C.I AC 4366 Editor 20/3/15 BET 19 THE Metropolitan Borough of Bethnal Green REPORT ON THE SANITARY CONDITION and VITAL STATISTICS DURING THE YEAR 1913. TOGETHER WITH THE Report of the Chief Sanitary Inspector, BY GEORGE PADDOCK BATE, M .D. Fellow of the Royal College of Surgeons and Licentiate of the Royal College of Physicians of Edinburgh; Fellow of the Royal Society of Medicine; Fellow of the Royal Microscopical Society; Fellow of the Royal Institute of Public Health; Vice-President (past President) of the Incorporated Society of Medical Officers of Health; Examiner in Sanitary Science, &c., to His Majesty's Civil Service Commissioners; Honorary Consulting Physician to Queen Adelaide's Dispensary; J.P. for the County of London; and Medical Officer of Health for the Borough of Bethnal Green. LONDON: Printed by Charles and Son, Emerson Street, Southwark, S.E. 1914. THE Metropolitan Borough of Bethnal Green REPORT ON THE SANITARY CONDITION AND VITAL STATISTICS DURING THE YEAR 1913. TOGETHER WITH THE Report of the Chief Sanitary Inspector, BY GEORGE PADDOCK BATE, M D Fellow of the Royal College of Surgeons and Licentiate of the Royal College of Physicians of Edinburgh; Fellow of the Royal Society of Medicine ; Fellow of the Royal Microscopical Society; Fellow of the Royal Institute of Public Health; Vice-President (past President) of the Incorporated Society of Medical Officers of Health ; Examiner in Sanitary Science, &c., to His Majesty's Civil Service Commissioners; Honorary Consulting Physician to Queen Adelaide's Dispensary; J.P. for the County of London; and Medical Officer of Health for the Borough of Bethnal Green. london: Printed by Charles and Son, Emerson Street, Southwark, S.e. 1914. 13/712 Metropolitan Borough of Bethnal Green. PUBLIC HEALTH COMMITTEE, 1913-14. Meetings held at the TOWN HALL, alternate Wednesdays at 6 p.m. Councillor T. O'Grady, J.P., Chairman. Councillor C. L. Coomber, Vice-Chairman. The Mayor (Councillor W. J. Lewis, J.P.). Alderman J. J. Fleming. Councillor F. W. Eaton. „ R. E. Pearson. „ W. T. Garner. „ J. Robertson. „ R. Larkins. Councillor T. Brooks. „ J. Sigournay. „ T. A. Dean. „ J. W. Ward. Ex-Offlcio Members of the Public Health Committee (Chairmen of Standing Committees of the Council.) COMMITTEE. CHAIRMAN. Finance Councillor A. J. King. Works and Stores „ G. Bayley. Baths „ A. Pendergrass. Electricity Alderman Capt. W. H. Hamilton. The Chairmen of the Law and General Purposes Committee, and the Valuation Committee, are ordinary members of the Public Health Committee. STAFF OF THE PUBLIC HEALTH DEPARTMENT. George Paddock Bate, Medical Officer of Health. John Foot, Chief Inspector. E. Ainley, Sanitary Inspector. I. R. Jones, Sanitary Inspector. F. T. Bare ,, E. Rchards „ W. Billings „ W. Rowsell ,, A. S. Henley „ J. 0. G. Weeks ,, Miss C. Hammond, Health Visitor. H. A. Saunders, General Assistant. CLERICAL STAFF. Ernest Q. Bilham, Chief Clerk. George I. Brighting, Assistant Clerk. Joseph H. Hewitt ,, „ F. G. Thomas ,, „ H. W. Pendrill W. H. Heron, Office Youth. Disinfectors. One Leading Disinfector. Two Assistant „ One ,, ,, and Messenger. Alfred Walter Stokes, F.C.S., F.I.C., Public Analyst. PUBLIC HEALTH OFFICES. Town Hall, Patriot Square, Bethnal Green, E. Disinfecting Station. The Council's Depot, Digby Street, Globe Road, E. Shelter. 3, St. James Road, Bethnal Green, E. Mortuary. Church Row, Bethnal Green Road, E. 4 SYNOPSIS OF Medical Officer's Annual Report, 1913. PAGE General Summary 8 Population 9 Census Returns, .1911 11-23 Births 24 Deaths 24 Table "B," Public Institutions outside Bethnal Green into which residents have been received and where they have died 27 Table "C," Public Institutions in Bethnal Green 29 Deaths in Sub-districts, Table "D" 30 Death Rate 31 Table "E," Monthly Mortality Rates—London and Bethnal Green 32 Table " F," Quarterly Death Rates—London and Bethnal Green 33 Birth Rate 33 Table "G," Marriages 33 Deaths of Infants 34 Table "H," Special Causes of Infantile Deaths 35 Deaths of Young Children 35 Senile Mortality 35 Table "I," Quarterly Mortality—Bethnal Green 37 Table "J," Quarterly Mortality—London 38 Deaths from Notifiable Infectious Diseases 39 The Seven Principal Zymotic Diseases 40 Table "M," Percentages of Deaths from Zymotic Diseases 41 Notification of Infectious Diseases 41 Table "N," Details of Notifications 42 Table "O," Condition of Premises 43 Scarlet Fever 43 Diphtheria 44 5 SYNOPSIS—continued. PAGE Enteric Fever 45 Whooping Cough 45 Diarrhoea 46 Measles 46 Chicken Pox 46 Erysipelas 47 Diseases of Parturition 47 Ophthalmia Neonatorum 48 Cerebro-Spinal Meningitis 48 Poliomyelitis and Polioencephalitis 49 Tuberculosis 52 Tuberculosis Dispensary 54 Cancer 75 Inquests 76 Suicides 76 Customs and Inland Revenue Acts, 1890 to 1903 76 Brady Street Unhealthy Area 77 Housing and Town Planning Act, 1909 98 Report of Woman Health Visitor 100 APPENDIX. Table I. Vital Statistics of Whole District 108 II. Cases of Infectious Disease Notified 109 II. (a) Public Health Tuberculosis Regulations, 1912 110 III. Causes of, and Ages at Death 111 III. (a) Deaths in Sub-districts 112 IV., IV. (a), IV. (b) Infantile Mortality 113-115 V. Number of Deaths from the Seven Principal Zymotic Diseases in ten years, 1903 to 1912, and in the year 1913 116 Administration of Factory and Workshop Act, 1901 117, 118 Official Arrangements for Pathological Work 119, 120 Street List 121-127 6 LONDON and the METROPOLITAN BOROUGHS.—Births and Deaths of Persons belonging to London and the Metropolitan Boroughs during the 53 Weeks ended 3rd January, 1914. Boroughs. Population estimated to the middle of 1913.* Births. Deaths from Deaths under 1 year of Age. All Causes. Enteric Fever. Small-pox. Measles. Scarlet Fever. Whooping cough.. Diphtheria. Diarrhoea and Enteritis (under 2 years) Pulmonary Tuberculosis. County of London 4,518,191 112,637 65 030 114 1570 188 800 431 3098 5981 11869 West. Paddington 142,210 3055 1941 6 - 55 7 37 12 71 157 305 Kensington 171,284 3357 2377 4 - 84 3 29 6 80 188 375 Hammersmith 123,745 3043 1754 — - 47 7 47 12 64 151 314 Fulham 157,117 4302 1992 8 - 50 3 27 14 98 209 414 Chelsea 64,598 1257 911 1 - 18 3 5 1 24 81 113 City of Westminster 154,810 2227 1992 3 - 22 7 7 8 52 206 213 North. St. Marylebone 114,532 2221 1633 5 - 33 10 10 6 37 158 202 Hampstead 86,346 1326 938 1 - 21 4 11 3 18 50 97 St. Pancras 214,330 5512 3321 6 - 41 6 31 16 114 327 508 Islington 325,585 8357 5009 5 - 107 17 61 34 221 441 894 Stoke Newington 50,518 1144 698 2 - 11 1 6 6 16 48 94 Hackney 223,353 5522 3037 4 - 68 11 23 11 141 261 549 Central. Holborn 46,949 798 698 - 10 — 6 4 15 89 83 Finsbury 84,679 2547 1576 — - 30 4 31 9 97 173 352 City of London 17,916 167 276 2 - — 1 2 1 2 27 16 East. Shoreditch 109,654 3513 2068 1 - 52 3 29 14 207 200 546 Bethnal Green 127,824 3998 2006 4 - 62 3 34 10 151 201 470 Stepney 275,300 8187 4172 11 - 95 8 26 22 287 471 916 Poplar 160,913 5230 2668 5 - 69 12 38 34 159 239 586 South. South wark 188,487 5936 3343 6 - 105 11 38 19 182 354 682 Bermondsey 124,739 3896 2266 3 - 90 4 47 17 165 204 513 Lambeth 297,139 7233 4314 8 - 99 14 47 37 202 389 736 Battersea 167,464 4239 2361 6 - 93 7 28 20 125 192 469 Wandsworth 330,395 6840 3550 5 - 116 11 23 16 148 288 603 Camberwell 261,805 6671 3653 5 - 68 13 54 18 179 306 708 Deptford 109,280 3103 1704 2 - 50 3 46 17 93 144 347 Greenwich 96,015 2541 1385 2 - 40 2 24 12 52 114 262 Lewisham 168,822 3522 1814 8 - 25 5 23 35 50 127 273 Woolwich 122,382 2893 1573 1 - 9 8 10 17 48 186 229 * Based on the results of the Censuses of 1901 and 1911. 7 LONDON and the METROPOLITAN BOROUGHS—Birth-rates and Death-rates of Persons belonging to London and the Metropolitan Boroughs daring the 53 Weeks ended 3rd January, 1914. Boroughs. Per 1000 Persons Living. Rate per 1000 Births. Births. Deaths from All Causes. Enteric Fever. Small-pox. Measles. Scarlet Fever. Whooping cough. Diphtheria. Pulmonary Tuberculosis. Diarrhœa and Enteritis (under 2 years). Total deaths under 1 year. Crude. Standardized. County of London 24.5 14.2 14.2 0. 02 0.34 0.04 0.17 0.09 1.30 27.50 105 West. Paddington 21.1 13.4 13.4 0.04 . 0.38 0.05 0.26 0.08 1.09 23.24 100 Kensington 19.3 13.7 13.6 0.02 . 0.48 0 .02 0.17 0 .03 1.08 23. 83 112 Hammersmith 24.2 13.9 13.8 — . 0.37 0.06 0.37 0.10 1 .20 21.03 103 Fulham 26 .9 12.5 12.9 0.05 . 0.31 0.02 0.17 0 09 1 .31 22.78 96 Chelsea 19.1 13 .9 13.2 0. 02 . 0.27 0 .05 0.08 0. 02 1.23 19.09 90 City of Westminster 14.2 12.7 13.3 0. 02 . 0.14 0.04 0.04 0.05 1.31 23.35 96 North. St. Marylebone 19.1 14.0 14.3 0.04 0.28 0.09 0.09 0. 05 1.36 16.66 91 Hampstead 15. 1 10 .7 11.3 0.01 . 0.24 0 .05 0.13 0.03 0.57 13.57 73 St Pancras 25.3 15.2 15.2 0. 03 . 0.19 0.03 0.14 0 .07 1.50 20.68 92 Islington 25 .3 15.1 14.8 0.02 . 0.32 0.05 0.18 0.10 1.33 26.44 107 Stoke Newington 22.3 18 .6 12.9 0.04 . 0.21 0 .02 0.12 0.12 0.93 13.99 82 Hackney 24.3 13.4 13.5 00.2 . 0.30 0.05 0. 10 0 .05 1.15 25.53 99 Central. Holborn 16.7 14.6 14.7 . 0.21 — 0.13 0.08 1.87 18.80 104 Finsbury 29.6 18.3 18.1 — . 0.35 0.05 0.36 0.10 2.01 38.08 138 City of London 9.2 15.2 15.8 0.11 . — 0.05 0.11 0.05 1.48 11.98 96 East. Shoreditch 31.5 18.6 19.2 0.01 0.47 0.03 0.26 0.13 1.79 58.92 155 Bethnal Green 30 .8 15 .4 16.1 0.03 - 0 .48 0 .02 0 .26 0 .08 1 .55 37 .77 118 Stepney 29.3 14 .9 15.6 0.04 - 0.34 0 .03 0 .09 0.08 1.68 35. 06 112 Poplar 32.0 16.3 16.1 0.03 - 0.42 0.07 0.23 0.21 1.46 30.40 112 South. Southwark 31.0 17.4 17.6 0.03 - 0.55 0.06 0.20 0.10 1.85 30.66 115 Bermondsey 30.7 17.9 17.8 0.02 - 0.71 0.03 0.37 0.13 1 .61 42.35 132 Lambeth 23.9 14.3 14.0 0.03 - 0.33 0.05 0.16 0.12 1.29 27.93 102 Battersea 24.9 13.9 14.0 0.04 - 0.55 0.04 016 0.12 1.13 29.49 111 Wandsworth 20.4 10.6 10.6 0.01 - 0.35 0.03 0 07 0.05 0.86 21.64 88 Camberwell 25 .1 13. 7 13.6 0.02 - 0.26 0.05 0.20 0.07 1.15 26.83 106 Deptford 27 .9 15.3 15.2 0.02 - 0.45 0.03 0.41 0.15 1.30 29.97 112 Greenwich 26.0 14.2 14.0 0.02 - 0.41 0.02 0 .25 0.12 1.17 20.46 103 Lewisham 20.5 10.6 10.4 0.05 - 0.15 0.03 0.13 0.20 0.74 14.20 78 Woolwich 23.3 12.6 13. 0 0. 01 - 0.07 0.06 0. 08 0.14 1.50 16.59 79 8 SUMMARY. 1912. 1913. Estimated Population of Betlinal Green 127,985 127,824 Young Children, under 5 years 16,300 16,280 Old People, over 65 years 4,833 4,827 Area—759 acres. Number of Inhabited Houses 14,784 14,756 Rateable Value £535,093 £535,336 Average number of Persons to each House 8.6 8.7 Average number of Persons to each Acre 168.6 168.4 Total number of Deaths in the year 1,957 2,011 Total number of Births in the year 3,904 4,008 Total number of Marriages 1,084 1,046 Marriage Rate—Bethnal Green 16.9 16.4 Marriage Rate—London 18.6 18.3 Death Rate—Bethnal Green 15.3 15.7 Death Rate—London 13.6 14.2 Birth Rate—Bethnal Green 30.5 31.3 Birth Rate—London 24.5 24.5 Infantile Death Rate (on Births)—Bethnal Green 96.0 117 .5 Infantile Death Rate (on Births)— London 90.0 105.0 Young Children's Death Hate (on estimated number of Young Children) 39.2 43.2 Old People's Death Rate (on estimated number of Old People) 92.7 95.3 Zymotic Death Rate (Bethnal Green) 1.45 1.97 Zymotic Death Rate (London) 1.1 1.37 Inquest Cases 257 247 metropolitan Borough of Bethnal Green. REPORT. To the Mayor, Aldermen & Councillors of the Metropolitan Borough of Bethnal Green. Sir and Gentlemen, I have the honour to place before you my thirty-eighth annual report on the vital and mortal statistics of the Borough of Bethnal Green. This is for the registration year 1913, which terminated on the third day of January, 1914. POPULATION. The Registrar-General estimates the population of the Borough for the year under consideration at 127,824, 161 fewer than the estimate for the previous year; this estimate assumes that the diminution in our numbers has continued at the rate obtaining during the last intercensal period, and it must be accepted as correct in the absence of more exact information, although it presupposes an enormous emigration. The actual number of births in the Borough during the year exceeds the deaths by nearly two thousand, and should represent the natural increase in the population, were it not more than counterbalanced by emigration. Table A shews these details and compares them with the corresponding figures of the previous year. 10 TABLE A. 1912. 1913. Estimated population in the middle of the year 127,895 127,824 Total Births 3,904 4,008 Total Deaths 1,957 2,011 Excess of births over deaths, shewing the natural increase of the population 1,947 1,997 The particulars in the following table are taken from the recently published 1911 census report. The table will be read with interest, as it indicates the nationality of the population in London and in the group of Eastern Boroughs. An inspection of the table will shew that although our proportion of aliens to total population is double that of the whole of London, yet it is only one-third of that of Stepney. 11 CENSUS RETURNS—1911. Nationality of Population.—Aliens. Area. Population. (Census, 1911.) Born British Subjects. Naturalised British Subjects. Foreigners. (Aliens.) Percentage of Naturalised British Subjects. Percentage of Foreigners. (Aliens.) Bethnal Green 128,183 120,035 357 7,791 .28 6.0 Poplar 162,442 160,323 153 1,966 .09 1.2 Shoreditch 111,390 109,251 121 2,018 .11 1.8 Stepney 279,804 223,788 2,956 53,060 1.06 18.9 London 4,521,685 4,358,764 9,793 153,128 216 3.38 12 The census report contains a mass of interesting information as to the vital statistics of the inhabitants of the United Kingdom. I have extracted most of the particulars which concern Bethnal Green and have printed them on pages 12-23 of this report. I wish to draw special attention to the table on pages 20 and 21 which shews the number of rooms per tenement in the occupation of private families in Bethnal Green; from this table it will be seen that the number of single room tenements in the Borough was 4,856, occupied by 10,707 persons, a proportion of 8.7 of the total population of this Borough. As this may be considered a fair test for the poverty or otherwise of the inhabitants of a district, I have calculated percentages of similar occupations in the adjoining Boroughs and in the County of London, for purposes of comparison. Borough. Total population, 1911. Population in single room tenements, 1911. Percentage of population in single room tenements. Bethnal Green 128,183 10,707 8.7 Poplar 162,442 7,408 4.5 Shoreditch 111,390 13,903 12.4 Stepney 279,804 23,688 8.5 London 4,521,685 265,553 5.8 The number of domestic servants employed in proportion to the number of private families in a district is also in some measure an index of the prosperity or otherwise of the inhabitants. There are in Bethnal Green 27,693 private families, and the number of domestic servants employed in these was found to be 23 males and 966 females, a proportion of about three and a half per cent. on the total number of private families. 13 PRIVATE FAMILIES AND DOMESTIC SERVANTS EMPLOYED IN BETHNAL GREEN AND ADJOINING BOROUGHS. Borough, Number of private families. Number of Domestic Servants employed. Percentages on total population (Males and Females) Percentages on number of private families (Males and Females) Males. Females. Betlmal Green 27,093 23 966 0.8 3.6 Poplar 34,903 21 1,891 1.2 5.5 Shoreditch 24,694 41 968 0.9 4.1 Stepney 56,515 82 3.635 1.3 6.0 14 Area, Families or Separate Occupiers, 1901 and 1911; Population 1901 and 1911; and Increase or Decrease per cent. in Population 1901-1911. Metropolitan Boroughs Area in Statute Acres Families or Separate Occupiers Population. Increase (+) or Decrease ( —) per cent. in Population 1901 to 1911 1901 1911 1901 1911 Persons Males Females Persons Males Females Battersea 2160.3 38987 39598 168907 81749 87158 167743 80916 86827 - 0.7 Bermondsey 1499.6 29073 28032 130760 65134 65626 125903 62890 63013 - 3.7 Bethnal Green 759.3 28209 27755 129680 63380 66300 128183 62658 65525 -1.2 Camberwell 4480.0 56985 58679 259339 122997 136342 261328 124255 137073 + 0.8 Chelsea 659.6 17467 15936 73842 32828 41014 66385 28470 37915 -10.1 Deptford 1562.7 24615 25040 110398 53613 56785 109496 52987 56509 - 0.8 Finsbury 586.6 24097 21239 101463 49910 51553 87923 42655 45268 -13.3 Fulham 1703.5 32137 36432 137289 64652 72637 153284 72662 80622 + 11.7 Greenwich 3851.7 19702 20692 95770 47633 48137 95968 47241 48727 + 0.2 Hackney 3287.8 48761 50622 219110 101085 118025 222533 102948 119585 + 1.6 Hammersmith 2286.3 25810 28462 112239 52714 59525 121521 58084 63437 + 8.3 Hampstead 2265.0 16998 18625 81942 31688 50254 85495 32807 52688 + 4.3 Holborn 405.1 13790 11030 59405 29589 29916 49357 24089 25268 -16.9 Islington 3091.5 79129 79902 331991 159290 175701 327403 155901 171502 - 2.3 Kensington 2291.1 38349 38387 176628 69084 107544 172317 66497 105820 - 2.4 Lambeth 4080.4 70887 70827 301895 142760 159135 298058 142080 155978 -1.3 Lewisham 7014.4 27701 37013 127495 56749 70746 160834 72780 88054 + 26.1 Paddington 1356.1 33661 33925 143976 61626 82350 142551 60415 82136 - 1.0 Poplar 2327.7 35787 35158 168822 84823 83999 162442 80912 81530 -8.8 St. Marylebone 1472.8 31623 28509 133301 57891 75410 118160 49685 68175 -11.4 St. Pancras 2634.4 57045 52994 235317 114305 121012 218387 106728 111659 - 7.2 Shoreditch 657.6 27031 24801 118637 58149 6048b 111390 54842 56548 - 6.1 Southwark 1131.5 47808 44453 206180 103360 102920 191907 95532 96375 - 6.9 Stepney 1765.6 61113 56949 298600 150711 147889 279804 140116 139688 - 6.3 Stoke Newington 863.5 11824 12163 51247 22634 28613 50659 22633 27996 - 1.1 Wandsworth 9107.4 49731 70155 231922 103710 128212 311360 140728 170632 + 34.3 Westminster 2502.7 41344 35984 183011 84963 98048 160261 73449 86812 -12.4 Woolwich 8276.6 24585 26504 117178 61273 55905 121376 61271 60105 + 3.6 Census Returns Vol. 1., p. 26. 15 Aggregate Numbers of Marriages, Births and Deaths Registered in each Registration District during the Interoensal Period, 1901-11. Registration Counties and Districts. Population. Registered from 1st April, 1901, to 31st March, 1911. Increase ( +) or Decrease (-) of Population. Excess of Births over Deaths (+) or of Deaths over Births (—) Gain ( + ) or Loss (—) by Migration. 1901. 1911. Marriages. Births. Deaths. England and Wales 32527843 36070492 2641170 9290058 5245411 + 3542649 + 4044647 —501998 London 4536541 4522200 396784 1250632 711939 —14504 + 538693 — 553197 Paddington 143976 142551 14621 31588 21437 —1425 + 10151 —11576 Kensington 176628 172317 16366 33696 28431 —4311 + 5265 —9576 Pulham 249528 274805 22949 76232 37667 + 25277 + 38565 — 13288 Chelsea 73842 66385 6190 14706 16430 —7457 —1724 —5733 St. George, Hanover Square 128256 117957 13651 21157 16915 —10299 + 4242 —14541 Westminster 33081 25445 4331 4850 2687 —7636 + 2163 —9799 St. Marylebone 133301 118160 13448 40006 17805 —15141 + 22201 — 37342 Hampstead 81942 85495 6217 13926 10950 + 3553 + 2976 + 577 St. Pancras 235617 218387 20818 58128 38464 —16930 +19664 — 36594 Islington 334991 327403 29357 85680 49266 —7588 + 36414 — 44002 Hackney 270519 273360 20198 69816 38621 + 2839 + 31195 —28356 St. Giles 31436 25088 3735 9667 3228 —6348 + 6439 —12787 Strand 21674 16859 3031 2113 5605 — 4815 —3492 —1323 Holborn 128691 111729 11476 41054 18485 —17219 + 22569 —39788 London City 27664 20120 4870 3085 9152 —7287 —6067 —12-20 Shoreditch 118637 111390 10651 37489 21755 — 7247 + 15734 —22981 Bethnal Green 129680 128183 9772 43151 23102 —1497 + 20049 —21546 Whitechapel 78768 67740 5573 26277 23172 —11028 + 3105 —14133 St. George-in-East 49068 47092 2652 19949 7558 —1976 + 12391 —14367 Stepney 57937 53685 4114 17934 10635 —4252 + 7299 —11551 Mile End Old Town. 112827 111287 14228 42518 14999 —1540 + 27519 —29059 Poplar. 168822 162442 14557 54107 30382 —6380 + 23725 —30105 South wark 206180 191907 20893 62288 32819 —14273 + 29469 —43742 St. Olave, Bermondsey 130760 125903 11065 41525 19980 —4857 + 21545 —26402 Lambeth 301895 298058 24817 88278 49489 —3837 + 38789 —42626 Wandsworth 400941 479450 33547 114856 56508 + 78348 + 58348 + 20000 Camberwell 259339 261328 20358 69278 41932 + 1989 + 27346 —25357 Greenwich 185034 185679 13250 53844 27937 + 645 + 25907 —25262 Lewisham 134721 174284 10131 37747 18908 + 39563 +18839 + 20724 Woolwich 131086 127711 9918 35687 17620 —3375 + 18067 —21442 (Census Returns. Vol. 2, p. 429) 16 Families on Separate Occupiers, and Population, 1901 and 1911; and Population enumerated in Institutions, Large Establishments, and on Vessels, Etc., 1911 (Sub-Districts). Metropolitan Borough. Registration Districts and Sub-Districts. Area in Statute Acres. Families or Separate Occupiers. Population. Institutions, Large Establishments, 1901. 1911. &c. 1901. 1911. Persons. Persons. Males. Females. No. Population. Bethnal Green 759.3 28,209 27,755 129,680 128,183 62,658 65,525 33 3,943 North East 470.0 13,932 13,850 65,138 63,966 31,222 32,744 24 3,692 South West 289.3 14,277 13,905 64,542 64,217 31,436 32,781 9 251 (Census Returns, Vol. 2. p. 11.) 17 CLASSIFICATION OF BUILDINGS, BETHNAL GREEN. Total. Total (cols. 4-11). Ordinary Dwelling Houses. Blocks of Plats. Shops. Hotels, Inns, and Public Houses. Offices. Warehouses, Workshops, Factories. Institutions. Others. Vessels, Sheds, Vagrants, etc. Separate Flats (included in col. 5). Buildings not used as Dwellings, Kind of Building. No. Cols. 1. 2 8 4 5 6 7 8 9 10 11 12 13 14 Places of Worship 41 Number Inhabited 14,005 13,649 10,975 322 1,985 220 74 34 39 — 4,716 Government and Municipal Buildings 15 Separate Occupiers 28,209 27,755 19,943 4,730 2.678 226 86 36 50 6 4,730 Population 129,680 128,183 89.761 20,453 12,323 1.104 440 3,863 224 15 20,453 Shops 352 Offices 31 Uninhabited 681 522 357 _ 145 1 6 1 12 — 323 Warehouses Workshops Factories 789 Being Built 59 9 3 _— 5 _ _ 1 _ _ _ Theatres and other places of amusement 8 (Census Returns, Vol. 6, p. 146.) 18 Families or Separate Occupiers, and Population, 1901 and 1911; and Population enumerated in institutions, large establishments, and on vessels, etc., 1911. (Wards.) Area in Statute Acres. Families or Separate Occupiers. Population. Institutions, Large Establishments, Etc. 1901. 1911. 1901. 1911. Persons. Persons. Males. Females. No. Population. Bethnal Green 759.3 28,209 27,755 129,680 128,183 62,658 65,525 33 3,943 Wards— East - - 8,999 - 42,622 20,788 21,834 14 3,237 North - - 4,851 - 21,344 10,434 10,910 10 455 South - - 7,534 - 34,479 16,857 17,622 4 70 West - - 6,371 - 29,738 14,579 15,159 5 181 Census Returns Vol. 1., p. 213. 19 Tenements of Five Rooms and upwards with more than Two Persons per Room. No of Rooms per Tenement. No. of Persons per Tenement. Nun aber of Children under 10 years of age in Private Families (or Tenements). Total Number of Private Families (or Tenements) Population. 0 1 2 3 4 5 6 7 8 9 10 All ages . Under 10. Number of Private Families (or Tenements). 5 11 1 10 17 27 22 6 2 1 — — — 86 946 262 12 1 1 2 6 19 3 2 — — — 34 408 126 13 — 1 1 1 2 4 1 1 — — — 11 143 47 14 1 1 — 1 — — 1 — — — 4 56 13 15 — — — — — — — — 1 — — 1 15 8 13 2 — 1 2 1 1 7 91 17 6 14 1 — 2 — 1 1 — — — 5 70 17 15 — — — — 1 — — — — — 1 15 5 16 — — — — — — 1 — — — 1 16 7 7 15 — — — — 1 — — — — — — i 15 4 (Census Returns, Vol. VIII., p 538.) 20 TENEMENTS IN THE OCCUPATION OF PRIVATE FAMILIES. 1901 1911 Tenements with more than two occupants per room 6,445 Total Population 129,68 128,183 Population, all ages 41,152 ,, Families or Separate Occupiers, under 10 years of age 15,132 "Private" or otherwise 28.209 27,755 Percentage of Population in "Private Families" living more than two in a room 33.2 Population in ''Private Families ... - 124,062 Number of Private Families - 27,693 No. of Rooms per Tenemenl No. of Children under 10 years of age. Number of Persons in Private Families lor Tenements*. Total Number of Private Families (or Tenements) Population. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 and upwards No. of Private Families (or Tenements). 1 . 0 1.615 1.549 259 60 17 1 — — — — — — — — — 3,501 5,821 1 — 95 618 55 11 2 — — — — — — — — 781 2,331 2 — — 32 323 28 7 — 1 — — —— — — — — 391 1,578 3 — — — 14 113 15 6 1 — 1 — — — — — 150 771 4 —— — — — 2 22 2 1 — — — — — — — 27 164 5 1 4 1 — — — — — — — 6 42 1.615 1.644 909 452 171 48 12 4 — 1 — — — — — 4,856 10,707 2 0 247 1,503 833 446 198 65 23 4 2 — — — — — — 3,321 9,127 1 — 39 853 303 186 84 81 15 1 — — — — — — 1,512 5,629 2 — — 17 793 256 116 41 30 7 3 1 — — — — 1,264 5,830 3 — — — 15 500 197 96 43 11 2 — — — — — 864 4,877 4 — — — — 8 211 83 47 26 3 3 1 — — — 382 2,572 5 — — — — — 1 67 21 9 5 1 — — —• — 104 785 6 — — — — — — — 9 1 — — — — — — 10 81 247 1542 1703 1557 1,148 674 341 169 57 13 5 1 — — — 7,457 28,901 21 3 0 98 829 678 584 409 217 81 25 13 3 — — — — — 2,937 10,387 1 — 10 507 263 239 165 122 53 22 8 1 — — — — 1,390 6,345 2 — — 4 438 274 196 151 106 49 15 2 2 — — — 1,237 6,852 3 — — — 4 287 196 170 150 61 23 3 — 1 1 — 896 5,856 4 — — — — 1 158 135 119 68 30 6 2 — — — 519 3,852 5 — — — — — 4 78 49 29 23 12 8 — — — 198 1,621 6 — — — — — — — 11 8 7 2 2 — — — 30 276 7 — — — — — — — — 1 2 3 — — — — 6 62 98 839 1,189 1.289 1210 936 737 513 251 111 29 9 1 1 — 7,213 35,251 4 0 39 254 388 419 334 275 155 60 23 7 — 1 — — — 1,955 8,561 1 — 4 90 134 136 148 117 97 42 16 4 4 — — — 801 4,634 2 — — 2 99 126 118 123 114 64 33 7 3 — — — 689 4,532 3 — — — 1 80 110 113 99 79 54 20 4 2 — — 562 4,192 4 — — — — — 64 65 75 71 65 25 14 5 — — 384 3,236 5 — — — — — 1 25 38 25 20 14 9 2 — — 134 1,198 6 — — — — — — — 4 7 4 4 2 1 2 — 24 244 7 — — — — — — — — — 2 — — 1 — 1+ 4 49 39 258 489 653 676 716 598 487 311 201 74 37 11 2 1 4,553 26,646 Total 1-4 — 1 999 4.283 4,290 3,951 3,205 2,374 1.688 1,173 619 326 108 47 12 3 1 24,079 101,505 5 — 19 112 182 276 294 2G5 247 218 175 109 86 34 11 4 1 2,033 12,659 6 — 7 58 88 136 137 150 135 128 84 65 37 14 7 5 2 1,053 6,658 7 — 1 11 26 39 53 36 34 18 19 6 9 4 3 — 1 260 1,552 8 — 2 10 13 30 18 25 22 18 11 8 3 5 — 1 2 168 1,035 9 — — 3 R 5 1 11 6 6 1 — 3 2 — 2 — 48 305 10 and upwards — 2 2 3 7 6 6 10 4 3 1 2 2 2 2 — 52 348 Totals 2,030 4,479 4,610 4.444 3,714 2,867 2,142 1,565 912 515 248 108 35 17 7 27,693 124,062 * Including two families with eight children under ten years of age. † This family included nine children under ten years of age. (Ceusus Returns, Vol. VIII., p. 538.) 22 CENSUS RETURN, 1911. Population in Single Room Tenements in London and in certain Eastern Districts. Area. Population (1911). Occupants of single room tenements. Percentage on total population. Bethnal Green 128,183 10,707 8.7 Poplar 162,442 7,408 4.5 Shoreditch 111,390 18,903 12.4 Stepney 379,804 23,688 8.5 LONDON 4,521,685 265,553 5.8 (Census Returns, vol. 8, pp. 534, 537, 554, 557 & 559). Bethnal Green forms a portion of the Petty Sessional Division of the Tower, which contains Area in Statute Acres. Families or Separate Occupiers. Population. 8,786.2 195,051 903,289 (Census Returns, vol. i., p. 418). 23 INSTITUTIONS. Persons Enumerated in Workhouse Establishments, in Hospitals and in Lunatic Asylums. Registration District and Sub-District. Civil Parish. Institution. Special Inmates (Patients, Paupers, Lunatics, Ac.). Officials and their Families. Persons. Males. Females. Persons Males. Females. Bethnal Green, North-east. Bethnal Green ... Workhouse 1,146 734 412 47 12 35 „ „ Workhouse Infirmary 593 332 261 124 16 109 „ „ Bethnal House Lunatic Asylum 278 122 156 56 19 37 „ „ Mildmay Mission Hospital 36 17 19 37 3 34 „ „ City of London Hospital for Chest Diseases 165 84 81 54 6 48 „ „ Queen's Hospital for Children 124 66 58 85 9 76 „ „„ Children's Home and Orphanage 326 212 114 42 11 31 (Census Returns, Vol. 1., p. 639.) 24 BIRTHS. The births of children registered as born actually in Bethnal Green numbered 3,863; two of these were infants born in the Workhouse of mothers only temporarily resident in Bethnal Green. In addition to the registered births I have received information from the RegistrarGeneral that 147 children were born during the year of Bethnal Green mothers in some one or other of the Metropolitan Lying-in Hospitals or other Institutions where maternity cases are admitted. The details of these trans ferable births are as follows :— London Hospital 97 City of London Lying-in Hospital 18 Mothers' Home, Commercial Road 18 Various 14 Total 147 Registered births 3,863 Inward transfers 147 Total 4,010 Deduct outward transfers 2 Total 4,008 DEATHS. During the year 2,028 deaths were registered in Bethnal Green, but this total includes 411 non-residents who were under treatment in some one or other of the 25 Public Institutions within our borders. Six other nonresidents died violent or sudden deaths; they were:— 1. A woman, aged 36, the wife of a Post Office sorter of East Ham, committed suicide by drowning in Duckett's Canal. 2. A warehouse packer, aged 36, of Shoreditch, died at 234, Hackney Road, from cardiac valvular disease and bronchitis. 