 2 1 5 7 15 Southampton terrace ... 1 1 ... 2 Spencer passage ... ... ... ... ... Railway arches ... ... ... ... ... Spicer buildings ... ... ... ... ... Ramsey street ... 1 1 ... 2 Spital street ... ... ... ... ... Rapley place ... ... ... ... ... (Nos. 11 to 27) Ravenscroft build'gs ... 1 1 7 9 Squirries street ... ... 1 4 5 Ravenscroft street ... 1 ... 6 7 St. Andrews street ... ... 1 ... 1 Reuben street ... 1 1 2 4 St. James road 1 2 ... ... 3 Riders buildings ... ... ... ... ... St. John street ... ... ... ... ... Roan horse yard ... ... ... ... ... St. Jude street ... 1 2 3 6 Robert street 1 1 ... 2 4 St. Mark's buildings (Tagg street) ... ... ... ... ... Robinson road ... ... ... 2 2 Roman road 1 1 3 4 9 St. Marys place ... ... ... ... ... (Odd Nos. to 127, even Nos. to 142). St. Matthias place ... ... ... 1 1 St. Peter square ... 1 ... ... 1 104 STREET LIST—continued. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Name of Street. Zymotic Diseases Tubercular Diseases Respiratory Diseases General Diseases Total St. Peter street ... 1 4 4 9 Viaduct place ... ... ... ... ... Stainsbury street 1 1 ... 2 4 Viaduct street 2 ... 3 6 11 Stanfield road ... ... ... ... ... Victoria park ... 1 ... ... 1 ("Stoneleigh" House and gateway adjoining) Victoria place ... ... ... ... ... Victoria place ... ... ... ... ... James street Steels buildings ... ... ... ... ... Victoria park square ... ... 2 ... 2 Strahan road ... 1 1 2 4 Violet row ... 1 ... ... 1 (odd numbers) Violet street ... ... ... ... ... Streatley buildings ... ... ... ... ... Virginia road 2 4 3 7 16 Stroud place ... ... ... ... ... Vivian road ... ... ... 7 7 Sugar loaf walk ... 1 1 ... 2 Voss street ... 3 ... 3 6 Sunbury buildings 1 ... 2 1 4 Vyner street ... ... 2 3 5 Surat street ... 2 1 5 8 Sweet apple square 2 ... ... 3 5 Wadeson street 1 3 2 2 8 Walter street 1 1 2 4 8 Walton buildings ... ... ... 2 2 Tagg street 2 2 2 2 8 Wargrave buildings 1 ... ... ... 1 Taplow buildings ... 1 2 ... 3 Warley street 5 1 2 6 14 Tapp street ... ... 1 ... 1 Warner place 1 2 2 8 13 Tavistock street ... 1 ... 1 2 Waterloo place ... ... ... ... ... Teale street ... l ... ... 1 Waterloo road ... 1 1 3 5 Tecsdale street 6 2 4 3 15 Waterloo terrace 1 ... ... 2 3 Temple dwellings ... 2 ... 1 3 Waterloo buildings ... ... ... ... ... Temple street 2 ... 4 1 7 Weaver street ... 1 1 ... 2 Tent street ... ... 2 2 4 (Odd numbers) Thorold street ... ... 1 4 5 Weldon street ... ... ... ... ... Thoydon road ... ... ... 2 2 Wellington row 5 6 3 9 23 Three Colt corner ... ... ... ... ... Wennington road 1 ... 1 3 5 Three Colt lane ... 1 3 4 8 West street ... ... 1 ... 1 Thurlow place ... ... 2 ... 2 Nos. 177 to 191) Totty street 1 ... 4 3 8 Wharf road ... ... 2 2 4 Toyes dwellings ... ... ... ... ... Wharncliffe street ... ... 1 2 3 (Old BethnalG'n rd) Whites court ... ... ... ... ... Toyes buildings 1 l 2 ... 4 Whitechapel road ... ... ... ... ... (Mansford street) (Odd nos from 319) Treadway street 2 6 3 13 24 Whitmore buildings ... ... ... ... ... Turin street 1 3 3 1 8 Wilmot house ... ... ... ... ... Turville street ... ... ... 1 1 Wilmot street ... 2 5 9 16 Tuscan street 1 ... 1 ... 2 Winbolt street 1 ... 2 1 4 Type street ... ... ... 4 4 Winchester b'ld'gs ... ... ... ... ... Tyrrell street ... ... 1 1 2 Winchester crescent ... ... ... 1 1 Winchester place 1 ... 1 ... 2 Winchester street ... ... 3 1 4 Usk street ... 2 3 3 8 Wolverley passage ... ... ... ... ... Wolverley street ... ... 1 7 8 Wood close ... ... ... ... ... Vallance road 1 3 4 12 20 Wood street ... ... ... ... ... Venice street ... ... 1 ... 1 Workhouse ... ... 1 1 2 Infirmary ... ... 2 1 3 No home 2 2 6 18 28 Metropolitan Borough of Bethnal Green. THE CHIEF INSPECTOR'S TWELFTH ANNUAL REPORT on the work of the Public Health Department, for the YEAR ENDING DECEMBER, 1907. Ordered by the Public Health Committee to be printed and circulated, 5th February, 1908. T. A. DEAN, Chairman Public Health Committee. Printed by Prince & Baugh, Ltd., 14, College Hill, E.C. The Public Health Committee. Councillor T. A. Dean, Chairman. Councillor J. T. Hobney, Vice-Chairman. Aldermen J. J. Fleming and J. Merison. Councillors G. Baylev, J. C. Davey, T. A. Dean, J. Durell, J. T. Hobney, J. W. How, R. Larkins, J. Phipps, E. A. Slade, J. W. Ward, His Worship the Mayor, G. Edmonds, Esq., J.P. EX OFFICIO MEMBERS. The Chairmen of Standing Committees of the Council: Councillor W. Rawles (Finance). Councillor T. F. Salmon (Works and Stores). Councillor T. Brooks (Law and Genera/ Purposes). Councillor W. Sweetman (Baths). Meetings—Alternate Wednesdays at 6 p.m., at the PUBLIC HEALTH OFFICES, 2. Paradise Row, Cambridge Road, N.E. TO THE PUBLIC HEALTH COMMITTEE. Mr. Chairman and Gentlemen, In presenting the Annual Report on the work of the Health Overcrowding. Department for the year 1907, it seems desirableto revert to the question of overcrowding, which appears to require further elucidation in spite of all that has been said and written on the subject. Overcrowding seems to be a good hardy annual flourishing all the year round, and providing endless subject matter for talk amongst all schools and classes of would-be sanitary reformers and others who appear to imagine that overcrowding and the condition of the people question, are to be remedied and removed by talking. It is true that in addition to mere words, resolutions in varying terms are passed from time to time, and the Sanitary Authorities called upon to put down what, without question, is a great evil; but as no one seems to know how the casual worker and the general labourer can be provided with at least three rooms at a price within his means, the question does not get much nearer a final solution, or, indeed, any settlement. Year after year the matter is kept up, and everything possible and impossible said and written about it, but with a view to emphasising the difficulties of the question, and if possible to prove the utter uselessness of continuing on existing lines, I have got the Inspectors to note the condition of the family when making their enquiries, and to mention those in which, from sheer poverty the people are unable to comply with even such a standard of accommodation as would be enforced in Common Lodging Houses. The result of their enquiries follow in detail, and your Committee will note that in numbers of cases poverty and lack 4 of means make it simply impossible for these people in their present circumstances to comply with the law. The total number of cases that have been dealt with during the year amount to 107, and it is perfectly safe to say, apart from the cases caused by drink, that 95 per cent. of them are not in a position to pay the rents necessary to abate the overcrowding complained of, and to obey the requirements of the Notices served. Families have been turned out time after time, and hunted from one tenement to the other, and from there on again. One poor wretched family was turned out five times in about as many months. We are, of course, carrying out the law just as we have been doing for some years past, but in the result we do not appear to help these poor people very much, and the question still remains, how to house the lower class workers family, requiring an average rental of 7s. 9d. per week on their present incomes? Preaching, and passing resolutions does not, unfortunately, provide any effective remedy, and it is to be feared that until our governors recognise that overcrowding with its attendant evils is an economic question right through, we shall remain just about where we are in the matter. Preaching, and passing resolutions does not, unfortunately, provide any effective remedy, and it is to be feared that until our governors recognise that overcrowding with its attendant evils is an economic question right through, we shall remain just about where we are in the matter. 5 No. of Case Locality. No. of overcrowded Persons. No. of Rooms occupied. Apparent Financial Condition. 2795—18 Florida Street 3 adults and 2 children 1 Room No apparent poverty. 121—19 Cranbrook Street 4 adults 1 do. Man out of work. Poverty case. 311—19 Quinns Square 3 adults and 6 children 2 do. Man ill; consumption. Great poverty. 345—19 Eastman Street Buildings 5 adults and 3 children 2 do. Man ill and both himself and son out of work. Poverty case. 366—19 Scott Street 3 adults and 5 children 2 do. Man casual dock labourer, out of work; woman office cleaner. Had overcrowded four places previously, and from which they had been moved on. Great poverty. 369—19 Anglesea Street 3 adults (also indecently occupied) 1 do. Man casual labourer. Small earnings. Poverty case. 375—19 Fleet Street Hill 2 adults and 2 children 1 do. Wilful overcrowding. Do. 2 adults and 4 children 1 do. Do. 386—19 Princes Court 2 adults and 5 children 1 do. Man a labourer. Out of work four months. Poverty case. Tent Street 427—19 3 adults and 1 child 1 do. Poverty case. 497—19 Bethnal Green Road 2 adults and 1 child 1 do. Overcrowding doubtless caused by poverty. No direct evidence. 619—19 Treadway Street 4 adults and 5 children 2 do. No apparent reason for overcrowding. 790—19 Cambridge Road 4 adults and 3 children 1 do. Fair. No apparent financial reason for overcrowding. 791—19 Gales Gardens 2 adults and 3 children 1 do. Drink led to poverty and thus to overcrowding. 9 No. of Case. Locality. No. of overcrowded Persons. No. of Rooms occupied. Apparent Financial Condition. 853—19 Treadway Street 4 adults 1 Room Man ill. Seven weeks attending hospital. Then Bethnal Green Infirmary and discharged on crutches. No income beyond that earned by wife at charing. Great poverty. 891—19 Gibraltar Buildings 3 adults and 1 child . 2 do. Povertv case. Do. 2 adults and 4 children 2 do. Do. 1132—19 Peacock Place 8 adults and 8 children 5 do. House generally overcrowded, owing to laziness of husband, who encourages taking in lodgers. 1207—19 Kite's Place 4 adults and 1 child 1 do. Husband dead. Widow supports old father and three children. Great poverty. 1370—19 Brick Lane 6 adults and 2 children 5 do. House overcrowded by aliens. Poor, but no apparent real scarcity. 1526-19 Preston Street 2 adults and 7 children 2 do. Man a casual labourer. Wife out-worker on boots and shoes. Poverty case. 1542-19 Queen Caroline Gardens 3 adults and 3 children 1 do. Man casual labourer. No work for some time. Poverty case. 1642—19 Russia Lane 3 adults and 2 children 1 do. No apparent severe need. 1763—19 New Tyssen Street 2 adults and 4 children 2 do. Poverty case. Do. 2 adults and 5 children 2 do. Do. 1800—19 Lisbon Street 4 adults and 1 child 1 do. Man unable to get work. Poverty case. Do. 2 adults and 6 children 1 do. Poverty case. 7 No. of Case. Locality. No. of overcrowded Persons. No. of Rooms occupied. Apparent Financial Condition. 1835—19 Canrobert Street 4 adults and 3 children 2 Rooms April.—Man a market porter out of work. One girl earns 4s. per week. Rent of two rooms, 6s. 6d. Scantily clad, but clean. September.—Same conditions. Man had relieved overcrowding by going to Hamburg in summer, but now back. Works on average 2 days per week. Average earnings per week 1s. 6d. 1840—19 Clare Street 2 adults and 4 children 2 do. No apparent cause for overcrowding. Do. 2 adults and 3 children 1 do. Do. do. 1964—19 Menotti Street 3 adults and 2 children 1 do. Poverty case. Man out of work, market porter. 2001—19 Clare Street 4 adults 1 do. Man in infirmary. Sons earning boys' wages. Great poverty. 2005—19 Ion Square 4 adults and 5 children 2 do. Man apparently drinks. Overcrowding seems to be caused by poverty due to drink. 2057—19 Blythe Street 2 adults and 2 children 1 do. Misuse of space. Overcrowding abated on re-arrangement. 2316—19 Peacock Place 2 adults and 6 children 1 do. Man a casual labourer. Average earnings £1 per week. 2325—19 Peacock Street 2 adults and 2 children 1 do. Poverty case. 2408—19 Blythe Street 3 adults and 3 children 1 do. Man out of work. Casual. Last job that of potman. 8 No. of Case. Locality. No. of overcrowded Persons. No. of Rooms occupied Apparent Financial Condition. 2441—19 Brady Street 2 adults and 3 children 1 Room Poverty case. 2519—19 Princes Court 2 adults and 4 children 1 do. Man out of work. Casual labourer. Great poverty. 2589—19 Lisbon Street 4 adults and 4 children 1 do. Man out of work. Great poverty. 2262—19 Fellbrigg Street 2 adults and 4 children 1 do. Poverty case. 2274—19 Teesdale Street 5 adults 1 do. Room used as workshop. No apparent scarcity. No poverty. 2329-19 Canrobert Street 9 adults and 5 children 5 do. General overcrowding of house. No apparent poverty. 2390—19 Pedley Street 3 adults 1 do. No apparent poverty. 2432 -19 Orange Street 5 adults and 1 child 1 do. Widow with large family. Poverty. 2488—19 Turin Street 4 adults 2 do. No apparent great poverty. 2512—19 Ravenscroft Street 3 adults and 2 children 1 do. No apparent poverty. 2592—19 Hemming Street 3 adults and 2 children 1 do. Widow and 4 children in great poverty. 2598—19 Linden Buildings 2 adults and 3 children 2 do. No apparent poverty. 2681 -19 Eastman Street Buildings 2 adults and 6 children 2 do. Man out of work. Poverty case. 2684—19 Do 4 adults and 5 children 2 do. Do. do. 2728—19 Globe Road 2 adults and 2 children 1 do. No apparent reason for overcrowding. No poverty. 2732—19 Lisbon Street 4 adults and 3 children 2 do. Poverty case. 2733—19 Do 3 adults and 2 children 1 do. Do. 2745—19 Darling Row 2 adults and 4 children 2 do. Man casual labourer. Poverty case. 9 No. of Case. Locality. No. of overcrowded Persons. No. of Rooms occupied. Apparent Financial Condition. 2755—19 Collingwood Street 2 adults and 8 children 2 Rooms Man unable to get work. In great poverty. 2744—19 Linden Buildings 1 adult and 4 children 2 do. Widow with 4 children. Very poor. 21 -20 Hare Street 2 adults and 4 children 1 do. No apparent poverty. 63—20 Robert Street 2 adults and 3 children 1 do. Man a casual workman out of work. Extreme poverty. 64—20 Emma Street 2 adults and 4 children 1 do. No apparent poverty or cause for overcrowding. 159—20 Lisbon Street 2 adults and 6 children 1 do. Man unable to get work. In great poverty. 160—20 Do 2 adults and 4 children 1 do. Do. do. 208—20 Meadows Buildings 2 adults and 6 children 2 do. Apparently wilful overcrowding. 215—20 Norah Street 3 adults and 7 children 3 do. No apparent poverty. 259—20 Bethnal Green Road 1 do. Do. do. 346—20 Bon well Street 6 adults and 4 children 3 do. Poverty a contributory cause. 396—20 Quinn's Square 2 adults and 6 children 1 do. Man a casual labourer. Wife did few match boxes at home. Severe poverty. 457—20 Church Street 1 adult and 4 children 1 do. Man gone to America and left wife with children. Poverty case. 462—20 Satchwell Street 2 adults and 6 children 1 do. Poverty doubtless due to drunken habits of 506-20 Austin Street 2 adults and 4 children 1 do. Man given to drunken habits. Woman respectable and hardworking. Poverty case. 598—20 Old Bethnal Green Road 1 adult and 4 children 1 do. No apparent poverty. 10 No. of Case. Locality. No. of overcrowded Persons. No. of Rooms occupied Apparent Financial Condition. 608—20 Bessy Street 2 adults and 3 children 1 Room Widow. Outworker. Matchboxes. Poverty case. 609—20 Poyser Street 2 adults and 4 children 1 do. Man out of work. Great poverty. Went to workhouse. 621 -20 Squirries Street 2 adults and 4 children 1 do. People in poor circumstances. 629-20 Church Street 2 adults and 1 child 1 do. Overcrowding by owner Wilful. 657—20 Anglesey Street 2 adults and 3 children 1 do Man a casual labourer out of work. Great poverty. 713—20 Gibraltar Buildings 8 adults and 10 children 4 do. Men at work. Fair wages. No poverty. 746—20 Bandon Road 2 adults and 6 children 2 do. Misuse of room for sleeping purposes. Remedied by re-arrangement. 787 -20 Coate Street 2 adults and 3 children 1 do. Great poverty caused by illness. 833—20 Meadows Buildings 4 adults and 4 children 2 do. No apparent poverty. 840-20 Seabright Street 2 adults and 3 children 1 do. Man out of work. Returned emigrant Poverty case. 849—20 James Street 5 adults and 3 children 3 do. Great poverty caused by illness. 967 -20 Turin Street 2 adults and 4 children 1 do. Poverty caused by drunken habits. 1001—20 Canrobert Street 2 adults and 4 children 1 do. No apparent poverty. 1037—20 Code Street 3 adults and 4 children 1 do. Do. Do 2 adults and 6 children 1 do. Man a cripple, unable to work. All effects pawned. Great poverty, 1067—20 Turin Street 2 adults and 6 children 2 do. No apparent poverty. 1143—20 Pedley Street 2 adults and 4 children 1 do. Wilful overcrowding. 11 No. of Case. Locality. No. of overcrowded Persons. No. of Rooms occupied. Apparent Financial Condition. 1147—20 Teesdale Street 2 adults and 4 children 1 Room Man and woman idle, and apparently prefer overcrowding. 1432 20 Chambord Street 6 adults and 6 children 3 do. • Sub-let by tenant unknown to owner. Poverty case. 1449—20 Minto Place 2 adults and 6 children 2 do. Poverty case. 1599—20 Chambord Street 2 adults and 3 children 1 do. Carman earns £1 per week Pays 3/6 per week rent. 1600—20 Orange Street 2 adults and 3 children 1 do. Man a cabinet maker. Average earnings 18/- per week. Rent 4/- per week. 1649—20 Cranbrook Street 2 adults and 3 children 1 do. No apparent poverty. 1679 -20 Bratley Street 4 adults and 2 children 1 do. Poor circumstances. 1712—20 Anglesea Street 2 adults and 2 children 1 do. Man a casual dock labourer. Poverty case. 1716—20 Pritchard Road 4 adults and 2 children 2 do. Shortness of work caused poverty. On getting work took larger premises. 1718—20 Moss Street 2 adults and 4 children 1 do. Man a casual labourer. Poverty case. 1766—20 Fellbrigg Street 3 adults and 2 children 1 do. Shoemaker out of work. Great poverty. 1793—20 Teesdale Street 2 adults and 3 children 1 do. Wilful overcrowding. 1799-20 Tent Street 2 adults and 3 children 1 do. Apparently poverty caused by drink. 1810—20 BIythe Street 2 adults and 5 children 1 do. Poverty case. Out of work tailor. 1838—20 Coventry Street 2 adults and 2 children 1 do. Poverty case. 1977-20 Teesdale Street 7 adults and 14 children 4 do. House generally overcrowded. Poor circumstances. 1992-20 Wolverley Street 4 adults and 12 children 3 do. Family in fair circumstances. No apparent poverty. 12 No. of Case. Locality. No. of overcrowded Persons. No. of Rooms occupied. Apparent Financial Condition. 1993—20 Wolverley Street 4 adults and 3 children 2 Rooms Extreme poverty due to shortness of work. 1994—20 Do. 2 adults and 5 children 2 do. Poverty apparently caused by laziness. 1997—20 Mace Street 2 adults and 6 children 1 do. Man a casual labourer Poverty case. 2126—20 Gales Gardens 3 adults 1 do. Widow with 2 lazy sons. Poverty case. 2189—20 Dixie Street 2 adults and 3 children 1 do. Poverty caused by drunken habits. 2269-20 Church Street 2 adults and 1 child 1 do. Transmigrants for America, proceeding later, thus abating overcrowding. Very poor. Man a cabinet maker. Out of work for 6 months. Great poverty. 2397- 20 Ducal Street 2 adults and 3 children 1 do. Somerford Street 3 adults and 7 children 2 do. Man a casual labouier. Unable to get work. Great povert)-. 13 The next question of the greatest importance to a Sanitary Authority and its Officers is that of the food supply. It is customary to refer to this subject as though Unsound Food and Adulterated Food were one and the same thing. There is, of course, a most essential difference in the powers and procedure, which are not only quite separate and distinct, but, in fact, obtained under two different Statutes. The power of " Inspecting" the meat and other foods deposited in the shops, or on stalls, etc., for the purpose of sale, and for "Seizing" any that appears to be unsound, unwholesome, or unfit for the food of man, are contained so far as London is concerned in Section 47 of the Public Health (London) Act, 1891. The powers and procedure for taking "Samples" of food for analysis—milk, butter, etc.— are given by a series of highly technical and, in several respects, contradictory measures known as the Sale of Food and Drugs Acts, 1875 to 1907. The first of these was passed in 1875, and to use a complimentary expression, they have been "amended" on several occasions since, up to and including the Act of last year. It is doubtful in whose interests these "amendments" have taken place, but one may say with absolute certainty that the various alterations are not in the end in the interests of the poorer class of purchaser who still seems to be left as fair game for the fraudulent sophisticator of food under various fancy legal phrases and devices. For convenience, we will deal with these two branches of the same subject separately, taking first the Food Supplies. Powers and Procedure. 14 INSPECTION OF FOOD AND MARKETS. Under the Powers of the above-mentioned Section 47, the shops, markets, and stalls have been under constant inspection by Mr. Rowsell throughout the year. Mr. Ainley, on many special occasions, particularly during the Sunday morning markets in the summer months, has rendered most able assistance. The results of their inspections are given in detail later on, but it may briefly be mentioned here, that upwards of tons of meat fish, fruit and vegetables were surrendered to or seized by these officers, and afterwards destroyed at Digby Street Depot. Arising out of the Official Seizures, ten summonses were issued and in each case a conviction followed. The sum of £93 3s. 6d. in fines and costs were ordered to be paid by the defendants. One butcher was fined £50 and 5 guineas costs in respect of beef exposed for sale and affected with tubercular disease. In default of paying the fine he went to prison for two months. Four other defendants went to prison for terms varying from two weeks to two months in default of paying their fines. Unsound Food Section 47, P. H. (Lond.) A., 1891. The approximate amount of unsound food surrendered by various owners and destroyed was as follows:— Tons. Cwts. Qrs. Lbs. Meat — 2 3 8 Fish 1 5 1 2 Vegetables — 15 3 — Fruit 4 5 — — 153 Rabbits also were destroyed. 15 The approximate amount of unsound food seized and destroyed was as follows:— Qrs. Lbs. Meat 3 18 Fish 2 - Fruit 2 6 24 Rabbits also were seized and destroyed. Total amount of unsound food destroyed:- Tons. Cwts. Qrs. Lbs. Surrendered 6 8 3 10 Seized — 1 3 24 6 10 3 6 The premises on which food is prepared for sale have been regularly inspected, and the particulars respecting same are as follows Number on Register at end of 1906 219 Number Removed during 1906 5 Number added during 1907 18 Number on Register at end of 1907 232 Number of Inspections during 1907 922 Number of Notices served 178 Number of Prosecutions Places where food is prepared for Sale. It will be noted that although no prosecution had to be instituted, no less than 178 notices had to be issued. In September the following letter was received by the Town Clerk:— Local Government Board, Whitehall, S.W. 10th September, 1907. Sir,— I am directed by the Local Government Board to state that they have had under consideration various representations with respect to the sale for human food of diseased cattle, and especially of cows suffering from tuberculosis or other wasting disease. Diseased Cattle for human consumption. 16 The Board understand that it is the practice of some dealers though aware of the diseased condition of animals coming into their hands, so to dispose of them or of their carcases, that there is risk that they will be used as food for the poorer classes in London and other large towns. The Board have reason to believe that the practice in question obtains to a considerable extent; and accordingly they are desirous of drawing the attention of local authorities to the matter, in order that they may as far as possible exercise supervision over the cattle in their districts with a view to anticipating, and so averting, possible or intended infringement of the law. With this object, the local authority should instruct such of their officers as are engaged in administering the provisions of the Dairies, Cowsheds and Milkshops Orders, to observe particularly the condition of the cows which come under their notice, and, where any animal is clearly diseased and presumably unfit for food, to take such steps as are practicable to ensure that, in the event of the animal being slaughtered, the carcase is disposed of properly. The Board would also suggest that the sanitary or other suitable officers of the local authority should be instructed to watch closely the cattle-markets, slaughter-houses and knackers' yards in the district, with the view of satisfying themselves that no animal, the condition of which appears to render it unfit for human consumption, is disposed of in such a manner that it is likely to be used for this purpose. I am, Sir, Your obedient Servant, S. B. Provis, Secretary. The Town Clerk, or The Clerk to the Urban District Council, or Rural District Council. Without in the slightest degree presuming to criticise, one might be allowed, as a matter of experience, to state that those 17 persons who engage in the sale and disposal of the flesh of diseased cattle for human consumption, do not, as a rule, carry on their business in the unconventional manner one may infer, from a casual perusal of that document. In actual practice the procedure is a little more interesting and intricate. Animals that are "clearly diseased and presumably unfit for food," are not invariably placed where they are likely to come under the eye of the Officer referred to. They will probably be quietly removed as early in the proceedings as may be, to a more remote place, say, to a stable quite apart from and having no connection with the actual dairy premises. In the country and suburbs an isolated shed in a corner of a convenient field will be suitable. A slaughterer, not necessarily a professional butcher is sent for, and if he arrives in time the beast is killed. Alive or dead, in either case, the carcase is dressed, the lungs and other internal organs that contain perhaps the only and certainly the strongest evidence of the disease, are carefully buried or otherwise promptly disposed of. The pleura and lining of the chest may be removed, and the surfaces that are roughened by this process carefully greased and rubbed or polished to look alright to the eye. Any suspicious or diseased glands will be artistically removed and other parts cut away, and the remaining sound-looking portions of the carcase sent off to the well-known dealers in this class of meat. It must not be imagined that the carcase will reach Smithfield, nor in fact any regularly inspected market. It may be, and often 18 is, openly dispatched to a most immaculate and respectable dealer in cat's and dog's meat, but who will have more than one side to his business. The condition of the carcase will govern the particular market or channel, but in whatever manner it may be handled or disposed of, there is not much doubt about the ultimate destination which will be, not where the food of quadrupeds is sold to the public. As stated in earlier Reports, an easy and not costly way to prevent this and similar trickery would be to require all animals to be submitted for examination prior to slaughtering, and to compel the meat or carcases to be marked or numbered for identification, and to be sold and delivered to the retailers with such marks or numbers in the invoices. It would then be easy to trace any suspicious meat back from the retailer in any district, and at one and the same time to protect the public and to assist the shop-keeping butcher who is often innocent. Presumably the objection to some such system as this is its simplicity and freedom from legal and other costly technicalities. Its practicability, too, would doubtless be considered a fatal objection to its being included in the system of Health Laws observed in a country where how not to be efficient and practical has become quite a science. Samples taken under Food and Drugs Act. Passing on to the procedure under the Sale of Food and Drugs Act, I have to report that 682 samples of various kinds of food were taken officially and submitted to analysis by Mr. Stokes, the Public Analyst, during the year. Forty-five of this number were found to be adulterated, and it will be noted that this shows a great reduction in the number of adulterated samples as compared with the results of any previous year. It would be well if one could report that improvement in the quality or purity of the food corresponded with 19 the decreased number of offences detected, and whilst in one sense it is strictly accurate to say these good results are entirely due to the energy and vigilance of your Sanitary Inspectors, there is quite another side of the case. As mentioned above, the various attempts at what is euphemiously termed "amending" the Sale of Food and Drugs Acts has resulted in something very like chaos so far as actual administration is concerned. What with warranty defences, differences of opinion as to what constitutes a warranty or only an invoice, exhibition of notices, and various other forms of what may be termed contracting out and avoiding the Acts, it becomes increasingly difficult to predict with any certainty what is likely to be the result of proceedings taken in any given case. The only thing absolutely certain is, that every single provision that has been introduced, with a view of protecting the honest shop keeper, has been taken advantage of by less scrupulous dealers and elaborated into a series of legal loopholes for their especial benefit. This form of protection is now so perfect that the intention of the Acts has been well nigh inverted, and after a little experience, say the second appearance at the Court, it is a very poor scholar who does not learn how to take full advantage of the position and trade on it with impunity. All this does not, of course, prevent our public men in their superabundant lack of knowledge from dilating on the excellent measures they have taken to protect the people's food from adulteration and to safeguard their interests in this direction. One can only regret that the legislature in its wisdom, iind after so many attempts, has not been able to devise something less intricate, less costly, and more likely to be useful to the community. It is significant that out of 45 offences detected nearly half are in connection with milk. On the publication of former Reports some dairymen have affected to be very indignant at what they have been pleased to term the harsh manner in which their trade has been dealt with. W ith 20 cases of adulterated milk and S of butter out of a total of 20 45, it appears that the indignant members might very well direct their energy to the using of a little " moral suasion " to the weaker brethren. One particularly bad case, of what the learned magistrate described as "a mean, deliberate fraud," should be referred to in fairness to the officers concerned. After having attention devoted to him by Messrs. Rowsell and Weeks, a certain tradesman with a notoriously evil reputation for delivering watered milk, and who literally boasted and traded on his knowledge of defects in the Act, was with considerable difficulty neatly and effectually caught by Inspector Bare early one morning when leaving milk at his customers' houses. These included not only private persons but small retail shop-keepers, who had to run the risk of selling this man's milk and water. One such tradesman was, in fact, fined. In the result all the particulars were conclusively proved before Mr. Cluer, who in spite of an energetic defence imposed a penalty of £20, and five guineas costs, and stated he regretted the defendant could not on that occasion be sent for imprisonment without the option of a fine. Details of samples and proceedings are on pages 64 to 71, together with particulars of about fifty articles of food purchased as means of information by agents, and not officially taken by Inspectors. The result of this proceeding was not only of interest, but most instructive. Certain traders who can "tell the tale" when officially caught were found to be merrily ignoring the requirements of the Act as to labelling their margarine or packing the same in the wrappers prescribed bylaw. Some margarine was found to contain mashed potatoes, some flour, and others starch, and such interesting trifles, none of which prevented one or two of the persons concerned from entering their solemn protest at such proceedings on our part. 21 The idea of sampling margarine was quite too low down an experiment to try on ratepayers and tradesmen of the Borough. On the 8th May a letter received from the Local Government Board was submitted to the Committee, with a report of the Inspector of Foods, Dr. A. W. J. MacFadden, upon the occasional occurrence of lead and arsenic in tartaric acid, citric acid, and cream of tartar. Samples of these substances were obtained, but in no case were they contaminated with lead or arsenic. In the latter part of 1906 and the early part of 1907 some prosecutions were taken against vendors in the Borough for selling jams described as goosebery, raspberry, black currant, &c. adulterated with apple pulp. Sample jars of raspberry jam were procured purporting to be manufactured by three leading firms. On the label of No. 1 appeared, among other printing, the words, " Improved with a small proportion of fruit jelly." On No. 2 was also the same notice. On No. 3 appeared the words, " Guaranteed Genuine." Nos 1 and 2 were found to contain 7 per cent, and 5 per cent of apple pulp respectively, but No. 3 was reported as genuine. As a result of the prosecutions which had taken place large quantities of jam were removed by manufacturers from shops in the district in the earlier portion of the year. Samples for Arsenic and Lead. Jam Manufacturers and wholesale firms collect and remove Jam from shops. 