3. The infant son of a cabinet maker of Shoreditch died from syncope in Hackney Road. 4. An engineer, of Barking, aged 43, was caught in some machinery at a factory in Bethnal Green Road, and died from fractured cervical vertebra. 5. The nine years old son of a shoemaker of Whitechapel was found drowned in Regent's Canal, near Cricketers' Bridge. 6. A brewer's foreman, aged 62 years, of Hockley, died from aortic valvular disease in Bethnal Green Road. The monthly returns of transferable deaths forwarded by the Somerset House authorities contain particulars of 400 deaths; these include, in addition to the deaths in Public Institutions, the names of eleven inhabitants of Bethnal Green who have died or were found drowned in various parts of London. They were:— 1. A bootmaker, aged 57, of Barnet Grove, was found drowned in the River Lea near Radley's Creek. 26 2. A mechanical engineer, aged 75, of Old Ford Road, died whilst on a visit to Hackney. The cause of death was nephritis and uraemia. 3. A biscuit baker, aged 50, of Coventry Street, died in Commercial Road from heart failure supervening upon lobar pneumonia. 4. A boot trimmer, aged 73, of Abingdon Buildings, died at Well Street, Hackney, from pericarditis with effusion of fluid. 5. A labourer, aged 63, of Old Ford Road, died in an electric tramcar at Woolwich. The cause of death was syncope, due to atheroma of the coronary arteries. 6. A carman, aged 42, of the Oval, Hackney Road, died of dilated heart at a timber wharf at Southfields. 7. A French polisher, aged 24, of Barnsley Houses, was found drowned in the River Thames off York Place, Battersea. 8. A labourer, aged 21, of Burgoyne Road, died at Wellington Road, Bromley. Death was due to syncope said to have been caused by the excitement of singing in a crowded room on a close night. 9. A carman's widow, aged 56, of Lansdell Place, was found dead at Barrow's Buildings, Devonshire Street, Stepney. The cause of death was haemorrhage into the cerebellum. 10. A shoe-maker, aged 68, of Wharncliffe 27 Street, died at Old Street Police Court from bronchitis and weak heart. 11. A woman, aged 55, the wife of a railway goods checker of Temple Street, died at Bath Street, St. Luke's, from disease of aortic valves, accelerated by chronic bronchitis. TABLE B. Public institutions, situated outside the Borough, into which Bethnal Green residents have been received, and where they have subsequently died:— Babies' Home, Shoreditch 2 Banstead Asylum 5 Brompton Hospital 1 Brook Hospital 1 Cancer Hospital, Chelsea 1 Cane Hill Asylum 2 Central London Throat and Ear Hospital 1 Children's Hospital, Great Ormond Street 6 Claybury Asylum 14 Colney Hatch Asylum 10 Darenth Asylum 1 Darenth Industrial Colony 1 Dartford Heath Asylum 4 Eastern Hospital, Homerton 2d East London Hospital, Shad well 13. Friedenheim Hospital 3 German Hospital 2 Guy's Hospital Hackney Infirmary 3 Hanwell Asylum 3 Home of Rest, Lower Clapton l Homoeopathic Hospital 1 28 Horton Asylum 1 King's College Hospital 1 Leavesden Asylum 6 London Hospital 186 Long Grove Asylum 2 Metropolitan Hospital 4 Middlesex Hospital 8 Mile End Infirmary 3 Mothers' Home, Mile End 1 Mount Vernon Hospital 1 Northern Hospital 1 North Eastern Hospital 8 Nursing Home, Queen's Down Road, Hackney 1 Park Hospital 9 Poplar Hospital 1 •Queen Mary's Hospital 2 Royal Free Hospital 2 Royal Hospital for Diseases of the Chest 1 St. Bartholomew's Hospital 15 St. Joseph's Hospice, Hackney 3 St. Luke's Hostel, Kensington 1 South Eastern Hospital 2 Shoreditch Infirmary 5 Tooting Bee Asylum 4 University College Hospital 2 Whitechapel Infirmary 1 Deaths occurring in various institutions outside London, particulars of which were forwarded to me by the Registrar General and subsequently verified 14 389 29 TABLE C. Public Institutions in Betiinal Green. Institution. Beds Available. In-patients Treated. Deaths— Bethnal Green Residents. Deaths— Bethnal Green Non-Residents. Out-patients Treated. City of London Hospital for Diseases of the Chest 175 1,041 7 47 8.996 Queen's Hospital for Children, Hackney Road 134 1,734 82 298 33,861 Mildmay Mission Hospital 50 592 18 29 11,887 Bethnal House Asylum 300 Not stated 2 23 - Bethnal Green Infirmary 669 2,876 991 20 - 30 SUMMARY. Total deaths registered 2,028 Sudden deaths of residents outside the Borough 11 Deaths of residents in Institutions outside the Borough 389 2,428 From these must be subtracted Sudden deaths of strangers in Bethnal Green 6 Deaths of strangers in Bethnal Green Institutions 411 417 Net Total 2,011 DEATHS IN SUB-DISTRICTS. In the North-East sub-district 1,014 deaths occurred amongst the residents and 964 in the South-West. Thirtythree persons who had no fixed home died in the Workhouse or in the Infirmary. These details are shewn in Table D. TABLE D. District. Deaths. Population. North-East 1,014 63,786 South-West 964 64,033 Previous residence unknown 33 — Total 2,011 127,824 31 DEATH RATE. We shew a mortality for the year 1913 of 15.7 per thousand living. This rate, slightly higher than that of the previous year, is one and a half points above the rate for London, which is 14.2 per thousand. MORTALITY RATES IN SUB-DISTRICTS. The death rate in the North-East sub-district was 15.9 and that in the South-West 15.5. These rates are exclusive of the thirty-three homeless paupers who died in the Workhouse, although these are of necessity included in the general rate for the whole of the Borough. Table E shews the mortality rates for Bethnal Green and for London, compared by months, the rainfall and the mean temperature for each quarter being also shewn. 32 TABLE E. Month. London Death Rate. Bethnal Green Death Rate. Mean Temperature (Degrees.) Rainfall (Inches). January 16.9 20.9 42.4 5.89 February 18.1 18.6 March 17.6 19.8 April 15.3 14.3 54.5 4.12 May 13.0 14.1 June 11.1 10.9 July 10.6 11.3 60.2 5.44 August 11.8 12.4 September 13.3 16.2 October 13.8 15.3 47.8 6.99 November 13.5 15.1 December 14.8 15.8 Average 14.2 15.7 51.2 Total Rainfall, 2244 33 Table F compares the death rates for London and for Bethnal Green by quarters:— TABLE F. Quarter Ending. London. Bethnal Green. March 29th 17.5 19.'9 June 28th 13.3 13.3 September 27th 11.8 13.2 January 3rd (1914) 14.1 15.4 Yearly average 14.2 15.7 BIRTH RATE. The births actually registered in Bethnal Green during the year numbered 3,863, but to these must be added the balance of the transferable births (145) notified by the Registrar-General, thus raising the total to 4,008. This gives a birth rate of 31.35 per thousand population, nearly one per thousand above that of last year. The general London rate still stands at 24.5, a figure identical with that of the two previous years. TABLE G. Marriages, 1914. First Quarter 212 Second Quarter 202 Third Quarter 321 Fourth Quarter 311 Total 1,046 These figures indicate a marriage rate of 16.4 to 34 every thousand persons, as against 18'3 in the County of London. DEATHS OF INFANTS. Nearly one quarter (23.4 per cent.) of the total deaths at all ages were those of infants in the first year of life; these numbered 470 and give an infantile death rate of 117.5 per thousand births. This is a very considerable increase on the figure for 1912, which was only 96. The general metropolitan rate has also risen to 105 as against 90 for the previous year. An inspection of the accompanying table of special causes of infantile deaths will demonstrate the fact that there has been an improvement in all causes except one, and that the great increase of mortality was due to deaths from Diarrhoea, a disease which was epidemic in the autumn of 1913. Tubercular Meningitis and Tabes Mesenterica each caused five deaths, other forms of tuberculosis caused six, a total of sixteen, which gives a mortality of 4.0 on the births. 35 TABLE H. Special Causes of Infantile Deaths. Totals. Rate per thousand births. 1913 1912 1913 1912 Diarrhceal diseases 115 36 28 7 9 2 Premature birth, injury at birth, and congenital defects, including Atelectasis 38 90 22 0 23.4 Respiratory diseases 83 73 20 7 18.7 Wasting diseases 39 41 9.7 10.5 Convulsive diseases 39 30 97 7.7 Common infectious diseases 32 30 80 7.7 Suffocation 17 26 42 6.6 Tubercular diseases 16 19 40 4.9 DEATHS OF YOUNG CHILDREN. The deaths of young children aged less than five years, including infants, numbered 703 and formed thirtyfive per cent. of the deaths at all ages; this is equivalent to a rate of 43.2 per thousand of the population of young children. SENILE MORTALITY. The deaths of persons aged over 65 numbered 460, a proportion of twenty-three per cent. of the total deaths at all ages, and a mortality rate of 95.3 as calculated upon the population of elderly people. 36 QUARTERLY AND ANNUAL DEATHS AND MORTALITY RATES. Tables I and J are compiled from the quarterly returns of the Registrar-General and are subject to correction on publication of the annual return. Following these will be found the graphic chart shewing the number of deaths week by week in the Borough, corrected for Institution deaths. 37 TABLE I. Quarterly Mortality for the Borough of Bethnal Green. 1913. Estimated Population in the middle of 1913. Births. All Causes. Enteric Fever. Small Pox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Diarrhcea and Enteritis (under 2 years). Pulmonary Tuberculosis. Deaths of Infants under 1 year of age. All Causes. Enteric Fever. Small Pox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Pulmonary Tuberoulosis. Diarrhoea and Enteritis (under 2 years) to 1000 Births registered Total deaths under 1 1 year to 1000 Births registered. Borough of Bethnal Green. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 March 29th 127,824 935 635 2 42 1 10 2 15 70 125 19.9 0.06 — 1.32 0.03 0.31 0.06 2.20 16.04 134 June 28th 127,824 992 423 1 — 11 1 5 4 6 39 74 13.3 0.03 — 0.35 0.03 0.16 0.13 1.22 6.05 75 September 27th 127,824 922 420 1 — 5 — 3 1 82 38 132 13.2 0.03 — 0.16 — 0.09 0.03 1.19 88.94 143 January 3rd, 1914 127,824 1,004 528 - — 4 1 16 3 48 54 139 15.4 - — 0.12 0.03 0.47 0.09 1.57 47.81 138 127,824 3,853 2,006 4 — 62 3 34 10 151 201 470 15.4 0.03 — 0.49 0.02 0.26 0.08 1.54 39.71 122 38 TABLE J. Quarterly Mortality tor the County of London. 1913. Estimated Population in the middle of 1913. Births. All Causes. Enteric Fever. Small Pox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Diarrhœa and Enteritis under 2 years). Pulmonary Tuberculosis. Deaths of Infants under 1 year of age. All Causes. Enteric Fever. Small Pox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Pulmonary Tuberculosis. Diarrhœa and Enteritis (under 2 years) per 1000 Births registered s under 1 year to 1000 Births registered/ County of Loudon 1 2 3 4 3 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 March 29th 4,519,191 28,945 19,695 29 — 845 52 300 113 298 1747 3353 17.5 0.03 - 0.75 0.05 0.27 0.10 1.55 10.30 116 June 28th 4,518,191 28,342 14,900 20 — 549 41 264 107 273 1428 2285 13.3 0.02 - 0.49 0.04 0.23 0.09 1.27 9.63 81 September 27th 4,518,191 27,769 13,301 28 — 124 46 120 73 150C 1204 291c 11.8 0.02 — 0.11 0.04 0.11 0.06 1.07 54.02 105 January 3rd, 1914 4,518,191 28,706 17,070 37 - 62 49 116 138 1027 1600 3315 14.1 0.03 — 0.04 0.04 0.10 011 1.32 35.70 115 4,518,191 113,822 65,026 114 - 1570 188 800 431 3098 5979 11869 14.2 0.02 — 0.35 0.04 0.18 0.09 1.30 27.41 104 39 DEATHS FROM NOTIFIABLE INFECTIOUS DISEASES. During the year 1913 no additional disease was included in the list of those already notifiable under Section 55 of the Public Health (London) Act, 1891. The following table indicates the locality (hospital or home) of the deaths, and includes Measles and Whooping Cough, cases of which are now admitted to the hospitals of the Metropolitan Asylums Board although the diseases are not notifiable. No death was recorded from any of the notifiable diseases other than those included in the following table. TABLE K. Disease. Deaths at Home. Deaths in Hospitals. Total. Scarlet Fever 1 2 Diphtheria 4 7 11 Enteric Fever 0 4 4 Measles 30 29 59 Polio-Myelitis 0 1 1 Whooping Cough 14 16 30 Puerperal Fever 0 2 2 40 THE SEVEN PRINCIPAL ZYMOTIC DISEASES. (Decennial average, 288.) The total number of deaths from the diseases usually included under this heading was 252, an increase of 60, due to the increased mortality from Diarrhoea, as will be seen from the following comparative table of mortalities in 1912-13:— TABLE L. Disease. 1913. / Small Pox - - Measles - - Small Pox 59 90 Scarlet Fever 3 2 Diphtheria 11 15 Whooping Cough 30 28 Enteric Fever 4 3 Diarrhoea 145 48 Totals 252 186 The death rate from these Zymotic diseases is 1.97 for 1913 against 1.45 for the previous year, the corresponding rates for the whole of London being 1.37 and 2.2]. The deaths from Zymotic diseases form twelve and a half per cent. of the total mortality from all causes. Table M shows the percentage of deaths from each of these diseases, calculated upon the total number of Zymotic deaths. 41 TABLE M. Small Pox caused 0 deaths, 0 per cent. Measles „ 59 „ 23.4 „ or 1 in 4.3 deaths. Scarlatina „ 3 „ 1.2 „ „ 84.0 ,, Diphtheria „ 11 „ 4.4 „ „ 22.9 „ Whooping Cough „ 30 „ 11.9 „ „ 8.4 „ Typhus Fever „ 0 „ 0 „ Enteric Fever „ 4 „ 16 „ „ 63.0 „ Diarrhoea „ 145 „ 57.4 „ „ 17 „ NOTIFICATION OF INFECTIOUS DISEASES. Public Health (London) Act, 1891, Sec. 55. A gross total of 1,031 notification certificates has been received from medical practitioners, but as 73 of these were duplicates (7%), the actual number of cases of infectious disease notified and dealt with was 958, a rate of 7.5 per thousand on the estimated population of the Borough. 613 of the sufferers were removed to hospitals under the control of the Metropolitan Asylums Board, and 33 to other hospitals. 27 cases were treated in private houses under such conditions of isolation as were fairly satisfactory. In seventeen instances (a proportion of nearly 2 per cent.) information was received from one or other of the Medical Superintendents of the Board's hospitals that the diagnosis, as given in the notification certificate, was incorrect. Table N sets out full particulars of all the notifications. 42 TABLE N. Nature of Disease No. of Certificates Received Duplicate Certificates Received Actual Number of Cases Reported Treated at Home Removed to M.A.B. Hospitals Treated at other Hospitals and Infirmary Diagnosis Incorrect Diphtheria 226 10 216 10 202 4 11 Membranous Croup 6 — 6 — 5 1 — Scarlet Fever 425 13 412 14 395 3 6 Erysipelas 310 45 265 — — — — Enteric Fever 23 — 23 — 11 12 — Ophthalmia Neonatorum 20 1 19 - — — Cerebro-Spinal Meningitis 1 — 1 — — — — Puerperal Fever 17 4 13 3 — 10 — Polio-Myelitis 3 — 3 - — 3 — 1,031 73 958 27 613 33 17 1913. Scarlet Fever. Cases, continuous line Deaths, dotted line ................................... 43 TABLE O. Condition of Premises where Cases of Infectious Disease have occurred during 1913. Scarlet Fever Diphtheria. Enteric Fever. Satisfactory 193 96 4 W.C.'s, or apparatus defective 21 19 2 Internal Drainage defective 6 5 1 External Drainage defective 32 23 1 Minor Insanitary Defects 168 97 11 Single Room Tenements 13 7 1 Overcrowded 1 2 - SCARLET FEVER. Deaths 3 (Decennial Average 20). A mild form of this disease was very prevalent during the year; 412 cases were notified, all of which, with the exception of fourteen, were removed to hospital. Six of the patients so removed were found upon examination not to be suffering from Scarlet Fever. There were three deaths, one at home and two in hospital. The case mortality was 1.17 per cent. as against 1.8 amongst all the Scarlet Fever cases treated in the M.A.B. Eastern Hospital. The Inspectors report that the homes of 193 of the patients were found to be in a satisfactory condition; the w.c. or the apparatus connected with it was defective in twenty-one instances, the drains inside the house were 44 leaky in six, and the yard drainage was faulty in thirtytwo; minor insanitary defects were noted in 168 instances. Thirteen persons were removed from single room tenements, one of which was overcrowded. DIPHTHERIA. Deaths 11 (Decennial Average 23). Diphtheria was notified in 226 cases and Membranous Croup in six. Ten of the certificates were duplicates, ten of the cases were treated at home, where four of them died, 212 were removed to hospital, but eleven of these were found to be suffering from some disease other than Diphtheria (usually Scarlet Fever). Of the 201 genuine cases seven died, making with the home deaths a total of 11, a case mortality of 5.44 as against 8.10 amongst the whole of the Eastern Hospital cases. The Inspectors report that 96 of the homes of the patients were in a fairly satisfactory condition but the w.c. or the apparatus connected therewith was faulty in 19, the internal drains were defective in five cases, and the yard drains in 23; minor insanitary defects were noted in 97 cases. Seven children were removed from singleroom tenements, two of which were overcrowded. 48,000 units of anti-toxin were supplied free to medical gentlemen during the year, and 151 throat swabs were submitted to the Clinical Research Association for examination, 36 of which gave positive results and 115 negative. All the Diphtheria deaths except three were amongst young children aged less than five years, a mortality of 0.5 per thousand on the estimated population of young children. 1913. Diphtbería. Cases, continuous line Deaths, dotted line ......................................... 1913. Enteríc Fever. Cases, continuous line Deaths, dotted line ............................................... 45 ENTERIC FEVER. Deaths 4 (Decennial Average 9). Twenty-three persons suffering from Enteric Fever were notified and removed, eleven to Asylums Board Hospitals and twelve to general hospitals; there were four deaths, a case mortality of 17.39 against 19.56 amongst the Eastern Hospital cases. The Inspectors report four of the homes as satisfactory. Closets were defective in two, bad drainage was noted in two others, and minor insanitary defects in eleven. One person was removed from a single-room tenement. Seventeen samples of blood in suspicious cases were examined at the request of medical practitioners; in five cases a positive reaction was reported, the twelve others were negative. Seven cases of Enteric Fever were removed from 55 Somerford Houses in July and August, all having contracted the disease from a man whose illness was supposed to arise from eating ice cream. We were unable to identify the vendor, so the enquiry could be pressed no further. In two other cases of enteric fever the patient had recently eaten ice cream purchased from a street vendor. Suspicion was also cast upon fried fish in nine cases, shell fish in four, and tinned fish, eels and water-cress each in one case. WHOOPING-COUGH. Deaths 30 (Decennial Average 44). All these deaths, with the exception of two, were amongst young children aged less than five years, a mortality of 1.8 per thousand on the estimated population of 46 young children. Forty-two children suffering from Whooping-cough were removed to M.A.B. Hospitals, where sixteen of them died. DIARRHOEA. Deaths 145 (Decennial Average 81). Diarrhoea was very prevalent during the autumn, and was the cause of 115 infantile deaths, a mortality of 28.7 per thousand births. MEASLES. Deaths 59 (Decennial Average 81). The mortality from measles has continued to decrease; all the deaths from this disease were amongst young children aged less than five years, a mortality of 3.6 per thousand children under that age. 530 cases of measles were reported to us by head teachers of elementary schools, all were visited and the surroundings carefully noted. In ninety-nine instances the home conditions were so unfavourable that removal to hospital was necessary. Twenty-nine of the children so removed died, as a result, in the majority of instances, of the accompanying lung complication. It is an evidence of the carelessness with which people still regard measles that ninety-one of the little sufferers were unprovided with medical care. CHICKEN POX. We received notice of 241 cases of Chicken Pox; they were visited and dealt with in the usual manner and call for no special remark. 47 ERYSIPELAS. The actual number of notifications of Erysipelas was 310, but no fewer than 45 of these certificates were duplicates (14½%). Erysipelas cases frequently pass through the hands of several doctors, and as the law requires that each medical gentleman shall report the case, the expense of notification is disproportionate to the good effected. The homes of all the patients were visited, and insanitary conditions noted and remedied, but removal (except to the infirmary) is impracticable, and we do not usually consider it necessary to disinfect. There were six deaths from Erysipelas, all except one amongst elderly people. In addition to the deaths from true Erysipelas, 45 persons died from diseases of a septic nature. Of these thirteen suffered from abscess in various parts of the body, six from gangrene, and a similar number from middle ear disease. Appendicitis caused five deaths, but only one certificate contained a record of operation. In the case of two infants, Pemphigus was the registered cause of death; in all probability this was syphilitic. DISEASES OF PARTURITION. Thirteen cases of puerperal fever were reported; all except three were removed to hospital, where two of them died. The deaths of seven other women were due to some one or other of the diseases or accidents incidental to the puerperal state; three died from convulsions and two from haemorrhage. One result, in Bethnal Green, of the passing of the National Insurance Act is somewhat peculiar. I have learned from various sources that women who expect confinement have considerable difficulty in engaging the services of a medical man. The doctors are so occupied 48 with panel patients that they are frequently obliged to decline maternity engagements, hence a larger proportion of these cases are now attended by midwives. The birth notifications would appear to throw some light upon this point. Miss Hammond reports that of the 3,662 notifications received during 1913 only 956 were from medical men, whilst 1,210 were from midwives and 1,002 from the Maternity Department of the London Hospital (students and midwives, with skilled medical assistance where necessary). The remainder of the notifications gave no information as to the position of the informant; but assuming that these were equally divided between doctors and midwives, the midwives appear to have attended by far the greater number of the whole 3,662. OPHTHALMIA NEONATORUM. Sixteen cases of this disease were notified during the year; the mothers were attended by doctors in seven cases, by midwives in six, and London Hospital maternity assistants in two. In eleven of the cases a complete cure has been effected, four remain under treatment, and the parents of the other infant have left the district. CEREBRO-SPINAL MENINGITIS. Only one notification of this disease was received. A girl aged eleven was taken ill on the 22nd of December. She had headache, drowsiness and delirium; squint was noticed on the 28th, Kernig's sign was present, there was retraction of the head and the reflexes were exaggerated. The girl was removed to the London Hospital, where the case was considered to be one of Tubercular Meningitis; lumbar puncture was in favour of this diagnosis, as no 1913. Deaths from all causes. 49 diplococcus was found. The girl died, but no post mortem examination was allowed. The death was certified as Tubercular Meningitis. I am indebted to Dr. M. L. Treston, the House Physician, for these particulars. The patient's home was in a fairly good condition as to sanitation; there was no other case of illness amongst the inmates and no animals were kept. POLIOMYELITIS AND POLIOENCEPHALITIS. Three cases of these diseases were notified :— 1. D.E., a female aged two years. Illness commenced on January 7th with irritability of temper, fever, and vomiting. The child was admitted to the London Hospital six hours after onset. There was no localised paralysis, but there was right unilateral spasm (leg, arm, and face). The child rapidly became unconscious and died. Acute polioencephalitis of right side of brain was found post mortem. The sanitary conditions of this child's home was found to be good, there had been no illness amongst the other inmates and no animals were kept. 2. H.S., a male aged one year and ten months. Illness commenced about the middle of May, and the child was admitted to the Queen's Hospital on the 24th of the month. The House Physician declined to furnish medical history, but at the date of this report the child is still under treatment and there is partial paralysis of both lower limbs. The child's home is in fair sanitary condition; there has been no illness amongst the other inmates; one cat is kept. 3. E.C., a girl aged two and a half years, was brought to the out-patient department of St. Bartholomew's Hospital in October. The history was somewhat vague; illness commenced about a fortnight previously 50 with sore throat and fever, paralysis was noticed almost at once. Upon examination both lower limbs were found to be affected; there was no pain or mental defect; the patient is still under treatment at date of this report; paralysis persists. The sanitary condition of the premises was fair, with the exception of some necessary cleansing; no animals were kept, and there had been no recent illness amongst the other inmates of the house. TUBERCULOSIS. The deaths recorded as from the various forms of Tubercular disease during 1913 numbered 274, 13½ per cent. of the total deaths from all causes in the Borough, a death rate of 2.14 per thousand population. Sixty of the deaths were amongst young children, a mortality of 3.7 per thousand children living. Five infants died from tubercular disease of the brain, and an equal number from tubercular disease of the bowels. PULMONARY PHTHISIS. The deaths from tubercular lung disease numbered 197, equal to a mortality rate of 1.54 against 1.32 for the whole of London. NOTIFICATION OF TUBERCULOSIS. Tuberculosis of all kinds is now a notifiable disease under the Public Health (Tuberculosis) Regulations of 1912, which came into operation on February 1st, 1913. Including the cases notified during the month of January (before the new regulation took effect), 766 cases of Phthisis have been notified, and 230 cases of non-pulmonary tuberculosis. In Table II. (a) in the appendix 51 will be found particulars of all the cases notified since February, 1913, to the end of the year (January 3rd, 1914). Of the persons notified as suffering from Tuberculosis 334 were stated to be insured under the National Health Insurance Act, 1912. No information could be obtained as to 124, but 538 were not insured. 214 specimens of sputum were submitted to the Clinical Research Association for examination; the tubercle bacillus was detected in 36, but the examination was negative in 160. The homes of all the sufferers from Tubercular disease have been visited, insanitary conditions noted, and (as far as possible) remedied. The chief trouble we have to contend with in the majority of instances is the insanitary sleeping arrangements, but as most of this is well within legal limits we can only advise improved methods and open windows. The narrowness of many of the streets in certain neighbourhoods certainly fosters this disease by preventing the free circulation of air and obstructing the health-giving rays of the sun. This is shown by the fact that in the Brady Street unhealthy area the Tubercular death rate is double that of the remainder of the Borough. I am strongly of opinion that a clearance of slum areas in all the large towns throughout the United Kingdom would do much more to abolish Phthisis than anything that is possible under the National Health Insurance Act. By direction of the Public Health Committee many of the sufferers from Phthisis were supplied with paperlined spitting cups and glass metal capped pocket-spittoons, the use of which was taught and strongly advocated. 