22 WORKHOUSE. In March I became aware that certain drainage works were being carried out at this institution, and on the 21st of that month I requested Mr. Richards to visit and report. Workhouse Drainage System. On the following day I personally examined what was being done. Quite apart from the work then in hand, I was aware, from previous knowledge, that from a sanitary standpoint the condition of the drains as a whole and certain of the sanitary fittings and conveniences were not at all of a satisfactory character, and in my judgment the time had fully come to deal with the matter on a practical basis, and not to proceed further along the costly lines of temporary repair and patching. Consequently, I reported the facts as they then stood to your Committee and suggested that having regard to all the circumstances, past and present, it was desirable that a conference between the Guardians and yourselves should take place, in order that the position might be fully considered and the future line of action determined. On your instructions I communicated with Mr. Thomas, Clerk to the Guardians, and the first result of this correspondence was that on April 25th your Sub-Committee proceeded to the Workhouse and met the House Sub-Committee of the Board. The members of the Guardians Committee present were, Messrs. Restall (Chairman), Nokes, Lee, Mount and Eickhoff. Of your Sub-Committee, the members present were, Messrs. Phipps (Chairman), How, Hobney, Ward and Alderman Fleming. The immediate outcome of this conference was that the following recommendation of the Workhouse Committee was adopted by the Guardians at their meeting on May 7th and received by me on the 8th, 23 " Your Committee have had under consideration the " question of the drainage at the Workhouse, and a Sub" Committee was appointed who have met a Sub-Committee " of the Public Health Committee of the Borough Council. " together with Mr. Foot, the Chief Sanitary Inspector. " After going very carefully into the matter your " Committee have unanimously adopted the following recom" mendation of such Sub-Committee and report their action " for approval :— " That the Public Health Committee of the Borough " Council be asked if they would kindly instruct their " Chief Sanitary Inspector, Mr. Foot, to have a thorough " inspection made, together with the necesary plans, of " the drainage at the Waterloo Road Workhouse, and to " make a report showing what is necessary to be done, " with an estimate of the probable expense in the event " of the Borough Council consenting to execute the " works for the Guardians." After careful consideration of the request contained in this recommendation, your Committee decided to make a report to the Council of the (acts so far as they were then known, and to ask for an instruction as to that portion respecting the execution of the works by the staff of your department. The following is a reprint from the Council's Minutes of your report, and the decision thereon by the Council at its meeting on May 16th. " It has recently been ascertained that the drainage " works and sanitary arrange nents generally at the Bethnal " Green Workhouse are in a defective condition and require " to be thoroughly overhauled, and so far as can be ascer" tained subsequently relaid. "A Sub-Committee of your Committee have met a " Sub-Committee of the Workhouse Committee on the 24 " ground, and at their meeting the necessity of overhauling " and relaying the drainage system at the Workhouse was " fully realised. A letter has since been received from the " Clerk to the Guardians containing copy of resolution passed " by the Workhouse Sub-Committee as follows:— " That the Public Health Committee of the Borough " Council be asked if they would kindly instruct their " Chief Sanitaty Inspector, Mr. Foot, to have a thorough " inspection made, together with the necessary plans, ol " the drainage at the Waterloo Road Workhouse, and " to make a report showing what is necessary to be " done, with an estimate of the probable expense in the " event of the Borough Council consenting to execute " the works for the Guardians. " So far as your Committee are concerned, they have no " doubt as to the practicability of the suggestion made by " the Workhouse Sub-Committee as to your Committee " undertaking the necessary works, but before deciding " desire, in view of the probable cost of the proposed works " amounting to £2,500 to £3,000, to ask for the instructions " of your Council as to whether such works shall be carried " out by the staff of your Public Health Committee, and " also as to the advisability of suggesting to the Board of " Guardians their engaging an independent Surveyor and " carrying out the requisite work as then advised." This report was referred back by the Council for further consideration, the Committee being directed to make a recommendation as to the work being carried out. Meantime, in accordance with your instructions I had continued our necessary examinations which had been commenced earlier, and presented amongst others the following reports dated respectively June 12th and 26th, together with a detailed report made by Messrs. Richards & Jones, after the opening up of the ground at various points. 25 REPORT. "Since the last meeting of the Committee, Inspectors Richards and Jones have devoted as much time as is possible consistent with carrying out the other duties of the office to making an examination and report upon the conditions existing at the Workhouse and Guardians' Offices in Bishops Road. " So far as the matter has gone there can be no doubt that in many respects the existing conditions and fittings are in an insanitary condition. Some of the w.c.'s, fittings, soil pipes, and the like are of modern construction, and in certain cases it would not appear necessary that these should be interfered with. It is. however, impossible to ascertain and report fully as to the condition of the main or branch drains underground from a mere surface examination. It will be necessary that the drainage system shall be opened at various points and examinations and tests made, and there is ample justification for this being done disclosed by the Inspectors' examination so far as it has gone. " In several cases it may be mentioned that rain-water pipes and sink waste pipes are connected with the drains or soil pipes without being trapped. There are also stoneware pipes trapped at the foot with ventilating gratings on the footpaths or passages, and when these water-closets are flushed the foul air is driven through the said gratings under the noses of passers by or into the doors and windows immediately over. These soil pipes receive several w.c.'s on each stack from various floors, and in addition to the other defects mentioned are unprovided with anti-syphonage pipes. " Stoneware soil pipes and the conditions so far disclosed are not recognised as sanitary fittings or in accordance with the requirements of the Bye-Laws of the London County Council. One of the soil pipes is in fact partly of lead, part of iron, and part stoneware. " As to w.c.'s, there are in some cases trough closets and pans of a wash-out pattern which cannot be described as sanitary or satisfactory. Some of the vent pipes are only of 3in. light iron and improperly jointed with putty. The above conditions would apply to the Workhouse generally. 26 "As regards the administrative block in Bishop's Road, the sanitary conditions there can only be described as somewhat worse than those at the W orkhouse, there being what are known as old bell traps or soakaways in the areas, rain-water pipes, bath and sink wastes apparently directly connected with the drains and untrapped, and, in the case of other of the sink wastes, they are connected to the drain but trapped. The soil pipes are apparently unventilated. " Generally, there can be no doubt that considera blesanitary improvements are necessary; but as regards the drainage system as above mentioned, it is now necessary that arrangements should be made for the opening-up of these drains and the proper testing and examination of same. " Apart from the condition of what may be described as the older portion of the drainage system, it should be mentioned that so far as any of the modern work is concerned no attempt whatever has been made to test the portions recently relaid or amended, neither do these works appear to have been carried out in any systematic manner, but bit by bit as occasion arose. "With regard to the question debated at the last Council meeting whether it is desirable that any works should be done on the Guardians' premises by the staff of this Department, I am strongly of opinion, and beg to recommend, that the Guardians should now be advised to call in an independent sanitary Surveyor, who should meet the Officers of your Committee in consultation, and who together should arrange for the necessary and requisite opening up and examination of the drainage system. When this has been done, a further and more complete Report can be presented. " Mr. Jones is preparing a plan which has had to be taken more or less from hearsay and from the bricklayer, Mr. Siggins, but this plan can be completed with the Report already referred to when the examination at different points has been made. JOHN FOOT, Chief Inspector. 12th June, 1907. 27 " Gentlemen, I beg to present the detailed report prepared by Inspectors Richards and Jones as the result of their openings and examinations made at the Workhouse in accordance with your instructions. It will be gathered from that report that the drainage system and the sanitary conditions generally are not at all satisfactory. " During the progress of the opening up I have visited the premises on several occasions and have myself seen the drains at all the points described in their detailed report, and I am personally cognisant of the accuracy of the conditions they describe. " Mr. Jones commenced these openings with the Council's men on Monday, the 10th instant. Since then 28 openings at different points have been made, all of which openings were made at or near the top ends of branch drains and near to the surfaces. " The conditions found are sufficiently bad to warrant the opinion that nothing short of a reconstruction of the drainage together with the remodelling and systematic grouping of the various branches will give any permanent satisfaction to the Guardians or render the Workhouse and offices at all sanitary. " With reference to the fittings, i.e., w.c's., lavatories, sinks and the like, some of these existing fittings can undoubtedly be allowed to remain, but other fittings, together with the pipes attached thereto, must be entirely reconstructed and renewed. This specially applies to obsolete forms of w.c's , which are at present fitted to stoneware soil pipes and unprovided with the necessary ventilating pipes. In certain cases trough closets are still in existence. These cannot now be described as sanitary or satisfactory, and should, in each case be replaced with modern w.c. pans and traps. The ventilation at present fixed is entirely insufficient, and in many cases consists only of Sin. light rain water piping. " As already mentioned, Mr. Jones commenced these openings on the 10th instant and they were continued up to the 24th, when I gave 28 instructions for this work to be stopped, as in my judgment sufficient has been discovered to prove the existing defects and to render it necessary for consideration to take place as to whether further openings are desirable or whether action should not be directed to removing what is defective and providing new. " With regard to the application of the Guardians that you should carry out the necessary redrainage by your staff at the Guardians' expense, I would add that after careful consideration of all the circumstances I am at present unable to see how it is possible for any tenders to be invited or contracts prepared in view of the fact that no one is aware of the extent, condition, or actual run of the various drains throughout this institution. " So far as we are able to gather, there is no accurate plan in existence. The old plan made about the year 1855 has been seen, but for all practical intents and purposes this plan is useless. Mr. Siggins, the Guardians' bricklayer, is the only person who appears to know anything whatever about the depth or direction of any portion of the drains, and I venture to add that it would be impossible to prepare anything like a specification that would hold good for a single week after the works had been commenced. Consequently the Guardians would be saddled with a large amount of extras and additional cost which it would be impossible to include in any original contract, and there can be no doubt that it would be to the interests of the ratepayers if you made a report to the Council recommending this should be dealt with as a sewer, and that the works be carried out, so far as the underground portion is concerned, by the Council's staff, and that an accurate account of time and material be kept and charged to the Guardians, exactly as though it were a sewer job being done for the Council. " With regard to the plumbing works, carpenter's works and making good necessary on the refitting of the w.c.'s and sanitary conveniences, these could be dealt with in the same way, i.e., the different tradesmen concerned could be asked to give an estimate for each section of work as it progressed, and the cost of such works be charged to the Guardians. 