52 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912, Occupations of Persons Notified during 1913. Occupation. Males. Females. Total. Artificial Flower Makers — 3 3 Boxmakers 16 10 26 Book-keepers — 1 1 Bookbinding Trade 9 — 9 Boot and Shoe Trade 17 4 21 Brass Finisher 1 — 1 Bricklayer 1 — 1 Brush Makers 3 1 4 Butchers 2 — 2 Cabinet Makers and Furniture Trade 54 12 66 Canvassers 6 — 6 Cap Makers 2 1 3 Carmen, Cab, 'Bus and Tram Workers 14 — 14 Caretaker — 1 1 Carpenter 1 — 1 Carpet Sewer 1 — 1 Cigar and Cigarette Makers 3 1 4 Clerks 2 — 2 Clothes Dealers 1 1 2 Coopers 2 — 2 Cork Sorter — 1 1 Cutlers 2 — 2 Confectioners 1 — 1 Dial Maker 1 — 1 Domestic Servants 4 24 28 Dressmakers, etc. — 12 12 Electrical Workers 2 — 2 Embosser 1 — 1 Envelope Sorter — 1 1 Errand Boy 1 — 1 Feather and Fur Workers 1 6 7 Fish Curers 3 — 3 Gas-mantle Makers 1 — 1 Gilder 1 — 1 Glass-workers 2 — 2 Greengrocer 1 — 1 Gun-maker 1 — 1 Hawkers 76 12 88 Housebreaker 1 — 1 House-wives — 93 93 Horsekeepers 2 — 2 Infants 51 26 77 Knifegrinder 1 — 1 Carried forward 288 210 498 53 Public Health (Tuberculosis)—continued. Occupation. Males. Females. Total. Brought forward 288 210 498 Labourers:—General 21 — 21 Dock 6 — 6 Gas Works 1 — 1 Railway 3 — 3 Laundresses — 12 12 Lavatory Attendant 1 — 1 Leather Workers 3 2 5 Lift Attendant — 1 1 Machinists — 16 16 Mat Makers 2 — 2 Mechanics 12 — 12 Milliners — 3 3 Milk Dealer 1 — 1 Musician 1 — 1 Newsagent 7 — 7 Nurses — 2 2 Painters 8 — 8 Packers 1 1 2 Paper Bag Maker — 1 1 Paper and Rag Sorters — 5 5 Picture Framer 1 — 1 Porters 8 — 8 Printers, Compositors, etc. 13 1 14 Public-house Employees. 6 — 6 Sawyers 5 — 5 Seaman 1 — 1 Shop Assistants 10 4 14 Schoolmaster 1 — 1 Silk-workers — 4 4 Starch-worker 1 — 1 Stationers 2 — 2 Stock-keepers 2 — 2 Surgical Instrument Makers 1 — 1 Sweeper 1 — 1 Tailors and Tailoresses 46 6 52 Tie-makers 1 2 3 Toy-makers 1 — 1 Umbrella-makers 3 — 3 Van Boys 2 — 2 Waiters and Waitresses 1 1 2 Warehousemen 5 — 5 Watchman 1 — 1 Whip-maker 1 — 1 Window Cleaners 4 — 4 Woodworkers 6 — 6 No occupation 27 34 61 No information obtainable, or persons removed 14 8 22 School-children 94 70 164 Total 613 383 996 54 TUBERCULOSIS DISPENSARY. Report of the Medical Officer of Health. 1. The Departmental Committee on Tuberculosis issued in May, 1912, an Interim Report in view of the coming into force of the National Insurance Act, 1911. 2. The Report stipulated that any scheme being the basis of an attempt to deal with the problem of tuberculosis should be available for the whole community. 3. Under its existing powers, conferred by the Public Health (London) Act 1891, and the Public Health (Tuberculosis) Regulations 1912, the Borough Council may undertake the treatment of persons suffering from Tuberculosis in Dispensaries, Sanatoria, and a home, having power to provide the necessary institutional and other facilities. 4. The National Insurance Act 1911, section 16 (i) provides that :— for the purpose of administering sanatorium benefit the Insurance Committees shall make arrangements to the satisfaction of the Insurance Commissioners, (a) with a view to providing treatment for insured persons suffering from Tuberculosis, with persons or local authorities, other than poor law authorities, having the management of sanatoria or other institutions approved by the Local Government Board, which treatment it shall be lawful for the Local Authority to provide with respect to insured persons resident outside as well as those resident within their area. * M.A.B. now excepted (National Insurance Act, 1913, Section 39). 55 (b) with a view to providing treatment for insured persons otherwise than in sanatoria or other institutions with the like persons or authorities as in (a), which treatment, including the appointment of officers, it shall be lawful for the local authority if so authorised by the Local Government Board toundertake. 5. The principal recommendations of the Departmental Committee were as follow :— (a) That with a view to encouraging the early provision and equipment of tuberculosis dispensaries, capital grants should be made up to four-fifths of the amount required, provided that this sum should, generally, not exceed £1 per 750 of population or an average of £240 per dispensary. (On the population of Bethnal Green it would amount to £170.) (b) That grants should be made for beds other than sanatorium beds (e.g., observation beds in hospitals). (c) That schemes dealing with the whole population should be drawn up by the Councils of counties and county-boroughs, or by a combination of these bodies, at the earliest possible date. (d) That so far as possible, grants in aid of tuberculosis dispensaries should be given only where such institutions will become constituent parts of complete schemes. (e) That in framing complete schemes, regard should be had to all the existing available authorities and organisations and institutions, with a view to avoiding waste by overlapping, and to obtain their co-operation and inclusion within the schemes proposed (e.g. Victoria Park Chest Hospital). 56 (f) That special regard should be paid to obtaining the co-operation of medical practitioners in the working of the schemes, particularly in relation to the early detection of the disease and its domiciliary and dispensary treatment. (The extended arrangements made with the panel doctors by the Insurance Committee would doubtless affect the possibility of securing the desired co-operation.) (g) That special attention should be paid to securing suitably qualified and experienced medical practitioners for the senior appointments in connection with the institutions established, as the ultimate results obtai ned by treatment recommended must depend to a great extent upon their medical and administrative qualifications. 6. The Local Government Board, in a circular letter dated 14th May, 1912, stated that they agreed generally with the finding of the Departmental Committee, including financial recommendations in regard to the distribution of the capital grants, which they proposed to adopt, and urging that councils of each county and county borough should forthwith take the matter into serious consideration. 7. A further circular letter followed dated 6th July, 1912, addressed to county councils and county-borough •councils, dealing with the provisional arrangements for the treatment of insured persons recommended for sanatorium benefit, and urging that complete schemes relating to the whole population, and not only to insured persons, should be prepared in conference with the Insurance Committees and sanitary authorities, the unit area for such schemes to be generally the county or county-borough. 8. On the 27th July, 1912, the Board sent a further 57 letter to county councils, sanitary authorities and insurance committees, making temporary arrangements for the domiciliary treatment of insured tubercular persons. These arrangements have now terminated. 9. On the 6th December, 1912, the Local Government Board issued a further letter with reference to schemes for institutional treatment, and a copy of a letter from the Chancellor of the Exchequer to Mr. Henry Hobhouse with regard to the financial arrangements contemplated, was appended. 10. Under "Preventive Measures" it stated that the Board wished to emphasize the fact that it was the duty of the Medical Officer of Health of a sanitary district, upon receipt of a notification under the Tuberculosis Regulations, either himself or through an officer acting under his instructions, to make such enquiries and to take such steps as might appear to him necessary or desirable for preventing the spread of infection and for removing conditions favourable to infection, e.g., investigation into cases of infection, search for contacts, and enquiry into housing conditions. 11. Under "Finance," and in regard to maintenance grants, the letter stated that the Act required Insurance Committees to make arrangements for insured persons to receive treatment, and empowered them to extend their arrangements to include the dependants, or any class of dependants, of insured persons. Further, it had been definitely decided that the Exchequer would pay half of the deficiency (i.e., the call on the local rates) in all cases where the Local Authority (the County Council) had accepted the like responsibility. The desirability of schemes which would include, not only insured persons and their dependants, but also those 58 who fall into neither category was mentioned, and it was stated that in such cases also the Exchequer should, under the following conditions, bear half of any deficiency, viz., after deducting the amounts received from the Insurance Committees out of moneys available under the Act in respect of insured persons, and any sums received in respect of non-insured persons or otherwise, the annual grant should be one-half the total net cost of the scheme. (Note.—The London County Council have definitely expressed their opinion against any payment out of rates in respect of insured persons.) 12. On the 11th December, 1912, the Local Government Board wrote to the London County Council stating that the Board had acted on the view suggested in the Report of the Departmental Committee that the unit as regarded dispensaries should be the Metropolitan Borough or a combination of Metropolitan Boroughs, and requesting the County Council, to whom they looked to be the central organising body, to formulate and submit to them a complete scheme for the Metropolis. 13. A question, however, arose between the County Council and the Local Government Board as to procedure in the approval of local schemes, certain of which had been approved by the Local Government Board (the County Council scheme for the proper co-ordination of dispensary treatment throughout London not having been formulated), and it was not until quite recently that the County Council proceeded to issue its views on the subject. 14. On the 8th January, 1913, the Public Health Committee appointed a sub-committee to consider and report upon the establishment of a dispensary by the Council. The sub-committee duly delivered its report. 59 recommending the use of the site of 18, Patriot Square (the property of the Council) for the establishment of a dispensary entirely under the control of the Council, with provision for a sufficient staff. It was, however, felt after further consideration that, until the questions outstanding between the central bodies had been settled, and definite lines laid down by the County Council, the Council should hold its hand. 15. Following is a note of correspondence with the Chest Hospital, which may possibly prove useful in the further preliminary deliberations of this Committee :— 16. On the 15th January, 1913, the Town Clerk, by the direction of the Public Health Committee, communicated with the Secretary of the Victoria Park Chest Hospital inviting any observation which it might be desired to make in connection with the establishment of a Tuberculosis Dispensary which the Council contemplated undertaking. 17. The Hospital Authorities in reply stated that they considered the provisions of the Act offered an opportunity of a natural and valuable development of the Hospital's work, and that they would be neglecting their duty if they failed to co-operate in the scheme; and furthermore that they would be disposed to recommend the Committee of Management to undertake the work upon voluntary lines as regarded arrangements which would not involve additional expenditure. 18. The meaning of the last sentence is not quite clear, but the statement should be borne in mind in the event of any further negotiations. 19. The letter points out the great value of the accumulated experience of hospital staffs in the treatment of Tuberculosis, particularly in its early stages; 60 and that the Hospital, having its staff of Consulting Physicians, was obviously able to make special provision in this respect. 20. The scheme suggested by the Hospital Committee was as follows:— Regulations. 1. (a) The internal administration to be under the control of a combined Committee of Management elected in numbers to be agreed upon from the Hospital Committee and the Borough Council. (b) The medical control to be in the hands of the Medical Staff of the Hospital in co-operation with the Medical Officer of Health. (c) The work of the Hospital Out-Patient Department to be kept separate from that of the Tuberculosis Dispensary. 2. The Medical Staff to consist of the following:— (a) A Tuberculosis Officer. (b) Physicians attached to the Out-Patient Department of the Hospital to be available for consultation by the Tuberculosis Officer. The number of Physicians would depend on the arrangements as to days and hours of attendance. (c) A Throat Specialist. Such Departments now existing at the Hos- (d) A Dental Surgeon pital would be available (e) A Bacteriologist. under arrangements as to additional cost of (f) An X-Ray Specialist. maintenance. 3. The department to deal with all such patients referred to it in the ordinary course and through the Medical Officer of Health. 4. Domiciliary visitation and examination of 61 contact cases to be in the hands of the Medical Officer of Health ; the Tuberculosis Officer to be available so far as his other duties would allow. 21. It was not desired at that stage to touch more definitely upon the financial aspect of the matter than to say that, if it was within the power of the Council to make arrangements on the basis of a definite payment per attendance of each patient, the Committee thought no more satisfactory nor convenient method could possibly be found. Failing this, a discussion on the matter would be welcomed. (It is now understood that the London County Council object to a system of payment per visit, or per capita.) 22. On the 29th March, 1913, a letter was received from the Local Government Board, enclosing a copy of a letter addressed by the Board to the Secretary of the Chest Hospital, stating that the Board welcomed a proposal of the Committee of Management to establish a tuberculosis dispensary at the Hospital, asking for further particulars of the proposal, and stating that the Board would require to be satisfied that the work of the Dispensary would be properly linked up with the work of the Borough Council under the Tuberculosis Regulations, and that arrangements were made for the examination of " contacts " by the Tuberculosis Officer of the Dispensary. (Sec. 4 in the proposed Regulations of the Hospital.) 23. On the 14th May 1913, the Local Government Board sent a letter to the Council requesting to be furnished with an estimate of the proposed expenditure of the Council in respect of their dispensary scheme. 24. About this time it became known that, in accordance with an arrangement made by the Treasury 62 the amount of 1s. 3d. per insured person originally provided by the Act had been reduced to the extent of 6d. per head, and one penny per head had been earmarked for administration purposes, leaving only 8d. per head out of the original 1s. 3d. 25. At the request of the Public Health Committee the Town Clerk communicated with the Local Government Board informing the Board of the scheme tentatively prepared by the Committee on the lines of independent management by the Council, definitely asking the Board's views as to arrangements which the Board would consider satisfactory for linking the work of a Dispensary at the Hospital with the preventive work of the Council, or as to the respective positions which the Hospital and the Council would occupy in a scheme for the whole Borough. The reduction of the amount allocated for treatment of insured persons was also mentioned. 26. The Board gave little indication of their views as to what the working arrangements between Hospital and Council should be in the event of the Council taking advantage of the Hospital Dispensary, but did emphasize the advantage of the availability at such a Hospital of expert methods of diagnosis, and " observation" beds. Generally it would be desirable that the Tuberculosis Officer and his assistants should be attached, for administrative purposes, to the staff of the Public Health Department, and that domiciliary visits and reports should be made by these officers. 27. As to finance, the Board stated that they had not modified their views as to the grant proposed to be made in respect of schemes, and that annual grants of one half the net annual cost (after deducting income in 63 respect of insured patients, etc.) would be made by the Board to the Council. 28. During September 1913 it became apparent that the Local Government Board and the London County Council had arrived at an understanding as regarded the formulation of a comprehensive scheme for the Metropolis, the monetary control resting mainly with the County Council, and the provision of local schemes with the Metropolitan Boroughs, the latter of course having to be so designed as to form part of a comprehensive scheme for the Metropolis. 29. On the 8th November, the County Council communicated to this Council its views as to the financial aspect in the form of a resolution as follows:— That any comprehensive scheme for dealing with the treatment of tuberculosis in London shall provide for a contribution being made by the Council from year to year towards so much of the cost of the dispensary treatment of uninsured persons in the City of London and each Metropolitan Borough as would otherwise fall on the local rate, after taking into account the promised grant from the Imperial Exchequer, provided such contribution (1) shall not exceed 50 per cent. of such cost; (2) shall in the first instance be made from a date to be fixed hereafter by the Council, and (3) shall be conditional upon the Council being satisfied with the local scheme in force in such area and upon the arrangements and expenditure being annually submitted to and approved by the Council, and that whilst by the above proposals ample funds will be provided to meet the cost of dispensary treatment for uninsured persons, in view of the fact that the Insurance Committee for the County of London have resolved 64 that representations should be made to the Treasury as to the inadequacy of the sums available for defraying the expenses of sanatorium benefit in respect of insured persons suffering from tuberculosis in the County of London, the Council is of the opinion that no comprehensive scheme can be adequately carried out unless provision is made for meeting the full cost of the treatment of insured persons out of the Insurance Fund or by the Government. 30. On the 18th November the County Council requested to be provided with full particulars of the proposals of the Borough Council with regard to the provision of dispensary treatment. 31. On the 2nd December, the Medical Officer of Health of the London County Council transmitted resolutions of the County Council dealing with the general principles by which the Council would be guided in the consideration of local schemes, as follows: (1) That in the opinion of the Council it is essential that, in connection with the treatment of tuberculosis in London : (i) all possible use should be made of existing institutions; and (ii) approval should not be given to any scheme which fails to provide for each dispensary being linked up with a hospital to which special cases shall be referred for consultation or treatment, residential or otherwise. (2) (a) That any comprehensive scheme for the treatment of tuberculosis in London shall provide for the undermentioned principles to be observed in any local scheme which the Council will approve for the provision of dispensary treatment. (i) The Council must be satisfied that the 65 premises to be utilised as a dispensary are suitable for the purpose. (ii) The scheme must include provision, either in the dispensary or at a hospital working in connection with the dispensary, for the diagnosis, not only of ordinary straightforward cases, but also of incipient, anomalous and difficult cases specially referred on the ground of difficulty of diagnosis. (iii) The physician in charge of the dispensary (or "Tuberculosis Officer"), must be a man of experience, not only in dealing with tuberculous affections, but also in general medicine. (iv) Proper records and statistics in connection with the work of the Dispensary shall be provided of the nature and form required by the Council and approved by the Local Government. Board. (v) The physician in charge of the Dispensary shall supply to the Medical Officer of Health of the Borough from which patients are drawn such information as the Medical Officer of Health may reasonably require, and the County Medical Officer of Health shall be entitled to receive this information from the Borough Medical Officer of Health. The physician in charge of the Dispensary shall also furnish the requisite information to any medical practitioner carrying out domiciliary treatment, or, in a case which is referred to a sanatorium, to the Medical Officer of that institution. (vi) The scheme shall include provision for home visitation of patients, either by the Dispell- 66 sary physician or by the Medical Officer of Health of the Borough and his staff, and for the examination by the Dispensary physician of such cases as the Medical Officer of Health or a medical practitioner may require, either at the Dispensary or in the homes of suspects and contacts. (vii) The scheme shall be conducted with reasonable economy and the arrangements and expenditure shall be annually submitted to the Council for its approval. (viii) The scheme shall provide for distinguishing clearly between the cost of treating insured and uninsured persons, having regard to the opinion expressed by the Council that insured persons should not be paid for out of the rates. (b) That it be suggested to local sanitary authorities that they should make arrangements to pay for patients residing in the districts under their respective jurisdiction attending dispensaries attached to hospitals in any part of the Administrative County of London. 32. The position summarised seems to be as follows:— Preventive and Other Measures. It appears, briefly, that the scheme to be formulated by the Borough Council must include not only a dispensary in the ordinarily accepted sense of the word, but provision for expert methods of diagnosis, including bacteriology, dental treatment, X-ray examinations, and so forth, and the provision of "observation" beds. Stress is laid on the necessity for co-operation with existing hospitals; and, in view of the Victoria Park Chest Hospital being 67 within the Borough, it would appear likely that one of the conditions of the approval of a scheme in this Borough would be co-operation with that hospital. Paragraph (b) of the County Council's recommendations requires, of course, very special consideration. Finance. (1) In the establishment of a dispensary the Council is promised a Government contribution of four-fifths of the initial cost; but in view of the restriction that the amount of such grant shall generally not exceed £1 per head per 750 population (about £170 in this Borough), this would not appear of itself to offer this Council much inducement to proceed with its own institution. However, it is understood that in one case at least (St. Pancras), the grant has been on a much more generous scale. (2) As to maintenance expenses, the Government have offered to contribute half the call on the rates of a complete scheme for insured and noninsured if the County Council will do likewise ; but as it is understood that the County Council and the Insurance Committee feel that the expense of treating insured persons should be paid entirely out of Government Funds, and that the latter have made representation to the Treasury on this point, this method of settlement appears not likely to be agreed upon. (3) Apart from this, it seems that the Treasury will contribute half the maintenance expenses with regard to non-insured persons and the County Council half of the remainder; and that with regard to insured persons the Insurance Committee will pay 68 to the Council so much as falls to the Council on a proportionate basis of the numbers treated by the Council as compared with the number treated throughout the Metropolis. It seems doubtful, however, whether this latter amount, having been considerably reduced (see paragraph 24) will equal the cost of treatment of insured persons. Recommendation. In view of the necessity which now devolves upon this Authority to proceed with the formulation of a scheme for the provision of dispensary treatment for persons suffering from tuberculosis within the Borough and mindful of the conditions imposed by the resolutionsof the London County Council, I Recommend.—That negotations be re-opened Avith the authorities of the Victoria Park Chest Hospital in order to ascertain to what extent this Authority mightbe able to avail itself of the facilities offered by them, and what modifications, in the altered circumstances, may be desirable in the conditions originally proposed by the Hospital Committee. Communications should be sent to the London Hospital and the Mildmay Mission Hospital inviting observations as to the provisions at these institions of beds for treatment of surgical cases of tuberculosis, and also at the Queen's Hospital, Hackney Road, as to the provision of beds for children, both for surgical cases and for " observation " purposes. Note- The facilities afforded by the Victoria Park Chest Hospital might be ulitised:— 1. In the direction of the provision only of expert methods of diagnosis and treatment, also of 69 the provision of "observation" beds, patients being sent to the Hospital from a dispensary entirely controlled by this Council, a course which I most strongly favour. 2. In the direction of the establishment of the Council's Dispensary at the Hospital. GEORGE PADDOCK BATE, M.D., Medical Officer of Health, Bethnal Green. The foregoing report was received and approved by the Dispensary Sub-Committee, who were decidedly in favour of a dispensary under municipal control, with provision for special methods of treatment at a local hospital. Enquiries were ordered to be made of the Victoria Park, the Mildmay Mission, the London, and the Queen's Hospitals, to ascertain upon what terms such treatment would be provided. About this time the Local Government Board issued a most important communication to the Metropolitan Borough Councils, setting out in further detail the views of the Board as to the manner in which arrangements for providing dispensaries throughout London should be further developed. The Board upheld the views of a conference of representatives of 12 general hospitals held in London, that in all dispensary schemes special cases for consultative purposes should be referred to appointed hospitals, amongst which should be the 12 general hospitals with medical schools. It was also urged that facilities provided at existing 70 hospitals or dispensaries should be utilised, if possible, to the fullest extent. Further requirements dealt with suggested preventive measures, including the complete co-ordination of the work of the dispensary with the work of the Borough Council under the Tuberculosis Regulations, 1912, and with the duties of Medical Officers of dispensaries. Under the heading of Finance two leading principles were laid down : (a) That the Borough Council be regarded as the providing authority for dispensaries, although such institutions might be provided at a hospital or by a voluntary organisation. (b) That the dispensary shall serve the needs of the whole community, including insured persons. The Board expressed the opinion that contributions of the Insurance Committee in respect of the treatment of insured persons should be by lump sum payments, subject to revision on experience, rather than by fees per case. The Board re-affirmed its intention to contribute to the cost of dispensary schemes, subject to its own approval and that of the London County Council. In these circumstances the expenditure of the Borough Council will be met as follows:— (1) The Insurance Committee will pay for the treatment of insured persons. (2) After deducting this payment and any other sums received by way of subscription (if any), the balance will be met as follows:— (a) 50 per cent. from the Local Government Board. 71 (b) 25 per cent. from the London County Council. (c) 25 per cent. from the Borough rates. Arrangements for the treatment of insured persons must be approved by the Insurance Commissioners. It is understood that the London County Council will provide, or arrange for, the Institutional treatment of insured patients. In December, replies to the enquiries ordered by the Sub-Committee were received:—(1) The terms quoted by the Queen's Hospital were too excessive to form the basis of any agreement. (2) The Victoria Park Hospital declined to agree to any part scheme, but offered the following alternative:— (a) To appoint and pay a Tuberculosis Officer a salary at the rate of £300 per annum. (b) To provide a dispensary within the precincts of the Hospital (apart from the ordinary out-patient rooms) for the reception and treatment of cases of Tuberculosis recommended by the Medical Officer of Health as representing the Borough Council; the advice and assistance of the full medical staff of the hospital (X Bay, Dental, and Throat Departments), in addition to that of the Tuberculosis Officer to be available when necessary. The inclusive payment quoted for this complete scheme was at the rate of two shillings for each attendance of a patient at the dispensary. The Mildmay Mission Hospital Trustees were unable to undertake for payment the treatment of Tuberculosis cases. 