29 " With regard to the total cost of the works, it is impossible to state even an approximate amount. " The total length of the area to be drained is from the sewer in Bishops Road nearly to the Regent's Canal, a total of about 730ft. ; the area across from Lark Row to Waterloo Road is a total of about 315ft., with numerous branch drains and fittings in various directions. " The works in connection with the main drain will be comparatively costly, apart from the length and dimensions of the area as, in consequence of the fact that the Guardians' kitchen is situate in the basement, the main drain will have to be kept at a depth sufficient to effectually drain this basement, which means that for a large portion of its length this drain will have to be kept at a depth of from 12ft. to 14ft., necessitating deep digging, timbering and the like. " In addition to the area and buildings thereon it may be mentioned that the drainage of the Workhouse entails the provision of a drainage system with all needful sanitary appliances and fittings for a population varying from 1,200 to 1,400. These figures are mentioned to give some idea as to the dimensions of the works required but, as stated above, in view of the uncertainty as to what the conditions throughout actually are, and which conditions can only be discovered by completely stripping out the entire system from end to end, it is impossible to fix anything like an approximate cost. " For the information of the Members I may add that some years ago when these same works were proposed to be carried out I met the then Guardians' Architect and Surveyor and with him very carefully went into the whole matter. After making careful inquiry it was then estimated that the approximate cost of the necessary works would be about £3,000, and as an approximate figure one may say that in all probability the cost of providing an entirely new drainage system, removing defective sanitary conveniences and fittings, providing new as necessary, making good and leaving all in a sanitary condition would be anything from £2,500 to £3,000. 30 " As a general recommendation I should advise that, with the Guardians' agreement, men should be taken to strip up the main drain at its junction with the sewer in Bishop's Road, and to open up throughout, relay with new, and deal with each section and every branch drain connected with the same as it was found, and so proceed with the works from the lower end right throughout. "There is one other feature, although strictly speaking not a sanitary matter, but which will have considerable effect on any system of drainage, which may be laid down, and that is the system of exhausts from steam calorifiers. " At present these, in many instances, blow off direct over gullies, with the result that the stoneware pipes of any drainage system would become heated and ultimately cracked and broken if this system was permitted to continue. " To prevent this a proper system of coolage tanks or cisterns must be provided, into which these exhaust pipes should be made to discharge, and the waste from same then conducted by means of proper channels on to drain inlets, to be provided at suitable points and where necessary throughout. JOHN FOOT, Chief Inspector. 26th June, 1907. 31 Report of Inspectors Richards and Jones as to Opening-up md Examination of Workhouse Drainage. " In accordance with instructions received, we beg to report that we have made an examination of the sanitary conditions existing at the Workhouse and have opened up the drainage system at several points. The result of the examination is as follows :— Administration Block, Bishops Road. " On opening up the ground in the basement of these premises, it was found that the block was drained by means of a 9in. main drain running underneath the corridor from east to west. This drain was without proper jointing material, in a very leaky condition, and the ground underneath the same was found to be saturated and black with leaky deposit or sewage matter from the drain. "This 9in. drain, after leaving the building, was connected to the main drainage system of the Workhouse in the yard next the Relief Offices at the western end of the administrative block. This main drain is of 18m., and on it there is in this yard a large manhole. " When this was constructed there is no doubt that it did contain what is known as a Mason or Dip trap. This trap in itself has long .since been condemned as being ineffective and insanitary, and in this particular instance does not act as a trap at all, as the dip and top have been removed, in addition to which it is not provided with any airtight or close-fitting cover, and is therefore practically open and discharging foul gases at all times. " In the bottom of this manhole was found to be a large deposit of sewage matter and filth about 2ft. Gin. deep. In other words, this manhole and so-called trap is nothing more or less than a cesspool, in a very offensive condition. " Returning to the conditions in the administrative block, the drainage system was opened in several places and was found to consist of 4in. and Gin. pipes running into the 9in. pipe first mentioned. In each place where these drains were examined, they were found to be withou' 32 proper jointing material, leaky and defective, in some places pipes broken and crudely patched, and at various points under the pipes the earth was found to be wee with percolation from the defective drain " In one room in the basement an old drain pipe was found apparently dead, and this had at some time or other been improperly sealed off. It was practically open at the bottom, allowing free run for rats and a passage for sewer gases and foul air at all times. When this drain was found in this condition it was sealed off the same night by the Council's men but on the following morning, on an examination being made it was found that fresh rat runs had been made into this same room, showing that further defects existed further on the same section of drainage. "The soil pipe from the w.c. over the Board Room is of part lead and part stoneware; the joints are defective and the soil pipe is unventilated. The soil pipes from the clerks' w.c. is of seamed lead and not of such construction as is now recognised as satisfactory although ventilated. Both these soil pipes must be reported as defective and unsatisfactory. " The sink waste pipes, and in certain instances the rain water pipes in this block are, although trapped, improperly connected into the drains, there being no gullies or open air space between such pipes and the entrance to the drains. " The waste pipes from the lavatory basins were not traced in their entirety as it was impossible to do so without dismantling the offices, but so far as can be judged they are in each case connected with the soil pipes above referred to. " The urinal waste from the Board Room lavatory discharges into a trap under the basement floor, but there is no trap under the fittings or to the floor waste. "There is a defective bell trap in the area, on the north side, entering into the drains by means of a square junction. 33 " In addition to the defects described as to the drainage, the w.c.'s and fittings will require to be overhauled and in certain instances remodelled and brought up to date, one w.c. at least being defective. B Block. "The drain was next opened up near the Needle Workroom where it was found to be a 6in. pipe taking two soil pipes, each receiving six w.c.'s on the different floors in this block. The drain at the foot of the soil pipe was patched up with red tile, the junction pipe was broken and the ground underneath was wet and saturated with percolation from the defective drain. " This drain then passes on and enters into a kind of intercepting trap which has been most improperly fixed under the footway, and which being provided with an open grating over it acts as a ventilaton for the drainage system and soil pipes immediately under the noses of passers-by and into the windows of the block and buildings adjacent. The emanations from this intercepting trap are rendered more dangerous from the fact that it also takes the drainage of the slop sinks of three floors and from a gulley in an angle of the building. " On opening the drain at the south-east corner near the gully a oin. drain was found with a 9in. drain almost immediately under it. The gully in the angle entered the 9in. drain in the centre of the yard. This 9in. drain is broken in places, is not provided with proper jointing material, has been patched up at different times and can only be described as being in a very defective condition. The (Sin. drain referred to appears to be dead but not disconnected from the drainage system. So far as it is possible to judge at some time or other it took the drainage from the lavatories inside the corridors. Yard of ablebodied female block. " On opening the ground at this point a large brick receiver measuring roughly 3ft. by 2ft. 6in. and about 2ft. 6in. deep was found under the w.c.'s. Two w c.'s discharge directly into this, the pipes from the w.c.'s being brought into this large receiver or cesspool about 2ft. Gin. from the bottom. It need hardly be added that the cesspool is in a very offensive and most insanitary condition. 34 " The outlet from this cesspool is, so far as can be judged from the surface, a 12in brick drain running from the said cesspool into the main drainage system of the Workhouse, which at this point is a brick barrel from 18in. to 2ft. in diameter. Near this point, and in the same yard, is a manhole opening direct on to the brick barrel drain just mentioned. At the bottom of this manhole was found several inches of black sewage deposit, the drain and manhole being in a very offensive and insanitary condition. "A further opening on the drain was made near the gully in the centre of the open yard, where it was found to consist of 6in. pipes and entirely without any jointing material. The gully in the open yard near the said wall was next examined, and the drain from this was found to pass from this point into the intercepting trap at B Block previously mentioned. The drain was examined near the stop cock box in this same yard, and found to be in a similarly unjointed and defective condition. The drain near the gully in the covered yard was also examined, when it was found that the gully outlet was butted up to the pipe drain without any socket, jointing, or proper connection. The drain outside the lavatory to the covered yard was opened, and found to be of 4in. pipes, with very rough cement joints, and laying on lime concrete. The drain from the trough closets was opened and examined and found to consist of 9in. pipes, which 9in. pipes are covered with concrete. This concrete was not broken away, in order to avoid damaging the drain, but the drain cannot be described as satisfactory. Nursery Yard. " The drain was opened in this yard near the gully outside the scullery. It was found to be of 4in. pipes, a socket patched near the gully ; the drain was entirely without joints, and the cement underneath was black and saturated with percolation from same. '"Opened the drain at the gully inside the scullery, where it was found that the 4in. drain was unsound and without proper jointing material- " Opened the drain by the gully by the nursery, where it was found that the drain had some rough cement jointing on the face but without concrete. 35 " Opened the gully taking the slop sink in the nursery bathroom, where it was found that the drain pipes were badly laid with rough cement joints and without concrete. " Opened the drain near the glass house where it was found to be of 6in. pipes, patched up, with only surface joints in cement, but with water running from the joints at the time it was opened. Infectious Disease Cottage. " Opened the drain at the south side of the infectious hospital, where it was found to be of 6in. pipes. The branch drain from the gully is not provided with any proper junction or connection, but the branch joins the larger drains by means of a hole cut into the pipe This drain so far as examined is found to be without joints and imperfectly fitted. EVAN RICHARDS, Sanitary Inspector. ISAAC R. JONES, Sanitary Inspector. 26th June. 1907. Following the consideration of these reports, further correspondence with the Guardians ensued, resulting in my meeting Mr. H. G. Pearson, of the Architects' Department of the Local Government Board, at the Workhouse, on July 25th, and fully explaining to him the position as it then stood. After further correspondence, explanations and the delays that seem inseparable from business matters of this nature, the Guardians definitely decided not to entertain the idea of entering into any contract, or calling in an independent Surveyor, as recommended at the Council Meeting in May. Their former request, that the work should be carried out by your department, was renewed. 36 I prepared the following memorandum : — Workhouse Drainage. Memorandam. Memorandum. "It will be within the recollection of the members of the Council that this matter of the Workhouse Drainage has been under consideration for some months past, and since the matter was before this Council in May last, the Committee have had the drainage system examined at various positions with the result that it has been ascertained that considerable amendments are required, and which amendments will entail the expenditure of a fairly substantial sum of money. "A representative of the Local Government Board has met the Chief Inspector there during the examinations, and it has been agreed that considerable works require to be carried out, and the question for immediate consideration is as to how best these works should be done. "The Guardians repeat their previous application, that this Council would give the necessary sanction for the Public Health Committee for carrying out these works at the cost of the Guardians' Board, and, as stated on the Agenda Paper, your Committee are of opinion and recommend that the application of the Guardians should be granted, and the Committee should have the proper authority, subject to a satisfactory agreement between the Town Clerk and the Guardians, to carry out the works required. The alternatives are .— 1. That the Guardians should be requested again to call in private contractors; or 2. That the Guardians will, in the event of the Council's refusal, endeavour to carry out the work by their own labour. " In view ol the fact that considerable temporary repair and works of a tentative character have been carried out for the last fifteen years, the Committee think it is essential that the matter should now be dealt with in a proper and practical way. 37 " Amongst the difficulties of proceeding to contract is that it is not entirely a new drainage system from end to end, as it is hoped that at least some of the existing drains may be found sufficiently good to remain in, but the whole trouble arises from the fact that there is a large area of about 730ft. by 315ft., in which there are three or four main lines of drainage with numerous branch drains in various directions, and that no plan is in existence or any accurate knowledge whatever of the thing as a whole. "It should be mentioned that the entire Workhouse and buildings throughout entail the provision of a drainage system with all needful sanitary appliances and fittings for a population varying from twelve hundred to fourteen hundred persons. " If the Council accede to the Guardians' request, the Committee will be prepared to make the necessary arrangements for proceeding with the works as speedily as possible. "N.B.—It should be emphasised that the only probable alternative to the Council's refusal will be that the Guardians will rightly or wrongly attempt to carry out this work by themselves. " In view of the highly technical and important character of the work, the Committee are of opinion that this would not be the most desirable solution of the difficulty. JOHN FOOT, Chief Inspector. 16th October, 1907. Subsequently the Council decided to acquiesce in your further report as follows :— Report of the Public Health Committee, dated the 9th October, 1907. Bethnal Green Workhouse Drainage. " We have received and considered a letter from the " Bethnal Green Board of Guardians, stating that a letter has " been received from the Local Government Board, intimating Report of Committee. 