72 The House Committee of the London Hospital were willing to enter into a part scheme on the following terms: (a) An annual retaining fee of £100. (b) Beds for patients requiring to be warded, 20 shillings weekly. (c) An inclusive capitation fee (amount to be settled later) for each patient recommended by the Medical Officer of Health. I was informed by Mr. Morris, the Secretary to the hospital, that they had an arrangement with the London County Council for the treatment of school children suffering from Ringworm, Eye, Ear and Throat diseases, &c., at the rate of two shillings per case, this to include the whole of the treatment necessary for cure. The result of these enquiries was reported to the Sub-Committee, and I strongly urged the claims of the London Hospital scheme in preference to the one suggested by the Victoria Park Hospital, for the following reasons:— (1) The Tuberculosis Officer would be on the staff of the Borough Council. (2) We should have a dispensary entirely under the control of the Borough Council, housed in a building forming part of the Town Hall itself. The London Hospital, with its staff of medical and surgical experts (Eye, Ear, Throat, Dental, X Ray and Finsen Light Departments) second to none in the world, would be available for consultation and special treatment for both in- and out-patients. 73 On the other hand:— The Tuberculosis Officer of the Victoria Park Hospital would be quite independent, and in no way under the control of the Public Health Committee of this Council. It would be invidious to assert that the skill of the Physicians at one of these hospitals is in any way superior to that of the other, but the Victoria Park Hospital is a medical institution, and at present does not undertake the treatment of non-pulmonary Tuberculosis, as it has no surgical staff. After careful consideration by the Sub-Committee, the matter was referred to the Town Clerk, the Borough Accountant, and the Medical Officer of Health to consider and report as to the gross cost to the Borought of:— (1) A Tuberculosis Dispensary established at the Victoria Park Hospital. (2) A Tuberculosis Dispensary established and controlled by the Council, with provision for treatment of special cases at the London Hospital. The following statement was accordingly prepared by the Borough Accountant; it sets forth (in accordance with details and requirements indicated by me) the financial particulars called for by the Public Health "Committee. ' % CAPITAL EXPENDITURE. £ Furniture 300 Instruments and Fittings 170 470 74 ANNUAL EXPENDITURE. £ Tuberculosis Officer, £400 to 500 Two Nurses (one to act as Dispenser), £100 to £120 240 Drugs and Medicines 140 Repairs and Fittings 10 Rent 73 Rates, Taxes, &c. 20 Light, Fuel, and Water 20 Cleaning, one Woman at 18s. per week 47 Printing, Stationery, and Sundries 25 London Hospital: Retaining Fee 100 30s. per week for each in-patient 100 Capitation Fee for each out-patient 100- 300 1,375 VICTORIA PARK HOSPITAL. £ 800 Patients at 2s. per visit (estimated on an average of 26 visits per annum for each patient) 2,080 Two Health Visitors, £100 to £120 240 2,320 This statement was not presented during the year 1913, but as the provision of a Tuberculosis Dispensary is still under discussion, and is of such vast importance to the Borough, I make no apology for bringing the matter up to date. 75 I reported to the Committee that, apart from the estimated financial advantage in favour of the establishment of a Dispensary under the control of the Council, I was strongly of opinion that in all other respects the balance of advantage would rest with such an arrangement. I foresee many difficulties, and much waste of time in the correlation of the detail work of a Hospital Dispensary with that of the Public Health Department of the Borough Council. The Public Health Committee concurred with my views and decided to call upon the Borough Surveyor to get out plans and estimates for the erection of a Dispensary, in accordance with my suggestions, on the site of 18, Patriot Square, the building to be an addition to the Town Hall. The plans are in course of preparation, and there the matter now rests. CANCER. Included under this head are deaths from Cancer, Sarcoma, Epithelioma and Glioma. They numbered 131, and, with the exception of three, occurred amongst persons aged over 25 years. The following list shows the organs and parts of the body chiefly affected by cancerous disease:— Stomach, Liver and Pancreas 38 Female Organs of Generation 18 Rectum 14 Intestines 12 Larynx and (Esophagus. 12 Female Breast 11 Tongue and Mouth 8 76 Prostate and Male Bladder 4 Lung and Mediastinum 4 Bones 3 Brain 2 INQUESTS. Inquests numbered 247. Fourteen persons committed suicide and 58 others died violent or sudden deaths. A house-painter, aged 59, died from General Paralysis which in the opinion of the Coroner's Jury, was the result of chronic lead-poisoning. An Engineer suffering from gout died from an overdose of Colchicum, self-administered. There was only one uncertified death, that of a premature infant aged 15 minutes; the case was reported to the Coroner, who did not consider an inquest necessary. SUICIDES. There were fourteen of these:—Five men and one woman hanged themselves, two men cut their throats and one other drowned himself, a man suffocated himself with coal gas, three others took poison (one each carbolic acid, spirit of salt and oxalic acid); two women also took poison, one selecting spirit of salt, the other oxalic acid. CUSTOMS AND INLAND REVENUE ACTS, 1890 to 1903. No application for exemption was received in respect of any premises during the year. 77 BRADY STREET UNHEALTHY AREA. A formal representation in respect of this area under Part I. of the Housing of the Working Classes Act, 1890, as amended by the Housing and Town Planning Act, 1900, was made to the London County Council on the 4th of April, 1912; a complete history of the area and full details of the representation will be found in my annual report for that year. No formal statement of the intentions of the County Council was received during 1912, and as nine months had elapsed since the date of the representation, the Town Clerk was directed to communicate with the London County Council in order to ascertain the views of the Council as to a scheme for dealing with the area. At a meeting of the Borough Council held on January 8th, 1913, the Town Clerk submitted a letter from the London County Council stating that the Housing of the Working Classes Committee of the Council had under consideration proposals for the improvement of the area otherwise than by means of a scheme under Part I. of the Act. The Council was invited to appoint representatives to confer with the Housing Committee upon the subject. A deputation was appointed, and the conference was held at Spring Gardens on January 22nd, 1913. Present: Alderman Robertson (Chairman P.H.C.), Alderman Pearson, and Councillors Brooks. Clark and Dean, the Town Clerk, the Chief Sanitary Inspector, and myself. Mr. Percy Harris (L.C.C.) having introduced the Deputation, the Chairman of the London County Council Housing Committee proceeded to review the general question of housing as it affects Manchester, Birmingham, and other large cities as compared with London. He 78 informed us that the Housing Committee had deputed a Mr. Nettlefold to inspect and report upon the Brady Street area, with a view to its treatment upon lines similar to those said to have been successful at Manchester and other places. The Deputation was not favoured with a copy of Mr. Nettlefold's report, and as he was not present at this conference, the members had no opportunity of securing any first hand information as to the grounds upon which he based his suggestions, nor as to what extent the area in question could be regarded as analagous to any of the areas said to have been dealt with so cheaply and so satisfactorily elsewhere. Shortly, Mr. Nettlefold's plan for dealing with the Brady Street area is to clear away a number of premises at various points (usually one side of each street) on the ground that such premises are "obstructive buildings" within the meaning of Section 38 of the Housing of the Working Classes Act, 1890, and to follow this up by vigorous action on the remaining houses under the Town Planning Act. In effect the suggestion would appear to be that with these "obstructive buildings" removed and the remaining houses thoroughly repaired (or closed and demolished) where necessary, the site would be so satisfactory as regards general condition, air snace and ventilation, that no further improvement scheme would be required. No reason was advanced by the Chairman for thus varying the usual procedure prescribed by Part I. of the Housing Act. On the other hand, the defects of Mr. Nettlefold's plan are apparent to any one with practical experience in dealing with slum property; but in order to prevent possible misunderstanding a few of the objections may be set out. 79 (1) It is, to say the least, doubtful if the premises referred to as "obstructive buildings" are in point of law and practice "obstructive buildings" within the meaning of the statute. (2) Assuming the practicability of proceeding under Section 38 to get these buildings demolished, the point seems to have been entirely lost sight of that compensation would have to be paid by the public authority to the owners precisely as though the site and buildings were being acquired under Part I. of the Housing Act. (3) Having expended money in the manner suggested, and having enforced such repairs as are legally possible to the houses allowed to remain, the resultant effect would be to perpetuate a series of lop-sided streets consisting of small, worn-out houses that have been patched and repaired time after time already. (4) From the point of view of public expenditure the plan would be costly and as to permanent improvement negative. (5) It is only fair to note that the proceedings suggested have never yet been carried out under a housing scheme, and that it is peculiar that a poor borough like Bethnal Green should be selected for such a novel experiment. At the Public Health Committee on March 5th, a letter from the London County Council was considered; it was to the effect that the Committee for the Housing of the Working Classes were not in a position to report upon the representation relating to the Brady Street area, and were unable to furnish this Council with further information as to their proposals, and that in view of the coming election 80 of County Councillors, it would not be possible to further consider the matter till after the Easter recess. It was resolved, after consideration, "That the Town Clerk be requested to communicate to the London County Council the surprise and regret of this Committee that further delay should take place in dealing with the Brady Street area, and that the Council be informed of the action of this Committee." On the 19th of June the Council directed the Town Clerk to communicate with the London County Council asking whether the London County Council was in a position to make any proposal for dealing with the area as an improvement scheme, and to impress upon the County Council the necessity for dealing with the matter without further delay. The reply of the County Council was received on October 2nd, and was as follows:— (a) The Council, after considering the representation dated April 4th. 1912, made by the Medical Officer of Health of the Metropolitan Borough of Bethnal Green with regard to the Brady Street area, is not at present prepared to undertake an improvement scheme under Part I. of the Housing of the Working Classes Act, 1890, in view of the fact that further legislation on the subject is practically certain at no distant date, and that such legislation will in all probability enable the area and other similar areas to be dealt with in a more satisfactory manner, and at less cost to the ratepayers than is the case under the present law. (b) That in pursuance of Section 10 of the 81 ing of the Working Classes Act, 1890, a copy of the official representation with regard to the Brady Street area referred to in the foregoing resolution (a) will be sent to the Local Government Board, together with the Council's reasons for not acting upon it. The communication was referred to the Public Health Committee, by whom the following report was presented: Brady Street Area. We have considered a communication from the London County Council stating— (a) That the Council, after considering the representation dated the 4th April, 1912, made by the medical officer of health of the Metropolitan Borough of Bethnal Green with regard to the Brady Street area, is not at present prepared to undertake an improvement scheme under Part I, of the Housing of the Working Classes Act, 1890, in view of the fact that further legislation on the subject is practically certain at no distant date, and that such legislation will in all probability enable the area and other similar areas to be dealt with in a more satisfactory manner, and at less cost to the ratepayers than is the case under the present law. (b) That, in pursuance of the provisions of section 10 of the Housing of the Working Classes Act, 1890, a copy of the official representation with regard to the Brady Street area referred to in the foregoing resolution (a) will be sent to the Local Government Board, together with the Council's reasons for not acting upon it. For the information of the Borough Council a copy of the report of the Housing of the Working Classes Committee in question was sent. 82 In order that members of the Council may be fully informed as to this important matter, we have directed that the report of the Housing of the Working Classes Committee be printed and a copy sent to every member. Tt will be observed that the report first refers to the fact that the representation under part I. of the Housing of the Working Classes Act, 1890, was made by the Medical Officer of Health more than nine years ago, when it was stated that "nothing short of clearing the area and rebuilding the houses would be effectual." Inasmuch as the Officers of the County Council confirmed this view as to dealing with the area, in our opinion it is most unsatisfactory that the area has been permitted to remain in so insanitary a condition for a lengthy period, except in so far as from time to time the Borough Council has been able within its limited powers to remedy the evils by means of closing orders. Such closing orders have generally resulted in the carrying out of merely superficial repairs by the owners of the property, with the inevitable consequence that the houses were soon afterwards found to have deteriorated into their former faulty and unsatisfactory condition without any prospect of permanent improvement. In this connection we notice that the County Council admits that the Borough Council cannot be charged with having taken no action at all under Part II. of the Act, and further that any drastic action on its part is for the time being naturally arrested. The County Council suggest a comparision between the property in the Brady Street area and that in the notorious Tabard Street area, which is now being dealt with by means of an improvement scheme under Part I. of the Housing Acts of 1890. It is further acknowledged that many of the houses in the Brady Street area are in as hopelessly bad and decayed 83 condition, as incapable of being made fit for human habitation, and as deserving of destruction as those in the Tabard Street area. The County Council, therefore, recognises and admits that the representation of the Medical Officer of Health was well-founded, and the facts upon which the representation was based cannot be disputed. The question at issue is how best to treat the area, and the Borough Council has consistently maintained that the only satisfactory way of dealing with it is by means of an improvement scheme under Part I. of the Act. We regret that the County Council for some considerable time failed to deal with the representation made in 1904 on the ground that there was an immediate prospect of the area being developed by private enterprise. There was no substance in that suggestion, and the County Council was so informed. The time that has since elapsed sufficiently demonstrates that there was no justification for postponement on the ground that the area would be re-developed by private enterprise. In view of the unfortunate delay and the lamentable consequences that have resulted from it, we are strongly convinced that there is no justification for any further postponement of the duty which rests upon the County Council to undertake its obligations in regard to the Brady Street area. The Town Clerk has drawn our attention to the fact that the first resolution of the London County Council states "that further legislation on the subject of the Housing of the Working Classes Act, 1890, is practically certain at no distant date." It may be that the County Counncil has reason for confidence in the 84 value and efficacy of possible further legislation at no distant date, but we do not share that view. We are satisfied that to ground further postponement of the discharge of a most important public duty affecting the lives of thousands of inhabitants of Bethnal Green upon the mere possibility of legislative efforts resulting in means of dealing with the area 'in a more satisfactory manner" is a course in which this Council cannot be recommended to acquiesce. We now learn that the Local Government Board has decided to proceed under Section 10 of the Act of 1890 to direct a Local Inquiry to be held on the subject by one of their inspectors. We welcome the intimation of such an inquiry, and had we not received a notice from the Local Government Board of this fact, we should have recommended the Council to have asked that an inquiry be held. In the circumstances we report as to the present position for the information of the Council, and we have asked the Officers of the Council to take such preliminary steps as may be necessary to prepare for the proposed inquiry. We therefore Recommend—That the London County Council be informed that this Council much regrets that after so long a period has elapsed since the Medical Officer of Health made a representation under Part I. of the Housing of the Working Classes Acts, 1890, in respect of the Brady Street area, it is not the intention of the County Council to undertake an improvement scheme under Part I. of the Act, and the reasons given for not acting on the representation are not satisfactory to the Council. 85 At the meeting of the Council on October 16th a letter was read from the Local Government Board giving formal notice of an inquiry proposed to be held at the Town Hall, on Friday, October 24th, 1913, by an Inspector of the Board with reference to the representation submitted to the London County Council by the Medical Officer of Health in respect of the Brady Street area. The Town Clerk was instructed to represent the Council at the inquiry. On October 22nd Major Norton, an Inspector of the Local Government Board, called upon the Town Clerk, and afterwards visited the area, accompanied by officers of this Council and of the London County Council. On October 24th a public inquiry was held at the Town Hall by Major Norton, and at the following meeting of the Council the Town Clerk presented an account of the proceedings in the form of a report by the Public Health Committee as follows:— (a) Brady Street Area. In our last report to the Council on the subject of the Brady Street area we intimated that the Local Government Board had decided to proceed under Section 10 of the Housing of the Working Classes Act, 1890, to direct a Local Inquiry to be held as to the correctness of the official representation made to the London County Council by the Medical Officer of Health (Dr. George Paddock Bate), and other matters in connection therewith. The Inquiry was held by Major C. E. Norton, R.E., the Inspector appointed for that purpose, at the Town Hall, Bethnal Green, on Friday, the 24th October, 1913, the Inspector having two days previously inspected the 86 area in company with representatives of the two Authorities. The London County Council were represented at the Inquiry by Mr. W. A. Hawes (of the Solicitor's Department) and the Borough Council by the Town Clerk. Evidence was given on behalf of the London County Council by Mr. Bernard Holland, Chairman of the Housing Committee, and Dr. Butler, the Assistant Medical Officer of Health for the County of London. The case for the Borough Council was supported by the evidence of Dr. Bate (Medical Officer of Health), Mr. Darby (Borough Surveyor), Mr. John Foot (Chief Sanitary Inspector), and Mr. Richards (Sanitary Inspector). The Solicitor representing the London County Council referred to the resolutions passed by that Authority on the 29th July, 1913 (a copy of which appears on the minutes of the Borough Council, Vol. XIII., page 367) with reference to the Brady Street area, and contended that the County Council had not by those resolutions arrived at a final decision in the matter, and that consequently the power of the Local Government Board to direct a Local Inquiry to be held had not become exerciseable. in the circumstances alleged the County Council reserved such rights as it might have in regard thereto. On behalf of the London County Council it was asserted, amongst other things, that the Borough Council had not been assiduous in the exercise of its statutory powers in the Brady Street area, that many of the evils complained of could be removed if the Council rigorously enforced its powers under the Housing, Town Planning, etc., Act, 1909, by way of closing premises and obtaining demolition orders in respect thereof, that the Borough Council might have exercised other powers under the 87 Housing Acts by the purchase and removal of buildings which obstructed light and air to other buildings, and that the Borough Council might have purchased and cleared small portions of the area as being unhealthy areas, too small for inclusion in a scheme under Part I. of the Act of 1890. Mr. Bernard Holland, in the course of his evidence on behalf of the County Council, stated that he did not challenge the accuracy of the official representation. In support of the views expressed by the London County Council that effective housing legislation was imminent, Mr. Holland referred to statements which have from time to time been made by the Prime Minister, the Chancellor of the Exchequer, and other persons; he also made reference to the proposal of the London County Council to seek statutory powers enabling the County Council to enter into agreement with the Metropolitan Borough Councils for the purpose of exercising collateral powers in respect of Part II. of the Housing of the Working Classes Act, 1890, and sections 17-21 of the Housing, Town Planning, etc., Act, 1909. Dr. Butler submitted statistical information relating to the area and, generally, confirmed the accuracy of the representation which had been made by Dr. Bate, the Medical Officer of Health. On behalf of the Borough Council, Dr. Bate gave evidence in support of his representation, and dealt fully with the steps which the Council and its predecessor, the late Vestry, had taken to deal with the area in question, and, as evidence of the futility of dealing with separate houses, he proved that several houses in the Brady Street area had been closed under the provision of the Housing Acts and re-opened after repair without any improvement being made in the narrowness of the street 88 on which the houses abutted, and that the houses had again become unfit for human habitation. Dr. Bate stated that in no single instance had the London County Council yet pointed out (i) any neglect oi the Borough Council or its predecessor to close a house unfit for human habitation, or (ii) failure to remove any building which was an obstructive building within the meaning of the housing statutes, or (iii) failure to put in force its powers, as Sanitary Authority, relating to the abatement of nuisances, the removal of insanitary conditions throughout the area generally, or otherwise. Dr. Bate emphatically expressed his opinion that the density of the population, the excessive death rate, the narrowness of the streets and the congestion of buildings confirmed his opinion that the most satisfactory method of dealing with the evils connected with the houses, courts and alleys, and the sanitary defects in the Brady Street area was that the area should be cleared and dealt with by the London County Council under the provisions of Part I. of the Housing of the Working Classes Act, 1890. Mr. Foot (Chief Sanitary Inspector) corroborated the evidence of Dr. Bate and produced photographs of various portions of the area, which were taken under his supervision on the 17th October, 1913. Mr. Foot also produced statements showing (a) the number of inspections made in the area by officers of the Council on complaints, the number of notices served and the number of cases abated during the period 1904-1912, and (b) the dimensions of typical houses, the number of occupants, frontage of houses, number of rooms, height of rooms, cubic capacity, rateable value, rental, &c. Mr. Foot also pointed out that the inspection and repair of separate houses did not result in the rearrangement of 89 the cul-de-sacs, passages and narrow streets existing in the area, and that any action taken by the Council under the Act of 1909 with regard to separate houses could not procure such permanent and satisfactory results as were necessary to ameliorate the unhealthy conditions obtaining in the area. Mr. Darby (Borough Surveyor) proved the width of the several streets, courts, alleys and passages in the area and produced a plan of the area, which he had prepared, with such widths marked thereon. Mr. Parby also gave evidence rebutting a suggestion that the Council had neglected to avail itself of an opportunity for the re-development of a portion of the area in the neighbourhood of Pereira Street, and stated the reasons why the Borough Council could not be recommended to adopt suggestions which had been made on behalf of Messrs. Mann Grossman & Paulin, Ltd. Mr. Richards produced a statement showing that of the 528 houses or tenements in the area only 21 houses or tenements were vacant at the date of the Inquiry, the percentage of empty houses being only four per cent. of the total number ot houses and tenements within the area. In conclusion the Town Clerk commented upon the evidence which had been adduced before the Inspector and strongly urged the necessity for drastic action being taken to remedy the unhealthy conditions prevailing for so long a period in the Brady Street area. The narrowness of the streets, the closeness of the houses and the generally defective planning of the whole area rendered it impossible to effect any satisfactory or permanent benefit by the closing and demolition of separate houses under the provisions of the Housing, Town Planning, etc. Act, 1909; and as the result of the very careful consideration which the Borough Council had given to all the aspects 90 of the question, the Council was unanimously of the opinion that nothing less than the demolition of all the houses and the complete rearrangement of the streets would suffice to remedy the lamentably unhealthy condition of the area. The Inspector intimated that he would report to the Local Government Board in due course, and the question as to dealing with the Brady Street area accordingly remains in abeyance pending the decision of the Local Government Board. We desire to direct the attention of the Council to the very valuable services rendered by the Town Clerk, the Medical Officer of Health, the Borough Surveyor and the Chief Sanitary Inspector in the preparation of evidence tendered at the Inquiry on behalf of the Council; further, we are of opinion that by the manner in which the case for the Council was presented by the Town Clerk, and by the evidence given by the other officers above mentioned, very material assistance was rendered in furthering the desire of the Council that the Brady Street Area should be dealt with by the London County Council under Part I. of the Housing of the Working Classes Act, 1890. We Recommend— (i) That our report be received and approved. (ii) That the thanks of the Council be tendered to the Town Clerk, the Medical Officer of Health, the Borough Surveyor, and the Chief Sanitary Inspector for services rendered by them in connection with the Inquiry. The report was received and the recommendations agreed to by the Council. 