38 " that the Board are not prepared to consent to an expendi" ture of more than £1,000 in respect of the proposed "reconstruction of the Bethnal Green Workhouse drains, " and that when the Board ot Guardians find it necessary to " apply for sanction to any further expenditure they will be " in a better position to state what work is actually required. " This the Clerk to the Guardians considers amounts to a " consent to the carrying out of the necessary works. The " Board of Guardians state they will be glad if the Council " will now take into their favourable consideration the "application contained in their letter of the 19th June last, " requesting this Authority to carry out the necessary amend" ments to the drainage system at the Workhouse on behalf " of the Board. This Committee are of opinion and recom" mend that in the best interests of the Borough the necessary " authority be given to the Public Health Committee to carry " out the amendments required to the drainage system at " the Bethnal Green Workhouse, Waterloo Road, in accord" ance with the request made by the Bethnal Green Board of " Guardians, subject to the preparation of a proper contract " between the Council and the Board of Guardians." Upon this it was resolved that the report of the Committee be received and the recommendation contained therein adopted. As was almost inevitable in such a complicated matter, certain legal difficulties in regard to contract between the authorities then presented themselves, but ultimately I was informed by the Town Clerk the contract was complete, and I commenced operations the following day, 18th November. Particulars of these works must of necessity follow in later reports, I can only say here, that we have just gone sufficiently far to find that we are face to face with enormous difficulties and responsibilities of such a character as to cause a considerable amount of anxiety. 39 With the experience and loyal assistance of Mr. Jones and the men under his charge, I hope and believe with every confidence that we shall ultimately dispose of this matter with satisfaction to the Guardians and some credit to your Committee and Department. I desire here to acknowledge the ready help and great assistance freely rendered by the Officers of the Guardians so far as we have gone. New Legislation. Sale of Food and Drugs Act. The long looked for and much talked about new Butter and Margarine Act, 1907, comes into operation on the 1st January, 1908. and may in a word be described as a disappointment. The following is a summary of the more important provisions of the Act. Butter factories and Milk-blended Butter factories and premises for wholesale trade in either of the articles must now be registered in the same manner as premises concerned in the manufacture and wholesale dealing in margarine, and no premises may be used as a Butter factory if they communicate with any other premises used as Margarine or Milk-Blended Butter premises, save where premises were so used in conjunction before the 1st January, 1907. If any substance, or any oil or fat intended to be used, or capable of being used in the adulteration of butter, is found in any Butter factory, the occupier of the same is deemed to have committed an offence under the Act. It is an offence, for which the occupier is liable, to have in any Margarine or Butter factory any butter or margarine which contains more than sixteen per cent of water, unless he or the consignor proves that the buttter or margarine was not made, blended, re-worked or treated, in that factory. 40 The sale of Milk-Blended Butter containing more than twenty-four per cent. of water is also an offence under the Act. The Local Government Board are empowered to make regulations for prohibiting the use of preservatives, or for regulating the extent in which they may be used in Butter, Margarine or Milk-Blended Butter. Milk-Blended Butter must in future be dea t with under such names as may be approved by the Board of Agriculture, and under the conditions relating to the sale or description of margarine. The wrappers of packages sold must have the approved name printed on them, together with such description of the article set out, and the percentage of moisture or water contained therein as may be approved by the Board of Agriculture. No fancy names for Margarine or Milk-Blended Butter will be approved if they refer to or are suggestive of Butter or anything connected with the dairy interest. Margarine is defined as any article of food whether mixed with Butter or not which resembles Butter and is not MilkBlended Butter, thus "amending" the definition contained in the Margarine Act, 1887. Other Sections relate to powers conferred on the Board of Agriculture and the Board of Customs. It sounds very nice, as most new Statutes do, until they are tested in the Courts. When that happens the inherent defects will become more obvious. Whether the poorer classes in whose benefit, we are told, this has been passed will be duly and properly grateful when they realise this measure seems legally to countenance the selling of something that looks like Butter, smells like Butter, and tastes like Butter, but is in fact 24 per cent. moisture or water, remains to be seen. Of course, the 41 unsuspecting public are to get this moisture-laden luxury under a variety of nice-sounding fancy names that have to he registered. During the passing of this, the very latest of all our Butter Bills, is was suggested, in view of the amount of water to be allowed, that "Aquatic" Butter should be the fixed definition of this humectated article. As with Butter, or more properly speaking moistened Butter, so with the new definition of Margarine. This article of food of the poor has always been more or less associated with a sort of mystery as to its manufacture, although many of the brands are perfectly wholesome and lor the price nutritious. For the future, however, it may apparently be a compound of any and everything that can be termed an article of food, from boiled carrots to mashed potatoes, so long as it is made to resembie Butter and does not contain more than 10 per cent. of Butter fat, or 16 per cent. of water. New Legislation Affecting Tenement Houses. Amongst other new legislation coming into force in the New Year and effecting Sanitary Authorities is Section 78 of the London County Council (General Powers) Act, 1907, which relates to the water supply of tenement houses. The following copy of a letter which I had written for the information of the District Inspectors contains all particulars, and is practically adapted from a circular letter received from the London County Council:— Public Health Department, Bethnal Green. 13th January, 1908. Dear Sir,— I have been directed to call your attention to the provisions of Sec ion 78 of the London County Council (General Powers) Act, 1907, which received the Royal Assent on the 28th August last. 42 The Section recites that— "For the purpose of Section 48 (Provisions as to house without proper water supply) of The Public Health (London) Act, 1891,' a tenement house shall be deemed to be a house without a proper and sufficient supply of water unless there shall be provided on the storey or one of the storeys in which the rooms or lodgings in the separate occupation of each family occupying such house are situate a sufficient provision for the supply of water for domestic purposes. "Provided that with respect to any building existing and in use as a tenement house at the passing of this Act this Section shall not (a) come into operation until the first day of January One Thousand Nine Hundred and Eight or (b) apply where the only storey or storeys on which a proper and sufficient supply of water is not provided is or are a storey or storeys (i) constructed at a height exceeding that to which the Metropolitan Water Board may for the time being be required to furnish a supply of water for domestic purposes and (ii) to which a supply of water for such purposes is not at the passing of this Act being furnished by the said Board by agreement. "Provided also that this Section shall not apply to any tenement house in respect of which it can be shown that any such provision for the supply of water as aforesaid is not reasonably necessary." In making the next inspection of tenement houses in your district I shall be glad if you will note any case where the water supply arrangements are inadequate and where it may be necessary to make any alteration to carry out the requirements of the above Section. Your obedient Servant, John Foot, 43 It will be noted that the provisions are not what one may term precisely clear and determinate, there being a fair amount of alternatives as well as the usual "Provided." Add to this the further item that no one seems quite to know what constitutes in law a tenement house, and in the result one may safely predict a further complication of what may be termed "latch-key" and "lodger" cases. New Legislation Relating to Verminous School Children. During the year there came into force certain powers under the L.C.C. General Powers Act, 1907, referring to the cleansing of verminous children and the disinfection of their clothing. To carry this desirable object into effect, it is, as I understand it, the duty of the L.C.C. to provide the requisite and necessary accommodation, or to make agreements with the local sanitary authorities, under which their existing disinfecting stations and apparatus may be used for this purpose. Almost before this Bill had become law we were asked on the 'phone by certain officials what steps we were taking for carrying out this measure, and, although neither in fact or law had any such obligation been thrown on you, certain of the local Education officials proceeded to send verminous children direct from school into the office, and with requests, very like commands, required the bathing and cleansing of the children. In each case I communicated with the parents, who apparently had not the slightest intimation of what was being done, and in the end the children were bathed at the station and sent home. Your Committee having carefully considered the matter on several occasions, directed me to refuse to receive any more children under such circumstances, and ordered the following letter to be sent to all the Head Masters of Schools in the Borough:— Re Verminous Children. Dear Sir,— You are probably aware that for some time past children in a most uncleanly condition have been brought to these Offices from various Schools in the Borough, with a request that such children should be bathed and their clothes disinfected. 44 The Public Health Committee have given the matter most careful consideration, and they are strongly of opinion, apart from the fact that they are advised it is no part of their duty to undertake and provide facilities for such bathing, that it is objectionable to bring school children to a disinfecting depot for this or any other purpose, and that the bathing and cleansing of such children should be provided for on premises in connection with the Schools. In any case, they object to children being brought here for such treatment without the previous knowledge and consent of their parents. Having regard to all the circumstances, the Committee have decided not to undertake the bathing of any more of these children, and I am directed to so inform the Head Masters of all the Schools in this Borough, and to request that for the present at all events, no more such children shall be sent here. May I ask you to kindly make this known to the Head Mistress and other members of your staff. I am, Sir, Your obedient Servant, John Foot, Chief Sanitary Inspector. 20th December, 1907. There for the moment the matter rests. Obviously, where interference with children in such a matter as this is concerned, the greatest discretion requires to be exercised, and the thing should be done thoughtfully and with some tact. To rush the children off to the Sanitary Inspector without notice or the previous knowledge or consent of the parents, seemed, apart from the kid-napping aspect, to be just the way to arouse the most bitter opposition and to cause a violent reaction to our efforts in this and other directions. 45 Other New Legislation The remaining new legislation calling for note as affecting health authorities is:— 1. The Factory and Workshop Act, 1907, and 2. The Public Health (Regulations as to Food) Act, 1907. Laundries. The first does not materially concern us, but is apparently intended to bring the Laundries of certain Institutions under inspection and the requirements of the Act. It also appears to make places where only one woman is employed subject to the requirements. Regulations as to Food Act. The Public Health (Regulations as to Food) Act is a much more important matter, and it is to be hoped the regulations when formulated will prove to be of some practical value and helpful to the local authority and its officers in their efforts to secure a pure and wholesome food supply to the people of their borough. If on the lines of many of our recent reforms of the food laws they will not be of any particular value, except perhaps to the lawyers. Discontinuance of Water Supply Notice by Metropolitan Water Board. During the year 105 Notices were received from the Metropolitan Water Board under Section 49, Public Health (London) Act, 1891, giving notice of the discontinuance of water supply to premises throughout the Borough. The majority of the cases arose from defective pipes and fittings. Close observation was in all cases maintained in order to secure the continuance of the supply at the earliest possible moment. Certificates Water Supply. The premises in respect of which Certificates were issued during 1907 were as follows:— 12th January 14 and 16, Camden Street. 28th May 8, 10, 12, and 14, Cyprus Street. 2, Moravian Street. 304, Globe Road. 11th July Clergy House, St. Barnabas Club Buildings. 25th July 267, 269, 271, 273, 273a, 275, 275a, 277, 277a Green Street. 46 Offensive Refuse, Fish Offal, &c. In the early part of the year several complaints were received as to nuisance arising from the temporary storage and removal of offensive refuse, mainly fish offal. An extensive investigation of all the premises in the Borough where such refuse is made was instituted, and it was found, generally speaking, that the Bye-Laws v ere fairly closely observed. It was, however, observed that in the removal of the refuse some laxity existed on the part of the carmen of the tank vans. The contractors, two in number, who are mainly responsible for the removal of fish offal in Bethnal Green were communicated with, likewise the offal producers in the Borough, and there is every reason to believe that the better conditions existing since are due to the action taken by this Department. As the investigations in this matter progressed it became increasingly apparent that the present arrangements for dealing with offensive refuse were most unsatisfactory, and after much consideration the following report was presented by your Committee to the Council:— "For some time past the Committee have had under consideration the question of removal of fish offal and other like offensive trade refuse from various establishments in the Borough. "This business is at present mainly in the hands of two contractors, and although carried on generally within the limits of the law it is impossible from the methods adopted, which do not constitute any infringment of the law, to avoid nuisance. "Recently an endeavour has been made to secure some working arrangement whereby the removal of such offensive matter may be carried on without nuisance or annoyance to the inhabitants. To this end the various offal producers in the Borough have been communicated with, and the general concensus of opinion is that the Council should undertake the work at some small charge to cover the cost to the Borough. 