91 Recent Correspondence in regard to the Brady Street Area. Metropolitan Borough of Bethnal Green. Town Hall, Bethnal Green, N.E. 19th March, 1914. Sir, The Public Health Committee of the Council at its meeting, held last evening, sought further information from me with reference to the Public Enquiry held at the Town Hall on October 24th last on the subject of the representation made to the London County Council by the Medical Officer of Health for Bethnal Green, under Section 4 of the Housing of the Working Classes Act, 1890, in respect of an area known as the Brady Street area, Bethnal Green. I reported that the last communication from the Board was dated the 24th February, and that it contained an intimation that the Board are in communication with the London County Council in regard to the matter. I am to enquire whether representations are being made or have been made, to the Board by the London County Council on the subject since the date of the enquiry and if so, whether this Sanitary Authority may be informed as to the nature of such representations, in order that they may submit their observations thereon. In view of the very lengthy period that the Brady Street area has, in the judgment of the Medical Officer of Health, been suffered to remain in a condition dangerous and injurious to the health of the inhabitants, and the serious concern of this Sanitary Authority that proper steps should be taken, without any further delay, to deal with the area in the manner provided by law, I am directed to enquire whether the Board can afford the 92 Borough Council information as to what the position now is in relation to the matter. The Council were much interested in the proceedings at the Public Enquiry and the evidence submitted thereat, and I am to ask whether it may be made acquainted with the substance, if not the terms, of the report of Major Norton. I am, Sir, Your obedient servant, (Signed) C. G. E. FLETCHER. Town Clerk. The Secretary, Local Government Board, Whitehall, S.W. Local Government Board, Whitehall, S.W. 15th April, 1914. Sir, I am directed by the Local Government Board to advert to your letter of the 19th ultimo with reference to the representation made to the London County Council under Section 4 of the Housing of the Working Classes Act, 1890, in respect of an area known as the Brady Street area, situate in the Metropolitan Borough of Bethnal Green ; and I am to forward herewith, for the information of the Borough Council, a copy of a letter which the Board have addressed to the London County Council on the matter. I am to state that the Board have not yet received a reply to that letter. I am, Sir, Your obedient Servant, (Signed) NOEL T. KERSHAW, Assistant Secretary. The Town Clerk of the Metropolitan Borough of Bethnal Green. 93 Local Government Board, Whitehall, S.W. 16th February, 1914. Sir, I am directed by the Local Government Board to state that they have had under consideration the Report made by their Inspector, Major Norton, after the Inquiry held by him with reference to a representation made to the London County Council, under Section 4 of the Housing of the Working Classes Act, 1890, in respect of an area known as the Brady Street area and situate in the Metropolitan Borough of Bethnal Green. The Board understand that the County Council are prepared to consider further the question of dealing with the area referred to, though they are unwilling at present to proceed by way of an improvement scheme under Part I. of the Act of 1890. Under the circumstances the Board would desire to defer for the present coming to any formal decision under Section 10 of the Act of 1890, and Section 4 of the Act of 1903, and they would suggest that the County Council should consider to what extent the matter might properly be dealt with by means of a scheme or schemes under Part II. of the Housing of the Working Classes Act, 1890. The Board are advised that the following areas might be considered in this connection, viz:— (1) The area comprising the houses in Neath Place ; the houses Nos. 10, 12 and 14 Tapp Street; the houses Nos. 126 to 140 fronting Brady Street; and, unless they can be and are to be dealt with under Sections 17 and 18 of the Housing, Town Planning, etc., Act 1909, the houses on the south side of Somerford Street. (2) The area comprising the houses on the south sides of Scott Street and Dixie Street. 94 (3) The area comprising the block of tenemental buildings in Lisbon Street, unless Section 38 of the Act of 1890 may be regarded as providing a more satisfactory method of procedure. (4) The area lying between Brady Street, Reuben Street, Pereira Street, and Merceron Street, except the site of the house immediately abutting on the last-named street. The Board understand that the County Council have under consideration a proposal for acquiring a site in this neighbourhood for educational purposes, and that this area might be suitable for such a site, and the Board would point out that if the area were included in a scheme under Part II. of the Act of 1890, it would be practicable to provide for its use, after clearance, as a site for a school. The question of providing for the housing of a number of persons who would be displaced would of course arise for consideration, but some other parts of the areas referred to might be available for this purpose if circumstances shewed that rehousing in the immediate neighbourhood is required. As regards the houses abutting on Pereira Street and Foster Street the Board are at present disposed to consider that a satisfactory arrangement with the Brewery Company who own the greater part of the property is capable of being made without including the property in a scheme, and other houses in the area could probably be dealt with under Sections 17 and 18 of the Act of 1909. The Board would be glad to be furnished as soon as possible with the observations of the County Council on the suggestions made above for dealing with this area. I am, Sir, Your obedient servont, (Signed] A. V. SYMONDS. Assistant Secretary. The Clerk of the London County Council. 95 Metropolitan Borough of Bethnal Green, Town Hall, Bethnal Green, N.E. 7th May, 1914. Sir, I am directed to reply to your communication of the 15th April, transmitting for the information of the Borough Council a copy of a letter, dated the 16th February, 1914, which the Board has addressed to the London County Council, on the subject of the representation made to that authority under Section 4 of the Housing of the Working Classes Act, 1890, in respect of an area known as the Brady Street area, Bethnal Green. The Council considers that the present position of the important question relating to the Brady Street area is extremely unsatisfactory. A Public Inquiry was held by an Inspector of the Board more than six months ago, and, although the report of the Inspector was prepared and submitted to the Board in the usual manner some months since, the Council now learns that "the Board understand that the County Council are prepared to consider further the question of dealing with the area referred to." No intimation has been made to the Council that the County Council are now willing to consider as to dealing with the area and the Council would much like to learn upon what grounds the Local Government Board has arrived at the understanding referred to. Since the date of the Inquiry the Borough Council has treated the subject of the Brady Street area as being subjudice. At the date of the Inquiry the County Council were admittedly unwilling to proceed in the matter by way of an improvement scheme under Part I. of the Housing of the Working Classes Act, 1890, in view of the fact "that further legislation on the subject ispractically certain 96 at no distant date, and that such legislation will in all probability enable the area and other similar areas to be dealt with in a more satisfactory manner and at less cost to the ratepayers than is the case under the present law" (see Minutes of the London County Council, 29th July, 1913, at page 472), and that would appear to be the position now. The Inquiry was primarily and mainly held to examine the correctness of the representation made to the London County Council by the Medical Officer of Health for Bethnal Green, and on that point I am to remind the Board that the London County Council has never questioned the accuracy of the official representation. In fact, at the inquiry Dr. Butler, on behalf of the London County Council, submitted statistical information relating to the area which confirmed the correctness of the representation made by this Council's Medical Officer of Health. With regard to the suggestions made by the Board that the London County Council should consider as to dealing with the area by means of a scheme or schemes under Part II. of the Act of 1890, I am to submit the following observations for the information of the Board:— (i) The proposals, even if practicable, would afford no sufficient remedy for the evils which obtain in this unhealthy area. (ii) Officers of the London County Council and the Borough Council are alike agreed that the only proper and satisfactory manner of dealing with the area is by means of a scheme under Part I. of the Housing of the Working Classes Act, 1890. As to the proposal to acquire a site in the area for educational purposes, I am to point out that, if the area were dealt with by means of an improvement scheme 97 under Part I. of the Act, the suggestion is one that might well be adopted, and such a proposal would be supported by the Council; but there are numerous objections to the proposal to erect a school in an unhealthy area which is suffered to remain so by reason of the evils connected with it being unremedied, and which, in the judgment of the Medical Officer of Health, are dangerous and injurious to the health of either the inhabitants of the buildings in the area or of the neighbouring buildings. With reference to the houses abutting on Periera Street and Foster Street, I am to express the regret of the Council that the Board should at this date put forward a proposal which would involve dealing with the property by means of private enterprise. The London County Council, several years ago, based an indefinite postponement of any serious consideration of an official representation affecting part of this area upon a so-called understanding that the area would be developed privately. The Council has received 110 proposal from any source for dealing with this area, or any part of it, in such manner as would remove the grounds upon which the official representation of the Medical Officer of Health was based. At the Public Inquiry in October last, the Medical Officer of Health submitted incontrovertible evidence of the futility of dealing with separate houses in the Brady Street area, and proved that several houses had been closed under the provisions of the Housing Acts and re-opened after repair, without any improvement being made as regards the narrowness of the street on which the houses abutted. The inevitable result followed, and houses again became unfit for human habitation. I am directed to remind the Board that the Council has received no reply to the enquiry as to whether representations are being made, or have been made, to 98 the Board by the London County Council on the subject since the date of the Inquiry; nor to the further question whether this Council may be made acquainted with the substance, if not the terms, of the report of Major Norton. I am to add that for many years the Council has confirmed the opinion of the Medical Officer of Health for Bethnal Green that the Brady Street area is an unhealthy area within the meaning of Part I. of the Housing of the Working Classes Act, 1890, and that the Council is strongly of opinion that the further postponement of the discharge of a most important public duty affecting the lives of thousand of inhabitants of Bethnal Green should not be grounded upon the mere possibility of legislative efforts resulting in means of dealing with the area "in a more satisfactory manner," as stated in the resolution of the London County Council. I am, Sir, Your obedient servant, (Signed) C. G. E. FLETCHER. Town Clerk. The Secretary, Local Government Board, Whitehall, S.W. HOUSING, TOWN PLANNING, &c., ACT, 1909. In appendix "T" of Mr. Foot's report will be found a summary of the action taken by the Special Inspector appointed to carry out the Act. Mr. Richards is an energetic and painstaking officer, and I am satisfied that he has accomplished everything that is possible with the means at his disposal, but I must confess that I am dissatisfied with the result of his efforts as procedure under this Act is both tedious and cumbersome. 99 In conclusion, I beg to draw special attention to the report of The Chief Inspector which follows my own. His report bears eloquent testimony to the fact that a large amount of valuable Public Health Work has been accomplished during the past year, and it affords me much pleasure to testify to the efficiency and zeal of each member of the Staff. I have the honour to be, Sir and Gentleman, Your very obedient servant, GEORGE PADDOCK BATE. 100 REPORT OF THE HEALTH VISITOR. Public Health Department, Town Hall, Bethnal Green. To the Medical Officer of Health. Sir, I have the honour to present to you a short account of the work done by me in this Borough for the year 1913. It has been almost entirely that entailed by the working of the Notification of Births Act. The total number of births notified was 3,662; the notifications being received from: Doctors 959 Midwives 1,210 London Hospital 1,002 Infirmary and Workhouse 61 Relatives 326 Outlying Institutions 22 Whom not stated 82 3,662 101 The mothers were attended at their confinements by Doctors in 1,285 cases. Midwives 1,210 „ London Hospital Assistants (Midwives & Students) 1,002 Infirmary or Workhouse 6.1 „ St. Bartholomew's Hospital 2 „ City of London Lying-in Hospital 20 „ Whom not stated 82 „ 3,662 „ The Number of Infants Born was 3,711. 1,852 males. 1,814 females. 45 sex not stated. 3,711 The number of births exceeded the number of notifications, as twins and triplets are usually notified on the same card. This year two sets of triplets were born: (A) 2 boys and a girl, (B) 2 girls and a boy. All were born alive, but died within the first week. 102 The twins born numbered 45 sets: 13 sets of boys. 12 sets of girls. 20 sets of boy and girl. 45 Information as to the infant being living or still-born was not given (although asked for on the notification cards) in 620 instances. Information that the child was still-born was given in the case of 69 boys and 46 girls and in 2 where the sex was not stated. The total number of still-births notified was 117. Of these four were male twins and two female twins. During the Year the Cases Visited were: After notification of birth 2,065 Special Visits: Illness, poverty, and enquiries after infant deaths 252 Re-visits 431 Total number of visits 2,748 2,716 mothers have attended at the Town Hall to obtain advice and have their babies weighed. I feel that this part of our work is doing much good; moreover, it enables me to have the babies continually under 103 tion and to keep in touch with the mothers with the least expenditure of time; it considerably lessens the number of ordinary re-visits which would otherwise be necessary, and gives me time to visit and keep under observation mothers who are not careful and who neglect to obtain necessary medical or surgical treatment for the little ones unless looked after. The re-visitation of these cases is imperative. I am glad to say they are not numerous. Ten infants were overlaid during the year, and in almost every case the mother had been previously warned and urged to get a cot. It seems almost impossible in some cases to make the parents realize the importance of letting the baby sleep by itself; expense is no excuse, as banana crates and orange boxes can be obtained for a penny each. Ophthalmia Neonatorum. The 5 cases remaining under observation from 1912 have all been cured. During 1913,18 cases were notified; 2 of these were found not to be in Bethnal Green, and the notices were forwarded to the districts to which the patients belonged. The remaining 16 notifications were sent, 14 by doctors and 2 by the Inspector of Midwives. The cases treated at home numbered 14: the cases admitted to the Infirmary 2. Seven cases were re-visited once each, 4 cases twice each, 2 cases three times each, 1 case five times; 2 cases were not revisited. Total number of re-visits being 26. 104 The mothers were attended at their confinements by doctors in 7 cases, midwives in 6 cases, London Hospital assistants in 2 cases. One case was that of a child born in the City of London Lying-in Hospital. In 11 cases the child has been cured. In 4 cases the child remains under observation. In one case the people have left the district. Epidemic Diarrhoea and Gastro-Enteritis. During the months of July, August, September and October the deaths from Gastro-Enteritis numbered 36, and those from Epidemic Diarrhoea numbered 55. Of the Gastro-Enteritis deaths, 9 occurred at home and 27 at the London Hospital. Many of the babies had been delicate from birth, and had been continually under observation. Of the deaths from Epidemic Diarrhoea 31 occurred at home, 9 at the Queen's Hospital, 3 at the Infirmary, 2 at the Mildmay Mission Hospital, 3 at the East London Hospital, 5 at the London Hospital, J. at the Metropolitan Hospital and 1 at the Babies' Home, Shoreditch. In 65 of these cases the homes were visited and inspected. The remainder had been under observation previously to the child's admission to hospital or before its death. In two cases the homes were not very clean, but in the remaining 63 they were clean, and the general sanitary condition of the premises was fairly good. 105 In 44 instances the baby was said to be entirely breast-fed, and the mothers almost always stated that the child had not been given any food other than breast milk; it is sometimes difficult to believe this. Of the hand-fed babies 21 were fed on cows' milk and barley water and 26 on Nestle's milk. In all cases I found the bottle kept clean. Fourteen mothers were found to have been using a bottle with a tube. In only six of the homes was the food cupboard wanting, but in the two not very clean homes the cupboard, although present, was unused. These numbers, of course, represent only the deaths. We had in addition 225 cases of Diarrhoea where the babies did not die. I feel quite sure that a great deal of the Diarrhoea we meet with in these young babies is due to the use of that filthy abomination, "The Dummy Teat." Unfortunately the mothers cannot be brought to realize the harm this thing does. In almost every case of Diarrhoea that came under my notice the baby had been given a dummy teat to suck in spite of all I had said to the mother when I visited her after the birth of the child. Having found that Glaxo is so much better than fresh milk after recovery from Diarrhoea, we are supplying it to the mothers at a reduced rate, the Necessitous Children s Fund having paid for the first supply. Employment of Mothers. Of the mothers visited after the birth of their infants 150 were found to have been regularly employed, whilst 106 50 more had casual employment, and all intended to resume work as soon after confinement as they were able. In visiting among the people one meets with a good deal of destitution, and one often wonders how the poor manage to get along at all and yet be so cheerful. They seem to worry so little, but to have a sublime trust that, to put it in their own words, " something will turn up." The women are always pleased to see me and much appreciate being visited. If any mother happens to be out when I call she invariably brings the baby to the Town Hall on my next weighing day. Our sale of Virol steadily increases, and it is a great help in our work among the babies to be able to supply it at a cheap rate to the poorer mothers, who would not otherwise be able to afford it. Our Necessitous Children's Fund pays part cost. It is marvellous how well the babies thrive on it and how they improve in weight, many of them gaining as much as three-quarters of a pound to a pound a week, and the improvement is well maintained. I feel sure that many of the more delicate babies would not now be alive but for Virol. In the majority of the cases visited I find the baby is being breast-fed, and, owing to our being able (through the Necessitous Children's Fund) to supply the mother with milk, she has in many cases been able to continue to breastfeed the baby when she would otherwise have been obliged to wean it. I always find that the mother would very willingly 107 nurse her baby, but often is unable to do so through not having sufficient food herself. 125 babies were entirely hand-fed and 70 partially hand-fed. It is with these hand-fed babies that so much re-visitation and supervision is necessary. The mothers will give nursery biscuits, boiled bread, cornflour and all manner of improper things unless looked after. Fourteen mothers were found to be using a bottle with a tube, and each of these I changed free of charge for a boat-shaped one. As regards teaching, one would like to do much more in this way than is at present possible, and I feel sure that not only would it be appreciated, but would do much good. I am, Sir, Yours obediently, CHARLOTTE HAMMOND. TABLE I. Vital Statistics of Whole District during 1913 and Previous Years. Year. Population estimated to Middle of each year. Births. Total deaths Registered in the district. Transferable Deaths. Nett Deaths belonging to the District Under 1 Year of Age. At all Ages. Uncorrected Number. Nett. Number. Rate. of Nonresidents registered in the District. Of Residents not registered in the District. Number. Rate per 1,000 Nett Births. Number. Rate. Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1908 131,006 4,220 4,341 33.13 2,251 16.9 399 423 572 131.8 2,266 17.0 1909 131,316 3,999 4,132 31.46 2,243 17.0 443 397 534 129.2 2,193 16.7 1910 131,579 4,040 4,208 31.98 2,034 15.4 406 376 516 122.6 2,002 15.2 1911 128,247 3,866 4,032 31.45 2,345 18.3 427 391 599 148.5 2,316 18.0 1912 127,985 3,702 3,904 30.5 1,851 13.4 314 420 375 96.1 1,957 15.3 1913 127,824 3,863 4,008 31.3 2,028 15.9 411 400 470 117.5 2,001 15.7 108 109 TABLE II. Cases of Infectious Disease notified during the Year 1913. Notifiable Disease. Number of cases Notified. Total Cases Notified in each Locality. (e.g., parish or Ward) of the District. Total Cases removed to hospital. At all Ages. At Ages—Years. Under 1. 1 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years. 45 and under 65 years. 65 and upwards. 1 Northeast. 2 Southwest. Northeast. Southwest. Small-pox - - - - - - - - - - - - Cholera (C) Plague(P) - - - - - - - - - - - - Diphtheria (including Membranous Croup) 222 12 95 93 16 6 - - 120 102 114 98 Erysipelas 265 9 13 16 49 72 74 32 131 134 - - Scarlet Fever 412 2 127 247 27 9 - - 192 220 187 211 Typhus Fever - - - - - - - - - - - - Enteric Fever 23 - 3 9 6 5 - - 5 18 5 18 Relapsing Fever (R) Continued Fever (C) - - - - - - - - - - - - Puerperal Fever 13 - - - 6 7 - - 2 11 1 9 Cerebro-spinal Meningitis 1 - - 1 - - - - - 1 - - Poliomyelitis 8 - 3 - - - - - 1 2 1 2 Pulmonary Tuberculosis 620 3 25 69 121 269 124 9 - - - - Other forms of Tuberculosis 224 7 48 112 32 20 5 - - - - - Ophthalmia Neonatorum 19 18 1 - - - - - 6 13 - - Totals 1,802 51 315 547 257 388 203 41 457 501 308 338 110 TABLE 11A. Public Health (Tuberculosis) Regulations, 1912. Summary of Notifications during the Period from 1st February, 1913, to the end of the week ending on the 3rd January, 1914. Age Periods. Number of Notifications on Form A. Number of Notifications on Form B. Number of Notications on Form C Primary Notifications. Total Notifications (i.e., including cases previouisly notified by other doctors). Primary Notifications. Total Notifications (i.e. including notifications by other doctors). Poor Law Institutions. Sanatoria. 0 t0 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards Total Under 5 5 t0 10 10 to 15 Total Pulmonary- Males 3 15 16 14 23 32 50 81 39 27 7 307 377 1 2 2 5 6 124 35 Females — 8 12 16 19 35 48 42 22 12 1 215 255 — 1 1 2 3 54 24 Non-pulmonary— Males 5 26 27 24 12 4 8 5 3 1 - 115 149 1 4 5 10 11 11 6 Females 2 15 20 13 10 4 4 2 1 - - 71 81 1 3 4 8 8 5 4 Totals 10 64 75 67 64 75 110 130 65 40 8 708 862 3 10 12 25 28 194 69 111 TABLE III. Causes of, and Ages at, Death during the Year 1913. Causes of Death. Nett Deaths at the subjoined ages of "Residents" whether occurring within or without the district. Total Deaths whether of Reside its or Nonresidents n Infetitutions in the District All Ages. Under 1 year. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. 2 3 4 5 6 7 8 9 10 11 Enteric Fever 4 – – – – 2 2 – – – Small Pox – – – – – – – – – – Measles 59 14 21 24 – – – – – 10 Scarlet Fever 3 – – 2 1 – – – – – Whooping Cough 30 16 9 3 2 – – – – 7 Diphtheria and Croup 11 1 3 4 2 – 1 – – 3 Influenza 18 1 – 1 – 1 3 5 7 – Erysipelas 6 1 – – – – – 2 3 7 Phthisis (Pulmonary Tuberculosis) 197 1 – 1 2 36 95 59 3 134 Tuberculous Meningitis 39 6 16 11 6 – – – – 52 Other Tuberculous Diseases 38 11 4 10 4 1 6 2 – 31 Cancer, malignant disease 131 – – 2 1 – 22 63 43 76 Rheumatic Fever 13 – – – 5 5 1 2 – 4 Organic Heart Disease 196 – 1 3 9 6 28 71 78 100 Bronchitis 184 26 4 3 – 1 11 42 97 67 Pneumonia (all forms) 226 64 36 22 3 8 27 25 41 144 Other diseases of Respiratory organs 12 – 1 – – 1 1 6 3 7 Diarrhosa and Enteritis 145 118 19 6 1 – 1 – – 97 Appendicitis and Typhlitis 5 – – – 3 – 1 1 – 3 Cirrhosis of Liver 14 – – – – – 4 9 1 6 Alcoholism 9 – – – – – 5 4 – 4 Nephritis&Bright's Disease 98 – 1 – 3 7 14 40 33 60 Puerperal Fever 2 – – – – 2 –_ – – – 0ther accidents and diseases of Pregnancy and Parturition 7 – – – – 1 6 – – 1 Congenital Debility and Malformation, including Premature Birth 138 131 5 2 – – – – – 89 Violent Deaths, excluding Suicide 58 18 1 5 4 3 5 5 17 28 Suicide 14 – – – – – 6 7 1 1 Other Defined Diseases 223 24 3 5 7 12 25 63 74 113 Diseases ill-defined or unknown 92 28 1 2 – 3 1 5 52 31 Other Septic Diseases 39 10 – 2 5 3 6 6 7 40 Totals 2011 470 125 108 58 92 271 417 460 1115 Subentries included in above figures Cerebro - spinal Meningitis 2 1 1 – – – – – – 13 Polio - myelitis 1 – – 1 — — — — – 4 112 TABLE IIIa. Deaths in Sub-Districts. Causes of Death. NorthEast. South west. No Home. Totals. Enteric Fever 2 2 – 4 Small-pox – – – – Measles 20 39 – 59 Scarlet Fever – 3 – 3 Whooping Cough 14 16 – 30 Diphtheria and Croup 5 6 – 11 Influenza 14 4 – 18 Erysipelas 3 3 – 6 Phthisis (Pulmonary Tuberculosis) 99 95 3 197 Tuberculous MeniDgitis 22 17 – 39 Other Tuberculous Diseases 21 16 1 38 Cancer, malignant disease 67 63 1 131 Rheumatic Fever 4 9 – 13 Organic Heart Disease 103 89 4 196 Bronchitis 88 93 3 184 Pneumonia (all forms) 121 104 1 226 Other diseases of respiratory organs 10 2 – 12 Diarrhoea and Enteritis 70 77 – 147 Appendicitis and Typhlitis 1 4 – 5 Cirrhosis of Liver 10 4 – 14 Alcoholism 2 7 —– 9 Nephritis and Bright's Disease 44 48 6 98 Puerperal Fever –• '2 – 2 Other accidents and diseases of Pregnancy and Parturition 4 3 – 7 Congenital Debility and Malformation, including Premature Birth 72 65 1 138 Violent Deaths, excluding Suicide 32 25 1 58 Suicide 10 4 – 14 Other Defined Diseases 115 101 5 223 Diseases ill-defined or unknown 46 40 6 92 Other Septic Diseases 15 23 1 39 Totals 1,014 964 33 2,011 Sub-entries included in above figures. Ccrebro-spinal Meningitis – 2 – 2 Poliomyelitis – 1 – 1 113 TABLE IV. (a) Whole District. Infantile Mortality during the Year 1913. Nett Deaths from stated Causes at various Ages under One Year of Age. Cause of Death. Under 1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 4 weeks. 4 weeks & under 3 months. 3 months & under 6 months. 6 months & under 9 months. 9 months & under 12 months. Total Deaths under 1 year. Small-pox – – – – – – – – – – Chicken-pox – – – – – – – – – – Measles – – – – – – 2 – 12 14 Scarlet fever – – – – – – – – – – Whooping Cough – – – – – 1 9 5 2 17 Diphtheria and Croup – – 1 – 1 – – – – 1 Erysipelas – – – – – – – 1 – 1 Tuberculous Meningitis – – – – – – 2 2 1 5 Abdominal Tuberculosis – – – – – 1 3 1 – 5 Other Tuberculous Diseases – – – – – 3 – 1 2 6 Meningitis (not tuberculous) – – – – – 3 2 2 2 9 Convulsions 7 4 1 3 15 8 5 2 – 30 Laryngitis – – – – – – – – – – Bronchitis – – – 1 1 4 11 6 1 23 Pneumonia – 1 2 – 3 10 13 18 16 60 Diarrhoea – 1 – 1 2 6 18 12 6 44 Enteritis – – 2 1 3 12 19 29 8 71 Gastritis – – – – – 4 5 4 4 17 Syphilis – – – – – 1 1 – – 2 Rickets – – – – – – 1 1 1 3 Suffocation, overlying 4 – – 1 5 5 6 1 – 17 Injury at birth 2 – 1 – 3 – – – – 3 Atelectasis 9 3 – 1 13 – 1 – – 14 Congenital Malformations 4 2 – – 6 4 1 1 – 12 Premature birth 36 3 7 3 49 7 1 1 1 59 Atrophy, Debility and Marasmus 5 5 5 2 17 8 7 6 1 39 Other Causes 1 – 1 1 3 3 6 1 5 18 Totals 68 19 20 14 121 80 113 94 62 470 Nett Births in the year 4,008. Nett Deaths in the year (Infants) 470. 114 TABLE IV. (b). North-East Bethnal Green. Infantile Mortality during the Year 1913. Nett Deaths from stated Causes at various Ages under One Year of Age. Causes of Death. Under 1 week 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 4 weeks. 4 weeks and under 3 months. 3 months and under 6 months. 6 months and under 9 months. 9 months and under 12 months. Total Deaths under 1 year. Small-pox - - - - - - - - - - Chicken-pox - - - - - - - - - - Measles - - - - - - 2 - 5 7 Scarlet Fever - - - - - - - - - - Whooping Cough - - - - - 1 1 2 2 6 Diphtheria and Croup - - 1 - 1 - - - - 1 Erysipelas - - - - - - - 1 - 1 Tuberculous Meningitis - - - - - - 1 2 1 4 Adbominal Tuberculosis - - - - - 1 1 - - 2 Other Tuberculosis Diseases - - - - - 3 - 1 1 5 Meningitis (not Tuberculous) - - - - - 1 2 — 1 4 Convulsions 3 2 1 - 6 6 1 1 — 14 Laryngitis - - - - - - — — — — Bronchitis - - - - - 2 3 4 1 10 Pneumonia (all forms) — — 2 - 2 6 6 7 7 28 Diarrhœa — — — 1 1 3 8 5 3 20 Enteritis — — 2 1 3 4 14 14 3 38 Gastritis - - - - - 3 2 1 2 8 Syphilis - - - - - - 1 — — 1 Rickets - - - - - - 1 1 — 2 Suffocation, overlying 2 — — - 2 3 1 1 — 7 Injury at birth 2 — — - 2 — — — — 2 Atelectasis 2 1 — - 3 — 1 — — 4 Congenital Malformations 3 2 — - 5 3 — — — 8 Premature birth 16 1 3 3 23 5 1 — — 29 Atrophy, Debility and Marasmus 2 4 3 2 11 2 4 4 1 22 Other Causes — — 1 1 2 2 - - 2 6 Totals 30 10 15 8 63 43 50 44 29 229 115 TABLE IV. South-West Bethnal Green. Infantile Mortality during the Year 1913. Nett Deaths from stated Causes at various Ages under One Year of Age. Causes of Death. Under 1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 4 weeks. 4 weeks & under 3 months. 3 months & under 6 months. 6 months & under 9 months. 9 months & under 12 months. Total Deaths under 1 year. Small-pox – – – – – – – – – – Chicken-pox – – – – – – – – – – Measles – – – – – – – – 7 7 Scarlet fever – – – – – – – – – – Whooping-cough – – – – – – 8 3 – 11 Diphtheria and Croup – – – – – – – – – – Erysipelas – – – – – – – – – – Tuberculous Meningitis – – – – – – 1 – – 1 Abdominal Tuberculosis – – – – – – 2 1 – 3 Other Tuberculous Diseases – – – – – – – – 1 1 Meningitis (not tuberculous) – – – – – 2 – 2 1 5 Convulsions 4 2 – 3 9 2 4 1 – 16 Laryngitis – – – – – – – – – – Bronchitis – – – 1 1 2 8 2 – 13 Pneumonia (all forms) – 1 – – 1 4 7 11 9 32 Diarrhoea – 1 – – 1 3 10 7 3 24 Enteritis – – – – – 8 5 15 5 33 Gastritis – – – – – 1 3 3 2 9 Syphilis – – – – – 1 – – – 1 Rickets – – – – – – – – 1 1 Suffocation, overlying 2 – – 1 3 2 5 – – 10 Injury at birth – – 1 – 1 – – – – 1 Atelectasis 7 2 – 1 10 – – – 10 Congenital malformation(d) 1 – – – 1 1 1 1 – 4 Premature birth 20 2 4 – 26 2 – 1 1 30 Atrophy, Debility and Marasmus 3 1 2 – 6 6 3 2 – 17 Other Causes 1 – – – 1 1 6 1 3 12 Totals 38 9 7 6 60 35 63 50 33 241 116 TABLE V. Showing the number of Deaths from the seven principal Zymotic Diseases, inclusive of Hospital Deaths in the 10 years 1903 to 1912 and in the year 1913. Disease. 1903. 1904. 1905. 1906. 1907. 1908. 1909. 1910. 1911. 1912. Annual Average of 10 yrs. 1903-1912. 1913. Small Pox — 8 — — — — — — — — 0.8 0 Measles 85 89 48 60 71 105 78 58 128 90 81 59 Scarlet Fever 13 18 27 22 43 39 25 9 6 2 20 3 Diphtheria 20 48 31 20 18 29 20 20 5 15 23 11 Whooping Cough 41 44 50 63 53 42 37 34 44 28 44 30 Fever 12 7 9 14 7 13 4 18 3 3 9 4 Diarrhœa (and Enteritis under 2 years after 1910) 112 147 119 152 59 102 90 43 230 48 110 145 Totals 289 361 284 . 331 251 330 254 182 416 186 288 252 117 Administration of the Factory and Workshop Act, 1901, in connection with FACTORIES, WORKSHOPS, WORKPLACES & HOMEWORK. 1—inspection of Factories, Workshops and Workplaces. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries) 124 22 — Workshops (Including Workshop Laundries) 4,149 1,043 — Workplaces (Other than Outworkers' premises (Included in Part 3 of this Report) 955 86 — Total 5,228 1,151 — 2. Defects found in Factories, Workshops and Workplaces. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred toH.M. Inspctor. Nuisances under the Public Health Acts :—* Want of cleanliness 606 606 — — Want of ventilation 23 23 — — Overcrowding 3 3 — — Want of drainage of floors 1 1 — — Other nuisances 1,097 1,097 — — Sanitary accommodation insufficient 13 13 — — unsuitable or defective 375 375 — — not separate for sexes 4 4 —• — Offences under the Factory and Workshop Acts:— Illegal occupation of underground bakehouse (s. 101) — — — — Breach of special sanitary requirements for bakehouses (ss. 97 to 100) — — — — Other offences (Excluding offences relating to outwork which are included in Part 3 of this Report) — — — — Total 2,122 2,122 — — Including those specified in Sections 2, 3, 7 and 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. 118 3.—HOME WORK NATURE OF WORK. Outworkers' Lists, Section 107, Outwork in unwholesome premises, section 108. Outwork in infected premises, sections 109, 110. Lists received from Employers. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (Section 110). Prosecutions (Sections 109, 110). Twice in the year. Once in the year. Failing to keep or permit inspection of lists. Failing to send lists. Lists. Outwork ers. Lists. OutWork ers. Wearing Apparel— Making, & c 134 1575 16 223 2 2 311 522 — — — — Cleaning and washing — — — — — — — — — — — — Furniture and upholstery 6 21 —— — — — 9 12 — — — — Umbrellas, & c 2 7 1 3 — — 13 22 — — — — Artificial Flowers — — — — — — 5 6 — — — — Paper, &c., boxes, paper bags 20 394 1 7 1 1 131 213 — — — — Brush making 8 660 — — — — 41 73 — — — — Carding, Sc., of buttons, & c 2 18 — — — — — — Textile weaving 2 39 — — — — 15 24 — — — — Total 174 2174 18 233 3 3 525 872 — — — — 4. - Registered Workshops. Workshops on the Register (s. 131) at the end of the year. Number. Workshops including Laundries 2,051 Food Premises 211 Bakehouses 86 Total number of Workshops on Register 2,348 5.—Other Matters. Class. Number. Matters Notified to H.M.Inspector of Factories- Failure to affix Abstract of the Factory and Workshop Act (s. 133) 20 Action taken in matters referred by H M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5) Notified by H.M.Inspector 110 Reports (of action taken) ( sent to H.M. Inspector 87 Other 1 Underground Bakehouses (s. 101)— Certificates granted during the year — In use at the end of the year 26 119 OFFICIAL ARRANGEMENTS FOR PATHOLOGICAL WORK. Arrangements provided by the Council for the Diagnosis of Disease, which are available for Practitioners, and the degree to which these facilities are utilised. A.—Pathological Work apart from such work at Isolation Hospitals. Arrangements made for examination of Yes or No. At what Institution or Laboratory. Charge per examination. Number of specimens examined during 1913. (a) to the Council if the examination is made in a Laboratory not staffed by the Co???s own officers. (b) to the Practitioner if any charge is made. 1. Serum for Widal reaction Yes Clinical Research Association 3/- None 17 2. (a) Serum for Wassermann reaction No None — — — (b) Examination for Spirochaetes No None — — — 3. Blood for Malaria No None — — — 4. Other blood examinations No None — — — 5. Bacteriological examination of blood &c., in Puerperal Fever No None — — — 6. Cerebro spinal fluid for determination of infecting organism and for enumeration of cells No None — — — 7. Swabs for Diphtheria Yes Clinical Research Association 3/- None 151 8. Examination for Tubercle bacilli (a) of sputum Yes Do. 2/9 None 214 (b) of milk Yes Do. ' 10/6 None 1 (c) of urine No — — — — 120 Arrangements made for examination of Yes or No. At what Institution or Laboratory. Charge per examination. N umber of specimens examined during 1913. (a) to the Council if the examnation is made in a Laboratory not staffed by the Co???s own officers. (b) to the Practitioner if any charge is made. 9. Examinationof Milk for (a) micro - organisms other than tubercle bacilli Yes ClinicalResearch Association Various — None (b) dirt — — — — — 10. Material in connection with food poisoning No — — — — 11. Pus, &c., for Gonococci Yes — — — None 12. Hair, etc., for ringworm, favus, &c. No — — — — 13. Examination for pathogenic organisms of (a) fæces – – – – (a) 2 (b) urine Yes Lister Institute – – (b)– 14. Vomit or Fæces for occult blood ... No None — — — 15. Pleuritic and ascitic fluids No Do. — — — 16. Morbid tissues for malignant disease, etc. No Do. — — — 17. Other materials No Do. — — — 18. Microscopical and chemical examination of urine No Do. — — — 19. Chemical examination of calculi, & c. No Do, — — — 20. Chemical examination of test meals No Do. — — — 21. Any other examinations Yes Clinical Rosearch Association Tuberculous Meat 7/6 — — 121 METROPOLITAN BOROUGH OF BETHNAL GREEN. STREET LIST. Name of Street. Zymotic Diseases. Tubercular Diseases Respiratory Diseases. General Diseases. Total. Name of Street. Zymotic Diseases Tubeicular Disesses. Respiratory Diseases. General Diseases. Total. Abbey street ... 3 1 4 8 Bonner street ... ... 2 3 5 Abingdon buildings ... ... ... ... 1 Bonwell street ... 2 1 2 5 Abingdon street ... 1 ... 2 3 Boreliam street 1 ... ... 1 2 Ada place ... ... 1 3 4 Boundary street ... ... ... ... ... Ainsley street ... ... ... ... 1 Bradys buildings ... ... 1 ... 1 Albert buildings ... ... ... ... ... Brady street 2 1 2 8 13 Albion place ... ... ... ... ... Braemar street ... ... 3 4 7 Alfred place ... 1 ... 1 2 Bratley street ... ... ... 2 2 Alias road ... 2 4 2 8 Brick lane ... 4 2 5 11 Alma road ... ... ... 8 8 Brierley street ... ... 1 3 4 Ames street 2 ... ... 2 4 , Bucks court ... ... ... ... ... Angela gardens ... 1 ... 1 2 Buckhurst street ... ... 1 5 6 Anglesea street ... ... 3 2 5 Billiards place ... ... ... ... ... Anns place ... ... 1 ... 1 Bunsen street ... ... ... ... ... Approach road ... ... 4 6 10 Burgoyne road ... ... ... 3 3 Arbery road ... 2 1 3 6 Burnham square ... ... ... ... ... (Except Nos. 74 and 76) Burnside street ... ... 3 1 4 Busby square ... 1 1 ... 2 Archer street ... 1 ... ... 1 Busby street 2 ... 3 1 6 Arline street 1 ... 4 3 8 Butler's buildings ... 2 1 ... 3 Artillery street ... ... 2 2 4 Butler street ... ... ... 1 1 Ashwell road ... ... 2 1 3 Buxton street ... 1 ... 2 3 Auckland road ... ... ... 7 7 (Odd Nos. 1 to 33 Even Nos. 2 to 10) Austin road ... ... 2 2 4 Bacon street 1 1 4 5 11 Cadell street ... ... 2 1 3 Baker's court ... ... ... ... ... Calvert avenue ... ... ... ... ... Baker's rents ... ... ... ... ... Cambridge bldgs ... 1 ... ... 1 Baker street 1 ... 1 ... 2 Cambridge circus 1 ... ... 1 2 Bandon road ... 1 1 3 5 Cambridge road 2 2 7 7 18 Barnet grove 1 1 ... 4 6 (All Odd Nos. and Barnsley houses 3 2 ... 1 6 Even Nos. from 160) Barnsley street ... ... 3 5 8 Cambridge street ... ... ... ... ... Baroness road 1 3 2 2 8 Camden street ... 2 3 5 10 Bath grove ... ... 1 2 3 Camlet street ... ... ... ... ... Bath street ... ... ... ... ... Canrobert street 1 ... 4 7 12 Baxendale street ... 1 1 2 4 Carlisle street ... ... ... ... ... Bellhaven street ... 1 1 2 4 Carmel house ... ... ... ... ... Benson buildings ... ... ... 2 2 Carter street ... ... ... ...... ... Bessy street ... ... 1 ... 1 Casket street 1 ... 1 ... 2 Bethnal Green road 4 ... 5 12 21 Caslon place ... ... ... ... ... Birkbeck street ... ... ... 2 2 Catherine street 1 1 ... 1 3 Bishops road ... ... ... 3 3 Centre street 2 ... 2 1 5 Blyth street 1 2 ... ... 3 Chambord street 1 1 1 2 5 Bonner road ... 1 1 7 9 Chance street ... ... ... 1 1 12 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 street ... ... i 2 3 Dagnall place ... ... ... 1 i Charles terrace ... 2 2 1 5 Daniel street 1 1 ... 2 4 Charlotte street 3 ... 2 3 8 Darling row ... ... ... ... ... Chertsey buildings ... ... ... 1 1 Davis place ... ... ... 1 1 Cheshire street ... 2 1 2 5 Davis buildings ... ... ... ... ... Chester street ... ... 1 4 5 Delamere dwellings ... ... ... ... ... Chilton street 2 3 ... 2 7 Delta street ... ... ... ... ... Chisenhale road ... 3 1 3 7 Derbyshire street 1 ... 1 2 4 Church row ... ... ... 2 2 Devonshire place ... ... ... ... ... Church street ... 1 2 3 6 Digby street 1 1 ... 2 4 (Except Even Nos. from 2 to 26) Digby walk 1 1 ... 2 4 Dinmont street ... ... 3 2 5 Clare street 1 1 1 1 4 Diss street 1 ... ... ... 1 Claremont street ... ... ... ... Dixie street 1 1 2 2 6 Clarence street 3 ... 1 1 5 Driffield road ... ... 1 2 3 Clarkson street 1 ... 3 5 9 (Odd numbers) Clifton buildings ... ... 1 2 3 Ducal street ... ... 1 ... 1 Club row ... ... ... ... ... Durant street ... l 1 3 5 Coate street ... 1 1 2 4 Code street ... ... 1 ... 1 Colling place ... ... ... ... ... Colling street ... ... ... ... ... Eastman street 4 ... 1 3 8 Collingwood street ... 1 5 3 9 Ebor street ... l ... 2 3 Collyer's court ... ... ... ... ... ( Except Nos. 11 to 19 odd) ... ... ... ... Columbia market ... ... ... ... ... Columbia road ... ... 4 4 8 Eckersley street. ... ... ... ... ... Columbia square 2 1 5 12 20 Edgar place ... ... ... ... ... Conyer street ... ... 2 ... 2 Edward place ... ... ... 2 2 Cookham buildings ... ... ... ... ... Ellesmere road ... 3 4 6 13 Co-operative b'ld'gs 1 ... ... ... 1 Elwin street ... 1 1 2 4 Cooper's gardens 2 ... 1 1 4 Emma street ... ... 2 ...... 2 Cordova road ... ... ... 4 4 Ernest place ... ... ... 1 1 Corfield street 2 3 4 10 19 Evesham houses . ... ... 1 ... 1 Cottage place ... ... ... ... ... Ezra street ... ... ... 3 3 Coventry place ... ... ... ... ... Coventry street 4 4 4 5 17 Cox's buildings ... ... ... ... ... Cranbrook road 1 1 1 1 4 Falcon buildings ... ... ... ... ... Cranbrook street ... ... 5 5 10 Felix street 2 1 1 4 8 Craven buildings 2 ... ... 2 4 Fellbrigg street 2 ... 5 6 13 Crescent cottages ... ... ... ... ... Finnis street ... ... 2 3 5 Crescent place ... 2 2 4 8 Fleet street hill ... ... ... ... ... Cross street ... ... ... ... ... Flint court 1 ... 1 2 4 Crossland square ... ... 1 1 2 Florida street ... 1 3 1 5 Cud worth street 2 1 ... 2 5 Florida terrace ... 1 ... 3 4 Culham buildings ... ... ... ... 1 Fossett's buildings ... ... ... ... ... Cygnet street ... ... ... ... ... Foster street ... ... ... 1 1 Cymon street 1 1 2 2 6 Fountain street ... ... ... 1 1 Cyprus street 1 3 3 4 11 Fox street 1 ... 1 1 3 123 STRE ET 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. Fox's buildings ... ... ... ... ... Hare court ... ... ... ... ... Fuller street 2 ... 2 5 9 Hare marsh ... ... ... 2 2 Hare row ... ... ... ... ... Hare street 2 1 6 6 15 Gales Gardens 1 2 1 5 9 Harold street 1 ... 1 2 4 Garden place ... ... ... ... ... Hartley street 1 1 4 2 8 Violet street Hassard place ... ... ... ... ... Garden place ... ... ... ... ... Hassard street 1 ... 1 9 11 James street Havelock placa 1 1 ... 1 3 Gardeners road ... ... ... 4 4 Hemming street. 1 1 1 3 6 Garner street 1 ... 2 3 6 Hedsor buildings ... 2 2 ... 4 Gascoigne place ... ... 1 3 4 Helens place ... ... 2 ... 2 Gawber street ... 2 ... 2 4 Henley buildings 1 ... 2 ... 3 George place ... ... ... ... ...... Henrietta street 1 ... 1 3 5 Georgina gardens ... ... ... 1 1 Hereford buildings ... ... ... 1 1 Gernon road ... ... ... 1 1 Hereford street 1 ... 2 ... 3 Gibraltar buildings 1 ... ... ... 1 Hersee place 1 ... 3 3 7 Gibraltar gardens 2 1 ... ... 3 Hocker street ... ... ... ... ... Gibraltar walk ... 3 3 2 8 Holly Mansions ...... ... ... 1 1 Gilman street 1 1 1 1 4 Hollybush gardens 2 1 ... 4 7 Glass street ... ... ... 1 1 Hollybush place ... ... ... 1 1 Globe road 2 3 2 9 16 Holmes avenue ... ... ... ... ... (Even Nos. from 156 Odd from 131) Horatio street ... 1 5 7 Horts place ... ... ... ... ... Gloucester passage ... ... ... ... ... Hunslett street ... ... ... ... ... Goldsmith's row ... ... 1 1 2 Huntingdon bldgs. ... 1 1 2 4 (Children's Hospital & Nos. 8 to 62 Even) Hurley buildings ... ... ... ... ... Gossett street 1 3 6 7 17 Granby place ... ... ... ... ... Iffley buildings ... ... ... ... ... Granby street 2 1 1 ... 4 Ion square 1 2 1 6 10 Gt. Eastern bldgs. ... ... 1 1 2 Ivimey street ... ... 1 ... 1 Green street 4 2 5 10 21 Gretton houses 1 1 2 8 1 2 _ Grimsby street, 1 ... ... ... 1 James court ... ... ... ... ... Grove road 2 1 1 12 16 James place ... ... ... ... ... (Odd Nos. from 59 Even Nos. from 110) Guinness' buildings 2 3 2 11 18 James street 1 2 2 5 10 (Odd Nos. from 39, Even from No. 4) Jersey street 2 ... 3 2 7 Hackney road 3 4 9 13 29 (All Even Nos. and Odd Nos. from 323) Kay street 2 ... ... 2 4 (Nos. 3 to 53 odd) Hague buildings ... ... ... 1 1 Kelsey street ... ... ... ... ... Hague place ... ... 1 1 2 Kenilworth road ... ... 2 1 3 Hague street ... ... 4 3 Kerbela street ... ... 1 ... 1 Hammonds gardens ... 1 ... ... 1 Kirkwall place ... ... 1 1 2 Hamilton road 1 6 2 4 13 Kite place ... ... 1 ... 1 124 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. Knottisford street 1 ... 2 1 4 Middleton street 1 1 4 3 9 Minerva street 1 ... ... 7 8 Minto place ... ... ... ... ... Luleham buildings 1 1 ... 1 3 Mocatta house ... ... ... 1 1 Lansdell place ... ... ... 3 3 Molesey buildings ... ... ... 2 2 Lark row ... ... ... 1 1 Montclare street ... ... ... ... ... Lawfranc road 1 ... 2 ... 3 Montfort house ... ... 1 ... 1 Leopold buildings 1 ... 1 3 5 Moravian street ... ... 1 ... 1 Leslie house ... ... ... ... ... Morpeth street ... 2 1 5 8 Letchford buildings ... ... ... ... ... Moss street 1 2 5 10 18 Lessada street 1 ... 1 11 13 Mount street ... ... ... 3 3 Ligonier street ... ... ... ... ... Mowlem street ... ... ... 1 1 Lily house 1 ... ... 1 2 Museum buildings 1 ... ... 1 Linden buildings ... ... 3 2 5 Lisbon buildings ... ... 1 4 7 Lisbon street ... ... ... ... ... Nant street ... ... ... ... ... Little York street. ... ... ... ... ... Navarre street ... ... ... ... ... London street ... ... 3 5 8 Neath place 1 ... ... 3 4 Lucas street ... ... ... 1 1 Nelson place 1 ... ... 2 3 Lyal road ... ... 1 ... 1 Nelson street ... 1 1 1 3 (Nos. 57 , and 58 to 88 Consecutive Nos.) ... ... ... ... New Church street ... ... ... ... ... Newling street ... ... 1 2 3 Lyte street ... ... ... 2 2 New Tyssen street ... 2 2 6 10 Norah street 2 2 8 3 15 Northampton street 2 ... 2 3 7 Mace street 1 ... 4 1 6 Norton street 1 ... 1 1 4 Manchester bldgs ... 2 ... ... 2 Manchester place ... ... ... ... ... Mansford buildings ... ... 2 ... 2 Octagon street ... ... 3 ... 3 Mansford street ... 1 1 6 8 Old Bethnal Green Mape street ... ... 4 6 10 road 3 7 1 3 14 Margaret place ... 3 ... 1 •± Old Ford road ... 2 5 15 22 Marian place ... ... ... ... ... (Odd Nos. to 205, Even Nos. to 368) Marian square ... ... ... ... ... Marian street 1 ... 1 3 5 Old Nicol street ... ... 1 1 2 Marlow buildings ... ... ... ... ... Olga street ... ... ... 2 2 Martha court ... ... 2 2 4 Orange street 1 ... 4 1 6 Matilda street ... ... 1 2 3 Oval 1 ... 2 4 7 Meadows dwellings ... 1 ... 6 7 Medhurst road ... ... 5 8 13 Medway buildings ... ... ... ... ... Palissy street ... ... ... ... ... Med way road 1 ... 1 3 5 Palm street ... 1 2 3 6 (Odd Nos. 3 to 49, Even Nos. 2 to 62) ... ... ... Palmer's road ... ... 1 ... 1 Paradise row ... ... 1 1 2 Memorial Hall bgs. ... ... ... ... Parliament place ... ... ... ... ... Mendip houses ... ... 2 2 Parliament street ... ... ... ... ... Menotti street ... 1 2 6 9 Parmiter houses ... ... ... 1 1 Merceron houses 1 ... ... 1 Parmiter street 1 2 1 6 10 Merceron street ... ... 1 ... 1 Patriot square ... ... 2 2 4 125 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. Peacock place ... ... ... ... ... Roan horse yard ... ... ... ... ... Peacock street ... ... 2 ... 2 Robert street ... 1 1 1 3 Pearl yard ... ... ... ... ... Robinson road ... 2 1 3 6 Pedley street ... ... l 1 2 Rochelle street ... ... ... ... ... Peel grove 1 ... ... ... 1 Roman road 2 4 3 3 12 Peel grove mewa. ... ... ... ... ... (Odd Nos to 127 Even Nos. to 142) Pelter street 1 ... ... 1 2 Pereira street 3 1 3 2 9 Peter street ... ... ... ... ... Pollard place ... ... ... ... ... Pollard row ... 3 2 6 11 Rooks place ... ... ... ... ... Pollard street ... ... ... 2 2 Ropley street ... ... ... 1 1 Portman place 1 ... ... 2 8 Ross buildings ... 1 ... ... 1 Pott street ... ... 2 5 7 Moss street. Povser street 1 ... 2 3 6 Royal Victor place ... ... ... ... ... Preston street ... 3 ... 1 4 Rovston street . 2 1 5 4 12 Primrose street ... ... ... 1 1 Russia lane 1 4 2 3 10 Princes court 3 1 ... 4 8 Pritchard's road 2 ... 2 5 9 (Except Nos. 57 to 117) Sabbage yard ... ... ... ... ... Sale street 2 ... ... 3 5 Prospect terrace 3 1 1 ... 5 Sandford buildings ... ... ... ... ... ... Providence place ... ... ... 1 1 Satchwell rents 2 ... 1 3 6 Providence yard ... ... ... ... ... Satchwell street ... 1 1 5 7 Punderson gardens 2 2 1 5 10 Sclater street ... 1 ... 1 2 Scott street 4 2 4 3 13 • Seabright street 6 1 4 12 23 Queen's buildings ... ... ... ... ... Selby street ... ... ... 1 1 Princes Place (Even Nos.) Queen's buildings ... ... 1 4 5 Sewardstone road 1 2 2 7 12 Gossett street Shacklewell street ... ... ... ... ... Queen's buildings ... ... ... ... ... Sheldon place ... ... ... ... ... Chambord street | Shetland street 1 ... ... 1 2 Qu'n Caroline place ... ... ... 1 1 Shiplake buildings ... 1 ... 1 2 Quilter street 1 3 2 8 14 Shipton street ... ... 6 1 7 Quinns square 2 3 7 13 25 Skinners court ... ... ... ... ... Sidney street ... ... 3 3 6 Smart street 1 ... ... 1 2 Smiths buildings ... ... 2 2 4 Railway arches ... ... ... ... ... Somerford houses 2 3 ... ... 5 Ramsey street 11 ... ... 6 7 Somerford street 1 2 4 5 12 Rapley place ... ... ... ... ... Sonning buildings ... ... 2 1 3 Ravenscroft bldgs. ... 2 4 3 9 S'hampton cottages 1 ... ... ... 1 Ravenscroft street 1 1 2 4 8 Southampton place ... ... ... ... ... Reid's mansions ... ... ... ... ... Southampton street ... ... ... ... ... Gossett street Southampton bldgs. ... ... ... 2 2 Reuben street ... ... ... 2 2 Spencer passage ... ... ... ... ... Riders buildings ... ... ... ... ... Spicer buildings ... ... ... ... ... 126 STREET LIST - continued. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Name of Street. Zvmotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Spital street ... ... ... ... ... Treadway street 1 3 6 7 17 (Nos. 11 to 27) Turin street 1 1 ... 2 4 Squirries street 1 2 2 4 9 Turville street ... ... ... ... ... St. Andrews street 1 ... ... ... 1 Tuscan street 1 ... 1 ... 2 St. James road ... ... ... 2 2 Type street 1 1 ... 3 5 St. Jude street ... ... ... 1 1 Tyrrell street ... 1 ... 3 4 St. Mark's bldgs ... ... ... ... ... Tagg street Usk street ... 1 2 5 8 St. Mary's place ... ... ... ... ... St. Matthias place ... ... ... ... ... St. Peter square 1 ... ... ... 1 Vallance road 1 2 3 8 14 St. Peter street 3 3 3 1 10 Venice street ... ... ... 2 2 Stainsbury street 1 ... ... 3 4 Viaduct place ... ... ... ... ... Stamp place ... ... ... ... Viaduct street ... 1 1 9 11 Stanfield road ... ... ... ... ... Victoria park ... ... ... ... ... ("Stonelcigh" House &Gateway adjoining ) Victoria place ... ... 1 ... 1 Victoria place ... ... ... ... ... Steels buildings ... ... ... ... ... James street Strahan road ... ... ... 2 2 * Victoria Park sq. ... 1 ... 1 2 (Odd Nos.) Violet row ... ... ... 1 1 Streatley buildings ... ... ... 1 1 Violet street ... ... ... ... ... Stroud place ... ... ... ... ... Virgima road ... 1 2 6 9 Sugar Loaf walk ... ... ... 2 2 Vivian road ... 2 4 ... 6 Sunbury buildings ... ... ... ... ... Voss street ... ... ... 1 1 Surat street 1 ... 1 3 5 Vyner street ... ... 1 3 4 Sutton buildings ... 1 3 5 9 Sweet Apple square ... 2 ... 2 4 Wadeson street 2 ... 1 5 8 Walter street 1 3 1 2 7 Walton buildings ... ... ... 3 3 Tagg street 1 1 1 5 8 Wargrave bldgs ... ... 1 1 2 Taplow buildings ... 1 ... ... 1 Warley street 2 1 8 7 18 Tapp street ... ... ... 1 1 Warner place 1 1 1 12 15 Tavistock street 2 ... ... ... 2 Waterloo place ... ... ... 1 1 Teale street ... 1 ... ... 1 Waterloo road ... ... 2 1 3 Teesdale street 1 2 1 6 10 Waterloo terrace ... ... ... 2 2 Temple dwellings ... ... ... ... ... Wear street ... ... ... ... ... Temple street 1 ... ... 6 7 Weaver street ... 1 ... ... 1 Tent street 1 2 2 4 9 (Odd Nos ) Thorold street 2 2 ... 4 8 Weldon street ... ... ... ... ... Thoydon road ... ... ... ... ... Wellington place ... ... ... ... ... Three Colt corner ... ... ... ... ... Wellington row 3 ... 4 4 11 Three Colt lane ... ... 1 ... 1 Wennington road 2 ... 2 1 5 Thurlow place ... ... ... 1 1 Wharf road ... ... ... 3 3 Tutty street ... ... 4 4 8 Wharncliffe street 2 3 2 ... 7 Toyes buildings ... ... ... 1 1 Wheeler street ... ... ... ... ... Old B'thnal G'n r'd Whites court ... ... ... ... ... Toyes buildings 1 ... ... 1 2 Whitechapel road ... ... ... ... ... Mansford street (Odd Nos. from 319) ... ... ... ... ... 127 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. Whitmore buildings ... ... ... ... ... Wolverley passage ... ... ... ... ... Wilmot house ... 1 ... ... 1 Wolverley street ... ... 2 4 6 Wilmot street 1 4 ... 6 11 Wood close ... ... ... ... ... Wimbolt street ... 1 1 2 4 Wood street ... ... ... 1 1 Winghara street. ... ... ... 1 1 No Home ... 3 4 23 30 Winchester bldgs ... ... ... ... .. Winchester cr'sc'nt ... ... ... ... ... Peabody buildings ... ... 1 7 8 Winchester place ... ... ... ... ... Shepton houses ... ... 1 1 2 Winchester street ... 2 2 1 5 Whitby street ... ... ... 1 1 INDEX TO Report of Chief Sanitary Inspector for 1913. PAGE Adulteration 24, 41 do. Decennial Period 41 Appendices, List of 7 Brady Street Area 6 Bakehouses 51 Cases in Hand 13 Clerical Work 61 Complaints 12 Cowhouses 60 Cream 47 Dairies 20 Defective W.C's. 14 do. Water Supply 14 Dirty Premises 14 Disinfectants 56 Disinfecting Work 55 Drains—Defective 14 Factory and Workshop Act 22 Foods and Drugs 8,9,24 Food Inspection 50 Food Premises Inspections 51 General Summary of Inspections 12,13 House to House Inspections 6, 53 Houses Let in Lodgings 53 Housing 5 Housing, Town Planning, etc., Act, 1909 6, 64 House to House Visitation 6 Ice Cream Premises 51 Improvements Effected 8 Insanitary Areas 6 Inspections—Bakehouses 51 Combined Drainage 13 Complaints 12 Cowhouses 60 Dairies and Milkshops 12, 60 Factories and Workshops 12 Food Premises House to House 12 Ice Cream Premises 12,51 Infectious Disease 12 Milkshops 12 New Buildings 12 Out-workers 12 INDEX—continued. PAGE Inspections (contd.)—Primary 12 Re-Inspections 12 Slaughter-Houses Tenement Houses (Houses let in Lodgings)12 Total 12, 13 Trade Premises 12 Verminous Homes 54 London County Council (General Powers) Act, 1908 8, 21 Milkshops 20,60 Milk and Cream Regulations, 1912 47 Miscellaneous 15 Mortuary Returns 57 New Buildings Inspections 12 Nuisances Abated 15 do. Discovered 8 Offensive Trades 60 Out-workers 52 do. Trades 52 Police Court Proceedings 16-23, 26-39 Premises Repaired and Cleansed 15 Primary Inspections 12 Public Health Committee 3 Rag Flock Act 11, 23, 62 Sale of Food and Drugs Acts 8, 9, 24-46 Samples—Informal 8, 9, 43-46 Official 8, 9, 24 Taken on Delivery 8, 9, 42 Sanitary Conveniences Repaired 15 Sanitary Defects 8 Sanitary Improvements effected 15 Slaughter-Houses 60 Smoke Nuisances 13, 14, 56 Staff 4 Summary of Inspections 12,13 do, Disinfection and Shelter 55 Tenement Houses (Houses let in Lodgings) 53 Total Inspections 12, 13 Trade Premises 12 Unsound Food 50 Verminous School Children 54 Water Supply 14 Water Closets 14,15 Metropolitan Borough of Bethnal Green Public Health Department, Town Hall, Patriot Square, Bethnal Green, E. TO THE PUBLIC HEALTH COMMITTEE. Mr. Chairman and Gentlemen, Herewith I beg leave to present my Annual Report on the work of the staff of the Public Health Department for the year ended December 31st, 1913. Respecting the sanitary work of the year generally I Annual Report. venture to hope you will find in the various details annexed hereto, that every effort has been made to secure the high level of sanitary improvement attempted in previous years. As regards the very important matter of Housing of Housing, the Working Classes so much has been said in previous Reports respecting this matter that there does not appear to be anything further left that can with advantage be added. It seems to be the general concensus of opinion that, from financial or other reasons, we have arrived at a deadlock so far as Housing generally and Improvement Areas are concerned in London. 