47 "At present your Council do not possess the powers necessary for the work, and your Committee hold a strong opinion that the removal of offal by the Council is the only way to remove the difficulty, and recommend that the London County Council be strongly recommended to include in its next General Powers Bill a clause enabling Borough Councils to carry out the removal of trade refuse within the districts under their several jurisdictions." This recommendation was adopted, with the result that the Public Health Committee of the London County Council was instructed by the County Council to submit, with a view to the promotion of legislation in the session of 1908, detailed proposals dealing, inter alia, with the acquisition of powers to enable sanitary authorities to require the surrender of offensive trade refuse, and to arrange for the temporary storage and systematic removal thereof. The powers proposed are very excellent so far as they appear to go. The real, practical and only permanent solution is for the local authority to have full powers to deal with the matter right throughout. Proposed New Powers. On the 25th September a letter received from the London County Council was submitted to the Committee, relating to the following proposals in regard to the promotion of legislation in the Parliamentary Session of 1908. 1. To enable the Sanitary Authorities in London to refuse to register, or to remove from the register, cowkeepers, dairymen or purveyors of milk, whose premises are unsuitable for the sale of milk thereon. 2. To regulate the sanitary conditions prevailing at premises on which food is sold or prepared for sale. 3. To enable the Sanitary Authorities to require the surrender for the purposes of destruction, of unsound food. 4. To enable Sanitary Authorities to require the surrender of offensive trade refuse, and to arrange for the temporary storage and systematic removal thereof. 48 5. To enable the Council to make Bye-Laws, to be enforced by Sanitary Authorities, with regard to the proper regulation of the businesses of a seller of fried fish, fish curer and marine store dealer. 6. To enable the Council to pay one half of the salaries of Female Health Visitors appointed by Sanitary Authorities in London. Upon this letter the following recommendation was made to the Council:— "That the London County Council be informed that this Council is of opinion that legislation is urgently required embodying the principles contained in each of the proposals formulated by the County Council.' This report and recommendation were in due course adopted by the Council, and clauses embodying the proposals set forth are included in the General Powers Bill which has been drafted. Renovation of Disinfecting Station. In the early part of the year the Chief Inspector reported that the outside and inside paintwork of the disinfecting station appeared to be in need of renovation, and that portions of the glass in the lights, broken by stone throwing, needed renewing. The Committee paid a visit of inspection and resolved that the work should be put in hand. This was done, the amount of £100 being provided in the half-yearly estimate for the same. The work was carried out by men directly employed by the Committee at a total cost of £70 in a most satisfactory manner. Outworkers and Sweated Industries. In view of the amount of attention directed to it during the last few years, the next matter calling for special note is the question of out-workers, and especially those engaged in what is termed the sweated industries. 49 Just as in the case of the overcrowding question, sc in this. The Sanitary Authority seems to be expected by some undefined process to apply an immediate and effectual remedy for all the admitted evils of this out-workers question. Some of our friends appear almost inclined to make it a matter of personal indictment that no effectual steps have been taken to ameliorate the conditions under which so many of these workers exist. Unfortunately, it is simply a weary tale of repetition. Sanitary Authorities, as such, have no legal power and no means of touching the remotest fringe of the many evils arising out of our present system of homeworking or sweating, as it is usually called. It is, indeed, most probable, that on balance the sweated outworker is in the end not much better off in spite of all our efforts intended for his benefit. Whilst on the one hand it is quite true that we improve the actual sanitary condition of his house, it is on the other equally true that the improvement is in many instances carried out at his own personal cost. In many cases under our notice the outworker has had to pay for the repairs himself, either directly or by means of an increased rental. In other words the already sweated outworker is further sweated by his landlord, and made to pay for the improved sanitary surroundings required by law out of his miserable earnings. In some other cases the outworkers have been given notice to quit, and turned out of their houses in consequence of the attention of the Sanitary Inspector, who visits after receipt of the outworker's lists, twice in each year. Others, again, have been refused houses or rooms. Apparently in one way or another, the lowest paid and most helpless section of the workers are still at the mercy of sweating employers or hard grinding landlords, and that in spite of all our talk and all our alleged improvement. 50 To such an extent has this pressure been exercised that we constantly hear of cases in which incorrect addresses are apparently deliberately given, or fictitious names used by persons who take work home from the different factories or workshops. In other cases a system seems to have sprung up under which one person receives the work and afterwards distributes the same amongst her friends and co-workers, who hope by some such means to escape the over-inspection and officialism, that the intended beneficent, but wrongly directed legislation of the last few years has brought about. 370 wrong addresses or denials that work is done on the premises seems highly significant. The very acme of disappointment seems to have been reached in connection with this matter, which unfortunately is only "a thrice told tale,'' and which in connection with so many matters of a similar kind, might be very briefly summed up in three short sentences. 1. Agitation and demand for improvement of the law in the worker's interest. 2. After long delay and enquiry, a Bill is introduced ultimately crystallising into an Act of Parliament, which might be well termed "an essence of compromises," and which— 3. Leaves the worker with a fresh batch of troubles if he has been lucky enough to get rid of any of his old ones. Enquiry by Select Committee. In J une last I was requested to give evidence before the Committee of the House, which sat to enquire into the question and by direction of your Committee I submitted evidence, of which the following is a copy. 51 Home Workers and Sweated Industries Enquiry by Select Committee, July, 1907. Evidence of John Foot, Associate Member of the Royal Institute of Public Health, Chief Sanitary Inspector to the Metropolitan Borough of Bethnal Green, who says:— "I have had about twenty years experience as a Sanitary Officer, and for the last thirteen years I have held the post of Chief Sanitary Inspector to the Borough Council of Bethnal Green. "During this later period it has been my duty on behalf of the Authority to enforce the Public Health (London) Act, together with those Sections of the Factory and Workshop Acts and all other Statutes enforceable by the Borough Council which in London acts as the Sanitary Authority. "Bethnal Green is an industrial community entirely occupied by persons of the working classes, and homework is carried on to a large extent in various trades and industries. "The area of our Borough is about 755 statutory acres; the rateable value £550,636; the population for the last census 129,680, and is now estimated to be 130,401; the number of rated premises is 21,617. "It will thus be seen that our population is densely packed, there being in (act about 172 persons to the acre, and also that our average assessment is only a little over £25. "The number of workshops and workplaces, exclusive of those factories that are under the jurisdiction of the Factory Department of the Home Office, is 2,070, of which a large number would be domestic workshops. 52 "The number of outworkers registered from the lists supplied by the various factory and workshop proprietors is 3,088, of which 2,248 are resident within the Borough, the remaining 840 being notified by us to the respective authorities outside. "For the purposes of sanitary administration this Borough is divided into six sub-districts, to each of which there is a Sanitary Inspector who carries out all the ordinary duties relating to the sanitary condition of the district. These duties include the inspection of all workshops, workplaces and outworkers' homes, which are all visited twice in each year on receipt of the lists of outworkers in February and August. "In addition we have a Woman Inspector who visits those premises where women exclusively are employed, and which amount to 178. These Officers, with the remainder of the Sanitary Staff, act under directions given by myself in conjunction with the Medical Officer of Health, I being the Statutory Officer officially appointed to execute the Sanitary Acts, and who is held personally responsible for the due enforcement of the same for and on behalf of the Authority. "The main industries carried on by outworkers in this Borough are tailoring and the making of wearing apparel, boot and shoe making, cabinet making, brush making, box making of various kinds, i.e., match boxes, draper's boxes, cardboard boxes, etc. "With regard to the sanitary conditions, the various outworkers' homes are kept under constant supervision. As stated above, each one is visited twice per year and as often subsequently as may be necessary to abate any insanitary conditions found existing. In all cases where the home conditions are found to be so unwholesome as to justify such action, the factory proprietor is communicated with and forbidden to give out further work until the unwholesome room or house has been cleansed or disinfected as the case may require. 53 "So far as existing law permits, everything possible is done by this Authority to keep the standard of cleanliness and sanitation up to a fair level, but it must be added that the existing legal standard is unfortunately not high, and the difficulties of administration are considerably enhanced by the fact that in addition to the regrettable ignorance of large numbers of the workers on all questions relating to domestic and personal hygiene, the facilities provided in the workers' dwellings are so unsuitable and absurdly inadequate that any really high standard of cleanliness is difficult to obtain and only rarely found. "With regard to the question of prices paid, it may be said generally that we have some of the worst and lowest paid labour as well as some of the best and highest priced. "For the information of your Honourable Commission I have made recent enquiries, and submit here some prices paid for the making of various articles. I purposely omit mentioning the names of either the factory proprietor or the worker, but these figures may be taken as authentic, and were in fact obtained by members of our staff, and by myself personally. 54 WEARING APPAREI,—Outworkers' Piece Payments. Work. Price Paid. Remarks. Men's jackets 10d. each Making throughout, pressing, lining, ticketing and finishing complete. Trousers finishing 2½d. per pair Pressing seams, turning up, felling bottoms, lining, sewing buttons and tickets on. Workers supply own thread and needles, and must buy thread from firm they work for. Police trousers finishing l½d. per pair Similar work to previous entry. This is price paid for sub-let work Corduroy trousers 1s. per pair Hand-made throughout. Making and finishing complete. (One pair per day.) Police Coats Is. 2d. each Making and finishing complete for service. Vest finishing 2½d. each On same lines as trousers finishing. Boys' knickers l0d. per dozen Making throughout and ticketing ready for sale. Cap finishing 3s. 3d. per gross Caps as taken from sewing machine to finish and line complete ready for sale. (Two long days to make one gross.) Children's Sailor Costumes 4d. each Made throughout, braided and finished complete. Collar button holing 8d. per dozen collars Hand sewn button holes. Three holes in each collar. Skirts 4s. 6d. per dozen Making, trimming, sewing on buttons and finishing complete. Blouses 2s. 6d. per dozen (sublet at 1s. 6d.) These are lace and silk blouses retailing from 6s. 6d. to 8s. 6d. each. The price includes making throughout from the materials in piece. 55 WEARING APPAREL —Outworkers' Piece Payment—continued. Work. Price Paid. Remarks. Blouses 9d. per dozen These are common blouses retailing at 1s. 11d. each. This price also includes making throughout from the piece. (In blouse work the workers do not provide their own thread.) Nursery Shoes 9d. per dozen pairs Made throughout. Boot machining— Ladies' Boots 1s. 9d. to 2s. 6d. per dozen pairs Machining together the parts already cut out for uppers, and putting in lining . „ Shoes l0d. to 1s. per dozen pairs do. do. Trousers (6d., 8d. and l0d. per pair Making up from the cut out parts and finishing complete, and ticketing ready for sale. Upholsterers' Trimmings (small silk balls tor edgings) 3d. per gross One gross takes from 4 to 5 hours. Match Boxes 2¼d. per gross. Supply own paste. Cardboard Boxes 1s. 2d. per gross One day to make gross (9 X 4 x 4). Out of payment 3d. for glue. Tooth Brush drawing ½d. per hundred holes Good worker can earn l¾d. per hour, hard work This is the best work. 56 "With regard to the question of under-letting or sub-contracting, this, of course, varies more in certain trades and districts than in others, and as a result of inquiry I should say in a general way that it may be taken that a reduction of from 20 per cent. to 30 per cent. is made in many instances by the person originally receiving the work from the factory proprietor and who then of course divides it up amongst his outworkers at the lower prices. "I may mention one case in which I have had an opportunity of examining certain figures and payments and in which I find that the middle man or contractor paid to the outworkers, to whom he sub-let the work, about 1s. 6d. out of every 2s. 6d. he received from the factory proprietors. In other words he sweated this particular work about 40 per cent. "With regard to the question as to how the workers generally are affected, it is undoubtedly a fact that in many instances the man is found without employment, and he and his family dependent upon the earnings of his wife or other females of the family who are outworkers. It is impossible to say with any exactitude to what extent this phase of the question affects the labour market generally. I should say personally that irregular employment acts as a most demoralising factor, and I have in fact met several cases where the man appears to be quite content to rest at home and live upon the earnings of his wife, although a few years back such a man was a regular and steady worker. "Whether the prohibition of all outwork would have any beneficial effect on the labour market as a whole is, of course, a matter of conjecture, but in many cases there would undoubtedly be hardship to individuals. "With regard to the question o??? what alteration of the law is necessary, one feels considerable diffidence in offering any suggestions in what is confessedly a difficult and intricate matter. It is, of course, very easy to say that all home or outwork shall be abolished, and that it shall be illegal for any factory proprietor to continue to give