6 Brady street The most important feature in connection with Area. Housing occurring during recent years is, of course, the Brady Street Area, the details of which the Members of the Council are all too familiar with, and in respect of which a Public Inquiry was held on the 24th October, 1913. It seems necessary to refer to the fact that the Brady Street Area, although so long delayed, does not by any means represent all the areas of Housing required for this Borough. As a matter of fact there are some four or five smaller areas equally congested, and equally ripe for treatment under Part 1 of the Act, but unfortunately, although these areas were all agreed to be ripe for treatment some years since, and although every effort is being made to keep them in a reasonable state of sanitation, there seems no immediate prospect of any one of them being dealt with so far as it is possible to judge. Special As regards the appointment of a Special Officer House under the provisions of the Housing, Town Planning, etc., Visitation. Act, it seems, notwithstanding the excellent efforts made by Mr. Richards in this connection, that we are now arriving at the same position as the officers of the local authorities were in 1892 and 1893, when similar serious effort was being made to execute the provisions of the Housing of the Working Classes Act of 1890. Now, as then, the effort seems to result in the spasmodic closing of a few houses here and there, the more or less efficient repair of such houses, their subsequent re-occupation, and, after a few months' wear and tear by a not too careful class of tenant, a relapse into the original condition. 7 As has already been pointed out on many previous occasions, this effort, however strenuously and seriously followed up, only results in the displacement of a certain number of families, and does not begin that steady and systematic process of slum demolition recognised by all Housing Authorities to be urgent and important at least twenty years back. In other words, it may fairly be stated that the present situation is one of maximum effort, of much interference with the people, for a minimum of improvement by means of additional housing accommodation. Whether it is possible, or the time is opportune, for some further representation to be made to the Governmental Authorities, is a matter that may perhaps be very well considered by the Council. In referring to this I wish clearly to say that I am making no reflection whatever on the results of the appointment of a Special Inspector to deal with this work. On the contrary, our Special Officer has done, and is doing, everything within his power, but the fact remains that, until there shall be some regular and methodical system of slum demolition to be carried on by some Authority—not yet introduced—equipped with far more drastic and farreaching powers than any yet possessed by local Housing Authorities, we are only patching, and making no sufficient effort to deal with the subject as a whole. It is indeed debatable whether the appointment of a Special Officer, under existing machinery, is really the best use to make of one's staff. As regards the detailed work of the Department, this Generally, is all very carefully set out in the Appendices A to S, which are as follows:— 8 appendix a In Appendix A will be found completed details Inspectorial visits and of the total numbers of inspections made throughout the year, the particulars of cases in hand, nuisances abated, and other routine work of each Inspector. Appendix b, Appendix B contains a detailed list of the various Classification of defects sanitary defects discovered throughout the year. discovered. Appendix c, Appendix C contains details of sanitary improvements ments and amendments effected under different headings effected. tor the same period. Appendix Appendix D (1), (2), (3), (4), (5) contains particulars D, (1 to 5), Police Court of the Police Court proceedings taken under the Public proceedings. Health (London) Act, 1891, the Dairies, Cowsheds and Milkshops Order, 188-5, the London County Council (General Powers) Act, 1908, and also under the Factory and Workshop Act, 1907, and the Rag Flock Act, 1911. Appendix Appendix E (1), (2), (3), (4), (5) deals with the total E ( 1 to 5) , Samples of number of samples of Food and Drugs taken officially and Pood and Drugs, results submitted for analysis to the Public Analyst during the of analisisand legal year, together with particulars of the Police Court proproceedmgs. ceedings taken in respect of the adulterated samples, the number of samples of milk and other articles taken on delivery at various Railway Stations,and other points in the Borough. Also detailed are particulars of other samples taken informally and submitted to the Public Analyst and the Clinical Research Association during the year, whilst in E (5) will be found details of a number of samples of food analysed by Mr. Bilham in the laboratory at the Town Hall. The numbers taken under the respective headings are as follows :— 9 Seven hundred and ten samples were taken officially official samples under the provisions of the Sale of Food and Drugs Acts. Fifty-four samples were taken on delivery from samles taken on wholesale firms, or at railway stations, or other places. delivery. Fifty-one samples were taken informally or privately, Samples taken informally and submitted for special examination to the Clinical informally. Research Association, or to the Public Analyst, whilst One hundred and thirty-three other samples of Samples analysed at various kinds were privately examined in the Laboratory the Town at the Town Hall by Mr. Bilham, who, as Members know, Laboratory, possesses some considerable practical knowledge in connection with analytical work. It will thus be seen that the total number of samples Total samples Dealt with of all kinds of food and drugs dealt with during the year during year, amounts to 948. In Appendix F appears details of administrative work Appendix F,milk and in connection with the Public Health (Milk and Cream) Cream Regulation 1912 Regulations, 1912. In Appendix G will be found particulars relating to Appendix G,Unsound unsound food both surrendered and seized, the total of food which amounts to about 2¾ tons, and in this connection it is only necessary to say that the steady and systematic inspection of the markets has been continued throughout the year by Inspector Rowsell, with able assistance from Inspector Ainley, and other Officers of the Staff. In Appendix H (1) are particulars relating to the Appendix H,(1,2) inspection of premises where food is prepared for sale, inspection of food premises and their technical classification as to Factories, Workshops, or Workplaces. In H (2) will be found similar details relating to the ice cream Shops. supervision of Ice-Cream Shops within the Borough. 10 Appendix I,Bakehouses Appendix I are given the usual details of inspection of Bakehouses. Appendices J(1&2) Appendix J. (1) and (2) appear particulars of the number of outworkers, the trades and industries in which they are concerned, and the number of inspections paid to the homes of such outworkers. Appendix K,Tenement Appendix K is set forth the details of the inspec- Houses. tions, breaches of bye-laws, and other work in connection with tenement houses. Appendix L, In Appendix L will be found some additional House to House ticulars as to house to house inspections which are really Inspection. an extract from the larger details in Appendices A and C, but are provided in this form for transmission to the Central Authority. appendix m, In Appendix M will be found particulars as to the Verminous children. inspection of homes of verminous children, which is becoming a serious factor in connection with the work of the Inspectors, whose ordinary routine duties are much disturbed and interfered with by the placing of these and many other additional duties upon them, which in former years were not so included. Appendix Appendix N (1) and (2) contains the usual parDisinfection ticulars of disinfecting work both as to the number of rooms disinfected, the number and nature of articles of bedding, clothing, etc., removed from various premises and disinfected at the Station, and disinfectants used during the year. Appendix o,In Appendix O will be found the details of work Smoke Nuisance undertaken in connection with the suppression of Smoke Abatement. Nuisances. 11 In Appendix P are the usual details as to the bodies Appendix p, Mortuary. received at the Mortuary in Church Row. In Appendix Q are the particulars of the inspection Appendix Q,Mikshops, of premises subject to special Bye-Laws and Regulations Cowsheds,Slaughter-Houses relating to Dairies, Cowsheds, Slaughterhouses, and other Offensive Offensive Trade premises. Trade premises. In Appendix R is set forth, so far as detailed figures appendix r, Clerical work can describe, the volume of work carried out by the clerical staff. In Appendix S will be found particulars and details of Appendix S, the samples taken under the Rag Flock Act, and the Rag Flock Act, proceedings result of the proceedings taken in respect of the same. thereunder. In Appendix T (1) and (2) are details of the work Appendix T(1&2) carried out by the Special Inspector under the provisions Housing and of the Housing and Town Planning Act, to which I have Planning, already called attention. Respectfully soliciting your favourable consideration to all the various matters of detail herein included, and in respect of which I desire to commend the efforts of all members of the staff to your notice. I have the honour to be, Mr. Chairman and Gentlemen, Your most obedient servant, JOHN FOOT. Certificate Sanitary Institute, 1888. Member Royal Institute Public Health, 1895. Chief Sanitary Inspector, 1895. NOTE.—Since writing the above, a case that went from Old Street Police Court for decision in the High Court on the vexed question of whether the Act referred to and included "remakes," has been decided adversely to the Local Authority. As a consequence it is probable that the prospect of any further successful action under this Act, as at present drawn, has become somewhat remote. 12 APPENDIX A. Total Number of Inspections and Particulars of Cases in Hand District. Infectious Cases. Complaints. House to House Inspections. Trade Inspections Re-inspections. Milkshop Inspections. Factory and Workshop Inspections Outworkers' Homes Inspections. Tenement House Inspections. New Buildings Inspections. Ice Cream Shop Inspections. A 318 213 67 – 3146 100 334 652 146 – 19 B 196 205 811 – 2506 115 261 368 165 1 36 C 346 330 45 20 2696 101 142 259 91 – 25 D 194 48 96 58 3751 219 937 182 526 – 63 E 436 303 33 43 3622 70 374 282 132 2 17 F 319 246 26 21 3017 56 581 483 30 – 19 9 22 578 1 3589 – – 19 – 17 – – 14 – 1067 – – – – – – – Totals 1818 1381 1656 1210 22327 661 2629 2245 1090 20 179 13 for the Year ended 31 st December, 1913. Combined Drainage Inspections. Smoke Nuisances— Observations made. Other Inspections or work of Special Character. Number of Calls. Unsound Food Seizures. Samples of Food and Drugs and Rag Flock taken. Police Court Attendances. Nuisances Abated. Number of Cases in Hand Total Visits for the Year. Inspector. – – 182 272 2 104 18 717 87 5449 E. Ainley. – – 157 105 – 104 7 Flock 12 818 65 4926 A. S. Henley. – – 488 124 – 100 2 Flock 31 858 26 4667 J. G. Weeks. – – 277 29 – 99 15 Flock 14 821 45 6380 F. Bare. – – 524 180 – 99 6 Flock 24 1326 85 6018 W. Billings, Jr. – – 395 286 – 96 5 Flock 4 1097 65 5479 I. R. Jones. – – 10 251 – 5 Flock 13 461 108 4496 E. Richards. – 423 – 3 6 142 57 – – 1507 W- Rowsell. – 423 2033 1250 8 744 40 Flock 173 6098 481 38922 14 APPENDIX B. Total number of Defects discovered during 1913. Month. Dirty Premises. Defective Drains. Defective and Dirty W.C.'s. Defective Water Supply. Smoke Nuisances. Other Matters. Total. Jan 323 15 230 67 – 706 1,341 Feb 291 18 188 47 4 596 1,144 Mar 317 16 215 48 2 549 1,147 April 431 17 306 125 2 753 1,634 May 359 11 235 107 4 676 1,392 June 338 17 221 92 1 729 1,398 July 372 19 281 106 1 754 1,533 Aug 243 7 72 38 5 394 759 Sept 501 20 301 85 – 808 1,715 Oct 675 14 296 35 – 957 1.977 Nov 562 25 306 27 4 1,072 1,996 Dec 478 25 270 24 3 903 1,703 Totals 4,890 204 2,921 801 26 8897 17,739 15 APPENDIX C. List of Sanitary Improvements effected during the year. Cleansing— Premises, etc., cleaned, repaired or whitewashed 6,597 Workshops ditto ditto ditto 683 House Drains— Drains relaid 167 Drains amended 208 Drains cleared 536 Drains trapped and ventilated 18 Rain water pipes and waste pipes disconnected 14 Sink and bath waste pipes trapped 171 Water Closets— W.C.'s repaired, cleansed, etc., 2,536 W.C.'s fitted with new pans and traps 163 W.C.'s supplied with water, and water supply apparatus 1,129 W.C.'s ventilated and lighted 14 W.C.'s rebuilt 7 New W.C.'s provided 40 Partitions provided round W.C.'s to separate same from workshops 5 Water Supply— Houses provided with water supply 170 House supply disconnected from W.C. cistern 17 Cisterns, supplied, repaired or cleansed 131 Miscellaneous— Paving of yards 831 Paving of Wash-houses 130 Forecourts and Areas paved and drained 34 Stables paved and drained 14 Removal of accumulation of Dung or other refuse 181 Removal of animals improperly kept 75 New Dung-pits provided and covers for same 16 Premises closed previous to executing the necessary repairs 84 Premises demolished following the service of notices 13 Gutters, Rainwater Pipes, and Waste Pipes repaired 1,298 Illegal occupation of basements discontinued 15 Overcrowding abated 231 Urinal accommodation provided 4 Urinals supplied with water 20 Urinals cleansed and repaired 61 Grids provided to Gullies 58 Dust Shoots repaired and Receptacles provided 904 Vacant lands cleansed 1 Areas cleansed 8 Yards cleansed 341 Indecent occupation discontinued 9 Verminous rooms remedied 440 Dampness remedied 784 Lighting and Ventilation improved 538 Total 18,696 16 APPENDIX D. (1.) Police Court Proceedings, 1913—Public Health (London) Act, 1891. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1913. Jan. 2 F. Non-compliance with notice F. Bare Mr. ChesterJones Fine 10s., costs £1 3s. Works done „ 9 A. H. C. „ (2 summonses) E. Ainley „ Costs 6s. Works done. „ 9 R. R. Non-compliance with notice J. G. Weeks „ Costs 3s. Works done. „ 9 P. „ F. Bare „ Costs 3s. Works done. „ 23 W. W. Depositing for sale unsound food W. Rowsell „ Fine £5, costs £2 4s. „ 30 W. R. Non-compliance with notice J. G. Weeks „ Costs 3s. Works done. „ 30 G. W. W. „ (4 summonses) „ „ Costs 12s. Works done. 17 Police Court Proceedings, 1913—Public Health (London) Act, 1891—continued. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1913. Mar. 6 F. H. Removing offensive refuse during prohibited hours Police Mr. Leycester Fine £2, costs £1 3s. July 17 S. S. Depositing for preparation for sale unsound eggs W. Rowsell Mr. ChesterJones Fine £10 and costs £2 4s. „ 17 „ Obstructing Inspector „ „ Withdrawn. Conviction on other summons Aug. 28 A. R. S. Exposing for sale unsound meat „ „ Fine £3, costs £2 2s. „ 28 G. G. Exposing and depositing for sale unsound meat „ „ Fine £4, costs £2 2s. Sept. 26 F. A. Carrying offensive refuse in improperly constructed vehicle J. G. Weeks Mr. Leycester Fine £2, costs £2 2s. „ 25 A. H. Exposing for sale unsound plums E. Ainley „ Fine £3, costs £1 7s. 6d. 18 Police Court Proceedings, 1913—Public Health (London) Act, 1891—continued. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1913. Sept. 25 R. D. Depositing for sale unsound pears E. Ainley Mr. Leycester Fine £3, costs £1 7s. 6d. Oct. 2 A. W. Overcrowding W. Billings „ Overcrowding abated. „ 2 W. A. „ „ „ „ „ 23 E. N. Exposing unsound rabbits for sale W. Rowsell Mr. ChesterJones Fine £5 and costs £1 3s. „ 23 E. N. Depositing unsound rabbits for the purpose of sale „ „ Fine £5 and costs £1 3s. „ 23 F. C. Depositing unsound meat for purpose of preparation for sale „1 „ Costs £5 5s. 19 Police Court Proceedings, 1913—Public Health (London) Act, 1891—continued. Date of hearing. Defendant Offence. Inspector. Magistrate. Result. 1913. Nov. 12 J. D. Non-compliance with sanitary notice E. Ainley Mr.ChesterJones Works done. Summons withdrawn on payment of costs, 3s. „ 20 C.C.T.M. „ „ 2 summonses J. G. Weeks Mr. Leycester Works done. Summons withdrawn on payment of costs, 6s. „ 20 W. A. R. „ „ „ „ Works done. Summons withdrawn on payment of costs, 3s. „ 20 J. P. „ „ W. Billings „ „ „ „ 20 D. „ „ „ „ Ordered to pay 42s. costs. Dec. 11 G. S. Non-compliance with notice „ Mr. ChesterJones Withdrawn. Unable to prove ownership. „ 18 M.S. A „ „ „ Mr. Biron 20 APPENDIX D (2). Police Court Proceedings, 1913. Dairies, Cowsheds, and Milkshops Orders, 1885 and 1886. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result 1913. *Jan. 10 Israel Solomon, 16, Club Row Selling milk whilst not registered (2 summonses) W. Eowsell Mr. Chester Jones Fine £10, costs £4 8s. *June 19 L. Sternberg, Turville House Selling milk whilst unregistered (2 summonses) Do. Do. Fine £5 and £3, costs £2 2s. * Second or subsequent offence, reported in accordance with instructions of Public Health Committee. 21 APPENDIX D (3). Police Court Proceedings, 1913. London County Council (General Powers) Act, 1908. Date of hearing. Defendant. Offence Inspector. Magistrate. Result. 1913. June 26 S. C. Depositing meat for preparation for food in a sleeping place F. T. Bare Mr. Chester Jones Withdrawn. Magistrate of opinion no actual contamination of meat. 22 APPENDIX D (4). Police Court Proceedings, 1913. Factory and Workshop Act, 1901, Date of hearing. Defendant. Offence. Inspector. Magistrate. Result 1913. June 26 A. & B. L. Failing to keep list of out-workers W.Billings Mr. Chester Jones Fine £1 and 23s. costs. July 17 A. S. Failing to keep list of out-workers W. Billings Do. Fine £1 10s. and £1 3s. costs. Oct. 16 S. R. ... Failing to keep list of out-workers W. Billings Do. Fine 5s. and 2s. costs. 23 APPENDIX D (5) Police Court Proceedings, 1913. Rag Flock Act, 1911. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1913. Jan. 30 W. E. Rag Flock. Excess of Chlorine A. S. Henley Mr. Chester Jones Fine £1, costs £'2 2s. 30 C. M. Do. Do. Do. Do. Costs £1 3s. Feb. 13 C. S. Do. Do. I. R. Jones Do. Defendant took proceedings against wholesale vendor, who was ordered to pay to the defendant £4, and to the Borough Council £5. 24 APPENDIX E (1). Sale of Food and Drugs Acts, 1875-1907. Samples taken officially and submitted for analysis during the year. Article. Total Number of Samples taken. Genuine Adulterated or deficient. Offences other than Adulteration. Butter 116 112 4 2 Camphorated Oil 9 5 4 – Cheese 3 3 – – Cocoa 6 6 – – Coffee 11 10 1 – Extract of Malt and Cod Liver Oil 1 1 – – Glycerine 6 2 4 – Jam, Black Currant 1 1 – – Jam, Raspberry 7 7 – – Lard 3 2 1 – Linseed, Crushed 5 5 – – Margarine 6 6 – 1 Milk 478 430 48 – Milk, separated 5 4 1 – Milk, sour 1 1 – – Milk and water 2 2 – – Mustard 1 1 – – Olive Oil 1 1 – – Peas, tinned 1 1 – – Pepper 3 3 – – Plasmon Oats 1 1 – – Saffron 5 5 – – Sugar, Demerara 1 1 – – Tea Dust 3 3 – – Vinegar 34 14 20 – Totals 710 627 83 3 25 As stated in similar circumstances last year, the samples of "Milk and Water" were probably sold as such owing to the vendor being suspicious of the Inspectors' agents. These samples contained 18 and 27 per cent, of added water respectively. Three samples of milk were deficient in fat to so slight an extent as not to warrant legal proceedings; the vendors were cautioned. In the undermentioned cases "legal" notice was given at the time of sale, and no proceedings therefore were possible: One margarine sold as butter, but in stamped wrapper, and one sample of milk 22 per cent. deficient in butter fat, which was sold under cover of a protective notice which was displayed in the shop. In one case the vendor of an adulterated sample of milk appeared before the Committee and gave good proof of having sold the milk in the same condition as it was received; proceedings against the wholesale dealer were pending, and the Committee exercised their discretionary power and warned the retailer. 26 APPENDIX E. (2). Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1913. Jan. 9 E. M. Selling butter containing 84 per cent, of foreign fat W. Rowsell Mr. Chester Jones Fine £5, costs £2 4s. „ 9 Do. Selling margarine in plain wrapper do. do. Withdrawn. Conviction on other summons re same sample. „ 9 F. C. Selling milk containing 5 per cent, added water F. Bare do. Dismissed. Warranty defence „ 9 F. A. Selling camphorated oil 62 per cent, deficient in camphor W. Rowsell do. Fine £2, costs £1 3s. „ 9 M. T. Selling milk containing 33 per cent, added water J. G. Weeks do. Fine £5, costs £3 3s. „ 9 Do. False warranty do. do. Withdrawn. Conviction on other summons re same sample. 27 Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1913. Feb. 27 I. Z. Selling milk 8 per cent. deficient in fat I. R. Jones Mr. Chester Jones Fine £1, costs £1 3s. *„ 27 E. J. Killick, 13, Calvert Avenue Selling milk 12 per cent. deficient in fat W. Rowsell do. Dismissed. Warranty defence. „ 27 J. W. Selling milk 12 per cent. deficient in fat A. S. Henley do. Fine 10s., costs 12s. 6d. * „ 27 Arthur Pritchard, 37, Hanbury Street Selling milk 6 per cent. deficient in fat W. Rowsell do. Dismissed. Warranty defence. *Mar. 6 Jacob Sheinbaum, 32, Pedley Street Selling milk containing 35 per cent. added water W. Rowsell. Mr. Leycester Fine £5, costs £1 3s. „ 6 M. T. Selling milk 18 per cent. deficient in fat do. do. Fine £2, costs £1 3s. *Second or subsequent offences reported in accordance with instructions of Public Health Committee. 28 Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1913. *Mar. 20 J. L. Latsky, 13, Spital Street Selling milk containing 6 per cent. added water J. G. Weeks Mr. Chester Jones Fine £2, costs £1 3s. *„ 20 A. Millman, 30, Smith Street, E. Selling milk containing 14 per cent. added water do. do. Fine £20, costs £2 2s. *„ 20 do. Obstructing Inspector do. do. Case withdrawn. *April 3 D. Jones, 5, Puma Court, E. Selling milk containing 4 per cent. added water F. Bare Mr. Chester Jones Dismissed. Warranty defence. *,, 3 J. Jones. 23 Ezra Street Selling milk containing 5 per cent. added water W. Rowsell do. do. * „ 10 E. W. Morgan, 184, Hackney Road Selling margarine in plain wrapper W. Billings do. Fine £2, costs £1 3s. *Second or subsequent offences reported in accordance with instructions of Public Health Committee. 29 Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1913, *April 10 W. J. Jones 147, Goldsmith Row Selling milk 7 per cent. deficient in butter fat W. Billings Mr. Chester Jones Dismissed. Warranty defence. *„ 17 J. Bercovitz, 24, Baker Street, E. Milk, 11 per cent. deficient in fat J. G. Weeks do. Fine £10, costs £1 3s. „ 17 M. L. M. Failure to have name and address inscribed on milk vehicle and receptacles A. S. Henley do. Fine 10s., costs 2s. *May 8 I. Shriber, 98, Columbia Rd. Selling camphorated oil 63 per cent. deficient in camphor W. Rowsell do. Fine 10s., costs 12s 6d. * „ 8 A. Letwin, 42, Blythe St. Selling camphorated oil 66 per cent. deficient in camphor do. do. Fine 10s., costs 12s. 6d. *Second or subsequent offences reported in accordance with instructions of Public Health Committee. 30 Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1913. May 8 D. L. Selling camphorated oil 83 per cent. deficient in camphor W. Rowsell Mr. Chester Jones Fine 10s., costs 12s. 6d. „ 8 H. E Selling glycerine containing 35 per cent. of sugar do. do. Fine 10s., costs 12s. 6d. „ 8 M. Tabakoff 8,Pedley St. Selling milk 9 per cent. deficient in fat F. Bare do. Fine £5, costs £2 2s. „ 15 A. C. Selling camphorated oil 42 per cent. deficient in camphor W. Rowsell Mr. Biron Fine 10s., costs 12s. 6d. * „ 15 M. Jenkins, 104, Gibraltar Walk Selling milk containing 5 per cent. added water W. Billings do. Fine £15, costs £2 2s. „ 15 I. P. Selling glycerine containing 25 per cent. of sugar W. Rowsell do. Fine 10s., costs 12s. 6d. *Second or subsequent offences reported in accordance with instructions of Public Health Committee. 31 Police Court Proceedings—Sale of Food and Drugs Acts, 1875- 1907. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1913. May 15 R. P. Selling glycerine containing 25 per cent. of sugar W. Rowsell Mr. Biron Fine 10s., costs 12s. 6d. „ 29 M. W. Selling glycerine containing 27 per cent. of sugar do. Mr. Leycester Fine 10s., costs 23s. *June 12 T. C. Thomas, 13, Beaumont St., Stepney Obstructing Inspector J. G. Weeks Mr. Chester Jones Withdrawn; magistrate of opinion that no technical obstruction occurred. * „ 26 M. Jones, 113, Cambridge Rd. Selling milk containing 13 par cent. of added water do. do. Fine 10s. and 23s. costs. * „ 26 A. Lines, 89, Teesdale St. Selling milk 7 per cent. deficient in fat W. Rowsell do. Dismissed. Warranty defence. *Second or subsequent offences reported in accordance with instructions of Public Health Committee. 32 Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1913. *June 26 A. Parfree, 2 and 3, Quinns bigs. Selling milk 8 per cent. deficient in fat E. Ainley Mr. Cheater Jones Fine £1 and 23s. costs. July 3 H. H. Delivering milk 15 per cent. deficient in fat do. do. Dismissed. Warranty proved. „ 3 do. Delivering milk 13 per cent. deficient in fat do. do. Dismissed. Warranty proved. „ 3 G. W. Selling vinegar 43 per cent. deficient in acetic acid W. Rowsell do. Fine £1, costs £1 3s. „ 3 D. J. W. Selling butter containing 45 per cent. of foreign fat I. R. Jones do. Fine £3, costs £1 3s. „ 3 do. Selling margarine in plain wrapper do. do. Withdrawn. Conviction on other summons re same sample „ 3 E. L. Selling milk 22 per cent. deficient in fat E. Ainley do. Fine 10s., costs £1 3s. *Second or subsequent offence reported in accordance with instructions of Public Health Committee. 33 Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1913. July 3 H.H. Selling milk 8 per cent. deficient in fat W. Rowsell Mr. Chester Jones Dismissed. Warranty proved ,, 3 E. A. L. Selling milk containing 14 per cent. of added water do. do. Fine £3, costs £1 3s. „ 17 W. C. Selling lard containing 80 per cent. of palm kernel oil A. S. Henley do. Fine £1, costs £1 3s. „ 17 S. T. Selling milk containing 8 per cent. of added water P. Bare do. Fine £3, costs £2 2s. „ 17 S. T. Selling milk 8 per cent. deficient in fat F. Bare do. Withdrawn. Conviction on other summons re same sample * „ 26 E. W. Morgan, 184, Hackney Rd Selling milk 14 per cent. deficient in fat W. Rowsell do. Dismissed. Warranty proved *Second or subsequent offence reported in accordance with instructions of Public Health Committee. 34 Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1913. July 31 S. J. Selling milk 23 per cent. deficient in fat I. R. Jones Mr. Chester Jones Dismissed. Warranty proved. „ 31 J. & B. B. Selling vinegar 36½ per cent. deficient in acetic acid W. Rowsell do. Costs 12s. 6d. Wholesale man convicted „ 31 J. R. Selling vinegar 27½per cent deficient in acetic acid do. do. Fine 5s. Costs 12s. 6d. „ 31 R. R. Selling vinegar 55 per cent½ deficient in acetic acid do. do. Fine 10s. Costs 12s. fid. „ 31 I. C. Selling vinegar 44 per cent½ deficient in acetic acid do. do. Fine 5s. Costs 12s. 6d. „ 31 A. M. Selling vinegar 24½ per cent. deficient in acetic acid do. do. Fine 5s. Costs 12s. 6d. „ 31 B. C. Selling vinegar 37½ per cent. deficient in acetic acid do. do. Fine 5s. Costs 12s. 6d. „ 31 J. B. Selling vinegar 32 per cent. deficient in acetic acid do. do. Fine £5. Costs £1 3s. 35 Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1913. *Aug. 7 M. Jenkins, 104, Gibraltar Walk Selling milk 14 per cent. deficient in fat W. Billings Mr. Chester Jones £100 and £3 3s. costs. * ,, 7 do. Selling milk containing 6 per cent. of added water do. do. * ,, 7 do. Selling milk containing 8 per cent. of added water do. do. Fine 1s. *„ 7 do. Selling milk 15 per cent. deficient in fat do. do. Withdrawn. Conviction on other summons re same sample * „ 7 E. E. B. Selling vinegar 37 per cent. deficient in acetic acid W. Rowsell do. Fine £5 and £2 2s. costs * ,, 7 H. Eidleman, 40, Church Street Selling vinegar 55 per cent. deficient in acetic acid do. do. Fine 5s. and 12s. 6d. costs *Second or subsequent offences reported in accordance with instructions of Public Health Committee. 