out work to be done outside his factory or workshop; it is also equally easy to say that outwork shall be continued only under some such system of certification as is anticipated in the Homework Regulation Bill presented in 57 February last by a labour member, and ordered by the House of Commons to be printed, but there is no getting away from the fact that either or both of these suggestions are calculated to result in the further oppression of the poorer and most helpless of the working classes. One cannot disguise the fact that hundreds of these poorer outworkers are living chronically a life of hardship and privation that one may truthfully describe as practically on the verge of semi-starvation. Whatever else may result, it seems tolerably certain that to cut these off from even such a wretched system of existence as the above figures and prices disclosed would mean the workhouse for many of these and their families. Poor and terribly inadequate as their present earnings are, it means in literally hundreds of cases that there is nothing whatever between these people and their scanty means but starvation or the workhouse, which to their credit be it said they absolutely abhor and fight against so long as it is possible to drag out an existence. Legal Proceedings not any Assistance. "As a result of considerable experience as a Prosecuting Officer 1 am, however, quite prepared to say that police court proceedings with the resultant fines and imprisonments provide no real or lasting remedy for any single one of the admitted evils arising from this outworkers system. "At the back of the whole matter there is undoubtedly a problem of poverty, which poverty is more deeply seated and widespread than has as yet been even faintly recognised. On no other basis is it possible to attempt to explain why human beings are content to struggle for work at prices that are scarcely sufficient to maintain existence. Apart from this and beyond all ideas of theory, I have, as a result of visiting hundreds of these "homes," become personally acquainted with the fact that troubles in connection with outworkers are like those met with in other directions—simply the result of this widespread poverty problem. "On one point I am fully prepared to express a decided opinion as to the administration of this or any other Statute so far as London is concerned, that is, that it is quite time a period was put to numerous Authorities with their different Departments and different sets of officials interfering with the self-same duties. 58 It is seriously affecting the efficiency of local administration generally in London, and the Factory and Workshop Acts supply a striking illustration. "It is possible for the Factory Department of the. Home Office to be engaged in certain circumstances in enforcing this Act as well as the officials of the Local Borough Councils. In addition the Officers of the London County Council from time to time intervene, and then as though these were not enough, the machinery of the Local Government Board as the superior Sanitary Authority is occasionally called into requisition. We have thus divided responsibility, a minimum of efficiency, the maximum of overlapping and fussy interference, each set of officers trying to justify their own existence at the expense of the other set and utterly destroying the confidence of the public, as well as burdening the community with high rates for the payment of all these different sets of officials, which might be entirely avoided by increasing the powers of some one Authority and compelling, if needs be, by means of a Government Department, their strict and proper exercise of such powers when granted." End of the Enquiry. Like many previous Commissions and Enquiries this one has ended and left us pretty much as before. Indeed it seems to be generally more clearly recognised now that the enquiry is the practical end of the matter. A sort of careful orthodox way of wearying out those who desire that something shall really be done by way of remedy. Details ot Works and Various Duties, I annex in the several Appendices details and particulars of an enormous amount of routine work carried out by the Staff of the Department during the year. These are set out in the following order:— Appendix A—Total number of Inspections, &c. „ B.—List of Nuisances and Insanitary Conditions Discovered. „ C.—List of Sanitary Improvements Effected. „ D (1), (2), and (3).—Particulars of samples of Food taken. „ E.—Premises subject to Special Bye-laws. F.—Proceedings under Food and Drugs Acts. „ G.—Proceedings under Public Health Act. 59 Appendix H.—Particulars of Houses let in Lodgings. „ I.—-Particulars of Ice Cream Shops, &c. „ J.—Particulars of Complaints received. „ K —Particulars of Clerical work. „ L.—Particulars of Outworkers. „ M.—Particulars of Combined Drainage and other Works. „ N (1), and (2).—Particulars of Disinfectors' Work, Shelter, Occupants and Disinfectants. „ O.—Particulars of Mortuary Returns. „ P (1), and (2).—Particulars of Wages, Sick Pay and Petty Cash Accounts. Illness of Members of Staff. It is impossible to indicate even briefly the entire detail work carried out in the Health Office of a Borough constituted as ours is, but I believe the most important matters have been dealt with and I trust sufficient has been adduced to show that every effort has been made by the staff to keep the Borough in as good a sanitary condition as possible, having regard to all the circumstances. As regards the staff the year under notice has been a somewhat unfortunate and trying one. We have, I regret to say, experienced a greater amount of sickness than in any similar period. Following the illness of Mr. Henley there followed that of Mr. Bridel, and I deeply regret to have to add, that although the first officer has returned in restored good health, the other is still absent, and up to the time of writing there appears to be no immediate prospect of his resuming. The duties of the absent officers were cheerfully undertaken by the rest of the staff, who at great inconvenience to themselves took up the work, which so far has not suffered. Respectfully tendering my best thanks for the continued support of your Committee. I am, Mr. Chairman and Gentlemen, Your obedient servant, JOHN FOOT, Chief Sanitary Inspector. Member Royal Institute of Public Health. 60 61 APPENDIX A. Total Number of Inspections and Particulars of Cases in Hand for the Year ended 31st December, 1907. District. Infections Cases Complaints. House to House Inspections. Trades' Inspections. Re-inspections. Milkshop Inspections. Factory and Workshop Inspections. Outworkers' Homes Inspections. Tenement House Inspections. New Buildings Inspections. Ice Cream Shop Inspections. Combined Drainage Inspections. Smoke NuisancesPremises under Observation. Other Inspections or Work of Special Character. Number of Calls. Unsound Food Seizures. Samples of Food and Drugs taken. Police Court Attendances. Nuisances Abated. Number of Cases in Hand. Total Visits for the Year. Inspector. a 300 375 107 — 2888 183 208 934 271 1 31 63 — 86 145 — 91 14 762 71 5592 E. Richards. b 197 244 88 2 2268 134 163 774 307 5 82 — — 185 73 — 74 5 592 61 4522 H. F. Bridel. c 362 463 582 97 3243 319 474 515 352 — 67 — — 184 — — 126 17 976 43 6658 F. T. Bare. d 236 362 42 — 2967 215 425 247 325 — 10 — — 145 110 — 95 14 665 30 5084 J. G. Weeks. e 397 260 124 — 2403 308 571 740 395 — 13 — — 98 113 — 101 1 738 69 5422 A. S. Henley. f 239 193 49 17 3169 249 754 703 90 — 11 — — 84 131 6 98 12 731 54 5689 E. Ainley. Drainage and New Buildings 13 — — — 148 — — — — 296 — 1871 — — 282 — — — — — 2610 I. R. Jones. Markets — 17 — 898 — — — 26 — — — — 560 4 2 6 160 31 — — 1507 W. Rowsell. totals 1744 1914 992 1014 17086 1408 2595 3939 1740 302 214 1934 560 786 856 12 745 94 4464 328 37084 — 62 APPENDIX B. List of Nuisances and Insanitary Conditions generally, discovered during the year 1907. Period. Dirty Premises. Defective Drains. Defective and Dirty W.C's. Defective Water Supply. Smoke Nuisances. Other Matters. Totals. 5 weeks ending 2nd February 205 49 193 36 1 481 965 4 „ „ 2nd March 287 19 116 59 4 291 776 4 „ „ 30th „ 308 29 113 50 2 319 821 4 „ „ 27tli April 262 18 63 44 4 223 5 „ „ 1st June 270 49 172 48 1 4 438 981 4 „ „ 29th „ 277 22 70 29 3 221 622 5 „ 3rd August 236 22 89 46 4 261 658 4 „ „ 31st „ 121 9 52 26 1 118 327 4 „ „ 28th September 275 37 148 51 2 393 906 5 » „ 2nd November 391 35 230 89 1 543 1289 4 „ 30th 295 29 121 48 7 387 887 4 „ „ 28th December 213 12 86 24 1 232 568 Totals 3140 330 1453 550 34 3907 9414 APPENDIX C. List of Sanitary Improvements effected during the Year. Cleansing— Premises, &c., cleansed, repaired, or whitewashed 3,504 Workshops ditto ditto ditto 579 House Drains— Drains relaid 312 Drains amended 70 Drains cleared 286 Drains trapped and ventilated 9 Rain water pipes and waste pipes disconnected 5 Sink and bath waste pipes trapped 69 Water Closets— W.C.'s repaired, cleansed, &c. 1,468 W.C.'s refitted with new pans and traps 270 W.C.'s supplied with water, and water supply apparatus 501 W.C.'s ventilated 18 W.C.'s rebuilt 11 New W.C.'s provided 36 Partitions provided round W.C.'s to separate same from workshops 4 Water Supply— Houses provided with water supply 133 House supply disconnected from W.C. cistern 1 Cisterns supplied, repaired and cleaned 11 Miscellaneous— Paving of yards 507 Washhouses paved 40 Forecourt and Areas paved and drained 32 Stables paved and drained 9 Removal of accumulation of Dung and other refuse 135 Removal of Animals improperly kept 40 New Dung-pits provided and covers for same 13 Premises closed previous to executing the necessary repairs 42 Gutters, Rainwater Pipes and Waste Pipes repaired 603 Illegal occupation of Basements discontinued 5 Overcrowding abated 212 Urinal accommodation provided 6 Grids provided to Gullies 14 Urinals supplied with proper Water Supply 1 Urinals cleaned 13 Dust Shoots repaired and Receptacles provided 721 Vacant lands cleansed 2 Yards cleansed 177 Indecent occupation discontinued 10 Verminous Rooms remedied 336 Damp Rooms remedied 99 Lighting and Ventilation improved 77 Total 10,381 64 APPENDIX D (1). Sale of Food and Drugs Acts, 1875 to 1899. Samples taken Officially and submitted for Analysis during the Year. Article. Total No. of Samples taken. Genuine. Adulterated. Almonds, Ground 4 4 — Arrowroot 2 2 — Butter 144 136 8 Brawn, Pork 1 1 — Camphorated Oil 6 5 1 Cheese 7 7 — Cocoa 1 1 — Coffee 35 31 4 Corned Beef 1 1 — Cream of Tartar 1 1 — Flour 1 1 Jam, Black Currant 5 5 — „ Gooseberry 2 2 ,, Raspberry 17 14 3 Margarine 16 10 6 Marmalade 3 3 — Milk 387 367 20 ,, Condensed 1 1 — Mustard 5 5 — Olive Oil 1 1 — Peas, Preserved 2 2 — Pepper 14 14 — Pickled Cabbage 1 1 — „ Walnuts 1 1 — Pickles, Mixed 2 2 — Pressed Veal 1 1 — Sausages, Beef 2 2 — „ Pork 11 8 3 Sweetmeats 2 2 — Tartaric Acid 4 4 — Vinegar 2 2 — Totals 682 637 45 65 The following is a summary of legal proceedings, etc., taken in connection with the above cases:— No. of Samples Adulterated. Other offences under Sale of Food and Drugs Acts. No. of Summonses Issued. (see below.) No. of Convictions Obtained. No. of Cases Dismissed, (see below.) No. of Summonses Withdrawn. 45 13 46 28 4 14 The offences against the Sale of Food and Drugs Acts, other than adulteration, consisted in one case of an unlabelled bulk of margarine exposed for sale and in six cases of margarine being sold to the retail purchaser in an unstamped wrapper. In twelve cases the Committee exercised their discretion and ordered that no prosecution should ensue, but that a severe caution be administered to the offenders. The cases were as follows:— In a case of deficiency of butter fat in milk, the sample was taken late in the afternoon from a very small quantity of milk, after considerable dipping from the counter pan to previous customers, the excuse put forward that by this means an undue proportion of fat had been unwittingly abstracted being accepted. In four cases of boric acid in milk, the amount fell below the minimum allowable amount, as suggested by the Local Government Board. In one case of excess of water in butter, above the legal limit of 16 per cent., the excess was so small as not to warrant proceedings. In the case of three butters, one milk, and one coffee, notices were exposed by the vendors, stating that purity was not guaranteed, which notice is apparently sufficient in law to protect the vendor. In one case of poor milk the actual cow which gave the milk was sampled in the presence of an inspector, and the sample thus taken was found to be deficient in fat. The milk which was given by the other cows belonging to the same owner was, however, found to be much above the standard, and the owner offering to dispose of the cow giving poor milk the Committee decided not to prosecute. 66 Two cases were dismissed on the "warranty" defence, and in two cases a purely technical flaw was discovered in the proceedings, which resulted in the dismissal of the summonses. One summons was withdrawn upon the magistrate's suggestion, the offender at the time of the offence having suffered a domestic bereavement and the offence being of a minor character. The remaining thirteen summonses were withdrawn, being second summonses taken out in respect of samples relating to which two summonses were issued, a conviction being recorded on the first summons. APPENDIX D (2). FOODS AND DRUGS. Table showing Percentage Adulteration for Decennial Period 1897-1906 Compared with 1907. Year. No. of Samples Taken. No. Adulterated. Per centage. 1897 103 32 31.1 1898 146 36 24.6 1899 201 42 20.9 1900 186 35 18.8 1901 326 62 19.0 1902 396 57 14.4 1903 485 64 13.2 1904 609 79 12.9 1905 656 75 11.4 1906 671 87 12.9 Decennial average percentage adulteration 17.9 1907 682 45 6.6 67 APPENDIX D (3). Sale of Food and Drugs Acts 1875 to 1899. Samples taken for General Information. Articles. No. of Samples Purchased. No. Reported Genuine. No. Reported Adulterated. Butter, Salt 5 4 1 Castor Oil 1 1 — Cheese 3 3 — Chocolate Powder 1 — 1 Cocoa and Milk 1 1 — Coffee 4 1 3 Cream of Tartar 2 2 — Gregory Powder 2 2 — Jam, Raspberry 4 2 2 „ Black Currant 1 1 — Lard 3 3 — Linseed, Liquorice and Chlorodyne Lozenges 1 1 — Mace, Ground 1 1 — Marmalade 2 2 — Margarine 13 9 4 „ (Best Mixture) 3 3 — Milk 4 3 1 „ Condensed 1 1 — Milk of Sulphur 2 2 — Pea Flour 1 1 — Peas, Preserved 1 1 — Saffron 1 1 — Sausage, Beef 1 1 — „ Pork 1 — 1 Strasburg Beef 1 1 — Sugar, Demerara 1 1 — Tartaric Acid 1 1 — Those vendors from whom adulterated or impure foodstuffs were obtained were, of course, kept under observation, and dealt with officially under the Sale of Food and Drugs Acts. Fried Fish Sampled. Owing to certain complaints, your Committee in December ordered portions of fried fish to be purchased and submitted to examination by the Clinical Research Association. This was done, the Association reporting in all cases that the fish was apparently in good condition when fried, nothing suspicious being discovered in connection with any of the portions examined. In two cases, however, the operation of cooking had been only partially performed, the interior parts of the pieces of fish being quite raw. 68 APPENDIX E. Inspection of Places subject to Special Bye-Laws and Regulations. Premises. No. of Places. No of Inspections. No. of Notices. No. of Prosecutions. Oil Register end of 1906. Added in 1907. Removed in 1907. On Register end of 1907. Milkshops 373 17 42 348 1350 43 — Cowhouses 15 — — 15 81 — — Slaughterhouses 6 — — 6 39 — — Other offensive Trade Premises 1 — — 1 6 — — 69 APPENDIX F. Police Court Proceedings.—Sale of Food and Drugs Acts, 1875-1899. Date of Hearing. Defendant. Offence. Inspector. Magistrate. Result. 1907 Jan. 1 J. D. M. Adulterated Butter E, Ainley Mr. Cluer Fine £2. „ 8 J. B. Do. Milk E. Richards Do. Costs £1 13s. 6d. „ „ A. L. Milk deficient in fat F. Bare Do. Fine and Costs £2. „ „ J. B. Do. do. Do. Do. Do. £3. „ „ J. P. Do. do. E. Richards Do. Do. £4. „ „ P. C. Adulterated Black Currant Jam W. Rowsell Do. Do. £3. „ „ N. M. Adulterated Raspberry Jam Do. Do. Do. £10. Feb. 26 J. B. Adulterated Milk H.F. Bridel Do. Do. £1 10s. „ „ F. G. Do. Coffee A. S. Henley Do. Do. £2. Mar. 26 A. L. Adulterated Milk J. G. Weeks Do. Fined £2, to include costs. „ „ J. S. Do. do. Do. Do. Defendant absconded before service of Summons „ „ H. K. Do. Butter Do. Do. Fined £4, to include costs. „ „ Do. Margarine sold in plain wrapper Do. Do. Other conviction re same sample. „ „ L. S. Adulterated Coffee W. Rowsell Do. Fined £1, to include costs. Apr. 9 H. S. Do. Milk F. Bare Do. Fined £3 including costs. „ „ Do. Milk deficient in fat Do. Do. Conviction on other summonses re same sample. „ „ A. M. Adulterated Coffee Do. Do. Fine £1. Costs £2 2s. „ 16 F. S. Sausages containing boric acid W. Rowsell Do. Fine £2. Costs £8 8s. 70 Police Court Proceedings.—Sale of Food and Drugs Acts, 1875-1899—continued. Date of Hearing. Defendant. Offence. Inspector. Magistrate. Result. 1907 Apr. 23 M. M. Adulterated Coffee H. F. Bridel Mr. Cluer Withdrawn on Magistrate's suggestion, owing to domestic bereavement. „ „ H. T. Milk deficient in fat F. Bare Do. Fine £2. May 16 S. J. Adulterated Milk A. S. Henley Mr. Biron Costs £1 11s. 6d. „ 28 H. B. Camphorated oil deficient in camphor W. Rowsell Mr. Cluer Costs £1 11s. 6d. June 4 L. T. Selling Milk deficient in fat F. Bare Do. Fined £6. July 2 L. M. Adulterated Milk E. Ainley Do. Costs 12s. 6d. „ 9 L. A. Milk deficient in butter fat F. Bare Do. Fine £2, including costs. „ „ T. J. Do. do. do. E. Ainley Do. Fine £4, Do. „ 16 S. N. Adulterated butter F. Bare Do. Fine £2, Do. „ „ W. L. Do. jam W. Rowsell Do. Fine £2 12s. 6d., including costs. Oct. 15 S. A. J. & A. T. J. Adulterated milk F. Bare Do. Fined £20. „ „ J. C. D. Do. do. Do. Do. Fined £2. „ „ J. B. Do. Jam W. Rowsell Do. Fined £2. „ 29 R. W. Do. Milk E. Ainley Do. Dismissed on warranty defence. „ „ R. R. Do. do. J. G. Weeks Do. Do. do. Nov. 5 C. H. Do. Butter F. Bare Do. Fine £1. Costs £1 3s. Dec. 19 H. K. Do. Margarine W. Rowsell Do. Adjourned to 29th Jan., 1908. „ „ F. T. Do. Raspberry Jam Do. Do. Fined £4, to include costs. „ „ J. L. Do. Margarine Do. Do. Fined £3, Do. 71 Police Court Proceedings.—Sale of Food and Drugs Acts, 1875-1899—continued. Date of Hearing. Defendant. Offence. Inspector. Magistrate. Result. 1907 Dec. 24 E.M. Adulterated Butter J. G. Weeks Mr. Cluer Fined £5, to include costs. „ „ Do. Margarine sold in plain wrapper Do. Do. Other conviction re same sample. „ 31 R. T. Margarine exposed for sale not labelled Do. Do. Dismissed on technicality. „ „ I. K. Adulterated Margarine W. Rowsell Do. Fined £4, to include costs. „ „ Do. Do. do. Do. Do. Withdrawn. Conviction on other summons re same sample. „ „ T. C. Margarine sold in plain wrapper Do. Do. £1 3s. costs. „ „ Do. Margarine containing more than 10 per cent, of butter fat Do. Do. Withdrawn. Conviction on other summons, re same sample „ „ W. R. P. Adulterated Margarine Do. Do. Adjourned to 29th January, 1908. „ „ F. M. Margarine sold in plain wrapper F. Bare Do. Dismissed on technicality. 72 APPENDIX G. Police Court Proceedings.—Public Health (London) Act, 1891. Date of Hearing. Defendant. Offence. Inspector. Magistrate. Result. 1907. Jan. 3 J.D. Non-compliance with notice (2 summonses) J.G. Weeks Mr. Biron Works done. Costs 6s. „ „ J.B. Non-compliance with notice A.S. Henley Do. Do. Costs 3s. „ 31 I.S. Do. (2 summonses) J.G. Weeks Do. Do. Costs 6s. Feb 2 J.D. Do. do. A.S. Henley Do. Do. Costs 6s. April 23 L. Non-notification of Infectious Disease E. Richards Mr. Cluer Fine £2. Costs 2s. or one month. Went to prison. „ 25 J.B. Non-compliance with notice A.S. Henley Mr. Biron Works done. Costs 3s. May 7 T.E. Exposing for sale tuberculous Beef W. Rowsell Do. Fined £50. Costs £5 5s. In default, two months hard labour. Went to prison. „ 30 D. Insanitary premises E. Richards Do. Notice complied with. Costs 3s. June 13 H.N. Unsound Food deposited for sale W. Rowsell Do. Fine £2. Costs £2 12s. 6d. „ „ A.P. Not exhibiting name and address on ice cream barrow H.F. Bridel Do. Fine 1s. Costs 12s. 6d. Costs only to Council. July 23 H.A. Exposing unsound Fish for sale W. Rowsell Mr. Cluer Fine £3. Costs 2s. 73 Police Court Proceedings.—Public Health (London) Act, 1891.—continued. Date of Hearing. Defendant. Offence. Inspector. Magistrate. Result. 1907 Sept. 24 H.E. Depositing for sale unsound Salt Beef E. Ainley Do. Fine, including Costs, £10. „ „ I.S. Exposing for sale unsound Pears Do. Do. Fine, including Costs, £6. Prison for two months. „ „ J.J.F. Exposing for sale unsound Rabbits Do. Do. Fine, including Costs, £4. „ „ L.B. Exposing and depositing for sale unsound Kippers W. Rowsell Do. Fined £2 and 2s. Costs. Prison for three weeks. „ „ W.S. Do. do. Do. Do. Fined £1 and 2s. Costs. Prison for two weeks. Oct. 15 M.A. Indecent occupation in Tenement House J.G. Weeks Do. Fined 10s. and 21s. Costs. Dec. 24 W.B. Unsound Pears exposed for sale E. Ainley Do. Defendant absconded. Adjourned sine die. „ 31 J.A.Y. Unsound Tripe, &c., deposited for purpose of sale. Do. Do. Fined £7, to include Costs. 74 APPENDIX H. Particulars respecting "Houses Let in Lodgings." Number of Houses Registered 509 Number of Houses Registered during the year 1907 23 Number of Houses Removed from Register during 1907 15 Visits paid to Registered Houses by Inspectors and particulars entered in Register 2637 Registration Forms written and served 23 Cases of Overcrowding abated 33 Cases of Indecent Occupation abated 8 Number of Notices served for Insanitary Conditions, &c.696 Number of Prosecutions 1 APPENDIX I. Particulars respecting Premises where "Ice Cream" is Manufactured or Sold. Number of Premises on Register at end of 1907 71 Number of Premises on Register at end of 1906 68 Number of Premises Removed from Register during 1907 10 Number of Premises Added to Register during 1907 13 Number of Visits paid to Premises by Inspectors and particulars entered in Register 265 Number of Notices written and served for the abatement of Nuisances or other Insanitary conditions 35 Number of Prosecutions 1 APPENDIX J. The complaints received during the year from public and semipublic bodies were as follows :— Mansion House Council (Local Sanitary Aid Committee) 80 H. M. Factory Inspector 44 London County Council (mainly copies of anonymous letters sent to L.C.C.) 0 London County Council Smoke Complaints, per Coal Officers 6 Jewish Board of Guardians 3 St. Margaret's House 2 Inspector of N.S.P.C.C 2 Board of Guardians 1 Industrial Law Committee 1 Total 159 75 APPENDIX K. Clerical Work. Intimation Notices Written and Served 4,828 Statutory Notices ditto 2,282 Entries in Nuisance Register 5,517 Entries in Tenement House Register 2,637 Entries in Food and Drugs Register 745 Entries in Outworkers' Register 6,789 Notices respecting Combined Drainage 126 Smoke Nuisance Notices Written and Served (Intimation) 38 Ditto ditto ditto (Statutory) 9 Number of Callers at Office and Particulars of Calls Recorded 2,003 Final Notices Prepared and Served 763 Letters Written 3,209 Briefs and Instructions to Solicitor Prepared 55 Summonses made out (four copies of each) 69 School Notifications Prepared and Despatched 2,395 Notices to District Surveyor 66 APPENDIX L. Outworkers. Year. Number of Lists Received from the Employers. Number of Outworkers comprised therein. Reported from other Boroughs. Reported to other Boroughs. 1906 142 2,832 1,883 1,345 1907 189 3,455 2,613 1,707 Number of Outworkers dealt with in 1907 6,068 ,, ,, ,, ,, 1906 4,715 Increase over 1906 1,353 76 The following list shows the trades pursued by the 2,004 outworkers dealt with in connection with lists received in August last:— Artificial Flower Making 8 Fur Trimmings 1 Bamboo Working 1 Glove Making 1 Bathing Costumes 1 Mantle Making 5 Belt Making 22 Military Trimmings 1 Bibs and Pinafores 4 Millinery 3 Blouse Work 15 Night Dress Making 1 Bodice Steel Making 1 Paper Bag Making 6 Bonnet Shape Making 1 Paste Fitting 2 Boot and Shoemaking, &c. 408 Pom-pom Making 7 Box making (Fancy, Clip, and Cardboard) 360 Shirt Making 4 Silk Trimmings 8 Brace Making 1 Silk Winding and Weaving 29 Brushwork 141 Skirt and Dress Trimmings 6 Button Covering 1 Smock Making 1 Button Holing 1 Stay Making 2 Cap Finishing 4 Tailoring 462 Collar Making 4 Tie and Bow Work 31 Curtain Nets 5 Umbrella Making 12 Dyeing 1 do. Band Making 8 Fancy Trimmings 22 do. Cover do. 4 Fanning 1 do. Tassel do. 1 French Polishing 5 Underclothing 11 Fur Hat Making 1 Upholsterers Trimmings 14 Fur Jacket Making 1 Work Box Making 1 Fur Sewing 1 Incorrect Addresses and Work Discontinued 370 Fur Skin Dressing and Fur Pulling 2 Total 2004 Fur Slip Stitching 1 77 APPENDIX M. Works Carried Out and in Progress by Combined Drainage Staff during the Year. Combined Drainage. 16 to 22, Arline Street. 1 to 4, Emma Street. 90 to 96, Bishop's Road. 10 to 18, Gardener's Road. 20 to 32, Cambridge Circus. 34 and 36, Goldsmith's Row. 13 to 17, Canrobert Street. 76 to 82, Green Street. 41 to 53, ditto 51 to 65, Hamilton Road. I to 5, Chester Street. 46 and 48, Hassard Street. 16 to 20. ditto 15 and 19, Horatio Street. 14 to 18, Coate Street. 81 to 86, Lyal Road. 7 to 25, Cranbrook Street. 6 to 13, New Church Street. 1 to 9, Diss Street. 151 to 155, Old Ford Road. 1 to 6, King's Place. 15 to 29, Parmiter Street. 8 to 16, Diss Street. 4 and 6, Sewardstone Road. 17 and 18, Pelter Street. 5 and 6, Thurlow Place. 1 to 9, Eckersley Street. 1 to 5, Winchester Street. 15 and 16, Pedley Street. 2 to 10, Cheshire Street. Other Works. N.B.—In the following cases the word sewer means those usually called combined drains, and not sewers proper. Workhouse. Drainage system reconstruction. Public Health Offices. Stoves re-set, cleansing, painting and paving. Disinfecting Station. Cleansing and re-painting, &c. Shelter 3, St. James Road. Fitting bath. 78 Other Works—continued. Mortuary. New spouting and repairing wall after water service repairs. 213 to 219, Bethnal Green Road Unstopping Council's sewer. Buckhurst Street, Railway Arch. Tracing drain. 51, Brady Street. Repairing front to sewer. 112, ditto Unstopping Council's sewer. 16, Ellesmere Road. Repairing defective front. 1, Gibraltar Buildings. Unstopping drain (private charge). 3, Hague Street. Cutting off old sewer connection. 23, Hare Street. Stripping and re-papering after Typhus Fever. 7, Russia Lane. Cutting off old sewer connection. 76, St. Peter Street. Unstopping Council's sewer. 2 to 10, Seabright Street. ditto 36 to 38, Somerford Street. ditto and repairing front to main sewer. 6, Thurlow Place. Unstopping Council's sewer. 230, Vallance Road. ditto Volunteer Barracks, Victoria Cleansing drainage system and Park Square. providing vent, shafts (private charge). White's Court and Butler's Buildings. Sweeping Council's sewer. 79 APPENDIX N (1). Particulars respecting Work of Disinfectors and Shelter. Month. No. of Rooms Disinfected. No. of Rooms Disinfected by Request. No. of Schools Disinfected. No. of Articles destroyed at Station. No. of Articles disinfected at Station. No. of Cases in which Shelter was used. No. of Persons accommodated at Shelter. No. of hours for which shelter was occupied. January 93 22 — 4 1753 — — — February 91 15 — — 1810 — — — March 120 24 1 4 1529 — — — April 122 46 1 — 1368 — — — May 131 33 — 2 1654 — — — June 141 18 — 2 2769 — — — July 161 21 — 8 6962 l 5 90 August 172 11 — 4 3222 — — — September 274 9 1 2 3344 — — — October 273 12 1 — 3939 2 6 28 November 200 4 — 5 3453 1 3 15 December 161 8 — 5 2418 — — — Totals 1939 223 4 36 34231 4 14 133 80 6 Sulphur Candles, Strips and Brown Paper supplied to Children's Home, Bonner Road, for own disinfection. 7 Formalin Lamps loaned and 400 Tablets supplied to Mildmay Mission Hospital. Lamps duly returned. 45 casks Sanitas Powder, each weighing 1 cwt. and making up 3,150 packets, have been distributed from the Offices. 224 1-pint Bottles Sanitas Fluid, 80 1-pint Tins "Creocide," and 192 1-pint Tins "Izal" Fluid have also been distributed from the Offices—62 gallons in all. Nearly 1 ton Sulphur Candles has been used in the disinfection of rooms throughout the year, ½ gallon of 40 per cent Formaldehyde Solution has been used in spraying the walls of rooms, and 6 lbs. of Formalin Tablets have been used in the Formalin Lamps for disinfection in cases where it was not practicable to use Sulphur. 1 gallon of Carbolic Acid has been used for disinfection in connection with cases of enteric fever. APPENDIX N (2). During 1907, with the consent of the Public Health Committee, the experiment of buying fluid disinfectants in bulk and bottling and labelling in the department, was tried. The services of the disinfector on duty distributing disinfectants to applicants daily from 9 a.m. to 10 a.m. were utilized, he having ample time then to fill and label the bottles and tin flasks. A considerable saving in cost has been effected, as the following figures will show:— DISINFECTANT. Fluid disinfectant bought already filled, 1 pint tins and bottles. Fluid disinfectant bought in bulk, and bottled at P.H. Department,including bottling and labelling. Sanitas Fluid 6/- per gall. 4/5 per gall. "Creocide" 3/- „ 2/11 „ "Izal" 9/4 „ 5/- „ 81 APPENDIX O. Mortuary Returns, 1907 Bodies removed to Mortuary— On Coroner's Order 234 By Police 22 By Firemen 2 From London Hospital 9 On Sanitary Inspector's Order 5 On Request of Relatives 73 Total 345 Number of Inquests held 258 Number of Post Mortem Examinations made 121 Particulars of Bodies on which Inquests were held— Bodies Removed by Police from Great Eastern Railway 3 „ „ ,, Canal 2 „ „ ,, Street, &c 12 „ „ „ Found in parcels 5 „ ,, Firemen from Thorold Street 2 Bodies Received from Bethnal Green Infirmary 36 „ „ „ House Asylum 1 ,, „ North-Eastern Hospital 16 „ „ Mildmay Mission Hospital 6 Private Houses, &c 175 Total 258 82 APPENDIX P (1). Wages and Sick Pay Account. No. of Weeks. Ending. Combined Drainage. Sanitary Labour. Sick Pay. £ s. d. £ s. d. £ s. d. 5 31st January 65 17 9 39 2 10 3 10 0 4 28th February 79 1 0 31 1 2 2 16 0 4 28th March 105 15 3 30 8 0 1 17 7 4 25th April 69 0 0 32 11 4 — 5 30th May 69 11 10 38 14 5 — 4 27th June 72 10 10 30 14 4 1 2 6 5 1st August 90 2 6 39 5 4 — 4 29th August 72 16 8 32 17 11 — 4 26th September 61 2 5 42 19 3 — 5 31st October 100 10 9 60 11 4 — 4 28th November 73 10 2 39 4 6 — 4 26th December 93 0 10 35 2 11 — Totals £953 0 0 £452 13 4 £9 6 1 83 APPENDIX P (2). STATEMENT OF PETTY CASH ACCOUNT. Amount received each month from Finance Committee. Public Health (London) Act 1891 Cost of Prosecutions, Seizures of Unsound Food, &c. Sale of Food and Drugs Act. Cost of obtaining Samples for Analysis, Prosecutions, &c. Combined Drainage and General Small Accounts for Tools, Materials, 4c., not kept in Stock. Drain Plug Hire. Returned Deposits. General. Sundry Small Payments, 'Bus Fares, Office, and Other Expenses. Mortuary. Washing, Sundry Requirements. &c. Fines, Costs, &c., recovered and paid into Council's Account. 1906. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. January 7 8 5 6 4 10 2 5 6 1 12 8 — 0 12 6 —. 31 9 11 February 16 9 4 1 4 11½ 1 16 1 2 14 10½ — 0 6 7 — 7 5 0 March 0 15 6 3 12 9 3 7 6½ 2 0 0½ — 0 7 6½ 0 10 10 April 6 2 6 2 17 2 2 3 7 1 11 8 — 0 6 6½ — May 9 18 9 3 1 9 2 13 3 0 9 7 — 0 8 5 0 11 2 39 4 6 June 6 18 11 3 19 7 2 16 3 0 8 8 — 0 8 11 0 13 11 2 3 0 July 7 4 2 11 7 6½ 1 13 2½ 0 3 6 — 0 9 1 — 22 10 6 August 8 7 4 3 17 0 0 3 10 1 1 11 — 0 4 4 — 8 0 6 Sept. — 8 14 0 1 2 4 0 5 10½ — 0 8 2½ 0 5 6 12 6 0 October 13 13 4 2 10 4 2 6 11 0 16 8 — 0 9 11 37 13 0 Nov. 16 3 0 1 8 2 3 7 7½ 2 8 8 2 5 0 0 6 8½ 19 9 9 Dec. 6 3 10 2 12 0 3 8 8½ 2 17 7 5 15 0 0 10 10½| 0 10 8 17 5 0 Total for Year 99 5 1 51 10 1 27 4 10 16 11 8½ 8 0 0 4 19 7½ 2 12 1 197 7 2 Total amount received from Finance Committee £99 5 1 Balance in hand from year 1905 21 2 2 £ £120 7 3 Less expenditure 110 18 4 Balance in hand ... £9 8 11