36 Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1913. Aug. 7 R. K. Selling vinegar 47½ per cent. deficient in acetic acid W. Rowsell Mr. Chester Jones Fine 5s. and 12s. 6d. costs *„ 21 E. A. Lewis, 82, Virginia Road Selling margarine in plain wrapper do. do. Fine 5s. and 12s. 6d. costs * „ 21 M. Tabakoff, 142, Old Montague Street Selling milk 22 per cent. deficient in fat do. do. Fine £3. Costs £1 3s. „ 28 F. J. Selling vinegar 20 percent. deficient in acetic acid do. do. Costs £1 1s. *„ 28 A. Letwin, 42, Blythe Street Selling vinegar 19 per cent. deficient in acetic acid do. do. Costs £1 1s. „ 28 E. E. Selling milk 31 per cent. deficient in fat A. S. Henley do. Costs £2 2s. *Second or subsequent offences reported in accordance with instructions of Public Health Committee. 37 Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1913. Sept. 4 D. L. Selling milk 24 per cent. deficient in fat A. S. Henley Mr. Chester Jones Fine £1. Costs £1. * „ 18 J. Latsky, 13, Spital Street Selling milk containing 4½ per cent. of added water W. Billings Mr. Leycester Fine £10. Costs £1 11s. 6d. „ 18 W. T. H. Selling milk containing 5½ per cent. of added water. ,, ,, Dismissed. Warranty proved. Oct. 9 C. J. S. Selling milk containing 7½ per cent. of added water. E. Ainley Mr. Chester Jones Costs £1 3s. * „ 16 J. Pugh, 24, Holywell Row. Selling milk containing 22 per cent. of added water. J. G. Weeks ,, Fine £15 and costs £2 2s. * „ 16 D. Galinsky 64,Pelham Street. Selling milk containing 6 per cent. of added water ,, ,, Costs £1 3s. *Second or subsequent offences reported in accordance with instructions of Public Health Committee. 38 Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1913. *Oct. 16 A. H. Liddiard, 18. Ordell Road, Bow Selling milk containing 11 per cent. of added water, and 47 per cent. deficient in fat (2 summonses) J. G. Weeks Mr. Biron Fine £25. (Went to prison in default of payment). „ 16 W. S. Selling milk containing 8 per cent. of added water. W. Rowsell Mr. Chester Jones Fine 5s. and costs 5s. * „ 23 A. Lines, 89, Teesdale Street. Selling milk containing 8½ per cent. of added water. W. Billings '' Withdrawn upon payment of £1 11s. 6d. by Council— difference in results of analyses by Public Analyst and at Somerset House. „ 23 D. M. G. Selling milk containing 8½ per cent. of added water. J. G. Weeks '' ,, ,, Nov. 20 J. B. Selling milk 5 per cent. deficient in fat. W. Rowsell Mr. Leycester Summons withdrawn—bottle containing third portion of sample burst. *Second or subsequent offences reported in accordance with instructions of Public Health Committee. 39 Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1913. Dec. 4 M. P. Selling vinegar 41 per cent. deficient in acetic acid. W. Rowsell Mr. Chester Jones Fine 10s. Costs 12s. 6d. „ 18 T. P. Selling milk containing 17 per cent. of added water. E. Ainley ,, Dismissed. Warranty defence „ 24 A. W. Selling vinegar 14 per cent. deficient in acetic acid. J. G. Weeks Mr. Biron Adjourned to 8th January, 1914 „ 24 R. S. Selling vinegar 34 per cent. deficient in acetic acid. ,, ,, ,, ,, „ 24 G. D. Selling vinegar 15 per cent. deficient in acetic acid. ,, ,, ,, ,, „ 24 E. H. Selling milk 6 per cent. deficient in fat. W. Billings ,, Fine 20s. Costs 23s. „ 24 A. M. Selling coffee containing 60 per cent. of chicory. ,, ,, Adjourned to 1st January, 1914 40 The following is a summary of legal proceedings, etc., in connection with samples taken for analysis: No. of Adulterated Samples. Other Offences. No. of Summonses Issued and Cases Pending at 31st Dec., 1912. No of Convictions Obtained. No. of Cases Dismissed. No. of Summonses Withdrawn. No. of Cases Pending at 31st Dec., 1913. 83 1 90 58 14 10 8 Fourteen cases were dismissed upon successful " warranty " defence. In two cases defendants applied to have the third portions of samples analysed at Somerset House The results of analysis differed from those obtained by the Public Analyst, and the cases were thereupon withdrawn, the Council paying ,£1 11s. 6d. in each case. In seven of the ten cases withdrawn, convictions were obtained on other summonses in respect of the same samples; in one case the bottle containing the third portion of sample burst, owing to the internal pressure developed by decomposition of the sample. 41 APPENDIX E. (3). Foods and Drugs. Table showing percentage adulteration for Decennial period 1903-1912, compared with 1913. Year. No. of Samples taken. No. of Samples Adulterated. Percentage of Adulterated Samples. 1903 396 57 14.4 1904 485 64 13.2 1905 609 79 12.9 1906 656 75 11.4 1907 671 87 12.9 1908 682 45 6.6 1909 617 52 8.4 1910 642 53 8.2 1911 646 62 9.6 1912 632 57 9.0 Decennial average percentage adulteration 10.66 1913 710 83 11.7 The rise in the percentage of adulterated samples is due to the enquiry into the composition of vinegars. Largely upon the representations of the London and County Vinegar Brewers' Association and a report upon the manufacture and composition of vinegar by an Inspector of the Local Government Board, the Board stated that 42 in their opinion vinegar, whether "brewed" or artificial, should contain the equivalent of 4 per cent. of acetic acid. Thirty-four samples of vinegar were taken officially, and of these nearly 60 per cent. were found to be adulterated. A content of 4 per cent. of acetic acid being taken as the standard on the strength of the expressed opinion of the Local Government Board, legal proceedings were taken, and by the pressure thus exerted on the wholesale supply, in some cases directly, but mainly through the retailer, much has been done to secure the observance of the 4 per cent. standard. Samples Taken on Delivery. The undermentioned samples were taken on delivery from wholesale firms delivering goods to retail tradesmen, etc., throughout the Borough. Article. No. of Samples Taken. Genuine. Adulterated. Milk Vinegar 51 3 45 — 6 3 43 APPENDIX E (4). Summary of Samples taken informally and submitted to Public Analyst and Clinical Research Association during 1913. Article. No. of Samples. Genuine. Adulterated or deficient in vital constituent. Other offences, e.g., margarine in unstamped wrapper. Milk 21 17 4 — do. Separated 1 — 1 — Butter 1 1 — — Flour 1 1 — — Rice 1 1 — — Rye Flour 1 1 — — Rye Bread 1 1 - — Cream 4 4 — — Margarine 14 14 — 4 Nut Margarine 5 5 — — Vinegar 1 — 1 — Totals 51 45 6 4 The sample of flour and another of rice were taken in consequence of complaint made at the office that the stocks held by a cornchandler in the district were attacked by weevils or other insects. This charge was completely disproved. Two of the samples of milk were taken on request, the reason for which was the complainants' belief that 44 infectious disease had been caused by children partaking of the milk. The milk was found to be quite normal, clean and of good quality. The samples of rye flour and bread were brought to the office by a man who complained that the stock of flour held by a certain baker was bad. It was found afterwards that the man was a discharged workman, who had a quarrel with his former employer. The flour and bread were quite good. Rye always has a bitter taste, particularly if allowed to ferment with yeast. The cream samples were taken informally for information in connection with the administration of the Milk and Cream Regulations. The margarines were taken in consequence of the sale in many cases of margarine as batter, being served in plain wrappers instead of being marked as required by the Margarine Act, 1877, etc. In four cases this was found to be so, in connection with samples taken informally; official samples were afterwards taken, and prosecutions resulted successfully. The samples of Nut Margarine were taken in the course of an enquiry into the relative nutriment values of margarine and butter. Nut Margarine is in almost all cases mainly composed of cocoa-nut fat. The Local Government Board has had an enquiry into the subject, and it is said has come to the conclusion that there is little difference in the nutritive values of nut and butter fats. From the public press it appears that an Inspector of the Local Government Board in his report to one of the Guardian Boards in the East Riding of Yorkshire, stated his opinion that the nutritive values of the two fats were very nearly (stated in figures) as fifteen and sixteen. 45 APPENDIX E. (5). Summary of samples analysed in the Laboratory at the Town Hall, Bethnal Green, during 1913. Article. No. of Samples. Genuine. Adulterated or deficient in vital constituent or preservatised. Of low quality. Milk 81 25 36 20 do. Skimmed 1 1 — — do. Condensed 1 1 — — do. do. Skim 1 1 — — Butter 9 7 2 — Margarine 9 9 — — Nut Margarine 13 13 — — Camphorated Oil 1 — 1 — Lard 11 10 1 — Vinegar 5 3 2 - German Sausage 1 — 1 — Totals 133 70 43 20 The samples of milk were mainly obtained from three or four milkmen who, after being convicted of adulteration, had commenced the "scientific" adulteration of milk. The majority of the samples taken were very slightly adulterated, but as the result of judicious in formal sampling which revealed the time when the retailer was becoming careless in the proportion of water added 46 to the milk, convictions were obtained in each case on official samples. The condensed milks were purchased from stalls in the roadway. The two samples mentioned were good examples of their kind. They had each apparently been immersed in water, judging from the condition of the labels and tins, and were probably ship or fire salvage. The butters were taken in the course of watch being kept upon butter retailers who had been several times convicted. The Nut Margarines were taken in the course of the enquiry into nutritive values of butters and margarines, and were simply samples of cocoa-nut margarine. The German sausage was taken at a shop where it was alleged undue amounts of preservative were added to the raw material. The sample contained a very small percentage of sulphite, probably added as sodium sulphite. 47 APPENDIX F. Report of Administration in connection with the Public Health (Milk and Cream) Regulations, 1912. 1. Milk, and Cream not sold as preserved cream. (a) Number of samples examined for the presence of a preservative. (b) Number in which a preservative was reported to be present. Milk 478 Nil Cream 5 5 In each case the preservative added was reported to be Boric Acid. In accordance with the provisions of the Regulations the vendor in each case was invited to lay before the Committee in person or in writing, any explanation he desired to make of the sale of cream in contravention of the provisions of the Regulations. Each of the vendors was of the Jewish persuasion, and in each case stated that the cream was not sold as ordinary fresh Cream, but as Sour Cream, the consumption of which with sauer kraut, cabbage, and in other ways, is peculiar to the Jewish people. They all steadfastly maintained that whilst they were aware of the Regulations, they understood that the Regulations did not apply to Sour Cream, which in their judgment, both in character and in use, was entirely different from the ordinary fresh Cream of commerce. 48 The wholesale dealer who supplied the retail vendors also appeared before the Committee giving a like testimony, and he stated that the Boric Acid was added to maintain the Cream at a certain standard of sourness. Enquiries were made, and there appearing to be no reason to doubt the bona fides of the vendors, the Committee exercised its discretion, and the vendors were each cautioned, as was also the wholesale man. In addition to the warning which was given to these dealers a notice was issued to all purveyors of milk and cream in the Borough calling attention to the main provisions of the Eegulations, and to the intention of the Committee to strictly enforce the same. 2. Cream sold as preserved cream. In four instances samples were submitted for analysis to ascertain if the statements on the label as to preservatives, were correct. In each case the correctness of the statement was confirmed. Four determinations were made of milk fat in cream sold as preserved cream, and in each instance the proportion of milk fat was above 35 per cent. In no case were contraventions observed of the requirements as to labelling or declaration of preserved cream, or as to the deposit of preserved cream for sale, or as to the dispatch or delivery, of preserved cream. 3. Thickening substances. In no case was any evidence discovered by the Public Analyst of the addition of any thickening substances to cream, or preserved cream. 49 Copy of letter circulated amongst traders. 18th September, 1913. To whom it may concern. Milk and Cream Regulations, 1912. At a meeting of the Public Health Committee, held on Wednesday, the 10th instant, the matter of the Milk and Cream Regulations, dated August 1st, 1912, was considered by the Authority. As you are probably aware, these Regulations prohibit any preservative whatever in cream containing less than 35 per cent, of fat, and in cream containing a higher percentage of fat, restrict the quantity of Boric Acid, or other similar preservative, which may be added to cream, and require that cream containing such boron, or other similar preservative, shall only be sold or exposed for sale with labels attached, and with notice to the purchaser; and makes various requirements respecting the sale of preserved cream. The Committee wish all members of the trade in this Borough to be aware of the fact that these Regulations are now in force, and I am directed to add for the information of all such members of the trade, and others concerned, that in their own interest the Committee trust that the Regulations referred to will be strictly observed. This notice is given for the protection of Dairymen and others, as it is intended that the Regulations above referred to shall be strictly enforced. By order of the Public Health Committee, JOHN FOOT, Chief Inspector. 50 APPENDIX G. Particulars relating to Unsound Food for 1913. Surrendered. Cwts. Qrs. St. Lb. Fish 8 3 — 12 Meat 1 — 2 3½ Fruit — 2 1 3 Tomatoes 4 3 — 12 Potatoes 35 — — — Rabbits — 1 — 8 Total Surrendered 50 3 — 12½ Also Kippers (2 boxes). Seized. Cwts. Qrs. St. Lb. Fish — — — — Meat 1 1 1 3 Fruit 1 2 — 2 Ostend Rabbits 1 1 — — Total Seized 3 4 0 13 Also 114 tins of Condensed Milk, 1 quart of Liquid Eggs. Cwts. Qrs. St. Lb. Grand Total Weight 53 7 0 25½ 51 APPENDIX H (1). Premises where Food is Prepared for Sale. { 11 Factories. No. of premises on Register at end of 1913 211 Workplaces {1 Factory. Do. removed from Register. 5 Workplaces. {- Factories. Do. added to Register4 Workplaces. { 87 Factories. No. of Inspections 955 Workplaces. { 1 Factory. No. of Notices Served 86 Workplaces. No. of Prosecutions{- APPENDIX H (2). Particulars relating to Ice Cream Shops. No. on Register 111 No. of Inspections made 263 No. of Notices Served 49 No. removed from Register 6 No. added to Register 14 APPENDIX I. Inspection of Bakehouses. No. of Bakehouses on Register at end of 1912 89 Do. do. do. 1913 86 Do. above ground 60 Do. underground 26 No. of Inspections 233 No. of Notices 24 No. of Prosecutions - 52 APPENDIX J. (1). Outworkers. Year. No. of Lists received from Employers. No. of Outworkers comprised therein. Reported from other Boroughs. Reported to other Boroughs. 1912 181 2,928 3,103 1,561 1913 192 2,947 2,832 1,452 Number of Outworkers dealt with in 1912 6,031 „ „ „ 1913 5,779 APPENDIX J (2) Outworkers List of Trades. Artificial Flower Making 14 Lace and Net Making 4 Bathing Costume Making 1 Leather Goods Making 6 Belt Making 17 Mantle Making 35 Bloute Making 32 Match Box Making 30 Bone Needle Making 1 Milliners 12 Boot and Shoe Making 411 Paper Bag Making 2 Box Making 359 Pyjama Making 2 Brace Making 3 Shirt Making 17 Brush Making 142 Silk Weaving 34 Button Making 1 Surgical Instrument Cabinet Making 2 Making 1 Chair and Furniture Tailoring 543 Making 6 Tie Making 36 Collar Making 7 Upholsterer's Trimmings 8 Corset Making 4 Underclothing Making 21 Dress Making 26 Umbrella Making 37 Dyers 2 Walking Stick Making 1 Embroiderers 39 Waterproof Making 2 Feather Workers 9 Incorrect addresses and Furriers 14 those discontinuing work 457 Glove Making 1 2,348 Hat and Cap Making 9 53 APPENDIX K. Tenement Houses. Number of Tenement Houses on Register at end of 1913:— Under original bye-laws 323 Under new bye-laws 253 Number of Tenement Houses cancelled during 1913:— Under original bye-laws 226 Under new bye-laws 6 Number of Tenement Houses registered during 1913:— Under original bye-laws nil. Under new bye-laws 259 Number of Inspections made:— Under original bye-laws 1,708 Under new bye-laws 334 Rooms overcrowded 8 Cellars illegally occupied 3 Water provided to upper floors 3 Cases of indecent occupation 2 Notices served 596 Registration Forms written and served (all under new bye-laws) 355 APPENDIX L. House-to-House Inspections. Number of inspections 1,656 Number of notices served 904 Cases of overcrowding remedied during 1913 231 Number of defects discovered 4,268 54 APPENDIX M. Verminous School Children. 1910. 1911. 1912. 1913. Number of complaints received 252 329 974 928 do. inspections and re- inspections made 289 358 991 1,742 do. premises found to be verminous 46 16 82 54 do. defects discovered 334 317 1,116 1,401 do. notices served 206 152 211 466 do. prosecutions — — — 1 The inspection of the homes of these children now forms a large item in the work of the inspectors, and the increase in clerical labour involved in the keeping of records and the returns which are required by the County Council is considerable. Whilst there is no doubt that good may be done by the moral pressure alone of the visits of the inspectors, in addition to notices served upon owners requiring the carrying out of necessary repairs, there is no effective scheme which touches the real inwardness of this question, viz., the lack in many cases of sufficient means, and the lack in training of the poorest of our folk in "mother-craft" and domestic hygiene, for which the best measures which we can take as a Public Authority are a very poor substitute. 55 APPENDIX N (1). Particulars respecting Work of Disinfectors. Month. NUMBER OF ROOMS DISINFECTED. Schools Disinfected. No. of Articles destroyed at Station No. of Articles Disinfected at Station. Notifiable Infectious Diseases (Public Health Act.) Pulmonary Tuberculosis. Verminous Premises. Cancer. Scabies. Measles. Chicken Pox. By Request. Total Number of Rooms. January 34 16 2 — 5 13 — — 70 — 5 1356 February 34 22 7 — 2 6 1 6 78 — 3 1586 March 19 11 8 — 3 10 — — 51 — 27 978 April 27 14 3 — 3 6 — — 53 — 2 3164 May 32 13 26 — 10 — — — 81 — 1 3165 June 40 16 31 — 4 — — — 91 — 6 1695 July 61 18 23 — 2 — — — 104 — 11 1859 August 54 17 6 — 1 — — — 78 — 15 1367 September 90 19 15 — 8 1 — — 133 — 5 1661 October 119 19 13 1 6 — — — 158 1 2 2285 November 79 13 6 — 3 — — 1 102 — 26 1238 December 52 8 3 1 7 — — — 71 — 1 1723 Totals 641 186 143 2 54 36 1 7 1070 1 104 22077 The total number of articles disinfected in the Formalin Chamber (Boots, Boot Uppers, Books, Fancy Dress Material etc.), was 1,350. 19 men were bathed at the Disinfecting Station under the provisions of the Cleansing of Persons Act. 56 APPENDIX N (2). Forty-nine casks of Sanitas Powder, making up into 3,430 packets, have been distributed from the Public Health Department. One thousand and forty pint bottles of Sanitas Fluid, and six hundred and eight pint tins of Izal Fluid have also been distributed. These figures show an increase over the previous year, and this is without doubt due to persons notified and advised under the provisions of the Public Health (Tuberculosis) Regulations, 1912, under which all forms of Tuberculosis are now notifiable, taking advantage of the facilities provided for them. Half-a-ton of Sulphur Candles have been used in the disinfection of rooms throughout the year. One gallon of Formaldehyde Solution (40 per cent.) has been used in spraying the walls of rooms, and three pounds of Formalin Tablets have been used for fumigating articles in the Formalin Chamber. Ten gallons of Creocide have also been used for disinfecting purposes. APPENDIX O. Smoke Nuisance Observation. No. of Shafts under Observation 100 No. of hours occupied in observation 200 No. of Intimation Notices Served 21 No. of Statutory notices served 3 No. of Prosecutions nil. 57 APPENDIX P. Mortuary Returns, 1913. Bodies removed to Mortuary— On Coroner's Order 237 By Police 16 From London Hospital 4 On Bequest of Relatives 77 Total 334 Number of Inquests held 247 Number of Post Mortem Examinations made 90 Particulars of Bodies on which Inquests were held— Bodies removed by Police from Canal 4 Do. do. Street, etc. 9 Do. do. found in Parcels 2 Bodies received from Bethnal Green Infirmary 56 Do. do. Queen's Hospital 17 Do. do. Mildmay Hospital 8 Do. do. Private Houses, etc 151 Total 247 Inquest cases according to age period— Number under one year 64 Number over one year and under five years 24 Do. five do. ten do. 11 Do. ten do. twenty years 5 Do. twenty do. thirty do. 7 Do. thirty do. forty do. 19 Do. forty do. fifty do. 22 Do. fifty do. sixty do. 31 Do. sixty do. seventy do. 26 Do. seventy do. eighty do. 26 Do. eighty years 12 247 Causes of Death in Inquest cases— Abscess on the Brain 1 Acute Bronchitis 8 58 Acute Gastritis 2 „ Pleurisy 4 ,, Pneumonia 16 Anasarca 1 Apoplexy 14 Atelectasis 1 Atheroma of the Aorta 2 Broncho-pneumonia 1 Cancer 1 Cardiac Aortic Diseases 5 „ Mitral „ 4 „ Valvular „ 3 Cerebral Softening 1 Chronic Bronchitis 4 ,, Kidney Disease 2 „ Nephritis 1 Cirrhosis of Liver 1 Congestion of Lungs 3 Convulsions 11 Erysipelas 1 Fatty Degeneration of Heart 10 Gastric Indigestion 1 Gastroenteritis 1 Inanition 1 Infantile Diarrhœa 4 Intussusception of Bowels 3 Marasmus 2 Pemphigus 1 Peritonitis 3 Pleuro-pneumonia 2 Premature Birth 6 Rickets 1 Rupture of an Aneurism of the Aorta 5 Scarlet Fever 1 Senile Decay 4 Status Lymphaticus 2 Still Born 3 59 Strangulation of Bowels 1 Suppurative Nephritis 1 Tuberculosis, General 3 „ Laryngeal 2 „ Meningitis 1 „ Mesenterica 2 „ Pulmonary 8 Want of attention at Birth 3 Chronic Alcoholism 6 Found Drowned 3 Self Neglect 1 Accidental Deaths— Broken Neck, caught by machinery 1 Burns 7 Chronic Lead Poisoning 1 Drowned 1 Falls 22 Meningitis, Accidental Blow 1 Misadventure, death whilst under Anaesthetic 4 „ ,, after operation of Tracheotomy 2 Mackerel Poisoning 1 Oyster „ 1 Run over in street by Horse Van 1 ,, ,, Motor Lorry 1 } 5 ,, „ ,, Bus 2 „ ,, Tram Car 1 Scalds 2 Suffocation whilst in Bed 16 „ „ a Fit 1 Sunstroke 1 Suicide— Cut Throat 2 Coal Gas Poisoning 1 Drowning 1 } 13 Hanging 6 Poisoning 3 Total 247 60 APPENDIX Q. Inspection of certain places subject to Special Bye-laws and Regulations. PREMISES. No. of Premises. No. of Inspections. No. of Notices. No. of Prosecutions. On Register at end of 1912. Added in 1913. Removed in 1913. On Register at end of 1913. Milkshops 243 8 7 244 869 132 4 Cow-houses 14 — — 14 60 1 — Slaughter-houses 4 — — 4 29 — — Other Offensive Trade Premises 1 — — 1 3 — — 61 APPENDIX R. Clerical Work. Intimation notices written and served, Public Health Act 5,554 Statutory Notices written and served, Public Health Act 3,387 Notices under Housing, Town Planning, &c., Act, 1909, Section 15 137 Entries in Nuisance Register 7,915 ,, Tenement House Register 2,596 ,, Food and Drugs Register 790 ,, Workshops Register 5,269 Notices respecting Combined Drainage 49 Final Notices prepared and served 1,270 Letters written 3,356 Instructions to Solicitor prepared 74 Summonses prepared (4 copies each) 127 School Notifications prepared and dispatched 1,500 Notices to District Surveyor 115 62 APPENDIX S. Rag Flock Act, 1911. Forty samples of Rag Flock were procured under the provisions of the Rag Flock Act, thirty-four being returned as within the limit of cleanliness prescribed by the Regulations made under the Act. The remaining six samples were above the limit. One of these samples was "mixed flock," thus being outside the scope of the Act, and, although being used for exactly similar work as rag flock is commonly used for, was not required to conform to any such standard of cleanliness as is required in the case of rag flock. In five cases legal proceedings were instituted against the vendors. Two of the summonses were withdrawn by consent of the Magistrate upon payment to the Council of 23s. in each case, the defendants' wholesale supply being at fault owing to inaccurate methods of testing being employed at the mills of origin; another defendant was fined £1 with £2 2s. costs in respect of two samples; in another case the defendant took proceedings against his wholesale supplier, who was ordered to pay £4 to the defendant and £5 to the Council. The drafting of this Act has proved to be most unsatisfactory; nothing whatever excepting flocks actually and entirely made from rags comes within its scope, despite the fact that a very large proportion of flocks other than purely rag flock used in the upholstery trade reveal extensive 63 and serious contamination when subjected to the tests prescribed by the Regulations; even "remade" flocks do not come within the operation of the Act, and these show generally a serious amount of contamination above the limit prescribed for rag flock, yet the sale and use of "remade" flocks in this unclean condition is not affected in the slightest degree by the Act. These matters are under consideration by many sanitary authorities and by the Bedding and Allied Trades' Association, and there is little doubt that legislation will shortly be introduced for dealing with the many weak points revealed by the first two years' working of the Act. 64 APPENDIX T. Housing and Town Planning, etc , Act, 1909. Summary of Results of House-to-House Inspections for the year 1913. Number of houses inspected 578 Number of houses where admission was not obtained 6 Number of empty houses 10 Number of houses where defects were found and where notices were required 448 Number of houses where no defects were found 130 Number of houses where overcrowding was found 12 Number of houses so unfit for human habitation as to be suitable for Closing Order under Section 17, Housing and Town Planning, etc., Act 34 Number of houses so defective as to be suitable for dealing with under Section 15, Housing and Town Planning, etc., Act 34 Number of houses where ordinary notices under the Public Health (London) Act, 1891, met the case 380 Number of houses to which it was necessary to draw the attention of the District Surveyor 34 EVAN RICHARDS, Special Officer under the Housing, Toivn Planning, etc.. Act, 1909. During the year the houses in the following streets were inspected:— Smith's Buildings. Pritchard's Road Gibraltar Walk (Nos. 1 to 43 odd). (Nos. 34 to 82 even). Coate Street. Florida Street Gillman Street. (Nos. 44 to 62 even). Dinmont Street. Pelter Street. White's Court. 65 Diss Street. Butler's Buildings. Martha Court. Eekersley Street. Tyrell Street. New Church Street. Charlotte Street. Fleet Street Hill. Shacklewell Street Bath Grove. (Nos. 7 to 23 odd). Dixie Street. Stamp Place. Scott Street (south side). Chapel Street. Weaver Street. Queen Caroline Place. Bratley Street. Collyer's Court. Pedley Street. Closing Orders. After inspection by the Public Health Committee and representation by the Medical Officer of Health the Borough Council made Cloning Orders in respect of Nos. 1, 2, 3, 4, 5, 6, 7, 9, 10, 11, 15, 19 and 30, Smith's Buildings; Nos. 46, 48, 50 and 52, Florida Street; and with regard to Nos. 114, 116, 118 and 120, Coventry Street, the Public Health Committee recommended the Council to make closing orders, but before this could be done the necessary works were commenced. The houses in Smith's Buildings were the first closed by the Borough Council under the Act. The houses and yards are so small that it is impossible to provide adequate light and ventilation; it will therefore be necessary to demolish them in the near future The site is offered for sale by the freeholder. Nos. 46, 48, 50 and 52, Florida Street, are to be demolished and three houses to be built on the site, plans of which have been submitted to the Council. Nos. 114, 116, 118 and 120, Coventry Street were closed, have been repaired and re-occupied. Houses Closed by the Owners. After much correspondence with the owners of Nos. 32, 34 and 36, Gossett Street and Nos. 18, 20, 22, 24, 26, 28, 30, 32, 34 and 36, Chambord Street and the workshops in the 66 rear, respecting the insanitary and worn-out condition of the premises, they were demolished. 10 houses and 2 workshops are being built on the site. During the year 53 houses were closed by the owners for the purpose of carrying ont repairs ordered to be done. The houses have been again occupied. It was necessary to notify to the Superintendent Architect of the London County Council 34 houses as being in a dangerous condition on account of bulged walls and similar defects.